Statistically verified methods for determining predictors of development of arterial hypertension depending on endothelial nitric oxide synthase T786C gene promoter polymorphism using lipid profile indicators.

Objective. Polymorphism investigation of T786C gene promoter of endothelial nitric oxide synthase (eNOS/NOS3) in the arterial hypertension is a promising field for determining the relationship between heredity, hypertension, and dyslipidemia, which still remains controversial. The purpose of the study was to investigate the lipid profile, which depends on the NOS3 T786C gene promotor region polymorphism in patients with arterial hypertension. Methods. The study involved 86 patients with arterial hypertension. The control group consisted of 30 basically healthy individuals. The lipid profile in the blood serum of the studied patients was measured by commercially available kits using Biochem FC-200 analyzer (HTI, USA). The allelic polymorphism of NOS3 T786C gene promoter was studied using a polymerase chain reaction technique with electrophoretic detection of the results. Results. An increase at the level of all atherogenic fractions in the blood was found in the group of patients carrying the CC genotype compared with carriers of the TT genotype of the NOS3 gene. The total cholesterol serum level in the group of carriers of the CC genotype of NOS3 T786C gene promoter increased by 33.3% compared with carriers of the TT genotype and it was almost twice as high as the control values. In the group of carriers in the CC genotype of the NOS3 gene, the serum level of triglycerides was statistically significantly higher (2.9 times) than in the group of carriers of the TT genotype. The low-density lipoprotein (LDL) and very low-density lipoprotein (VLDL) serum levels significantly increased in patients with arterial hypertension with the CC genotype by 1.6 and 4.6 times, respectively, compared with the TT genotype carriers. The high-density lipoprotein (HDL) serum level, as an antiatherogenic factor, was statistically significantly lower (by 45.8%) in the group of the CC genotype carriers of the NOS3 gene than in the group with carriers of the TT genotype (0.58±0.06 vs. 1.07±0.03 mmol/l.) Conclusions. The increase in all atherogenic and decrease in antiatherogenic lipid parameters of the lipidogram of patients with arterial hypertension and the deepening of dyslipidemia in carriers of the CC genotype compared with carriers of the TT genotype of the NOS3 T786C gene promoter is crucial in the development of dyslipidemia.

GHRL, LEP, LEPR genes polymorphism and their association with the metabolic syndrome in the Ukrainian population.

Objective. Many conflicting results have been obtained in the study of leptin (LEP) and leptin receptor (LEPR) gene variants that are associated with the obesity and diabetes possibly due to differences in the study populations. The aim of this study was to evaluate changes in the metabolic hormones (leptin, ghrelin, adiponectin, resistin) levels in the blood of obese patients in relation to the GHRL (rs696217), LEP (rs7799039), LEPR (rs1137100, rs1137101, rs1805094) polymorphism in Ukrainian population. Methods. The study involved 53 obesity cases and 48 non-obesity subjects (controls). The GHRL, LEP, and LEPR genes polymorphism (rs696217, rs7799039, rs1137100, rs1137101, rs1805094) was genotyped using a TaqMan real-time polymerase chain reaction method. Blood hormones (leptin, ghrelin, adiponectin, resistin) were determined with commercially available kits using a Multiskan FC analyzer. Results. The study of the effect of genotypes of the GHRL (rs696217), LEP (rs7799039), and LEPR (rs1137100, rs1805094) polymorphisms on the level of metabolic hormones (leptin, ghrelin, adiponectin, resistin) in the blood of obese patients did not show reliably significant results. Thus, the presence of the LEPR genes (rs1137101) polymorphism in the Ukrainian population indicates an increased risk of the metabolic syndrome development regardless of the homozygous or heterozygous genotype (genotypes AA, AG, GG). Conclusions. We established a significant effect of the presence of the A allele and G allele of the LEPR gene polymorphism (rs1137101) on the level of leptin, ghrelin, adiponectin, and resistin in the serum of patients diagnosed with the metabolic syndrome in the Ukrainian population.

PATHOGENETIC ASPECTS OF METABOLIC SYNDROME IN EXPERIMENTAL ANIMALS.

OBJECTIVE: The aim: Was to study the state of the nitric oxide system, LPO and antioxidant system in the body of experimental animals in simulated metabolic syndrome. The aim of the study was to study the state of the nitric oxide system, lipid peroxidation and antioxidant system in the body of experimental animals in simulated MS. PATIENTS AND METHODS: Materials and methods: The study was performed on 20 white male Wistar rats. Male control rats (n = 10) were fed a normal control diet. Male rats of the main group (n = 10) were fed a diet high in fat (over 60 % energy from fats) for 16 weeks, thus modeling the development of MS. The indicators of the prooxidant and antioxidant system, as well as the nitric oxide system were determined by photospectrographic method. RESULTS: Results: In animals with simulated MS, intensification of lipoperoxidation (statistically significantly higher level of TBA-active products 1.84 times), depletion of antioxidant protection (statistically significantly lower level of superoxide dismutase 2 times), activation of nitric oxide system (statistically significantly higher NO-synthase level 2.15 times) were found compared with intact animals. CONCLUSION: Conclusions: In animals with simulated MS, activation of lipid peroxidation processes, depletion of antioxidant protection and increased.

The concept of the comorbidity model in predicting laparoscopic cholecystectomy results in patients with acute cholecystitis.

In recent years, there has been an unceasing increase in the number of patients with acute cholecystitis, including those with a complicated course of the disease against the background of concomitant pathology. The aim of the study was to establish the level of comorbidity and its influence on the level of postoperative complications in patients with acute cholecystitis who underwent laparoscopic cholecystectomy. We included 457 patients with acute cholecystitis with accompanying pathology, averaging 64.5±9.74 years. Operative intervention was carried out laparoscopically. Patients who scored 4-3 points were considered favorable, and those who scored 0-2 were considered unfavorable. The assessment of comorbidity was carried out using a special index - the Charlson comorbidity index. The majority of patients had a comorbidity index at 2 points (28.0% of all examined patients), indicating the presence of concomitant pathology in the vast majority of patients. We found that the Charleston comorbidity index increased with age, which indicates a higher frequency of concomitant diseases in older patients. A reliable correlation of medium strength was established (R=0.68; p<0.05) between the age and comorbidity indexes. When predicting the mortality of an experimental cohort of patients with acute cholecystitis who underwent laparoscopic cholecystectomy, it can be predicted that the level of the Charlson comorbidity index correlates with the age of patients while the level of postoperative complications increases.

Changes of pro- and antioxidant indicators in experimental animals under acute small bowel obstructions.

Acute small bowel obstruction remains one of the most challenging nosologies in emergency surgery, leading to a pronounced imbalance between lipid peroxidation and the antioxidant defense system. We aimed to study changes in the anti- and prooxidant status of serum and small intestine wall in an experiment modeling acute small bowel obstruction. The control group included 11 rats, and the main group included 42 rats (simulation of mechanical bowel obstruction on day 1 was conducted in 14 rats, on day 2 - in 12 rats, on day 3 - in 16 rats). Acute small bowel obstruction was modeled by ligation. Serum analysis and removal of the small intestinal wall were performed on days 1, 2, and 3. Indicators of lipid peroxidation and antioxidant protection were determined by the spectrophotometric method, and the imbalance between lipid peroxidation and antioxidant protection gradually increased from 1 to 3 days of observation. On day 3, the low level of aldehyde increased 1.3 times, and the level of superoxide dismutase decreased 1.2 times compared to the control group. Pathophysiological changes in the wall of the small intestine are caused by the activation of lipid peroxidation and the exhaustion antioxidant protection, whereby the degree of their severity increases depending on the increase in time from the moment of modeling of acute obstruction of the small intestine.

Dynamics of Cytokine Profile Indicators Changes in Animals with Acute Generalized Peritonitis on the Background of Diabetes Mellitus.

In acute peritonitis, any surgical intervention leads to impaired immune protection with the development of postoperative purulent-septic complications, which increases several times the likelihood of death, especially in people with secondary immunodeficiency as a consequence diabetes mellitus. We aimed to study the dynamics of pro- and anti-inflammatory cytokine content in rat serum under experimental acute generalized peritonitis on the background of diabetes mellitus. Fifty-six white rats were used for the study. The determination of the serum cytokine profile was performed by enzyme-linked immunosorbent assay. When comparing the levels of interleukins between the study groups, a statistically significant increase in the level of proinflammatory cytokines was found in the group of diabetic animals during all experimental periods. In particular, the concentration of interleukin - 1ß increased significantly by 94% on day 1 of observation, by 115% on day 3, and by 121% on day 7 compared to the control group. Similarly, a significant increase in TNF-α levels was observed in animals with diabetes. In this group, the most significant increase in the level of TNF-α was recorded on the seventh day of the experiment, and it increased by 3.4 times. Animals with acute peritonitis on the background of diabetes had a significantly increased concentration of anti-inflammatory cytokines in the serum of all study groups, which confirms their involvement in the pathogenesis of the disease under study.