Home – Home – Jornals – The journal "Ateroskleroz" 2014 number 2

The purpose of short-term, randomized, placebo-controlled, double-blind clinical trial was to study the effect of «functional» products containing plant sterols or stanols esters on lipoprotein and coagulation parameters in Russian CHD patients with moderate hypercholesterolemia.Materials and Methods. The study included 69 patients aged 44-70 years with total CH 5.0-6.5 mmol/l; among them 61 patients had LDL CH 3.4-5.0 mmol/l. “Functional” foods containing sterols or stanols took 36 patients, 25 patients received similar products without sterols or stanols - placebo. A daily dose contained 1.6 g of phytosterols (yogurt Danakor) or 2.0 g phytostanols (spread Benekol). Parameters of gemodynamics, lipids and apolipoproteins and coagulation system were examined in all patients, adverse events were controled. Results. No HDL CH changes were found in any group. In group taking phytosterol-containing product, level of total CH decreased within 3 weeks by 10 %, vs by 4.3 % in placebo. LDL CH decreased by 11.2 % vs 7.1% on placebo; TG levels decreased by 17.5 %, non-HDL CH decreased - 12.5 %. The level of the major LDL apoprotein - apo B declined by 11.84 % and apo B/AI ratio dropped from 0.94 to 0.88. Fibrinogen decreased from 3.8 to 3.1 g/l. After 4 weeks of consumption of spread enriched with phytostanols, total CH decreased by 8.6 %, LDL CH - by 7.6 %, when compared with placebo - by 10.7 % and 10.4 %, respectively; TG decreased by 17.0 %, non-HDL CH - by 11 %. SBP, DBP, heart rate, AST and ALT activities of did not change. Three cases of light gastrointestinal adverse effects were detected. Conclusion. Consumption of «functional» foods enriched with plant sterol and stanol in Russian CHD patients with moderate hypercholesterolemia have lipid lowering effect similar to that found in the international prevention programs. Obviously, foods enriched with phytosterols and phytostanols may be used as non-pharmacological approach for correction of moderate hypercholesterolemia in CHD patients.

The aim of the study was to investigate of parameters of oxidation-antioxidant changes in low density lipoprotein (LDL) in men population and to evaluate their associations with risk factors for atherosclerosis and coronary artery disease (CAD). A population-based survey of 1024 Novosibirsk men 47-73 years old was performed. Programm of the survey included the questionnaires, standardized cardiological survey, anthropometry, blood pressure measurement, ECG recording. In 223 people (21.8 %) had «definitely CHD» (stable angina pectoris, FC II-IV) by a validated epidemiological, clinical and functional criteria. Biochemical studies included the determinations of blood total cholesterol (CH), triglyceride (TG), high density lipoprotein cholesterol (HDL-CH), C-reactive protein in a highly sensitive range (hsCRP), glucose, baseline lipid peroxidation (LPO) and fat-soluble antioxidants (alpha-tocopherol, retinol, beta-carotene, xanthine) in LDL, LDL resistance to oxidation in vitro, the concentration of autoantibodies to oxidized LDL (oxLDL). For the Novosibirsk male population as regional values are 10-90 % cut-off point percentile distribution of baseline LPO level in LDL, LDL resistance to oxidation at the initial and propagation stages of their oxidation, lipophilic antioxidants in LDL, concentration of autoantibodies to oxLDL. Elevated level of LPO products in LDL, decreased antioxidants content in LDL and, especially, decreased resistance of LDL to oxidation in men independently associated with elevated blood levels of CH, TG, hsCRP, reduced HDL-CH, increased BMI. Positive correlations and independent associations between decreased LDL resistance to oxidation in vitro and CHD were revealed. Negative correlations between decreased LDL alpha-tocopherol content and CHD were revealed also. The incidence of CHD is higher in the index of the initial level of lipid peroxidation (LPO) in LDL >0.8 nM MDA/mg LDL protein and decreased resistance of LDL to oxidation (at rates in the initial stage of LDL oxidation >5.4 nM MDA/mg LDL protein and in the progressive stage of LDL oxidation >13.2 nM MDA/mg LDL protein). On the other hand, the incidence of CHD is lower in the index of alpha-tocopherol in LDL >1.06 mg/mg protein LDL. The results confirm the known data about the key role of LDL oxidative modification in the pathogenesis of atherosclerosis and CHD.

Background and aims: we have analyzed the frequencies of HindIII polymorphism of lipoprotein lipase gene (LPL) and lipid profile in Caucasian population of West Siberia and the groups this high and low total cholesterol (TC) level. Methods: The patients included in the analyses were selected based on TC level from population sample surveyed in frame of HAPIEE project (9360 participants, aged 45-69, men 50 %). Totally 259 patients with highest TC level (>300 mg/dl) and 228 patients with lowest TC level (<200 mg/dl) and 170 randomly selected patients (mean TC level - 235.8±43.9 mg/dl) were included. The differences of TC level between groups are significant. The plasma lipid levels were determined by standard enzymatic assays.The subfractional profile of LDL was determined by method of electrophoresis. The HindIII polymorphism (22125T/G) of LPL gene was analyzed by RELF-PCR. Results: Frequencies of H+H+, H+H- and H-H- genotypes were 61 %, 35 % and 4 % in population. The frequency of H- allele was 0.22, 0.28 and 0.29 in HAPIEE population, low and highest TC level groups, respectively ( p > 0.05). We have found the association of HindIII polymorphism of LPL gene with TG level in HAPIEE population ( p = 0.002). We have found the association of polymorphism HindIII of gene LPL with minor peak on a descending curve of the subfractional profile LDL ( p = 0.02). Depression of activity LPL leads to depression of formation of the fine dense particles rich of cholesterol and the maintenance of the particles rich of triglyceride that can lead to development combined hyperlipidemia. Conclusions: The Caucasian population of West Siberia is not significantly differs from populations of Europe by frequencies of alleles and genotypes. The genotype H+H+ of HindIII polymorphism of LPL gene has been associated with high TG level. The polymorphism HindIII of gene LPL has been associated with the subfractional profile LDL.

54 patients, who were in the surgical department for subsequent carotid endarterectomy, were analyzed. Depending on long-term one-year prognosis all patients have been divided into two groups: with unfavorable (34 individuals - 62.9 %) and favorable (20 individuals - 37.1 %) prognosis. Interleukin-12 in serum was investigated in all patients in preoperative period. It was proved that patients who had such cardiovascular events as stroke, transient ischemic attack, myocardial infarction, death, and courses deterioration of multifocal atherosclerosis in any arterial region, increase or clinical presentations onset of ischemia in any organ during the first year after surgical procedure had significantly higher level of interleukin-12 in serum.

Arterial hypertension (AH) is one of the major risk factors for atherosclerosis and associated cardiovascular diseases. Shown that elevated levels of blood pressure (BP) in adolescence with a high degree of probability can be transformed into AH. The purpose of this study was to examine 20-year trends of blood pressure and prevalence of hypertension among adolescents 14-17 years - residents of a major Russian industrial city on the example of Novosibirsk. Methods. Study design - cross-sectional population surveys of representative samples of schoolchildren aged 14-17 of both sexes. In the period from 1989 to 2009 five screenings of pupils of secondary schools of Novosibirsk were performed. The survey program was unified for all screenings. Assessment of blood pressure levels in adolescents was conducted according to the criteria of the 4th report of the Working Group on the control of hypertension in children and adolescents (NHBPEP, USA, 2004), based on the percentile distribution of BP values according to sex, age and height. Results. Analysis of the mean values of SBP and DBP trends during 1989-2009 in adolescents revealed a significant changes in some periods of the monitoring. The prevalence of hypertension among adolescents was in averaged 14 % of boys and 10 % in girls 14-17 years old. The highest prevalence of hypertension in adolescents of both sexes noted in 1989, the lowest - in 1994. Significant relationship between the level of blood pressure and body mass index detected: among children with overweight percentage of persons with high blood pressure was recorded twice as likely as children with normal weight, both boys and girls ( p <0.001). Conclusion. Early detection of elevated BP levels in adolescents enables selection among them groups of risk for developing hypertension in adulthood for preventive interventions at the population and family levels.

Gallstone disease (GSD) and arterial hypertension (AH) have many common risk factors - age, overweight, dyslipidemia, low physical activity, diabetes mellitus, in addition, the presence of AH is considered by many authors as a risk factor for GSD. Numerous trials are devoted to the study of the contribution of gene polymorphisms in the development of AH, but researches about common candidate genes for AH and GSD are rare. In several studies, including a meta-analysis, the association of GSD and APOE4 allele genotype is depicted. Our clinical study in women with GSD in combination with AH shows the greatest frequency of allele APOE4 (21.2) compared with women with GSD without AH (8.0) or with women with isolated AH (10.6, p < 0.05). Also in this study, we found no significant differences in the frequency of genotypes A/A, A/G and G/G polymorphism A145G ADRB1 gene in women with AH in combination with GSD and women with isolated AH. Earlier in epidemiological study we did not found any association of GSD with I/D polymorphism of angiotensin converting enzyme gene. Thus, further research is needed to find a common candidate genes involved in the regulation of blood pressure and in the development of GSD in each population that will help identify patients at highest risk of complications of GSD and AH.

The purpose of the study. Study of influence of sleep disorders on the risk of myocardial infarction within 8 years in men aged 25-64 years. Materials and Methods. The WHO Programme «MONICA - psychosocial” in 1994 was conducted a screening study of the male population aged 25-64 years residents of one of the districts of Novosibirsk. Cohort was monitored for 8 years (1994-2002) to determine the endpoint (myocardial infarction), statistical analysis was performed using the software package «SPSS-10.» Cox proportional regression model was used to estimate relative risk. Results. Only one third of men aged 25-64 years with newly emerged MI, regarded the dream as «good», and two thirds had sleep disorders. The relative risk of myocardial infarction in men aged 25-44 years during the 8-year period was 9.25 times higher than the assessment of sleep «bad» than «good», ie in this age group sleep disorders are one of the major factors leading to the occurrence of myocardial infarction; aged 45-64 years, these differences were not significant. The risk of myocardial infarction in patients with sleep disorders was higher in males widowed, divorced, those with low levels of social support, with the initial level of education, belonging to the group of working professionals and retirees. Conclusion. The results suggest that sleep disturbance, primarily a social problems, contributes significantly to the risk of myocardial infarction in men of the youngest age group.

Social and medical significance of the problem of coronary heart disease (CHD) is defined the increase in morbidity and mortality and worsening disability population are caused by myocardial infarction (MI). It should be noted that the number of patients increases largely due to persons in active working age. Just around the world an increasing number of young patients with diabetes mellitus (DM) and the presence in them of vascular complications. Thus, the study of the features of CHD and MI in particular in young patients (under 40 years) with diabetes is relevant and socially significant problem. Complex and controversial clinical study is the question about the causes of myocardial infarction in young patients with diabetes. If the origin of myocardial infarction in elderly and senile age leading role is atherosclerotic lesions of the coronary arteries, then the development of the disease in young people, along with early atherosclerotic changes of the coronary arteries, is also influenced by other factors that must be considered in this group of patients.

Given is there view of research and development papers dedicated to issues of epidemiology of cardiovascular pathology and its risk factors at the population of the Republic of Sakha (Yakutia). The treated scope of materials from epidemiological, clinical, functional, immunopathological and genetic studies of cardiovascular diseases and their risk factors testify the unfavorable epidemiological situation in regard to cardiovascular pathology both at alien and indigenous population of Yakutia at active working age and elderly age requiring the implementation of targeted programs to improve health conditionsand life quality of the population of different ages at one of the most northern regions of Russia - the Republic of Sakha (Yakutia).