emcardioНеотложная кардиология и кардиоваскулярные рискиEmergency Cardiology and Cardiovascular Risks journal2616-633XБелорусский государственный медицинский университетemcardio-230Research ArticleОригинальные научные публикацииOriginal Scientific ResearchМетаболическая активность жировой ткани у пациентов с хронической обструктивной болезнью легких в условиях хронического неспецифического воспаленияAdipose tissue metabolic activity in chronic obstructive pulmonary disease patients in case of chronic nonspecific inflammationЛапицкийД. В.LapitskiD. V.РяполовА. Н.RyapolovA. N.ПупкевичВ. А.PupkevichV. A.ЧириковаТ. В.ChirikovaT. V.БутяновскаяИ. Б.ButyanovskayaI. B.ЕрмолкевичР. Ф.ErmolkevchR. F.АрабейА. А.ArabeyA. A.ГончарикА. В.GoncharikA. V.ИбрагимоваЖ. А.IbragimovaG. A.МитьковскаяН. П.MitkovskayaN. P.ГУ «432 Главный военный клинический медицинский центр МО ВС Республики Беларусь»Main military hospitalБелорусский государственный медицинский университетBelarusian State Medical University20191111202532698–708Copyright © Лапицкий Д.В., Ряполов А.Н., Пупкевич В.А., Чирикова Т.В., Бутяновская И.Б., Ермолкевич Р.Ф., Арабей А.А., Гончарик А.В., Ибрагимова Ж.А., Митьковская Н.П., 20252025Лапицкий Д.В., Ряполов А.Н., Пупкевич В.А., Чирикова Т.В., Бутяновская И.Б., Ермолкевич Р.Ф., Арабей А.А., Гончарик А.В., Ибрагимова Ж.А., Митьковская Н.П.Lapitski D.V., Ryapolov A.N., Pupkevich V.A., Chirikova T.V., Butyanovskaya I.B., Ermolkevch R.F., Arabey A.A., Goncharik A.V., Ibragimova G.A., Mitkovskaya N.P.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://emcardio.bsmu.by/jour/article/view/230

В статье отражены результаты изучения динамики гормонов жировой ткани лептина и адипонектина в зависимости от выраженности неспецифического воспаления, а также дан анализ взаимосвязей адипокинов с показателями, отражающими нарушения обмена глюкозы, липидов, содержание жировой ткани в организме пациентов с ХОБЛ при различных уровнях маркеров неспецифического воспаления (высокочувствительного С-реактивного белка, интерлейкина–8). При высоком уровне маркеров воспаления отмечено снижение уровня лептина и повышение уровня адипонектина. Обратное соотношение уровней адипокинов выявлено при уменьшении маркеров воспалительной реакции. Низкий уровень лептина в условиях воспаления, а также высокий уровень лептина при уменьшении выраженности воспаления способствуют нарушениям обмена глюкозы, повышению содержания жировой ткани в организме. Снижение уровня адипонектина при уменьшении маркеров воспалительной реакции сопровождается уменьшением его протективных свойств относительно нарушений обмена глюкозы. Применение селективного блокатора небиволола ассоциировано с повышением уровня адипонектина. Использование розувастатина ассоциировано с повышением уровня лептина, снижением уровня адипонектина, вероятно, за счет подавления воспалительной реакции (плейотропное действие лекарственного средства).

The article addresses the dynamics of adipose tissue hormones leptin (LN) and adiponectin (AN) depending on nonspecific inflammation (NI) degree, as well as relations between adipokin and glucose/lipids metabolic disorders, adipose tissue capacity with different NI degrees in patients with chronic obstructive pulmonary disease (COPD). NI is associated with a high AN degree and a low LN degree which promotes the increase in metabolic substrata intake for immunity caloric supply. NI decrease is associated with a low AN degree and a highLN degree which promotes increase in adipose tissue capacity and worsening of glucose/lipids metabolic disorders. Nebivolol administration is associated with increase in AN level. Statins administration results in decrease in AN level and increase in LN level, due to reduced NI. Thus, treatment strategy in COPD patients should include some measures to prevent adipose tissue capacity increase and glucose/lipids metabolic disorders when NI is reduced.

лептинадипонектиннеспецифическое воспалениенарушение обмена глюкозыповышение содержания жировой тканинебивололстатиныleptinadiponectinnonspecific inflammationglucose metabolic disordersadipose tissue capacity increasenebivololstatinsReferencesKrasil’nikova E.I., Simonenkova A.V., Karabickaya N.L., SHapkova E.A., Baranova E.I. Osobennosti stroeniya i funkcionirovaniya jirovoy tkani v norme i pri razvitii ojireniya [Features of the structure and functioning of adipose tissue in normal and in the development of obesity]. Ucheny’e zapiski SPbGMU im. Akad. I.P. Pavlova, 2012, vol. 9, no. 3, pp. 99–107. (in Russian).Krasil’nikova E.I., Simonenkova A.V., Karabickaya N.L., SHapkova E.A., Baranova E.I. Osobennosti stroeniya i funkcionirovaniya jirovoy tkani v norme i pri razvitii ojireniya [Features of the structure and functioning of adipose tissue in normal and in the development of obesity]. Ucheny’e zapiski SPbGMU im. Akad. I.P. Pavlova, 2012, vol. 9, no. 3, pp. 99–107. (in Russian).Kershaw E.E., Flier J.S. Adipose tissue as an endocrine organ. J. Clin. Endocrinol. Metab, 2004, vol. 89, no. 6, pp. 2548–2556.Kershaw E.E., Flier J.S. Adipose tissue as an endocrine organ. J. Clin. Endocrinol. Metab, 2004, vol. 89, no. 6, pp. 2548–2556.Kahn C.R.,Wang G., Lee K.Y. Altered adipose tissue and adipocyte function in the pathogenesis of metabolic syndrome. J. Clin. Invest, 2019, vol. 129, no. 10, pp. 3990–4000.Kahn C.R.,Wang G., Lee K.Y. Altered adipose tissue and adipocyte function in the pathogenesis of metabolic syndrome. J. Clin. Invest, 2019, vol. 129, no. 10, pp. 3990–4000.Finkelstein J., Cha E., Scharf S.M. Chronic obstructive pulmonary disease as an independent risk factor for cardiovascular morbidity.Int. J. Chron. Obstruct. Pulmon. пDis, 2009, no. 4, pp. 337–349.Finkelstein J., Cha E., Scharf S.M. Chronic obstructive pulmonary disease as an independent risk factor for cardiovascular morbidity.Int. J. Chron. Obstruct. Pulmon. пDis, 2009, no. 4, pp. 337–349.Grigoryeva N.Y., Maiorova М.V., Korolyova M.E., Samolyuk M.O. Сomorbidity and polymorbidity of the patient withгchronic obstructive pulmonary diseaseгand cardiovascular diseases. Ter. Arkh, 2019, vol. 91, no. 1, pp. 44–47.Grigoryeva N.Y., Maiorova М.V., Korolyova M.E., Samolyuk M.O. Сomorbidity and polymorbidity of the patient withгchronic obstructive pulmonary diseaseгand cardiovascular diseases. Ter. Arkh, 2019, vol. 91, no. 1, pp. 44–47.Müllerova H., Agusti A., Erqou S., Mapel D.W. Cardiovascular comorbidity in COPD: systematic literature review. Chest, 2013, vol.144, no. 14, pp.1163–1178.Müllerova H., Agusti A., Erqou S., Mapel D.W. Cardiovascular comorbidity in COPD: systematic literature review. Chest, 2013, vol.144, no. 14, pp.1163–1178.Donaldson G.C., Hurst J.R., Smith C.J., Hubbard R.B., Wedzicha J.A. Increased risk of myocardial infarction and stroke following exacerbation of COPD. Chest, 2010, vol.137, no. 5, pp.1091–1097.Donaldson G.C., Hurst J.R., Smith C.J., Hubbard R.B., Wedzicha J.A. Increased risk of myocardial infarction and stroke following exacerbation of COPD. Chest, 2010, vol.137, no. 5, pp.1091–1097.Barnes P.J. Inflammatory mechanisms in patients with chronic obstructive pulmonary disease. J. Allergy Clin. Immunol, 2016, vol. 138, no. 1, pp. 16–27.Barnes P.J. Inflammatory mechanisms in patients with chronic obstructive pulmonary disease. J. Allergy Clin. Immunol, 2016, vol. 138, no. 1, pp. 16–27.Lapickiy D.V. Stratifikaciya kardiovaskulyarnogo riska u pacientov s HOBL [Stratification of cardiovascular risk in COPD patients]. Neotlojnaya kardiologiya i kardiovaskulyarny’e riski, 2018, vol. 2, no. 2, pp. 364–372. (in Russian).Lapickiy D.V. Stratifikaciya kardiovaskulyarnogo riska u pacientov s HOBL [Stratification of cardiovascular risk in COPD patients]. Neotlojnaya kardiologiya i kardiovaskulyarny’e riski, 2018, vol. 2, no. 2, pp. 364–372. (in Russian).Lapickiy D.V., Ryapolov A.N., Ermolkevich R.F., Pupkevich V.A, CHirikova T.V., Mit’kovskaya N.P. Istochniki sistemnogo vospaleniya u pacientov s hronicheskoy obstruktivnoy bolezn’yu legkih [Sources of systemic inflammation in patients with chronic obstructive pulmonary disease]. V S`ezd Evraziyskoy Associacii terapevtov: tez. dokl., Minsk, 16–17 maya 2019 g. Minsk, 2019. S. 36.(in Russian).Lapickiy D.V., Ryapolov A.N., Ermolkevich R.F., Pupkevich V.A, CHirikova T.V., Mit’kovskaya N.P. Istochniki sistemnogo vospaleniya u pacientov s hronicheskoy obstruktivnoy bolezn’yu legkih [Sources of systemic inflammation in patients with chronic obstructive pulmonary disease]. V S`ezd Evraziyskoy Associacii terapevtov: tez. dokl., Minsk, 16–17 maya 2019 g. Minsk, 2019. S. 36.(in Russian).Mantzoros C.S. The role of leptin in human obesity and disease: A review of current evidence.Ann. Intern. Med, 1999, vol. 130, no. 8, pp.671–680.Mantzoros C.S. The role of leptin in human obesity and disease: A review of current evidence.Ann. Intern. Med, 1999, vol. 130, no. 8, pp.671–680.Wasim M., Awan F.R., Najam S.S., Khan A.R., Khan H.N. Role of Leptin Deficiency, Inefficiency, and Leptin Receptors in Obesity. Biochem. Genet, 2016, vol.54, no. 5, pp. 565–572.Wasim M., Awan F.R., Najam S.S., Khan A.R., Khan H.N. Role of Leptin Deficiency, Inefficiency, and Leptin Receptors in Obesity. Biochem. Genet, 2016, vol.54, no. 5, pp. 565–572.Anaszewicz M., Wawrzeńczyk A., Czerniak B., Banaś W., Socha E., Lis K., Żbikowska-Gotz M., Bartuzi Z., Budzyński J. High leptin and low blood adiponectin, TNF-alpha and irisin blood concentrations as factors linking obesity with the risk of atrial fibrillation among inpatients with cardiovascular disorders. Kardiol. Pol, 2019. doi: 10.33963/KP.14989.Anaszewicz M., Wawrzeńczyk A., Czerniak B., Banaś W., Socha E., Lis K., Żbikowska-Gotz M., Bartuzi Z., Budzyński J. High leptin and low blood adiponectin, TNF-alpha and irisin blood concentrations as factors linking obesity with the risk of atrial fibrillation among inpatients with cardiovascular disorders. Kardiol. Pol, 2019. doi: 10.33963/KP.14989.Yang H., Guo W., Li J., Cao S., Zhang J., Pan J., Wang Z., Wen P., Shi X., Zhang S. Leptin concentration and risk of coronary heart disease and stroke: A systematic review and meta-analysis. PLoS One., 2017, vol. 12, no. 3, pp. e0166360.doi: 10.1371/journal.pone.0166360.Yang H., Guo W., Li J., Cao S., Zhang J., Pan J., Wang Z., Wen P., Shi X., Zhang S. Leptin concentration and risk of coronary heart disease and stroke: A systematic review and meta-analysis. PLoS One., 2017, vol. 12, no. 3, pp. e0166360.doi: 10.1371/journal.pone.0166360.Fantuzzi G. Adiponectin and inflammation: consensus and controversy. J. Allergy Clin. Immunol,2008, vol.121, no. 2, pp.326–330.Fantuzzi G. Adiponectin and inflammation: consensus and controversy. J. Allergy Clin. Immunol,2008, vol.121, no. 2, pp.326–330.Essick E.E., Wilson R.M., Pimentel D.R., Shimano M., Baid S., Ouchi N., Sam F.Adiponectin Modulates Oxidative Stress-Induced Autophagy in Cardiomyocytes. PLoS. One, 2013, vol.8, no. 7, pp. e68697. doi: 10.1371/journal.pone.0068697.Essick E.E., Wilson R.M., Pimentel D.R., Shimano M., Baid S., Ouchi N., Sam F.Adiponectin Modulates Oxidative Stress-Induced Autophagy in Cardiomyocytes. PLoS. One, 2013, vol.8, no. 7, pp. e68697. doi: 10.1371/journal.pone.0068697.Kryukov N.N., Ginzburg M.M., Kiseleva E.V. Sovremenny’y vzglyad na rol’ asepticheskogo vospaleniya jirovoytkani v geneze ojireniya i metabolicheskogo sindroma [Modern view on the role of aseptic inflammation of adipose tissue in the Genesis of obesity and metabolic syndrome].Arterial’naya gipertenziya, 2013, vol. 19, no. 4, pp. 305–310.(in Russian).Kryukov N.N., Ginzburg M.M., Kiseleva E.V. Sovremenny’y vzglyad na rol’ asepticheskogo vospaleniya jirovoytkani v geneze ojireniya i metabolicheskogo sindroma [Modern view on the role of aseptic inflammation of adipose tissue in the Genesis of obesity and metabolic syndrome].Arterial’naya gipertenziya, 2013, vol. 19, no. 4, pp. 305–310.(in Russian).SinghD., AgustiA., AnzuetoA., BarnesP.J., BourbeauJ., CelliB.R., CrinerG.J., FrithP., Halpin D.M.G., HanM., López Varela M.V., Martinez F., Montes de Oca M., Papi A., Pavord I.D., Roche N., Sin D.D., Stockley R., Vestbo J., Wedzicha J.A., Vogelmeier C. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease (2019 report). Eur. Respir. J., 2019, vol. 53, no. 5, pp. 1900164. doi: 10.1183/13993003.00164–2019.SinghD., AgustiA., AnzuetoA., BarnesP.J., BourbeauJ., CelliB.R., CrinerG.J., FrithP., Halpin D.M.G., HanM., López Varela M.V., Martinez F., Montes de Oca M., Papi A., Pavord I.D., Roche N., Sin D.D., Stockley R., Vestbo J., Wedzicha J.A., Vogelmeier C. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease (2019 report). Eur. Respir. J., 2019, vol. 53, no. 5, pp. 1900164. doi: 10.1183/13993003.00164–2019.Davidovskaya E.I., Slipchenko E`.G, Hapalyuk A.V., Manichev I.A., SCH’erbickiy V.G. Issledovanie funkcii vneshnego dy’haniya v terapevticheskoy praktike: novy’e vozmojnosti [Study of respiratory function in therapeutic practice: new opportunities]. Medicinskie novosti, 2005, no. 3, pp. 81–84. (in Russian).Davidovskaya E.I., Slipchenko E`.G, Hapalyuk A.V., Manichev I.A., SCH’erbickiy V.G. Issledovanie funkcii vneshnego dy’haniya v terapevticheskoy praktike: novy’e vozmojnosti [Study of respiratory function in therapeutic practice: new opportunities]. Medicinskie novosti, 2005, no. 3, pp. 81–84. (in Russian).Biryukova E.V., Bondarenko I.Z., Bordan N.S., Dzgoeva F.H., Ershova E.V., Komshilova K.A., Mkrtumyan A.M., Petunina N.A., Romancova T.I., Starostina E.G., Strongin L.G., Suplotova L.A., Fadeev V.V. Nacional’ny’e klinicheskie rekomendacii po lecheniyu morbidnogo ojireniya u vzrosly’h. 3-iy peresmotr [National clinical guidelines for the treatment of morbid obesity in adults. 3rd revision]. Ojirenie i metabolizm, 2018, vol. 15, no. 1, s.53–70. (in Russian).Biryukova E.V., Bondarenko I.Z., Bordan N.S., Dzgoeva F.H., Ershova E.V., Komshilova K.A., Mkrtumyan A.M., Petunina N.A., Romancova T.I., Starostina E.G., Strongin L.G., Suplotova L.A., Fadeev V.V. Nacional’ny’e klinicheskie rekomendacii po lecheniyu morbidnogo ojireniya u vzrosly’h. 3-iy peresmotr [National clinical guidelines for the treatment of morbid obesity in adults. 3rd revision]. Ojirenie i metabolizm, 2018, vol. 15, no. 1, s.53–70. (in Russian).Ry’tikova N.S., Smirnova M.A., Ugol’kova. N.V., Silina I.A., Romanov. S.V., Egorov E.L., Filatova L.V., Simanov A.L., Pichugina L.V., CHernoglazova N.I., Tokar M.I., Gulidova O.B., Ermolova T.V., Otstavnov, G.YU., Kurakova I.V. compil; Kozlov I.G. ed. Markery’ vospaleniya i oksidativnogo stressa [Markers of inflammation and oxidative stress]. Katalog BioHimMak (obzory’ po vsem voprosam). M.: Gruppa kompaniy «Biohimmak», 2007, s. 355–366. (in Russian).Ry’tikova N.S., Smirnova M.A., Ugol’kova. N.V., Silina I.A., Romanov. S.V., Egorov E.L., Filatova L.V., Simanov A.L., Pichugina L.V., CHernoglazova N.I., Tokar M.I., Gulidova O.B., Ermolova T.V., Otstavnov, G.YU., Kurakova I.V. compil; Kozlov I.G. ed. Markery’ vospaleniya i oksidativnogo stressa [Markers of inflammation and oxidative stress]. Katalog BioHimMak (obzory’ po vsem voprosam). M.: Gruppa kompaniy «Biohimmak», 2007, s. 355–366. (in Russian).Ry’tikova N.S., Smirnova M.A., Ugol’kova. N.V., Silina I.A., Romanov. S.V., Egorov E.L., Filatova L.V., Simanov A.L., Pichugina L.V., CHernoglazova N.I., Tokar M.I., Gulidova O.B., Ermolova T.V., Otstavnov, G.YU., Kurakova I.V. compil; Kozlov I.G. ed. Metabolicheskiy sindrom [Metabolic syndrome]. Katalog BioHimMak (obzory’ po vsem voprosam). M.: Gruppa kompaniy «Biohimmak», 2007. s.26–36. (in Russian).Ry’tikova N.S., Smirnova M.A., Ugol’kova. N.V., Silina I.A., Romanov. S.V., Egorov E.L., Filatova L.V., Simanov A.L., Pichugina L.V., CHernoglazova N.I., Tokar M.I., Gulidova O.B., Ermolova T.V., Otstavnov, G.YU., Kurakova I.V. compil; Kozlov I.G. ed. Metabolicheskiy sindrom [Metabolic syndrome]. Katalog BioHimMak (obzory’ po vsem voprosam). M.: Gruppa kompaniy «Biohimmak», 2007. s.26–36. (in Russian).Makarov L.M. Holterovskoe monitorirovanie [Holter monitoring]. M.: Medpraktika, 2011. 456 s. (in Russian).Makarov L.M. Holterovskoe monitorirovanie [Holter monitoring]. M.: Medpraktika, 2011. 456 s. (in Russian).Gorbunov V.M. Sutochnoe monitorirovanie arterial’nogo davleniya. Sovremenny’e aspekty ‘[Daily monitoring of blood pressure. Modern aspect]. M.: Logosfera, 2015. 240 s. (in Russian).Gorbunov V.M. Sutochnoe monitorirovanie arterial’nogo davleniya. Sovremenny’e aspekty ‘[Daily monitoring of blood pressure. Modern aspect]. M.: Logosfera, 2015. 240 s. (in Russian).Halafyan A.A. Statistica 6. Matematicheskaya statistika s e`lementami teorii veroyatnostey [Statistica 6. Mathematical statistics with elements of probability theory]. M.: Binom, 2010. 496s. (in Russian).Halafyan A.A. Statistica 6. Matematicheskaya statistika s e`lementami teorii veroyatnostey [Statistica 6. Mathematical statistics with elements of probability theory]. M.: Binom, 2010. 496s. (in Russian).Lapach S.N., Chubenko A.V., Babich P.N. Statisticheskie metody’ v mediko-biologicheskih issledovaniyah s ispol’zovaniem Excel [Statistical methods in biomedical research using Excel]. Kiev: Morion, 2001. 408s. (in Russian).Lapach S.N., Chubenko A.V., Babich P.N. Statisticheskie metody’ v mediko-biologicheskih issledovaniyah s ispol’zovaniem Excel [Statistical methods in biomedical research using Excel]. Kiev: Morion, 2001. 408s. (in Russian).Williams B., Mancia G., Spiering W., Agabiti Rosei E., Azizi M., Burnier M., Clement D.L., Coca A., deSimone G., Dominiczak A., Kahan T., Mahfoud F., Redon J., Ruilope L., Zanchetti A., Kerins M., Kjeldsen S.E., Kreutz R., Laurent S., Lip GY.H., McManus R., Narkiewicz K., Ruschitzka F., Schmieder R.E., Shlyakhto E., Tsioufis C., Aboyans V., Desormais I.2018 ESH/ESC Guidelines for the management of arterial hypertension: The Task Force for the management of arterial hypertension of the European Society of Hyper tension (ESH) and of the European Societ y of Cardiology (ESC). J. Hypertens, 2018, vol. 36, no. 10, pp. 1953–2041.Williams B., Mancia G., Spiering W., Agabiti Rosei E., Azizi M., Burnier M., Clement D.L., Coca A., deSimone G., Dominiczak A., Kahan T., Mahfoud F., Redon J., Ruilope L., Zanchetti A., Kerins M., Kjeldsen S.E., Kreutz R., Laurent S., Lip GY.H., McManus R., Narkiewicz K., Ruschitzka F., Schmieder R.E., Shlyakhto E., Tsioufis C., Aboyans V., Desormais I.2018 ESH/ESC Guidelines for the management of arterial hypertension: The Task Force for the management of arterial hypertension of the European Society of Hyper tension (ESH) and of the European Societ y of Cardiology (ESC). J. Hypertens, 2018, vol. 36, no. 10, pp. 1953–2041.Piepoli M.F., Hoes A.W., Agewall S., Albus C., Brotons C., Catapano A.L., Cooney M.T., Corrà U., Cosyns B., Deaton C., Graham I., Hall M.S., Hobbs F.D.R., Løchen M.L., Löllgen H., Marques-Vidal P., Perk J., Prescott E., Redon J., Richter D.J., Sattar N., Smulders Y., Tiberi M., van der Worp H..B, van Dis I., Verschuren W.M.M., Binno S.2016 European Guidelines on cardiovascular disease prevention in clinical practice The Sixth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of 10 societies and by invited experts).Eur. Heart J, 2016,vol. 37, no. 29, pp. 2315–2381.Piepoli M.F., Hoes A.W., Agewall S., Albus C., Brotons C., Catapano A.L., Cooney M.T., Corrà U., Cosyns B., Deaton C., Graham I., Hall M.S., Hobbs F.D.R., Løchen M.L., Löllgen H., Marques-Vidal P., Perk J., Prescott E., Redon J., Richter D.J., Sattar N., Smulders Y., Tiberi M., van der Worp H..B, van Dis I., Verschuren W.M.M., Binno S.2016 European Guidelines on cardiovascular disease prevention in clinical practice The Sixth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of 10 societies and by invited experts).Eur. Heart J, 2016,vol. 37, no. 29, pp. 2315–2381.Montalescot G., Sechtem U., Achenbach S., Andreotti F., Arden C., Budaj A., Bugiardini R., Crea F., Cuisset T., Di Mario C., Ferreira J.R., Gersh B.J.[et al.] 2013 ESC guidelines on the management of stable coronary artery disease The Task Force on the management of stable coronary artery disease of the European Society of Cardiology.Eur. Heart J, 2013, vol.34, no. 38, pp. 2949–3003.Montalescot G., Sechtem U., Achenbach S., Andreotti F., Arden C., Budaj A., Bugiardini R., Crea F., Cuisset T., Di Mario C., Ferreira J.R., Gersh B.J.[et al.] 2013 ESC guidelines on the management of stable coronary artery disease The Task Force on the management of stable coronary artery disease of the European Society of Cardiology.Eur. Heart J, 2013, vol.34, no. 38, pp. 2949–3003.Lenglet S., Quercioli A., Fabre M., Galan K, Pelli G., Nencioni A., Bauer I., Pende A., Python M., Bertolotto M., Spinella G., Pane B., Palombo D., Dallegri F., Mach F., Vuilleumier N., Montecucco F.Statin Treatment Is Associated with Reduction in Serum Levels of Receptor Activator of NF-κB Ligand and Neutrophil Activation in Patients with Severe Carotid Stenosis[elec tronic resource]. Available at: http://dx.doi.org/10.1155/2014/720987. (accessed 28.10.2019). doi: 10.1155/2014/720987.Lenglet S., Quercioli A., Fabre M., Galan K, Pelli G., Nencioni A., Bauer I., Pende A., Python M., Bertolotto M., Spinella G., Pane B., Palombo D., Dallegri F., Mach F., Vuilleumier N., Montecucco F.Statin Treatment Is Associated with Reduction in Serum Levels of Receptor Activator of NF-κB Ligand and Neutrophil Activation in Patients with Severe Carotid Stenosis[elec tronic resource]. Available at: http://dx.doi.org/10.1155/2014/720987. (accessed 28.10.2019). doi: 10.1155/2014/720987.Wang X.-L., SunW., ZhouY.-L., Li L. Rosuvastatin Attenuates CD40L-Induced Downregulation of Extracellular Matrix Production in Human Aortic Smooth Muscle Cells via TRAF6-JNK-NF-κB Pathway. PLoS One, 2016, vol.11, no. 4, pp.e0153919. doi: 10.1371/journal.pone.0153919.Wang X.-L., SunW., ZhouY.-L., Li L. Rosuvastatin Attenuates CD40L-Induced Downregulation of Extracellular Matrix Production in Human Aortic Smooth Muscle Cells via TRAF6-JNK-NF-κB Pathway. PLoS One, 2016, vol.11, no. 4, pp.e0153919. doi: 10.1371/journal.pone.0153919.Suksomboon N., Poolsup N., Prasit T. Systematic review of the effect of telmisartan on insulin sensitivity in hypertensive patients with insulin resistance or diabetes. J. Clin. Pharm. Ther, 2012, vol.37, no. 3, pp. 319–327.Suksomboon N., Poolsup N., Prasit T. Systematic review of the effect of telmisartan on insulin sensitivity in hypertensive patients with insulin resistance or diabetes. J. Clin. Pharm. Ther, 2012, vol.37, no. 3, pp. 319–327.Taguchi I., Toyoda S., Takano K., Arikawa T., Kikuchi M., Ogawa M., Abe S., Node K., Inoue T. Irbesartan, an angiotensin receptor blocker, exhibits metabolic, anti-inflammatory and antioxidative effects in patients with high-risk hypertension. Hypertens Res, 2013, vol.36, no. 7, pp. 608–613.Taguchi I., Toyoda S., Takano K., Arikawa T., Kikuchi M., Ogawa M., Abe S., Node K., Inoue T. Irbesartan, an angiotensin receptor blocker, exhibits metabolic, anti-inflammatory and antioxidative effects in patients with high-risk hypertension. Hypertens Res, 2013, vol.36, no. 7, pp. 608–613.De Mello W.C. Spironolactone enhances the beneficial effect of aliskiren on cardiac structural and electrical remodeling in TGR (mRen2) 27 rats. J. Renin Angiotensin Aldosterone Syst, 2015, vol.16, no. 3, pp.488–494.De Mello W.C. Spironolactone enhances the beneficial effect of aliskiren on cardiac structural and electrical remodeling in TGR (mRen2) 27 rats. J. Renin Angiotensin Aldosterone Syst, 2015, vol.16, no. 3, pp.488–494.Coelho-Filho O.R., Shah R.V., Neilan T.G., Mitchell R., Moreno H. Jr., Kwong R., Jerosch-Herold M. Cardiac Magnetic Resonance Assessment of Interstitial Myocardial Fibrosis and Cardiomyocyte Hypertrophy in Hypertensive Mice Treated With Spironolactone. J. Am. Heart Assoc, 2014, vol.3, no. 3, pp. e000790.doi: 10.1161/JAHA.114.000790.Coelho-Filho O.R., Shah R.V., Neilan T.G., Mitchell R., Moreno H. Jr., Kwong R., Jerosch-Herold M. Cardiac Magnetic Resonance Assessment of Interstitial Myocardial Fibrosis and Cardiomyocyte Hypertrophy in Hypertensive Mice Treated With Spironolactone. J. Am. Heart Assoc, 2014, vol.3, no. 3, pp. e000790.doi: 10.1161/JAHA.114.000790.Zvizdic F., Begic E., Mujakovic A., Hodzic E., Prnjavorac B., Bedak O., Čustović F., Bradaric H., Durak-Nalbantic A. Beta-blocker Use in Moderate and Severe Chronic Obstructive Pulmonary Disease. Med Arch., 2019, vol. 73, no. 2. pp. 72–75. doi: 10.5455/medarh.2019.73.72–75Zvizdic F., Begic E., Mujakovic A., Hodzic E., Prnjavorac B., Bedak O., Čustović F., Bradaric H., Durak-Nalbantic A. Beta-blocker Use in Moderate and Severe Chronic Obstructive Pulmonary Disease. Med Arch., 2019, vol. 73, no. 2. pp. 72–75. doi: 10.5455/medarh.2019.73.72–75Dal Negro R. Pulmonary effects of nebivolol. Ther. Adv. Cardiovasc. Dis, 2009, vol. 3, no. 4, pp. 329–334.Dal Negro R. Pulmonary effects of nebivolol. Ther. Adv. Cardiovasc. Dis, 2009, vol. 3, no. 4, pp. 329–334.Abuelezz S.A. Nebivololat tenuates oxidative s tress and inflammation in a guinea pig model of ovalbumin-induced asthma: a possible mechanism for its favorable respiratory effects. Can. J. Physiol. Pharmacol, 2018, vol. 96, no. 3, pp. 258–265.Abuelezz S.A. Nebivololat tenuates oxidative s tress and inflammation in a guinea pig model of ovalbumin-induced asthma: a possible mechanism for its favorable respiratory effects. Can. J. Physiol. Pharmacol, 2018, vol. 96, no. 3, pp. 258–265.

The authors declare that there are no conflicts of interest present.