The aim of study was to study the features of the adipokine blood profile in young people with comorbid pathology.
Material and methods. A cross-sectional population survey of Novosibirsk was conducted. The population sample included 1415 people, including 47 % of men. Comorbid pathology was considered a combination of 3 or more pathological conditions (CHD, AG, CB, hyperLDL-C, decreased renal function and type 2 diabetes). Adipokine levels in the blood were determined using the multiplex analysis method on a Milliplex multiplex analyzer (Merck, Millipore).
Results. When conducting a univariate logistic regression analysis, it was found that the presence of comorbid pathology was associated with an increase in amylin by 1 pg/ml (p < 0.0001), ghrelin by 1 pg/ml (p = 0.016), resistin by 1 ng/ml (p = 0.001), IL-6 by 1 pg/ml (p = 0.005), C-peptide by 1 ng/ml (p = 0.024) and a decrease in PYY by 1 pg/ml (p = 0.007). In multivariate regression analysis in model 1 (gender, age, OT, resistin, IL-6, and PYY), the chance of having comorbid pathology increased by 15 % with an increase in age by 1 year (p = 0.011) and by 2.5 % with a decrease in PYY by 1 pg/ml (p = 0.005); in model 2 (gender, age, WC, resistin, IL-6, and C-peptide), the chance of having a comorbid pathology increased by 13 % with an increase in age by 1 year (p = 0.001), by 0.1 % with an increase in resistin levels by 1 ng/ml (p = 0.046), by 12 % with an increase in IL-6 levels by 1 pg/ml (p = 0.041), and by 116 % with an increase in C-peptide levels by 1 ng/ml (p = 0.019).
Conclusions. In young people, the presence of comorbid pathology is associated with an increase in the blood of amylin, ghrelin and a decrease in the level of PYY, responsible for appetite regulation, as well as with an increase in the levels of resistin, IL-6 and C-peptide, involved in the formation of insulin resistance.

The increasing prevalence of low-density lipoprotein (LDL) hypercholesterolemia and its associated diseases among young people is a major public health concern in many countries. The aim of this study was to identify rare functionally significant variants in coding regions and adjacent splice sites of genes associated with elevated LDL cholesterol (LDL-C) levels in men and women aged 25–44 years.
Methods. A population-based sample was stratified by deciles according to LDL-C concentration. The study included 146 individuals with LDL-C <2.1 mmol/L (first decile) and 158 individuals with LDL-C ≥ 4.2 mmol/L (tenth decile). Targeted high-throughput sequencing was performed.
Results. In the sample of young adults, 0.07 % had LDL-C levels >8.5 mmol/L, 0.13 % had levels ranging from 6.5 to 8.4 mmol/L, and 2.25 % had levels between 5.0 and 6.4 mmol/L. Participants in the first and tenth LDL-C deciles differed in the spectrum of variants in lipid metabolism genes. Functionally significant variants associated with LDL hypercholesterolemia were identified in individuals with LDL-C ≥4.2 mmol/L in the coding regions of the LDLR and APOB genes, as well as in ABCA1, LCAT, LIPA, LIPC, and LPA.
Conclusions. Rare functionally significant variants in coding regions and adjacent splice sites of genes associated with elevated LDL-C levels were identified in young men and women.

Aim. Optimization of surgical coronary revascularization tactics for women and men, based on a comparative analysis of modern coronary surgery techniques from the CROWN-SAGA (Coronary Revascularization Outcomes Within Necessary Sex And Gender Aspects) study.
Material and methods. Single-center CROWN-SAGA study (NCT06749171) presented a comparative analysis of the impact of preoperative profile and range of surgical techniques in coronary artery bypass grafting (CABG) surgery on short- and long-term outcomes in women and men. The primary endpoint was a composite of all-cause mortality, myocardial infarction (MI), stroke or transient ischemic attack (TIA) and repeat revascularization (major adverse cardiovascular and cerebrovascular events, MACCE) during the long-term follow-up. The secondary endpoint was allcause mortality during the long-term followup.
Results. Among the included sample of 400 patients (200 women and 200 men) in the CROWNSAGA study, women were older than men and had less favorable preoperative profile. Short-term in-hospital outcomes in terms of mortality and MACCE were comparable between women and men. Over long-term follow-up, the incidence of MACCE was 21.2 % in women and 16.2 % in men (hazard ratio (HR) = 1.15 [95 % confidence interval (CI) 0.72; 1.82], p = 0.557) and the incidence of death was 11.1 % in women and 10.2 % in men (HR = 0.94 [95 % CI 0.51; 1.72], p = 0.83), women had higher risks of MI (HR = 6.66 [95 % CI 0.83; 53.28], p = 0,038), repeat revascularization (HR = 4.11 [95 % CI 1.18; 14.32], p = 0.016) and stroke (HR = 1.24 [95 % CI 0.59; 2.6], p = 0.567). ONCAB compared to OPCAB within the men cohort had a significantly lower risk of death (HR = 0.28 [95 % CI 0.09; 0.91], p = 0.03). Women had an increased risk of graft occlusion. All Off-pumps strata (OPCAB, NTA, MICSCAB) compared with ONCAB showed higher risk of adverse long-term outcomes among all patients in regard to MACCE (HR = 1.54 [95 % CI 0.95; 2.49], p = 0.08), death (HR = 2.17 [95 % CI 1.14; 4.14], p = 0.016) and graft occlusion. Predictor of long-term MACCE and death for women was use of composite grafts, while for men — ejection fraction (EF) ≤ 40 %, age > 70 years, and off-pump CABG. Considering the obtained data and identified predictors, CABG approach for both sexes implies complete coronary revascularization with an increased number of distal anastomoses, the use of arterial grafts, use of sequential grafts, limiting use of venous conduits, for women limiting use of composite grafting, while for men an adherence to an anoartic technique and the use of composite grafting.
Conclusions. The developed algorithm for surgical management is based on a sex and gender approach and a comprehensive analysis of a wide range of CABG techniques aimed at improving patient outcomes after coronary revascularization, particularly reducing the burden of adverse CABG outcomes among women. Recommended approach for both women and men involves complete arterial revascularization and sequential anastomoses; for women we advise surgical techniques that reduce the risk of sternal and wound complications, along with limiting the use of composite grafts; for men the use of composite grafts is permissible and the no-touch-aorta (NTA) technique is advised.

The aim of the study: to evaluate clinical, functional, molecular and genetic indicators and to develop prognostic markers of chronic heart failure with preserved left ventricular ejection fraction (CHFpEF) in comorbid patients in the context of medical rehabilitation. Material and methods. The study was conducted on the basis of the State Budgetary Healthcare Institution of the Novosibirsk Region “NOKGVV № 3” and the State Budgetary Healthcare Institution of the Novosibirsk Region “City Clinical Hospital № 1” of Novosibirsk (the period from December 1, 2022 to December 1, 2023) with the participation of 260 patients with myocardial infarction and CHFpEF. The main group (n = 132) underwent a one-year course of medical rehabilitation (MR); the comparison group (n = 128) refused MR. At the start and after 12 months, a comprehensive examination was performed (general clinical diagnostics, including NT-proBNP, 6-minute walk test, EQ-5D questionnaire), genetic testing – rs632793 of the NPPB gene, rs5065 of the NPPA gene), with subsequent observation of the groups until December 1, 2024 with an assessment of “soft” and “hard” endpoints. Results. An association was found between the G/G rs5065 genotype of the NPPA gene and the development of recurrent myocardial infarction (OR 5.139, 95 % CI 1.593–16.583, p = 0.003), GG rs5065 genotype (OR 3.357; 95 % CI 1.025–10.999; p = 0.035) and allele G (OR 1.805; 95 % CI 1.159–2.813; p = 0.009), CKD stages 3a–4 (OR = 2.813; 95 % CI 1.259–6.281; p = 0.010) and stage I–III obesity (OR = 3.023; 95 % CI 1.340–6.817; p = 0.006) with an unfavorable 1-year outcome. MR significantly increased the left ventricular ejection fraction (LVEF), functional status, and quality of life. Refusal of MR was associated with an increased frequency of hospitalizations for CHF decompensation (OR 4.762, 95 % CI 2.788–8.132, p < 0.001), the risk of a combined endpoint (OR 8.667, 95 % CI 4.888–15.366, p < 0.001), and mortality (OR 8.628, 95 % CI 1.931–38.545, p < 0.001). The probability of LVEF reduction was determined by a mathematical model that included: Nt-proBNP, hemoglobin, TSH, HDL-C, rs5065 of the NPPA gene, ESV, left atrial volume, CKD, and the fact of MR. Conclusions. The GG genotype of rs5065 of the NPPA gene, CKD stages 3a–4, and obesity are predictors of an unfavorable outcome in CHFpEF. MR reduces mortality and improves the functional status of patients.

Evaluation of the capabilities of stress echocardiography (stress EchoCG) in predicting the presence of hemodynamically significant coronary artery stenoses.
Materials and methods. The study included 1529 people with stable coronary heart disease (CHD). All patients underwent stress echocardiography with pharmacological (dobutamine) or physical (bicycle ergometer (BEM), treadmill) load to assess the condition of the myocardium, before the study, each patient had their blood pressure measured to determine the presence of hypertension. Some patients – 1212 (79.27 %) underwent coronary angiography.
Results. Arterial hypertension of varying degrees was detected in 53.83 % of the examined patients. According to the results of stress echocardiography, 996 (65.17 %) patients had a positive test (no increase in contractility), coronary artery stenosis of more than 50% was detected in 530 (53.21 %) of them. The majority also had diastolic dysfunction of the left ventricle (98.41 %). Normal diastolic function was detected in 1.59 % of the examined patients, only twelve of them underwent coronary angiography, according to the results of which stenosis of the anterior interventricular branch was detected. The accuracy of the method was 92.72 %, sensitivity – 93.81 %, specificity – 72.02 %.
Conclusions. Stress echocardiography has demonstrated a fairly high level of accuracy, sensitivity and specificity, which indicates the need to perform this procedure in all patients with suspected coronary heart disease with an average and high pre-test probability in order to reduce the number of coronary angiographic studies.

Aim. To study the associations between cardiometabolic risk factors (CRF) and osteoporotic fractures (OF) in a population sample aged over 50 years.
Materials and methods. The cross-sectional study was based on Russian part of the HAPIEE Project (Novosibirsk, 2003–2005). This analysis included 7363 men and women 50–69 years old. We collected information on the OF over the past 12 months using a standard questionnaire, we assessed socio-demographic parameters and the main CRF (obesity, hyperglycemia, dyslipidemia, menopause duration in women, smoking, alcohol consumption), and taking of hormone replacement therapy in postmenopausal women. The analysis of associations between CRF and the chance of OF was performed.
Results. The frequency of OF over the past 12 months was 3.6 % (3.2 % in men and 4.0 % in women, p = 0.074). The risk of fracture was directly associated with blood pressure, HDL cholesterol, and ethanol consumption of more than 30 g per 1 session, and it was inversely associated with BMI among men. In women, the chance of a fracture was directly associated with current smoking, an increase in the menopause duration and inversely associated with TG level independent of other factors.
Conclusion. Among the examined persons over 50 years of age, we reveled the syndemia of CRF in relation to OF risk in men, the chance of OF has positive association with an increase of blood pressure and HDL-C levels, ethanol consumption of more than 30 g per session and negative association with BMI value; in women, the chance of fracture positively associated with current smoking, postmenopausal duration, and negatively associated with TG level, regardless of other factors. The data obtained make it possible to speak of significant links between CRF and OF.

The aim of the study: to identify the most significant associations of depression with candidate genes associated with atherosclerosis-related cardiovascular diseases among individuals aged 25–64 in Novosibirsk. Material and methods. The study of the association of candidate genes with depression in the population of individuals aged 25–64 years in Novosibirsk was carried out using the material of three large-scale epidemiological studies in which residents of the Oktyabrsky district of Novosibirsk participated. This study included: III screening of the WHO MONICA psychosocial program in 1994–1995 (657 men); IV screening “HAPIEE” 2003–2005 (642 men); VI screening of the population in 2013–2017 (403 men and 531 women). Genotyping of the studied polymorphisms was carried out in the laboratory of molecular genetic studies of the Research Institute of Therapeutic Microbiology and Microbiology, branch of the Institute of Cytology and Genetics (Novosibirsk). Results. A reliable association was found between depression and carriage of the following genotypes: SLA and LALA of the SLC6A4 gene, “long” alleles (6 repeats and higher) of the DRD4 gene, 9/9 of the SLC6A3 gene, T/C genotype of the DRD2/ANKK1 Taq1A gene, G/G of the COMT gene, C/G of the IL-6 gene, G/A of the TNF-α gene and ε3/4 of the APOE gene (p < 0.05). Conclusions. The demonstration of a common genetic substrate for depression and atherosclerosis-related cardiovascular diseases may further reveal the bidirectional mechanisms by which depression and cardiovascular diseases potentiate each other.

The aim. To identify associations between proinflammatory cytokines of visceral adipose tissue with metabolic disorders in abdominal obesity.
Materials and methods. The study was conducted on 101 people aged 25–65 years. Questionnaires, anthropometry, blood pressure measurements, as well as fasting blood sampling and visceral adipose tissue biopsies during elective surgery were conducted. Enzymatic methods were used to determine the parameters of the lipid profile and glucose in the blood. Homogenates were prepared from biopsies of visceral adipose tissue. The level of tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), monocytic chemoattractant protein-1 (MCP-1) was determined in blood and obtained homogenates of adipose tissue by multiplex analysis.
Results. A weak positive relationship was found between serum IL-6 levels and adipose tissue. A weak positive relationship was found between IL-6 visceral adipose tissue and the VAI index, as well as between MCP-1 visceral adipose tissue and the LAP and VAI indices. The level of MCP-1 in visceral adipose tissue is directly associated with the LAP insulin resistance index (6,255 [1,648; 10,862], p = 0.008), TNF-α – with the VAI insulin resistance index (1,076 [0.335; 1,817], p = 0.005).
Conclusion. Of the proinflammatory cytokines we studied, an association with insulin resistance was shown for MCP-1 and TNF-α visceral adipose tissue. At the same time, MCP-1 is directly associated with the LAP index, and TNF-α is directly associated with the VAI index.

Non-alcoholic fatty liver disease (NAFLD) is a global medical and social problem, with its prevalence increasing amid the obesity pandemic. Studying disease progression in patients with different nutritional statuses requires the development of differentiated diagnostic approaches. The study aimed to evaluate clinical, functional, and nutritional-metabolic parameters and develop additional diagnostic markers for nutritional disorders in NAFLD.
Materials and methods.A crosssectional, open-label, non-randomized study was conducted, involving 349 participants (235 NAFLD patients [113 without obesity and 122 with obesity] and 114 controls). All participants underwent nutritional status assessment, including anthropometric measurements, bioimpedance analysis, evaluation of eating behavior , and dietary intake analysis. NAFLD patients additionally underwent non-invasive fibrosis assessment via transient elastography and calculated indices (FIB-4, BARD). Laboratory tests included adipokine profiling (visfatin, adipsin, PAI-1), 25(OH) vitamin D levels, and protein metabolism markers (prealbumin).
Results. NAFLD patients exhibited significant nutritional disturbances: reduced protein intake (< 0.7 g/kg body weight), predominant emotional eating (40.1 % in obese vs. 19.8 % in controls), and physical inactivity (72.1 %). Bioimpedance analysis revealed decreased active cell mass (42 % in obese vs. 49 % in controls) and increased fat mass (41 % vs. 32 %). Laboratory findings confirmed hypoprealbuminemia (18.1 vs. 23.0 mg/dL), vitamin D deficiency (17.5 vs. 23.0 ng/mL), and adipokine dysregulation. Fibrosis stage F2–F4 was 5.5 times more frequent in obese patients (p < 0.001). Multivariate analysis identified significant fibrosis-associated predictors: waist circumference (β = 0.420), fat mass percentage (β = 0.900), prealbumin (β = –0.184), and 25(OH)D (β = –0.058).
Conclusions. Differentiated diagnostic models were developed: for non-obese patients, key markers were anthropometric indices (waist-to-hip ratio), adipokines, and vitamin D; for obese patients – active cell mass percentage (% ACM), prealbumin, and vitamin D. Universal fibrosis predictors included body composition parameters, prealbumin levels, and adipokines.

Objective. To systematize and critically analyze current approaches to the diagnosis and treatment of chronic heart failure (CHF), with a focus on personalized therapeutic strategies and the integration of digital technologies into clinical practice.
Material and methods. A systematic search was conducted in PubMed, Scopus, Web of Science, and eLibrary databases for the period 2019–2024. Keywords included: “chronic heart failure”, “CHF pathogenesis”, “personalized CHF therapy”, and “digital technologies in cardiology”. A total of 145 sources meeting the inclusion criteria were selected and analyzed.
Results. The review describes the most recent pathophysiological mechanisms of CHF development and examines current pharmacological and device-based therapies, including SGLT2 inhibitors, sacubitril/valsartan, cardiac resynchronization therapy, implantable cardioverterdefibrillators, and mechanical circulatory support devices. Special attention is given to the role of digital technologies, including telemedicine, remote monitoring, and artificial intelligence, in managing patients with CHF.
Conclusions. A personalized approach, incorporating pharmacogenetics and the implementation of digital solutions, represents a promising direction for improving the effectiveness of CHF treatment and patient outcomes. Further integration of innovative technologies into clinical practice and addressing the accessibility of novel therapeutic methods are required.