Gordina M. Clinical and pathogenetic mechanisms of action of hypovitaminosis D on the course of coronary heart disease, assosiated with the metabolic syndrome, and its correction

The thesis is presented for the Scientific Degree of Medical Sciences in the internal medicine specialty. The thesis is devoted to study the prevalence of hypovitaminosis D in patients with coronary heart disease and metabolic syndrome and its impact on the development of the components of the metabolic syndrome and subclinical inflammation, and exposure correction D-deficiency on these parameters. Determined that comorbid patients with coronary heart disease and metabolic syndrome found deeper hypovitaminosis D compared with patients with isolated coronary artery disease course. Established that vitamin D deficiency contributes to the development of components of the metabolic syndrome: atherogenic dyslipidemia, hyperglycemia, systolic hypertension and inversely correlated with anthropometric parameters - centralization fat ratio and body mass index. Severity level of insulin resistance and subclinical inflammation depend on the deficiency of vitamin D. There is credible inverse correlation between levels of vitamin D in blood plasma and carbohydrate metabolism, levels of C-reactive protein and cytokines, and the greatest strength of this bond is registered among comorbid patients. In terms of hypovitaminosis D included as standard therapies for coronary heart disease drugs cholecalciferol is accompanied by an increase in the effectiveness of treatment in terms of increasing exercise tolerance, and improve quality of life by correcting insulin resistance index HOMA-IR and QUCKI, decrease subclinical inflammation on the content of C-reactive protein and cytokines - tumor necrosis factor -? and IL -6 , given the growing supply of vitamin D.