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The journal "Ateroskleroz"

2020 year, number 4

1.
ASSOCIATION OF rs662799 POLYMORPHISM WITH THE DEVELOPMENT OF ACUTE CEREBROVASCULAR ACCIDENT IN PATIENTS WITH CARDIOVASCULAR PATHOLOGY

D.A. Nikulin1, A.A. Chernova1, S.Yu. Nikulina1, A.N. Kelemeneva1, V.N. Maksimov1,2
1Krasnoyarsk State Medical University, 660022, Krasnoyarsk, Partizan Zheleznyak str., 1
2Research Institute of Internal and Preventive Medicine, 630089, Novosibirsk, Boris Bogatkov str., 175/1
Keywords: cerebral circulatory disorders, ischemic stroke, supraventricular tachycardia, arterial hypertension, dyslipidemia, atherosclerosis, hemostasis, rs662799

Abstract >>
Objective: to study the association of rs662799 with the development of acute cerebrovascular accident in patients with cardiovascular diseases and risk factors for their development. Material and methods. The material of the study was presented by 260 inpatient patients with acute cerebrovascular accident at the age of [57.0; 51.0-62.0] years as a comparison group, 272 patients aged [55.0; 51.0-62.0] years were examined, this is the control group of our study. According to gender, all patients in the main group were divided into 157 men and 103 women. There were 170 men and 102 women in the control group. All patients of the main group, along with routine methods of examination, were analyzed by the blood coagulation system, from instrumental methods of investigation-electrocardiography, echocardioscopy, ultrasound duplex scanning of extracranial brachiocephalic arteries, daily monitoring of blood pressure and heart rate, computed tomography of the brain. In patients of the main group, comorbid pathology was represented by the following cardiovascular diseases and risk factors: arterial hypertension (AG), paroxysmal supraventricular tachycardia, dyslipidemia, atherosclerosis of brachiocephalic arteries, disorders of the hemostasis system. The control group was investigated as part of the HAPIEE international project. Molecular genetic analysis was performed by real-time PCR. Statistical processing of the material was carried out using the Excel application kit and SPSS 22. The study was performed in accordance with Good Clinical Practice standards and the principles of the Helsinki Declaration. The study protocol was approved by the Ethics Committees of all participating clinical centers. Prior to inclusion in the study, written informed consent was obtained from all participants. Results. In all analyzed groups and subgroups of patients, an association was established between the rare G allele and the increased risk of PMC. The GG genotype showed significant associations with PMK in the main patient group, in the male subgroup, and in the AG subgroup. Conclusion. The AG genotype and the G allele rs662799 increase the risk of stroke in patients regardless of previous cardiovascular pathology and risk factors, including patients with arterial hypertension, supraventricular tachyarrhythmias, atherosclerosis of the brachiocephalic arteries, impaired lipid metabolism and the hemostatic system.



2.
EFFECT OF BLOOD PLASMA LIPOPROTEINS ON HYDROXYLATION OF BENZO[a]PYRENE IN LIVER MICROSOMES OF RATS

L.M. Polyakov, R.A. Knyazev, N.V. Trifonova, M.V. Kotova, E.I. Solovyova, A.V. Ryabchenko
Research Institute of Biochemistry of Federal Research Center of Fundamental and Translational Medicine, 630117, Novosibirsk, Timakov str., 2
Keywords: benzo[a]pyrene, rat liver microsomes, blood plasma lipoproteins

Abstract >>
This work presents the characteristics of the catalytic activity of hydroxylation of benzo[a]pyrene (B[a]P) in rat liver microsomes using plasma lipoproteins (LP) (VLDL, LDL, HDL) as transport forms of B[a]P. The aim of the study was: to study the effect of the LP-component of the LP-B[a]P complexes on the rate of B[a]P hydroxylation in rat liver microsomes. The studies were carried out on the microsomal fraction of rat liver using B[a]P as a substrate, ultracentrifugation of individual fractions of VLDL, LDL, HDL plasma, and spectrofluorimetric determination of the activity of arylhydrocarbonhydroxylase. In work on microsomes of rat liver the rate of hydroxylation of B[a]P in free form and in the form of B[a]P complexes with various fractions of LP was analyzed. The analysis showed that the arylhydrocarbonhydroxylase activity (pmol 3-OH-B[a]P in 1 min per 1 mg of protein) decreases in the complex form B[a]P with LP. So for transport form B[a]P with HDL the decrease was by 22%, for transport form B[a]P with VLDL the decrease was 30%, and for transport form B[a]P with LDL it was 52%. It should be noted that K m for the substrate remained practically unchanged in all forms. The V max and K m values indicate that the LP component in complexes with B[a]P can be a noncompetitive inhibitor of B[a]P hydroxylation in rat liver microsomes.



3.
STEREOTYPES OF EATING BEHAVIOR AND RISK FACTORS FOR CARDIOVASCULAR DISEASE IN RESIDENTS OF A LARGE INDUSTRIAL REGION OF SIBERIA

D.P. Tsygankova, E.D. Bazdyrev, E.V. Indukaeva, G.V. Artamonova, O.L. Barbarash
Research Institute for Complex Issues of Cardiovascular Diseases, 650002, Kemerovo, Sosnovy blvd., 6
Keywords: nutrition, factor analysis, cardiovascular diseases, risk factors, arterial hypertension, dyslipidemia, diabetes mellitus

Abstract >>
Purpose of the study was to identify the main stereotypes of eating behavior among residents of a large industrial region of Siberia and to assess their relationship with the main factors of cardiovascular risk. Material and methods. It included 1600 people aged 35-70, permanently residing in the Kemerovo region. The sample is mainly represented by females (1124 people, men - 476 people), the average age was 54.9 ± 9.75 years and 52.6 ± 10.0 years, respectively, p < 0.001. Taking into account the differences in age between men and women, to identify gender and age characteristics, the entire sample was divided into age groups: 35-49 years old, 50-59 years old, 60-70 years old. To identify latent factors (stereotypes of eating behavior), factor analysis (principal component analysis) was used. Three stereotypes of eating behavior were identified: «fruit and vegetable», «protein-carbohydrate» and «mixed». Results. Most of the examined persons aged 35-49 adhered to the protein-carbohydrate stereotype of nutrition (40.3 % versus 25.3 % and 34.4 % of persons who adhered to the fruit-vegetable and mixed, respectively, p < 0.001). In other age groups, no statistically significant differences were found. Thus, among respondents aged 50-59, 34.0 % preferred fruit and vegetable, 33.8 % - protein-carbohydrate, 32.0 % - mixed. Among people 60-70 years old - 36.6 %, 30.4 %, 33.0 %, respectively. Adherence to a fruit and vegetable diet was associated with an increased risk of diabetes (OR = 1.27, CI: 1.2-2.2, p = 0.046) and obesity (OR = 1.57, CI: 1.27-1.96, p < 0.001), and adherence to protein-carbohydrate - with a decrease in the risk of detecting obesity (OR = 0.75, CI: 0.6-0.95, p = 0.015), DM (OR = 0.66, CI: 0.47-0.93, p = 0.018), hypercholesterolemia (OR = 0.78, CI: 0.62-0.98, p = 0.032) and hypertriglyceridemia (OR = 0.66, CI: 0, 52-0.83, p < 0.001). Conclusion. Among the inhabitants of a large industrial region of Siberia, it was possible to distinguish three stereotypes of nutrition: fruit-vegetable, protein-carbohydrate and mixed. Among the supporters of the mixed and protein-carbohydrate stereotype aged 35-49, hypercholesterolemia, hypertriglyceridemia and high LDL levels were more often diagnosed in men than in women of the corresponding group. Also, hypertriglyceridemia and diabetes were more often detected in young men adhering to a fruit and vegetable stereotype of nutrition, in contrast to women in a similar group. Adherence to a fruit-vegetable dietary stereotype was associated with an increased risk of diabetes and obesity, and adherence to protein-carbohydrate - with a decrease in the risk of obesity, diabetes, hypercholesterolemia and hypertriglyceridemia.



4.
POSSIBILITIES OF THE METHOD OF DIELECTROPHORESIS OF ERYTHROCYTES IN DISTINCTION OF PATIENTS WITH FATTY LIVER DISEASE OF ALCOHOLIC AND NON-ALCOHOLIC GENESIS

M.V. Kruchinina1, M.V. Parulikova1, S.A. Kurilovich1, A.A. Gromov1, V.M. Generalov2, V.N. Kruchinin3, S.V. Rykhlitsky3, A.A. Shestov4
1Research Institute of Internal and Preventive Medicine, 630089, Novosibirsk, Boris Bogatkov str., 175/1
2State Research Center of Virology and Biotechnology "Vector", 630559 Novosibirsk region, Koltsovo
3Rzhanov Institute of Semiconductor Physics of SB RAS, 630090 Novosibirsk, Academician Lavrentev av., 13
4University of Pennsylvania, Philadelphia, USA
Keywords: fatty liver disease, etiology, differential diagnosis, erythrocytes, dielectrophoresis, ethanol, acute exposure

Abstract >>
The aim of the work is to study the possibilities of distinguishing between men with fatty disease of alcoholic and non-alcoholic origin using the viscoelastic parameters of erythrocytes - deformation amplitude, summerized indicators of viscosity and rigidity (baseline and after exposure to ethanol in vitro) obtained using the method of erythrocyte dielectrophoresis; to determine associations of the amplitude of deformation, summerized viscosity and rigidity of erythrocytes with blood lipid levels. The study involved 54 men (44,62±1.52 years) with fatty liver disease according to ultrasound of the abdominal organs, the severity of fibrosis corresponded to 0-1 (FibroScan® 502 Echosens, France). All patients underwent a study of the viscoelastic parameters of erythrocytes - the amplitude of deformation, summerized indicators of viscosity and rigidity by the dielectrophoresis method: the baseline level of indicators was determined, as well as their values after exposure of red blood cells with 10 μl of 0,0 2% ethanol solution in vitro for 300 s. The dynamics of changes in the viscoelastic parameters of erythrocytes during the experiment with alcohol in patients with fatty liver disease of unknown origin made it possible to highlight two groups with diametrically opposite trends in erythrocyte indices. The group with a decrease in the amplitude of erythrocyte deformation against the background of an increase in summerized viscosity and rigidity ( n = 26) consisted mainly of patients with metabolic syndrome who do not drink or occasionally consume alcohol in low doses (less than 20 g in terms of pure ethanol). Group with increased erythrocyte deformability and decrease in summerized viscosity and rigidity ( n = 28) includes systematic alcohol consumers who were in a state of abstinence. Ethanol exposure, important energy substrate of this group, built into metabolic processes, led to an increase in the amplitude of cell deformation. Correlations of the viscoelastic parameters of erythrocytes with the style of alcohol consumption, components of the metabolic syndrome, lipid profile indicators, and liver tests were established. Direct associations of the amplitude of erythrocyte deformation with the level of HDL cholesterol and inverse - with the values of total cholesterol, LDL cholesterol, triglycerides were identified. Summarized viscosity and rigidity correlated with the levels of these lipid indicators inversely compared with the amplitude of deformation. The diagnostic accuracy of distinguishing between NAFLD and AFLD using models, including the viscoelastic parameters of erythrocytes and their changes after exposure to ethanol, using Random Forest and SVM methods reached 99 %, sensitivity of 98 % and specificity of 99 %.



5.
ASSESSMENT OF ASSOCIATIONS OF COGNITIVE COMPLAINTS WITH INCREASED BLOOD PRESSURE LEVELS IN YOUNG AND MIDDLE-AGED WOMEN IN NOVOSIBIRSK POPULATION

A.V. Sukhanov, S.N. Duma, V.V. Gafarov, D.V. Denisova
Research Institute of Internal and Preventive Medicine, 630089, Novosibirsk, Boris Bogatkov str., 175/1
Keywords: cognitive functions, complaints of memory and attention, questionnaire, arterial hypertension, population

Abstract >>
Background. The literature data on the frequency of cognitive complaints in cardiovascular pathology, in particular, in hypertension in young and middle-aged women in an open population, remain poorly studied to date. Objective. To examine the frequency of cognitive complaints in young and middle-aged women associated with hypertension in an open population of Novosibirsk. Methods. Using the method of questioning, we obtained information about the cognitive complaints in 546 young and middle-aged women - residents of Novosibirsk. Cognitive complaints assessed included: 1. «I don’t remember what I put where»; 2. «I don’t recognize people I know»; 3. «I find it difficult to concentrate when I read»; 4. «I am doing everything very slowly.» The analysis of contingency tables and methods of logistic regression (univariate analysis) were performed. Results. In women under the age of 45, a statistically significant association of the above cognitive complaints with hypertension was revealed; it was independent of age and educational level. Conclusion. The analysis of cognitive complaints at the young and middle-aged persons can be of great interest for the detailed development of preventive and therapeutic measures for arterial hypertension in women.



6.
DIAGNOSTIC VALUE OF CAPILLAROSCOPY WHEN CHOOSING TREATMENT TACTICS FOR PATIENTS WITH TIBIAL ARTERY OCCLUSION

N.A. Lysov1, D.L. Pribytkov1,2, A.A. Supilnikov1
1Medical University "Reaviz", 443001, Samara, Chkalova str., 100
2Samara Regional V.D. Seredavin Clinical Hospital, 443095, Samara, Tashkentskaya str., 159
Keywords: atherosclerosis, tibial artery occlusion, capillaroscopy

Abstract >>
Obliterating arterial atherosclerosis of the lower limbs is from 2% to 4% in the structure of cardiovascular disease. A dangerous complication of critical lower limb ischemia is an amputation of the affected limb. Evaluation of microcirculatory channel on the lower extremities in patients with occlusal diseases is one of the most important prognostic criteria when choosing treatment tactics for this group of patients. Objective of the study was to evaluate the results of surgical treatment in patients with tibial artery occlusion depending on the number of functioning capillaries of the affected lower limb. The received results of treatment in the postoperative period for 12 months showed that all patients arriving with tibial artery occlusion with chronic lower limb ischemia stage III according to Pokrovsky - Fontein should include capillaroscopy of 1 finger of the affected lower limb in the examination algorithm for optimal choice of treatment tactics. These observations can improve the quality of medical care in hospitals of the vascular profile and reduce the number of amputations of the lower limbs in patients with tibial artery occlusion.



7.
ASSOCIATIONS OF EXCESS BODY WEIGHT, SOCIO-ECONOMIC FACTORS AND PHYSICAL ACTIVITY IN THE YOUNG AGE POPULATION (25-35 YEARS OLD) IN NOVOSIBIRSK

D.V. Denisova, T.I. Batluk, L.V. Shcherbakova, E.A. Belyaevskaya
Research Institute of Internal and Preventive Medicine, 630089, Novosibirsk, Boris Bogatkov str., 175/1
Keywords: population, overweight, socio-economic factors, physical activity

Abstract >>
Purpose: To study the associations of overweight with the level of physical activity and some socio-economic factors in the young population of Novosibirsk. Material and methods. A cross-sectional survey of the young population of Novosibirsk was carried out, 697 people (45 % of men) were examined. Overweight was determined at body mass index values ≥25 <30 kg/m2, obesity - ≥30 kg/m2. The waist to height ratio was calculated, the value 0.5 was taken as the cut-off point. Physical activity was determined using the international self-reported physical activity questionnaire over the last 7 days (IPAQ). The screen time (a time spent in front of a TV screen and computer during working and non-working hours for the last 7 days) was estimated. A number of socio-economic factors were studied, such as education (higher, secondary and secondary vocational), marital status (married / extramarital partnership, single / divorced), employment (working, not working). Results. The prevalence of overweight in men was about twice as high as in women (36.8 % versus 21.0 %, p < 0.05), while obesity was recorded almost the same in both genders. In 53% of men and 62% of women, the frequency of physical activity did not exceed 1 time per month. The average screen time per week was 35.0 hours, without gender differences. The chances of having low physical activity were higher with increasing screen time and waist / height index. Employment also influenced weight and height parameters. In non-working people, BMI, waist circumference and waist to height ratio were significantly lower than in working people. Marital status was associated with the level of physical activity: persons in any family relationships (married / partnership) had a 1.5 times greater risk of low physical activity. Among persons with high education, significantly lower figures for waist circumference and waist / height index were revealed, and screen time was higher. Conclusion. cross-sectional survey of the young population of Novosibirsk, associations of overweight indicators with the level of physical activity and some socio-economic factors (education, marital status, employment) were revealed.



8.
ANALYSIS OF ASSOCIATION OF rs9536314 OF THE KL GENE WITH ANTHROPOMETRIC AND BIOCHEMICAL INDICATORS IN MEN OF NOVOSIBIRSK (WEST SIBERIA)

O.V. Timoshchenko, S.E. Semaev, D.E. Ivanoshchuk, E.M. Stakhneva, Yu.P. Nikitin, E.V. Shakhtshneider, Yu.I. Ragino
Research Institute of Internal and Preventive Medicine, 630089, Novosibirsk, Boris Bogatkov, 175/1
Keywords: Klotho gene, rs9536314, ischemic heart disease, population of Western Siberia

Abstract >>
Purpose of the study. To determine the frequency of the rs9536314 (F325V) polymorphism of the KL gene and the association of this variant with a number of biochemical and anthropometric parameters in men of the study group and in the Caucasian population of Western Siberia. Materials and methods. The study group (69 men, average age 61.2 ±11.5 years) was randomly formed from a sample of persons who applied to the clinic and polyclinic of NIITPM - a branch of the ICG SB RAS and GBUZ NSO Hospital of war veterans No. 3 (178 men, aged 50-65 years old and over 80 years old). The population group was randomly selected (219 people) from the sample surveyed within the framework of the International Multicenter Project “Risk Factors for Cardiovascular Diseases in Eastern Europe” HAPIEE (9360 participants, 45-69 years old, mean age 53.8±7 years old, Caucasians > 90 %). Biochemical parameters were determined by standard enzymatic methods. Serum concentration of Klotho protein was measured by ELISA. Genomic DNA was amplified by polymerase chain reaction in a standard reaction mixture and further digested with TaqI B restriction enzyme. Results. The frequency of genotypes (TT, TG, and GG) and alleles (T and G) rs9536314 of the KL gene in the study group corresponds to the data in the population of Western Siberia, as well as the population of Western and Eastern Europe. There were no statistically significant differences in the mean values of the studied clinical and biochemical parameters depending on the rs9536314 genotypes of the KL gene in the study group and in the population. In the study group, the level of Klotho protein in the blood and the glomerular filtration rate in men with coronary heart disease and arterial hypertension did not differ in the autosomal dominant and autosomal recessive models for the rs9536314 KL gene. Conclusion. Thus, the frequency of the rs9536314 polymorphism of the KL gene in the study group corresponds to the frequency of the rs9536314 polymorphism of the KL gene in the Caucasian population of Western Siberia. Biochemical and anthropometric parameters, as well as the Klotho protein, do not have statistically significant differences depending on the genotypes of rs9536314 of the KL gene in the examined men.



9.
SPONTANEOUS AND PROGRESSIVE ATHEROSCLEROSIS - IS THERE A DIFFERENCE?

N.G. Lozhkina, O.M. Parkhomenko
Novosibirsk State Medical University of Minzdrav of Russia, 630091, Novosibirsk, Krasny av., 52
Keywords: progressive atherosclerosis, spontaneous atherosclerosis

Abstract >>
The article analyzes the state of the problem of rapidly progressive atherosclerosis in comparison with the spontaneous or classical course of the disease. The authors have identified the most well-known factors responsible for the accelerated course of atherosclerosis and the prospects for therapeutic intervention. The analysis used data on the topic from publications over the past five years based on databases PubMed, Google Scholar è Russian Science Citation Index.



10.
LIPIDS, LIVER AND PANCREAS AT THE CROSSROADS OF METABOLIC SYNDROME AND OBESITY EPIDEMICS

O.V. Efimova1, I.N. Grigor'eva2, N.L. Tov3, T.S. Suvorova3, D.L. Nepomnyashchikh3, T.I. Romanova2
1State Budgetary Healthcare Institution "City Infectious Diseases Clinical Hospital N1", 630089, Novosibirsk, Olga Zhilina str., 90a
2Research Institute of Internal and Preventive Medicine, 6300898, Novosibirsk, Boris Bogatkov str., 175/1
3Novosibirsk State Medical University of Minzdrav of Russia, 630091, Novosibirsk, Krasny av., 52
Keywords: metabolic syndrome, non-alcoholic fatty pancreatic disease, non-alcoholic fatty liver disease, acute pancreatitis, chronic pancreatitis, blood lipids

Abstract >>
The prevalence of metabolic syndrome (MS), non-alcoholic fatty liver disease (NAFLD) and non-alcoholic fatty pancreatic disease (NAFPD) is 1/4-1/3 of the planet population. It has been proven that the main links in their pathogenesis are disorders of lipid and carbohydrate metabolism. A high comorbidity of NAFLD and NAFPD was shown: in 67,9 % of patients with NAFPD, fatty liver was revealed, and in 96,8 % of patients with NAFLD, pancreatic steatosis was diagnosed. The prevalence of MC among NAFPD patients is 59,2-76,9 %. A meta-analysis revealed that NAFPD is associated with an increased risk of MS (relative risk (RR) = 2,25; 95 % CI 2,00-2,53; p < 0,0001), arterial hypertension (RR = 1,43; 95 % CI 1,08-1,90; p = 0,013), NAFLD (RR = 2,49; 95 % CI 2,06-3,02; p < 0,0001), diabetes mellitus 2 type (RR = 1,99; 95 % CI 1,18-3,35; p = 0,01), and obesity (RR = 1,91; 95 % CI 1,67-2,19; p < 0,0001). Concomitant MS negatively affects the clinical course of acute and chronic pancreatitis, for example, moderately severe acute pancreatitis is observed 3 times more often with MS than without MS, partly due to that I, IV and V types of hyperlipidemia are associated with acute pancreatitis. Dyslipidemia in NAFLD occurs in 60-70 % of cases and is characterized by hypertriglyceridemia, elevated level of free fatty acids and low density lipoprotein cholesterol, decreased content of high density lipoprotein cholesterol. Therefore, strategies aimed at the primary prevention of dyslipidemia can help reduce morbidity and mortality in liver and pancreatic pathology associated with MS.



11.
PATHOGENETIC MECHANISMS OF ATHEROSCLEROSIS DEVELOPMENT IN ATHLETES

Ya.A. Pushkina, I.V. Sychev, L.N. Goncharova, N.P. Sergutova, O.I. Shepeleva
National Research Ogarev Mordovia State University, 430005, Saransk, Bolshevistskaya str., 68
Keywords: coronary atherosclerosis, high-intensity exercise, sudden death

Abstract >>
Aim of the study was to reveal the relationship between the performance of high-intensity physical activity and the development of endothelial dysfunction in people involved in professional sports. The development of endothelial dysfunction as one of the main markers of atherosclerotic damage to the vascular wall in athletes is an urgent problem in modern medicine in connection with the asymptomatic course and unpredictability of the development of cardiovascular complications. Material and methods. The publications on the topic of the scientific review from 2010 to 2020 were analyzed. The electronic databases of the Google Academy (https://scholar.google.ru/), UpToDate (www.uptodate.com), Oxford Medicine Online (https://oxfordmedicine.com/), PubMed (https: // pubmed.ncbi.nlm.nih.gov/), scientific electronic library «Cyberleninka» and foreign journals Springer (https://www.springer.com/gp), Journal of the American College of Cardiology (https: // imaging. onlinejacc.org/). Results. Recent foreign and domestic studies show a relatively high relationship between the level of physical activity and the development of coronary atherosclerosis in professional athletes. Conclusion. When performing prolonged and excessive physical exertion, trained athletes often experience oxidative stress, the presence of which causes the development of endothelial dysfunction, which from modern positions is a key link in the pathogenesis of atherosclerosis. Further study of the mechanism of atherogenesis will contribute to the use of new diagnostic methods in predicting the disease at an early stage and treating it, thus preserving the health of an athlete.