Изменения адипокинового профиля у больных стабильной стенокардией и ожирением

Abstract

Статья посвящена изучению влияния гормонов жировой ткани на развитие атеросклероза у больных со стабильной стенокардией и сопутствующим ожирением. Установлено, что дисфункция адипокинового обмена способствует развитию гиперлипидемии и как следствие этого прогрессированию атеросклероза у больных со стабильной стенокардией и ожирением. The article studied the effects of adipokines in the development of atherosclerosis in patients with stable angina and concomitant obesity. The most widespread among all cardiovascular diseases is the ischemic heart disease (IHD), which is found in 58% of patients. Despite significant progress in treatment, the prevalence of stable angina grows and reaches 20% among population . Obesity is an important risk factor of IHD development. Cardiovascular disorders in patients with obesity are found in the form of systemic atherosclerosis, myocardiodystrophy, arterial hypertension. The results of the latest research in endocrinology have shown the presence of hormonal activity of adipose tissue and its indirect and direct impact on the body on the whole and on the cardiovascular system in particular. Active scientific research in pathogenic mechanisms of adipose tissue hormones biosynthesis and their role in development of obesity and cardiovascular diseases is performed. The level of adiponectin in patients with obesity is proved to be decreased. Visfatin – adipokine, which is produced by visceral adipocytes, is being actively examined. Introduction of recombinant visfatin affects the insulin receptor in the same manner as insulin. The level of visfatin grows in proportion to the level of obesity. We examined 110 patients with stable angina (Functional Classes II – III). All patients were divided into 2 groups: 1st group – patients with stable angina with concomitant obesity (n=80), 2nd group – patients with stable angina without obesity (n=30). The average age of the patients suffering from stable angina with concomitant obesity was 66,45±1,08 years old, and of the 2 group - 65,87±1,98. 66 men (60,95%) and 44 women (39,05%) have been examined. The control group comprised 20 practically healthy people. All patients underwent comprehensive investigation in accordance with the order № 436 of Ministry of Health of Ukraine “Protocols on delivery of health care to the patients with IHD – stable angina”. According to the results of our study among the patients with stable angina with concomitant obesity the level of adiponectin is 17% lower and visfatin level is 9,3 % higher in comparison to patients without obesity. Adipokine exchange dysfunction contributes to development of atherosclerosis in patients suffering from stable angina with concomitant obesity through exhaustion of antiatherogenic capabilities of adiponectine together with activation of lipid disorders with the help of visfatin, which is confirmed by the detected correlation ties.