The aim: To investigate the relationship between serum bilirubin level and the presence of the APS in women with a history of spontaneous miscarriages. Materials and methods: Fifty six women aged 22-38 (median 27) years with a history of spontaneous miscarriages were divided into two groups: 33 women with the APS and 23 without. Patients were tested for the presence of lupus anticoagulant, anticardiolipin, anti-β2-glycoprotein 1, antiphospholipid antibodies and genetic thrombophilic defects. Results: Groups were comparable by age, blood pressure, BMI, co-morbidity (anemia, heart abnormality, thyroid disease, overweight). Median serum total bilirubin levels were 7,2 μmol/L (interquartile range [5,8-9,7]) in women with the APS and 10,5 μmol/L (interquartile range [7,5-15,1]) in control group, p=0.005. The chance of detecting a total bilirubin level of less than 8 μmol/L is 4.1 times higher in the APS patients than in the control group (OR 4,1; 95% CI 1,274-13,213). Logistic regression analysis found a statistically significant association between total bilirubin and the presence of the APS (odds ratio, 0.856; 95% CI, 0.734-0.997, p =0.046). Patients with the APS had elevated serum C-reactive protein (medians 2,3 vs 1,1 mg/L, p=0.01) and fibrinogen (medians 2,8 vs 2,5 g/L, p=0.006) levels compared with controls. Correlation analysis revealed a significant correlation between all types of bilirubin and inflammatory markers. Conclusions: All types of serum bilirubin (total, direct and indirect) are significantly reduced in women with APS, associated with higher inflammatory markers and lower levels of 25-hydroxyvitamin D, which may be the result of oxidative stress.

The article presents the results of the study on the features of metabolic factors of cardiovascular risk in patients with essential arterial hypertension depending on body weight and gender.Material and methods. The study included 103 essential arterial hypertension patients and 55 patients in the comparison and control groups. In addition to the general examination prescribed by order No. 436, the survey included also anthropometry, testing the levels of uric acid in serum and leptin, and lipidogram.Results and discussion. The study results showed that in general, patients with essential arterial hypertension had it combined with obesity or overweight presented with impaired renal function, with a decrease in the glomerular filtration rate, which was accompanied by higher levels of uric acid and creatinine, dyslipidaemia and higher levels of C-reactive protein as an indicator of systemic inflammation. In particular, in case of essential arterial hypertension combined with obesity, there were observed significantly higher levels of uric acid and Creactive protein and proatherogenic dyslipidaemia, in contrast to overweight. Certain gender differences were found: men had higher levels of triglycerides and very low density lipoprotein cholesterol and lower levels of high density lipoprotein cholesterol than women, which caused an increase in the atherogenic index. Both dyslipidaemia and hyperuricemia were more commonly observed in men, who had better kidney function than women.Regardless of gender, in case of obesity, higher levels of uricemia were diagnosed as compared to overweight. In men it was accompanied by dyslipidaemia; in women with obesity, higher uricemia was accompanied by a decrease in glomerular filtration rate and an increase in C-reactive protein levels. We found direct correlations between uric acid and PSA levels and anthropometric indicators (body weight, body mass index, waist and thigh circumferences) both in men and in women with obesity. We also revealed a direct correlation of uric acid with C-reactive protein and creatinine and an inverse correlation with glomerular filtration rate.Conclusion. The obtained results proved that in patients with essential arterial hypertension and obesity, leptin levels were higher than in the case of overweight. In women, both in terms of overweight and obesity, leptin levels exceeded the values in men in whom it depended on the body weight. We observed direct significant associations of leptin levels with uric acid and C-reactive protein in women.

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The aim: To evaluate the structural changes of the brain in relation to the formation of cognitive disorders (CD) in patients with arrhythmias Materials and methods: 147 patients with different clinical forms arrhythmias against the background of ischemic heart disease were examine. At the first stage, all patients with arrhythmias assessed cognitive functions. At the second stage, patients were distributed divided into two groups: the main group patients with CD, control – patients without CD. These groups underwent computed tomography examination of the brain. Results: CD were established in 83% patients with arrhythmias. Mild CD were more often diagnosed in patients with persistent form of atrial fibrillation (AF), severe CD – in patients with permanent form of AF and atrioventricular blockade ІI-III degrees. Neuroimaging changes were found in 73.8% patients with CD and in 36% patients without CD. They were manifested by atrophic changes of the cortex, internal hydrocephalus, a decrease in the density of the brain sub¬stance of the periventricular area. In patients with CD, compared to patients without CD, showed lacunar foci with predominant localization in the parietal and frontal lobes of the brain, periventricular and subcortical leukoaraiosis. Multiple correlations were established between CD and structural changes of the brain. Conclusions: The increase in the severity of CD in patients with arrhythmias is associated with atrophic changes at the cortical-subcortical level, accompanied by the phenomena of internal hydrocephalus, periventricular and subcortical LA, lacunar foci, with a predominant localization in the frontal-temporal-occipital lobes, in the visual hump and basal ganglia of both cerebral hemispheres.