The purpose of the study was to determine the prevalence of metabolic syndrome as a cluster of risk factors for atherosclerotic cardiovascular disease and type 2 diabetes mellitus and its individual components in groups of men and women with primary obesity having different types of fat distribution. The study involved 142 men and 185 women with primary alimentary-constitutional obesity. The study participants were divided into 2 groups depending on waist-to-hip ratio value. Standardized criteria were used to determine the prevalence of metabolic syndrome and its individual components among the examined men and women. The ratios of the number of participants with lower or upper type of fat distribution in men and women were 28:114 and 84:101, respectively. Hence the frequency of lower type of fat distribution was 19.7% in men and 45.4% in women (p < 0.000). Men with lower type of body fat distribution as compared to upper type were characterized by a lower prevalence of abdominal obesity (1.9 times), hypertriglyceridemia (1.4 times), low HDL-C (1.6 times), and hypertension (2 times). The frequency of metabolic syndrome in men with lower type of fat distribution was lower by 2.7 times than that of men with upper type of fat distribution. Women with lower type of fat distribution as compared to upper type had a lower prevalence of abdominal obesity (1.2 times), hypertriglyceridemia (1.8 times), low HDL-C (1.2-fold), and hypertension (in 1.5 times). The frequency of metabolic syndrome in women with lower type of fat distribution was lower by 1.9 times than that of women with upper type of fat distribution. Both men and women in the groups with lower type of fat distribution were missing such a component of metabolic syndrome as hyperglycemia i.e. they had the minimal risk of type 2 diabetes mellitus.

Blood levels of glucose and immunoreactive insulin were assessed in women with android and gynoid types of obesity or normal body weight (control group) in the dynamics of oral glucose tolerance test in the morning and in the evening. In the control group, the mean concentrations of glucose and immunoreactive insulin were significantly higher in the evening at all test terms (0, 60 and 120 min), which is indicative of physiological insulin resistance in the evening. In the group of women with gynoid obesity, no difference in the levels of glucose and immunoreactive insulin was revealed in the morning and evening tests, but in the evening tests, glucose (60 and 120 min) and immunoreactive insulin (120 min) levels were lower than in the control group. In the group of women with android obesity, the evening glucose level on minutes 60 and 120 of the test was higher than in the morning, but immunoreactive insulin did not vary throughout the day and on minutes 60 and 120 it surpassed the corresponding parameter in the control group by 2-4 times. In case of gynoid obesity, glucose load was followed by hyperinsulinemia and hypoglycemia; in android obesity, it was followed by hyperinsulinemia, hyperglycemia, and insulin resistance irrespective of the time of the day.

Context. The dominant type of adipose tissue accumulation in the body is associated with the peculiarities of using key substrates in energy metabolism and their hormonal regulation. Hormonal and metabolic parameters were investigated in women with android and gynoid obesity before and after the short-term food deprivation test.Results. At baseline, at gynoid obesity as compared to android obesity, the women's blood contained lower glucose and insulin levels and higher FFA levels. The reaction to food deprivation manifested by a decrease in glucose level and an increase in FFA level in the blood is less pronounced in women with gynoid obesity than in those with android obesity. At the same time, a similar (though varying in expression) decrease in insulin level and elevated levels of glucagon, growth hormone and thyroxine were revealed in women's blood in both groups. Blood cortisol level increased in women with gynoid obesity and remained unchanged in those with android obesity.Conclusions. More pronounced activation of hormonal mechanisms for maintaining blood glucose levels at gynoid obesity as compared to android one suggests that glucose is the preferable substrate for energy metabolism at gynoid obesity in women.