Grozna L. Pathogenetic and clinical significance of adiponectin in patients with hypertensive disease combined with obesity and impaired glucose tolerance.

The thesis deals with study of the pathogenetic and clinical significance of adiponectin, an important antidiabetogenic, antiatherogenic and anti-inflammatory adipokin, in patients with hypertensive disease combined with obesity and impaired glucose tolerance and without them. A significant deficit of adiponectin was found in the blood of patients suffering from hypertensive disease combined with abdominal obesity, particularly in combination with impaired glucose tolerance. Reliable negative associations were revealed between the blood adiponectin level and levels of insulin, triglycerides and total cholesterol in the blood, the insulin resistance index and the waist circumference. It was for the first time that negative relationships were found between the blood adiponectin levels and levels of the systolic and pulse blood pressure and the mass index of the left ventricular myocardium. A relationship was revealed between the extent of cardiovascular risk and hypoadiponectinaemia intensity in patients with hypertensive disease combined with obesity and glucose tolerance impairment. It was for the first time that a possibility of increasing the production of adiponectin under the effect of combined antihypertensive therapy with the angiotensin converting enzyme inhibitor perindopril and the thiazide-type diuretic indapamide in combination, if needed, with nebivolol, a beta-adrenoblocker with NO activity, against a background of statin therapy in patients suffering from hypertensive disease combined with impaired glucose tolerance was proved.