FUNCTIONAL CHARACTERISTICS OF THE CARDIOVASCULAR SYSTEM OF PATIENTS WITH ISCHEMIC HEART DISEASE WITH OBESITY.

OBJECTIVE: The aim: To determine the features of the functional characteristics of the cardiovascular system of patients with ischemic heart disease with obesity. PATIENTS AND METHODS: Materials and methods: Examined 130 persons (mostly military personnel and persons who were in the zone of active hostilities): 65 patients (the main group, 62,67±8,93 years) with coronary heart disease and obesity and 45 people of the control group (virtually healthy people, randomized by age and sex, 58,76±14,6 years). RESULTS: Results: Coronary heart disease and obesity compared to healthy individuals probably the exceed all values of the functional state of the cardiovascular system: systolic blood pressure (152.72±14.61 and 119.03±7.94 mmHg; p<0.001); diastolic blood pressure (90.74±7.36 and 80.36±6.74 mmHg; p<0.001); end-diastolic volume (103.17±40.84 and 52.48±8.58 mm3; р<0.001); end-systolic volume (47.98±29.92 and 31.47±8.42 mm3; р=0.001); end-diastolic size (4.74±0.81 and 4.12 ± 0.27 cm; р<0.001); end-systolic size (3.34±0.76 and 3.17±0.59 cm; р=0.014). CONCLUSION: Conclusions: The identified functional disorders of the heart in the comorbid course of coronary heart disease and obesity can be used for early diagnosis of cardiovascular complications in such patients and for the development of adequate therapeutic schemes.

PATHOMORPHOLOGICAL FEATURES OF GASTROESOPHAGEAL REFLUX DISEASE REALIZATION IN YOUNG PEOPLE WITH AUTOIMMUNE THYROIDITIS.

OBJECTIVE: The aim: To evaluate the pathomorphological features of the esophageal mucous membrane in young people with GERD and autoimmune thyroiditis. PATIENTS AND METHODS: Materials and methods: 120 patients with GERD and AIT and 45 people with isolated GERD matched for age, gender and social status were examined. Esophagogastroduodenoscopy, histological study and comparative morphometry of the esophageal mucosa were performed. RESULTS: Results: The frequency of erosive GERD in the examined groups of patients did not statistically differ. At the same time, integral analysis of the structure of erosive forms of GERD revealed statistically significant redistribution of grades of esophagitis towards its enhancement in patients with comorbid pathology. The histological study showed that in patients with GERD and AIT all the morphometric parameters studied had a significantly more severe course and exceeded similar indicators of the group with isolated GERD: epithelium total thickness, epithelium basal layer thickness, connective tissue papillae height, intercellular space. The analysis of morphological changes frequency showed that epithelium basal layer hyperplasia, dystrophic changes and epithelial edema, elongation of papillae and dilation of intercellular space were significantly more frequent in the group with comorbid pathology. CONCLUSION: Conclusions: GERD and euthyroid AIT comorbidity in the student population is accompanied by a statistically significant redistribution of esophagitis grades towards its aggravation. The presence of concomitant euthyroid AIT in patients with non-erosive GERD leads to statistically more pronounced disorganization of esophageal mucosal epithelium.

SELENIUM-ASSOCIATED MECHANISMS OF PROGRESSION OF NONALCOHOLIC FATTY LIVER DISEASE IN HYPERTENSIVE PATIENTS.

OBJECTIVE: The aim: To determine the role of selenium and Selenoprotein P in the intensification of inflammation processes, deviations of the functional state of the liver and the progression of changes in its parenchyma in patients with NAFLD and hypertension. PATIENTS AND METHODS: Material and methods: Study included 100 gender and age matched NAFLD patients: 49 (67.3 % women) hypertensive (main group) and 51 (58.8 % women) non-hypertensive NAFLD patients. 20 individuals (55.0 % women) formed control group. Diagnosis of NAFLD and hypertension was made according to respective guidelines. All patients underwent measurement of liver transferases, selenium, Selenoprotein P, IL-8 and IL-10. RESULTS: Results: In both study groups, ALT and AST levels were significantly predominant in patients with steatohepatitis than steatosis. Increase in IL-8 and IL-10 was found in main study groups but not in subgroup analysis. In hypertensive NAFLD patients with steatosis, ALT correlated with selenium and Selenoprotein P. A direct correlation was between the de Ritis index and IL-8. Selenium correlated with IL-8 but not IL-10. Selenoprotein P correlated inversely with IL-8 and directly with IL-10. CONCLUSION: Conclusions: Intensification of inflammation and depletion of antioxidant protection under presence of hypertension deepen redox violations in NAFLD patients. Such changes can be only partially compensated by anti-inflammatory and antioxidative activity. Selenium and Selenoprotein P are important substances in progression of NAFLD and should be assessed regarding diagnosis and treatment of NAFLD patients.

TOTAL ANTIOXIDANT ACTIVITY AND MANGANESE SUPEROXIDE DISMUTASE IN COMORBIDITY OF GASTROESOPHAGEAL REFLUX DISEASE AND AUTOIMMUNE THYROIDITIS IN STUDENT POPULATION.

OBJECTIVE: The aim: To determine the state of total antioxidant activity and the content of the mitochondrial enzyme - manganese superoxide dismutase in students with gastroesophageal reflux disease (GERD) and autoimmune thyroiditis (AIT) comorbidity. PATIENTS AND METHODS: Materials and methods: 120 patients with GERD and AIT, 45 patients with GERD and 42 patients with AIT were examined. The patients involved in the study were students. The international standardized GerdQ questionnaire was used. Total antioxidant activity and manganese superoxide dismutase levels were determined. RESULTS: Results: The study showed that comorbidity of GERD and AIT was accompanied with a significant increase in the frequency and intensity of heartburn, sleep disorders and the use of additional medications to relieve symptoms. Patients with GERD and AIT had significantly lower total antioxidant activity than patients with isolated GERD and isolated AIT. At the same time, the manganese superoxide dismutase level was significantly higher in group with comorbidity than in patients with isolated diseases. CONCLUSION: Conclusions: The presence of concomitant AIT in patients with GERD among the student population contributes to some deviations in the clinical characteristics, inhibition of total antioxidant activity and activation of manganese superoxide dismutase.