Theoretical generalization has been presented in the thesis based on complex research of clinical, instrumental, biochemical and immunological parameters in patients with type 2 diabetes and cardiovascular complications. A new solution to the current problem of modern endocrinology - the establishment of pathogenetic interrelations between traditional risk factors for the development of cardiovascular complications of type 2 diabetes such as hyperglycemia, insulin resistance (IR), dislipoproteinemia (DLP), and the content of adipose tissue hormones and chronic non-specific inflammatory mediators, has been proposed. Based on the obtained results, a new solution to the scientific and practical task regarding processing methods of prediction in the development of cardiovascular complications in patients with identified type 2 DM for the first time, has been presented; strategy, diagnostic and therapeutic measures to correct detected impairments in the production of adipocytokines as a risk factor for cardiovascular impairments in patients with type 2 diabetes has been elaborated. The object of investigation: type 2 diabetes mellitus combined with ischemic heart disease (IHD) and/or stage I-II hypertension, its clinical course and treatment. The subject of investigation: hormones of adipose tissue, mediators of chronic non-specific inflammation, insulin resistance indices, lipoprotein metabolism in patients with type 2 diabetes and cardiovascular complications, their interconnections, methods of prevention and correction. Methods of research: general clinical, biochemical, immunoenzymatic, instrumental, and statistical. Character of changes and the structure of interrelations between impairment of lipid and carbohydrate metabolism, imbalance of adipose tissue hormones and mediators of non-specific inflammation in patients with type 2 diabetes has been determined depending on the disease course, the level of glycemic control of diabetes, gender, the presence of overweight and obesity as well as cardiovascular complications. It has been established that occurrence and progression of hypertension in patients with type 2 diabetes is accompanied by an increase in the concentration of resistin, sP-selectin, TNF-?, and IL-6. Contribution of increased levels of resistin, IL-6 and TNF-? to the formation of the most unfavorable circadian rhythm of a daily AT - Night-peaker profile has been established in patients with type 2 diabetes and hypertension. An increase in IL-2, TNF-? contents in these patients has been established by the activation of immunoinflammatory reactions with increased expression of pro-inflammatory cytokines and intensified interactions between them and resistin. The role of IL-2 in CVD pathogenesis in type 2 diabetes has been studied for the first time.It has been established that the contribution of IL-2 and TNF-? to the occurrence and progression of ischemic heart disease in patients with type 2 diabetes is characterized by the formation of prognostically unfavorable painless form of myocardial ischemia. Worsening of the adipose tissue dysfunction is manifested by an increase in leptin and leptin resistance, higher level of resistin, an increase in the expression of cytokines - TNF-?, IL-6 and an increase in the concentration of sP-selectin under the conditions of hypertension with coronary heart disease comorbidity in type 2 diabetes. Mathematical models have been formed which allow to assess the risk for the development of hypertension and ischemic heart disease in patients with type 2 diabetes, revealed for the first time, based on the levels of anthropometric indices, parameters of carbohydrate and lipid metabolism, concentration of leptin, resistin, mediators of non-specific inflammation and sP-selectin in the blood. Respectively, the most unfavorable prognostic criteria of the development of cardiovascular complications in type 2 diabetes, which can be used in the elaboration of preventive measures to slow down the development and progression of cardiovascular pathology in patients with type 2 diabetes, have been revealed.
