Anthropometric indices and their relationship with poor prognosis in patients with coronary artery disease and obesity

Aim. To assess the association of anthropometric indices in patients with coronary artery disease (CAD) and obesity and to study their predictive value in the development of adverse cardiovascular events.Material and methods. The study included 229 patients with CAD (median age, 55±7,56 years). Depending on the presence of obesity according to the World Health Organization criteria (1999), patients were divided into 2 groups. The 1st group included 107 obese patients, while the 2nd group — those without obesity (n=122). The groups were comparable in age. We measured waist (WC) and hip circumference (HC), followed by waist-to-hip ratio and body mass index calculation. The lipid profile parameters were determined by the enzymatic colorimetric method. During the study, the following indices were calculated: body mass index, visceral adiposity index, insulin resistance index, body shape index (BSI), fasting triglyceride (TG)/plasma glucose index, waist-to-height ratio, lipid accumulation product, TG-to-high density lipoprotein cholesterol ratio.Results. During the follow-up period, adverse cardiovascular events in the 1st group of patients were found in 37 (34,5%) patients, while in the 2nd group, the composite endpoint was revealed in 12,3% of patients. In order to develop a model for predicting the risk of an unfavorable CAD course in obese patients, we performed a logistic regression analysis, which showed that the following were the most significant predictors of unfavorable cardiovascular outcomes: TG/glucose index and BSI.Conclusion. Thus, of all the considered anthropometric indices, only two were associated with unfavorable CAD course — TG/glucose index and BSI. The data obtained indicate the validity of the search for novel useful obesity indicators with a good predictive value

The role of SH groups in the regulation of Gardos channels in glucose deficiency

Background. Disruption of the energy balance of erythrocytes under conditions of a decrease in the glycolysis level can cause a change in the ion permeability of their membrane.   The aim. To study Ca2+-dependent potassium permeability of the erythrocytes membrane in the presence of SH group modifiers under conditions of glucose deficiency.   Materials and methods. The study used precipitated erythrocytes obtained from the blood of 20 male Wistar rats. The change in the Ca2+-dependent potassium conductivity of the erythrocyte membrane was determined using the potentiometric method. The A23187-and redox-induced hyperpolarization responses of erythrocytes were evaluated.   Results. Glucose deficiency in the medium, as well as the use of the glycolysis inhibitor 2-deoxyglucose, led to an increase in the amplitude of A23187-stimulated membrane hyperpolarization by the opening of the Gardos channels. At the same time, the redox-dependent hyperpolarization of the erythrocyte membrane turned out to be insensitive to a decrease in the glucose content in the medium and to the glycolysis inhibition. The effects of SH group modifiers in the normal incubation medium and under glucose deficiency turned out to be multidirectional and depended on the method of stimulation of Gardos channels.   Conclusion. The results obtained indicate that metabolic disorders in erythrocytes under conditions of glucose deficiency lead to a change in the mechanisms of control of Gardos channels with the participation of SH groups of the proteins of these channels or their regulatory proteins

IMMUNOREGULATORY IMBALANCE AND FUNCTIONAL STATE OF THE HEART IN THE PATIENTS WITH DIABETES MELLITUS TYPE 2

Diabetes mellitus type 2 is one of the most important non-infectious diseases in the modern world, being an important risk factor of cardiovascular disorders. Changes in left ventricular myocardial diastolic function are observed in diabetic patients independently from other comorbidities. Etiology of the heart failure during diabetes mellitus type 2 is multifactorial, exhibiting cellular,  molecular and metabolic aspects. However, its pathophysiological mechanisms are not completely understood. The aim of this study was to evaluate numbers of inflammatory T lymphocytes, i.e., T helper type 1 (Th1) and T helper type 17 (Th17) cells, and FoxP3+T regulatory lymphocytes, depending on the functional state of the heart assessed by two-dimensional echocardiography in patients with arterial hypertension and diabetes mellitus type 2. A total of twenty-five patients with a combination of arterial hypertension and diabetes mellitus type 2, and 14 patients with arterial hypertension without carbohydrate disturbances were recruited to a cross-ectional case-control study. All the patients underwent echocardiography with transthoracic access at the M-mode, B-mode and Doppler mode of imaging. We evaluated numbers of Th1 and Th17 lymphocytes by intracellular production of IL-17 and IFNγ by CD4+ lymphocytes, respectively. The numbers of FoxP3+T regulatory lymphocytes were estimated by expression of CD25 and FoxP3 transcription factor. A flow cytometry approach was used in both cases. We revealed some correlations between the numbers of Th17 lymphocytes, FoxP3+T regulatory lymphocytes and functional parameters of myocardium in patients with diabetes mellitus type 2, which were absent in patientswithout carbohydrate impairments. The numbers of FoxP3+T egulatory lymphocytes, Treg/Th17 lymphocyte ratio, and mean fluorescence intensity of IL-17 for Th17 cells was lower in patients with diabetes mellitus and diastolic dysfunction compared to the patients with diabetes free of diastolic dysfunction. Association of diastolic dysfunction with diabetes mellitus type 2 was accompanied by increase of IFNγ+Th1 lymphocyte numbers and concentrations of IL-10, IFNγ and TNFα in serum as compared to the patients with diastolic dysfunction in the absence of carbohydrate metabolism disturbances. The diabetic patients with diastolic dysfunction were characterized by hyperinsulinemia, hyperglycemia, higher index of insulin resistance, increase of waist circumference and visceral adiposity index when compared to the patients with diastolic dysfunction without diabetes. Visceral obesity and decrease of insulin sensitivity may be regarded as pathogenetically significant factors for the development of immune regulatory imbalance and diastolic dysfunction in the patients with diabetes mellitus type 2

SUBCELLULAR LOCALIZATION OF FoxP3 TRANSCRIPTION FACTOR IN PATIENTS WITH ACUTE CORONARY SYNDROME: COMPARATIVE ANALYSIS AND PROSPECTIVE OBSERVATION

The key cellular and molecular factors being involved in the resolution of inflammation following acute myocardial infarction remain poorly understood. T-regulatory (Treg) lymphocytes are characterized by the extreme potential to regulate the strength and direction of immune responses during the myocardial injury. The functional activity of Treg-lymphocytes depends upon the transcription factor forkhead box protein P3 (FoxP3). It may be also expressed in conventional T-lymphocytes at the stage of their activation. Nuclear localization of FoxP3 is a prerequisite factor determining its ability to impact the suppressive functions of Treglymphocytes.The aim of the present study was comparative evaluation of FoxP3+T-lymphocytes frequency and counts, combined with estimation of FoxP3 subcellular localization, in patients with acute myocardial infarction and chronic coronary syndrome and examination of changes of these parameters in the short-term follow-up of patients with myocardial infarction. The study included 14 patients with chronic coronary syndrome (8 males; 6 females; 63.2±9.0 y.o.) and 5 patients with acute anterior ST-segment elevation myocardial infarction (4 males; 1 female; 61.4±11.2 y.o.) at days 1, 3 and 7 after the event. The frequency of FoxP3+ conventional and regulatory T-lymphocytes was evaluated in peripheral blood mononuclear cells together with estimation of the level of FoxP3 nuclear localization by imaging flow cytometry.Patients with infarction were characterized by the decreased counts of FoxP3+Treg-lymphocytes compared to patients with chronic coronary syndrome, and exhibited even further decrease in the counts of FoxP3+Tregcells at day 7 after infarction, while frequency of Treg and conventional T-lymphocytes did not differ significantly. The level of FoxP3 nuclear translocation was lower both in Treg and conventional T-lymphocytes in patients at day 1 post-infarction compared to patients with chronic coronary syndrome. Absolute counts of FoxP3+Tregs with nuclear FoxP3 localization remained significantly lower both at days 1 and 7 post-infarction compared to patients with chronic coronary syndrome.Thus, here we demonstrated that FoxP3 nuclear localization experiences decrease in the course of acute myocardial infarction and may serve as a more sensitive marker of changes in Treg-lymphocyte functioning than simple evaluation of their frequency

TECHNIQUE FOR DETERMINATION OF THE MAIN ELEMENTS AND IMPURITIES IN FERROVANADIUM ALLOYS BY X-RAY FLUORESCENCE ANALYSIS

The technique for determining the content of the main and impurity components in ferrovanadium was developed, considering particle size distribution of samples. The obtained technique is rapid and can be used for the intermediate control of ferrovanadium ingots

The Opportunity of Using Diode Laser with the Length of 1940 nm in the Treatment of Hemorrhoids

Aim: to improve the results of treatment of patients with hemorrhoidal disease of the 2nd and 3rd stages by using a diode laser with a wavelength of 1940 nm.Materials and methods. The study included 28 patients with hemorrhoids of the second or third stage. A new treatment method based on the use of a diode laser with a wavelength of 1940 nm was applied to all patients. This technique (laser hemorrhoidoplasty) provides for the thermal effect of laser radiation on the cavernous tissue of the internal hemorrhoid node and the terminal branches of the upper rectal artery. The intensity of postoperative pain syndrome was assessed and the clinical symptoms of hemorrhoidal disease manifestations were studied before and after surgery. To study the effectiveness of the proposed method and to assess the depth of thermal exposure to laser radiation, transrectal ultrasound with Dopplerography and pathomorphological examination were performed. The functional state of the rectal locking apparatus before surgery and in the postoperative period was assessed using sphincterometry. The quality of life of patients who underwent laser hemorrhoidoplasty was studied according to the SF 36 questionnaire.Results. Surgical intervention was performed under both local and spinal anesthesia. Intraoperative complications in the form of hemorrhoidal node bleeding were noted in 3 patients. In the early postoperative period, inflammatory edema of external hemorrhoids was diagnosed in 4 patients. The intensity of the pain syndrome was assessed on the VAS scale and by day 7 in 93 % of patients it did not exceed 1 point. All 28 patients were followed up within 1 to 6 months after the operation. All had no complaints characteristic of hemorrhoidal disease, no relapse of the disease was detected in any observation. Transrectal ultrasound with Dopplerography was performed, which made it possible to diagnose a 2–3-fold decrease in blood flow along the terminal branches of the upper rectal artery, and internal hemorrhoids determined earlier, before surgery, were not visualized already 1 month after surgery. According to sphincterometry, no violations of anal retention function were detected in all 28 patients.Conclusion. Surgical treatment of hemorrhoids of the 2nd and 3rd stages with the use of a diode laser with a wavelength of 1940 nm. with proper technical performance and the choice of optimal energy, it allows to achieve a good clinical effect. The proposed method of intervention ensures the absence of a pronounced pain syndrome, which does not lead to a significant decrease in the quality of life already in the early postoperative period and allows to shorten the period of labor rehabilitation. Laser hemorrhoidoplasty is a highly effective method of treating hemorrhoids at stages 2 and 3 of the disease and opens up the possibility of treatment on an outpatient basis

THE ASSOCIATION OF DEPRESSION WITH C-REACTIVE PROTEIN (THE DATA OF ESSE-RF EPIDEMIOLOGICAL STUDY)

Aim. To study the association of depression with a high-sensitivity C-reactive protein (hsCRP) level, taking into account the main risk factors and noncommunicable diseases in Russia residents.Material and methods. The data of ESSE-RF multicenter study (a representative sample of the unorganized male and female population aged 25-64 years from 8 regions surveyed in 2012-2014) were used in the work. A total 11884 people were involved into the study including 35.9% men. The examination included a survey on the standard questionnaire containing data on disease history, etc. The level of depression was assessed by the validated in Russian Hospital Anxiety and Depression Scale (HADS, 1983). hsCRP level was determined in all patients.Results. The continuing association between elevated levels of depression (HADS-D ≥8+) and high level of hsCRP ≥3.0 mg/l (odds ratio [OR] 1.15; 95% confidence interval [CI] 1.03-1.27; p=0.009) was found in the multivariate model, after adjustment for sex, age, education, and risk factors. Reducing of the relationship of elevated levels of depression with a high level of hsCRP (OR 1.11; 95% CI 1.00-1.24; p=0.048) was found with the additional introduction of diseases in the model. This relationship was reduced to not statistically significant level (OR 1.08; 95% CI 0.98-1.20; p=0.134) in the full model adjusted for regions.Conclusion. The reduced association of depression with hsCRP ajusted for aggregate risk factors was found in the study. This suggests about multifactor affecting on this relationship

Влияние высокожировой и высокоуглеводной диеты на клетки крови крыс

Aim. To study the effects of a high-fat, high-carbohydrate diet on erythrocytes and platelets of rats.Materials and methods. Male Wistar rats (n = 23) were used for the study. The rats were divided into a control group and an experimental group. The rats from the control group were fed with standard rat chow. The rats from the experimental group had received a high-fat and high-carbohydrate diet for 12 weeks. In the rats, body weight and blood pressure (BP) were measured, an oral glucose tolerance test was carried out, and hematological and lipid metabolism parameters were analyzed. The conductance of erythrocyte KCa-channels was measured by the potentiometric method, and platelet aggregation was determined by the turbidimetric method.Results. Feeding the rats with a high-fat, high-carbohydrate diet for 12 weeks resulted in obesity, BP elevation, hyperglycemia, impaired glucose tolerance, and dyslipidemia with pronounced triglyceridemia. In the experimental group, a rise in the number of leukocytes, mainly due to granulocytes, and an increase in the number of platelets and their collagen-induced aggregation were observed. The red blood cell count in the rats of the experimental group did not significantly differ from that of the control group. In the experimental group, multidirectional changes in the membrane potential were observed in response to the stimulation of the KCa-channels in the erythrocyte membrane with the Ca2+ ionophore A23187 or artificial redox systems.Conclusion. The obtained data indicate that a high-fat, high-carbohydrate diet leads to metabolic and hemorheological disorders that are typical of metabolic syndrome.Цель – изучить воздействие высокожировой и высокоуглеводной диеты на эритроциты и тромбоциты крови крыс.Материалы и методы. Исследование выполнено на 23 самцах крыс линии Вистар, которые были разделены на контрольную и опытную группу. Крысы контрольной группы находились на стандартной диете. Крысы опытной группы в течение 12 нед получали высокожировую и высокоуглеводную диету. Животным измеряли массу тела, артериальное давление (АД), выполняли глюкозотолерантный тест, определяли гематологические показатели и параметры липидного обмена. Потенциометрическим методом изучали проводимость КСа-каналов мембраны эритроцитов, турбидиметрическим – агрегационную способность тромбоцитов.Результаты. Содержание животных на высокожировой и высокоуглеводной диете приводило к ожирению, повышению АД, гипергликемии, снижению толерантности к глюкозе, дислипидемии с выраженной триглицеридемией. У животных опытной группы происходило увеличение количества лейкоцитов, главным образом, за счет гранулоцитов, повышение числа тромбоцитов и их коллаген-индуцированной агрегации. Количественные показатели клеток красной крови крыс опытной группы не отличались от контрольной группы. В ответ на стимуляцию КСа-каналов мембраны эритроцитов животных экспериментальной группы с помощью Са2+-ионофора А23187 или редокс-системы наблюдались разнонаправленные изменения мембранного потенциала.Заключение. Полученные результаты свидетельствуют, что высокожировая и высокоуглеводная диета приводит к метаболическим и гемореологическим нарушениям, характерным для метаболического синдрома