Патофизиологический анализ проатерогенных изменений обмена липопротеидов и углеводов, обусловленных субклиническим воспалением и оксидантным стрессом

Pathophysiological analysis of lipid, carbohydrate metabolism, induced by subclinical inflammation and oxidative stress

The aim of investigation was to determination the role of inflammation as factor, common for pathogenesis of atherosclerosis and insulin resistance. Indexes of the systemic inflammation activity, oxidative status, the mode of the changes of blood lipid spectrum, glucose metabolism and insulin sensitivity were determined in rabbits with systemic inflammation induced by intravenous injection of pyrogenal and in patients with ischemic heart disease in acute phase. Systemic inflammation activity was evaluated by C-reactive protein blood level, activity of peripheral monocytes and neutrophils. In parallel there we determined main indexes of lipid, lipoprotein and carbohydrate metabolism, modified lipoproteins amount in blood, activity of lipid peroxydation and antioxydative blood potential. Insulin sensitivity was evaluated by results of subcutaneous insulin test. It was established that the systemic inflammation development was accompanied with pronounced proatherogenic blood lipid and lipoprotein metabolism disturbances in association with insulin resistance, hyperglycemia and glycoxidation of blood proteins. Under these conditions fenofibrate revealed its antiinflammatory effect and suppressed the activity of both systemic inflammation and systemic oxidative stress. These changes were accompanied with prevention of lipid, lipoprotein and glucose metabolism disturbances and decrease of blood atherogenicity The results of clinical investigation also pointed to the common features of pathogenesis of systemic inflammation, proatherogenic disturbances of lipid, lipoprotein and glucose metabolism. The obtained data allow to conclude that systemic inflammation can be the cause of the development of complex metabolic changes which are independent atherogenic factors, first of all insulin resistance and proatherogenic changes of lipid, lipoprotein and glucose metabolism.