NESFATIN-1 ACTIVITY IN THE BLOOD SERUM IN PATIENTS WITH CHRONIC HEART FAILURE OF ISCHEMIC ORIGIN AGAINST THE BACKGROUND OF TYPE 2 DIABETES MELLITUS AND OBESITY.

OBJECTIVE: The aim: To study the nesfatin-1 activity in the blood serum of patients with chronic heart failure (CHF) of ischemic origin against the background of such metabolic disorders as type 2 diabetes mellitus (T2DM) and obesity. PATIENTS AND METHODS: Materials and methods: 154 patients with CHF were examined, and divided into 4 groups, according to the presence of metabolic disorders. Group 1 included patients with CHF on the background of coronary heart disease (CHD) and T2DM and obesity (n=42). The second group consisted of patients with heart failure on the background of CHD with concomitant T2DM (n=46), the third group - with concomitant obesity (n=36), the fourth group was formed from patients with signs of heart failure of ischemic origin without metabolic disorders (n=30). The control group (CG) included 30 practically healthy persons of comparable age. RESULTS: Results: The mean level of serum nesfatin-1 was 1.64±0.27 ng/mL in the СHF group, 0.342±0.19 ng/mL in the CHF + T2DM + obesity group, 1.06±0.36 ng/ mL in the obese + CHF group, 0.96±0.27 ng/mL in the CHF + T2DM group and 2.98±0.38 ng/mL in the CG. Significant correlation was found between the serum nesfatin-1 level and BMI (r=-0.34, p<0.05), HOMA (r=-0.54, p<0.05), insulin (r=-0.41, p<0.05). No significant correlation was found between the serum nesfatin-1 level and blood glucose level (r=0.13, p=0.65). CONCLUSION: Conclusions: Thus, nesfatin-1 may play a significant role in the pathogenesis of both weight-related abnormalities and type 2 diabetes mellitus in patients with chronic heart failure of ischemic origin.

PROGNOSTICATION OF COMPLICATED COURSE OF ACUTE MYOCARDIAL INFARCTION WITH CONCOMITANT TYPE 2 DIABETES MELLITUS BASED ON USE OF ENDOTHELIAL MONOCYTE ACTIVATING POLYPEPTIDE-ІІ.

OBJECTIVE: The aim: To determine the prognostic value of endothelial monocytic peptide ІІ in the course of AMI (acute myocardial infarction) in combination with type 2 diabetes mellitus (DM). PATIENTS AND METHODS: Materials and methods: The study involved 120 patients divided in 2 groups: Group 1 - patients with acute myocardial infarction (AMI) with concomitant type 2 DM (n=69); Group 2 - patients with AMI without concomitant type 2 DM (n=51). Control group was composed with 20 almost healthy persons. RESULTS: Results: It was determined that in patients with AMI in combination with type 2 diabetes, the level of endothelial monocyte-activating polypeptide II (EMAP-II) was 1.65 times higher than in patients without concomitant type 2 DM (p <0.05). The patients with AMI and type 2 DM who were included in the group of the 3rd tertile according to level of EMAR-II had the complicated course compared to patients in the groups of the 1st and 2nd tertiles. Q-positive AMI was found in 100% of patients who belonged to the group of the 3rd tertile; recurrence of AMI occurred only in patients whose EMAR-II index was included in the 3rd tertile. CONCLUSION: Conclusions: According to the results of endothelial function analysis with usу ща the marker of EMAP-II endothelial dysfunction in patients with AMI and concomitant type 2 DM, the increased level of this parameter was characteristic of pronounced violation of dilatation properties of the vascular wall and of the other indicators of complicated comorbid conditions.

THE DYNAMICS OF NEUROHUMORAL MEDIATORS OF VASOCONSTRICTION AND VASODILATION AND TROPONIN I IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION DEPENDING ON THE DEGREE OF CONCOMITANT OBESITY.

OBJECTIVE: The aim: Is to evaluate copetin's, MRproADM's and troponin's I dynamic in patients with acute myocardial infarction depending on the degree of concomitant obesity. PATIENTS AND METHODS: Material and methods: The study included 105 patients with AMI. There were formed 2 groups: 1st group of patients with AMI and concomitant obesity (n=75), 2nd group - patients with AMI without obesity (n=30). 37 patients had obesity of the I degree, 38 patients - II degree. The groups were comparable in age and gender. Copeptin, MRproADM, troponin I were determined by enzyme immunoassay method. Data are presented as mean values and the error of the mean (M±m). Differences were considered statistically significant at p<0,05. RESULTS: Results: It was found an increased copeptin's level by 73,8 % (p<0,001) in obesity I degree and by 205,9 % in obesity II degree compared with group with isolated AMI, MRproADM - by 30,68 % (p<0,001) and 54,5 % (p<0,001) respectively. Concentration of copeptin was higher by 76 % (p<0,001) in patients with AMI and II degree obesity comparing to patients with obesity of I degree, and MRproADM - by 18,3% (p<0,001) respectively. Troponin I value fully corresponded the comparison group both in obesity of I degree and II degree (p>0,05). CONCLUSION: Conclusions: The present study provides evidence that a high activity of copeptin and MRproADM in patients with AMI and obesity of I degree with an excessive activity of a marker of vasoconstriction copeptin in conditions of moderate inadequate to the needs MRproADM functioning in patients with obesity of II degree.