Objective: of the research was to study preclinical changes in heart rate variability (HRV) associated with overweight and obesity in young people in order to determine the targets of predictive therapy.Material and methods: the study involved 105 young men and 111 young women aged 18 to 30 years. Questionnaires, anthropometry with determination of body mass index and waist circumference, bioimpedansometry with determination of body fat (BF) and visceral fat (VF) level, as well as monitoring of HRV based on short (ten-minute) records were carried out.Result: young people of both sexes showed a high frequency of overweight (24.1%) and obesity (18.5%), as well as a low level of physical activity (FA, 46.3%). In 28.8% of young men and 12.5% of young women with overweight and obesity, there was a high level of VF. Taking into account the outstripping increase in VF as compared to BF, it is reasonable to divide the VF levels into low (<5 conventional units), intermediate (5-9 conventional units), and high (> 9 conventional units). In overweight young people, compared with normal body weight, HRV is characterized by less pronounced parasympathetic activity, and in girls compared with young men, there is less total HRV. A high HRV level is associated with such HRV indicators as an increase values of LF/ HF and SDANN, reflecting, respectively, a reduction in the parasympathetic and enhanced sympathetic activity of the autonomic nervous system with a predominance of the central circuit of heart rhythm regulation over the autonomous one.Conclusion: to diagnose autonomic imbalance in young people, it is necessary to determine the composition of the body, FA level, take into account the individual dynamics of HRV parameters, since they rarely exceed the norm. Changes in total HRV, sympathetic and parasympathetic activity during the non-drug correction of obesity should be monitored with an emphasis on pNN (50) and SDANN indicators associated with BF, and when correcting physical activity — on the indicator of voltage index of regulatory systems.

Objective: to study the parameters of the compound body composition in middle-aged people with arterial hypertension (AH) to determine the targets for prevention and treatment.Materials and methods: 37 men and 58 women with AH aged 45 to 59 years were examined. Questioning, anthropometry with determination of waist circumference (WC), body mass index (BMI), study of compound body composition by bioimpedancemetry, as well as measurement of blood pressure (BP) were carried out.Results: overweight and obesity were found in 87,3% of middle-aged people with AH. In both sexes, there was a direct correlation of visceral fat (VF) with age, BMI, WC and also with diastolic BP.Conclusion: detection of hypertension, increased BMI, VF is necessary for diagnosing metabolic imbalance in middle-aged people in order to further conduct non-drug and preventive therapy, as well as reduce the development of possible complications.

Objective: identifying age-related changes in the variability of the heart rhythm (HRV) in individuals with arterial hypertension (AG) associated with psychological stress and physical activity (FA) for targeted prevention and rehabilitation. Material and methods: the survey of the main groups consisting of 37 people’s persons (26 young men and 11 girls at the age of 22,2 years) and 94 - 2nd middle age (35 men and 59 women aged 56,0 years) included: questioning, anthropometry, clinical and instrumental examination, electrocardiography, HRV monitoring. Control groups for young people (n = 72) and persons of the 2nd middle age (n = 10) were comparable with the main ones and sex. Results: the frequency of excess body and obesity, low facilities, as well as the average and high levels of psychological stress in young people with AG amounted to 51,4%, 64,1%, and 59,5%, and in middle-aged people with AG — 87,2%, 55,4% and 41,5%, respectively. With AG in persons of the 2nd middle age, in contrast to young people, HRV were characterized at a low level of psychological stress with smaller values of the parameters of SDNN, RMSSD, PNN (50) and VP, which were indicated to a smaller HRV and low parasympathetic activity and, on the contrary, higher the value of the voltage index (VI) reflecting the intensity of the control processes of the heart rhythm; with an average and high levels of stress, statistically significant differences in the above parameters were supplemented by a lower value of the triangular index, which integrally reflects the decrease in WRC. The presence of hypertension in the patients of the 2nd middle age, in contrast to young people and at a low level, and at a moderate and high levels of the FA, was accompanied by a decrease in SDNN, RMSSD, PNN (50) values, which indicated the smaller general HRV, low parasympathetic activity the vegetative nervous system; on the contrary, higher VI confirmed the participation of the central contour and the intensity of the regulation of the rhythm of the heart. Conclusion: determination of the predictors of the development of AG reflecting the general HRV, the sympathy-vagal balance and the tension of the rhythm of the heart rhythm associated with the levels of psychological stress and physical activity, as well as age, can be broadcast in an outpatient practice to designate targets of preventive and rehabilitation activities.

АННОТАЦИЯВведение. Респираторные проявления у больных бронхиальной астмой (БА) с коморбидной гастроэзофагеальной рефлюксной болезнью (ГЭРБ) может провоцировать дуоденогастроэзофагеальный рефлюкс (ДГЭР) такими повреждающими агентами, как пепсиногены и билирубин.Цель исследования -изучение клинических и функциональных особенностей ГЭРБ, коморбидной с БА, ассоциированных с наличием пепсиногена и билирубина в ротовой жидкости, для неинвазивной диагностики ДГЭР.Методы. Были обследованы 29 больных с аллергическим фенотипом БА, коморбидной с ГЭРБ со средним возрастом 50,2 ± 2,4 года. Биохимическое исследование крови включало определение билирубина, С-реактивного белка, а также определение аллерген-специфического IgE. В жидкости ротовой полости колориметрической методикой изучали наличие билирубина, а иммунологическими исследованиями -содержание пепсиногена-1 и пепсиногена-2. При эзофагоскопии рефлюкс-эзофагит (РЭ) A-D степеней относили к эрозивной рефлюксной болезни, а изменения эзофагеальной слизистой оболочки (СО) N-и M-градации считали неэрозивной рефлюксной болезнью. Функции внешнего дыхания (ФВД) оценивали по объему форсированного выдоха (ОФВ 1 в л/сек), форсированной жизненной емкости легких (ФЖЕЛ), индексу Тиффно (ОФВ 1 /ФЖЕЛ), по динамике значений ОФВ 1 и ФЖЕЛ до и после приема беродуала.Результаты. У больных БА, коморбидной с ГЭРБ, наблюдалась выраженная полиморбидность. Наличие кашля и симптома «сдавления грудной клетки» ассоциировалось с возрастом, а частота «сдавления грудной клетки» -с увеличением индекса массы тела и снижением величины ОФВ 1 /ФЖЕЛ. Выявленные ассоциации между повышением пепсиногена-1 и снижением показателей ОФВ 1 /ФЖЕЛ и ФЖЕЛ в ответ на ингаляцию беродуала, между увеличением в жидкости полости рта билирубина и уменьшением ФЖЕЛ, ОФВ 1 и ОФВ 1 после приема беродуала отражают существенное влияние высокого ДГЭР на проявления БА.Заключение. У больных БА с коморбидной ГЭРБ пепсиноген и билирубин в ротовой жидкости являются не только биомаркерами ДГЭР, но и идентификаторами респираторного воспаления с бронхоспазмом. 4.0

BACKGROUND: The decisive importance of the sympathetic and parasympathetic nervous system in maintaining vegetative homeostasis requires the determination of sensitive non-invasive parameters of multidimensional outpatient monitoring of cardiorespiratory adaptation under various physiological and clinical conditions, taking into account the function of external respiration (FER), compound body composition and heart rate variability (HRV).AIM: To identify concomitant changes in HRV, HR and compound body composition in young people as markers of cardiorespiratory adaptation and rehabilitation.MATERIALS AND METHODS: On the basis of the Kuban State Medical University, a single-centre, interventional, cross-sectional, single-sample, comparative, uncontrolled study of a general group of young people in which respiratory parameters and parameters of the compound body composition were determined. Some individuals in this group additionally underwent Holter monitoring of the electrocardiogram (ECG) at short intervals.RESULTS: In young people, a change in the compound body composition with an increase in total fat mass, visceral and body fat is associated with a decrease in respiratory function (a decrease in the Tiffno index, a decrease in the maximum middle-expiratory flow — MMEF), manifested by a decrease in HRV (according to the TI indicator), the absence of an increase in the autonomic regulation circuit (according to SDNN indicator), a decrease in parasympathetic activity (in terms of rMSSD) and the absence of sympathetic activation (in terms of SDANN). Positive shifts in the form of an increase in trunk muscles, the total amount of water and a decrease in the total fat mass are accompanied by an increase in lung capacity, forced expiratory volume in the first second and a change in HRV with sympathetic (in terms of LF / HF, SDANN) and parasympathetic activation (in terms of rMSSD), an increase in HRV (in terms of TI) and an increase in the autonomic regulation circuit of the vegetative nervous system (in terms of SDNN).CONCLUSION: Accurate and rapid diagnostics of vegetative homeostasis requires a comprehensive correlative analysis of the parameters characterizing HRV in short recordings, the compound composition of the human body and respiratory function.