ОЦЕНКА СИСТЕМЫ ГЕМОСТАЗА И ФАКТОРОВ, АССОЦИИРОВАННЫХ С ГИПЕРКОАГУЛЯЦИЕЙ, У МУЖЧИН С МЕТАБОЛИЧЕСКИМ СИНДРОМОМ И НАЧАЛЬНЫМ СНИЖЕНИЕМ СКОРОСТИ КЛУБОЧКОВОЙ ФИЛЬТРАЦИИ

THE AIM. To assess hypercoagulation factors in men with initial decrease of glomerular filtration rate (IDGFR) and metabolic syndrome (MS) depending on carbohydrate metabolism disorders (CMD). PATIENTS AND METHODS. The study included 79 men with IDGFR and MS. Two groups were assessed: main – patients IDGFR and CMD with MS (n=44) and control group – with IDGFR and MS without CMD (n=35). Besides examinations for confirming IDGFR and CMD type specification all patients were performed following tests: estimated thrombodynamics factors, serum concentration of common testosterone (CT), leptin (L), adiponectin (A), D-dimer (DD), activated platelets count (CD41+CD62P+) (APC), PAI-1, homocysteine (H). We also studied polymorphism of the genes associated with hyperhomocysteinemia (HHC). RESULTS. 90% cases of hyperhomocysteinemia (HHC) in men with IDGFR and MS were associated with genetic defects in enzyme systems regulating this amino acid metabolism.. Patients from the main group in comparison with the subjects without CMD had significantly higher density of the fibrin clot  (28012,21±1013,60 vs. 25209,15±1176,90 c.u., р<0,05), serum levels of PAI-1 (78,78±13,00 vs. 43,66±4,00 ng/ml, p<0,01), leptin (13,56±1,40 vs. 8,95±1,60 ng/ml, p<0,01) and lower serum concentration of CT (11,54±0,70 vs. 14,50±1,10 nmol/l, p<0,05). In men with IDGFR and MS with CMD we found positive correlations between activated platelets count and fasting glucose (rs=0,4; р<0,05), activated platelets count and postprandial glucose (rs=0,5; р<0,05), PAI-1 and adiponectin (rs=0,4;  р<0,05), PAI-1 and leptin (rs=0,4; р<0,05), homocysteine and MCH (rs=0,5; р<0,05), homocysteine and density of the fibrin clot (rs=0,5; р<0,05), insulin and PAI-1 (rs=0,4; р<0,05), adiponectin and density of the fibrin clot (rs=0,4; р<0,05), hemoglobin and clot growth rate (rs=0,4; р<0,05), RDW and D-dimer (rs=0,4; р<0,05), RDW and density of the fibrin clot (rs=0,6;  р<0,05); a negative correlation – between fasting glucose and adiponectin (rs= -0,4; р<0,05). CONCLUSION. CMD in men with IDGFR and MS are associated with procoagulant status via direct and indirect influence on hypercoaculation factors. The role  of adiponectin in thrombogenesis is controversial and requires further investigations.