Numerous clinical studies have established that overweight or obesity have a significant impact on the endocrine axis: hypothalamus-pituitary-ovaries, and through the ovaries affect the oocytes and endometrium. Excessive weight gain or obesity have adverse consequences for a womеn before pregnancy, during pregnancy and after pregnancy, which can provoke a lifelong risk of comorbid conditions. Given the high prevalence of overweight and obesity and the impact of these conditions on women's reproductive health, there is a need for personalized in-depth examination of such patients.

The aim: to assess the characteristics of reproductive health of patients aged 40+ with manifestations of metabolic syndrome and to determine the improvement of diagnostics and stratification of the degree of risk of developing pathological changes.

Materials and methods: The study involved adult patients aged 40 to 49 years old: 55 women of reproductive age, 19 men and 18 women (control group). The studies were used to determine the level of glucose, insulin, Noma IR index, total cholesterol, thyroid-stimulating hormone, prolactin, vitamin 25OH D3 (the indicators were determined using chemiluminescence analysis); anthropometric parameters: waist circumference, height, weight, which were used to calculate the body mass index (BMI).
The architecture of the vessels was determined by measuring blood pressure and extracranial and intracranial Dopplerography, and the condition of the heart was determined by echocardiography.
Statistical data processing was performed using a software package, in particular, the relationship between quantitative indicators was assessed using Pearson correlation analysis (rs). Statistical probability was assessed using the parametric Student t-test. The difference was considered probable with p<0.05. The relationship between quantitative and rank indicators was assessed using the Fisher coefficient variance analysis (F).

Results. A register of patients was created - adult men and women, most of whom were overweight or obese. During in-depth examinations, it was established: from the cohort of patients of reproductive age (55 patients), only 19 patients (34.54%) have a state of health that corresponds to reproductive intentions; each patient's body has personalized changes in the state of health and they can appear separately or all at the same time and, thereby, potentiate the effect of each other.

Conclusions: for women aged 40+ who have obvious health problems, pregnancy and childbirth are an unpredictable risk for their own health and the health of babies; men aged 40+ need to be aware of their responsibility for their own state of health before future descendants, so as not to introduce significant deviations into the genetic makeup.

body mass index, arterial hypertension, metabolic syndrome, cardiovascular diseases, intimate/media complex

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