[Modern methods of correction of systemic inflammation and insulin resistance by patients with coronary heart disease and diabetes mellitus type 2].

Mediterranean diet and regular exercise are the best means to reduce the systemic smoldering inflammation (SI) and insulin resistance (IR). Of drugs prescribed to patients with diabetes mellitus type 2, have the greatest effect receptor agonists that activate the peroxisome proliferator (PPAR], activators of incretine and metformin. Debate the use of "submaximal" double and triple agonist PPAR. Sulfonylurea drugs have very weak anti-inflammatory effect and is not reduce insulin resistance, and insulin as monotherapy increases IR.

[Peroxysome proliferator-activated receptors at pathogenesis and treatment of atherosclerosis (achievements, paradoxes and perspectives)].

All three types of peroxisome proliferation activating rexeptiors (PPAR): α, ß/δ and γ, are sensors of fat acids and their derivatives and carry out the transcription adjusting of genes of exchange of lipids, including circulation of cholesterol and sensitiveness of tissues to insulin. They possess antiinflammatory properties, control activity of cells of the immune system, endothelia and smooth musculature of vessels. Such combination of functions does PPAR an ideal target for a prophylaxis and treatment of atherosclerosis. Nevertheless, 20-years-old experience of the use of tiazolidinodiones--agonists of PPARγ, as antidiabetic facilities, did not bring to the decline of morbidity and death rate of patients with diabetes mellitus 2 types from cardiovascular complication. The only exception is pioglitazone, which significantly reduces the mortality rate of patients with T2DM remains effective in the prevention and treatment of atherosclerosis. Effective not enough in this plan and fibrates--agonists of PPARa. Possible reasons of it and nearest perspestives are examined in a review.

[Peroxisome proliferator-activated receptors-gamma and hypertension: lessons of the history of researches].

The paper analyzes data from the clinical use of thiazolidinediones, human genetic observations and experiments with peroxisome proliferator-activated receptor (PPAR-gamma) gene removal, and also those on the role of PPAR-alpha and -gamma in the function of the vascular endothelium, sympathetic autonomic nervous system, and renal sodium reabsorption. It is concluded that the tonic activity of PPAR is a universal protective mechanism counteracting the development of hypertension.

[Efficacy of metformin as initial therapy in patients with coronary artery disease and diabetes type 2].

The use of metformin during the first month of treatment of patients with coronary artery disease and diabetes type 2 led to the decrease of insulin resistance and reduced activity of systemic inflammation (significant decrease in the concentrations of IL-1, IL-6, IL-8 and TNF-alpha). Reduced activity of systemic inflammation had a beneficial effect on the course of coronary artery disease (significant decrease in the functional class of stable angina). Type 2 diabetes appears to be quite successfully modifiable risk factor for coronary artery disease by the adequate controls.

[Efficacy of short-term metformin application in complex treatment of patients with coronary artery disease and concomitant metabolic syndrome].

The inclusion of a short course of metformin in complex therapy of coronary artery disease with metabolic syndrome does not alter the clinical features of disease. It had a positive effect on weight loss and the activity of systemic inflammation. The lipid metabolism and insulin resistance were not significantly altered. This results suggest that the treatment with metformin during 1 month in patients with coronary artery disease and metabolic syndrome is sufficient for the manifestation of systemic anti-inflammatory effect of the drug, but not enough to implement a reliable effect of insulin resistance and to improve the clinical features of coronary artery disease.

[Frequency of the Pro 12Ala polymorphism of PPARgamma2 gene in Ukrainian population and its possible role in development of metabolic syndrome].

Frequency of the Pro 12Ala gene polymorphism PPARg2 has been studied in 39 healthy men and 42 men with metabolic syndrome (MS) of the age of 40-65 years in Ukrainian population. The frequencies were 27.9% for 12Ala allele, 32.6% for Pro12Ala, and 4.4% for Ala1Ala that is close to the results of estimation of Czech population. The frequency of 12Ala allele was significantly less--18.4% (p < 0.05) in the persons with MS that corresponds to the pre-established information concerning the patients with diabetes of the 2nd type. A tendency has been detected to the increase of the body mass index in patients with 12Ala allele in the metabolic syndrome group.

[Metabolic syndrome in men of 35-65 years old from rural district of Poltava region and possibility of the prophylactic therapy with atorvastatine].

Observation of 250 men aged 35-65 years (middle age was 52 +/- 2 years) showed that prevalence of MS was 27%. Atorvastatine administration at dose of 10-20 mg per day for patients with ischemic heart disease and chronic obstructive lung disease associated with MS reduced during month administration the level of cholesterol, triglycerides, beta- and pre-beta-lipoproteids and increased the level of alpha-cholesterol in blood of these patients. Addition of atorvastatine to a common treatment patients with chronic obstructive lung disease improved as well the clinical picture of systemic inflammation process.

[Clinical efficiency of candesartan in patients with renoparenchymal hypertension in dependence on genotype of angeotensin II receptors of I type].

The authors present obtained data on the frequency of genotypes and A and C alleles of polymorphous gene related to Angiotension II first type receptor in patients of Poltava region. These patients were with chronic pyelonephritis and arterial hypertension. Therapeutic efficacy of candesartan treatment of the patients and at the same time their genotypes were considered. Obtained data evidence that AC genotype is more often found among patients with reniparenchymal hypertension, genotype CC is less found among these patients and genotype AA occupies an intermediate place (in 1,7 times less found than among healthy individuals and in 2,2 times more often than among patients with essential hypertension). Candesartan used in monotherapy has a high clinical efficiency in the treatment of patients with AC genotype. Patients with genotype AA and severe course of their disease have to be in a complex treatment or prescribed is applied candesartan in high dosage.

[Polymorphism of the angiotensin II type 1 receptor in patients with essential hypertension in Ukrainian population].

The distribution of polymorphism of the angiotensin II type 1 receptor in Ukrainian population was investigated. Healthy persons had genotypes AA (51%), AC (34%), CC (15%) and alleles A (68%), C (32%). We suppose the prevalence of allele C and genotypes CC in health persons in Ukrainian population. The frequencies of genotypes and alleles in patients with essential hypertension were AA (22,85%), AC (51,9%), CC (25,3%) and A (48,7%), C (51,3%). Thus the development of essential hypertension was associated with the presence of allele C and its homozygote variant. Moreover the severity and complications of hypertension depended on the presence of this allele and genotype. We concluded that Ukrainian population has specific distribution of polymorphism of the angiotensin II type 1 receptor with prevalence of allele C1166 and genotype CC. The presence of these genetic variants is a risk factor for essential hypertension.

[Clinical efficiency of candesatran depends on angiotension II receptor, type 1 gene polymorphism].

Frequency of A and C alleles of the polymorphic gene (A1166C) of first type angiotension II receptor in healthy men of Poltava region was 68% and 32% accordingly, the AA, AC and CC genotypes made up 51%,34% and 15% correspondingly. The patients with essential hypertension had the following figures: 44% and 56%; 23%, 52% and 25% accordingly. The presence of C allele has been established to lead to more severe course and an early development of essential hypertension. Candesatran monoterapy is more effective for treatment patients having C allele.