[Physical activity in sarcopenia: rehabilitation approaches in prevention and treatment of age-related muscle disorders]. / Fizicheskaya aktivnost' pri sarkopenii: reabilitatsionnye podkhody v profilaktike i lechenii vozrastnoi patologii myshechnoi tkani.

Sarcopenia is a widespread condition in the elderly people, that occurs as a result of impaired muscle structure and function and is significantly associated with reduced quality and time of life. This review represents current approaches to the diagnosis of sarcopenia with reference to recent European and Asian consensus. They include rules for the evaluation of the main muscle strength and function tests (hand dynamometry, sit-to-stand test, 6-minute walk test, physical performance battery tests, etc.), physical and instrumental methods of muscle mass analysis (densitometry, bioimpedance analysis, magnetic resonance imaging). Furthermore, the pathogenetic relationship between the lack of physical activity and muscle dysfunction in elderly people is broached, including in particular the role of myostatin, interleukin-6, somatotropin and insulin resistance. The article represents possibilities of impact of aerobic, strength and neuromuscular physical exercises on prevention and correction of sarcopenic changes in different age groups based on the analysis of current clinical studies.

[Cardiovascular nutrition: disease management and prevention as major public health problem nowadays].

Cardiovascular disease (CVD) is the leading cause of death in many developed countries. At the same time, nutrition is the basis of preventive cardiology. Earlier researches were focused on the importance of individual nutrients, including saturated fats, sodium, and dietary fiber, or certain foods, such as fruits, vegetables, fish, and olive oil, in the development of СVD. Recently, however, an analysis of nutritional patterns has been preferred to take into account the heterogeneity of the diet and the interaction of foods and nutrients. Besides, studies of the cardioprotective potential of bioactive compounds, e.g. polyphenols, peptides, oligosaccharides, vitamins, mono- and polyunsaturated fatty acids, are of particular interest. This paper covers dietary patterns that are associated with improved cardiovascular outcomes, including the Mediterranean diet. The use of a pattern-based approach will help practitioners make optimal and meaningful changes to the patients' diet. Personalized diet therapy is also very important, which implies flexibility and tailoring guidelines to patient needs and comorbidities.

[Non-pharmaceutical treatment of dyslipidemia: review of current methods of diet and nutraceuticals].

The role of nutrition in the development and progression of atherosclerosis is well known. The correction of diet in patients with dyslipidemia is important as an independent intervention (in the group of patients with low and, partially, moderate cardiovascular risk), and as an addition to drug therapy in patients with at higher risk of cardiovascular events. The current review describes the effect of modern methods of diet therapy, as well as the use of a number of nutraceutical agents in terms of evidence-based medicine.

[Characteristics of lipid metabolism and the cardiovascular system in glycogenosis types I and III]. / Kharakteristika lipidnogo obmena i sostoianie serdechno-sosudistoi sistemy pri glikogenozakh I i III tipov.

Glycogen storage disease (GSD) is an inherited metabolic disorder characterized by early childhood lipid metabolic disturbances with potentially proatherogenic effects. The review outlines the characteristics of impaired lipid composition and other changes in the cardiovascular system in GSD types I and III. It analyzes the factors enabling and inhibiting the development of atherosclerosis in patients with GSD. The review describes the paradox of vascular resistance to the development of early atherosclerosis despite the proatherogenic composition of lipids in the patients of this group.

[Factors associated with low ankle-brachial index in patients with type 2 diabetes and prediabetes].

PURPOSE: To elucidate factors associated with an established marker of occlusive atherosclerosis of lower extremities - low ankle-brachial index (ABI) - in patients with diabetes mellitus or prediabetes. METHODS: We examined 182 patients with diabetes (n=158), impaired glucose tolerance (n=17), or impaired fasting glucose (n=7). We analyzed history, demographic parameters, anthropometric data (body mass index [BMI], waist circumference), levels of plasma high and low density lipoprotein cholesterol, triglycerides, degree of glycemic control, and presence of signs of atherosclerosis of other localizations. RESULTS: ABI was < or = 0.9 in 47/182 patients (23.6%). Patients with ABI < or = 0.9 were older, more often had history of smoking (p<0.001). They also had higher leukocyte count (p=0.002). Body mass index was elevated in most patients, however it was lower in those with decreased ABI (29.8+/-4.4 and 32.1+/-5.2 in patients with ABI < or = 0.9 and >0.9, respectively, p=0.006). Factors independently related to ABI < or = 0.9 were age (OR 1.12; 95%CI 1.05-1.19; p=<0,001), history of smoking (OR 7.06, 95%CI 2.23-22.3, p=0.001), leukocyte count (OR 1.36; 95% CI 1.05-1.75, p=0.019), and BMI (OR 0.856, 95%CI 0.768-0.995). Leukocyte count above 7.6 x 10(3)/mm(3) compared with that < or = 7.6 x 10(3)/mm(3) was associated with more than 3 fold increase of OR (3.38, 95%CI 1.49-7.48, p=0.003). BMI <30.8 conferred almost similar increase of risk to have ABI < or = 0.9 (OR 2.9, 95%CI 1.28-6.73, p=0.011). None of biochemical parameters including characteristics of control of glycemia was related to the presence of low ABI. CONCLUSION: In this group of mostly overweight patients with type 2 diabetes and prediabetes besides such classical factors as age and smoking white blood cells count but not lipids were associated with low ABI. Observed association of low ABI with smaller BMI within overall increased range is in line with some recent clinical reports but requires confirmation in specially designed studies.

[Rosuvastatin and fenofibrate in patients with diabetes and low high density lipoprotein cholesterol: comparison of changes of lipid levels and some markers of inflammation].

PURPOSE: To compare lipid lowering profile and effects on markers of inflammation of rosuvastatin and fenofibrate in patients with type 2 diabetes with low high density lipoprotein (HDL) cholesterol (CH). METHODS: We enrolled into randomized open comparative study 30 pts (20 women) aged 62.5 +/- 7.2 (47-74) years with type 2 diabetes and low HDLCH level (below 1.0 mmol/l for men and 1.2 mmol/l for women). All patients had arterial hypertension, 25--coronary heart disease, 4--peripheral arterial disease. Baseline BMI was > 25 kg/m2 in all patients (above 30 kg/m2 in 70%). Median waist circumference was 105.5 cm. Patients were assigned to receive either rosuvastatin 10 mg/day (n=17) or fenobibrate 200 mg/day (n=13). Serum lipids, high sensitivity C reactive protein (CPR), interleukin 6 (IL-6) and fibrinogen levels were measured at baseline and after 3 months. RESULTS: Median fasting glucose and HbA1c were 9.14 mmol/l and 6.8%, 8.78 mmol/l and 7.0% at baseline and study end respectively, without significant differences between groups. Mean baseline levels of low density lipoprotein (LDL) CH, HDLCH and triglycerides (TG) were 3.9, 0.93, and 2.39 mmol/l, respectively. Median baseline CRP was relatively low (1.5, interquartile range 0.78-3.08 mg/l). Both rosuvastatin and fenofibrate decreased total CH, LDLCH and TG and increased HDLCH. Tendencies to more pronounced effect of rosuvastatin on total and LDL CH and fenofibrate on TG and HDLCH were not statistically significant. CPR, IL-6, and fibrinogen levels did not significantly change in either group. There were no associations between changes of lipid levels and those of CRP or IL-6 when all patients were taken together. CONCLUSION: In this relatively small group of overweight diabetics with low HDLCH rosuvastatin and fenofibrate exerted expected effects on lipid profile. However 3 months administration of both starting dose of rosuvastatin (10 mg) and standard dose of fenofibrate was similarly neutral relative to CPR, IL-6 and fibrinogen levels. This can reflect true absence of marked effect or be a consequence of low baseline values of these markers of inflammation.