ASSOCIATION BETWEEN ADIPOCYTOKINES AND INSULIN RESISTANCE IN PATIENTS WITH METABOLIC DISORDERS
O.V. Goptsii, 
Kharkiv National Medical University, Kharkiv, Ukraine.

The purpose.Study of activity of TNF-α and leptin depending on the presence of insulin resistance (IR) in patients with arterial hypertension with concomitant obesity. 
Materials and Methods. 123 patients suffering from arterial hypertension with concomitant obesity were investigated. The levels of TNF-α, leptin and insulin were identified by means of immunoenzyme method. The Insulin Resistance Index (HOMA index) was calculated using the formula: HOMA index = fasting blood glucose (mmol/l) x fasting blood insulin (mkgU/ml) / 22.5. HOMA Index > 2.77 cu is associated with the presence of IR. 
Results. All the patients were divided into two groups: the 1st group consisted of 80 patients without IR (insulin level 7.60±0.35 mkgU/ml, HOMA index 1.47±0.06 cu); the 2nd group consisted of 43 patients with IR (insulin level 31.35±2.51 mkgU/ml, HOMA index 7.22±0.68 cu). It was established that the indices of blood pressure (BP) in the patients with IR were higher (Systolic BP 182.44±2.50 mmHg, Diastolic BP 104.21±1.17 mmHg) in comparison to hypertensive patients without IR (Systolic BP 167.75±1.66 mmHg, Diastolic BP 100.01±0.87 mmHg). The levels of TNF-α and leptin increased evidently in hypertensive patients with IR (TNF-α 10.38±0.66 pg/ml, leptin 13.24±0.81 ng/ml, in female patients 13.74±0.99 ng/ml, in male patients 12.38±1.40 ng/ml) in comparison to the patients without IR (TNF-α 5.95±0.29 pg/ml, leptin 9.7±0.86 ng/ml, in female patients 11.41±1.32 ng/ml, in male patients 7.07±0.53 ng/ml), p <0.005. 
In correlation analysis in the group of the patients with IR a positive correlation between the level of insulin and TNF-α (R=0.46; p<0.004), level of leptin (R=0.32; p<0.03); HOMA index and TNF-α (R=0.44; p<0.005), level of leptin (R=0.33; p<0.03); level of leptin and TNF-α (R=0.57; p<0.00001) was established. 
Conclusion: The activity of TNF-α and leptin increase evidently in hypertensive patients with IR in comparison to the group of patients without IR (p<0.001). Direct correlation dependence in the group of the patients with IR between the levels of TNF-α, leptin and Insulin Resistance Index was established.