Recent research shows that the number of diseases associated with obesity has been increasing. In obese persons, association with functional constipation is noted in 24.0% of cases, and obesity is recorded in 60.0% of patients with functional constipation. Among the possible mechanisms for the development of such a combination are changes in serotonin level in the blood, although the existing data are ambiguous and sometimes controversial.The objective of the study is to investigate the changes in serotonin level in the blood of obese patients in combination with constipation and its relationship with the lipid profile of the blood.Materials and methods. 63 patients with obesity in combination with irritable bowel syndrome with constipation (IBSc), 24 patients with normal body mass index and 10 practically healthy people were examined. 25 patients with obesity and constipation had a body mass index of 32.8±0.24kg/m2, 28 patients – 37.8±kg/m2, and 10 patients – 42.6±0.5kg/m2. In patients with irritable bowel syndrome without obesity, the body mass index was 21.7±0.4kg/m2. The blood serotonin level and lipid profile of the blood was determined in all patients.Results. It was deermined that in case of irritable bowel syndrome with constipation, serotonin level in the blood was reduced. In obesity with IBSc, the concentration of serotonin, on the contrary, was elevated. All patients with IBSc and obesity were marked an elevated level of total cholesterol and triglycerides. A direct correlation between high levels of triglycerides and serotonin concentration in serum of such comorbid patients was detected. The increase in the degree of obesity in the presence of IBSc was accompanied by a decrease in the concentration of cholesterol of high density lipoprotein. Patients with IBSc without excessive body weight had no such deviations.Conclusions. With an increase in the degree of obesity, serotonin level in the blood increases and the lipid blood spectrum worsens.

The aim: The aim of the research was to study the prevalence of visceral and phenotypic markers of UCTD syndrome in patients with GERD for the purpose of early diagnosis of this comorbidity. Materials and methods: The study included 120 patients: 75 patients (Group II) – GERD was on the background of UCTD, 45 (Group I ) – the patients with GERD. The average age of the patients was 42.05 ± 6.5 years. Evaluations of UCTD’s were performed accordingly to the criteria recommended by M. Moska et al., A. Doria et al., T. I. Kadurina, L. M. Abbakumova in the modification of T. Milkovskaya-Dimitrova, and the degree of their expression on the scale of T. Y. Smolnova. Results: Among the examined patients, the specific criteria for the certain connective tissue diseases were detected in the patients with UCTD from 2.7 and 20.0% more often. Bone, joint and skin phenotypic signs of dysplasia were observed in patients with GERD associated with UCTD by 4-4.5 times more often. Various abnormalities of internal organs development were detected in the majority of patients of Group II, namely in 88.0%, and only in 6.6% of the patients of Group I. According to the data on daily pH monitoring, esophagus AET constituted 4.6% of the total monitoring period in Group I and 5.48% in the patients of Group II. The number of refluxes with pH<4 recorded in the patients of Group I constituted 57±8 episodes, and 79±6 episodes in the patients of Group II. Conclusions: The obtained data indicated that the number of pathological GER was significantly higher in the setting of comorbidity. Our research also showed that the chances of diagnosing Reynaud’s Syndrome, arthralgia, unmotivated body weight loss, dysphagia, skin rash, oral ulcers, proximal muscle weakness in the patients with GERD associated with UCTD are higher in comparison with the patients with GERD without comorbidity (р<0.05). This should necessarily be taken into account in the early diagnosis and when assigning a complex therapy in case of this pathology.

Introduction. The problem of pathology of internal organs comorbidity with obesity has become particularly relevant in recent years. The association of obesity with gastrointestinal pathology, in particular, irritable bowel syndrome has not been studied enough. The role of melatonin in the development of these diseases and the possibility of using its synthetic forms in their treatment has drawn the attention of researchers in recent years. Objective-to study the effect of synthetic melatonin on blood pressure, autonomic status, sleep quality, the level of ghrelin and serotonin in patients suffering from obesity combined with arterial hypertension and irritable bowel syndrome with constipation. Material and methods. The study involved 78 patients, of which 34 were diagnosed with irritable bowel syndrome with constipation combined with obesity, and 54 of those who suffered obesity, irritable bowel syndrome combined with arterial hypertension. Patients of each group were divided into two subgroups depending on the treatment complex, one of which received standard therapy, and in the case of combination with arterial hypertension, they also received three component antihypertensive therapy, while the other two received synthetic melatonin before the standard therapy. Results. There was a more significant decrease in average daily systolic and diastolic blood pressure values under the influence of therapy with the inclusion of vitae-melatonin and a significant decrease in the number of patients with a non-dipper and night-picker blood pressure profile. The more positive influence of comprehensive therapy with the inclusion of melatonin on parameters of heart rate variability and its quality was noted. The administration of melatonin combined with a standard therapy led to an increase in the frequency of the bowel movement, approaching serotonin in the serum to normal rates and a decrease in the postprandial level of ghrelin without changes in its fasting concentration. Conclusions. The obtained results are indicative of the positive effect of melatonin on obesity combined with irritable bowel syndrome with constipation and arterial hypertension.

The objective of the research was to study the effectiveness of course application of magnesium and calcium-containing drugs on the background of conventional therapy on the changes in the content of macronutrients in red blood cells and the activity of matrix metalloproteinase - 9 in the patients with a co-existence of undifferentiated connective tissue disease and gastroesophageal reflux disease. Materials and Methods. All 75 patients with gastroesophageal reflux disease associated with undifferentiated connective tissue disease were divided into three groups: Group I included 25 patients who received Magne-B6 at a dose of 2 tablets 3 times a day in addition to the standard background therapy with “Panocid” at a dose of 40mg once a day; Group II comprised 25 patients who received “Ca-D3 Nycomed” at a dose of 1 tablet 3 times a day in addition to the standard background therapy; Group III included 25 patients who received a combination of “Magne-B6” and “Ca-D3 Nycomed” in addition to the standard background therapy.  Results. In Group I, the proposed complex therapy resulted in a significant increase in Mg2+ by 40.9%. Mg2+ dynamics was less significant in Group II; this index reached the level of 17.9 ± 2.04 µg/g (р"˃0.05); in its turn, Ca2+ level increased to 80.6 ± 2.12 μg/g (p"<0.05) in these patients. Mg2+ and Ca2+ indices showed the most significant positive dynamics in Group III: 21.52 ± 2.47 μg/g (р"<0.05) and 102.7±1.37 µg/g, respectively. After combination treatment, we traced the dynamics of changes in the level of matrix metalloproteinase - 9: it decreased by 39.45% in Group I, by 35.3% in Group II, by 53.18% in Group III and reached the level of 1689.266 ± 14.89 pg/ml, approaching the indicators of the control group. Сonclusions. Based on the data obtained, it can be argued that simultaneous addition of “Magne-B6” and “Ca-D3 Nikomed” to the standard therapy for gastroesophageal reflux disease in the patients with undifferentiated connective tissue disease contributed to a significant decrease in the level of matrix metalloproteinase-9 resulting in reduced degradation and increasing synthesis of new connective tissue components.

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