Gabisoniya T. Optimization of the diagnostic and treatment of cardiometabolic and humoral disorders based on an assessment of adipokines and neopterin with a combination of stable angina and obesity.

The thesis concerns the increase of effectiveness of diagnostics and treatment of cardiometabolic and neurohumoral disorders on the basis of studying of the role of adipokines and neopterin in atherogenesis in patients suffering from angina pectoris and obesity. The pathogenetic relations between dysfunction of adipokine and lipid profiles have been detailed and associations between adipokines and sonographic parameters of the myocardium in the clinical series have been revealed. Dysfunction of the adipose tissue, which occurs in the form of visfatin expression and decrease of adiponectin level, is observed. It has been proved that such dysfunction of adipokine metabolism against the background of the body weight gain promotes development and progression of atherosclerosis in patients with stable angina pectoris by means of depletion of antiatherogenic abilities of adiponectin and activation of metabolic disorders by the use of visfatin. It has been ascertained that with increase of stenosis of coronary arteries by means of atheromatous plaque, reliable level increase of neopterin occurs that makes it possible to consider level increase of neopterin as a risk marker of development of complications of stable forms of ischemic heart disease in patients with concomitant obesity. Against the background of standard medical therapy combined with ethylmethylhydroxypyridine succinate, the positive effect on adipokine metabolism indices in the form of a tendency to visfatin level decrease and adiponectin increase, and immune status indices in the form of reliable level decrease of neopterin (p>0,05) leading to risk reduction of development of cardiovascular complications, have been also ascertained.