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Aims of the study were to determine main pathophysiologic mechanisms of decreased exercise tolerance in patients with metabolic syndrome (MS); to prove the state of hypoxemia by ergospirometry in patients with MS; to reveal with the help of echocardiography lowering of functional activity of the myocardium in MS; to confirm by electron microscopic techniques the presence of perivascular and interstitial fibrosis and fatty infiltration of the myocardium in patients with MS. In the study we have observed 39 patients with MS and 12 healthy individuals. We have noted the decrease of peak oxygen consumption and carbon dioxide excretion during the ergospirometry at anaerobic threshold in patients with MS. Echocardiographic examination has proven the reduction of left ventricular ejection fraction and cardiac contractile performance. The electron microscopic techniques have shown diffuse-focal interstitial fibrosis, hypertrophy of myocardial cells and fatty infiltration of the myocardium.

Hyperinsulinemic and euglycemic clamp studies were done in 17 women selected from 64 postmenopausal female patients aged 46-67 years with clinical picture of metabolic syndrome, and in 7 control women. Clamp test made it possible to follow dynamics of insulin and other hormones in the process of regulation of glucose level. This method allowed to prove quantitatively the presence of resistance to insulin and hormonal disintegration in patients with metabolic syndrome. Elevation of activity of sympathoadrenal system plays an important role in the pathogenesis of hypertension in metabolic syndrome at the account of augmented sensitivity of receptor apparatus. Lowering of somatotropic hormone level in patients with metabolic syndrome is associated with disturbed somatotropic function of the hypophysis which regulates blood pressure.