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The aim is to study morpho-functional state of the heart and vascular wall of the common carotid artery, verify the type of left ventricle remodeling in patients with hypertension (HTN) and type 2 diabetes (DM2T) and without it, to explore transmitral blood flow indices of the left ventricle and to clarify the severity of diastolic dysfunction in patients with combination of HTN and DM2T, to make a comparative evaluation of сardiohemodynamic disorders and disorders of carbohydrate metabolism, to determine the dynamic changes in indices of oxidative stress, antioxidant protection, to assess adipokines levels, proinflammatory cytokines, to identify possible correlations between the balance of hormones of adipose tissue, inflammatory markers and indicators of carbohydrate metabolism, anthropometric data and indicators of intracardiac hemodynamics, markers of endothelial dysfunction. Material and methods. Depending on the presence of DM2T, patients were divided into three groups. In the first group with HTN 20 patients with DM2T were included. Among them, there were 11 (55 %) women and 9 (45 %) men. The second group consisted of 20 patients with exclusively HTN. Among them, there were 10 (50 %) women and 10 (50 %) males. The control group included 10 practically healthy people (6 men (60%) and 5 women (40 %) of representative age and sex as the main group. According to the set goal, we analyzed clinical features, metabolic and cardiovascular disorders at different course of HTN and DM2T. For this purpose, all patients were examined by a single program, which included: 1 Professor of Clinical Pharmacology and Internal Medicine, Kharkiv National Medical University, Ukraine 2 Postdoctoral Researcher, Medical University of Gdansk, Poland © Zlatkina Vira, Shalimova Anna 76 Zlatkina Vira, Shalimova Anna physical (blood pressure (BP), body mass index (BMI), clinical, biochemical (glucose, insulin levels, HOMA-IR, hormonal (leptin, adiponectin), proinflammatory markers (tumor necrosis factor (TNF–alpha), interleukin-6 (IL-6), oxidative stress and antioxidative system parametres, and instrumental methods (ultrasound parameters of the carotid artery and the heart) of research. Results and Conclusions. Prognostically unfavorable variants of hypertrophic remodeling of left ventrecle are determined in patients with HTN and DM2T – concentric (65,3 %) and eccentric (17,01 %) types of left ventricle hypertrophy, whereas in HTN patients without comorbidities there are no statistically significant differences. The progression of diastolic dysfunction is identified with combination HTN and DM2T, which is confirmed by indicators of blood flow in pseudonormal 14, 5 % of patients, higher values of E/A – integral indicator of diastolic function of the LV, while patients with exclusively HTN diastolic dysfunction is presented only by initial changes in the form of excited relaxation. Specific feature of patients with concomitant HTN and DM2T in comparison with patients of HTN are higher values intema-media thickness (TIM), with increased carbohydrate metabolism (blood glucose index and HOMA-IR), confirming the aggressive vascular remodeling in this disease. Pronounced activation of prooxidant system simultaneously with a depressed antioxidant defense system can be observed in patients with the combination of HTN and DM2T, as evidenced by significantly higher malonedialdehyd (MDA) and diene conjugates (DC) (38,7 ± 0,08 nmol/ml and 40.0 ± 0,050 nmol/ml, respectively) while decreases of superoxide dismutase (SOD) and catalase (Cat) (41,9 ± 0,061 u/mg Hb min 0,162 ± 0,018 u/mg Hb min, respectively) compared with exclusively HTN (p<0.001). In patients with HTN and DM2T, hyperleptinemia and hypoadiponectinemia were identified, the severity of which depends on the anthropometric indices (BMI). The effect of hyperleptinemia on the severity of IR with the growth of BMI is confirmed by the correlations between the increasing levels of leptin, insulin and increased HOMA-IR. The role of proinflammatory cytokines TNF-α and IL-6 in the formation of endothelial dysfunction (ED), and disorders of carbohydrate metabolism in patients with HTN and DM2T was confirmed, increasing levels of which is associated with increases of TIM, index HOMA-IR, fasting glucose and BMI. This research optimized differentiated approaches to the diagnosis of patients with HTN and DM2T – based on the study of anthropometric, car-

OPTIMIZATION OF COMORBIDE PATHOLOGY DIAGNOSTICS: HYPERTENSION AND DIABETES MELLITUS TYPE 2 BASED ON THE EVALUATION OF CARDIAC HEMODYNAMICS AND METABOLIC DISORDERS