Recent studies have revealed many new facets of the pathogenesis of MS and expanded the range of its etiologic factors beyond the alimentary factors, which determines the possibility of finding new approaches to prevention and treatment of this pathology. The review presents: evolution of diagnostic criteria for MS and reflection of this process in epidemiology and clinical approaches to the disease; epidemiological data on the prevalence of MS in young adults. A brief overview of a large array of scientific research of the last decade on etiology and pathogenesis of MS, in particular the role of adipose tissue dysfunction of visceral, ileofemoral and ectopic depots, causes of the tendency to prevail in one or another adipose tissue depot, new obesity classification, as well as the role of perinatal and epigenetic, ecological (environmental obesogenes, artificial light contamination), composition of intestinal microbiota, state of the sympathetic nervous system, nutritional deficiencies in the development of obesity and MS is provided. The gender differences of pathogenesis and clinical features of MS, as well as the association of MS with dyshormonal and other pathologies (PCOS, hyperprolactinemia, uterine myoma, endometriosis) of female reproductive health are considered.

Obesity is an established risk factor for cardiovascular diseases (CVD) such as hypertension (HD), coronary artery disease (CAD), heart failure (HF), arrhythmias and venous thromboembolism. Lifestyle modifications to reduce weight have been shown to be successful in the short term, however their long-term results are still equivocal likely due to modest weight reduction and high recurrence rates. Bariatric surgery has been recognized as the most effective strategy in achieving substantial sustained weight loss, and can prevent the development or reverse CVD, metabolic syndrome, diabetes mellitus, obstructive sleep apnea syndrome, cancer, and COVID-associated complications. Bariatric surgery results in rapid weight loss over several months that lasts for at least 12-18 months. The surgery lowers all-cause mortality risks, risks of myocardial infarction and stroke. Furthermore, bariatric surgery contributes to the reduction of urgent hospitalizations for heart failure, coronary artery disease, and hypertension. The article shows modern view on the impact of bariatric surgery on the pathogenesis of the CVD in patients with obesity, indications and contraindications of the surgery, tactics of management of patients with existing cardiovascular pathology before the bariatric surgery.

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Aim. To improve treatment of type 2 diabetes mellitus associated with obesity by analyzing the results of surgical treatment during a 24 months follow-up. Material and Methods. The study included 75 patients with type 2 diabetes and obesity. In the study, 32 patients of patients underwent biliopancreatic diversion with duodenal switch; sleeve gastrectomy was performed in 33 patients, and Roux-n-Y gastric bypass-in 10 patients. Mean age of the