Aim of the study was to investigate the relationship between dietary fiber (DF) intake and the state of cognitive function (CF) in a population sample of middle and elderly age in Novosibirsk. Material and methods. The study was conducted on a random population sample from residents of Novosibirsk (n = 9360, men and women 45–69 years old), examined as a part of the international HAPIEE project. A subsample from the baseline population sample (4684 subjects) people who make up a lift from the general baseline population sample were examined for cognitive functions during the 2nd survey in 2006–2008. The examination protocol included standardized neuropsychological testing (quantitative assessment of memory function, semantic and concentration of attention) and collecting the data on nutrition (DF intake). Assessment of odds ratio (OR) was carried out using binary logistics regression by quartiles of nutrients. Results. According to cross-sectional analysis, we revealed a positive association between CF indicators and DF intake in a population sample aged 45–69, while the DF intake in the groups of men and women is not statistically different. Some gender features associated with DF intake have been established: presumably, the influence of DF on semantic memory and speech activity of women is more expressed than in men. Previously identified evidence that education modifies the level of age cognitive decline in our population, apparently, is also relates to DF intake. Conclusions. DF intake in men and women aged 45–69 years in a population of high cardiovascular risk is positively associated with an increase of indicators for all studied CF domains. Established relationships are instrumental in identifying risk groups of age cognitive decline.

Aim of the study was to investigate the association of polymorphisms of some genes with overweight and certain anthropometric and biochemical parameters in a population sample of adolescents in Novosibirsk. Material and methods. In 2019, a population-based screening of a representative sample of adolescents (609 people) was carried out in Novosibirsk. All children and their parents signed an informed consent for the examination. The study was approved by the local Ethics Committee of the Research Institute of Internal and Preventive Medicine – Branch of the Institute of Cytology and Genetics of SB RAS. During the examination, a questionnaire was filled out, anthropometric measurements were carried out, blood sampling was carried out, followed by a biochemical study. 157 people (75 boys (47.8 %), 82 girls (52.2 %)) were selected for molecular genetic analysis using tables of random numbers. The weight status of adolescents was assessed using the IOTF (International Obesity Task Force) criteria. The subsequent analysis compared 2 groups: 1st group included teenagers with weight deficiency and normal body weight), the 2nd – with overweight, obesity and extreme obesity). Results. In the general group, differences in carriers of different genotypes of the rs9939609 FTO gene were found in the level of low-density lipoprotein cholesterol (LDL-C) (p = 0,024). The girls with the AA rs9939609 genotype had the greatest average thickness of the skin fold in the middle third of the right shoulder. Differences were found in carriers of different genotypes rs7903146 of TCF7L2 gene in the average fasting plasma glucose (FPG) level (p = 0,021). The average thickness of the skin fold in the middle third of the right shoulder was greater in girls carrying the CC genotype compared with carriers of the CT and TT genotypes (p = 0,041). In separate subgroups, in carriers of different genotypes of rs10811661 CDKN2AB gene were found differences in high-density lipoprotein cholesterol, FPN, and waist circumference, in nucleotide sequence variant (NSV) rs2237892 KCNQ1 gene carriers – in triglyceride, FPG, LDL-C and total cholesterol concentration, in rs1111875 HHEX gene carriers – in total cholesterol, LDL-C level, waist and hip circumference, thickness of the skin fold under the scapula, diastolic blood pressure. Conclusions. Associations of the studied NSV (rs9939609, rs7903146, rs10811661, rs2237892, rs1111875) were found in the group as a whole and in separate subgroups (with division by body mass index, gender), with anthropometric and biochemical parameters, such as total cholesterol, triglyceride, LDL-C, FPN content, diastolic blood pressure, waist and hip circumferences, thickness of the skin fold under the scapula and in the middle third of the right shoulder. There were no statistically significant differences in the frequencies of studied NVS genotypes and alleles between the 1st and 2nd groups.

Aim of the study was to analyze the factors affecting treatment adherence in working-age patients with myocardial infarction (MI). Material and methods. During hospitalization, data of 150 patients with MI were collected using medical records and questionnaires. Social treatment readiness was assessed using the S.V. Davydov method with the calculation of treatment adherence (TA) score. After 6 months, the vital status, frequency and causes of hospitalizations, intake of the main groups of drugs, achievement of cardiovascular health target, frequency of regular medical check-up and the type of specialist conducting it were analyzed. In conclusion, the factors affecting the TA score were identified, as well as factors related to the achievement of cardiovascular health targets. Results. 6 months after MI, 4 (2.7 %) patients died due to cardiovascular diseases, 24 (16 %) were hospitalized. The inpatient TA score was 5 (4; 8) (median (lower quartile; upper quartile)), in 79 (52.6 %) patients it was low. The adherence of the surviving patients to treatment after six months was high: 142 (97.3 %) were taking disaggregants, 138 (94.5 %) were taking beta-blockers and reninangiotensin-aldosterone system inhibitors, 139 (95.2 %) were taking statins. However, only 56 (69.1 %) patients achieved target levels of low-density lipoproteins (LDL); 118 (80.8 %) patients achieved target levels of blood pressure, 95 (65.1 %) patients achieved target levels of heart rate (HR) at rest. Only about half (56.8 %) of patients with MI had regular medical check-ups, and only 38.5 % visited cardiologist. Patients who did not achieve target levels of LDL and HR had lower baseline TA score (p = 0.038 and p = 0.029, respectively), they showed up to fewer regular medical checkups after MI (p < 0.001). In patients who did not achieve target HR, the indicator of willingness to pay for treatment was low (p = 0.041), and regular medical check-ups were 4.2 more likely to be performed by a paramedic (p = 0.021). High-score TA was associated with the patient`s lack of propensity for social isolation, high social awareness, trust in the therapeutic treatment, willingness to pay for treatment, high sociability, dyslipidemia in history, the absence of passive smoking during the year, undergoing stage 2 of stroke recovery, working at the time of MI or the late age at onset of alcohol consumption. Low TA score was associated with the patient being the resident in the city, Q-wave MI, and a long-term smoking. Conclusions. Among the factors affecting treatment adherence in working-age patients with MI, certain indicators such as medical and social treatment readiness throughout hospitalization, and social, economic and clinical anamnestic characteristics are highlighted. The identification these factors should be implemented in real clinical practice to improve secondary prevention and outpatient follow-up.

Both in Russia and worldwide, morbidity and mortality from acute coronary syndrome (ACS) remain high. The emergence of a new coronavirus infection, the active participation of medical workers in its elimination, determined a new phenotype of patients, which determines the relevance of the problem and of a more detailed assessment of this cohort of patients. Aim of the study was to identify and determine the clinical and functional features, phenotype and endotype of the course of ACS in medical workers who have had a new coronavirus infection. Material and methods. An open cohort comparative study was conducted. It included 60 healthcare workers with ACS and a previous novel coronavirus infection, who were selected based on the identification of SARS-CoV-2 and/or its antibodies (positive PCR test) in anamnesis. All patients were admitted to the regional vascular center № 7 of the City Clinical Hospital № 2, Novosibirsk. The comparison group consisted of 60 healthcare workers with ACS without positive PCR test in anamnesis. General clinical and instrumental, coronary angiography with possible stenting. Results. Of the 60 medical workers with ACS after a new coronavirus infection, myocardial infarction with ST segment elevation was detected in 21 people, myocardial infarction without ST segment elevation – in 31, unstable angina pectoris – in 8 people. Within 6 months of undergoing COVID-19, they developed complex rhythm disorders, such as paroxysm of fibrillation or atrial flutter, more frequently than in the comparison group, as well as a full AV-blockade (n = 25, 41.6 %, p = 0.020), bradyarrhythmias and conductivity disturbances (n = 8, 13.3 %, p = 0.045), revealed a more than 2-fold increase in the pro-brain natriuretic peptide (proBNP) (n = 21, 35 %, p = 0.033), observed myocardial dysfunction (ejection fraction less than 50 %) (n = 6, 10 %, p = 041). Conclusions. The data obtained indicate the formation of a new ACS phenotype in medical workers who have undergone a new coronavirus infection.

The development of atherosclerotic diseases is pathogenetically associated with an increase in insulin resistance, an indirect marker of which is the C-peptide. In addition, literature data indicate the intrinsic proatherogenic effects of C-peptide. In recent years, the concept of separating metabolically healthy (MHP) and unhealthy phenotype (MUHP) at different body weights has become increasingly widespread. It believed that the key difference between MHP and MUHP is the more pronounced insulin resistance in the latter, but there are no clear data on the association of C-peptide with MHP or MUHP. Aim of the study was to investigate the association of C-peptide level with different metabolic phenotypes in women aged 25–44 years. Material and methods. The study was conducted on the basis of a representative sample of women aged 25–44 years (n = 1513, of which 840 women). The analysis included indicators of 655 women. The definition of MHP and MUHP carried out using the IDF criteria, 2005 for the diagnosis of metabolic syndrome. Anthropometric measurements, biochemical and hormonal blood tests have been carried out in groups divided by the body mass index (BMI). The level of C-peptide was determined by the method of multiplex analysis. Results. C-peptide content in the examined sample was 0.9 [0.5; 1.3] ng/ml (Me [Q1; Q3]), with MHP – 0.8 [0.5; 1.1] ng/ml, with MUHP – 1.3 [0.7; 1.8] ng/ml, p < 0.0001. With an increase in BMI, the median of C-peptide increased both in MHP (from 0.8 [0.4; 1.1] to 1.2 [0.8; 1.7] ng/mL, p_trend < 0.0001) and with MUHP (from 0.8 [0.2; 1.2] to 1.5 [0.9; 2.1] ng/mL, p_trend = 0.006). The frequency of MUHP in the 4th quartile of the C-peptide is 2.7 times higher than in the 1st quartile (p < 0.0001), and the frequency of MHP – 1.6 times lower (p = 0.001). C-peptide content correlated with anthropometric parameters, glucose, lipid concentration, transaminase activity, kidney filtration capacity. A C-peptide level of more than 1.33 in young women indicates a high probability of having MUHP with maximum sensitivity and specificity (Se = 49.3 %, Sp = 85.9 %). Conclusions. In women with MUHP, C-peptide content is 38.5 % higher than in women with MHP. The frequency of MUHP in the 4th quartile of the C-peptide is 3.2 times higher than in the 1st quartile. The level of C-peptide above 1.33 ng/ml is associated with the presence of MUHP.

The clinical case of cardiac pseudoamyloidosis associated with multiple myeloma Cardiac amyloidosis is an infiltrative cardiomyopathy resulting from extracellular deposition of amyloid- a specific protein-polysaccharide complex. This clinical case demonstrates an unverified amyloid-like heart lesion in the presence of unexplained thickening of the wall of an undilated left ventricle and manifestations of restrictive heart failure in a patient with myeloma. The difficulty of establishing an accurate diagnosis lies in the existence of a large number of types of amyloidogenic proteins, the diversity of the clinical picture, the absence of pathognomonic symptoms and of a single non-invasive diagnostic tool for verification.

A brief review presents current data on the possibilities of predicting the course of cardiovascular and other diseases, as well as the results of surgical treatment in patients by assessing the concentration of atrial, brain natriuretic peptides, polymorphic gene variants of these peptides and their receptors. Significant prospects for further research in this direction have been identified in order to develop prognostic molecular genetic panels for assessing the risk of developing myocardial infarction, arterial hypertension, heart failure in the framework of primary and secondary prevention.

Due to the rapid spread and large coverage, chronic heart failure (CHF) is reaching the state of a pandemic of the 21st century. Among elderly patients, HF is the main reason for referral to hospital. Half of patients with this pathology die within 5 years after diagnosis. Currently, the diagnosis of CHF is gaining momentum due to the importance of this disease. There are more and more studies and works that prove the high sensitivity of cardiac markers for diagnosing CHF. There are many genes that can participate in the formation of a hereditary predisposition, both independently and through interaction with each other. This literature review was carried out in order to identify genetic markers for diagnosing CHF. The results of studies that can be used to analyze the effect of polymorphism of the genes coding angiotensinogen, angiotensin-converting enzyme, β2-adrenoreceptor, nitric oxide synthase, aldosterone synthase are presented. An in-depth study of molecular genetic markers, as well as determining their significance in the development of heart failure, is an urgent problem of modern medicine, the solution of which will make it possible to carry out effective prevention of cardiovascular complications, optimize treatment and improve the prognosis of patients. Information on the topic from publications based on the PubMed, eLibrary databases was used.

Heart and vascular diseases, or cardiovascular diseases (CVDs), have remained relevant for many decades and remain the most serious health problem in many countries around the world, including Kazakhstan. Experts from the World Health Organization (WHO) predict that by 2030 death from CVD may occur in 23.6 million people of working age. The widespread use of reconstructive and interventional methods, ensuring the restoration of blood flow in the myocardium, has made progress in the treatment of cardiovascular diseases. At the same time, serious problems remain during the reperfusion period at various stages of rehabilitation. The purpose of the review was to analyze the results of studies on the state of the myocardium in overweight individuals, especially after undergoing coronary artery surgery. The depth of the sample of literary sources was 20 years.

At present, the issues of the relationship between non-alcoholic fatty liver disease (NAFLD) and obesity, especially abdominal, as well as metabolic syndrome, which, in turn, significantly increases the cardiometabolic risk and affects the incidence, prognosis and life expectancy of patients, are quite well studied. And although the prevalence of various clinical forms of NAFLD is significantly higher in obese patients than in the general population, 7–20 % of people with NAFLD are estimated to have a lean body habit. At the same time, the rate of disease progression, associated conditions, anddiagnostic and management approaches differ for patients with NAFLD depending on body mass index (BMI), which reveals the need for clear guidance to clinicians regarding the NAFLD treatment depending on nutritional status. We performed a systematic review to summarize the clinical and metabolic aspects of NAFLD depending on nutritional status, as well as approaches to non-drug treatment through lifestyle changes. The fundamental clinical and functional, metabolic, hormonal and other factors of the pathological process that determine the mechanisms and prognosis of the disease in patients with NAFLD with different BMI are discussed. Information on the topic from publications based on the PubMed and RSCI databases was used.

The aim of the study was to identify the dominant types of rhythm disturbances in pregnant women, to discuss the features of the pathogenesis of ventricular arrhythmias during pregnancy, the relevance of pre-gravidar diagnosis, the expediency of using antiarrhythmic drugs during gestation. Basics. Proarrhythmic mechanisms of pregnancy are associated with cardiovascular, vegetative and hormonal changes. The risk factor for complications is a previous cardiological disease. Ventricular extrasystoles are the most common. The risk of pregnancy complications increases with persistent rhythm disturbances. Conclusions. Pregnancy is associated with an increased risk of arrhythmias. Patients with a burdened history are at significant risk of relapse during pregnancy. Conducting a thorough examination of women at risk at the stage of pre-pregnancy preparation will allow timely corrective treatment.