Ivanova K. Role of the fibroblast growth factor 21 in regulation of the bone tissue metabolism and carbohydrate homeostasis in the patients suffering from the coronary artery disease associated with obesity.

The thesis is devoted to the definition of ways to improve the efficiency of diagnosis and predict the development of osteopenic conditions in patients with coronary heart disease against the background of obesity on the basis of determining the diagnostic value of fibroblast growth factor 21. It was found that the comorbid course of coronary artery disease and obesity is characterized by an increase in the level of cytokine fibroblast growth factor 21 as well as by an increase in the atherogenic activity and the development of insulin resistance, which were increased to a greater extent than in patients with isolated pathology. It has also been proven, that in patients with coronary artery disease and class 1 obesity, the decreased in bone mineral density is formed much less frequently than in patients with high obesity rates and normal body weight. Bone resorption rates were higher in patients with high obesity rates and normal body weight, which confirms the theory of the protective effect of adipose tissue cytokines on the formation of osteoporosis. Predictor markers for the development of osteopenic conditions have been determined and a model for assessing the risk of osteoporosis progression has been proposed.