Zaozers'ka N. Diagnostic importance of the study of respiratory disorders and adhesion molecules expression in patients with diabetic nephropathy and obesity.

Thesis is devoted to theoretical generalization of the results and achieved decisions of the actual scientific task: optimization of the diagnosis of respiratory disorders in patients with diabetic nephropathy (DN) and obesity based on an integrated assessment of clinical and pathogenetic features of the lungs' functional state violations, endothelial dysfunction (expression of adhesion molecules sE-selectin, sICAM, sVCAM) and their interrelations in patients with diabetes mellitus, which was accompanied with obesity. Found that the presence of combination of DN with obesity leads to early appearing of obstructive type ventilation disorders, and the progression of CKD reveals tendency to increase the amount of patients with mixed ventilation disorders. The presence of obstructive ventilation disorders in 50% of patients with DN without obesity give possibility to consider obstructive changes in the lungs in diabetes as a risk factor, and development of CKD as unfavorable factor for the development of restrictive disturbances. It is shown that the expression of adhesion molecules - sE-selectin, sICAM, sVCAM should be attributed to the early markers of diabetic microangiopathy. In the later stages of CKD progressively increased levels of sICAM and sVCAM can be used as a criterion of poor prognosis of progression CKD. Significantly decreasing the performance scales of mental health and physical functioning revealed in patients with diabetes and obesity is found. It is shown ACE inhibitors (enalapril) and BRAІІ (telmisartan) has nephroprotec-tive and antihypertensive action in the treatment of patients with diabetes and obesity.