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Polymorphisms of the ATP-binding cassette sterol efflux transporter genes g5 and g8 in cardiovascular diseases and type 2 diabetes mellitus 心血管疾病和 2 型糖尿病中 ATP 结合盒甾醇外排转运体基因 g5 和 g8 的多态性
Pub Date : 2024-03-15 DOI: 10.52727/2078-256x-2024-20-1-6-15
I. N. Grigor’eva, T. Notova, T. Suvorova, D. Nepomnyashchikh
Mutations with a decrease in the expression and function of the of the ATP-binding cassette genes proteins ABCG5 and ABCG8, as the main sterol efflux transporters, lead to the accumulation of xenosterols in plasma associated with changes in the lipid profile, hyperglycemia and the risk of cardiovascular diseases (CVD) and type 2 diabetes mellitus (DM2). The review presents studies of the role of ABCG5/G8 polymorphisms in CVD and DM2. In several studies, including large–scale ones, the influence of ABCG5/G8 variants (rs4245791, rs41360247 rs4299376, rs11887534, rs7598542, rs78451356, etc.) on the risk of coronary heart disease (CHD) was proved, in others – when confirming the association of the risk of CHD with ABCG5 polymorphism, this status for ABCG8 was denied. Since sterol metabolism disorders observed in individuals with DM2 are probably associated with low insulin sensitivity, many authors confirmed the association of variants rs4299376, rs4148211, rs140231607 and rs6720173 of the ABCG5/G8 with the risk of DM2, but some authors did not find such a connection with DM2 for variants rs4299376, rs11887534 and rs4148217 of the ABCG8. A decrease in ABCG5/G8 mRNA expression was observed in DM2 in experimental animals and in humans; on the contrary, overexpression of ABCG5/G8 in db/db mice restored the sensitivity of the liver to insulin, which led to a decrease in fasting glucose, lipids and improved glucose tolerance. The inconsistency of data on the association of ABCG5/G8 gene polymorphism with the risk of CVD and DM2 may probably be due to inter-population differences, which necessitates further study of the contribution of ABCG5/G8 variants to the risk of these diseases.
ATP结合盒基因蛋白ABCG5和ABCG8是主要的固醇外排转运体,如果发生突变,其表达和功能就会下降,导致血浆中异甾醇的积累,从而引起血脂变化、高血糖以及心血管疾病(CVD)和2型糖尿病(DM2)的风险。本综述介绍了有关 ABCG5/G8 多态性在心血管疾病和 DM2 中作用的研究。在一些研究(包括大规模研究)中,ABCG5/G8 变体(rs4245791、rs41360247、rs4299376、rs11887534、rs7598542、rs78451356 等)对冠心病(CHD)风险的影响得到了证实,而在另一些研究中,当证实冠心病风险与 ABCG5 多态性有关时,却否认了 ABCG8 的这一地位。由于在 DM2 患者中观察到的固醇代谢紊乱可能与胰岛素敏感性低有关,许多作者证实了 ABCG5/G8 的变异体 rs4299376、rs4148211、rs140231607 和 rs6720173 与 DM2 风险的关联,但有些作者没有发现 ABCG8 的变异体 rs4299376、rs11887534 和 rs4148217 与 DM2 的关联。在实验动物和人类的 DM2 中观察到 ABCG5/G8 mRNA 表达减少;相反,在 db/db 小鼠中过表达 ABCG5/G8 可恢复肝脏对胰岛素的敏感性,从而导致空腹血糖和血脂下降,并改善葡萄糖耐量。ABCG5/G8基因多态性与心血管疾病和DM2风险相关性的数据不一致可能是由于人群间的差异造成的,因此有必要进一步研究ABCG5/G8变体对这些疾病风险的贡献。
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引用次数: 0
Possibilities of non-drug treatment methods in the correction of dyslipidemia and manifestations of individual components of the metabolic syndrome 非药物治疗方法在纠正血脂异常和新陈代谢综合征各组成部分表现方面的可能性
Pub Date : 2024-03-15 DOI: 10.52727/2078-256x-2024-20-1-24-34
V. Drobyshev, L. A. Shpagina, I. I. Logvinenko, L. Agasarov, S. Abramovich, E. A. Zaikina, N. P. Kareva
Aim of the study was to identify the place of low-intensity electro-pulse therapy with biofeedback when it is included in the rehabilitation complex of patients with abdominal obesity to correct the quality of life and individual components of the metabolic syndrome.Material and methods. In the conditions of the outpatient diagnostic center of City Clinical Hospital No. 2 of Novosibirsk, 60 men and women with abdominal obesity, arterial hypertension and insulin resistance were examined, divided into 3 groups: 1st (main group, n = 25) in addition for standard therapy received a 15-day course of dynamic electroneurostimulation (DENS) from the Neurodance-PCM device; the 2nd (comparison group 1, n = 20), in addition to the basic complex, received DENS procedures from a placebo device, the 3rd (comparison group 2, n = 15) was treated with the use of only a basic therapeutic complex. The control group included 17 men and women without clinical manifestations from the endocrine and cardiovascular systems. The examination included examinations by an endocrinologist, a nutritionist, anthropometry and bioimpedance, assessment of quality of life parameters.Results. In group 1 patients, 1 month after the start of rehabilitation, there was a greater tendency than in the comparison groups to decrease the body mass index by 9.0 %, a correction of the percentage content in the body structure of fat mass by 1.4 times (p = 0.029) occurred, preprandial glycemia decreased by 1.4 times (p = 0.043) and the level of triglycerides in the blood serum – by 1.4 times (p = 0.044), the increased concentration of free leptin and resistin decreased (1.2 times, p = 0.039), the content of adiponectin in the blood serum increased by 1.2 times (p = 0.041), the quality of life improved 1 month after the start of rehabilitation according to the components of physical and psychological health, which is not observed in the placebo and standard treatment groups.Conclusions. The inclusion   of DENS from the Neurodance-PCM device   in the comprehensive rehabilitation of patients with abdominal obesity can contribute to the correction of anthropometry, bioimpedance, carbohydrate and adipokine metabolism indicators. This makes it possible to recommend the inclusion of low-intensity electro-pulse therapy in complex rehabilitation for the correction of quality of life indicators and individual components of the metabolic syndrome.
该研究旨在确定低强度电脉冲疗法与生物反馈疗法在腹部肥胖症患者康复综合治疗中的位置,以改善生活质量和代谢综合征的个体成分。材料和方法材料和方法:在新西伯利亚市第二临床医院门诊诊断中心的条件下,60名患有腹部肥胖、动脉高血压和胰岛素抵抗的男性和女性接受了检查,并分为3组:第一组(主要组,n = 25)除接受标准治疗外,还接受为期15天的神经电刺激(DENS)疗程;第二组(对比组1,n = 20)除接受基本综合治疗外,还接受安慰剂设备的DENS疗程;第三组(对比组2,n = 15)仅接受基本综合治疗。对照组包括17名没有内分泌和心血管系统临床表现的男性和女性。检查包括内分泌科医生、营养学家、人体测量、生物阻抗、生活质量参数评估。第一组患者在开始康复治疗 1 个月后,体重指数比对比组降低了 9.0%,身体结构中脂肪含量的百分比降低了 1.4 倍(p = 0.029),餐前血糖降低了 1.4 倍(p = 0.043),血清中甘油三酯的水平降低了 1.4 倍(p = 0.044)。044),游离瘦素和抵抗素的浓度降低(1.2 倍,p = 0.039),血清中脂肪连通素的含量增加了 1.2 倍(p = 0.041),根据身体和心理健康的组成部分,康复开始 1 个月后生活质量有所改善,这在安慰剂组和标准治疗组中没有观察到。在腹部肥胖症患者的综合康复治疗中加入神经ance-PCM装置的DENS,有助于纠正人体测量、生物阻抗、碳水化合物和脂肪因子代谢指标。因此,建议将低强度电脉冲疗法纳入综合康复治疗,以纠正生活质量指标和代谢综合征的各个组成部分。
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引用次数: 0
Contribution of new coronavirus infection to the development of cardiovascular diseases (systematic review) 新型冠状病毒感染对心血管疾病发展的影响(系统综述)
Pub Date : 2024-03-15 DOI: 10.52727/2078-256x-2024-20-1-42-54
N. E. Apartseva, A. D. Khudiakova
In 2020, the National Institute for Health and Care Excellence in the UK   proposed   the concept of post-Covid syndrome. One of the main manifestations of the post-COVID syndrome are cardiovascular diseases (CVD) and dyslipidemia. However, the pathogenetic patterns of CVD development in COVID-19 convalescents remain unclear. The purpose of the systematic review was to analyze research data on the contribution of past new coronavirus infection to the development of dyslipidemia and atherosclerosis-associated diseases (AAD) in the post-COVID period. 106 publications were selected for analysis. After excluding clinical cases, drug studies, literature reviews and publications devoted to the acute period of COVID-19, a total of 19 articles were selected from Russian and international search engines. Analysis of studies has led to the conclusion that COVID-19 infection makes a significant contribution to the development of new AADs and worsening existing. One of the most likely mechanisms for occurrence of this phenomenon seems to be the development of endotheliitis against the background of the course of COVID-19, however, there are not enough works devoted to this problem.
2020 年,英国国家健康与护理卓越研究所提出了后科维德综合征的概念。后科维德综合征的主要表现之一是心血管疾病(CVD)和血脂异常。然而,COVID-19 康復者心血管疾病的發病模式仍不清楚。本系统性综述的目的是分析有关过去新型冠状病毒感染对后 COVID 时期血脂异常和动脉粥样硬化相关疾病(AAD)发展的贡献的研究数据。共选取了 106 篇文献进行分析。在排除了临床病例、药物研究、文献综述和专门论述 COVID-19 急性期的出版物后,从俄罗斯和国际搜索引擎上共筛选出 19 篇文章。研究分析得出的结论是,COVID-19 感染对新的急性呼吸道感染的发展和现有感染的恶化做出了重要贡献。这种现象最有可能的发生机制之一似乎是在 COVID-19 病程背景下内皮炎症的发展,但专门研究这一问题的著作并不多。
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引用次数: 0
Assessment of the association of the rs12329760 polymorphism of the TMPRSS2 gene with acute coronary syndrome in patients with new coronavirus infection 评估 TMPRSS2 基因 rs12329760 多态性与新冠状病毒感染患者急性冠状动脉综合征的关系
Pub Date : 2024-03-15 DOI: 10.52727/2078-256x-2024-20-1-35-41
V. A. Kozik, L. A. Shpagina, I. Shpagin, S. V. Maksimova, N. G. Lozhkina, V. N. Maksimov
Introduction. Cardiovascular diseases (СVD) rank first in terms of morbidity and mortality not only in the Russian Federation but throughout the world. Since the end of 2019 a pandemic of Severe Acute Respiratory Syndrome (SARS) or new coronavirus infection (NCI) has spread throughout the world, which contributed to the development and course of CVD. Therefore, genetic markers began to be considered as factors potentially influencing CVD, its development and severity. Objective: To evaluate the association of the nucleotide sequence variant rs12329760 of the TMPRSS2 gene with acute coronary syndrome in patients who have had a new coronavirus infection.Material and methods. The study included 100 patients (women – 50, men – 50) with ACS and previous NCI, who were selected on the basis of a positive PCR test for the presence of SARS-CoV-2 in the anamnesis, hospitalized at the regional vascular center No. 7 of the City Clinical Hospital No. 2 of the city of Novosibirsk. Women age was 59.5 ± 7.2 years, men age was 53.5 ± 9.3 years. The diagnosis of ACS was established according to a set of criteria proposed and established by the Russian Society of Cardiology and in accordance with the updated clinical recommendations of the Ministry of Health of the Russian Federation of 2020. Patients underwent clinical and instrumental examination, coronary angiography with possible stenting, as provided for in the standards of medical care and clinical guidelines. The nucleotide sequence variant rs12329760 of the TMPSS2 gene was determined in patients using PCR with further analysis of restriction fragment length polymorphism. The comparison group consisted of 200 patients with ACS without previous NCI (no positive PCR test, no positive antibodies).Results. Carriage of CC, СТ, TT, genotype variants of the nucleotide sequence rs12329760 of the TMPSS2 gene are not associated with an increased risk of developing ACS in patients with previous NCI. When comparing the frequencies of the rs12329760 genotypes of the TMPSS2 gene in groups with ACS with NCI and ACS without NCI, no statistically significant differences were obtained. In the group with ACS with NCI, carriage of the homozygous genotype was more common (p = 0.011).Conclusions. Variants of the nucleotide sequence rs12329760 of the TMPSS2 gene are  not associated with  ACS with previous  NCI.
导言。心血管疾病(СVD)不仅在俄罗斯联邦,而且在全世界都是发病率和死亡率最高的疾病。自 2019 年年底以来,严重急性呼吸系统综合征(SARS)或新型冠状病毒感染(NCI)大流行已蔓延至世界各地,这对心血管疾病的发展和进程起到了推波助澜的作用。因此,遗传标记开始被视为可能影响心血管疾病及其发展和严重程度的因素。研究目的评估 TMPRSS2 基因核苷酸序列变异 rs12329760 与新感染冠状病毒患者急性冠状动脉综合征的相关性。研究对象包括在新西伯利亚市第二临床医院第 7 区域血管中心住院治疗的 100 名患有急性冠状动脉综合征并曾感染新冠状病毒的患者(女性 50 人,男性 50 人),这些患者的病历中 SARS-CoV-2 PCR 检测结果呈阳性。女性年龄为 59.5 ± 7.2 岁,男性年龄为 53.5 ± 9.3 岁。急性冠状动脉综合征的诊断是根据俄罗斯心脏病学会提出和制定的一套标准以及俄罗斯联邦卫生部 2020 年更新的临床建议确定的。根据医疗标准和临床指南的规定,患者接受了临床和仪器检查、冠状动脉造影术和可能的支架植入术。通过聚合酶链式反应(PCR)和限制性片段长度多态性进一步分析,确定了患者 TMPSS2 基因的核苷酸序列变异 rs12329760。对比组包括200名既往无NCI(PCR检测无阳性、抗体无阳性)的ACS患者。TMPSS2基因核苷酸序列rs12329760的CC、СТ、TT基因型变异与既往患有NCI的ACS患者患病风险增加无关。在比较有 NCI 的 ACS 组和没有 NCI 的 ACS 组中 TMPSS2 基因 rs12329760 基因型的频率时,没有发现统计学上的显著差异。在患有 ACS 并伴有 NCI 的人群中,携带同源基因型的情况更为常见(p = 0.011)。结论:TMPSS2基因核苷酸序列rs12329760变异与既往患有NCI的ACS无关。
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引用次数: 0
Association of pro-atherogenic risk factors with thyroid-stimulating hormone level in women 25–44 years old 促甲状腺激素水平与 25-44 岁女性致动脉粥样硬化风险因素的关系
Pub Date : 2024-03-15 DOI: 10.52727/2078-256x-2024-20-1-16-23
V. I. Alferova, S. Mustafina, O. Rymar, L. V. Shcherbakova, S. M. Voevoda, E. Stakhneva, D. Denisova
Thyroid hormones play an important role in regulating metabolism. A large body of literature suggests an increased risk of developing metabolic syndrome (MS) in individuals with hypothyroidism, but little data exists on the effects of high-normal levels of thyroid-stimulating hormone (TSH) on metabolism.Material and methods. The study was conducted on a representative sample of people aged 25–44 years (n = 1513, of which 840 were women). The analysis included the results of 343 women. A questionnaire, anthropometric and biochemical study were carried out. Biochemical parameters were analyzed in quartiles of TSH content. Determination of MS was carried out using the criteria of NCEP ATP III (2001), IDF (2005), VNOK (2009).Results. TSH content in the examined sample was 1.5 [1.0; 2.2] mU/l (median [lower quartile; upper quartile]). Among women 25–44 years old, women with highly normal TSH level (3.1 [2.7, 3.8] mU/l) have less favorable metabolic parameters. MS was detected in 31 % cases, with a predominant increase in the frequency of abdominal obesity – in 51 %, with increased triglyceride levels in 18 %. Women with hypertriglyceridemia had higher TSH content than those with normal triglyceride levels (2.4 ± 1.6 vs. 1.8 ± 1.3 mU/L, respectively, p = 0.007).Conclusions. In women 25–44 years of age, high-normal TSH content is more often associated with metabolic unhealth.
甲状腺激素在调节新陈代谢方面发挥着重要作用。大量文献表明,甲状腺功能减退症患者患代谢综合征(MS)的风险增加,但关于高正常水平的促甲状腺激素(TSH)对新陈代谢的影响的数据却很少。研究对象为 25-44 岁的代表性样本(n = 1513,其中 840 人为女性)。分析包括 343 名女性的结果。进行了问卷调查、人体测量和生化研究。生化指标按 TSH 含量的四分位数进行分析。根据 NCEP ATP III(2001 年)、IDF(2005 年)和 VNOK(2009 年)的标准对 MS 进行了测定。受检样本的促甲状腺激素含量为 1.5 [1.0; 2.2] mU/l(中位数 [下四分位数; 上四分位数])。在 25-44 岁的女性中,促甲状腺激素水平高度正常(3.1 [2.7, 3.8] mU/l)的女性代谢指标较差。在 31% 的病例中发现了多发性硬化症,其中腹部肥胖的发病率明显增加,占 51%,甘油三酯水平升高的占 18%。高甘油三酯血症妇女的促甲状腺激素含量高于甘油三酯水平正常的妇女(分别为 2.4 ± 1.6 vs. 1.8 ± 1.3 mU/L,p = 0.007)。结论:在25-44岁的女性中,促甲状腺激素含量正常者多与代谢性疾病相关。
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引用次数: 0
Prevalence of “hidden” forms of chronic heart failure 隐性 "慢性心力衰竭的发病率
Pub Date : 2023-12-15 DOI: 10.52727/2078-256x-2023-19-4-457-468
E. A. Medvedeva, N. G. Lozhkina, Z. K. Zhilokov
The article discusses the prevalence of chronic heart failure and the possibility of its detection at an early, asymptomatic stage, when timely treatment can slow the progression of the disease. The data on the widely used and recognized biomarkers and their informative value for diagnostics of the “hidden: forms are presented, and also on the search of new markers. We used information on the topic from publications based on PubMed and Google Scholar databases, 5 years in depth.
文章讨论了慢性心力衰竭的发病率,以及在早期无症状阶段发现慢性心力衰竭的可能性,此时及时治疗可以延缓疾病的进展。文章介绍了广泛使用和公认的生物标志物的数据及其对诊断 "隐性:形式 "的信息价值,以及寻找新标志物的情况。我们使用了基于 PubMed 和 Google Scholar 数据库的 5 年深度出版物中的相关信息。
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引用次数: 0
Associations of Klotho protein level and blood lipid parameters with carotid atherosclerosis in men Klotho 蛋白水平和血脂参数与男性颈动脉粥样硬化的关系
Pub Date : 2023-12-15 DOI: 10.52727/2078-256x-2023-19-4-426-433
O. V. Timoshchenko, Yu. V. Shchepina, Yulia I. Ragino, E. Stakhneva, V. S. Shramko, A. N. Ryabikov
Aim of the study was to investigate the association of serum Klotho protein content and lipid parameters with atherosclerosis of the brachiocephalic arteries (BCA) in men.Material and methods. A cross-sectional comparative study that included men aged 50–65 years (n = 63, age 54 [53; 60] years (median [lower quartile; upper quartile])) underwent ultrasound examination of BCA at the outpatient department of the Institute of Internal and Preventive Medicine. Biochemical parameters were determined by standard enzymatic methods. Serum concentration of Klotho protein was measured by enzyme immunoassay.Results. A trend towards content of Klotho protein in serum was found in the group of persons with BCA atherosclerosis compared to the group without BCA atherosclerosis (705 [463; 1255] and 447 [282; 881] pg/ml, respectively, p = 0.061). Also, in men of this group, higher level of triglycerides (TG) (1.7 [1.1; 2.2] and 1.4 [0.9; 1.8] mmol/l, p = 0.046) and lower high-density lipoprotein cholesterol (HDL-C) content (1.1 [0.8; 1.3] m 1.4 [0.9; 1.6] mmol/l, p = 0.016) has been found. Correlation analysis in the group of men with BCA atherosclerosis revealed a direct relationship of Klotho protein with TG level (0.290; p = 0.031) and a negative relationship with HDL-C content (–0.361; p = 0.046). The results of logistic regression analysis showed that the probability of atherosclerotic plaques presence in BCA increased by 1.2 times (95 % confidence interval (95 % CI) 1.0–1.4, p = 0.038) with increasing age and by 9.2 times (95 % CI 2, 3–36.5, p = 0.002) in the presence of hypertension.Conclusions. In a clinical sample of men aged 50–65 years, the relative risk of carotid atherosclerosis is directly associated with age and the presence of hypertension and is not associated with the level of Klotho serum protein.
该研究旨在探讨男性血清Klotho蛋白含量和血脂参数与肱动脉(BCA)粥样硬化的关系。这是一项横断面比较研究,包括在内科和预防医学研究所门诊部接受肱动脉超声检查的 50-65 岁男性(n = 63,年龄 54 [53; 60] 岁(中位数 [下四分位数;上四分位数])。生化指标采用标准酶法测定。血清中 Klotho 蛋白的浓度通过酶联免疫法测定。与无 BCA 动脉粥样硬化的人群相比,BCA 动脉粥样硬化人群血清中 Klotho 蛋白的含量呈上升趋势(分别为 705 [463; 1255] pg/ml 和 447 [282; 881] pg/ml,P = 0.061)。此外,还发现该组男性甘油三酯(TG)水平较高(1.7 [1.1; 2.2] 和 1.4 [0.9; 1.8] mmol/l,p = 0.046),高密度脂蛋白胆固醇(HDL-C)含量较低(1.1 [0.8; 1.3] m 1.4 [0.9; 1.6] mmol/l,p = 0.016)。对 BCA 动脉粥样硬化男性组的相关性分析显示,Klotho 蛋白与 TG 水平有直接关系(0.290;p = 0.031),与 HDL-C 含量呈负相关(-0.361;p = 0.046)。逻辑回归分析结果显示,随着年龄的增长,BCA 中出现动脉粥样硬化斑块的概率增加了 1.2 倍(95 % 置信区间 (95 % CI) 1.0-1.4,p = 0.038),如果存在高血压,则增加了 9.2 倍(95 % CI 2,3-36.5,p = 0.002)。在 50-65 岁男性临床样本中,颈动脉粥样硬化的相对风险与年龄和高血压直接相关,而与 Klotho 血清蛋白水平无关。
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引用次数: 0
Atherogenic features of the fatty acid profile of erythrocyte membranes of patients with fatty liver disease of mixed genesis 混合型脂肪肝患者红细胞膜脂肪酸谱的致动脉粥样硬化特征
Pub Date : 2023-12-15 DOI: 10.52727/2078-256x-2023-19-4-350-368
M. Kruchinina, A. V. Belkovets, M. V. Parulikova, A. Gromov
Aim of the study was to investigate the features of the fatty acid (FA) profile of erythrocyte membranes of patients with fatty liver disease (FLD) of mixed genesis (metabolic + alcoholic) from the point of view of atherogenic changes.Material and methods. 31 men (50.6 ± 9.9 years old) with FLD of mixed genesis, the degree of liver fibrosis corresponded to 0-1 (FibroScan ® 502 Echosens, France), and 28 persons of the comparison group, comparable in age, were examined. The study of the composition of FAs of erythrocyte membranes was carried out using gas chromatography/mass spectrometry – a system based on three quadrupoles Agilent 7000B (USA).Results. Patients with FLD of mixed genesis had higher level of palmitoleic (p = 0.03), pentadecanoic (p = 0.05), omega-6 to omega-3 polyunsaturated fatter acids (PUFA) ratio (p = 0.03) and, conversely, lower level of docosahexaenoic (p = 0.0002), total content of eicosapentaenoic and docosahexaenoic FA (p = 0.0007), of all omega-3 PUFA (p = 0.001) in the membranes of erythrocytes compared to healthy persons. There are trends towards a decrease in the content of omega-3 eicosapentaenoic acid and an increase in the ratio of SFA/PUFA in patients with fibroids of mixed genesis in contrast to healthy individuals. The level of individual FA provided high diagnostic accuracy in differentiating patients with FLD of mixed genesis from healthy individuals: palmitoleic (9-C16:1) (area under ROC (AUC) 0.702, sensitivity 66.7 %, specificity 69.6 %), docosahexaenoic (C22:6n-3) (AUC 0.795, sensitivity 77.3 %, specificity 78.3 %), as well as the total content of eicosapentaenoic and docosegexaenoic FA (C20:5n-3 + C22:6n-3) (AUC 0.777, sensitivity 70.1 %, specificity 82.6 %).Conclusions. The revealed features of the profile of erythrocyte membrane FA in FLD of mixed genesis – increase of saturated, monounsaturated, omega-6 PUFA content and reduce of omega-3 PUFA concentration are atherogenic. The continuation of research in terms of the use of FAs as biomarkers of this pathology and targets for therapeutic effects should be considered promising.
该研究的目的是从动脉粥样硬化变化的角度研究混合型脂肪肝(代谢性+酒精性)患者红细胞膜脂肪酸(FA)谱的特征。对 31 名混合型脂肪肝患者(50.6 ± 9.9 岁)(肝纤维化程度为 0-1 级)(FibroScan ® 502 Echosens,法国)和 28 名年龄相当的对比组患者进行了检查。使用气相色谱/质谱--基于三个四极的 Agilent 7000B 系统(美国)对红细胞膜的脂肪酸组成进行了研究。混合型FLD患者的棕榈油酸(p = 0.03)、十五烷酸(p = 0.05)、ω-6与ω-3多不饱和脂肪酸(PUFA)的比率(p = 0.03),相反,与健康人相比,红细胞膜中二十二碳六烯酸(p = 0.0002)、二十碳五烯酸和二十二碳六烯酸脂肪酸总含量(p = 0.0007)以及所有欧米伽-3 多不饱和脂肪酸(p = 0.001)的含量较低。与健康人相比,混合性子宫肌瘤患者的ω-3二十碳五烯酸含量呈下降趋势,SFA/PUFA比例呈上升趋势。单个脂肪酸水平在区分混合成因的 FLD 患者和健康人方面具有很高的诊断准确性:棕榈油酸(9-C16:1)(ROC 下面积(AUC)为 0.702,灵敏度为 66.7%,特异性为 69.6 %)、二十二碳六烯酸(C22:6n-3)(AUC 0.795,灵敏度 77.3 %,特异性 78.3 %)以及二十碳五烯酸和二十二碳六烯酸脂肪酸(C20:5n-3 + C22:6n-3)的总含量(AUC 0.777,灵敏度 70.1 %,特异性 82.6 %)。混合型前列腺增生症患者红细胞膜脂肪酸谱的特征--饱和、单不饱和、ω-6 PUFA 含量增加,而ω-3 PUFA 浓度降低--具有致动脉粥样硬化性。将脂肪酸用作这种病理现象的生物标志物和治疗效果的靶点,继续进行这方面的研究是很有希望的。
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引用次数: 0
Sex differences in adherence to treatment in patients with myocardial infarction 心肌梗死患者坚持治疗的性别差异
Pub Date : 2023-12-15 DOI: 10.52727/2078-256x-2023-19-4-414-425
D. Sedykh, O. Barbarash
The aim of the study is to identify factors affecting adherence to treatment in men and women with myocardial infarction (MI).Material and methods. The study included 150 patients diagnosed with MI (47 women and 103 men). Treatment readiness was assessed according to the S.V. Davydov method and with the calculation of the integral indicator of adherence to treatment (IIAT).Results. During 6-month follow-up, men and women with MI were comparable in mortality rates, however, men were more frequently hospitalized for cardiovascular complications. Adherence to treatment was high in both genders. Treatment readiness at the time of MI indicated higher satisfaction with the results of treatment in women, and higher willingness to pay for treatment, higher confidence in the treatment strategy and a higher IIAT in men. Both women and men with MI reported a comparable number of outpatient visits within 6 months (not exceeding 56 %). Only small number of patients reached the target heart rate (HR) and low-density lipoprotein (LDL) content within 6 months. Patients of both genders who reached and not reached the target LDL level and HR did not differ in mortality rates, hospitalizations and adherence to treatment within 6 months. At the same time, patients who reached the target HR, regardless of gender, were more likely to make outpatient postMI visits compared with those who did not reach the targets; men with MI who did not achieve the target HR were less likely to visit a doctor, whereas women with MI who achieved the target HR and LDL were more likely to have a high IIAT during in-patient care and were more willing to pay for further treatment (an exclusive characteristic of women who reached target HR). Moreover, we have identified predictors of IIAT and achievement of HR and LDL in women and men with MI.Conclusions. Patients with MI present with sex-specific factors that are affecting treatment adherence, which should be accounted for in the development of measures for secondary prevention of disease.
本研究旨在确定影响男性和女性心肌梗死(MI)患者坚持治疗的因素。研究对象包括 150 名确诊为心肌梗死的患者(47 名女性和 103 名男性)。根据 S.V. Davydov 方法和治疗依从性综合指标(IIAT)的计算方法对治疗准备情况进行了评估。在6个月的随访中,男性和女性心肌梗死患者的死亡率相当,但男性因心血管并发症住院的频率更高。男女患者的治疗依从性都很高。发生心肌梗塞时的治疗准备情况表明,女性对治疗结果的满意度更高,而男性则更愿意支付治疗费用,对治疗策略更有信心,IIAT也更高。患有心肌梗死的女性和男性在 6 个月内的门诊次数相当(不超过 56%)。只有少数患者在 6 个月内达到了目标心率(HR)和低密度脂蛋白(LDL)含量。在 6 个月内,达到和未达到目标低密度脂蛋白含量和心率的男女患者在死亡率、住院率和坚持治疗率方面没有差异。同时,达到目标 HR 的患者,无论性别如何,与未达到目标的患者相比,更有可能在MI 后进行门诊就诊;未达到目标 HR 的男性 MI 患者就医的可能性较低,而达到目标 HR 和 LDL 的女性 MI 患者在住院治疗期间更有可能出现高 IIAT,并且更愿意为进一步治疗付费(这是达到目标 HR 的女性患者的独有特征)。此外,我们还发现了女性和男性心肌梗死患者的 IIAT 以及达到 HR 和 LDL 目标的预测因素。心肌梗死患者存在影响治疗依从性的性别特异性因素,在制定疾病二级预防措施时应考虑到这些因素。
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引用次数: 0
Origin and formation of early changes in the retina under the influence of atherosclerosis factors 动脉粥样硬化因素影响下视网膜早期变化的起源和形成
Pub Date : 2023-12-15 DOI: 10.52727/2078-256x-2023-19-4-385-403
A. Y. Lazutkina
Lesions of the microcirculatory bed of the retina are an urgent problem due to their prevalence, severity of irreversible changes and their association with an unfavorable cardiovascular prognosis. Their pathogenesis is associated with endothelial dysfunction. Determining the processes of the formation and progression of retinopathy (RP) will bring closer the solution of problematic issues in ophthalmology and cardiology, and reduce cardiovascular morbidity and mortality.Aim. To study the processes of formation and progression of retinopathy in the initial stages of mixed origin (hypertensive, diabetic, unspecified etiology).Material and methods. The origin and progression of I–II degree RP under the influence of predictors of this symptom has been revealed through statistical analysis using the data of the 2008–2013 prospective follow-up of 22 clinical indicators of a natural group of initially healthy 7.959 male workers of locomotive crews of the Trans-Baikal Railway aged 18–66 years. Multivariate stepwise analysis, a 2 × 2 confusion matrix, Cox and Kaplan-Meier proportional hazard models were used, and a relative risk was assessed.Results. Such predictors of grade I–II RP as arterial hypertension, I–III degree obesity, smoking, dyslipidemia, left ventricular hypertrophy, family history of early cardiovascular disease, hyperglycemia, aortic atherosclerosis, creatininemia, atherosclerotic plaque / intima-media complex thickening, microalbuminuria, type 2 diabetes mellitus and age showed statistical heterogeneity in mathematical models. The distinctive feature was the different mutually exclusive assessment of the predictors’ significance in the models used. Thus, the predictors of I–II degree RP showed their specific identification characteristics, defined in qualitative and quantitative dimensions, by which they could be found and studied in the cell as well as their damaging effect.Conclusions. The course of endothelial dysfunction varies significantly when influenced by RP predictors. Its manifestations are determined by the influence of a specific factor, a set of factors or by all predictors taken together and involved simultaneously. This shows the need to determine the qualitative and quantitative ultrastructural and biochemical specific markers of endothelial dysfunction of the microvasculature of the eye appearing under the influence of RP predictors during the formation and progression of this pathological symptom in order to restore the normal function of the endothelial cell and the affected organ as a whole, as long as there is still room for therapeutic efforts.
视网膜微循环床的病变是一个亟待解决的问题,因为其发病率高、不可逆转病变的严重程度以及与心血管预后不良有关。其发病机制与内皮功能障碍有关。确定视网膜病变(RP)的形成和发展过程将有助于解决眼科和心脏科的难题,降低心血管疾病的发病率和死亡率。研究混合病因(高血压、糖尿病、不明病因)初期视网膜病变的形成和发展过程。利用 2008-2013 年对横贯贝加尔湖铁路机车组 7959 名最初健康的 18-66 岁男性工人自然群体的 22 项临床指标进行前瞻性跟踪调查的数据,通过统计分析揭示了 I-II 度视网膜病变的起源和进展受该症状预测因素的影响。研究采用了多变量逐步分析、2 × 2 混淆矩阵、Cox 和 Kaplan-Meier 比例危险模型,并评估了相对风险。在数学模型中,动脉高血压、I-III度肥胖、吸烟、血脂异常、左心室肥大、早期心血管疾病家族史、高血糖、主动脉粥样硬化、肌酐血症、动脉粥样硬化斑块/内膜-中膜复合体增厚、微量白蛋白尿、2型糖尿病和年龄等I-II级RP的预测因素显示出统计学异质性。其显著特点是在所使用的模型中对预测因子的重要性进行了不同的互斥性评估。因此,I-II 级 RP 的预测因子显示了其特定的识别特征,这些特征在定性和定量维度上都有定义,通过这些特征可以在细胞中发现和研究它们以及它们的破坏作用。内皮功能障碍的过程受 RP 预测因素的影响而有很大不同。内皮功能障碍的表现取决于一个特定因素、一组因素或所有预测因素的影响。这表明,有必要确定眼球微血管内皮功能障碍的超微结构和生化特异性定性和定量标志物,这些标志物在这一病理症状的形成和发展过程中会受到 RP 预测因子的影响,以便在仍有治疗余地的情况下恢复内皮细胞和整个受影响器官的正常功能。
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Ateroscleroz
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