Herasymchuk U. Clinical and pathogenetic significance of galanin and adiponutrin in patients with hypertension combined with obesity

Today, hypertension is one of the most common cardiovascular diseases (CVD), moreover, high blood pressure (BP) is becoming the main factor in the development of cardiovascular complications and premature death in Europe and the world. According to official statistics, the overall prevalence of hypertension in Europe among adults is 30 - 45%. In Ukraine, compared to Europe, the prevalence of hypertension is 34 968 patients per 100 000 population. Patients with hypertension, as a rule, have one, and more often several accompanying pathologies. One of the main reasons for this trend is the prevalence of obesity, which is becoming one of the leading risk factors for increased blood pressure. The prevalence of obesity is steadily increasing in Ukraine as well. Recently, the main attention of scientists has been focused on the study of adipokines in conditions of overweight and obesity, since it is possible that a violation of adipokine metabolism is one of the key processes in the development of hypertension. In this regard, the following aim of our research was determined: to improve the diagnosis, treatment and forecasting of the course of hypertension with accompanying obesity based on the study of the pathogenetic role of galanin and adiponutrin and to establish their relationship with disorders of lipid and carbohydrate metabolism through a comprehensive assessment of the above indicators. A comprehensive examination of 107 patients with hypertension, who were receiving inpatient treatment at the Communal non-profit enterprise "City Clinical Hospital № 27" of the Kharkiv City Council, which is a basic medical institution, was conducted Department of Internal Medicine № 2, Clinical іmmunology and аllergology named after аcademician L.T. Malaya Kharkiv National Medical University, Ministry of Health of Ukraine. Among them, 67 were diagnosed with hypertension with accompanying obesity and 40 without obesity. According to the purpose and objectives of the study, all patients were divided into subgroups depending on comorbidity. The age of patients in the examined sample ranged from 32 to 79 years (average age 58,6 ± 9,88 years). The control group consisted of 20 practically healthy people. The average age of practically healthy persons was 45,6 ± 13,2 years (from 22 to 62 years). Among them there are 10 (50%) men and 10 (50%) women. Thus, the scientific novelty consists in establishing the mutually aggravating influence of hypertension and obesity on the basis of complex clinical-laboratory and instrumental research. In particular, scientific data regarding the pathogenetic role of adipokines (GAL and ADPN) in relation to carbohydrate and lipid metabolism disorders, structural and functional changes of the myocardium in patients with hypertension in combination with obesity have been expanded. The practical significance of the obtained results is that the determination of serum levels of GAL and ADPN in patients with hypertension and obesity will contribute to the optimization of diagnosis of comorbidity and allows the treating physician, cardiologist to improve the quality of prognosis in practical work. The acquirer personally substantiated the relevance of the question for study and selected the scientific direction of its research, determined the aim, formulated research tasks, carried out a patent and information search, developed a research plan and methodology. The author conducted the clinical stage of the study, which included the selection of patients according to inclusion and exclusion criteria, a comprehensive clinical examination of patients using general clinical, instrumental and laboratory research methods. The dissertation student personally created an electronic database, carried out statistical processing, analyzed and summarized the obtained results. The recipient evaluated the dynamics of the studied indicators against the background of the treatment, all sections of the dissertation were written by his own hand. Based on the data obtained during the research, conclusions were formulated and practical recommendations were developed, the results of the research were implemented in the practical work of health care institutions and the educational process, a dissertation work was prepared and designed for publication. The main provisions and conclusions of the dissertation work were implemented in the practical activities of medical and preventive institutions of Ukraine: the cardiology department of the Communal Non-Profit Enterprise "Ivano-Frankivsk Regional Clinical Cardiology Center" of the Ivano-Frankivsk Regional Council, the cardiology department of the Communal Non-Profit Enterprise Lviv Regional Council "Lviv Regional Clinical Hospital".