[The prognostic value of basic laboratory blood tests in predicting the results of cardiac rehabilitation in post STEMI patients]. / Wartosc prognostyczna podstawowych badan laboratoryjnych krwi w przewidywaniu wyników rehabilitacji kardiologicznej u chorych po STEMI.

UNLABELLED: The possibility of complications and death from cardiovascular causes in patients with acute coronary syndromes (ACS) is an important element in the assessment of their clinical condition. It is believed that the prognosis of patients after ACS is affected, among others, by leukocytosis, anemia, hyperglycemia, thrombocytopenia, and increased volume of these cells and decreased GFR. AIM: The aim of the study was an attempt to use basic laboratory blood tests and an index of own design to predict the results of in-hospital cardiac rehabilitation (phase II) of post STEMI patients. MATERIALS AND METHODS: The study included 100 post STEMI patients, 70 men and 30 women, aged 60,9±11,8 years, admitted for cardiac rehabilitation to the Department of Internal Diseases and Cardiac Rehabilitation, MU in Lodz. On admission fasting blood cell count was performed, serum glucose and creatinine level was determined (GFR assessment). The following results were considered abnormal: glucose level ≥100mg/dl, GFR <60 ml/min/1,73m(2), RBC <4x10(6)/µl, WBC >10x10(3)/µl, PLT <150x10(3)/µl. Exercise test was performed twice in all patients - before and after the completion of the II phase of rehabilitation to assess its effects. RESULTS: Basing on logistic regression analysis and the results of individual odds ratio (OR) of the tested blood parameters, their prognostic impact on the risk of cardiac rehabilitation failure was determined. This risk was defined on the basis of patient's inability to tolerate workload increment ≥20 Watt despite the applied cardiac rehabilitation program. The most statistically significant risk factors were selected as the result of logistic regression model building on the basis of which cardiac rehabilitation failure index was determined. Leukocytosis and anemia determined most significantly the failure of cardiac rehabilitation (respectively: OR=6,4 and OR=2,9;p=0,01). They were used to construct a rehabilitation failure index with the values 0-2, as follows: 0 - corresponds to the situation of the absence of leukocytosis and anemia, 1 - corresponds to the situation of the occurrence of leucocytosis or anemia in post STEMI patients and was associated with 3,5-fold increase in the risk of not obtaining the full effect of cardiac rehabilitation, 2 - corresponds to the situation of the simultaneous occurrence of both parameters (leukocytosis and anemia) and was associated with 12,25-fold increase in the risk of not obtaining full effect of cardiac rehabilitation. CONCLUSIONS: Peripheral blood cell count is essential in predicting cardiac rehabilitation effects. Leukocytosis and anemia determine to the greatest degree the failure of cardiac rehabilitation. Cardiac rehabilitation failure index may be useful in classifying post STEMI patients into an appropriate model of rehabilitation.

[Evaluation of effects of cardiac rehabilitation in patients after coronary artery bypass grafting by six minute walk test]. / Ocena efektów rehabilitacji kardiologicznej u chory4 po zabiegach pomostowania aortalno-wiencowego przy uzyciu testu 6-minutowego marszu.

UNLABELLED: Exercise capacity testing is a procedure that enables enrollment into cardiac rehabilitation (CR) and CR effects evaluation. Six minute walk test (6MWT) is an easy and measurable method of exercise capacity assessment in patients after acute coronary syndrome (ACS). The aim of study was to evaluate effects of CR in patients after cardiac surgery for ACS using 6MWT MATERIAL AND METHODS: 50 patients (aged 41-65 years; mean age 56.7 +/- 9.1; 43 male and 7 female) after cardiac surgery for ACS NSTEMI were enrolled into the study. 6MWT was performed on admission and after the second stage of CR. RESULTS: The mean 6MWD (expressed in meters +/- SD) was 522.14 +/- 69.5 before CR and 584 +/- 70.8 after 4-week-long CR period (p < 0.05). The mean distance walked in patients before CR was 138,16% of recommended minimal value; in patients after CR was 154.37% of recommended minimal value, respectively, (p < 0.05). The mean distance walked by patients before CR was 98.26% of the recommended mean value; in patients after CR it was 109.83% of the recommended mean value, respectively (p < 0.05). None of the performed tests required interruption and none of the individuals required assistance during 6MWT. CONCLUSIONS. In patients after cardiac surgery 6MWT is a useful method of CR effects evaluation. Test is a well-tolerated and safe procedure for assessment of functional capacity in patients after cardiac surgery with an increased risk of ACS and reduced exercise capacity.

[Oxidative-reductive balance in patients after acute coronary syndrome that undergo cardiac rehabilitation]. / Ocena równowagi oksydacyjno-redukcyjnej krwi u chorych po ostrych zespolach wiencowych poddanych rehabilitacji kardiologicznej.

UNLABELLED: Cardiac rehabilitation is essential part of acute coronary syndrome (ACS) treatment. Controlled physical activity (both aerobic exercise and muscle-strengthening activities) is the most important part of cardiac rehabilitation (CR). There is a close relationship between regular physical exercise and secondary prevention in patients after ACS. However, influence of physical activity on antioxidative protection mechanisms and free radical reactions is not yet fully known. The aim of study was to evaluate CR effects (the second phase) on oxidative-reductive balance in patients after ACS hospitalised for CR. MATERIAL AND METHODS: Our study comprised 50 patients (32 male, 18 female), aged 42-75 years (56.42 +/- 8.34) after ACS treated by percutaneous transluminal coronary angioplasty (PTCA), that subsequently underwent the second phase of CR. Interval cycloergometer training was performed five times a week (in total 15 training sessions). In addition to interval training, patients underwent individual breathing exercises, relaxation exercises, isometric exercises of particular muscle groups and general rehabilitation twice a day. Thiobarbituric acid reactive substances (TBARS) level in erythrocytes, total antioxidant status (TAS) of plasma, superoxide dysmutase-1 (SOD-1), catalase (CAT) and glutathione peroxidase (GSH-Px) activity in erythrocytes were determined before and after CR programme. Statistical analysis of physical activity influence on oxidative-reductive balance was performed by Wilcoxon matched pairs test. P < 0.05 was acknowledged as statistically significant. RESULTS: After rehabilitation programme in patients after ACS following significant results were found: increase in SOD-1 activity compared to baseline values (3624.22 +/- 1003.38 U/gHb vs 3086.71 +/- 683.14 U/gHb; p = 0.007), increase in GSH-Px activity compared to baseline values (41.27+/- 13.87 U/gHb vs. 38.02 +/- 13.98 U/gHb; p = 0.006), decrease in CAT activity compared to baseline values (17.30 +/- 4.87 U/gHb vs. 19.64 +/- 4.36 U/gHb; p = 0.001), increase in TAS level compared to baseline values (2.00 +/- 0.75 mM/L vs. 1.66 +/- 0.71 mM/L; p = 0.003), increase in TBARS level compared to baseline values (0.21 +/- 0.05 microM/gHb vs. 0.19 +/- 0.03 microM/gHb; p = 0.0006). CONCLUSIONS: Improvement of antioxidative protection in patients after ACS was observed after cardiac rehabilitatiom programme. Increase in SOD-1 and GSH-Px activity in erythrocytes and TAS plasma level was found. Increase of TBARS level in erythrocytes in patients after ACS and subsequent cardiac rehabilitation is associated with intensification of free-radical chain reaction related to physical activity.

[Assessment of the clinical symptoms and treatment tolerance in patients with non-small cell lung cancer (NSCLC) undergoing first-line chemotherapy and pulmonary rehabilitation]. / Ocena stanu klinicznego I tolerancji leczenia u chorych na niedrobnokomórkowego raka pluca poddanych chemioterapii pierwszorzutowe i rehabilitacji oddechowej.

UNLABELLED: In Poland lung cancer is the most commonly occurring cancer type, both in men and women. Among the most important concerns related to this disease are clinical symptoms caused by deteriorating physical condition and intolerance to chemotherapy. The aim of this work was the assessment of the clinical symptoms and treatment tolerance in patients with non-small cell lung cancer (NSCLC) undergoing first-line chemotherapy and pulmonary rehabilitation. MATERIALS AND METHODS: 90 patients with inoperable NSCLC have undergone the examination. This included 69 men and 21 women aged between 46-75 years (average age 61.5 +/- 8.2 years). These were divided into 3 groups: group 1--30 patients undergoing standard chemotherapy; group II--30 patients undergoing standard chemotherapy and pulmonary rehabilitation; group Ill--30 patients undergoing standard chemotherapy and pulmonary rehabilitation with additional vitamin C supplementation. Clinical symptoms intensification was assessed using the ESAS scale (Edmonton Symptom Assessment System), by comparing the initial score with that after 6 weeks of chemotherapy in each individual. RESULTS: In groups II and III, where pulmonary rehabilitation was carried out, the intensification of the clinical symptoms and lowering of the tolerance for the treatment after 6 weeks of first-line chemotherapy were significantly lower (p < 0.05) than in group I. CONCLUSIONS. Pulmonary rehabilitation significantly limits the side effects of chemotherapy and the deterioration of the state of patients with NSCLC. Simultaneous supplementation with ascorbic acid increases the positive effects of pulmonary rehabilitation in those patients.

Blood gas analysis, blood saturation and chosen parameters of spirometric examination in NSCLC patients undergoing chemotherapy and pulmonary rehabilitation.

UNLABELLED: In industrialized countries lung cancer is associated with highest mortality among carcinoma. Progression of the disease is associated with diminished tolerance for physical activities, aggravated dyspnea and lowering of life quality. The aim of study was the evaluation of blood gas, blood saturation and chosen parameters of spirometric examination in NSCLC patients undergoing chemotherapy and pulmonary rehabilitation. Analysis of capillary blood was done using RapidPoint 405 Siemens device. Spirometric examination was done using PNEUMO abcMED device. MATERIAL AND METHODS: Forty-nine patients with inoperable NSCLC were subjected to the examination. This included 38 men and 11 women aged between 46-75 years (mean age 63 +/- 7.5 years) who were separated into two groups: group I--25 patients undergoing standard chemotherapy (group C); group II--24 patients undergoing standard chemotherapy and pulmonary rehabilitation (group CK). All patients were subjected to blood gas analysis, blood saturation analysis and spirometric examination twice, before and after first-line chemotherapy RESULTS: Increase of pO2 and SaO2 in blood, and FEV1 and FVC in spirometric examination was significantly higher in patients undergoing pulmonary rehabilitation and chemotherapy (group II) (p < 0.05) in comparison to NSCLC patients undergoing only chemotherapy (group I). CONCLUSIONS: Pulmonary rehabilitation of NSCLC patients undergoing first-line chemotherapy results in improvement of indicators of blood gas, blood saturation analysis and chosen parameters of spirometric analysis. Pulmonary rehabilitation in patients with lung cancer seems to be an important form of supplementary treatment.

[The impact of ascorbic acid on the concentrations of antioxidative vitamins in the plasma of patients with non-small cell lung cancer undergoing first-line chemotherapy]. / Wplyw kwasu askorbinowego na stezenie witamin antyoksydacyjnych w osoczu chorych na niedrobnokomórkowego raka pluca poddanych chemioterapii pierwszorzutowej.

UNLABELLED: One of the main after-effects of chemotherapy used in cancer treatment is an augmented production of reactive oxygen species (ROS). In turn ROS become a source of unwanted side effects of chemotherapy, often forcing the discontinuation of the therapy. Ascorbic acid (vitamin C), being an antioxidant, can strengthen the antioxidative barrier of an organism. The aim of the study was an assessment of the concentrations of A, C and E vitamins in the plasma of NSCLC patients undergoing chemotherapy supplemented with vitamin C. MATERIAL AND METHODS: 25 first-line chemotherapy patients with inoperable NSCLC, including 19 men and 6 women aged between 37-73 years (average age 60.1 +/- 8.8 years) have undergone the examination. Their chemotherapy has been supplemented with ascorbic acid (vitamin C dose of 600 mg per 24 hours). Control group consisted of 24 healthy individuals, including 18 men and 6 women aged between 49-71 years (average age 59.5 +/- 6.6 years). In cancer patients the concentration of A, C and E vitamins was assessed by spectrophotometry using T60V spectrophotometer (PG Instruments) before and after first-line chemotherapy which was supplemented with vitamin C. In control group the concentrations of antioxidative vitamins was assessed only once. RESULTS: In comparison to the control group the concentrations of the A, C and E vitamins in the plasma of NSCLC patients was significantly lower (p < 0.05). After 6 weeks of chemotherapy supplemented with vitamin C a significant rise of concentrations (p < 0.05) of all the vitamins tested for was observed. The biggest rise was noted for vitamin C (99.8%). CONCLUSIONS: The supplementation of the chemotherapy of NSCLC patients with C vitamin leads to rise of the low concentrations of A, C and E vitamins in the plasma. This suggests strengthening of the antioxidative barrier in patients.

[Assessment of concentrations of A, C and E vitamins in the plasma of patients with NSCLC undergoing first-line chemotherapy]. / Ocena stezenia witamin A, C i E w osoczu chorych na niedrobnokomórkowego raka pluca, poddanych chemioterapii pierwszorzutowej.

UNLABELLED: Lung cancer is one of the most common cancer types and it usually takes the form of non-small cell lung cancer (NSCLC). ROS take part in the process of carcinogenesis. What more, chemotherapy used in cancer treatment augments their production, leading to the weakening of the antioxidative barrier. As a result in cancer patients undergoing chemotherapy the reduction-oxidation processes are imbalanced. Vitamins A, C and E form an important part of the nonenzymatic antioxidative barrier in humans. THE AIM OF THE STUDY was an assessment of concentrations of A, C and E vitamins in the plasma of patients with NSCLC before and after chemotherapy MATERIAL AND METHODS: 25 first-line chemotherapy patients with inoperable NSCLC have undergone examination, including 20 men and 5 women aged between 50-75 years (average age 62.6 +/- 6.1 years). 24 healthy individuals including 18 men and 6 women aged between 49-71 years (average age 59.5 +/- 6.6 years) formed a control group. In cancer patients the concentration of vitamins A, C and E was assessed by spectrophotometry using T60V spectrophotometer (PG Instruments) before and after first-line chemotherapy, while in control group it was assessed only once. RESULTS: The concentration of A, C and E vitamins in plasma of NSCLC patients was lower (p < 0.05) than in the control group. After 6 weeks of chemotherapy another significant drop in vitamin concentrations in NSCLC patients was observed (p < 0.05) and was biggest for vitamin C (39.1%). CONCLUSIONS: Lowering of A, C and E vitamins concentrations in the plasma of NSCLCpatients suggests a weakening of antioxidative barrier. Chemotherapy leads to further fall in the concentration of those vitamins in patients' plasma.

[Assessment the lifestyle in patients after recent acute coronary syndrome qualified for cardiac rehabilitation and in healthy subjects]. / Ocena stylu zycia chorych po swiezo przebytym ostrym zespole wiencowym zakwalifikowanych do rehabilitacji kardiologicznej oraz zdrowych.

UNLABELLED: Results of a lot of research indicate that preventive activities consisting in the fighting of risk factors have the greatest influence on the reduction of the incidence of ischaemic heart disease. THE AIM OF THE STUDY was to assess the lifestyle in patients after recent acute coronary syndrome (ACS) qualified for cardiac rehabilitation and in healthy subjects (with no diagnosis of coronary thrombosis). MATERIAL AND METHODS: The research included 86 patients, 64 men and 22 women aged 42-78 (mean age 61.7 +/- 9.6 years) after recent ACS, treated with PCI (percutaneous coronary interventions), and qualified for cardiac rehabilitation (stage II)--group I. The control group included 88 people, 54 men and 34 women aged 34-75 (mean age 56.2 +/- 9.7 years), who were clinically healthy--group II. The assessment of a lifestyle was performed based on the presence of four positive behaviours, i.e. eating appropriate amount of vegetables and (or) fruit every day, refraining from smoking, satisfactory levels of physical activity, and correct body mass. Based on these factors, a lifestyle index was calculated, from 0 (no positive health behaviours) to 4 (all positive health behaviours present), the so-called healthy lifestyle index. RESULTS: Among the examined elements of lifestyle index in ill and healthy subjects, satisfactory physical activity was the rarest (in 16.67% of men and in 9.09% women after ACS and in 16.22% of healthy men and 11.63% healthy women). Healthy lifestyle index was determined in 4.88% of patients after ACS. It was not found in healthy subjects. CONCLUSION: The analysis of the lifestyle index shows that a change of one's lifestyle is necessary as an initial and secondary prevention.

[Exercise testing to estimate dysfunction of the autonomic nervous system in subjects with carbohydrate disorders]. / Test wysilkowy w ocenie dysfunkcji autonomicznego ukladu nerwowego u osób z zaburzeniami gospodarki weglowodanowej.

UNLABELLED: Slow heart rate recovery (HRR) 2 minutes after exercise testing is a predictor of cardiovascular mortality and index of decreased parasympathetic activity. The aim of the study was to evaluate the heart rate recovery in subjects with carbohydrate disorders. MATERIAL AND METHODS: The study comprised 112 subjects with carbohydrate disorders (54 females and 58 males), aged 30-78 (57.4 +/- 9.6) years. Carbohydrate disorders were diagnosed according to the Polish Diabetes Association criteria from 2007 (group I). 56 subjects had impaired fasting glucose (IFG), 36 - impaired glucose tolerance (IGT) and 20 - type 2 diabetes. Comparative group comprised 30 subjects without cardiovascular diseases and carbohydrate disorders (15 females and 15 males), aged 29-64 (52.70 +/- 8.8) years (group II). The fasting serum glucose level was evaluated using an enzymatic method, Kone-Pro biochemical analyzer and bioMérieux Glucose RTU kit. In subjects with fasting glucose level > or = 100 mg/dl, an oral glucose tolerance test (OGTT) was performed. In all subjects submaximal exercise treadmill testing was performed. Heart rate recovery was defined as a difference between the peak heart rate and that after 2 minutes of recovery in sitting position. RESULTS: In subjects with carbohydrate disorders the mean value of HRR was 38.93 +/- 12.08/min and it was significantly lower (p < 0.05) than in comparative group (57.0 +/- 11.44/min). In subjects with carbohydrate disorders negative correlation between HRR and patients' age as well as between HRR and fasting glucose level in males. On the basis of ROC curve analysis and OR (odds ratio) it was shown that HRR < or = 43.5/min results in almost threefold increased risk of carbohydrate disorders. CONCLUSIONS: In subjects with carbohydrate disorders the value of HRR is lowered, what stands for decreased parasympathetic activity and increased cardiovascular risk. HRR < or = 43.5/min results in almost threefold increased risk of carbohydrate disorders.

[Heart rate recovery after exercise in subjects undergoing cardiologic rehabilitation]. / Szybkosc normalizacji czestosci rytmu serca po wysilku u osób poddanych rehabilitacjti kardiologicznej.

UNLABELLED: Research indicates that slow heart rate recovery 1-2 minutes after exercise is a predictor of cardiovascular mortality, sudden mortality as well. It is hardly related to myocardial ischemia; most of all, it is related to impaired activities of the parasympathetic system. The purpose of this study was to assess HRR in subjects after a surgical treatment (percutaneous coronary intervention - PCI) of acute coronary syndromes (ACS), undergoing cardiologic rehabilitation. MATERIALS AND METHODS: The study comprised 58 subjects, 42 men and 16 women aged 49-68 (56.8 +/- 7.6) after ACS treated with PCI undergoing cardiologic rehabilitation (stage 2)--group I. The comparative group comprised 34 subjects, 25 men and 9 women aged 46-61 (55.5 +/- 8.9 lat) who were clinically healthy and who underwent a single sub-maximal exercise test--group II. In subjects undergoing rehabilitation, an exercise test was performed twice --before and after stage 2 of rehabilitation. HRR was defined as a difference between the peak heart rate and those after the 1st (HRR1) and 2nd (HRR) minute of recovery. RESULTS: After stationary rehabilitation as a part of stage 2 of cardiologic rehabilitation, HRR2 was 26.3 +/- 10.6/min and was 40.8/min +/- 13.8/min; both these values were not significantly different from values observed in healthy subjects (p > 0.05). Significant increase in HRR1 and HRR2 was observed after the completion of stage 2 of cardiologic rehabilitation in ill subjects (p < 0.05) as compared to initial values. CONCLUSIONS: In subjects after ACS treated with PCI, it is observed that HRR changes back to normal values observed in healthy subjects as a result of underwent cardiologic rehabilitation. HRR should become an important factor in assessing effectiveness of conducted cardiologic rehabilitation.

[Vascular complications in patients with metabolic syndrome]. / Powiklania naczyniowe u chorych na zespól metaboliczny.

UNLABELLED: All risk factors of metabolic syndrome (MS) are responsible for endothelial dysfunction what accelerate the development of atherosclerosis. It causes increased cardiovascular risk and development of cardiovascular complications in these subjects. The aim of the study was to assess the presence of vascular complications in subjects with MS. MATERIAL AND METHODS: The study comprised of 108 patients with metabolic syndrome (36 males and 72 females), aged 46-67 (57+/-8.5) years. MS was diagnosed according to the International Diabetes Federation criteria from 2005. Ischaemic heart disease was diagnosed according to the coronarography or patient care documentation. The assessment of nephrological complications was conducted with use of glomerular filtration rate (eGFR) calculated by using the simplified Modification of Diet in Renal Disease Study (MDRD) equation. The occurrence of brain strokes and diabetic foot was estimated basing on medical history and documentation. Vascular complications in the bottom of the eye were assessed with ophtalmoscopic examination and fluorescein angiography. RESULTS: The frequency of vascular complications in subjects with MS was: vascular complications in the bottom of the eye - 72.7% (symptoms of vascular angiopathy without retinopathy - 41.2%, retinopathy - 31.5%), ischaemic heart disease - 54.9%, eGFR < 90 m/min. - 38.9%, diabetic foot - 5.55%. brain stroke - 3.7%. Ischaemic heart disease was present in all subjects with MS qualified to the second and higher class of retinopathy. CONCLUSIONS: In patients with MS, ischaemic heart disease was the most common macroangiopathic complication, with increasing in the frequency together with retinopathy intensification. Changes in the bottom of the eye were the most common microangiopathic complications. Early identification and treatment of metabolic syndrome may have important value in prophylaxis and delay of vascular complications.

[Tissue inhibitor of metalloproteinases-1 level in patients with metabolic syndrome qualified for cardiac rehabilitation]. / Ocena stezenia tkankowego inhibitora metaloproteinaz u chorych na zespól metaboliczny zakwalifikowanych do rehabilitacji kardiologicznej.

UNLABELLED: Each year in Poland, the number of patients treated by PCI and CABG increases. Many of them have metabolic syndrome. After these procedures patients are qualified for cardiac rehabilitation. It is preceded by risk stratification for cardiac events. Metalloproteinases belong to the enzymes responsible for destabilization of atheroma plaques. The activity of metalloproteinases is tightly regulated by their inhibitors. The aim of the study was to estimate plasma tissue inhibitor of metalloproteinases-1 (TIMP-1) level in patients with metabolic syndrome qualified for cardiac rehabilitation after PCI procedures. MATERIAL AND METHODS: The study comprised of 50 subjects with metabolic syndrome (26 males, 24 females) aged 18-65 (mean 50.9+/-11.8) years, qualified for cardiac rehabilitation after PCI procedures and 25 healthy participants (13 males, 12 females) aged 21-55 (mean 50.2+/-12.8) years. The estimation of plasma TIMP-1 level was determined with use of R&D Systems kit. RESULTS: Plasma level of tissue inhibitor of metalloproteinases-1 in subjects with metabolic syndrome was 119.1+/-15.3 ng/ml and it was significantly lower than in group of healthy participants (188.5+/-14.7 ng/ml (p<0.001). CONCLUSIONS: Decreased plasma level of tissue inhibitor of metalloproteinases-1 in subjects with metabolic syndrome qualified for cardiac rehabilitation indicates disturbances of metalloproteinases activity control which take part in destabilization of atheroma plaque. In cardiac rehabilitation of subjects with metabolic syndrome we should pay attention to the type, time and intensity of exercise, because of increased risk of cardiovascular events.

[Plasma nitric oxide and vascular endothelial growth factor levels in patients with metabolic syndrome and co-existing vascular complications]. / Stezenie tlenku azotu i naczyniowo-sródblonkowego czynnika wzrostu w osoczu chorych na zespól metaboliczny ze wspólistniejacymi powiklaniami naczyniowymi.

UNLABELLED: Subjects with metabolic syndrome (MS) are especially exposed to co-existing several cardiovascular risk factors. It's aggregated action leads to the endothelial damage. Tissue hipoxaemia increases VEGF synthesis. NO may also play the crucial role in VEGF synthesis The balance between factors increasing and decreasing VEGF synthesis has special importance in development of vascular complications. The aim of the study was to estimate plasma nitric oxide (NO) and vascular endothelial growth factor (VEGF) levels in patients with metabolic syndrome and vascular complications. MATERIAL AND METHODS: The study was conducted in two groups of patients. I Group--54 patients with metabolic syndrome (diagnosed according to the IDF criteria from 2005) and macro- and microvascular complications, aged 46-67 (58 +/- 6.7) years. II Group--20 healthy subjects, aged 40-61 (51 +/- 5.1) years. Plasma levels of NO and VEGF were determined in all participants. RESULTS: Plasma level of nitric oxide in subjects with metabolic syndrome and vascular complications was 6.48 +/- 1.5 micromol/l and in healthy participants 10.08 +/- 1.09 micromol/l (p < 0.05). Plasma level of vascular endothelial growth factor in subjects with metabolic syndrome and vascular complications was 193.45 +/- 131.0 pg/ml and in healthy participants 71.09 +/- 14.49 pg/ml (p < 0.05). CONCLUSIONS: Endothelial dysfunction seems to be the substantial factor responsible for the vascular complications in subjects with metabolic syndrome, which manifests in increased plasma level of VEGF and decreased plasma level of NO.