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© 2021 Elsevier Ltd Objectives: Metabolic syndrome (MetS) and its components (high blood pressure, BMI≥30, altered fasting glucose, low HDL cholesterol and high triglycerides) may undermine early perioperative outcomes after radical prostatectomy (RP). We tested this hypothesis. Materials & methods: Within the National Inpatient Sample database (2008–2015) we identified RP patients. The effect of MetS was tested in four separate univariable analyses, as well as in multivariable regression models predicting: 1) overall complications, 2) length of stay, 3) total hospital charges and 4) non-home based discharge. All models were weighted and adjusted for clustering, as well as all available patient and hospital characteristics. Results: Of 91,618 patients: 1) 50.2% had high blood pressure, 2) 8.0% had BMI≥30, 3) 13.0% had altered fasting glucose, 4) 22.8% had high triglycerides and 5) 0.03% had low HDL cholesterol. Respectively, one vs. two vs. three vs. four MetS components were recorded in 36.2% vs. 19.0% vs. 5.5% vs. 0.8% patients. Of all patients, 6.3% exhibited ≥3 components and qualified for MetS diagnosis. The rates of MetS increased over time (EAPC:+9.8%; p < 0.001). All four tested MetS components (high blood pressure, BMI≥30, altered fasting glucose and high triglycerides) achieved independent predictor status in all four examined endpoints. Moreover, a highly statistically significant dose-response was also confirmed for all four tested endpoints. Conclusion: MetS and its components consistently and strongly predict early adverse outcomes after RP. Moreover, the strength of the effect was directly proportional to the number of MetS components exhibited by each individual patient, even if formal MetS diagnosis of ≥3 components has not been met.

© 2020 Elsevier Ltd Objectives: To test contemporary rates and predictors of open conversion at minimally invasive partial nephrectomy (MIPN: laparoscopic or robotic partial nephrectomy). Materials and methods: Within the National Inpatient Sample database (2008–2015) we identified all MIPN patients and patients that underwent open conversion at MIPN. First, estimated annual percentage changes (EAPC) tested temporal trends of open conversion. Second, univariable and multivariable logistic regression models predicted open conversion at MIPN. All models were weighted and adjusted for clustering, as well as all available patient and hospital characteristics. Results: Of 7649 MIPN patients, 287 (3.8%) underwent open conversion. The rates of open conversion decreased over time (from 12 to 2.4%; EAPC: 24.8%; p = 0.004). In multivariable logistic regression models predicting open conversion, patient obesity achieved independent predictor status (OR:1.80; p < 0.001). Moreover, compared to high volume hospitals, medium volume (OR:1.48; p = 0.02) and low volume hospitals (OR:2.11; p < 0.001) were associated with higher rates of open conversion. Last but not least, when the effect of obesity was tested according to hospital volume, the rates of open conversion ranged from 2.2 (non obese patients treated at high volume hospitals) to 9.8% (obese patients treated at low volume hospitals). Conclusion: Overall contemporary (2008–2015) rate of open conversion at MIPN was 3.8% and it was strongly associated with patient obesity and hospital surgical volume. In consequence, these two parameters should be taken into account during preoperative patients counselling, as well as in clinical and administrative decision making.

© 2020, Springer Science+Business Media, LLC, part of Springer Nature. The objective of this study was to investigate of selenium (Se), zinc (Zn), chromium (Cr), and vanadium (V) levels in blood serum, hair, and urine of adult obese patients. A total of 199 lean and 196 obese subjects were enrolled in the study. Serum, hair, and urinary metal and metalloid analysis were performed by inductively coupled plasma mass spectrometry at NexION 300D (PerkinElmer Inc., USA). The results established that obese subjects were characterized by 47% and 30% lower serum Cr and V levels compared with controls, respectively, whereas serum Se levels exceeded control values by 9%. In contrast, hair Cr, Se, and V content in obese subjects exceeded the control values by 51%, 21%, and 50%, respectively. In turn, hair Zn levels were found to be significantly lower by 11% compared with the lean control values. In urine, the levels of V and Zn were found to be 30% and 18% higher in obese patients. Prevalence of hypertension in obese subjects was associated with a trend for impaired Se and Zn levels. In a regression model adjusted for age, gender, hypertension, atherosclerosis, and glucose intolerance, serum Cr, V, and hair Zn were inversely associated with body mass index (BMI), whereas hair Se was considered as the positive predictor. Our data allow proposing that the observed alterations may at least partially contribute to metabolic disturbances in obesity. In turn, monitoring of Se exposure in a well-nourished adult population is required to reduce its potential contribution to obesity.

© 2020, Springer Science+Business Media, LLC, part of Springer Nature. The objective of this study was to investigate of selenium (Se), zinc (Zn), chromium (Cr), and vanadium (V) levels in blood serum, hair, and urine of adult obese patients. A total of 199 lean and 196 obese subjects were enrolled in the study. Serum, hair, and urinary metal and metalloid analysis were performed by inductively coupled plasma mass spectrometry at NexION 300D (PerkinElmer Inc., USA). The results established that obese subjects were characterized by 47% and 30% lower serum Cr and V levels compared with controls, respectively, whereas serum Se levels exceeded control values by 9%. In contrast, hair Cr, Se, and V content in obese subjects exceeded the control values by 51%, 21%, and 50%, respectively. In turn, hair Zn levels were found to be significantly lower by 11% compared with the lean control values. In urine, the levels of V and Zn were found to be 30% and 18% higher in obese patients. Prevalence of hypertension in obese subjects was associated with a trend for impaired Se and Zn levels. In a regression model adjusted for age, gender, hypertension, atherosclerosis, and glucose intolerance, serum Cr, V, and hair Zn were inversely associated with body mass index (BMI), whereas hair Se was considered as the positive predictor. Our data allow proposing that the observed alterations may at least partially contribute to metabolic disturbances in obesity. In turn, monitoring of Se exposure in a well-nourished adult population is required to reduce its potential contribution to obesity.

© 2019 Elsevier GmbH Background: Data on the association between aluminium (Al) exposure and obesity and/or metabolic syndrome are insufficient. The objective of the present study was to investigate the association between hair and urine Al levels and obesity. Methods: A total of 206 lean and 205 obese non-occupationally exposed subjects (30–50 y.o.) were enrolled in the study. Hair and urine Al levels were assessed with ICP-MS. Laboratory quality control was performed using the certified reference materials of human hair, plasma, and urine. Results: Hair and urinary Al levels in obese subjects were significantly higher by 31% and 46% compared to the control levels, respectively. The presence of hypertension (41% cases), atherosclerosis (8%), type 2 diabetes mellitus (10%), and non-alcoholic fatty liver disease (NAFLD) (53%) in obese patients were not associated with Al levels in the studied subjects. An overall multiple regression model established urinary Al levels (β = 0.395; p < 0.001), hypertension (β = 0.331; p < 0.001) and NAFLD (β = 0.257; p = 0.003) were significantly and directly associated with BMI. Hair Al levels were found to be border-line significantly related to BMI after adjustment for several confounders (β = −0.205; p = 0.054). Conclusions: Aluminium body burden is associated with increased body weight, although the causal relationship between Al exposure and obesity is not clear. Both clinical and experimental studies are required to further investigate the impact of Al exposure on metabolic parameters in obesity and especially direct effects of Al in adipose tissue.

© 2019 The Author(s). Background: The increasing prevalence of obesity has become a pandemic problem, and dietary patterns are one of the important factors causing obesity. Although the correlation between dietary patterns and obesity has been well explored, the gender difference on the association between dietary patterns and obesity remains unclear. The objective of this study examined whether gender difference existed in the relationship of dietary patterns with metabolic parameters and specific indices of adiposity among young and middle-aged adults with dyslipidemia and abnormal fasting plasma glucose (FPG) in Taiwan. Methods: A total of 14,087 subjects aged between 20 and 50 years with dyslipidemia and abnormal FPG were recruited in Taiwan between 2001 and 2010 for a cross-sectional study. Dyslipidemia was defined primarily according to the National Cholesterol Education Program Adult Treatment Panel III guidelines with minor modification. Abnormal FPG level was defined by the American Diabetes Association. Principal component analysis was conducted to identify dietary patterns. Multivariate logistic regression analysis was performed to evaluate the association of dietary patterns and metabolic parameters with different indices of adiposity including general obesity, central obesity, and high body fat, stratified by gender. Results: Two dietary patterns derived from principal component analysis were the prudent dietary pattern and the western dietary pattern. Both men and women in the highest quartile of the western dietary pattern had a significantly increased odds ratio of general obesity, central obesity, and high body fat. However, only male subjects in the higher quartiles of the prudent dietary pattern had a significantly decreased odds ratio of all indices of obesity. Both men and women with higher high-density lipoprotein cholesterol and total cholesterol levels had a significantly reduced odds ratio of general and central obesity, while those with higher triglycerides and FPG levels had a significantly increased odds ratio of general and central obesity. Higher low-density lipoprotein cholesterol level was significantly associated with an elevated odds ratio of high body fat, while higher total cholesterol level was significantly correlated with a reduced odds ratio of high body fat only in women. Conclusions: Gender difference exists in the association of dietary patterns and metabolic parameters with obesity and body fat in young and middle-aged adults with dyslipidemia and abnormal FPG in Taiwan.

© 2019 by the authors. Licensee MDPI, Basel, Switzerland. Diet plays an important role in the development of obesity and may contribute to dysregulated iron metabolism (DIM). A cross-sectional survey of 208 adults was conducted in Taipei Medical University Hospital (Taipei, Taiwan). A reduced-rank regression from 31 food groups was used for a dietary pattern analysis. DIM was defined as at least four of the following criteria: serum hepcidin (men >200 ng/mL and women >140 ng/mL), hyperferritinemia (serum ferritin of >300 ng/mL in men and >200 ng/mL in women), central obesity, non-alcoholic fatty liver disease, and two or more abnormal metabolic profiles. Compared to non-DIM patients, DIM patients were associated with an altered body composition and had a 4.52-fold (95% confidence interval (CI): (1.95–10.49); p < 0.001) greater risk of metabolic syndrome (MetS) after adjusting for covariates. A DIM-associated dietary pattern (high intake of deep-fried food, processed meats, chicken, pork, eating out, coffee, and animal fat/skin but low intake of steamed/boiled/raw foods and dairy products) independently predicted central obesity (odds ratio (OR): 1.57; 95% CI: 1.05–2.34; p < 0.05) and MetS (OR: 1.89; 95% CI: 1.07–3.35; p < 0.05). Individuals with the highest DIM pattern scores (tertile 3) had a higher visceral fat mass (%) (β = 0.232; 95% CI: 0.011–0.453; p < 0.05) but lower skeletal muscle mass (%) (β = −1.208; 95% CI: −2.177–−0.239; p < 0.05) compared to those with the lowest DIM pattern scores (tertile 1). In conclusion, a high score for the identified DIM-associated dietary pattern was associated with an unhealthier body composition and a higher risk of MetS.

BACKGROUND: total hip replacement has long ago become the «golden standard» for the treatment of dysplastic coxarthrosis in thousands of the patients receiving it every year. In the meantime, the analysis of the specialized literature gives evidence of the lack of a systematic and personified approach to the rehabilitation treatment. AIM: The objective of the present study was to improve medical rehabilitation of the patients following the total hip replacement and to develop the personalized programs for walking modality reconstruction taking into consideration the age and the body weight of the patients. PATIENTS AND METHODS: A total of 240 patients were available for the observation including 184 women and 56 men. They were divided into three study groups and one control group, with the differentiation into the following three subgroups: one comprised of the patients of moderate acerage age and body weight, the other containing the obese patients (BMI>35), and the third one involving the elderly patients (age >70 years); each subgroup consisted of 20 patients. All the patients received the early basic rehabilitation treatment, those in the study groups had to perform in addition the robotic training based on the use of hardware techniques supplemented by passive mechanotherapy and electromyostimulation designed to restore the walking stereotype with three types of devices: body weight unloading, video-reconstruction associated with biological feedback and robototherapy. RESULTS: The comparative analysis of the effectiveness of various methods of gait reconstruction has demonstrated the high effectiveness of the application of the hardware technique in the patients of moderate acerage age and body weight. At the same time, the elderly patients had a significantly higher rate of successful walking reconstruction efficiency under the influence of the video-associated training with biological feedback (3 times that achieved with training using the device for unloading the body weight and 4 times compared with the result of a course of robotic walk. The evaluation of the application of the techniques for the gait stereotype reconstruction in the obese patients gave evidence of the advantage of the Lokomat robotic trainings that produced 6 times better results than unloading of the body weight and 5 times better ones than the video-associated training with biological feedback. DISCUSSION: The results of the present study are on the whole comparable with the data reported by other authors although its design was different from that of the majority of the published studies in that our patients were allocated to different subgroups for the further personalization of the methods applied to restore the gait stereotype. The factors limiting the use of the results of this study include the medium-high level of the patients' welfare most of whom are residents of the city of Moscow and Moscow region characterized by a relatively high quality and accessibility of health care. It means that the results of such studies as the one described in the present article are directly related to the quality and accessibility of health care and can be extrapolated only to the socially safe and well-to-do patients. CONCLUSIONS: All the hardware techniques are equally effective in the patients of moderate average age and body weight. The elderly patients showed the best results using the video-reconstruction associated with biological feedback, while the Locomat technique was especially useful for the obese patients.

© 2018 Cardiovascular Therapy and Prevention. The article discusses the role of telmisartan in the treatment of arterial hypertension in patients with metabolic syndrome. Telmisartan is second-generation type 1 angiotensin II receptor blocker, which has unique pleiotropic effects due to partial affinity for receptors that activate the proliferation of subtype γ peroxisomes (PPARγ) located in adipose tissue. The interrelation of metaflamation, a specific chronic inflammatory process with pathogenetic mechanisms of development of cardiovascular diseases, including arterial hypertension, is also described in study. The role of the adiponectin peptide is considered, which synthesis is stimulated by partial PPARγ receptor agonists (as mentioned above - telmisartan). It has a positive effect on fat and carbohydrate metabolism, as well as cardioprotective properties. The conclusion contains the results of numerous randomized studies and meta-analyzes confirming the high efficacy of telmisartan in the treatment of arterial hypertension in patients with morbid obesity.

© 2018 Russian Association of Endocrinologists. All rights reserved. Significant number of patients with type 2 diabetes mellitus are obese. It is known that even glucose intolerance, as well as diabetes, can lead to vascular complications. At the same time, weight loss can reduce the risk of type 2 diabetes in obese and pre-diabetic patients. According to available data, a significant decrease in the incretin effect is observed in patients with type 2 diabetes and obese individuals. Thus, a decrease in the incretin effect leads to a violation of the insulin response to the intake of carbohydrates, and, consequently, an increase in the level of glucose in the blood. It was also found that the decrease in the incretin effect in patients with type 2 diabetes can be associated with a lower secretion of glucagon-like peptide-1. The interest is represented by groups of antidiabetic drugs capable of regulating glycemia by affecting the secretion of insulin and glucagon, depending on its level. Such drugs include glucagon-like peptide-1 receptor agonists. The article shows the advantage of prolonged action in patients with type 2 diabetes and obesity of the glucagon-like peptide 1 receptor agonists (albiglutide, dulaglutide, exenatide with slow release) dosing 1 time a week.

BACKGROUND: The relevance of this ensues from the fact that despite the numerous currently available health promotion training programs for the reduction of body weight, there is still the need for the development of the new forms of the efficacious physical training programs and the methods of motivation for compliance with them among the people of different age, sex and social status. AIM: The objective of the present study was to determine the role of motivational factors, including the assessment of the biological age, in the improvement of the effectiveness of the health promotion training programs for the reduction of the excess body weight. MATERIAL AND METHODS: A total of 82 students with overweight and first-degree obesity at the age from 17 to 21 years (average age 18.5±1.4 years) were examined. 42 girls included in the first (main) group spent 9 months performing health promotion training programs on an individual basis developed taking into consideration the motivational factors. The physical training programs included the aerobic exercise in the form of dance classes. 40 students in the control group were engaged in physical training envisaged by the academic curriculum of the university. The third group (the group of comparison) was comprised of 36 practically healthy girls having the normal body weight. We studied the components of the body composition with the use of bioimpedanceometry, evaluated the physical working capacity (the PWC-170 test) and the adaptive reserves of the body (heart rate variability test as proposed by R.M. Baevskyi, Garkavi test). In addition, the psycho-emotional status of the participants was estimated making use of the Lusher test and SAN. The biological age was determined by the original method based on the combination of the morphological and functional indices. RESULTS: The excess body weight in the students comprising group 1 was reduced by 10% on the average; simultaneously the physical working capacity among these students increased by an average of 24.5% while the level of emotional stability and self-esteem increased by 20% and 24%, respectively. We also documented a decrease in the initially increased biological age by 5 years on the average. The students included in group II did not experience any significant changes in the parameters of interest. CONCLUSION: The consideration of the motivational factors for the development of the training programs designed to promote the reduction of the excessive body weight significantly increases their effectiveness, as evidenced by the improvement of the morpho-functional and psychological characteristics in the students of the first group and its absence in their counterparts included in group II.

© 2018 Stolichnaya Izdatelskaya Kompaniya. Aim. To study the erythrocyte electric charge (EEC) in patients with metabolic syndrome (MS). Material and methods. 112 patients (mean age 61.4±7.2 years) with MS (average duration of MS 8.7±5.2 years) were examined. Control group consisted of healthy volunteers (n=25) of similar age. The level of EEC was detected by the method of adsorption of a positive cationic dye (cationic blue O) on the surface of the erythrocyte plasma membrane up to the complete neutralization of their negative charge, followed by photometry of the solution and calculation of the number of charges on the erythrocyte cell surface. The results of the study were processed by Statistica 10.0 software. Results. Hypertension was found in 73% of patients with MS, hyperglycemia - in 39%, diabetes - in 36%, dyslipidemia - in 80% of patients. The EEC in MS patients (1.59±0.05×107) was lower than this in the control group (1.65±0.03×107; p < 0.05). With MS duration more than 5 years, the EEC was significantly lower in comparison with control group (p < 0.05). In patients with obesity II-III degrees as well as dyslipidemia the EEC values were significantly lower vs control group (p < 0.05). In patients with MS, a significant negative correlation of EEC with total cholesterol (r=-0.51, p < 0.05) and triglycerides (r=-0.51, p < 0.05) levels were revealed. Conclusion. In patients with MS with increase in the MS duration, degree of obesity and lipid metabolism disorders, significantly lower values of EEC were observed..

© 2018 Russian Association of Endocrinologists. All rights reserved. The development of effective methods of obesity treatment with the goal of preventing many associated diseases is among the priorities of modern biomedical research. In 2016 glucagon-like peptide-1 analog (GLP-1) liraglutide 3 mg (Saxenda®) was approved in the Russian Federation for the treatment of obesity. This review presents literature data on the effects of GLP-1 and liraglutide on appetite and body weight as well as an analysis of the effectiveness and safety of drug Saxenda based on the results of major clinical trials.

© 2018, Stolichnaya Izdatelskaya Kompaniya. Aim. To study the erythrocyte electric charge (EEC) in patients with metabolic syndrome (MS) depending on glycemia levels. Material and methods. 112 patients (45 men and 67 women, age 61.4±7.2 years) with MS (MS duration 8.7±5.2 years) were studied. EEC level was detected by the method of adsorption of a positive cationic dye (cationic blue O) on the surface of the erythrocyte plasma membrane up to the complete neutralization of their negative charge, followed by photometry of the solution and calculation of the number of charges on the erythrocyte cell surface. All statistical analyses were done using Statistics 10.0 software. Results: Abdominal obesity was registered in 100% of patients, hypertension - in 73%, fasting hyperglycemia - in 75%, dyslipidemia - in 80% of patients. Mean glycated hemoglobin (HbA1c) level in patients with MS was 7.3±1.9%. The mean EEC level in group of MS patients (1.59±0.05×107) was significantly lower than in the control group (1.67±0.03×107), p < 0.05. In patients with MS and fasting hyperglycemia the EEC levels were significantly lower than in those without fasting hyperglycemia (1.58±0.05×107 vs 1.64±0.03×107, respectively; p < 0.001). Significant negative correlations between EEC and age (r=-0.43, p < 0.05), average duration of MS (r=-0.87, p < 0.05), average plasma glucose concentration (r=-0.6, p < 0.05), average duration of fasting hyperglycemia (r=-0.83, p < 0.05), and blood HbA1c level (r=-0.56, p < 0.05) were found in patients with MS. Conclusion: Significantly lower values of EEC are observed in MS patients with increasing age, duration of MS, and duration of hyperglycemia. Negative correlation between HbA1c and EEC was also shown.

© Russian Association of Endocrinologists, 2018. Background: As in many other developed nations, the problem of obesity and type 2 diabetes is acute in Russia. In Russia, the only combination of sibutramine and metformine (Reduxin®Met) is authorized to reduce body mass and prevention development of type 2 diabetes mellitus or its complication. The article presents the results of the observational program “AVRORA”. Aim: Evaluation of the effectiveness and safety of Reduxin®Met (sibutramine + microcrystalline cellulose + Metformin) in patients with type 2 diabetes and alimentary obesity in routine clinical practice. Materials & methods: The observational program “AVRORA” was conducted from September 2016 to October 2017 under the auspices of the Endocrinological Scientific Center and the Russian Association of Endocrinologists. The “AVRORA” program was a multicenter, non-interventional study of patients to whom the attending physicians prescribed Reduxin®Met, a set (tablets + capsules), in accordance with the instruction for medical use as part of routine clinical practice. The treated group included patients of both sexes, aged 18–65 years, with an established diagnosis of obesity in combination with type 2 diabetes. The duration of the drug usage was determined by the attending physician and was up to 6 months. Reduxine®Met was prescribed in addition to the existing glucose-lowering therapy, the dose of metformin was adjusted to the patient's needs. Results: The “AVRORA” study was attended by 259 doctors and 5,812 patients in 240 medical institutions from 12 cities of the Russian Federation. The average age of patients was 46.6 ± 10.5 years, the ratio of male / female -24% / 76%. The decreasing of BMI during 6 months of the therapy amounted to 5.4 ± 2.3 kg / m2 (on average, 15.1 ± 6.4 kg). After 3 months of the therapy 81.6% of patients achieved clinically significant weight loss of 10.6% or more. The average decrease in waist circumference during 6 months of therapy was 13.8 ± 7.4 cm. A decrease of indicators of glycemic control and lipid metabolism right up to the target values was observed. Conclusions: In “AVRORA” study it was shown that addition of Reduxine®Met (sibutramine+ microcrystalline cellulose+met-formine) to the complex therapy of the diabetes in combination with obesity according to approved indications is safe and effective for long-term treatment in regards to weight loss, regulation of lipemic index, glucose profile and quality of life.

© 2018 Russian Association of Endocrinologists. The prevalence of cholelithiasis, its close pathogenetic connection with metabolic syndrome, high frequency of surgical intervention, significant economic losses put forward this comorbid pathology in a number of leading problems of modern clinical medicine. The factors associated with the metabolic syndrome not only increase the risk of developing cholelithiasis, but also form the basis of non-drug and drug therapy. Metabolic syndrome often determines the occurrence of three common and potentially life-Threatening complications of cholelithiasis: Acute cholecystitis, acute cholangitis and biliary pancreatitis. Therefore, the solution of this problem is associated with the need for early detection of additional risk factors for cholelithiasis, optimization of the early diagnostic and prognostic model of existing multi-organ pathology with the aim of reducing the progression of the disease and its complications. The data obtained in recent years on the human genome with metabolic syndrome and cholelithiasis make it possible to predict the development of comorbid pathology and to fully ensure the effectiveness of primary prevention.

© 2018 Stolichnaya Izdatelskaya Kompaniya. All rights reserved. Obesity is one of the leading and the most serious risk factors of cardiovascular diseases. Overweight provokes many metabolic and hemodynamic disorders. About 30% of inhabitants of the planet have overweight and prevalence of obesity increases by 10% every 10 years according to the WHO data. The probability of arterial hypertension in obese patients is 50% higher than in people with normal body mass. Framingham study showed that obesity is an independent, significant risk factor of ischemic heart disease, myocardial infarction, cerebral stroke and diabetes mellitus. The most dangerous is the central obesity with the preferential fat deposition in the abdomen. Combination of visceral obesity, violation of carbohydrate and lipid metabolism, arterial hypertension, and close pathogenic relationship between these factors underlie the isolated symptom complex known as metabolic syndrome. J. Vague was the first to describe relationship between abdominal obesity with cardiovascular disease and mortality in 1947. In our country G.F. Lang noticed common combination of arterial hypertension with obesity, lipid and carbohydrate metabolism disorders. Thus, metabolic syndrome significantly increases risk and severity of cardiovascular disease. Within last decades criteria of metabolic syndrome stays constant. The factors of insulin resistance and endothelial dysfunction as stages of the pathogenesis of the metabolic syndrome have been studied in detail. The mechanisms of insulin resistance and endothelial dysfunction are discussed in detail in this article as well as inflammatory markers and the significance of highly sensitive C-reactive protein.

© 2018 Stolichnaya Izdatelskaya Kompaniya. Цель. Изучить влияние ожирения в детском и зрелом возрасте на показатели артериальной жесткости, центрального аортального давления в популяционной выборке мужчин 42-43 лет. Материал и методы. Представленное исследование является частью 32-летнего проспективного, когортного наблюдения за лицами мужского пола, начиная с детского возраста (11-12 лет). Через 32 года обследованы 303 (30,1%) представителя исходной популяционной выборки - 1005 человек. В анализ включены 290 человек. Средний возраст мужчин на момент настоящего обследования составил 42,9 лет. Обследование включало опрос по стандартной анкете, измерение антропометрических показателей, артериального давления (АД), подсчет пульса. Измерение жесткости артериальной стенки и центрального давления проводилось методом аппланационной тонометрии. Результаты. Согласно нашим данным из 290 мужчин в возрасте 43 лет только 95 (32,8%) имеют нормальную массу тела (МТ), у 111 (38,3%) выявлена избыточная МТ (ИМТ), а у 84 (28,9%) - ожирение (ОЖ). Мужчины с ОЖ и ИМТ во взрослом возрасте имели статистически значимую ИМТ уже в детском возрасте. Центральное аортальное АД (ЦАД) как суррогатный показатель жесткости сосудов было статистически значимо выше в группах с ОЖ и ИМТ. Корреляционный анализ выявил статистически значимую положительную взаимосвязь между показа- телями, характеризующими ОЖ в детском возрасте (индекс Кетле, толщина кожных складок), и уровнем АД в детском возрасте. Имеется по- ложительная корреляция между толщиной кожных складок в детстве с ЦАД во взрослом возрасте, а также слабая положительная связь между периферическим систолическим АД (пСАД) в детстве и центральным систолическим АД (цСАД) во взрослом возрасте. Из потенци- альных предикторов, оцененных в возрасте 12 лет и включенных в регрессионную модель, только толщина кожной складки под лопаткой (КСЛ) оказывает влияние на значение цСАД в возрасте 43 лет. С увеличением толщины КСЛ в детском возрасте на 1 мм связано повышение цСАД во взрослом состоянии на 0,4 мм.рт.ст. Среди предикторов, оцененных во взрослом возрасте, статистически значимое влияние на уровень цСАД оказывают пСАД, периферическое диастолическое АД (пДАД) и индекс Кетле. На значение центрального диастолического АД (цДАД) в возрасте 43 лет оказывает влияние толщина кожной складки на животе в 12-летнем возрасте. Среди потенциальных предикторов, оцененных во взрослом возрасте, статистически значимое влияние на уровень цДАД оказывают пДАД, показатели ожирения. Заключение. Во взрослом возрасте центральное аортальное давление максимально зависит от повышения периферического АД и показа- телей, характеризующих ожирение. Из детских предикторов (12-летнего возраста) значение имело только ожирение.

© 2018 Blackwell Publishing Ltd. All rights reserved. AIMS: On the basis of echocardiography to evaluate the thickness of epicardial fat (TEF) in patients with metabolic syndrome (MS) and to establish a connection with the main indicators of laboratory and instrumental methods of research. MATERIALS AND METHODS: The study included 76 patients, 43 patients with MS and 33 without MS.The average age of patients in the MS group at the time of inclusion in the study was 62.7±10.3 years in the control group (without MS) - 60±14.7 years. All patients underwent a comprehensive examination that included the collection of complaints, study of history, physical examination, anthropometric measurements, laboratory (including the study of the levels of caspase - 8, leptin in blood plasma enzyme-linked immunosorbent assay using kits «Platinum ELISA») and instrumental examination (echocardiography, ultrasound examination of organs of small pelvis). TEF was determined using transthoracic echocardiography on the machine Acuson Sequoia 512. RESULTS: According transthoracic echocardiography was significantly higher in the group of patients with MS and was 4.67±1.7 mm, as compared to 2.66+1.15 mm in the control group (p<0.001). Identified moderate and strong correlation between TEF and weight of the patients, waist circumference, ratio of waist circumference to hip circumference, body mass index, glucose levels in the blood plasma, the presence of diabetes mellitus type 2, ultrasonic signs of steatosis of the liver and pancreas, increased aminotransferases, the level of caspase-8 concentration in plasma leptin. Patients the MS group with increased TEF increases the risk of developing hypertension, ischemic heart disease, left ventricular hypertrophy, diastolic dysfunction of the left ventricle type 2, level of caspase-8 and concentration in plasma leptin. CONCLUSION: Based on the obtained data, the measurement of TEF is justified in patients with MS in everyday clinical practice. The correlations between theTEF and the clinical and metabolic parameters of the CVD and MS make it possible to consider the TEF as a new marker of the risk of developing MS and cardiovascular diseases.

© 2018 Media Sphera Publishing Group. All rights reserved. Obesity, including morbid obesity, is a growing worldwide problem. The adverse effect of obesity on the kidneys is associated with the development of comorbid conditions, such as insulin resistance (IR), metabolic syndrome (MS), diabetes mellitus (DM), arterial hypertension (AH), which are the recognized risk factors of chronic kidney disease (ÑKD). Obesity also causes direct kidney damage with the development of non-immune focal segmental glomerulosclerosis. The leading pathophysiological mechanisms of kidney damage in obesity are intrarenal hemodynamic disorders with the formation of hyperfiltration and damaging effects of adipokines produced by adipose tissue. Bariatric surgery (BS) has taken a leading position in the treatment of morbid obesity, demonstrating its effectiveness not only in long-term weight loss, but also in the correction of IR, MS, DM, AH. Nephroprotective effect of significant and persistent weight loss is caused by the elimination of hyperfiltration and damaging effect of adipokines. Results of the observational studies of the immediate and long-term effects of BS have demonstrated positive renal outcomes, in particular, the decrease in albuminuria/proteinuria, the improvement or stabilization of glomerular filtration rate, the delay of end-stage renal failure development; surgical correction of body weight in dialysis patients with morbid obesity lets them realize subsequent kidney transplantation. Large, randomized prospective studies with a longer follow- up are needed; analysis of the long-term renal consequences of BS in obesity patients with pre-existing renal impairment, including dialysis patients, is required; stratification of the BS risk of renal complications (acute kidney damage, nephrolithiasis, nephrocalcinosis) and effective strategy for managing these risks need to be developed.