Colorectal cancer is a type of oncopathology widespread in Kazakhstan. The genetic component, as well as the possible etiopathogenetic mechanisms, is widely studied. One of the most promising areas is the study of diagnostic and prognostic possibilities of inflammatory biomarkers in patients with different degrees of tumor differentiation. The following biomarkers were included in the study panel: stem cell factor (SCF), vascular endothelial growth factor (VEGF), fibroblast growth factor (FGF2), interleukin 6 (IL6), interleukin 8 (IL8), macrophage migration inhibitory factor (MIF), soluble Fas (SFAS), soluble Fas ligand (sFASL), transforming growth factor β (TGF), tumor necrosis factor (TNF), TNF-related apoptosis-inducing ligand (TRAIL), and programmed death ligand 1 (PD-L1). The data of our study show that most of the basic proinflammatory cytokines are involved in the systemic process and their levels do not depend on the level of tissue differentiation. Serum PD-L1 has shown itself to be a promising marker for tumor growth, which depends on the degree of differentiation.

Background:The Aral crisis consider as one of the largest ecological catastrophes on the planet. TheKazakhstan part of the Aral Sea regiondeclared an environmental disaster zone. The constantly changing unfavorable environmental situation contributed to higher number of thyroid pathology and initiates the study of this problem in women of reproductive age in the AralSea area.Aims:To study thyroid function in women of reproductive age living in ecologically unfavorable territories of Kazakhstan part of the Aral Sea region.Materials and methods: The survey was conducted within scientific and technical program: “Integrated approaches in managing the health status of the population of the Aral Sea region”  2014–2016 years, performed by Ministry of Health and Social Development of the Republic of Kazakhstan. The study was cross-sectional, observational, uncontrolled and multicenter.Study included the representative sample of 2205 women of reproductive age from 18 to 49 years old living in the Aral Sea region.The levels ofTSH,FT4and AntiTPOweredetermined by the laboratory of collective use of KSMU on the Evolis Robotized System using“Tiroid-ELISA-TTG,0.23-3.4µIU/ml”, “Thyroid–ELISAfreeT4,10-23.2pmol/l”,“Tiroid ELISA – atTPO,<30EDU/ml”testsystems.Results:A huge number of women from environmental disadvantaged areas of the Kazakhstan part of the Aral Sea region have TSH values exceeding reference of 3.4 μI/ml.The frequency of SH was 0.2%;0.9%,0.2% in the different study areas at TTG values≥10.0 μIU/ml and freeT4 from 10to23.2 pmol/l. The frequency of MH was 2.4%;2.7%,2.5% in the studied areas at TSH values ≥10.0μIU/ml and FreeT4<10.0 pmol/l, Thus, the data obtained on the prevalence of reduced thyroid function in women living in the studied areas of the Aral Sea ecological disaster can be considered as comparative. About3%of women of reproductive age neededon replacement therapy for hypothyroidism. Thelargest number of women with elevated AT-TPO identified in the zone of the ecological crisis. Almost same number of women with hypothyroidism was revealed among AT-TPO hosts in all studied zones.Conclusions: Women of reproductive age living in ecologically unfavorable territories havea high, comparable frequency of manifest hypothyroidism in the three studied zones of the Kazakhstan part of the Aral Sea region of the Republic of Kazakhstan.

Введение. Колоректальный рак (КРР) занимает одно из ведущих мест в структуре онкологической заболеваемости, в том числе в азиатских странах. В Республике Казахстан прирост заболеваемости раком ободочной кишки за последнее десятилетие составил 23 %, раком прямой кишки -17 %. Несмотря на действующие программы скрининга колоректального рака, продолжается поиск новых, в том числе сывороточных, маркеров для ранней диагностики, а у пациентов с выявленным КРР -панелей маркеров для прогноза течения заболевания. Целью исследования является изучение диагностической ценности и динамики сывороточных биомаркеров у больных КРР разных стадий. Материал и методы. Биомаркеры изучены иммунофлуоресцентным методом с использованием технологии xMap, который включал в себя одновременное иммунофлуоресцентное определение на магнитных сферах CA125, CA15-3, CA19-9, CEA, CYFRA21-1, sFAS, sFasL, HE4, Остеопонтин, VEGF-A, pd-L1. Результаты. Показано, что уровень исследованных маркеров не имел значимых различий у здоровых лиц и у больных с неонкологической патологией толстой кишки. При КРР выявлена статистически значимая зависимость уровня только 2 биомаркеров -CEA и ОПН -от стадии заболевания. У больных КРР IV стадии наблюдается значимое повышение CA125 по сравнению с новообразованиями I-III стадий. Такие маркеры, как CA19-9, HE-4, CA15-3, CYFRA 21-1, наряду с CEA, могут быть предложены для применения в комплексной диагностической панели. Полученные результаты позволяют сделать вывод о диагностических перспективах маркера pd-L1 при колоректальном раке.

BACKGROUND: Prediabetes itself could be an independent predictor of such adverse cardiovascular events as myocardial infarction and ischemic stroke. Since prediabetes is linked with hyperinsulinism it could also cause fluctuations of incretins concentration. Another significant fact related to prediabetes is glycemic variability. The impact of these factors on prediabetes and acute myocardial infarction is a promising phenomenon to study. AIM: The study aims to estimate insulin, incretins, and glycemic variability in patients with impaired carbohydrate metabolism and acute myocardial infarction METHODS: The 255 prediabetes patients participated in the observational case-control study. The first group included 85 patients hospitalized for STEMI. The second group included 170 patients without STEMI. Insulin and incretins were measured using a multiplex immunological assay with XMap technology on Bioplex 3D. The high-performance liquid chromatography with mass spectrometry was used to evaluate 1,5-AG concentration. The binary logistic regression was performed to evaluate the association between studying parameters and STEMI.  RESULTS: The insulin secretion parameters showed higher insulin and C-peptide level in patients with STEMI. A similar trend was noted for the HOMA-IR index. Among incretin, we revealed a higher level of glucagon and reduced GLP-1 in patients with STEMI. The of 1,5-AG in STEMI patients was significantly lower than in non-STEMI patients. The logistic regression model shows that a lower plasma concentration of 1,5-AG increases the odds of STEMI in patients with prediabetes [OR 2.304 (95% CI 1.980–2.973), p = 0.018]. Reduced GLP-1 concentration also increased the odds of STEMI [OR 1.775 (95% CI 1.460-1.990), p = 0.001]. CONCLUSION: We discovered the association between 1,5-AG, GLP-1, and STEMI in patients with prediabetes. It is designating their potential role as cardiovascular risk markers in non-diabetic patients with impaired glucose metabolism.

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Due to the fact that there are scientific discussions about the significance of gene polymorphisms in the risk of developing cardiovascular complications after a percutaneous coronary intervention, it is of interest to evaluate the genetic predictors of the development of cardiovascular events. This study is a molecular genetic study. Association with the genes of biomarkers for inflammation and immune response increases the risk of cardiovascular events: rs1234313 (TNFSF4): (A/G, OR-4.57 (2.35–8.87), p ≤ 0.0001), (A/G-A/A, OR-3.14 (1.75–5.63), p ≤ 0.0001), and (A/G, OR = 4.01 (2.19–7.36), p ≤ 0.0001); rs3184504 (SH2D3); ATXN2: (C/T, OR-2.53 (1.28–5.01), T/T, OR-2.99 (1.13–7.92), p = 0.017)), (C/T-T/T, OR-2.61 (1.35–5.07), p = 0.000), and (OR-1.89 (1.15–3.09), p = 0.009)). According to the lipid metabolism biomarker genes, rs2943634: (A/C OR-2.57 (1.18–5.62), p = 0.013); according to the endothelial biomarker genes, rs2713604: (DNAJB8-AS1; GATA2): (C/T, OR-4.27 (2.35–7.76), p ≤ 0.0001), (C/T-C/C, OR-4.13 (2.31–7.40), p ≤ 0.0001), (OR-4.05 (2.24–7.30), p ≤ 0.0001), and (C/T, OR-3.46 (1.99–6.00), p ≤ 0.0001). The regression analysis found that in the presence of the rs2943634 gene polymorphism, the risk of late cardiovascular events increases by 4.007 times with 95% CI (1.502:10.692), p = 0.006. The genes of biomarkers for the risk of cardiovascular events are rs1234313(TNFSF4), rs3184504 (SH2D3; ATXN2), rs2943634, and rs2713604 (DNAJB8-AS1; GATA2). The only predictor of the development of new cardiovascular events was rs2943634, which belongs to the group of lipid metabolism biomarkers.