Coronary heart disease (CHD) is the second in Ukraine among all diseases of the circulatory system. The prevalence of major risk factors for coronary heart disease is steadily increasing and according to WHO it may be increased by 50% during the next 25 years. One of the important risk factors is overweight or obesity, the prevalence of which is 29,7% among women and 14,8% among men in Ukraine. An important prognostic and unfavourable factor for progression of atherosclerosis is the adherence to the existing type 2 diabetes mellitus obesity. Neuroendocrinal mechanisms induced by excessive amount of adipose tissue play the important role in atherogenesis. In addition to the functions of the energy depot, adipose tissue is a source of various bioactive substances, leptin, resistin, adiponectin, tumor necrosis factor -α, which contribute significantly to the pathogenesis of IR, endothelial dysfunction and atherogenesis. Tissue IR which is a common pathophysiological disturbance in obesity and diabetes type 2 is closely associated with the accumulation of visceral fat mass and adipose tissue – of leptin, a hormone that is produced by adipocytes. The question of the relationship of leptin with insulin and IR is still being left open. However, the researcher’s hypothesis about the role of leptin in atherogenesis in patients with type 2 diabetes with obesity remains controversial. The aim of the research was to investigate the peculiarity of leptin contents in blood of the patients with type 2 diabetes mellitus with obesity and coronary heart disease; to identify possible correlation of leptin with IR parameters.

All the patients were divided into four groups. The first group included 28 patients with diabetes type 2 with obesity and coronary heart disease, the second group consisted of 20 patients with diabetes type 2 with obesity without CHD and the third one – with 20 patients with obesity (without impaired carbohydrate exchange) and coronary heart disease, and the fourth one included 12 obese patients with pathology of the carbohydrate metabolism and the cardiovascular system. Increase in the concentration of leptin in the blood is directly correlated with BMI. Thus, in obese patients, regardless of the status of carbohydrate metabolism, blood leptin content was significantly increased. Indicate the amount of leptin in the blood of people with obesity were within the physiological norm. Number of plasma leptin is directly proportional to the degree of obesity. These results are the same as in scientific literature, which indicates an increase in the concentration of leptin in patients with overweight. Comparing data between a leptin concentration in patients with verified coronary artery disease and without it, it was found that patients with coronary heart disease observed the highest content of the hormone in the blood.

An interesting fact was available hiperleptin in patients with type 2 diabetes with obesity with coronary heart disease, which was equivalent to the concentration of leptin in the blood of patients with obesity and coronary artery disease with impaired carbohydrate metabolism. This result supports the hypothesis that diabetes type 2 is considered as an “equivalent” to coronary artery disease.

An increase of insulin and leptin concentration in the blood, negative trend indicators, which characterize insulin resistance, has been observed in examined patients with type 2 diabetes with obesity and coronary heart disease. A strong positive correlation between the concentrations of insulin and leptin in the blood that may indicate hypothetically stimulating effect of leptin on insulin secretion and processes of atherogenesis, which further leads to the rapid development and progression of coronary heart diseases, has been determined in this group of patients.

Keywords: type 2 diabetes, coronary heart disease, leptin, insulin resistance, atherogenesis

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