COGNITIVE DYSFUNCTION IN MILITARY PERSONNEL – COMBATANTS WITH METABOLIC SYNDROME

Cognitive dysfunction is a frequent yet underrecognized complication of metabolic syndrome (MS), with important medical and social implications. Impairment of cognitive abilities in these patients can reduce quality of life and increase the long-term risk of dementia and social maladaptation. This study evaluated the prevalence and clinical features of cognitive disorders (CDs) in military personnel—combatants—diagnosed with MS. Eighty-two patients with MS (main group) and 40 patients with arterial hypertension (AH) without MS (control group) underwent comprehensive assessment, including
neuropsychological testing, biochemical analysis (lipid profile, glucose), blood pressure measurement, and statistical evaluation. Absence of cognitive impairment was significantly more frequent in the control group (χ2=11.7, p<0.01), whereas moderate CDs predominated in the MS group (χ2=4.2, p<0.05). The MS group demonstrated significantly lower performance across most neuropsychological measures, including screening scales, auditory-verbal memory, attention, processing speed, speech, and spatial orientation. Depression and anxiety scores correlated negatively with MMSE (r=–0.3, p<0.05) and positively with deficits in word memorization, naming, and attention tasks. Elevated triglycerides were associated with poorer attention and delayed recall (p<0.05), while low high-density lipoprotein (HDL) levels correlated with more errors in delayed reproduction (p<0.05). Findings indicate that in military personnel with MS, CDs are predominantly neurodynamic and, at present, do not result in complete social or domestic maladaptation. However, affected individuals remain at elevated risk for progression to severe cognitive impairment and dementia, underscoring the need for early detection and targeted preventive interventions.
Keywords: metabolic syndrome, cognitive disorders, metabolic disorders, hypertriglyceridemia, military personnel, combatants
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ВЗАЄМОЗВ’ЯЗКИ МІЖ РІВНЯМИ SST2, NT-PROBNP ТА ФУНКЦІЄЮ НИРОК ПРИ ГОСТРОМУ КОРОНАРНОМУ СИНДРОМІ: РОЛЬ ФАКТОРА КУРІННЯ INTERRELATIONSHIPS BETWEEN LEVELS OF SST2, NT-PROBNP AND KIDNEY FUNCTION IN ACUTE CORONARY SYNDROME: THE ROLE OF SMOKING)

Мета дослідження – проаналізувати взаємозв’язки між рівнями розчинної форми стимулюючого фактора росту, що експресується геном 2 (sST2), N-кінцевого фрагменту попередника мозкового натрійуретичного пептиду (NT-proBNP) та функцією нирок при гострому коронарному синдромі (ГКС), оцінивши роль фактора куріння.

КЛЮЧОВІ СЛОВА: гострий коронарний синдром; хронічна хвороба нирок; швидкість клубочкової фільтрації; куріння, sST2; NT-proBNP; серцева недостатність.

Summary. The aim of the study was to analyze the relationships between the levels of the soluble form of the stimulating growth factor expressed by the gene 2 (sST2), the N-terminal fragment of the precursor of brain natriuretic peptide (NT-proBNP) and kidney function in acute coronary syndrome (ACS), assessing the role of the smoking factor.

KEYWORDS: acute coronary syndrome; chronic kidney disease; glomerular filtration rate; smoking, sST2; NT-proBNP; heart failure.

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CARDIOVASCULAR-RENAL-METABOLIC SYNDROME IN PATIENTS WITH CHRONIC HEART FAILURE

Cardiovascular-kidney-metabolic syndrome (CKMS) is characterized by a vicious cycle where each pathogenic link exacerbates the others, contributing to progressive deterioration in cardiac function, renal performance, and metabolic stability. The study aimed to assess kidney, heart, and metabolic functions in chronic heart failure (CHF) patients and examine these charac- teristics in dependence on endogenous intoxication severity. A number of 110 CHF patients (main group, MG) and 90 patients without CHF (control group, CG) were studied. The MG had a median age of 69.9 years, with 74.5% male patients. Echocardiographic parameters, renal function markers, and endogenous intoxication indices were measured. CKMS subgroups were stratified by estimated glomerular filtration rate (eGFR): GFR1 (>90 mL/min/1.73 m2), GFR2 (60–90 mL/min/1.73 m2), and GFR3 (<60 mL/min/1.73 m2). MG patients exhibited significantly higher serum creatinine (97.7 μmol/L versus 72.8 μmol/L) and urea levels (7.1 mmol/L vs. 5.3 mmol/L), alongside lower eGFR (67.1 vs. 87.0 mL/min/1.73 m2) compared to CG (p<0.006). Survival analysis revealed a cumulative event-free survival rate of 60.8% in patients with eGFR <60 mL/min/1.73 m2 vs. 75.2% in those with eGFR >90 mL/min/1.73 m2 (p=0.04). Structural heart abnormalities, including reduced left ventricular ejection fraction and increased left ventricle end-diastolic diameter, correlated with declining eGFR levels. Body mass index was inversely related to eGFR and positively associated with adverse cardiac remodeling, hypertension, and metabolic dysregulation. Patients with eGFR <60 mL/min/1.73 m2 demonstrated more severe lipid abnormalities and systemic inflammation, reflected in elevated fibrinogen and middle-mass molecules. CKMS in CHF patients is characterized by impaired renal filtration, metabolic instability, and cardiac dysfunction. These changes correlate with systemic inflammation and endogenous intoxication, underscoring the need for integrated therapeutic strategies targeting these interrelated pathologies.
Keywords: cardiovascular-renal-metabolic syndrome, chronic heart failure, eGFR, endogenous intoxication, systemic inflammation
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Вплив відмови від куріння на стан ліпідного обміну хворих, які перенесли аортокоронарне шунтування The effect of smoking cessation on lipid metabolism in patients after coronary artery bypass grafting

У дослідженні проаналізовано вплив куріння та відмови від нього на стан ліпідного обміну в пацієнтів з ішемічною хворобою серця до та після аортокоронарного шунтування. Обстежено 122 хворих, поділених за віком і фактором куріння. Курці мали значно гірші показники ліпідного профілю: підвищені проатерогенні ліпіди та дуже низький рівень ЛПВЩ. Через 6 місяців після операції та повної відмови від куріння саме у цій групі спостерігали найбільш виражене покращення ліпідних показників і високий відсоток досягнення цільових значень. У некурців позитивні зміни були менш значними. Відмова від куріння посилює ефективність статинотерапії й сприяє нормалізації ліпідного обміну.

Ключові слова: аортокоронарне шунтування, показники ліпідного обміну, статини, відмова від куріння.

Summary. The study analyzed the effect of smoking and quitting smoking on lipid metabolism in patients with ischemic heart disease before and after coronary artery bypass grafting. 122 patients were examined, divided by age and smoking factor. Smokers had significantly worse lipid profile indicators: increased proatherogenic lipids and very low HDL levels. 6 months after surgery and complete smoking cessation, this group showed the most pronounced improvement in lipid parameters and a high percentage of achieving target values. In non-smokers, positive changes were less significant. Quitting smoking enhances the effectiveness of statin therapy and contributes to the normalization of lipid metabolism.

Keywords: coronary artery bypass grafting, lipid metabolism indicators, statins, quitting smoking.

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STRUCTUTAL-FUNCTIONAL HEART STATE IN PATIENTS WITH HENOCH-SCHÖNLEIN PURPURA DEPENDING GALLBLADDER CONDITION

UDC 616.12-002.77:616.5-003.214:616.366 

Introduction. Cardiovascular complications are the common in patients with Henoch-Schönlein purpura (HSP; IgA-vasculitis). Heart condition is strictly connected with gall bladder (GB) changes. However the heart condition in patients with HSP in dependence of gallbladder status was not studied before.
Purpose. To reveal peculiarities of heart structure and function in patients with HSP in dependence of gall bladder condition.
Material and methods. We analyzed data from 75 patients with active HSP, which underwent the treatment according to guidelines of Helsinki Declaration. Investigated patients included 57% females and 43% males, middle age – 47.7±4.3 years; middle body mass index (BMI) 27,9 kg/m2. Patients were divided into 6 groups: group 0 – normal intact GB (38.7%); group 1 – sludge, polyposis and cholesterosis of GB (14.7%); group 2 – bent GB body (10.1%); group 3 – GB neck deformations and signs of chronic cholecystitis (18.7%); group 4 – cholelithiasis (10.1%); group 5 – patients with removed GB (7.7%). Digital data was processed with the statistical methods, the quantitative variables are expressed as mean ± standard deviation. Values of р<0.05 were considered statistically significant.
Results. Patients with HSP significantly more often had some GB disorders than its intact status (61.3% vs 38.7%, р<0.05). Group 1 with sludge, cholesterosis and polyposis of GB was characterized by the normal values of EchoCG parameters. Patients with bent GB body (group 2) had bigger arrhythmia frequency and heart rate close to the maximal value but the best EchoCG. Group 3 had the most often left axis deviation and quite rare arrhythmias. Group 4 of patients with HSP and cholelithiasis was characterized by the maximal frequency of arterial hypertension, the highest frequency of arrhythmias, the most often presence of both bundle branch block and the worst EchoCG parameters. Group 5 of patients with HSP and removed GB was characterized by the maximal frequency of presence of left ventricle hypertrophy, the highest heart rate and left axis deviation. Heart structure in these patients can be estimated as better than in patients with cholelithiasis.
Conclusions. The heart and GB conditions in patients with HSP are tightly connected. The worsening of GB condition was accompanied by worsening of structural and functional heart parameters. Cholecystectomy can improve heart condition. Patients with HSP and GB disorders need more thorough examination and early correction of biliary diseases.
Keywords: Henoch-Schönlein purpura, gall bladder, heart structure and function, cholelithiasis, cholecystitis, arrhythmia, heart block. 

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