VOLUME LXXIII, ISSUE 7, JULY 2020 Since 1928 ALUNA Publishing House Memory of dr Władysław BiegańskiOfficial journal of the Polish Medical Association Wiadomości Lekarskie monthly journal You can order the subscription for the journal from Wydawnictwo Aluna by: prenumerata@wydawnictwo-aluna.pl Wydawnictwo Aluna Z.M. Przesmyckiego 29 05-510 Konstancin-Jeziorna Poland Place a written order first. If you need, ask for an invoice. Payment should be done to the following account of the Publisher: Credit Agricole Bank Polska S. 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Ewa Małecka-Tendera (SUM Katowice) Dr hab. med. Tomasz Szczepański (SUM Katowice) Położnictwo i ginekologia Prof. dr hab. med. Jan Kotarski (UM Lublin) Prof. dr hab. med. Andrzej Witek (SUM Katowice) Stomatologia Prof. dr hab. Maria Kleinrok (UM Lublin) Polskie Towarzystwo Lekarskie Prof. dr hab. med. Waldemar Kostewicz (Prezes ZG PTL) Prof. dr hab. med. Jerzy Woy-Wojciechowski (Prezes Honorowy PTL) Prof. emerytowany dr hab. med. Tadeusz Petelenz (O. Katowicki PTL) Koordynator projektu Agnieszka Rosa tel. 694 778 068 amarosa@wp.pl Redakcja zagraniczna dr n. med. Lesia Rudenko l.rudenko@wydawnictwo-aluna.pl Wydawca Wydawnictwo Aluna ul. 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Krzysztof Bielecki (CMKP Warszawa) Prof. dr hab. med. Stanislav Czudek (Onkologickié Centrum J.G. Mendla Czechy) Prof. dr hab. med. Marek Rudnicki (University of Illinois USA) Choroby wewnętrzne Prof. dr hab. med. Ryszarda Chazan, pneumonologia i alergologia (UM Warszawa) Prof. dr hab. med. Jacek Dubiel, kardiologia (CM UJ Kraków) Prof. dr hab. med. Zbigniew Gąsior, kardiologia (SUM Katowice) Prof. dr hab. med. Marek Hartleb, gastroenterologia (SUM Katowice) Prof. dr hab. med. Jerzy Korewicki, kardiologia (Instytut Kardiologii Warszawa) Dr hab. med. Krzysztof Łabuzek, farmakologia kliniczna, diabetologia (SUM Katowice) Prof. dr hab. med. Tadeusz Płusa, pneumonologia i alergologia (WIM Warszawa) Dr hab. med. Antoni Wystrychowski, nefrologia (SUM Katowice) Choroby zakaźne Prof. dr hab. med. Andrzej Gładysz (UM Wrocław) Epidemiologia Prof. dr hab. med. Jan Zejda (SUM Katowice) Neurologia i neurochirurgia Prof. dr hab. med. Henryk Majchrzak, neurochirurgia (SUM Katowice) Prof. dr hab. med. Krystyna Pierzchała, neurologia (SUM Katowice) Redaktor naczelny Prof. dr hab. med. Władysław Pierzchała (SUM Katowice) Zastępca redaktora naczelnego Prof. zw. dr hab. n. med. Aleksander Sieroń (SUM Katowice) Sekretarz redakcji Joanna Grocholska Redaktor statystyczny Ewa Guterman Rada naukowa Redaktorzy tematyczni: Chirurgia Prof. dr hab. med. Krzysztof Bielecki (CMKP Warszawa) Prof. dr hab. med. Stanislav Czudek (Onkologickié Centrum J.G. Mendla Czechy) Prof. dr hab. med. Marek Rudnicki (University of Illinois USA) Choroby wewnętrzne Prof. dr hab. med. Marek Hartleb, gastroenterologia (SUM Katowice) Prof. dr hab. med. Jacek Dubiel, kardiologia (CM UJ Kraków) Prof. dr hab. med. Zbigniew Gąsior, kardiologia (SUM Katowice) Prof. dr hab. med. Jerzy Korewicki, kardiologia (Instytut Kardiologii Warszawa) Dr hab. med. Antoni Wystrychowski, nefrologia (SUM Katowice) Prof. dr hab. med. Ryszarda Chazan, pneumonologia i alergologia (UM Warszawa) Prof. dr hab. med. Tadeusz Płusa, pneumonologia i alergologia (WIM Warszawa) Choroby zakaźne Prof. dr hab. med. Andrzej Gładysz (UM Wrocław) Epidemiologia Prof. dr hab. med. Jan Zejda (SUM Katowice) Neurologia i neurochirurgia Prof. dr hab. med. Krystyna Pierzchała, neurologia (SUM Katowice) Prof. dr hab. med. Henryk Majchrzak, neurochirurgia (SUM Katowice) Pediatria Prof. dr hab. med. Ewa Małecka-Tendera (SUM Katowice) Dr hab. med. Tomasz Szczepański (SUM Katowice) Położnictwo i ginekologia Prof. dr hab. med. Jan Kotarski (UM Lublin) Prof. dr hab. med. Andrzej Witek (SUM Katowice) Stomatologia Prof. dr hab. Maria Kleinrok (UM Lublin) Polskie Towarzystwo Lekarskie Prof. dr hab. med. Jerzy Woy-Wojciechowski (Prezes PTL) Prof. emerytowany dr hab. med. Tadeusz Petelenz (O. Katowicki PTL) Kontakt z redakcją i wydawnictwem Joanna Grocholska e-mail: j.grocholska@blue-sparks.pl Wydawca Blue Sparks Publishing Group Sp. z o.o. ul. Obornicka 15/4, 02-948 Warszawa tel. (22) 858-92-53 Zarząd: dr Anna Łuczyńska − prezes Reklama i marketing: Agnieszka Rosa tel. 662-116-020 e-mail: a.rosa@blue-sparks.pl Zamówienia na prenumeratę: e-mail: prenumerata@blue-sparks.pl lub tel. (22) 858-92-53 Projekt okładki: Dorota Cybulska Opracowanie gra� czne: Tomasz Białkowski Nakład: do 6000 egz. © Copyright by Blue-Sparks Publishing Group Wydanie czasopisma Wiadomości Lekarskie w formie papierowej jest wersją pierwotną (referencyjną). Redakcja wdraża procedurę zabezpieczającą ory- ginalność publikacji naukowych oraz przestrzega zasad recenzowania prac zgodnie z wytycznymi Ministerstwa Nauki i Szkolnictwa Wyższego. Czasopismo indeksowane w: Medline, EBSCO, MNiSW (6 pkt), Index Copernicus, PBL. Czasopismo Polskiego Towarzystwa Lekarskiego Pamięci dra Władysława Biegańskiego Wiadomości Lekarskie WL_1_2013.indb 1 27.03.2013 12:23 Editor in-Chief: Prof. Władysław Pierzchała Deputy Editor in-Chief: Prof. Aleksander Sieroń Statistical Editor: Dr Lesia Rudenko Polish Medical Association (Polskie Towarzystwo Lekarskie): Prof. Waldemar Kostewicz – President PTL Prof. Jerzy Woy-Wojciechowski – Honorary President PTL Prof. Tadeusz Petelenz Kris Bankiewicz San Francisco, USA Christopher Bara Hannover, Germany Krzysztof Bielecki Warsaw, Poland Zana Bumbuliene Vilnius, Lithuania Ryszarda Chazan Warsaw, Poland Stanislav Czudek Ostrava, Czech Republic Jacek Dubiel Cracow, Poland Zbigniew Gasior Katowice, Poland Andrzej Gładysz Wroclaw, Poland Nataliya Gutorova Kharkiv, Ukraine Marek Hartleb Katowice, Poland Roman Jaeschke Hamilton, Canada Andrzej Jakubowiak Chicago, USA Oleksandr Katrushov Poltava, Ukraine Peter Konturek Saalfeld, Germany Jerzy Korewicki Warsaw, Poland Jan Kotarski Lublin, Poland George Krol New York, USA Krzysztof Łabuzek Katowice, Poland Henryk Majchrzak Katowice, Poland Ewa Małecka-Tendera Katowice, Poland Stella Nowicki Memphis, USA Alfred Patyk Gottingen, Germany Palmira Petrova Yakutsk, Russia Krystyna Pierzchała Katowice, Poland Tadeusz Płusa Warsaw, Poland Waldemar Priebe Houston, USA Maria Siemionow Chicago, USA Vladyslav Smiianov Sumy, Ukraine Tomasz Szczepański Katowice, Poland Andrzej Witek Katowice, Poland Zbigniew Wszolek Jacksonville, USA Vyacheslav Zhdan Poltava, Ukraine Jan Zejda Katowice, Poland Distribution and Subscriptions: Bartosz Guterman prenumerata@wydawnictwo-aluna.pl Graphic design / production: Grzegorz Sztank www.red-studio.eu Publisher: ALUNA Publishing House ul. 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The editors take no responsibility for the contents of the advertisements. 1311 Wiadomości Lekarskie, VOLUME LXXIII, ISSUE 7, JULY 2020© Aluna Publishing CONTENS EDITORIAL ARTICLE Jakub Adamczyk, Dominik Sieroń, Karolina Sieroń, Aleksander Sieroń, Ewa Kucharska METHODS OF SPECTRAL DIAGNOSTICS IN MODERN PREVENTION OF ONCOLOGICAL DISEASES 1313 ORIGINAL ARTICLES Galyna А. Yeroshenko, Larysa Ya. Fedoniuk, Konstantyn V. Shevchenko, Denys R. Kramarenko, Аnastasiia І. Yachmin, Olena V. Vilkhova, Tetiana A. Skotarenko STRUCTURAL REORGANIZATION OF THE RATS’ SUBMANDIBULAR GLANDS ACINI AFTER THE INFLUENCE OF 1% METHACRYLATE 1318 Jarosław Świrta, Michał Romaniszyn, Marcin Barczyński RISK FACTORS OF MALIGNANCY IN PATIENTS WITH FINE NEEDLE ASPIRATION BIOPSY RESULTS INTERPRETED AS “SUSPICIOUS FOR FOLLICULAR NEOPLASM” 1323 Ivanna I. Horban, Arsen A. Hudyma, Roman V. Maksymiv, Iryna V. Antonyshyn INFLUENCE OF TWO-HOUR TOURNIQUETS ISCHEMIA OF LIMB AND ACUTE BLOOD LOSS ON SYSTEMIC DISORDERS OF THE BODY IN THE REPERFUSION PERIOD (EXPERIMENTAL STUDY) 1330 Svitlana I. Zhuk, Oksana D. Shchurevska MATERNAL PSYCHOSOCIAL STRESS AND LABOR DYSTOCIA 1334 Martyna Rozek, Zuzann Smiech, Marcin Kolacz, Dariusz Kosson PAIN RELIEF DURING LABOR – WHAT DO WE KNOW AND WHAT SHOULD WE KNOW? RESEARCH BASED ON THE STUDENT POPULATION IN WARSAW 1339 Svetlana A. Pavlenko, Elena V. Pavlenkova, Irina. M. Tkachenko, Alla I. Sidorova, Dmytro M. Korol PROGNOSTIC INDICES OF PATHOLOGICAL TOOTH WEAR DEVELOPMENT 1345 Igor V. Yaishen, Karina Y. Andrienko, Irina O. Pereshivaylova, Leah G. Salia, Elena O. Berezhna EVALUATION OF PATIENT’S QUALITY LIFE WITH JOINT AND MUSCLE DYSFUNCTION 1350 Oleksander V. Kovtunenko, Bohdan V. Shportko, Serhey M. Tymchuk ANALYSIS OF СYTOCERATINE 19 EXPRESSION LEVEL BY IMMUNOCYTOCHEMICAL DIAGNOSTIC METHOD IN LARYNGEAL CANCER PATIENTS WITH REGIONAL METASTASES 1355 Tetiana V. Budnik, Tetiana B. Bevzenko A TEN-YEAR ANALYSIS OF CHANGES IN THE SENSITIVITY OF THE LEADING UROPATHOGEN TO ANTIBACTERIAL AGENTS IN CHILDREN WITH URINARY TRACT INFECTION IN THE NEPHROLOGY DEPARTMENT 1360 Aleksey A. Oparin, Iryna O. Balaklytska, Olga G. Morozova, Anatolii G. Oparin, Ludmila O. Khomenko MECHANISMS OF INSOMNIA FORMATION WITH GASTROESOPHAGEAL REFLUX DISEASE, TAKING INTO ACCOUNT THE PSYCHOSOMATIC STATUS IN YOUNG PEOPLE 1365 Volodymyr V. Kasian, Volodymyr D. Sheiko, Tetiana V. Mamontova, Liudmyla E. Vesnina, Oksana A. Shlykova PROCALCITONIN IN EARLY PREDICTION OF ACUTE SEVERE PANCREATITIS 1370 Olga M. Shvets, Olga S. Shevchenko, Liliіa D. Todoriko, Rostyslav S. Shevchenko, Volodumur V. Yakimets, Oleksandra I. Choporova, Ganna L. Stepanenko CARBOHYDRATE AND LIPID METABOLIC PROFILES OF TUBERCULOSIS PATIENTS WITH BILATERAL PULMONARY LESIONS AND MYCOBACTERIA EXCRETION 1373 Olexandra V. Tiazhka, Zoriana V. Selska APPLICATION OF VITAMIN D IN DIFFERENT DOSAGE TO TREAT CHILDREN WITH ALLERGIC DISEASES 1377 Agnieszka Wiorek, Milena Horodecka, Lukasz J. Krzych CLINICAL USEFULNESS OF THE INTERNATIONAL RENAL RESEARCH INSTITUTE OF VICENZA (IRRIV) SCORE IN THE INTENSIVE CARE SUBJECTS WITH RENAL FAILURE: SINGLE-CENTRE EXPERIENCE 1384 Olena F. Mruh ASSESSMENT OF THE ADAPTIVE PERSONAL POTENTIAL OF THE PATIENTS WITH PARANOID SCHIZOPHRENIA 1391 Oleksandra Ya. Pryshliak, Tetiana O. Nikiforova, Zoriana R. Tylishchak, Oleksandr P. Boichuk, Nadiya V. Vaskul, Oksana V. Kopchak, Andriy L. Protsyk RETROSPECTIVE ANALYSIS OF LEPTOSPIROSIS MORBIDITY IN IVANO-FRANKIVSK REGION (EPIDEMIOLOGICAL AND CLINICAL CHARACTERISTICS) 1397 Sergiy M. Pyvovar, Iurii S. Rudyk, Mykola P. Kopytsya, Tetiana V. Lozyk, Valentina Ir. Galchinskaya, Tetiana O. Chenchik THE EFFECT OF BETA-BLOCKERS ON A COURSE OF CHRONIC HEART FAILURE IN PATIENTS WITH A LOW TRIIODOTHYRONINE SYNDROME 1402 Vadym A. Bodnar, Tetiana I. Koval, Nataliia O. Pryimenko, Galyna M. Dubyns’ka, Tetiana M. Kotelevska, Nina P. Lymarenko, Liudmyla M. Syzova, Lesia A. Bodnar SOME CLINICAL AND EPIDEMIOLOGICAL FEATURES OF INFLUENZA-ASSOCIATED PNEUMONIA DEPENDING ON THE ETIOLOGICAL AGENT 1410 Tetiana V. Ivakhniuk, Viktoriia M. Holubnycha, Vladyslav A. Smiianov, Lesia A. Rudenko, Yevgen V. Smiianov ANTIBIOTIC RESISTANCE OF THE NASOPHARYNX MICROBIOTA IN PATIENTS WITH INFLAMMATORY PROCESSES 1415 Mykhailo S. Myroshnychenko, Olena O. Dyadyk, Victor D. Urzhumov, Nataliia V. Kapustnyk, Iryna V. Borzenkova, Larisa I. Selivanova, Inna I. Torianyk, Yuliia Ya. Fedulenkova, Iuliia M. Kalashnyk, Pavel V. Tkachenko, Varvara R. Hryhorenko, Dmytro V. Molodan, Serhii S. Myroshnychenko CLINICAL AND MORPHOLOGICAL FEATURES OF THE OVARIAN BRENNER TUMOUR: CURRENT STATE OF THE PROBLEM 1420 Oskar Kublin, Mariusz Stępień EFFECT OF USING THE NIGHTSCOUT SYSTEM ON METABOLIC CONTROL, SAFETY, AND INCIDENCE OF COMPLICATIONS IN PATIENTS WITH DIABETES MELLITUS 1427 Irуna M. Nikitina, Svitlana A. Smiian, Kateryna O. Kondratiuk, Natalia V. Kalashnyk, Anzhelika A. Shevel CONDITIONS OF MICROELEMENTS EXCHANGE PROCESSES IN WOMEN’S PLACENTS IN INTRAUTERINE INFECTION OF THE FETUS 1434 Grygoriy P. Griban, Natalia A. Lyakhova, Oleksii V. Tymoshenko, Zhanna G. Domina, Nadya Yu. Dovgan, Mykola Z. Kruk, Ivan V. Mychka, Pavlo P. Tkachenko, Bogdan S. Semeniv, Ganna P. Grokhova, Natalya O. Zelenenko, Kostiantyn V. Prontenko CURRENT STATE OF STUDENTS’ HEALTH AND ITS IMPROVEMENT IN THE PROCESS OF PHYSICAL EDUCATION 1438 Kamila Wachuła, Joanna Furman, Beata Łabuz-Roszak THE MEDITERRANEAN DIET IN THE PREVENTION OF CARDIOVASCULAR AND NERVOUS SYSTEM DISEASES – THE ASSESSMENT OF NUTRITIONAL KNOWLEDGE 1448 1373 Wiadomości Lekarskie, VOLUME LXXIII, ISSUE 7, JULY 2020© Aluna Publishing INTRODUCTION Diabetes mellitus (DM) leads to increased susceptibility to tuberculosis (TB) via multiple mechanisms. The mechanisms include those directly related to hyperglycaemia and cellular insulinopenia, as well as indirect effects on macrophage and lymphocyte function. DM is known to affect chemotaxis, phago- cytosis, activation, and antigen presentation by phagocytes in response to M. tuberculosis [1]. But the link between DM and TB is bidirectional. TB can lead to impaired glucose tolerance (IGT) and new onset DM [2]. Dysglycemia in TB patients might be the result of stress response to infection, though dedicated studies to assess whether TB increases the risk of diabetes are still few. THE AIM The study was performed to assess changes in carbohydrate and lipid metabolic profiles in tuberculosis patients with bilateral lesions of the lungs and mycobacteria excretion. MATERIALS AND METHODS We examined 72 newly diagnosed pulmonary TB patients, who were treated in Kharkiv Regional TB Dispensary No. 1 from 2016 to 2017. Those patients who had HIV/TB co-infection, TB/DM comorbidity and body mass index (BMI) >25 were excluded from the study. Depending on the mycobacteria excretion, which was confirmed by spu- tum microscopy and sputum culture test, and the extent of pathological changes in the lungs on X-ray, patients were divided into groups. The control group included 20 healthy persons, which were correlated with the comparison groups by gender and age. Additionally we performed oral glucose tolerance test (OGTT) and measured fasting insulin level. Also, indices of lipidogram were measured: total cholesterol, high-density lipoproteins (HDL), low-density lipoproteins (LDL), very low density lipoproteins (VLDL), triglycerides and athero- genicity index (AI). BMI and HOMA-IR were calculated. Statistical processing of the obtained results was carried out by analyzing the contingency tables using the Statisti- caBasicAcademic 13 for Windows software package. We used the median (Me) interquartile range (Lower – lower quartile, Upper – upper quartile) and sample size (min – minimum, max – maximum value). The difference between groups was determined by non-parametric statistics using the Kolmogorov-Smirnov test and Mann-Whitney test CARBOHYDRATE AND LIPID METABOLIC PROFILES OF TUBERCULOSIS PATIENTS WITH BILATERAL PULMONARY LESIONS AND MYCOBACTERIA EXCRETION DOI: 10.36740/WLek202007113 Olga M. Shvets1, Olga S. Shevchenko1, Liliіa D. Todoriko2, Rostyslav S. Shevchenko1, Volodumur V. Yakimets3, Oleksandra I. Choporova1, Ganna L. Stepanenko1 1 KHARKIV NATIONAL MEDICAL UNIVERSITY, KHARKIV, UKRAINE 2 BUKOVINIAN STATE MEDICAL UNIVERSITY, CHERNIVTSI, UKRAINE 3 RIVNE REGIONAL CLINICAL MEDICAL AND DIAGNOSTIC CENTER NAMED AFTER VICTOR POLISHCHU, RIVNE, UKRAINE ABSTRACT The aim: To assess carbohydrate and lipid metabolic profiles of tuberculosis patients with bilateral injuries of the lungs and mycobacteria excretion. Materials and methods: Seventy two newly diagnosed pulmonary TB patients were examined. Group I – 17 newly diagnosed TB patients who had unilateral pulmonary lesions and had no mycobacteria excretion. Group II – 55 newly diagnosed TB patients who had bilateral pulmonary lesions and mycobacteria excretion. The control group included 20 healthy persons. Fasting insulin level, indices of lipidogram were measured, oral glucose tolerance test was performed. Statistical processing of the obtained results was carried out by analyzing the contingency tables using the StatisticaBasicAcademic 13 for Windows software package. Results: Tuberculosis patients develop insulin resistance – condition that is a precursor to developing type 2 diabetes and metabolic disorder of lipid exchange – dyslipidemia. Patients with bilateral pulmonary lesions and mycobacteria excretion have the most pronounced disorders of carbohydrate and lipid metabolism compared to patients with limited lesions of the lungs. Conclusions: We suppose that mycobacteria excretion and bilateral lesions of lungs may be the markers of the degree of carbohydrate and lipid metabolism disorders in patients with pulmonary tuberculosis. KEY WORDS: pulmonary tuberculosis, mycobacteria excretion, glucose metabolism, lipidogram Wiad Lek. 2020;73(7):1373-1376 ORIGINAL ARTICLE Olga M. Shvets et al. 1374 criteria (MWC). To study the independent variables, we used the non-parametric Kruskal-Wallis test criteria and the median test. The work was performed according to the requirements for researches with the participation of people: Statute of the Ukrainian Association for Bioethics and the GCP norms (1992), requirements and norms of ІСН GLP (2002), typical ethics provisions of the Ministry of Public Health of Ukraine 66 dated February 13, 2006. RESULTS AND DISCUSSION Group I consisted of 17 newly diagnosed TB patients who had unilateral pulmonary lesions and had no myco- bacteria excretion (23.6 %). Group II included 55 newly diagnosed TB patients who had bilateral pulmonary le- sions and mycobacteria excretion (76.4 %). Age and sex distribution were nearly the same in both groups. Age ranged from 19 to 58. Men prevailed in both groups: 11 (64.7 %) and 44 (80 %) respectively. The overwhelming majority of Group I patients were hospitalized to the TB hospital in satisfactory condition. Clinical course of the Group II patients was aggravated. They were often com- plained of signs and symptoms typical for active pulmo- nary tuberculosis. More detailed information presented in the Table 1. Infiltrative TB was diagnosed in sixteen patients (94.1%) from group I and in fifty three patients (96.4%). One patient from group I (5.9%) was diagnosed with miliary TB and two patients (3.8%) from group II had fibrous-cavernous TB. In group I patients pulmonary lesions on X-Ray, mainly were localized within one lobe (88.2%), cavitation had three patients (17.6%). All patients from group II had lung cavitation and the multiple decay cavities of various sizes were prevailed – 81.8% (45 patients). BMI was within normal ranges in most patients of both groups, though 10 patients from Group II (18.2%) had expressed underweight (BMI < 16.0). When comparing medians of the carbohydrate profile indicators of TB patients and healthy controls (Table 2.), we found that the median of fasting glucose levels were within normal ranges (3.5 -5.3 mmol/L) in both groups, though it was higher among TB patients (5.1 mmol/L vs 3.9 mmol/L). But these differences were not significant (р>0.01, CMW). Oral glucose tolerance test revealed that the median of postprandial glucose levels did not have significant differences (4.3 mmol/L vs 4.0 mmol/L). We found statistically significant difference (р<0.01, CMW) in median of fasting insulin levels of TB patients and healthy controls (16.15 mcU/ml vs. 4.8 mcU/ml). HOMA-IR also was statistically significantly higher(р<0.01, CMW) among TB patients (5.8 vs. 0.8). Medians of lipid metabolism indi- ces of TB patients and healthy controls were within normal ranges(Table 2.), except atherogenicity index which was significantly higher (р<0.01, CMW) among the group of patients (2.8 vs 1.5). This changes were associated with el- evated total cholesterol level among TB patients compared to healthy controls (4.3 vs 3.8mmol/L) and decreased level of HDL (1.0 vs 1.3 mmol/L). At the same time, we found an increase in median level of LDL in the group of TB patients (2.4 vs 1.7 mmol/L). When comparing the results obtained in groups of patients, we found that among patients of group II, who had bilateral pulmonary lesions and mycobacteria excre- tion, pronounced metabolic changes were revealed. The median of fasting glucose levels was significantly higher (р<0.01, CMW) among group II patients (5.4 mmol/L vs 4.2 mmol/L). Postprandial glucose levels during oral glucose tolerance test did not have significant differences but the median meaning was also higher among group II patients (5.1 mmol/L vs 4.2 mmol/L). The median of fasting insulin levels was significantly higher (р<0.01, CMW) in group II patients (26.2 mcU/ml vs. 10.8 mcU/ml) and it is even exceeded normal ranges (2 mcU/ml – 25 mcU/ml). HOMA-IR also was significantly higher (р<0.01, CMW) among patients who had bilateral pulmonary lesions and mycobacteria excretion (6.8 vs. 2.6). The median of total cholesterol level exceeded the norm in group II and it was significantly higher compering to the results of group I patients (5.6 vs 4.0 mmol/L). Level of HDL was within normal ranges and had no significant differences between groups (1.2 vs 1.0 mmol/L). The me- dian level of LDL in both groups also were within normal ranges but the results of group II were significantly higher comparing to the group I (3.2 vs 2.1. mmol/L). Athero- genicity index excided the norm in both groups and was higher in group II patients (3.2 vs 2.8) (р<0.01, CMW). Studies show that many people with type 2 diabetes also suffer from interstitial lung disease. The pro-inflammatory, proliferative, and oxidative properties of hyperglycemia have been shown to have an important role in affecting pulmonary vasculature, airways, and lung parenchyma [3-5]. But inflammatory lung diseases also can be a reason of glucose metabolism disorders. Findings of Cyphert TJ and others show that targeted induction of low-grade inflammation in the lung airway epithelium that does not result in systemic hypoxemia triggers systemic insulin resistance [6]. The same findings were revealed during our study, patients with newly diagnose pulmonary TB had Table 1. Signs and symptoms on admission Signs and symptoms Group I (unilateral lesions, MTB-) n=17 Group II (bilateral lesions, MTB+) n= 55 Fatigue 11 (64.7 %) 31 (56.4 %) Loss of appetite 3 (17.6 %) 5 (9.1 %) Fever 5 (29.4 %) 38 (69.31 %) Night sweats 5 (29.4 %) 20 (36.4 %) Coughing that lasts three or more weeks 5 (29.4 %) 30 (54.5 %) Chest pain, or pain with breathing or coughing 0 3 (5.5 %) Unintentional weight loss 0 8 (14.5 %) CARBOHYDRATE AND LIPID METABOLIC PROFILES OF TUBERCULOSIS PATIENTS WITH BILATERAL PULMONARY... 1375 increased indices of fasting insulin levels and HOMA-IR. Moreover, we revealed significant increase both of these indices in TB patients who had bilateral pulmonary lesions and mycobacteria excretion, comparing to those patients who had limited lesions in their lungs and had no myco- bacteria excretion. Insulin resistance lead to increased synthesis and secre- tion of triglycerides, very low-density lipoprotein (VLDL) particles by the liver, an increase in plasma triglycerides, enrichment of plasma HDL particles by triglycerides and more active catabolism of triglyceride-rich HDL-C [7,8]. Unlike these research data we did not find an increase in plasma triglycerides level in pulmonary TB patients. Instead we revealed signs of dyslipidemia: an increase in total cho- lesterol level due to an increase in the LDL fraction and a decrease in HDL and increase in atherogenicity index. These changes were also more pronounced among patients with bilateral pulmonary lesions and mycobacteria excretion. CONCLUSIONS According to our results, patients with newly diagnosed pulmonary tuberculosis develop insulin resistance – con- dition that is a precursor to developing type 2 diabetes and metabolic disorder of lipid exchange – dyslipidemia. Patients with bilateral pulmonary lesions and mycobac- teria excretion have the most pronounced disorders of carbohydrate and lipid metabolism compared to patients with limited lesions of the lungs. We suppose that mycobacteria excretion and bilateral lesions of lung tissue may be the markers of the degree of carbohydrate metabolism disorders in patients with pulmonary tuberculosis. REFERENCES 1. Restrepo B.I. Diabetes and Tuberculosis. Microbiol Spectr. 2016;4(6):10.1128/ microbiolspec.TNMI7-0023-2016 doi:10.1128/microbiolspec.TNMI7-0023-2016 (1) 2. Yorke E., Atiase Y., Akpalu J., et al. The Bidirectional Relationship between Tuberculosis and Diabetes. Tuberc Res Treat. 2017;2017:1702578. doi:10.1155/2017/1702578 3. De Santi F., Zoppini G., Locatelli F., et al. Type 2 diabetes is associated with an increased prevalence of respiratory symptoms as compared to the general population. BMC Pulm Med 2017. 17(1):101. 4. Olga S. Shevchenko, Lilia D. Todoriko, Iryna A. Ovcharenko, et al. Dynamics of aldosterone, connective tissue reorganization and glucose level as markers for tuberculosis treatment effectiveness. Archives of the Balkan Medical Union. 2019. 54(2): 274-280. Table II. Glucose and lipid metabolism indices in pulmonary TB patients and control group Parameter, (units) mean median min max Lower upper Stn.dev. pulmonary TB patients Fasting blood glucose level, (mmol/L) 5.3 5.1 2.4 10.5 4.7 5.6 1.7 2-hour glucose level, (mmol/L) 4.92 4.3 2.8 9.8 3.6 6.2 1.7 Fasting blood insulin level, (mcU/ml) 18.2 16.5 1.8 53.3 8.2 26.1 11.6 НОМА –IR 5.9 5.8 1.9 26.9 3.9 7.3 2.2 Total cholesterol, (mmol/L) 4.5 4.3 3.8 5.1 4.1 4.4 0.4 Triglycerides, (mmol/L) 1.4 1.3 1.2 1.4 1.3 1.3 0.1 HDL, (mmol/L) 1.2 1.0 0.8 1.6 1 1.3 0.2 LDL, (mmol/L) 2.6 2.4 2.1 3.3 2.2 2.9 0.4 VLDL, (mmol/L) 0.6 0.6 0.5 0.7 0.6 0.6 0.1 AI 2.9 2.8 1.9 3.5 2.7 3.1 0.5 control group Fasting blood glucose level, (mmol/L) 4.1 3.9 3.0 5.8 3.5 4.8 0.9 2-hour glucose level, (mmol/L) 3.9 4 2.8 5.7 3.2 4.5 0.9 Fasting blood insulin level, (mcU/ml) 4.7 4.8 2.6 6.1 4.1 5.2 1 НОМА –IR 0.9 0.8 0.5 1.5 0.7 0.9 0.2 Total cholesterol, (mmol/L) 3.8 3.8 2.9 4.7 3.4 4.2 0.5 Triglycerides, (mmol/L) 1.3 1.3 1.2 1.5 1.3 1.4 0.1 HDL, (mmol/L) 1.5 1.3 1.2 1.7 1.4 1.6 0.2 LDL, (mmol/L) 1.7 1.7 0.8 2.4 1.4 2.2 0.5 VLDL, (mmol/L) 0.6 0.6 0.5 0.6 0.6 0.6 0.1 AI 1.6 1.5 0.8 2.3 1.4 1.9 0.5 Olga M. Shvets et al. 1376 5. Khateeb J., Fuchs E., Khamaisi M. Diabetes and Lung Disease: A Neglected Relationship. Rev Diabet Stud. 2019 Feb 25;15:1-15. doi: 10.1900/RDS.2019.15.1.PubMed PMID: 30489598.4. 6. Cyphert T.J., Morris R.T., House L.M. et al. NF-κB-dependent airway inflammation triggers systemic insulin resistance. Am J Physiol Regul Integr Comp Physiol. 2015;309(9):R1144–R1152. doi:10.1152/ ajpregu.00442.2014 7. Mechanisms of HDL lowering in insulin resistant, hypertriglyceridemic states: the combined effect of HDL triglyceride enrichment and elevated hepatic lipase activity. Rashid S, Watanabe T, Sakaue T, Lewis GF Clin Biochem. 2003 Sep; 36(6):421-9. 8. Olga S. Shevchenko, Oksana A. Nakonechna, Liliia D. Todoriko, et al. Study of cell death and stages of leukocytes apoptosis in pulmonary tuberculosis patients with different antimycobacterial treatments. Archives of the Balkan Medical Union. 2019. 54(4):692-698 The study was performed within the research work of the Department of Phthisiology and Pulmonology of Kharkiv National Medical University “Optimization of forecasting and improving the treatment of newly diagnosed pulmo- nary tuberculosis based on the study of the dynamics of carbohydrate, lipid and protein metabolism” (state register #0119U002903). ORCID and contributionship: Olga M. Shvets: 000-0002-8371-8258 B,C,D,F Ganna L. Stepanenko: 0000-0002-0424-8383 B Olga S. Shevchenko: 000-0002-5476-3981 E,F Rostyslav S. Shevchenko: 0000-0002-6535-0939 A Liliіa D. Todoriko: 000-0002-0117-6513 A Volodumur V. Yakimets: 000-0003-3864-2423 C Oleksandra I. Choporova: 000-0003-1927-1815 D Conflict of interest: Authors have no conflict of interests. CORRESPONDING AUTHOR Olga M. Shvets Kharkiv National Medical University 4 Nauky Avenue, 61022 Kharkiv, Ukraine tel:+380999193762 e-mail: olga.shvets733@ukr.net Received: 03.04.2019 Accepted: 23.04.2020 A – Work concept and design, B – Data collection and analysis, C – Responsibility for statistical analysis, D – Writing the article, E – Critical review, F – Final approval of the article