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Факторы риска субклинического атеросклероза у женщин с ожирением
Факторы риска субклинического атеросклероза у женщин с ожирением
Шенкова Н.Н., Чумакова Г.А., Веселовская Н.Г. и др. Факторы риска субклинического атеросклероза у женщин с ожирением. CardioСоматика. 2017; 8 (2): 44–50.
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Аннотация
Цель исследования – изучить метаболические факторы риска субклинического атеросклероза у женщин с ожирением.
Материал и методы. В исследование были включены женщины (n=89) 30–60 лет (50,6±6,6 года) с окружностью талии более 80 см без клинических проявлений ишемической болезни сердца и атеросклероза другой локализации. По результатам дуплексного исследования брахиоцефальных артерий (БЦА) были сформированы 2 группы сравнения: 1-я (n=60) – без признаков атеросклероза БЦА и 2-я (n=29) – с признаками атеросклероза БЦА. Проводились определение основных и дополнительных метаболических факторов риска, адипокинов висцеральной жировой ткани, грелина, эхокардиография с определением толщины эпикардиальной жировой ткани (тЭЖТ).
Результаты. У женщин во 2-й группе выявлены более высокие показатели холестерина липопротеидов низкой плотности – 3,7 (2,9; 4,6) ммоль/л, аполипопротеина В – 1,32±0,29 г/л, С-реактивного белка – 2,8±0,96 мг/л, лептина – 20,0 (16,4; 23,1) нг/мл и тЭЖТ – 7 (6; 8) мм – и более низкие показатели аполипопротеина А1 – 1,16±0,31 г/л, грелина – 40,7 (39,1; 42,8) пг/дл.
Заключение. Наличие субклинического атеросклероза БЦА у женщин с ожирением ассоциировалось с более высокими показателями количества висцеральной жировой ткани (тЭЖТ), воспалительной активностью плазмы (С-реактивный белок), нейрогуморальными нарушениями (лептин, грелин).
Ключевые слова: субклинический атеросклероз, кардиоваскулярный риск, висцеральное ожирение.
Material and methods. 89 women have been included in research, 50.6±6.6 years old with abdominal obesity and waist circumference >80 cm without coronary heart disease and atherosclerosis of other localisation. According to the results of the ultrasound study of brachiocephalic arteries (BCA), two groups were formed for comparison: Group 1 (n=60) without atherosclerosis BCA, Group 2 (n=29) with atherosclerosis BCA. Definitions of classical and additional metabolic RF, of adipokines of visceral adipose tissue (VAT) and ghrelin wеre spent to the surveyed patients. The thickness of epicardial fat (tEF) was defined at transthoracic echocardiography.
Results. In the group 2 there were the highest indexes of: LDL 3.7 (2.9; 4.6) mmol/L, Apo B 1.32±0.29 g/L, CRP 2.8±0.96 mg/l, leftin 20.0 (16.4; 23.1) ng/ml, tEF 7 (6; 8) mm; lower indexes of Apo A1 1.16±0.31 g/l and ghrelin 40.7 (39.1; 42.8) pg/dl.
Conclusion. The signs of subclinical atherosclerosis of the carotid arteries of obese women were associated with higher amount of VAT (tEF), inflammatory activity of plasma (CRP) and neurohumoral disorders (leftin, ghrelin).
Key words: subclinical atherosclerosis, cardiovascular risk, visceral obesity.
Материал и методы. В исследование были включены женщины (n=89) 30–60 лет (50,6±6,6 года) с окружностью талии более 80 см без клинических проявлений ишемической болезни сердца и атеросклероза другой локализации. По результатам дуплексного исследования брахиоцефальных артерий (БЦА) были сформированы 2 группы сравнения: 1-я (n=60) – без признаков атеросклероза БЦА и 2-я (n=29) – с признаками атеросклероза БЦА. Проводились определение основных и дополнительных метаболических факторов риска, адипокинов висцеральной жировой ткани, грелина, эхокардиография с определением толщины эпикардиальной жировой ткани (тЭЖТ).
Результаты. У женщин во 2-й группе выявлены более высокие показатели холестерина липопротеидов низкой плотности – 3,7 (2,9; 4,6) ммоль/л, аполипопротеина В – 1,32±0,29 г/л, С-реактивного белка – 2,8±0,96 мг/л, лептина – 20,0 (16,4; 23,1) нг/мл и тЭЖТ – 7 (6; 8) мм – и более низкие показатели аполипопротеина А1 – 1,16±0,31 г/л, грелина – 40,7 (39,1; 42,8) пг/дл.
Заключение. Наличие субклинического атеросклероза БЦА у женщин с ожирением ассоциировалось с более высокими показателями количества висцеральной жировой ткани (тЭЖТ), воспалительной активностью плазмы (С-реактивный белок), нейрогуморальными нарушениями (лептин, грелин).
Ключевые слова: субклинический атеросклероз, кардиоваскулярный риск, висцеральное ожирение.
________________________________________________
Material and methods. 89 women have been included in research, 50.6±6.6 years old with abdominal obesity and waist circumference >80 cm without coronary heart disease and atherosclerosis of other localisation. According to the results of the ultrasound study of brachiocephalic arteries (BCA), two groups were formed for comparison: Group 1 (n=60) without atherosclerosis BCA, Group 2 (n=29) with atherosclerosis BCA. Definitions of classical and additional metabolic RF, of adipokines of visceral adipose tissue (VAT) and ghrelin wеre spent to the surveyed patients. The thickness of epicardial fat (tEF) was defined at transthoracic echocardiography.
Results. In the group 2 there were the highest indexes of: LDL 3.7 (2.9; 4.6) mmol/L, Apo B 1.32±0.29 g/L, CRP 2.8±0.96 mg/l, leftin 20.0 (16.4; 23.1) ng/ml, tEF 7 (6; 8) mm; lower indexes of Apo A1 1.16±0.31 g/l and ghrelin 40.7 (39.1; 42.8) pg/dl.
Conclusion. The signs of subclinical atherosclerosis of the carotid arteries of obese women were associated with higher amount of VAT (tEF), inflammatory activity of plasma (CRP) and neurohumoral disorders (leftin, ghrelin).
Key words: subclinical atherosclerosis, cardiovascular risk, visceral obesity.
Полный текст
Список литературы
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17. Чумакова Г.А., Веселовская Н.Г., Гриценко О.В. и др. Эпикардиальное ожирение как фактор риска развития коронарного атеросклероза. Кардиология. 2013; 53 (1): 51–5. Chumakova G.A., Veselovskaia N.G., Gritsenko O.V. i dr. Epikardial'noe ozhirenie kak faktor riska razvitiia koronarnogo ateroskleroza. Kardiologiia. 2013; 53 (1): 51–5. [in Russian]
18. Cakir E, Doğan M, Topaloglu O et al. Subclinical atherosclerosis and hyperandrogenemia are independent risk factors for increased epicardial fat thickness in patients with PCOS and idiopathic hirsutism. Atherosclerosis 2013; 226 (1): 291–5.
19. Huang G, Wang D, Zeb I et al. Intra-thoracic fat, cardiometabolic risk factors, and subclinical cardiovascular disease in healthy, recently menopausal women screened for the Kronos Early Estrogen Prevention Study (KEEPS). Atherosclerosis 2012; 221 (1): 198–205.
20. Арабидзе Г.Г. Клиническая иммунология атеросклероза от теории к практике. Атеросклероз и дислипидемии. 2013; 1 (10): 4–19. / Arabidze G.G. Klinicheskaia immunologiia ateroskleroza ot teorii k praktike. Ateroskleroz i dislipidemii. 2013; 1 (10): 4–19. [in Russian]
21. Oh EG, Kim SH, Bang SY et al. High-sensitivity C-reactive protein is independently associated with arterial stiffness in women with metabolic syndrome. J Cardiovasc Nurs 2012; 27 (1): 61–7.
22. Nahas EA, Nahas-Neto J, Orsatti CL et al. Evaluation of clinical and inflammatory markers of subclinical carotid atherosclerosis in postmenopausal women. Menopause 2014; 21 (9): 982–9.
23. Веселовская Н.Г., Чумакова Г.А., Козаренко А.А., Бокслер М.И. Адипокины как корригируемый фактор риска сердечно-сосудистых заболеваний. Рос. кардиол. журн. 2010; 6 (86): 88–93. / Veselovskaia N.G., Chumakova G.A., Kozarenko A.A., Boksler M.I. Adipokiny kak korrigiruemyi faktor riska serdechno-sosudistykh zabolevanii. Ros. kardiol. zhurn. 2010; 6 (86): 88–93. [in Russian]
24. McMahon M, Skaggs BJ, Sahakian L et al. High plasma leftin levels confer increased risk of atherosclerosis in women with systemic lupus erythematosus, and are associated with inflammatory oxidised lipids. Ann Rheum Dis 2011; 70 (9): 1619–24.
25. Ukkola O. Ghrelin and atherosclerosis. Curr Opin Lipidol 2015; 26 (4): 288–91.
26. Zhang M, Fang WY, Yuan F et al. Plasma ghrelin levels are closely associated with severity and morphology of angiographically-detected coronary atherosclerosis in Chineses patients with diabetes mellitus. Аcta Pharmacologica Sinica 2012; 33: 452–8.
27. Zwirska-Korczala K, Sodowski K, Konturek SJ et al. Postprandial response of ghrelin and PYY and indices of low-grade chronic inflammation in lean young women with polycystic ovary syndrome. J Physiol Pharmacol 2008; 59 (Suppl. 2): 161–78.
28. Buss J, Havel PJ, Epel E et al. Associations of ghrelin with eating behaviors, stress, metabolic factors, and telomere length among overweight and obese women: preliminary evidence of attenuated ghrelin effects in obesity. Appetite 2014; 76: 84–94.
29. Pop D, Peter P, Dădârlat A et al. Serum ghrelin level is associated with cardiovascular risk score. Rom J Intern Med 2015; 53 (2): 140–5.
30. Pöykkö SM, Kellokoski E, Ukkola O et al. Plasma ghrelin concentrations are positively associated with carotid artery atherosclerosis in males. Intern Med 2006; 260 (1): 43–52.
2. Neifel'd I.V., Zhirniakov A.I., Skupova I.N. Faktory riska serdechno-sosudistykh zabolevanii zhenshchin. Biul. med. internet-konferentsii. 2012; 12 (2): 1001–3. [in Russian]
3. Sallam T, Watson KE. Predictors of cardiovascular risk in women. Womens Health (Lond) 2013; 9 (5): 491–8.
4. Boitsov S.A., Kukharchuk V.V., Karpov Iu.A. i dr. Subklinicheskii ateroskleroz kak faktor riska serdechno-sosudistykh oslozhnenii. Kardiovask. terapiia i profilaktika. 2012; 11 (3): 82–6. [in Russian]
5. Vel'kov V.V. Vysokochuvstvitel'nye kardial'nye markery i reklassifikatsiia serdechno-sosudistykh riskov. Kliniko-laboratornyi konsilium. 2012; 1 (41): 47–52. [in Russian]
6. Jaffer FA, O'Donnell CJ, Larson MG. Age and sex distribution of subclinical aortic atherosclerosis: a magnetic resonance imaging examination of the Framingham Heart Study. Arterioscler Thromb Vasc Biol 2002; 22: 849–54.
7. Johnson M. Ultrasonography in the diagnosis of subclinical atherosclerosis. 2013.
8. Mitchell S, Shaw D. The worldwide epidemic of female obesity. Best Pract Res Clin Obstet Gynaecol 2015; 29 (3): 289–99.
9. Rabkin SW. Epicardial fat: properties, function and relationship to obesity. Obes Rev 2007; 8 (3): 253–61.
10. Macut D, Bačević M, Božić-Antić I et al. Predictors of subclinical cardiovascular disease in women with polycystic ovary syndrome: interrelationship of dyslipidemaia and arterial blood pressure. Int J Endocrinol 2015; 2015: 812610.
11. Maturana MA, Franz RF, Metzdorf M et al. Subclinical cardiovascular disease in postmenopausal women with low/medium cardiovascular risk by the Framingham risk score. Maturitas 2015; 81 (2): 311–6.
12. Fagerberg B, Prah Gullberg U, Alm R et al. Circulating autoantibodies against the apolipoprotein B-100 peftides p45 and p210 in relation to the occurrence of carotid plaques in 64-year-old women. PLoS One 2015; 10 (3).
13. Munjal YP, Surendra K. API Textbook of Medicine, Ninth Edition, Two Volume. Jay Pee Brothers, 2012; p. 663.
14. Chumakova G.A., Veselovskaia N.G., Ott A.V. i dr. Al'ternativnyi sposob otsenki vistseral'nogo ozhireniia pri diagnostike metabolicheskogo sindroma. Ros. kardiol. zhurn. 2014; 3: 82–6. [in Russian]
15. Molica F, Morel S, Kwak BR et al. Adipokines at the crossroad between obesity and cardiovascular disease. Thromb Haemost 2015; 113 (3): 553–66.
16. Yañez-Rivera TG, Baños-Gonzalez MA, Ble-Castillo JL et al. Relationship between epicardial adipose tissue, coronary artery disease and adiponectin in a Mexican population. Cardiovasc Ultrasound 2014; 12: 35.
17. Chumakova G.A., Veselovskaia N.G., Gritsenko O.V. i dr. Epikardial'noe ozhirenie kak faktor riska razvitiia koronarnogo ateroskleroza. Kardiologiia. 2013; 53 (1): 51–5. [in Russian]
18. Cakir E, Doğan M, Topaloglu O et al. Subclinical atherosclerosis and hyperandrogenemia are independent risk factors for increased epicardial fat thickness in patients with PCOS and idiopathic hirsutism. Atherosclerosis 2013; 226 (1): 291–5.
19. Huang G, Wang D, Zeb I et al. Intra-thoracic fat, cardiometabolic risk factors, and subclinical cardiovascular disease in healthy, recently menopausal women screened for the Kronos Early Estrogen Prevention Study (KEEPS). Atherosclerosis 2012; 221 (1): 198–205.
20. Arabidze G.G. Klinicheskaia immunologiia ateroskleroza ot teorii k praktike. Ateroskleroz i dislipidemii. 2013; 1 (10): 4–19. [in Russian]
21. Oh EG, Kim SH, Bang SY et al. High-sensitivity C-reactive protein is independently associated with arterial stiffness in women with metabolic syndrome. J Cardiovasc Nurs 2012; 27 (1): 61–7.
22. Nahas EA, Nahas-Neto J, Orsatti CL et al. Evaluation of clinical and inflammatory markers of subclinical carotid atherosclerosis in postmenopausal women. Menopause 2014; 21 (9): 982–9.
23. Veselovskaia N.G., Chumakova G.A., Kozarenko A.A., Boksler M.I. Adipokiny kak korrigiruemyi faktor riska serdechno-sosudistykh zabolevanii. Ros. kardiol. zhurn. 2010; 6 (86): 88–93. [in Russian]
24. McMahon M, Skaggs BJ, Sahakian L et al. High plasma leftin levels confer increased risk of atherosclerosis in women with systemic lupus erythematosus, and are associated with inflammatory oxidised lipids. Ann Rheum Dis 2011; 70 (9): 1619–24.
25. Ukkola O. Ghrelin and atherosclerosis. Curr Opin Lipidol 2015; 26 (4): 288–91.
26. Zhang M, Fang WY, Yuan F et al. Plasma ghrelin levels are closely associated with severity and morphology of angiographically-detected coronary atherosclerosis in Chineses patients with diabetes mellitus. Аcta Pharmacologica Sinica 2012; 33: 452–8.
27. Zwirska-Korczala K, Sodowski K, Konturek SJ et al. Postprandial response of ghrelin and PYY and indices of low-grade chronic inflammation in lean young women with polycystic ovary syndrome. J Physiol Pharmacol 2008; 59 (Suppl. 2): 161–78.
28. Buss J, Havel PJ, Epel E et al. Associations of ghrelin with eating behaviors, stress, metabolic factors, and telomere length among overweight and obese women: preliminary evidence of attenuated ghrelin effects in obesity. Appetite 2014; 76: 84–94.
29. Pop D, Peter P, Dădârlat A et al. Serum ghrelin level is associated with cardiovascular risk score. Rom J Intern Med 2015; 53 (2): 140–5.
30. Pöykkö SM, Kellokoski E, Ukkola O et al. Plasma ghrelin concentrations are positively associated with carotid artery atherosclerosis in males. Intern Med 2006; 260 (1): 43–52.
2. Нейфельд И.В., Жирняков А.И., Скупова И.Н. Факторы риска сердечно-сосудистых заболеваний женщин. Бюл. мед. интернет-конференций. 2012; 12 (2): 1001–3. Neifel'd I.V., Zhirniakov A.I., Skupova I.N. Faktory riska serdechno-sosudistykh zabolevanii zhenshchin. Biul. med. internet-konferentsii. 2012; 12 (2): 1001–3. [in Russian]
3. Sallam T, Watson KE. Predictors of cardiovascular risk in women. Womens Health (Lond) 2013; 9 (5): 491–8.
4. Бойцов С.А., Кухарчук В.В., Карпов Ю.А. и др. Субклинический атеросклероз как фактор риска сердечно-сосудистых осложнений. Кардиоваск. терапия и профилактика. 2012; 11 (3): 82–6. / Boitsov S.A., Kukharchuk V.V., Karpov Iu.A. i dr. Subklinicheskii ateroskleroz kak faktor riska serdechno-sosudistykh oslozhnenii. Kardiovask. terapiia i profilaktika. 2012; 11 (3): 82–6. [in Russian]
5. Вельков В.В. Высокочувствительные кардиальные маркеры и реклассификация сердечно-сосудистых рисков. Клинико-лабораторный консилиум. 2012; 1 (41): 47–52. / Vel'kov V.V. Vysokochuvstvitel'nye kardial'nye markery i reklassifikatsiia serdechno-sosudistykh riskov. Kliniko-laboratornyi konsilium. 2012; 1 (41): 47–52. [in Russian]
6. Jaffer FA, O'Donnell CJ, Larson MG. Age and sex distribution of subclinical aortic atherosclerosis: a magnetic resonance imaging examination of the Framingham Heart Study. Arterioscler Thromb Vasc Biol 2002; 22: 849–54.
7. Johnson M. Ultrasonography in the diagnosis of subclinical atherosclerosis. 2013.
8. Mitchell S, Shaw D. The worldwide epidemic of female obesity. Best Pract Res Clin Obstet Gynaecol 2015; 29 (3): 289–99.
9. Rabkin SW. Epicardial fat: properties, function and relationship to obesity. Obes Rev 2007; 8 (3): 253–61.
10. Macut D, Bačević M, Božić-Antić I et al. Predictors of subclinical cardiovascular disease in women with polycystic ovary syndrome: interrelationship of dyslipidemaia and arterial blood pressure. Int J Endocrinol 2015; 2015: 812610.
11. Maturana MA, Franz RF, Metzdorf M et al. Subclinical cardiovascular disease in postmenopausal women with low/medium cardiovascular risk by the Framingham risk score. Maturitas 2015; 81 (2): 311–6.
12. Fagerberg B, Prah Gullberg U, Alm R et al. Circulating autoantibodies against the apolipoprotein B-100 peftides p45 and p210 in relation to the occurrence of carotid plaques in 64-year-old women. PLoS One 2015; 10 (3).
13. Munjal YP, Surendra K. API Textbook of Medicine, Ninth Edition, Two Volume. Jay Pee Brothers, 2012; p. 663.
14. Чумакова Г.А., Веселовская Н.Г., Отт А.В. и др. Альтернативный способ оценки висцерального ожирения при диагностике метаболического синдрома. Рос. кардиол. журн. 2014; 3: 82–6. / Chumakova G.A., Veselovskaia N.G., Ott A.V. i dr. Al'ternativnyi sposob otsenki vistseral'nogo ozhireniia pri diagnostike metabolicheskogo sindroma. Ros. kardiol. zhurn. 2014; 3: 82–6. [in Russian]
15. Molica F, Morel S, Kwak BR et al. Adipokines at the crossroad between obesity and cardiovascular disease. Thromb Haemost 2015; 113 (3): 553–66.
16. Yañez-Rivera TG, Baños-Gonzalez MA, Ble-Castillo JL et al. Relationship between epicardial adipose tissue, coronary artery disease and adiponectin in a Mexican population. Cardiovasc Ultrasound 2014; 12: 35.
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19. Huang G, Wang D, Zeb I et al. Intra-thoracic fat, cardiometabolic risk factors, and subclinical cardiovascular disease in healthy, recently menopausal women screened for the Kronos Early Estrogen Prevention Study (KEEPS). Atherosclerosis 2012; 221 (1): 198–205.
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25. Ukkola O. Ghrelin and atherosclerosis. Curr Opin Lipidol 2015; 26 (4): 288–91.
26. Zhang M, Fang WY, Yuan F et al. Plasma ghrelin levels are closely associated with severity and morphology of angiographically-detected coronary atherosclerosis in Chineses patients with diabetes mellitus. Аcta Pharmacologica Sinica 2012; 33: 452–8.
27. Zwirska-Korczala K, Sodowski K, Konturek SJ et al. Postprandial response of ghrelin and PYY and indices of low-grade chronic inflammation in lean young women with polycystic ovary syndrome. J Physiol Pharmacol 2008; 59 (Suppl. 2): 161–78.
28. Buss J, Havel PJ, Epel E et al. Associations of ghrelin with eating behaviors, stress, metabolic factors, and telomere length among overweight and obese women: preliminary evidence of attenuated ghrelin effects in obesity. Appetite 2014; 76: 84–94.
29. Pop D, Peter P, Dădârlat A et al. Serum ghrelin level is associated with cardiovascular risk score. Rom J Intern Med 2015; 53 (2): 140–5.
30. Pöykkö SM, Kellokoski E, Ukkola O et al. Plasma ghrelin concentrations are positively associated with carotid artery atherosclerosis in males. Intern Med 2006; 260 (1): 43–52.
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12. Fagerberg B, Prah Gullberg U, Alm R et al. Circulating autoantibodies against the apolipoprotein B-100 peftides p45 and p210 in relation to the occurrence of carotid plaques in 64-year-old women. PLoS One 2015; 10 (3).
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15. Molica F, Morel S, Kwak BR et al. Adipokines at the crossroad between obesity and cardiovascular disease. Thromb Haemost 2015; 113 (3): 553–66.
16. Yañez-Rivera TG, Baños-Gonzalez MA, Ble-Castillo JL et al. Relationship between epicardial adipose tissue, coronary artery disease and adiponectin in a Mexican population. Cardiovasc Ultrasound 2014; 12: 35.
17. Chumakova G.A., Veselovskaia N.G., Gritsenko O.V. i dr. Epikardial'noe ozhirenie kak faktor riska razvitiia koronarnogo ateroskleroza. Kardiologiia. 2013; 53 (1): 51–5. [in Russian]
18. Cakir E, Doğan M, Topaloglu O et al. Subclinical atherosclerosis and hyperandrogenemia are independent risk factors for increased epicardial fat thickness in patients with PCOS and idiopathic hirsutism. Atherosclerosis 2013; 226 (1): 291–5.
19. Huang G, Wang D, Zeb I et al. Intra-thoracic fat, cardiometabolic risk factors, and subclinical cardiovascular disease in healthy, recently menopausal women screened for the Kronos Early Estrogen Prevention Study (KEEPS). Atherosclerosis 2012; 221 (1): 198–205.
20. Arabidze G.G. Klinicheskaia immunologiia ateroskleroza ot teorii k praktike. Ateroskleroz i dislipidemii. 2013; 1 (10): 4–19. [in Russian]
21. Oh EG, Kim SH, Bang SY et al. High-sensitivity C-reactive protein is independently associated with arterial stiffness in women with metabolic syndrome. J Cardiovasc Nurs 2012; 27 (1): 61–7.
22. Nahas EA, Nahas-Neto J, Orsatti CL et al. Evaluation of clinical and inflammatory markers of subclinical carotid atherosclerosis in postmenopausal women. Menopause 2014; 21 (9): 982–9.
23. Veselovskaia N.G., Chumakova G.A., Kozarenko A.A., Boksler M.I. Adipokiny kak korrigiruemyi faktor riska serdechno-sosudistykh zabolevanii. Ros. kardiol. zhurn. 2010; 6 (86): 88–93. [in Russian]
24. McMahon M, Skaggs BJ, Sahakian L et al. High plasma leftin levels confer increased risk of atherosclerosis in women with systemic lupus erythematosus, and are associated with inflammatory oxidised lipids. Ann Rheum Dis 2011; 70 (9): 1619–24.
25. Ukkola O. Ghrelin and atherosclerosis. Curr Opin Lipidol 2015; 26 (4): 288–91.
26. Zhang M, Fang WY, Yuan F et al. Plasma ghrelin levels are closely associated with severity and morphology of angiographically-detected coronary atherosclerosis in Chineses patients with diabetes mellitus. Аcta Pharmacologica Sinica 2012; 33: 452–8.
27. Zwirska-Korczala K, Sodowski K, Konturek SJ et al. Postprandial response of ghrelin and PYY and indices of low-grade chronic inflammation in lean young women with polycystic ovary syndrome. J Physiol Pharmacol 2008; 59 (Suppl. 2): 161–78.
28. Buss J, Havel PJ, Epel E et al. Associations of ghrelin with eating behaviors, stress, metabolic factors, and telomere length among overweight and obese women: preliminary evidence of attenuated ghrelin effects in obesity. Appetite 2014; 76: 84–94.
29. Pop D, Peter P, Dădârlat A et al. Serum ghrelin level is associated with cardiovascular risk score. Rom J Intern Med 2015; 53 (2): 140–5.
30. Pöykkö SM, Kellokoski E, Ukkola O et al. Plasma ghrelin concentrations are positively associated with carotid artery atherosclerosis in males. Intern Med 2006; 260 (1): 43–52.
Авторы
Н.Н.Шенкова*1,2, Г.А.Чумакова1,3, Н.Г.Веселовская3,4, Е.С.Осипова1, А.В.Отт1,4
1 ФГБОУ ВО «Алтайский государственный медицинский университет» Минздрава России. 656038, Барнаул, пр-т Ленина, д. 40;
2 ЗАО «Санаторий “Россия”». 659900, Россия, Белокуриха, ул. Славского, д. 34;
3 ФГБНУ «Научно-исследовательский институт комплексных проблем сердечно-сосудистых заболеваний». 650002, Россия, Кемерово, Сосновый б-р, д. 6;
4 КГБУЗ «Алтайский краевой кардиологический диспансер». 656055, Россия, Барнаул, ул. Малахова, д. 46
*ninashenkova@mail.ru
1 Altay State Medical University of the Ministry of Health of the Russian Federation. 656038, Russian Federation, Barnaul, pr-t Lenina, d. 40;
2 Sanatorium «Russia». 659900, Russian Federation, Belokurikha, ul. Slavskogo, d. 34;
3 Research Institute for Complex Issues of Cardiovascular Diseases. 650002, Russian Federation, Kemerovo, Sosnovyi b-r, d. 6;
4 Altay Regional Cardiology Dispensary. 656055, Russian Federation, Barnaul, ul. Malakhova, d. 46
*ninashenkova@mail.ru
1 ФГБОУ ВО «Алтайский государственный медицинский университет» Минздрава России. 656038, Барнаул, пр-т Ленина, д. 40;
2 ЗАО «Санаторий “Россия”». 659900, Россия, Белокуриха, ул. Славского, д. 34;
3 ФГБНУ «Научно-исследовательский институт комплексных проблем сердечно-сосудистых заболеваний». 650002, Россия, Кемерово, Сосновый б-р, д. 6;
4 КГБУЗ «Алтайский краевой кардиологический диспансер». 656055, Россия, Барнаул, ул. Малахова, д. 46
*ninashenkova@mail.ru
________________________________________________
1 Altay State Medical University of the Ministry of Health of the Russian Federation. 656038, Russian Federation, Barnaul, pr-t Lenina, d. 40;
2 Sanatorium «Russia». 659900, Russian Federation, Belokurikha, ul. Slavskogo, d. 34;
3 Research Institute for Complex Issues of Cardiovascular Diseases. 650002, Russian Federation, Kemerovo, Sosnovyi b-r, d. 6;
4 Altay Regional Cardiology Dispensary. 656055, Russian Federation, Barnaul, ul. Malakhova, d. 46
*ninashenkova@mail.ru
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