Introduction: Cardiovascular diseases (CVD) are one of the most important medical-biological and social problems in Ukraine and in the world because coronary artery disease (CAD) is a major cause of death and disability. Overweight and obesity are risk factor of CVD and type 2 diabetes mellitus (T2DM). Although statins have been shown to be beneficial in secondary prevention of CVD in a number of trials, current reports of increased risk of T2DM with statin use raise concerns. The aim: To compare the metabolic profile and therapeutic targets of non-diabetic obese patients with CAD depending on the dose of atorvastatin. Materials and methods: The study included 107 patients (82 men and 25 women) with CAD and abdominal obesity. Patients were divided into two groups: those taking 20 mg and 40 mg of atorvastatin daily correspondingly. Glucose, insulin, HbA1c, HOMA-IR, lipids, hs-CRP and anthropometric parameters were measured for each subject. Results: For patients with CAD and obesity, who had taken atorvastatin in a 40-mg dose, we observed a significant increase in insulin resistance and impaired fasting glucose. Also we found a reliable correlation between the carbohydrate and lipid spectrum. These parameters reflect the mechanism of the formation of metabolic disorders as a result of intensive statin therapy. Сonclusions: Despite of the beneficial reductions in LDL and total cholesterol, atorvastatin treatment on a dose 40 mg resulted in significant increase of fasting glucose, insulin levels and insulin resistance pertaining to those patients.

Adipose tissue is a powerful endocrine organ, which synthesizes significant amount of biologically active substances – adipokines. Due to adipokine dysfunction, a spectrum of diseases associated with obesity appears, namely, coronary artery disease, diabetes mellitus, hypertension and oncology. Hyperinsulinemia and insulin resistance play a significant role in pathogenesis of cardiometabolic complications in patients with obesity. They trigger a pathological cascade of reactions leading to cardiovascular diseases. Omentin-1 possesses anti-atherogenic action and it can modify peripheral effects of insulin. The aim of the study – to analyze changes in omentin-1 concentration and the condition of insulin resistance in patients with coronary artery disease and obesity during atorvastatin treatment. Materials and Methods. 55 patients with obesity were examined. They had general clinical examination; blood lipids, uric acid level and liver enzymes; glycated hemoglobin, glucose, insulin with the calculation of HOMA index and omentin-1 concentration was determined. Patients were divided into two groups: the group 1 – 20 patients with obesity, who did not suffer from CAD and did not take atorvastatin, and the group 2 – patients with CAD and obesity, who took atorvastatin. Determination of these indices was performed for patients of the group 2 in dynamics in 12 months. Results and Discussion. In the group of patients with CAD and obesity, who took atorvastatin, lipid levels were reliably lower, but levels of fasting glucose concentration, uric acid and liver enzymes were higher than in the patients who did not take the drug. Elevation of omentin-1 in blood serum was observed in 12 months in patients with CAD and obesity simultaneously with the increase in insulin level and the decrease in tissue sensitivity to it. Conclusions. Intake of atorvastatin by patients with coronary artery disease and obesity is accompanied by elevation of insulin concentration, intensification of insulin resistance and increase in omentin-1 level.

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74 Ðåôåðàò Ìåòà. Ïîêðàùèòè ä³à´íîñòèêó òà ë³êóâàííÿ ïàö³ºíò³â ç ³øåì³÷íîþ õâîðîáîþ ñåðöÿ íà òë³ îaeèð³ííÿ. Ìàòåð³àë ³ ìåòîäè. Îïèñàíî âèïàäîê âïåðøå âèÿâëåíîãî öóêðîâîãî ä³àáåòó 2 òèïó ó ïàö³ºíòà ç ³øåì³÷íîþ õâîðîáîþ ñåðöÿ òà êîìîðá³äíèì îaeèð³ííÿì ÷åðåç 6 ì³ñÿö³â â³ä ïî÷àòêó ïðèéîìó àòîðâàñòàòèíó. Ðåçóëüòàòè é îáãîâîðåííÿ. Ó íàøîìó ñïîñòåðåaeåíí³ ïàö³ºíò Ê. ñòàíîì íà 11.07.16 ìàâ ä³à´íîç: ³øåì³÷íà õâîðîáà ñåðöÿ, ñòàá³ëüíà ñòåíîêàðä³ÿ III ôóíêö³îíàëüíèé êëàñ, ï³ñëÿ³íôàðêòíèé (08.04.2016) êàðä³îñêëåðîç. Ïëàíîâå ñòåíòóâàííÿ ïðàâî¿ êîðîíàðíî¿ àðòå𳿠äðóãî¿ ã³ëêè ³ç ñòåíîçîì 99% 17.05.16 ð. óïåðòîí³÷íà õâîðîáà III ñòà䳿, ñòóï³íü I, ðèçèê 4 (äóaeå âèñîêèé). óïåðòåíçèâíå ñåðöå. Ñåðöåâà íåäîñòàòí³ñòü IIÀ ç³ çáåðåaeåíîþ ñèñ-òîë³÷íîþ ôóíêö³ºþ ë³âîãî øëóíî÷êà. Îaeèð³ííÿ 1 ñòóïåíÿ çà àáäîì³íàëüíèì òèïîì.  ïàö³ºíòà áóëè íàÿâí³ ïî÷àò-êîâ³ ïîðóøåííÿ âóãëåâîäíîãî îáì³íó, à ñàìå ã³ïåð´ë³êåì³ÿ íàòùå òà ³íñóë³íîðåçèñòåíò³ñòü, ã³ïåðëåïòèíåì³ÿ, òàêîae ñïîñòåð³ãàëîñÿ çíèaeåííÿ ð³âíÿ îìåíòèíó. Îòðèìóâàâ ë³êóâàííÿ çã³äíî ïðîòîêîëó ç âêëþ÷åííÿì àòîðâàñòàòèíó ó äîç³ 40 ì´. ×åðåç 6 ì³ñÿö³â ó ïàö³ºíòà ä³à´íîñòóâàëè âïåðøå âèÿâëåíèé öóêðîâèé ä³àáåò 2 òèïó ³ ïðèçíà÷èëè ìåòôîðì³í 500 ì´/äîáó. Òàêèì ÷èíîì, â ðå-çóëüòàò³ ñâîº÷àñíî ä³à´íîñòîâàíîãî öóêðîâîãî ä³àáåòó 2 òèïó âäàëîñÿ ïðèçíà÷èòè íåîáõ³äíå ë³êóâàííÿ òà óíèêíóòè óñêëàäíåíü. Âèñíîâîê. Ïàö³ºíòè ç ³øåì³÷íîþ õâîðîáîþ ñåðöÿ òà îaeè-ð³ííÿì ìàþòü ï³äâèùåíèé ðèçèê âèíèêíåííÿ öóêðîâîãî ä³àáåòó 2 òèïó, òîìó ïîòðåáóþòü á³ëüøî¿ óâàãè ë³êàðÿ òà ÷àñò³øîãî êîíòðîëþ ïîêàçíèê³â âóãëåâîäíîãî îáì³íó. Êëþ÷îâ³ ñëîâà: ³øåì³÷íà õâîðîáà ñåðöÿ, ³íñóë³íîðåçèñ-òåíòí³ñòü, îaeèð³ííÿ, öóêðîâèé ä³àáåò 2 òèïó, àòîðâàñòàòèí. Aim. To improve diagnosis and treatment of patients with coronary artery disease and obesity. Material and methods. New onset diabetes mellitus in