Palienka O. Clinico-metabolic, molecular-genetic and neurophysiological features of the course of dyscirculatory encephalopathy of stage II in persons with obesity

The thesis have been prepared on the basis of a comprehensive study of the theoretical substantiation and improvement of the diagnosis of discirculatory encephalopathy (DE) subject to the presence of obesity, taking into account the polymorphic variants of the leptin and apolipoprotein receptor genes. The main features of the clinical course of DE in obese patients have been identified: these are the main risk factors (abuse of overeating, alcohol intake, inactivity), family history (hypertension and obesity in the father). In DE patients with obesity there are high level of comorbidity, increased blood pressure, predominance of cortico-nuclear pathway have lesions, extrapyramidal system and vegetative tonus disorders, decreased cognitive functions, lipid metabolism disorders and hemocoagulation, a tendency to stenosis and angiospasm in cerebral vessels, an increase in atrophic changes in the brain tissue. It was proved that the most severe course of DE against the background of a combination of essential hypertension and cerebral atherosclerosis. It was defined that the distribution of polymorphisms of leptin receptor and apolipoprotein E genes are in a cohort of patients with DE, and their polymorphic variants associated with obesity (LEPR QQ, E3 /3, E3/4), heavier DE flow (LEPR QQ, LEPR RR, E3/4) and cognitive impairment (E3/4). Also the impact of the genes determining lipid metabolism (leptin and apolipoprotein E) in the definition of polymorphism was confirmed in order to predict the development of DE and the formation of risk groups for the prevention of DE in obesity.