This paper discusses the clinical and pathogenetic aspects of hypertension comorbid with type 2 diabetes mellitus. The role of sympathetic hyperactivation in the mechanisms of this comorbidity and the damage to target organ are reviewed. Authors analyze the capabilities of endovascular renal artery denervation and discuss the mechanisms of therapeutic effect of this procedure. The article is intended for cardiologists, therapists, endocrinologists, and endovascular surgeons.

The broad benefits of vitamin and mineral supplementation can improve rehabilitation outcomes in patients with stroke. In this aspect, the most compelling evidence exists for vitamin C, vitamin E, potassium, and magnesium. Individualized nutritional counseling was also associated with positive outcomes.

Complications associated with the disorders of lymphatic outflow in the lower extremities are common in cardiovascular surgery involving the isolation of venous conduits and interventions on the femoral vessels. Despite the relatively low frequency, treatment of these complications requires significant efforts and does not always yield the expected results whereas timely diagnosis of lymphatic drainage disorders is often difficult. This becomes the reason for repeated hospitalizations, surgical interventions, long hospital stays, and disabilities. However, the problem of lymphatic complications is still not getting enough attention. This article discusses the pathogenesis, predictors of lymphatic complications, and the options and approaches to their treatment and diagnosis.

The study of long-term results of coronary artery bypass grafting (CABG) in patients with different sexes has been a relevant problem of cardiology and heart surgery over the past thirty years. Female sex is an independent risk factors for worse outcomes in the long-term follow-up period after CABG according to many studies. However, there are publications suggesting that the results in women are better than in men in the long-term period after CABG. This literature review is devoted to studies of long-term complications and survival in patients after CABG depending on their gender. The evidence for gender differences after CABG is currently based on male-dominated studies. Most authors show that women have a higher degree of comorbidity. Another risk factor is age. Women undergo surgery at an older age. Besides, long-term survival is affected by the completeness of revascularization and multiarterial bypass grafting. Current diagnostic and treatment algorithms shift towards the assessment of coronary artery disease in men, which potentially may result in incorrect diagnosis or interpretation of existing disease and incorrect choice of treatment tactics in female patients. Despite large pool of accumulated data, this question remains open and requires new trials and continuing studies focusing on the impact of gender factor on the long-term survival.

The literature review is devoted to a new class of chronic heart failure, namely: chronic heart failure with mid-range ejection fraction (HFmrEF). In this article, we aim to clarify the existing literature on the clinical characteristics and pathophysiology of this newly-defined group of patients. Modern approaches to the therapy of HFmrEF are analyzed.

Aim. To identify the indicators of cardiac magnetic resonance (CMR), which have diagnostic value in the individual assessment of the cardiovascular prognosis in young patients with type 1 diabetes mellitus (T1DM).

Material and Methods. The study included a total of 60 patients (29 men and 31 women) aged 18 to 36 years with a history of T1DM from 5 to 16 years, who underwent contrast-enhanced CMR. Circular strain, strain relaxation index (SRI), peak early diastolic strain rate (SRe), epicardial fat thickness (EFT), ejection fraction (EF), stroke volume (SV), end-diastolic volume (EDV), end-systolic volume (ESV), and left ventricular mass (LVM) were assessed. Echocardiography, 24-h electrocardiography (ECG), treadmill test, and NT-proBNP blood test were performed to exclude heart pathology. Statistical data processing was used to identify the relationships of changes in CMR parameters of the left ventricle and epicardial adipose tissue with disease duration, carbohydrate metabolism compensation (HbA1c), total cholesterol, and low-density lipoprotein (LDL).

Results. Using the nonparametric Mann – Whitney U-test, the study showed the presence of significant differences in the values of SV, EDV, end-diastolic volume index (EDVI), and LVM in the groups of 5–10and 11–16-year duration of disease, respectively. The assessment of Spearman’s rank correlation coefficients revealed negative correlations between the values of SV, ESV, ESV index (ESVI), EDV, and LVM and T1DM duration; between the index of circular strain and blood level of HbA1c; between the values of SV, EDVI, ESVI, EDV, ESV, and LVM and blood levels of total cholesterol and LDL; between SV, EDVI, ESVI, EDV, ESV, and LVM and mean EFT in the left ventricular projection.

Conclusion. The CMR-based evaluation of strain parameters may become a key in personalized identification of young T1DM patients with a high risk of adverse cardiovascular events. The thickness and distribution of epicardial adipose tissue in young patients with T1DM may have predictive value for risk stratification of developing diseases associated with atherosclerosis and chronic heart failure, which will affect the primary prevention strategy in this population.

The mechanisms of oxidative stress in adipocytes of local fat depots in patients with cardiometabolic diseases have been studied insufficiently.

Purpose. To study the levels of reactive oxygen species (ROS) production in adipocytes of epicardial (EAT) and subcutaneous adipose tissue (SAT) in patients with stable coronary artery disease (CAD) and severe coronary atherosclerosis who underwent coronary artery bypass grafting; to investigate the potential relationships between the levels of ROS production by EAT and SAT adipocytes and obesity parameters, EAT accumulation, basal and postprandial glycemia, and blood lipid transport function.

Material and Methods. The study included 19 patients (12 men and 7 women including 6 patients (31.5%) with type 2 diabetes mellitus) aged 53–72 years with stable CAD and severe coronary atherosclerosis. The material for the study was EAT and SAT adipocytes obtained by the enzymatic method from intraoperative explants. The ROS level in adipocytes was determined using the fluorimetry with 2,3-dihydrodichlorofluorescein diacetate. Anthropometric parameters of obesity and EAT thickness were studied using echocardiography. The blood lipid transport function and the levels of basal and postprandial glucose were assessed.

Results. The levels of ROS production by EAT and SAT adipocytes in the overall group of patients did not differ significantly and amounted to 1710 (1608; 2079) and 1876 (1374; 2215) arbitrary units, respectively. The level of ROS production by SAT adipocytes did not correlate with the parameters of obesity, EAT thickness, or biomarker levels. The level of ROS production by EAT adipocytes directly correlated with the level of postprandial glycemia (r_s = 0.62, p < 0.05), but did not correlate with measures of general and abdominal obesity, EAT thickness, and dyslipidemia. The level of ROS production by EAT adipocytes in patients with postprandial glycemia ≥ 7.7 mmol/L (n = 9) exceeded the corresponding value in patients with lower level of postprandial glycemia (n = 10): 2079 (1710; 2458) against 1625.5 (1332; 1699) arbitrary units (p = 0.015), respectively.

Conclusion. We showed for the first time that the level of ROS production by EAT adipocytes in CAD patients with severe coronary atherosclerosis was directly associated with the level of postprandial glycemia. The highest level of ROS production in EAT adipocytes occurred in these patients when the level of postprandial glycemia exceeds 7.7 mmol/L.

Dysfunctional changes and remodeling of adipose tissue (АT) are associated with the formation of microcalcifications in the vascular wall. Biologically active substances synthesized by АT (adipocytokines) can act as promoters and inhibitors  of vascular calcification development. The few available experimental and clinical studies do not fully explain the possible mechanisms of these effects.

Aim. To study the relationships between the adipocytokine profiles of adipocytes in epicardial and perivascular AT with the severity of coronary artery calcification in patients with coronary artery disease (CAD).

Material and Methods. A total of 125 patients with CAD aged 59 (53; 66) years were examined. The isolated adipocytes of subcutaneous adipose tissue (SAT), epicardial adipose tissue (EAT), and perivascular adipose tissue (PVAT), obtained during coronary artery bypass grafting, were used to determine gene expression and secretion of adipocytokines (adiponectin, leptin, and IL-6). Expression of adipocytokine genes was assessed using quantitative PCR with detection of products in real time (real-time qPCR); the concentration of adipocytokines in the culture medium was determined by enzyme-linked immunosorbent assay using R&D Systems kits (Canada). Coronary artery (CA) calcification degree was assessed by multislice spiral computed tomography (MSCT) method. The calcium index of CA was determined by the Agatston method using the Syngo Calcium Scoring software package (Siemens AG Medical Solution, Germany).

Results. Massive coronary calcification (CC) had the highest prevalence (58.8%) in patients with CAD. The highest level of expression of the ADIPOQ gene in all types of fat stores was observed in patients with moderate/medium CС compared to those with massive CС; the maximum expression of ADIPOQ was observed in the culture of PVAT adipocytes. Expression of the LEP and IL6 genes in massive CC was higher, with the maximum values in the culture of EAT adipocytes relative to SAT and PVAT adipocytes. Decreases in the levels of ADIPOQ mRNA and its secretion, increases in the levels of mRNA of LEP and IL6 and their secretion in adipocytes of the EAT and PVAT were associated with the development of СС in patients with CAD.

Conclusion. Proinflammatory adipokines produced by adipocytes of patients with CAD during hypoxia induced vascular calcification by stimulating oxidative stress, osteoblast differentiation, apoptosis, and proliferation of smooth muscle cells. Endothelial cells, when stimulated with proinflammatory adipocytokines, tended to transform into osteoblasts, which further aggravated the degree of vascular inflammation and calcification.

Type 1 diabetes mellitus (T1DM) triggers disruption of oxygen transport system in patients. The maximum oxygen consumption (VO2 max) during spiroergometry depends on the functional capabilities and composition of the body. Moreover, VO2 max may be considered a predictor of pathological changes in cardiovascular system.

Aim. The purpose of the study was to investigate the compositional body characteristics and functional cardiorespiratory parameters in T1DM patients.

Material and Methods. The study comprised 30 patients with T1DM (average age of 25.5 ± 8.1 years) and 10 patients of control group (average age of 27 ± 9 years). Patients received spiroergometry examination according to B. Bruce protocol and bioimpedansometry using the Inbody 770 apparatus. The study showed that T1DM patients reached anaerobic threshold faster (p = 0.032) and had significantly lower VO2 max and carbon dioxide emission compared to patients without diabetes (p = 0.021; p = 0.034) whereas exercise tolerance did not significantly differ compared with the corresponding value in control group. Patients with higher muscle mass i.e. muscle tissue weight (kg) according to bioimpedance measurements had higher values of VO2 max (L) in control group (p = 0.017) and in group of T1DM patients (p = 0.028).

Conclusions: Young T1DM patients without cardiovascular diseases had significantly less effective cardiorespiratory system compared with that in people without diabetes even in those with high exercise tolerance. Rapid achievement of anaerobic threshold with preserved performance efficiency was a sign of unfavorable prognosis. Body mass index and lean body mass did not significantly affect the performance parameters in young T1DM patients. Screening of spiroergometry parameters may be used for identification of young T1DM patients at high risk of unfavorable cardiovascular diseases including chronic heart failure.

Erythrocyte morphology is a reflection of both physiological and pathological reactions occurring in the body of patients with diabetes mellitus (hyperglycemia, adipose tissue dysfunction, dyslipidemia, lipid peroxidation, angiopathy, diabetic nephropathy, etc.). There are no available data in the literature that would characterize gradual and progressive changes in the morphology of the erythron system in patients with diabetes mellitus, the more so any analysis of the relationships with pathogenetic factors affecting them.

Aim. The aim of the study was to evaluate the nature of erythrocyte index relationships with vascular and metabolic complications of type 1 and type 2 diabetes mellitus. The main objective of the study was to determine the changes in red blood cell indices at different stages of diabetic microangiopathies and in the presence of different indicators of metabolic control.

Material and Methods. A total of 122 patients were enrolled in a single-stage, single-center, comparative, controlled study. Patients were assigned to three groups: group 1 comprised patients with type 1 diabetes mellitus (n = 41); group 2 comprised patients with type 2 diabetes mellitus (n = 67); and group 3 comprised control patients (n = 14). Statistical processing of the results was performed using the SPSS Statistics 20 software.

Results. Patients with diabetes mellitus are characterized by qualitative changes in the erythron system manifesting as changes in red blood cell indices.

The study identified the significant associations between the changes in erythron system (erythrocyte indices) and various phenotypic features of patients with type 1 and type 2 diabetes mellitus, namely: the duration of diabetes of over 10 years, type 2 diabetes mellitus in combination with obesity, and the presence of dyslipidemia, diabetic retinopathy, and poorly controlled diabetes mellitus if glycated hemoglobin exceeded 8% with a subsequent corresponding increase per each 1%.

Conclusion. Additional studies are required to implement these markers, in particular, a red cell distribution width, as risk factors for unfavorable prognosis i.e. the risk of developing various diabetes mellitus complications.

Aim. To study the prognostic significance of abdominal obesity and endothelial dysfunction marker in patients undergoing elective coronary stenting.

Material and Methods. The study included 225 patients with coronary artery disease at an average age of 57 [51; 63] years admitted to hospital for the purpose of performing planned endovascular myocardial revascularization through stenting. Depending on the presence or absence of adverse cardiovascular events, the patients were divided into two groups. Group 1 included 127 patients with an unfavorable course of disease; group 2 comprised 98 examined patients with a favorable course. The serum levels of endothelin-1 (ET-1), insulin, interleukin-1 (IL-1), interleukin-6 (IL-6), and interleukin-10 (IL -10) and the ratio of waist to hip circumference (waist-to-hip ratio) were assessed directly before stenting the coronary arteries. The insulin resistance index (HOMA-IR) was calculated using the formula: fasting insulin (μIU/mL) × fasting blood glucose (mmol/L)/22.5. The lipid spectrum was determined by the enzymatic colorimetric method.

Results. Correlation analysis of data in group 1 showed the presence of strong relationships of waist-to-hip ratio with body mass index (BMI) (r = 0.776; p = 0.000), ET-1 (r = 0.873; p = 0.000), and HOMA-IR index (r = 0.544; p = 0.000); weak relationships were found with basal glycemia (r = 0.238; p = 0.019), IL-10 (r = 0.295; p = 0.006), and IL-1 (r = 0.219; p = 0.047). Correlation analysis of data in group 2 showed the presence of week relationships of waist-to-hip ratio with BMI (r = 0.371; p = 0.002) and ET-1 (r = 0.471; p = 0.000) only.

Conclusion. The study showed that ET-1 and the waist-to-hip ratio are strongly associated with the risk of adverse cardiovascular events after coronary stenting compared with other markers studied.

Aim. The aim of the study was to develop the model for establishing early diagnosis of hypertension in patients with gout. The model was based on data of 24-hour blood pressure monitoring.

Material and Methods. A total of 69 patients with gout were enrolled in a single-stage cross-sectional prospective study. Three study groups were assigned as follows: group 1 (main group) comprised hypertensive men with gout (n = 41); group 2 (comparison group) comprised normotensive men with gout (n = 28); group 3 (control) included relatively healthy men  (n = 30). Daily blood pressure monitoring was performed on an outpatient basis using a BPLab device (Peter Telegin, Russia).

Results. The significant intergroup differences were found in the following parameters: lowest, mean, and highest 24-hour systolic blood pressure (SBP) values in patients of main and comparison groups (р < 0.001) and in patients of main and control groups (р < 0.001); mean and maximum 24-hour diastolic blood pressure (DBP) values in patients of main and comparison groups (р < 0.001) and in patients of main and control groups (р < 0.001); lowest, mean, and highest 24-hour pulse blood pressure (PBP) values in patients of main and comparison groups (р < 0.001) and in patients of main and control groups (р < 0.001); mean, and maximum 24-hour PBP values in patients of comparison and control groups (р < 0.001). Median values of the lowest, mean, and highest 24-hour SBP in hypertensive patients with gout were significantly higher than the corresponding values in normotensive patients with gout and healthy men of group 3 (p < 0.001). Median values of mean and maximum 24-hour DBP in main group were higher than the corresponding values in comparison group and control group (p < 0.001). Median values of the lowest, mean, and highest 24-hour PBP in hypertensive patients with gout exceeded the corresponding values of patients of control group (p < 0.001). Median values of the mean and maximum 24-hour PBP in main group exceeded the corresponding values of patients of comparison group (p < 0.001). Based on the binary logistic regression model, the prognostic algorithm for hypertension development in gout patients was created using the parameters of 24-hour blood pressure monitoring as predictors and the cut-off K value. If the value of K was > 0.54, then the hypertension development was predicted in gout patients. The sensitivity of developed diagnostic model was 0.84, and the specificity was 0.95.

Conclusion. Тhe proposed model, based on the assessment of average-daily values of the lowest, mean, and highest SBP, allowed to establish early diagnosis of hypertension in patients with gout with the accuracy of up to 90%.

Objective. To determine serum levels of immunoglobulin M (IgM) and G (IgG) antibodies to human herpes virus type 6 (HHV-6) (anti-HHV-6) and features of clinical and morphological portrait in patients with acute decompensated heart failure (ADHF) of ischemic genesis and/or adverse left ventricular (LV) remodeling.

Material and Methods. This open-label, nonrandomized, single-center, prospective trial was registered at clinicaltrials. gov (#NCT02649517) and comprised 25 patients (84% men) with ADHF and LV ejection fraction (EF) ≤ 40%. All patients underwent endomyocardial biopsy (EMB) with immunohistochemistry (IHC) analysis for the presence of HHV-6, compliment C1q, major histocompatibility complex of class II (MHC II), and B-lymphocyte antigen (CD19) as the markers of autoimmune reaction as well as the serum levels of anti-HHV-6 IgM and IgG. Serum levels of IgM and IgG were measured using enzymelinked immunosorbent assay (ELISA) with the calculation of positivity coefficient (PC) according to manufacturer instructions. The test results were interpreted as positive when PC value was greater than 0.8.

Results. The endomyocardial biopsy study detected HHV-6 antigen expression in 15 (60%) out of 25 enrolled patients including 10 cases with diagnosed HHV-6-positive myocarditis and five patients with carriage of viruses. According to IHC, the autoimmune HHV-6 myocarditis was confirmed in three cases (30%). The data of ELISA (n = 18) detected anti-HHV-6 IgM in 5 patients (28%) and anti-HHV-6 IgG in 11 cases (61%). The simultaneous presence of both anti-HHV-6 IgM and IgG was detected in two patients (11%). In addition, anti-HHV-6 IgM and IgG were absent in two (11%) cases. Eight patients (44%) with HHV-6-positive myocarditis included three patients (17%) tested positive for serum anti-HHV-6 IgM, three patients (17%) tested positive for serum anti-HHV-6 IgG, and two patients (11%) who had nether anti-HHV-6 IgM nor anti-HHV-6 IgG in blood serum. Among virus carriers, one patient (20%) was tested positive for anti-HHV-6 IgM and four patients (80%) were tested positive for anti-HHV-6 IgG. The patients without HHV-6 antigen expression (n = 5, 28%) included one patient (5.6%) tested positive for anti-HHV-6 IgM and two patients (11%) tested positive for anti-HHV-6 IgG. The entire sample of patients was divided into two groups depending on the serum level of anti-HHV-6 IgM: group 1 comprised patients tested positive for anti-HHV-6 IgM (n = 5); group 2 comprised patients (n = 13) tested negative for anti-HHV-6 IgM. Clinical and instrumental parameters differed only in the duration of CHF history, which was greater in group 1 than in group 2 (11.0 [8.0; 12.0] vs. 22.5 [14.5; 75.5] months, respectively (p = 0.045). The groups did not significantly differ in the studied markers in myocardial tissue according to the results of IHC analysis. No associations were found between the severity of HHV-6 antigen expression and serum levels of anti-HHV-6 IgM and IgG.

Conclusion. Patients with ADHF and/or adverse LV remodeling after complete myocardial revascularization had higher percentage of HHV-6 antigen expression whose severity was not associated with the serum levels of anti-HHV-6 IgM and IgG.

Old age and insulin resistance accompanying metabolic syndrome are significant factors in the development of cardiovascular pathology.

Aim. The aim of the study was to identify the age-related characteristics of developing insulin resistance on the body level and insulin resistance in rat adipocytes in animals with induced metabolic syndrome.

Material and Methods. The study was carried out on male Wistar rats, which were divided into the following groups: group 1 (n = 14) comprised intact rats aged 150 days at the end of study; group 2 (n = 14) comprised rats aged 150 days at the end of 90-day period on diet with high contents of carbohydrates and fats (HCHFD); group 3 (n = 14) comprised intact rats aged 540 days at the end of the study; group 4 (n = 14) comprised rats aged 540 days after the end of 90-day HCHFD. Diet composition was as follows: 16% proteins, 21% fats, 46% carbohydrates including 17% fructose, 0.125% cholesterol, and replacement of drinking water with a 20%-fructose solution. At the end of the diet, body and organ weights were measured, and contents of glucose, insulin, triglycerides, serum leptin, and liver triglycerides were assessed. Epididymal adipose tissue adipocytes were isolated enzymatically. The content of reactive oxygen species (ROS) was investigated using 2,3-dihydrodichlorofluorescein diacetate. Increased ROS production and lipolysis inhibition in response to insulin were observed.

Results. The signs of metabolic syndrome were observed in both age groups of HCHFD animals and included visceral obesity, hyperglycemia, and insulin resistance measured by homeostatic model assessment of insulin resistance (HOMA-IR). However, the obesity indicators were more pronounced in the group of young rats, whereas the signs of insulin resistance prevailed in older rats. Leptinemia directly correlated with HOMA-IR (rSp = 0.485, p = 0.03). Insulin resistance of adipocytes was observed in rats older than 540 days after the HCHFD.

Conclusion. The obtained results suggested that age was a risk factor for the development of insulin resistance on the body level. Aging resulted in a decrease in the adipocyte sensitivity to insulin in metabolic syndrome. An increase in leptin may be a possible mechanism for worsening of insulin resistance with age.

Metabolic disorders represent a serious medical and social problem and are risk factors for the development of thromboembolic complications. Disturbances of both carbohydrate and fat metabolism contribute to an increase in blood viscosity, creating prothrombotic conditions, which are not always objectively assessed even by specialists. In addition, multiple comorbid conditions usually significantly complicate the prognosis. The article presents a clinical case of recurrent thrombosis of the right atrium and the orifices of the superior and inferior vena cava in a 39-year-old patient with type 2 diabetes mellitus, obesity, arterial hypertension, and varicose vein disease.

The article presents a clinical case of a staged hybrid treatment for an aortic arch aneurysm in patient who previously underwent coronary artery bypass grafting and exoplasty of the ascending aorta. Possible alternative treatment options for this pathology are reviewed, and the features of surgical and endovascular treatment are also described.

The article describes clinical cases demonstrating the advantages of non-invasive long-term electrocardiogram (ECG) monitoring allowing to detect asymptomatic atrial fibrillation (AF) and transient atrioventricular (AV) and sinoatrial (SA) blocks.

Aim. To study the effects of diet optimization and weight loss on the dynamics of metabolic syndrome and cardiovascular risk factors in women with overweight and obesity in six-month dietary counseling and remote monitoring.

Material and Methods. A balanced caloric restriction by 240–250 kcal a day on average was recommended to 119 women with overweight and obesity. Actual nutrition was evaluated using special computer software “1C Nutrition Evaluation”.

Results. The study showed a significant nutritional imbalance with a relatively high consumption of fats (40.4%) and low consumption of carbohydrates (39.6%), mainly due to the low consumption of starch. On the contrary, the consumption level of monoand disaccharides (20.9%) was twice as high as recommended (10%) by the World Health Organization (WHO). Dietary restriction and nutritional optimization led to a significant decrease in the values of body weight, body mass index, waist circumference, blood pressure, and lipid metabolism. As a result, the risks and probability of metabolic syndrome and cardiovascular diseases decreased.

Conclusion. Correction of eating habits allowed to establish a rational and balanced approach to dietary energy restriction and nutritional structure optimization. Achieved weight loss was associated with normalization of parameters of abdominal obesity, blood pressure, and lipid metabolism. Six-month dietary intervention in women promoted control of risk factors for metabolic syndrome and cardiovascular diseases. The results of the study may be used to improve the personalized technology of distant preventive counseling in primary health care aimed at weight loss to achieve both primary and secondary prophylactics of metabolic syndrome and chronic non-infectious diseases.

Purpose. The aim of the study was to develop a technology for dietary correction of nutritional and metabolic status disorders in patients with coronary heart disease with concomitant obesity in the system for comprehensive preoperative preparation.

Material and Methods. The study was performed in the Department of Cardiovascular Pathology and Diet Therapy of the Federal Research Center for Nutrition, Biotechnology and Food Safety. The study comprised a total of 76 patients with coronary artery disease and obesity who required surgical myocardial revascularization and received the course of specialized targeted diet therapy. Patients were assigned to two groups: control group comprised 16 men and 25 women aged 65.6 ± 1.37 years; main group comprised 12 men and 20 women aged 66.0 ± 1.87 years. Patients of control group received a reduced calorie diet during 30-day treatment. Patients of main group additionally received a specialized food product for therapeutic dietary nutrition developed specifically for this category of patients (modified diet therapy). The effects of diet therapy on the parameters of nutritional and metabolic status were assessed.

Results. The study showed that administration of modified diet therapy allowed to achieve more pronounced reduction of body weight and body mass index as well as optimization of body composition, basal metabolic rate, and blood lipid profile including a significantly more pronounced decreases in the levels of total cholesterol (p < 0.001), triglycerides (p < 0.05), low density lipoprotein cholesterol (p < 0.01), and atherogenic coefficient (p < 0.01).

Conclusion. The proposed technology of nutritional care for patients with coronary artery disease and obesity may be used for the purpose of preoperative preparation for surgical myocardial revascularization.

Aim. The aim of work was to study the existing environmental risk factors for overweight and obesity in preschool and primary school children living in Novosibirsk.

Material and Methods. The study included 56 patients who visited a pediatrician or endocrinologist in Clinic of New Medical Technology Center, Institute of Chemical Biology and Fundamental Medicine. We used the individual food preference questionnaire developed based on the most common foods affecting body weight gain according to data of World Health Organization (WHO). Physical inactivity was assessment using a questionnaire developed based on the materials the International Physical Activity Prevalence Study. Children were divided into groups according consumption of carbohydrates: group 1 comprised children with excess consumption of carbohydrates; children of group 2 consumed normal amount of carbohydrates. The examined children included 21 children with normal body weight (10 boys and 11 girls with the average age of 7.19 ± 0.56 years); 35 children were overweight/obese (15 boys and 20 girls with the average age of 7.37 ± 0.35 years). A group of children with sleep time less than eight hours was assigned depending on sleep duration assessment.

Results and discussion. The study included 56 children including 21 patients with normal body weight (37.5%), seven overweight children (12.5%), and 28 obese children (50%). The following significant differences were found between groups of obese and control children: physical inactivity was detected in 71.4% out of 35 obese children and in 23.8% of children in control group (p < 0.005, χ² = 10.12). Sleep duration less than eight hours was observed in 34.3% of obese children and in 4.7% of healthy children (p < 0.01). Excessive consumption of carbohydrates was observed in 65.7% of obese children and in 19% of children with normal weight (p < 0.001). Intake of complex carbohydrates was approximately the same in both groups.

Conclusion. We identified the following risk factors for overweight and obesity in our study: (1) factors contributing to obesity were physical inactivity, excessive consumption of carbohydrates, and impaired sleep-wakefulness pattern due to decrease in sleep time at night less than eight hours; (2) consumption of recommended amounts of fresh fruits and berries was protective against overweight and obesity.