[Primary prevention of cardiovascular diseases: long term results of five year long preventive intervention in 12-year old boys (ten year prospective study)].

In a longitudinal cohort (prevention group, n=213, comparison group, n=163) of 10-year prospective follow-up we addressed efficacy of 5-year-long multifactor preventive intervention, conducted in a sample of population of 12 year old boys. Preventive intervention was carried out both at populational level and among persons with risk factors of development of cardiovascular diseases with the use of group, individual, and partly family approaches, and was directed at rationalization of nutrition, elevation of physical activity and prevention of harmful habits. During first 3 years of prevention we succeeded to achieve stable statistically significant lowering of mean levels of total cholesterol, low density lipoprotein cholesterol, triglycerides, and atherogeneity index, as well as to affect fatty component of body mass (skinfold thickness). Long term effect of 5-year long preventive intervention manifested as significantly lower level of systolic blood pressure, lower prevalence of low levels of high density lipoprotein cholesterol, smaller increment of low density lipoprotein cholesterol and index of atherogeneity in the prevention group. These results evidence that prevention of main factors of risk of development of cardiovascular diseases (obesity, arterial hypertension, disorders of lipid composition of the blood, and low physical activity) in child and adolescent age in the period of active growth and development is feasible, effective, safe and is able to lead to decrease of levels of these factors in adults, but should last uninterruptedly until formation of stable habits of healthy life style.

Association of serum apolipoprotein A-II concentration with combined hyperlipidemia and impaired glucose tolerance.

We studied the relationship of serum apolipoprotein A-II concentration with biochemical parameters of lipid and carbohydrate metabolism, type of hyperlipidemia, and insulin sensitivity in male patients with hyperlipidemia. High concentration of apolipoprotein A-II was associated with increased indices of atherogenic lipoproteins and high-density lipoprotein-mediated reverse cholesterol transport, combined hyperlipidemia, and decreased insulin sensitivity calculated with consideration for glucose and insulin levels in glucose tolerance test and body weight.

[Signs of metabolic syndrome in combinations of hypertension with coronary risk factors].

Anthropometric data, parameters of lipoprotein spectrum and carbohydrate metabolism were obtained from 115 men aged 34-67 years with hypertension. Hypertension combined with any other criterion of metabolic syndrome was associated with deviations of parameters of insulin resistance, blood pressure, body mass index, waist circumference, levels of cholesterol, low density lipoproteins and lipoprotein (a) similar to those observed in complete metabolic syndrome. Combinations of hypertension with hypercholesterolemia and/or excessive body mass were not associated with signs of insulin resistance in the presence of higher then in isolated hypertension values of body mass index, cholesterol, low density lipoprotein cholesterol.

[Exercise and nicotinic acid delayed action drug Enduracin: application in outpatient rehabilitation of patients with ischemic heart disease]. / Primenenie fizicheskikh trenirovok i preparata nikotinovoi kisloty dlitel'nogo vysvobozhdeniia énduratsina na poliklinicheskom étape reabilitatsii bol'nykh ishemicheskoi bolezn'iu serdtsa.

AIM: To evaluate efficacy of combined use of moderate exercise and nicotinic acid drug enduracin in patients with coronary heart disease (CHD) with moderate dyslipidemia (DE). MATERIAL AND METHODS: The effects of exercise therapy alone, enduracin alone and their combination on physical performance (PP), hemodynamics, blood lipid spectrum and clinical course of CHD were studied in 93 CHD patients with moderate DE. The results were evaluated clinically after 1-year treatment. RESULTS: Combined used of exercise and enduracin in CHD patients showed its efficacy manifesting in improvement of PP, hemodynamics at rest and exercise test, left ventricular systolic function, clinical course, reduction of DE. Enduracin + exercise appeared more efficient than their use in monotherapy. Enduracin monotherapy had a positive action on PP, arterial pressure and anginal attacks frequency. CONCLUSION: Enduracin is recommended as monotherapy and in combination with moderate exercise in outpatient rehabilitation and secondary prophylaxis of CHD patients with moderate dyslipidemia and angina pectoris to relieve myocardial ischemia under exercise, to raise PP, improve lipid composition of blood and prevent maladaptive left ventricular remodeling.

[Effect of long-term physical training on hemostasis in patients with coronary heart disease and non-insulin dependent diabetes]. / Vliianie dlitel'nykh fizicheskikh trenirovok na parametry sistemy gemostaza u bol'nykh ishemicheskoi bolezn'iu serdtsa v sochetanii s sakharnym diabetom 2-go tipa.

AIM: To study effects of 6-month physical training on some parameters of hemostasis in patients with coronary heart disease and non-insulin dependent diabetes (NIDDM). RESULTS: Long-term physical training resulted in lowering of fibrinogen level and increase of fibrinolytic activity assessed as euglobulin fraction clot lysis time, while factor VII activity remained unchanged. These changes were accompanied with elevation of total and high density lipoprotein cholesterol levels without any shifts in low density lipoprotein cholesterol and triglycerides. Most pronounced positive effect physical training exerted on results of a test with standard single fat load, which was used as a model of postprandial lipemia. Serum cortisol level significantly decreased after 6-month training, especially after fat load and subsequent physical exertion. CONCLUSION: In patients with combination of coronary heart disease and NIDDM long-term physical training was associated with decreased thrombogenicity of blood.

[Prevalence of dyslipidemia in open population of Tiumen']. / Rasprostranennost' dislipidemii v otkrytoi populiatsii Tiumeni.

AIM: To evaluate levels of total cholesterol (TC), HDLP cholesterol, triglycerides (TG), occurrence of hypercholesterolemia (HCE), hypertriglyceridemia (HTG) and low HDLP cholesterol in the Tyumen population. MATERIAL AND METHODS: 866 men and women aged 25-64 years have been examined in one-stage cardiological screening within a two-stage epidemiological study of serum lipoproteins by WHO criteria. RESULTS: HCE was registered in 15.6% males and 18.8% females, a low HDLP cholesterol--in 5.3 and 4.2%, HTG--in 5.8 and 4.3% males and females, respectively. A high TC level and HCE occurred more frequently in women over 54 years of age; a low HDLP cholesterol level in insignificant fall in HDLP cholesterol and no age-related changes of this index were found both in males and females; TG were elevated in older males in moderate prevalence of HTG in the population. CONCLUSION: It is shown that Tyumen population is at high risk of cardiovascular diseases. Further studies are needed to specify targeted preventive programs.

[Effect of lycopene on blood lipoproteids in women with type 2 diabetes mellitus in postmenopause]. / Deistvie likopina na lipoproteidy krovi u zhenshchin s sakharnym diabetom 2 tipa v postmenopauze.

Blind randomized placebo-control research included 39 women. The following criteria were: menopause period for more then 1 year long; diabetes mellitus; arterial hypertension; hypercholesterolemia. The patients were divided into two groups. Women from the first group (N = 24) were given 30 mg lycopene (composed with "Tomatol") per day during 24 weeks. The second group (N = 15) were given placebo. It was showed that during 12-week "Tomatol" intake we state that lycopene concentration in serum increased twice (337.0 +/- 133.0 nM), total cholesterol (CH) and CH LDL decreased by 12% and 16% respectively. The lipoproteins spectrum normalization correlated to serum antioxidative activity (r = 0.30, p < 0.05), and malonic dialdehyde concentration decrease by 44.8% correlated to lycopene increase (r = -0.51, p < 0.05). Our results give us a possibility to use "Tomatol" as an additional medicine for the prevention of atherosclerosis.

[Lowering of antiatherogenic significance of high density lipoproteins in obese persons]. / Snizhenie antiaterogennoi znachimosti lipoproteidov vysokoi plotnosti u lits s ozhireniem.

Protein and lipid components of blood serum high density lipoproteins (HDL) responsible for their functional activity were studied before and after fat load in subjects with normal body mass and various types of obesity. Subjects with abdominal obesity compared with those with gluteo-femoral obesity and normal body mass initially had pronounced disturbances in components of HDL and their acceptor capacity. Fat load caused changes of HDL composition in all study groups. Postprandial effect in persons with normal body mass became obvious 6 hours after load while in those with excess mass it occurred earlier - 3 hours after fatty meal. In subjects with gluteo-femoral obesity this effect remained on the same level while in those with abdominal obesity it became more pronounced by hour 6. Contrary to subjects with normal body mass and gluteo-femoral obesity fat load induced changes of HDL components in persons with abdominal obesity were not associated with augmented acceptor capacity of HDL what could be considered as proatherogenic effect.

[X chromosome inactivation pattern in elderly women over 70 years of age]. / Osobennosti inaktivatsii khromosomy X u pozhilykh zhenshchin starshe 70 let.

In the present study we have analyzed X chromosome inactivation patterns in 40 women aged from 74 to 85 years (mean age 78 years). The control group was 36 women (mean age 30 years). The most common AR-assay was used to determine X-inactivation patterns (the study of methylation patterns of HpaII site in human androgen receptor gene (HUMARA) by quantative PCR). The age dependence of X-inactivation was not observed. We have detected skewed X-inactivation in three women among 40 (7.5%) elderly women comparing to two women among 36 (5.5%) women from control group. The difference was not found to be statistically significant. We made a suggestion that higher incidence of skewed X-inactivation in elderly women revealed by previous studies could occur due to some experimental ambiguities as heterogeneity of the group studied; inclusion of women having relatives with genetic abnormalities associated with skewed X-inactivation patterns; the difference of X chromosome inactivation skewing determination. We conclude that present study does not show X chromosome inactivation to be age dependent.

Oxidation of plasma low-density lipoproteins from coronary patients with various forms of hypercholesterolemia.

The duration of lag-phase of copper-induced free-radical oxidation of atherogenic LDL isolated from the plasma of coronary patients without hypercholesterolemia virtually does not differ from that of normal human LDL. On the other hand, lag-phase of plasma LDL oxidation was minimal in coronary patients with primary hypercholesterolemia without familial history and especially in patients with familial hypercholesterolemia. This can be attributed to sharply decreased content of natural lipid antioxidants in LDL of patients with familial hypercholesterolemia. However, therapy with natural antioxidant vitamin E did not modulate oxidizability of these LDL. By contrast, therapy with beta-hydroxy-beta-methylglutaryl-coenzyme A reductase inhibitor suppressing biosynthesis of ubiphenol Q induced sharp accumulation of lipoperoxides in LDL in vivo. These data suggest that reduced form of ubiquinone Q is the main antioxidant protecting LDL from free-radical oxidation.

[Syndrome of impaired tolerance to dietary fats in coronary heart disease]. / Sindrom narushennoi tolerantnosti k pishchevym zhiram pri koronarnoi bolezni serdtsa.

Changes of main lipid and apolipoprotein parameters of lipid transport system during postprandial hyperlipidemia were studied in subjects without (n=72) and with (n=167) overt coronary heart disease (CHD) including patients with noninsulin dependent diabetes (n=48). Tolerance to dietary fat was evaluated by oral fat load test (consumption of 639+/-7 ml of 20% cream after fast). In subjects without CHD reaction of lipid transport system to fat load was characterized by lowered total, low density lipoprotein cholesterol, apolipoprotein apo B and apo B/apo A-1 ratio, lowered or unchanged triglycerides, stable high density lipoprotein cholesterol level at the background of apo A-1 elevation by 6-th hour after load. Patients with CHD exhibited signs of impaired tolerance to dietary fat: elevation of triglycerides, apo B and apo B/apo A-1 ratio, lowering of high density lipoprotein cholesterol, increase of percentage of subfractions of small high density lipoproteins particles, increase of triglyceride content in low and high density lipoprotein fraction during 6 hours after fat load.

[Physical exercise and atherosclerosis: dynamic high intensity exercise as a factor inducing exogenous dyslipidemia]. / Fizicheskie nagruzki i ateroskleroz: dinamicheskie fizicheskie nagruzki vysokoi intensivnosti kak faktor, indutsiruiushchii ékzogennuiu dislipidemiiu.

Effect of dynamic exercise of various intensity (maximal 100% and submaximal -- 80, 70 and 60% of individual maximally tolerated work load) on blood lipids, lipo- and apolipoproteins (apo) was studied in healthy subjects and patients with coronary heart disease. Both in healthy persons and patients high intensity (100 and 80%) exercise was associated with atherogenic changes of lipid transport system: increases of levels of total and low density lipoprotein cholesterol, triglycerides, apolipoprotein B and apo B/apo-A1 ratio. On the contrary, changes after exercise of moderate (60%) intensity (lowering of apo-B containing lipoproteins in healthy subjects and patients and elevation of apo-A1 concentration in healthy subjects) were antiatherogenic.

[Physical exercise and atherosclerosis: proatherogenic effects of high and moderate intensity static exercise on blood lipid transport system]. / Fizicheskie nagruzki i ateroskleroz: proaterogennoe vliianie staticheskikh nagruzok vysokoi i umerennoi intensivnosti na lipidtransportnuiu sistemu krovi.

Effects of high (100 and 80 kg) and moderate (60 kg) intensity static leg exercise on blood serum lipoproteins and apolipoproteins (apo) A1 and B were studied in healthy subjects (n=11) and patients with coronary heart disease and class I angina (n=11). Static leg exercise with loads exceeding 60 kg were associated with atherogenic changes of blood lipid transport system: elevation of levels of triglycerides, apoprotein B and apo B/A ratio both in healthy subjects and patients, and of total and low density lipoprotein cholesterol in patients. These post exercise changes were more pronounced in the presence of fasting hyperlipidemia and their severity increased with increase in duration of exercise. Static leg exercise did not increase concentration of high density lipoprotein cholesterol. For prevention of post exercise atherogenic dyslipidemia it is expedient to supplement strength training programs with dynamic exercise of moderate intensity.

[Correction of atherogenic exogenously-induced postprandial hyperlipidemia with pravastatin]. / Pravastatin v korrektsii aterogennoi ékzogenno-indutsirovannoi postprandial'noi giperlipidemii.

Effect of an HMG-CoA reductase inhibitor pravastatin on atherogenic changes in the lipid transport system during postprandial hyperlipidemia immediately after ingestion of fatty meal was studied in patients with coronary heart disease and fasting hyperlipidemia. Treatment with pravastatin (20-40 mg/day for 3 months) resulted in normalization of fasting levels of blood lipids and decreased postprandial hyperlipidemia due to of enhanced removal of triglyceride-rich atherogenic lipoproteins from blood and their diminished secretion in response to fat load. Moreover pravastatin increased tolerance of the lipid-transport system to exogenous saturated fats. KEY WORDS. coronary heart disease; postprandial hyperlipidemia; pravastatin; lipoproteins, metabolism.

Effects of simvastatin on the phospholipid composition of high-density lipoproteins in patients with hypercholesterolemia.

We studied the phospholipid composition of high-density lipoproteins in patients with hypercholesterolemia before and after treatment with simvastatin. Individual phospholipids were separated by thin-layer chromatography on glass plates coated with silica gel. It was found that apart from hypolipidemic effect, simvastatin changed the concentration and phospholipid composition of high-density lipoproteins, which improved their cholesterol-accepting and cholesterol-transporting properties.

Phospholipid composition of high-density lipoproteins reflects lipolysis of triglyceride-rich lipoproteins during hyperlipidemia.

We studied phospholipid composition of high-density lipoproteins in patients with normo- and hypertriglyceridemia treated with various hypolipidemic preparations (simvastatin and fenofibrate). Both preparations changed phospholipid composition of high-density lipoproteins and improved their functional activity. The differences in the phospholipid composition of high-density lipoproteins were probably related to lipolysis of triglyceride-rich lipoproteins catalyzed by lipoprotein lipase and, in particular, hepatic lipase.

[C-reactive protein and defect in lipid transport blood system in patients with rheumatoid arthritis]. / S-reaktivnyi belok i narusheniia lipid-transportnoi sistemy krovi u bol'nykh revmatoidnym artritom.

In 88 patients with rheumatoid arthritis lipid-protein spectrum of the blood serum were determined biochemically and by means of nefelometric technique, C-reactive protein (CRP) was measured with enzyme immunoassay. An increase in CRP concentration was associated with lowering of apoA1 and HDL FL, triglycerides. Thus, elevation of CRP in RA reflects not only activity of inflammation but also defects in serum lipid-transport system by the atherogenic type.

[Relationship between parameters of hemostasis and manifestations of the metabolic syndrome in men with mild and moderate hypertension]. / Sviaz' mezhdu parametrami gemostaza i proiavleniiami metabolicheskogo sindroma u muzhchin s miagkoi i umerennoi gipertoniei.

AIM: To study the relationship between major hemostasis parameters and hypertriglyceridemia with or without insulin resistance/hyperinsulinemia in men suffering from mild or moderate arterial hypertension. MATERIAL AND METHODS: Major hemostasis parameters including fibrinogen level, coagulation factor VII activity and fibrinolytic activity were analysed in groups of men with moderate or mild AH who had normal or elevated triglycerides level regarding presence or absence of insulin resistance/hyperinsulinemia. RESULTS: High factor VII activity was found in both groups with insulin resistance irrespective of their triglycerides level. Patients with insulin resistance combined with hypertriglyceridemia had low fibrinolytic activity. CONCLUSION: In men with metabolic syndrome components insulin resistance is accompanied with activation of coagulation external pathway, whereas combination of insulin resistance with hypertriglyceridemia was associated with hypofibrinolysis.

Development of a model system for evaluation of human endothelial cell proliferation in vitro: possible clinical applications.

A system for evaluation of the ability of human blood serum to affect endothelial cell proliferation was developed and tested. The system based on incorporation of (3)H-thymidine into DNA was used to analyze the effects of hormone replacement therapy on endothelial repair and angiogenesis. Blood serum from 12 menopausal women less effectively activated endothelial proliferation compared to control donor serum. After 6-month hormone replacement therapy with Divina (a combination of estradiol and medroxyprogesterone), this index increased in seven female subjects (58.3%), but remained below the control level. The model proposed by us can be used in clinical practice and drug testing for evaluation of the influence of blood serum on vascular endothelium.

[level of 7alpha-hydroxycholesterol in blood plasma as an indicator of cholesterol catabolism in hyperlipidemia and with hypolipidemic therapy]. / Uroven' 7alpha-gidroksikholesterina plazmy krovi kak pokazatel' katabolizma kholesterina pri giperlipidemii i gipolipidemicheskoi teripii.

The effect of micronized fenofibrate (Lipanthyl 200 M, Laboratoire Fournier, France, in dose 200 mg per day) on the serum level of 7 alpha-hydroxycholesterol (7 alpha-(OH)C) was studied in 10 men (aged 31-60 years) with hyperlipidemia (total C > 6.5 mmol/l). The levels of 7 alpha-(OH)C as well as that of total C, LDL C, VLDL C and HDL C and triglycerides (Tg) were measured before Lipanthyl 200 M treatment (point 0) and after 1, 2 and 3 months of the drug administration. The content of 7 alpha-(OH)C was determined by the reversed phase HPLC after the enzymatic conversion of serum 7 alpha-(OH)C to 7 alpha-(OH)-4-cholesten-3-one in cholesterol oxidase reaction. 7 beta-(OH)C was used as the internal recovery standard. Lipanthyl treatment resulted in considerable reduction of total C, VLDL C and LDL C levels and 7 alpha-(OH)C content. After the second and third months of therapy serum levels of 7 alpha-(OH)C were significantly reduced from 1.3 +/- 0.1 to 0.8 +/- 0.2 and 0.7 +/- 0.1 mumol/l; (P < 0.02). The decrease of 7 alpha-(OH)C content was associated with the decrease in Tg and VLDL C levels. Thus, our data suggest that the level of 7 alpha-(OH)C of in human serum may be used as an indicator of intensity of cholesterol oxidation into bile acids.