bluuebunny/crossref_metadata_2025 huggingface dataset:
Inflammation of adipose tissue. Part 3. Pathogenetic role in the development of atherosclerosis
Authors: Shvarts Viktor
Published: March 2014

Obesity is a factor contributing to the development of atherosclerosis and cardiovasular diseases. A key pathogenetic mechanism of obesity-associated atherosclerosis is inflammation of the adipose tissue concomitant with mild systemic inflammation, altered secretion of adipokines and cytokines, and insulin resistance. This review is focused on the role of hypoadiponectinemia, enhanced secretion of leptin, resistin, TNF-alpha, IL-1, IL-6, interferon-gamma, and activation of renin-angiotensin system in pathogenesis of atherosclerosis. The stimulatory action of insulin resistance accompanying inflammation of the adipose tissue on evolution of atherosclerosis is mediated through the development of dyslipidemia, hyperglycemia, and arterial hypertension. Other important factors involved in pathogenetic mechanisms of atherosclerosis are inflammation of perivascular fatty tissue and paracrine activity of cytokines and chemokines it releases.
Significanvce of dysfunction of vascular endothelium for the evaluation of episodes of myocardial ischemia in type 2 diabetes mellitus
Authors: Tatarchenko I P , Pozdnyakova N V , Mordovina A G , Morozova O I , Kolomiets Ekaterina Viktorovna
Published: March 2014

The objective of this study was to evaluate the vasculomotor function of endothelium in patients with type 2 diabetes mellitus and assess the role of its functional state in the development of ischemic episodes. A total of 93 patients (52 men and 41 women) of the mean age of 58.3+-4.8 years were involved in the study. Group 1 comprised 47 patients with coronary heart disease (CHD) and type 2 diabetes, group 2 included 46 patients with CHD in the absence of disturbances of carbohydrate metabolism. Patients of the two groups were matched for age, gender, and major risk factors. Their comprehensive examination included 24 hour ECG monitoring, veloergometry, echocardiography, and reactive hyperemia test (ultrasound evaluation of endothelium-dependent dilation of the brachial artery). The patients of group 2 showed longer total duration of episodes of myocardial ischemia, the elevated number of painless (PMI) episodes, and greater maximum depression of ST-segment compared with CHD patients having no disturbances of carbohydrate metabolism. Correlation analysis demonstrated significant negative relationship between endothelial dysfunction, the number and duration of PMI episodes, and delay of pain syndrome with respect to ischemic depression of ST-segment in patients of group 1.
Expression of somatostatin and dopamine receptors in ACTH-producing tumours
Authors: Dedov I I , Marova E I , Abrosimov A Iu , Lapshina A M , Grigor'ev A Iu ,  Ablitsov Iu A , Kuznetsov N S , Goncharov N P , Arapova S D , Rozhinskaia L Ia
Published: March 2014

This study was designed to compare immunoexpression of somatostatin receptors (SR)1-5 and dopamine receptors 2 (DR2) in pituitary and non-pituitary ectopic ACTH-producing tumours. A total of 35 patients were enrolled in the study including 21 with Cushing's disease (CD) and 14 with ACTH-ectopic syndrome (ACTH-ES) associated with carcinoid tumours of lungs (n=11), kidney (n=1), thymus (n=1) and with small-cell lung carcinoma (n=1). All patients with corticotropinomas exhibited expression of SR 1-5 dominated by SR-1 (57%). 81% of these tumours expressed two and more SR subtypes. DR2 expression was documented in 52% of the tumours and co-expression of DR2 with different SR subtypes in 29%. Neoplasms associated with ACTH-ES expressed SR with the predominance of SR-3 (72%). Half of these tumours co-expressed two and more SR subtypes. Expression of DR2 was demonstrated in 50% of the neoplasms associated with ACTH-ES; 38% of them co-expressed SR and DF2.
Screening for diabetic complications as a tool for the evaluation of medical and preventive aid to patients
Authors: Suntsov Iu I , Maslova O V , Dedov I I
Published: March 2014

The objective of this work was to study the actual prevalence of diabetes mellitus complications and evaluate the quality of health care provided to the patients with these problems in different regions of Russia. A random sample of 11 240 patients with diabetes mellitus (DM) was obtained from a total of 20 regions of the Russian Federation. The study protocol included evaluation of visual function, the state of peripheral nervous system and lower extremities, renal and cardiovascular functions; in addition, HbA1c, creatinine, total cholesterol and triglyceride levels were measured along with albuminuria. It was found that the actual prevalence of major diabetic complications is 20-50% higher than the registered one. The overwhelming majority of the patients were shown to be chronically decompensated. This finding holds for 85.5% of the children, 92.6% of the adolescents, 83.9% and 74.8% of the adult patients with types 1 and 2 DM respectively. The HbA1c level in patients living in rural areas was 33.7-42.1% higher than in residents of regional urban centres. Fewer than 14.4% and 0.6% of the patients with type 2 DM used insulin and its analogs respectively. Overall, the study demonstrated rather poor quality of medical and preventive aid provided to diabetic patients and the necessity of its improvement.
Treatment of oligospermia in male infertility
Authors: Rozhivanov R V , Parfenova N S , Kurbatov D G
Published: March 2014

We examined 22 infertile patients with oligospermia to evaluate efficiency of hormonal therapy. All the patients were treated with clomiphene citrate or chorionic gonadotropin for 3 months and showed significant elevation of testosterone levels. Clomiphene therapy caused a statistically significant rise in the number of spermatozoa per 1 ml ejaculate and percentage of their morphologically intact forms coupled to insignificant improvement of sperm motility (A + B). Sexual partners of two patients reported being pregnant. Treatment with chorionic gonadotropin resulted in a significant rise in the number of spermatozoa per 1 ml ejaculate and insignificant increase in percentage of their morphologically normal forms. No improvement of (A + B) spermatozoon motility was documented. The partner of one patient developed pregnancy. Patients of either group with azoospermia failed to exhibit spermatozoa in the ejaculate after the treatment. It is concluded that the two therapeutic modalities are efficacious in terms of increasing the total number of spermatozoa. Their additional advantage is normalization of the total testosterone level. Moreover, therapy with clomiphene citrate brought about a rise in the number of morphologically adequate cells. However, neither modality produced beneficial effect in patients with azoospermia.
Biochemical risk factors of vascular complications in children with type 2 diabetes mellitus in the late postoperative period following reconstructive surgery
Authors: Pokrovskiĭ A V , Doguzhieva R M , Demidova V S , Lebedeva A N
Published: March 2014

The objective of the present study was to compare levels of homocysteine (HC), total cholesterol (TC), triglycerides, high and low density lipoproteins (HDLP and LDLP respectively), and C-reactive protein (CRP) and to evaluate their role in the development of atherosclerosis in patients with type 2 diabetes mellitus (DM2) or without it in the late postoperative period following aortofemoral reconstructive (AFR) operations. A total of 79 patients (40 with DM2 and 39 without it) examined after AFR surgery had the above parameters enhanced compared with the respective baseline values. In the majority of the cases, hyperhomocysteinemia (HHC) was associated with the increased levels of CRP, fibrinogen, and LDLP. However, they were higher in patients with DM2 than without it and correlated with the HbA1c level (r=0.32-0.45; p<0.05). In DM2 patients with HHC, simultaneous hyperlipidemia and elevated CRP levels, the thickness of the intima-media complex in aorta, popliteal artery, anterior and posterior tibial arteries significantly increased. Moreover, these patients experienced more apparent stenosis of these arteries (>50%). Patients with DM2 more frequently exhibited a combination of several markers of the atherosclerotic process especially in the presence of the smouldering inflammatory process in the vascular wall.
Low-dose ACTH test for the diagnosis of non-classical form of congenital adrenocortical dysfunction
Authors: Chagaĭ N B , Fadeev V V , Bakulina E G
Published: March 2014

The possibilities to diagnose the non-classical form of 21-hydroxylase deficiency using the low-dose (5 mcg) 1-24 ACTH stimulation test are considered.
Lipid oxidation during physical exercises of different intensity in patients with abdominal obesity
Authors: Berezina A V , Beliaeva O D , Bazhenova E A , Berkovich O A , Baranova E I , Grineva E N
Published: March 2014

The objective of this work was to study the character of lipid oxidation during physical exercises of different intensity and identify factors influencing this process in patients with abdominal obesity. The study included 90 patients aged from 30 to 55 years with abdominal obesity (AO). Lipid oxidation (LO) during physical exercises (PE) was measured by the indirect colorimetric technique with the assessment of oxygen consumption (VO2peak), anaerobic threshold (AT), and respiratory coefficient (RQ). The level of physical activity (PA) and body composition were determined. Patients with abdominal obesity exhibited maximum lipid oxidation at low-intensity physical exercise; it decreased with increasing PE intensity. Lipid oxidation was related to AT (r=0,6; p=0,0001), heart rate at maximum PE (r=0,8; p<0,001), energy expenditure during physical exercices (r=0,98; p=0,016), total energy consumption for the maintenance of physical activity (r=0,3; p<0,035), lean body mass (r=0,3; p=0,04), and duration of obesity (r=0,6; p=0,04).
Insulin-potentiating action of antioxidants in experimental diabetes mellitus
Authors: Volchegorskiĭ I A , Rassokhina L M , Miroshnichenko I Iu
Published: March 2014

The objective of this work was to study effects of alpha-lipoic acid (α-LA), 3-oxypyridine and succinic acid derivatives (emo­xipine, reamberine, and mexidole) on the metabolic status, conditioned reflex learning, and motivated behaviour in rats with alloxan-induced diabetes receiving basal insulin therapy. The data obtained were compared with effects of the above antioxidants (AO) on insulin sensitivity and results of glucose tolerance test in intact animals. It was shown that administration of AO during two weeks corrected disturbances of carbohydrate and lipid metabolism, normalized the behaviour and learning in terms of the conditioned reflex in diabetic rats. These effects depended on the influence of antioxidative compounds on insulin sensitivity and tolerance of glucose loading. The best correction of diabetic manifestations was achieved using course doses of a-LA that maximally enhanced insulin sensitivity and of mexidole that markedly improved glucose tolerance. It is concluded that significant elevation of blood lipoperoxide levels in rats with alloxan-induced diabetes following administration of AO agents for 14 days gives no evidence of the direct relationship between their efficiency and antioxidative action.
Diagnosis, differential diagnosis, and treatment of endogenous hypercorticism
Authors: Troshina E A , Bel'tsevich D G , Molashenko N V , Gazizova D O
Published: March 2014

The present review deals with diagnosis, differential diagnosis, and treatment of endogenous hypercorticism. Key diagnostic steps are described along with main pharmacological tests, instrumental methods, treatment and follow-up strategies.
Assessment of iodine availability and its influence on hematological characteristics of iodine prophylaxis in pregnant women living in the iodine deficient natural environment
Authors: Troshina E A , Petrova V N , Abdulkhabirova F M , Sekinaeva A V , Petrova S V , Vinogradova E I
Published: March 2014

The objective of the present study was to evaluate effects of iron deficiency anemia in pregnant women on the effectiveness of iodine prophylaxis; the secondary objective was to develop standard prophylactic iodine dose schedule for these patients. The study included two groups of pregnant women treated either with a daily dose of 200 mcg potassium iodide (group 1, n=32) or with 300 mcg potassium iodide/day (group 2, n=68). In all of them, blood TSH, free thyroxin and antithyroid peroxidase antibody levels were measured along with iodine excretion in urine. Thyroid volume was determined by ultrasound. Diagnosis of anemia was based on the results of clinical blood analysis including hemoglobin level, erythrocyte count, hematocrit, and mean hemoglobin content of red blood cells. Iron deficiency was estimated from serum iron and ferritin (SF) levels. Treatment with potassium iodide during pregnancy resulted in a significant increase of the median urine iodine level to 260.9 mcg/l and 143.7 mcg/l in groups 1 and 2 respectively (p<0.05). It means that iodine excretion in urine during pregnancy is directly related to the efficiency of prophylaxis; it is optimal in women consuming daily at least 300 mcg of potassium iodide. Of all hematological parameters, the serum ferritin level undergoes the largest deviation (decrease) from the normal value. It was below 15 ng/ml in 24 (31.2%) patients with the median urine iodine level of less than 150 mcg/l and in 10 (11.1%) patients with the median urine iodine level higher than 150 mcg/l (a three-fold difference).
Regulation of expression of membrane molecules and apoptosis of human lymphocyte by leptin and ghrelin during pregnancy
Authors: Orlova E G , Shirshev S V
Published: March 2014

This work was designed to study effects of leptin and/or ghrelin in combinations characteristic of different trimesters of pregnancy on the expression of membrane molecules and apoptosis of lymphocyte in the peripheral blood of women. Leptin was shown to decrease the relative number of activated Th-cells and apoptosis of lymphocytes. Moreover, it either increased or decreased the number of CD16+CD56+NK and CD16+CD56+NKT cells depending on the dose but did not change the number of T-lymphocytes CD4+CD25bright. In contrast, ghrelin caused a dose-dependent increase in the number of activated Th-cells and enhanced lymphocyte apoptosis but did not influence the number of CD16+CD56+NK, CD16+CD56+NKT cells, and T-lymphocytes CD4+CD25bright. Simultaneous administration of both hormones in combinations known to occur in the first and second trimesters of pregnancy did not change percentage of activated Th-cells, the relative number of CD16+CD56+NK and CD16+CD56+NKT cells or apoptosis of lymphocytes. However, they stimulated expression of CD25 on Th-cells and CD16 on NK-cells.
The treatment of primary hyperaldosteronism
Authors: Fadeev V V , Bel'tsevich D G , Rogal' E Iu , Molashenko N V , Mel'nichenko G A
Published: March 2014

The present review deals with the treatment of main nosological forms of primary hyperaldosteronism, such as aldosteron-producing adenoma (APA) and idiopathic hyperaldosteronism (IHA). Much attention is given to perioperative management of APA patients for whom surgical treatment is the method of choice. Idiopathic hyperaldosteronism characterized by bilateral macro- and micronodular changes dictates the necessity of medicamentous therapy, in the first place with antagonists of mi­neralocorticoid receptors (e.g. spironolactone). Pharmacological standards of drug therapy are described for patients with IHA and those with APA in whom surgical treatment is impracticable.
Metabolically healthy obese subjects and metabolic signs of obesity in subjects with normal body weight: what is behind?
Authors: Bershteĭn L M , Kovalenko I G
Published: March 2014

The current concept of obesity as a heterogeneous condition is discussed. Such interpretation provides a basis for distinguishing a group of obese subjects without metabolic disturbances (metabolically healthy obese (MHO) subjects) and another one including subjects with normal body weight and signs of hormonal and metabolic disorders (metabolically obese normal weight (MONW) subjects). A separate subgroup is represented by obese patients with deficit of muscular mass and force (sarcopenic obesity). Potential mechanisms underlying development of these conditions are considered along with selected applied aspects of this problem.
The influence of certain medicinal products on the function of the hypothalamo-pituitary-thyroid axis and the efficiency of substitution therapy with thyroid hormones
Authors: Troshina E A , Mazurina N V , Iukina M Iu , Ogneva N A
Published: March 2014

The influence of various medicinal preparations on the function of the hypothalamo-pituitary-thyroid axis is discussed. Thyroidal status at different somatic diseases is considered alongside the efficiency of substitution therapy with thyroid hormones for the management of hypothyroidism.
Population-based genetic analysis of the prevalence of obesity in Chuvash Republic
Authors: Markova T N , Kichigin V A , Madianov I V , Semenova T N
Published: March 2014

The objective of the present work was to study the prevalence of obesity among 271 residents of the Chuvash Republic taking account of their sex and ethnic background. Simultaneously, genetic predisposition to obesity was assessed from the presence or absence of this condition in 955 blood relatives of the probands using Edwards' coefficient of genetic determination and coefficient of association. Results of the study suggest higher prevalence of obesity in women than in men and in Russians compared with Chuvashes. Genetic determination of obesity was found to be independent of sex and type of fat distribution. The risk of developing obesity proved to be significantly higher in the probands from families in which both parents were obese than from those with only one obese parent.
Emotional-volitional disorders in patients with type 2 diabetes mellitus, concomitant arterial hypertension and diabetic polyneuropathy
Authors: Petrova M M , Kurumchina O B , Pronina E A
Published: March 2014

The objective of the present work was to evaluate effects of type 2 diabetes mellitus (DM2) combined with arterial hypertension (AH) and diabetic polyneuropathy (DPN) on the development of alterations in the emotional-volitional sphere. The work was comprised of two prospective studies; one of them (study 1) included 140 women presenting with DM2, the other (study 2) enrolled 80 patients with DM2 hospitalized at the Endocrinological Department of N.S. Karpovich City Clinical Hospital No 6, Krasnoyarsk. Disturbances in the emotional-volitional sphere were evaluated based on the hospital anxiety and depression scale (HADS). Their frequency proved to be as high as 67.9 and 70.7% in studies 1 and 2 respectively. The number of anxiety disorders was on the whole greater than that of depressive ones. The latter disorders in patients with AH occurred twice as often as in DM2 patients without AH (50.5 and 25.9% respectively). The frequency of anxiety disorders was not significantly different in the two groups, but they were found to be more severe in patients presenting with combination of DM2 and AH. It is concluded that DM2 is associated with frequent clinically significant anxiety and depressive symptoms depending on the duration of the disease and insulinotherapy. Patients presenting with a combination of DM2 and AH or DPN suffer significantly more pronounced anxiety and depression disordered.
A case of severe neonatal hyperparathyroidism due to defect in calcium receptors
Authors: Vitebskaia A V , Petriaĭkina E E , Razumovskiĭ A Iu , Pavlov A A , Tiul'pakov A N
Published: March 2014

The first case of severe neonatal hyperparathyroidism in the Russian population verified by molecular-genetic testing is described. The patient presented with very high calcium and parathyroid hormone (PTH) levels and showed characteristic clinical symptoms of hyperparathyroidism in the absence of lesions in long tubular bones. Removal of all parathyroid glands resulted in normalization of laboratory parameters and general health status of the patient. Diagnosis of severe neonatal hyperparathyroidism was confirmed by sequencing the CASR gene while parents of the child were shown to suffer familial hypocalciuric hypercalcemia.
Cyclic Cushing's syndrome
Authors: Marova E I , Voronkova I A
Published: March 2014

The cyclic Cushing's syndrome is a rare disease characterized by multiple episodes of elevated cortisol levels alternating with periods of its normal secretion. The so-called hypercorticism cycles may be either regular or episodic with intercycle intervals as long as a few days to several years. Most researchers agree that the reliable diagnosis of cyclic Cushing's syndrome should be based on laboratory detection of 3 peaks and 2 falls of plasma cortisol level. Cyclic Cushing's syndrome may be either ACTH dependent or independent. A review of 65 verified cases indicates that this condition may be caused by pituitary corticotropinoma (54%), ectopic ACTH-producing tumour (26%), and adrenal tumour (roughly 11%). The cause of the disease remains uncertain in 9% of the patients. Pathophysiological mechanisms of cyclic Cushing's syndrome are poorly known. In certain cases of bilateral macronodular adrenal hyperplasia or adrenal corticosteroma, it may be associated with the presence of ectopic receptors or anomalous expression of normally located receptors. The majority of the patients presenting with cyclic Cushing's syndrome exhibit symptoms of classical hypercorticism that manifest themselves either on a permanent or cyclic basis. In a small number of patients, clinical signs of cyclic Cushing's syndrome are virtually absent. Variations of the clinical picture and conflicting results of hormonal assays taken together make cyclic Cushing's syndrome difficult to diagnose. Therefore, physicians must be aware of this condition and actively search for it in all patients believed to have an enhanced cortisol production despite normal results of laboratory analysis. Frequent changes of urinary or salivary free cortisol levels are reliable and convenient criteria for cyclic Cushing's syndrome in patients suspected to have this condition. Results of cortisol stimulation or suppression tests are likely to lead to a false conclusion due to spontaneous falls and rises in serum cortisol levels at the time of analysis. Given laboratory confirmation of cyclic Cushing's syndrome, subsequent studies should be focused on the elucidation of its cause. The average life expectancy of patients with cyclic Cushing's syndrome remains to be determined.
The importance of combined glycemic control in patients with type 2 diabetes mellitus
Authors: Kononenko I V , Smirnova O M
Published: March 2014

The contribution of intensive control of glycemia to the reduction of the risk of microvascular complications of type 2 diabetes mellitus is known perfectly well whereas its influence on the development of macrovascular complications remains to be clarified and remains a subject of debates. Bearing in mind that hyperglycemia is a key pathogenetic factor triggering formation of diabetic complications, it is necessary to identify characteristics of carbohydrate metabolism to be taken into account when choosing therapeutic strategies and to determine their target values. Control of the HbA1c level remains the most accessible and informative tool for the assessment of the efficiency of long-term compensation of type 2 diabetes mellitus. However, this method is not altogether free from limitations that can hamper its clinical application. The fasting glycemia level does not completely reflect the quality of DM2 treatment. There is potential relationship between high postprandial plasma glucose levels and the development of vascular complications. Also, it has been shown that variability of glucose concentration may be an important risk factor of diabetic complications. Measurement of the full range of glycemic parameters including fasting plasma glucose level, HbA1c and postprandial glycemia gives an idea of the general picture of the course of the disease necessary for the choice of the treatment strategy.
Extension of the group of incretin-targeted preparations: Saxagliptin – a new dipeptidyl peptidase-4 inhibitor
Authors: Shestakova M V , Sukhareva O Iu
Published: March 2014

A new selective incretin-targeted dipeptidyl peptidase-4 inhibitor was registered in the Russian Federation in August 2010. The enzyme dipeptidyl peptidase-4 inactivates glucagon-like peptide-1 (GLP-1). A rise of GLP-1 concentration in blood plasma is known to result in the glucose-dependent stimulation of insulin secretion by pancreatic beta-cells and suppression of glucagon release. Saxagliptin is readily absorbed in the gastrointestinal tract and remains active within 24 hours after oral intake. It allows the drug to be taken once during 24 hours. Clinical studies have demonstrated that saxagliptin improves glycemic control when used as both monotherapy and in combination with other antidiabetic medicines (metformin, sulfonylureas, and thiazolidinediones). The use of saxagliptin leads to a reduction of fasting and postprandial plasma glucose level and thereby to the clinically significant decrease in glycated hemoglobin (HbA1c) concentration. The low risk of hypoglycemia following saxagliptin intake is due to the glucose-dependent mechanism of its action. The results of clinical investigations indicate that saxagliptin is safe and well tolerated by the patients and has no significant influence on their body weight; its dose does not need to be corrected for the sex and age of the patients or the presence of concomitant hepatic disorders.
ACTH-producing neuroendocrine chest wall tumours
Authors: Marova E I , Kokshagina N V , Rozhinskaia L Ia
Published: March 2014

This paper reports data on the prevalence and pathogenesis of ectopic ACTH-producing neuroendocrine chest wall tumours, analyse their specific clinical, morphological, and immunohistochemical features, describe methods available for their diagnosis and treatment. Detailed characteristics of bronchial carcinoid, thymic carcinoid, and small-cell lung cancer are presented.
The efficacy and safety of recombinant growth hormone in children with idiopathic short stature (two-year experience)
Authors: Shandin A N , Nagaeva E V , Peterkova V A , Dedov I I
Published: March 2014

This study was designed to evaluate the efficacy and safety of the treatment of children with idiopathic short stature using recombinant growth hormone (rGH); in addition, the factors influencing its therapeutic efficiency were analysed. A total of 93 patients aging from 3 to 12 years were available for the observation. They were divided into three groups. The children in group 1 (n=38 ) were given rGH at a dose of 0.033 mg/kg/24 hours and in group 2 (n=18 ) at 0.05 mg/kg/24 hr; the control group 3 was comprised of 37 children. The duration of therapy was 6 months in 56 children, 12 months in 41, 18 months in 24, and 24 months in 18 children. The end points of the study were bone age variations; dynamics of insulin-like growth factor-1 levels; characteristics of carbohydrate, lipid, and phosphorus-calcium metabolism; hepatic, renal, and thyroid function. The growth rate within the first year after the onset of the treatment increased from 4.5±1.2 to 7.9±1.5 cm/year in group 1 (0.033 mg/kg/24 hours) and from 9.1±1.5 cm/year in group 2 (0.05 mg/kg/24 hr). In the second year, the growth rate under effect of the same GH doses was 7.1±1.4 and 7.9±1.6 cm/year respectively. The total growth rate ΔSDS for the first year of therapy was 0,56±0,28 (0,033 mg/kg/24 hr) and 0,71±0,22 (0,05 mg/kg/24 hr), the respective ΔSDS values in the second year were 0,94±0,29 and 1,06±0,67. Neither the growth rate nor the failure to thrive changed significantly in the control group. The growth rate in the treated children correlated with their age at the onset of therapy (r = –0.28, p= –0.045; n=56) and the dose of GH (r=0.32, p<=0.043; n=41); in addition, there was correlation between the growth rate ΔSDS values and the age at the onset of therapy (r=–0.50, p=0.0002; n=56). 21% of the children reached the normal growth range (>–2ΔSDS) 6 months after the beginning of therapy, 30% and 37% after 1 and 2 years respectively. None of the patients in the control group showed the normal growth. Some of them underwent accelerated bone maturation, and their growth prognosis (calculated according to Bayley-Pinneau) was improved. The IGF-1 level in the treated patients increased within the normal range but did not correlate with the efficacy of therapy. Nor were apparent changes recorded in the characteristics of carbohydrate, lipid, and phosphorus-calcium metabolism. It is concluded that the growth-stimulating treatment of children with idiopathic short stature using rGH at a dose range from 0.033 to 0.05 mg/kg/24 hours significantly increased the growth rate and dynamics. The main factors determining the therapeutic efficacy of rGH are the age of the patients at which the treatment is initiated and the calculated rGH dose.
The relationship between the level of glycemia, the length of the QT-interval, and locomotor activity in children and adolescents presenting with type 1 diabetes mellitus
Authors: Laptev D N , Riabykina G V , Sobolev A V , Kirillov K K , Seid-Guseĭnov A A
Published: March 2014

In this study, we investigated the relationship between the blood glucose level and the length of the QT-interval as well as the influence of locomotor activity on these characteristics in children and adolescents presenting with type 1 diabetes mellitus during the long-term monitoring of ECG, the level of glycemia, and locomotor activity. The daily dynamics of these parameters was elucidated along with the measurements of the lengths of QT and RR intervals. Specifically, the correlation between the length of the QTc interval and the blood glucose level appears from the fact that the maximum QTc length occurred when glycemia dropped below 4 mmol/l. It also significantly increased at glycemia in excess of 16 mmol/l (and up to 21 mmol/l). Moreover the length of the QTc interval directly depended on the duration of the disease. The locomotor activity was shown to significantly affect the blood glucose level within 3-4 hours after its onset.
Expression of the adiponectin gene (ADIPOQ) in the subcutaneous and visceral fatty tissues and the serum adiponectin level in children
Authors: Kosygina A V , Sosunov V V , Peterkova V A , Dedov I I
Published: March 2014

The primary objective of the present work was to study specific features of adiponectin gene (ADIPOQ) expression in the subcutaneous and visceral fatty tissues along with the serum adiponectin level in children. The secondary objective was to elucidate the relationship between these variables and the basic anthropometric characteristics. The study included a total of 62 patients (31 boys and 31 girls at the age from 2.5 to 18 (median 13.6 (8.5-15.1) years] after they underwent planned surgical interventions. The expression of the adiponectin gene ADIPOQ was determined in paired samples of adipose tissue using the polymerase chain reaction in the real time; in addition, the serum adiponectin levels were measured. The expression of the adiponectin gene ADIPOQ was shown to be unrelated either to the age or to the sex of the children. Nor was there any significant difference between its expression in the subcutaneous and visceral tissues. The highest expression of mRNA encoding for adiponectin was recorded in the children at the Tanner stages 2-3 of sexual development. The ADIPOQ gene expression in the subcutaneous and visceral tissues of overweight children was 22% and 22.6% higher respectively than in the same tissues of normal weight children. Gene expression in the subcutaneous adipose tissue negatively correlated with the serum adiponectin level ( R = –0.38, p = 0.002), BMI SD (R = –0.35, p = 0.004 ), and the waist circumference (R = –0.36, p = 0.004). The results of the study suggest the necessity of further studies to clarify the pathophysiological role of adiponectin in the development of obesity and the related metabolic disturbances.
Congenital hyperinsulinism
Authors: Melikian M A
Published: March 2014

Congenital hyperinsulinism (CHI) is one of the main causes underlying the development of persistent hypoglycemic conditions in children. Biochemically, CHI is characterized by inadequate insulin secretion from pancreatic β-cells. CHI is a heterogeneous pathology in terms of clinical manifestations, morphological features, and molecular-genetic defects contributing to its development. The present paper is focused on the current views of CHI pathogenesis; the clinical characteristic of the disease is given and the internationally accepted protocols for the examination and treatment of children with congenital hyperinsulinism are described.
Syndrome of hyperandrogenism in girls of pubertal age
Authors: Bogdanova P S , Kareva M A
Published: March 2014

Syndrome of hyperandrogenism in women is one of the commonest disease of the adult age. It is associated with a high risk of metabolic disturbances, cardiovascular disorders, and infertility. Taken together, these factors dictate the necessity of in-depth investigations of this pathology. At present, both etiology and pathogenesis of the syndrome of hyperandrogenism remain obscure. As a rule, its clinical manifestations become apparent at puberty. The present review summarizes the data on the development and clinical course of female hyperandrogenism with special reference to its occurrence, diagnostic tools, and therapeutic modalities in adolescent girls.
The application of lanreotide autogel for the treatment of acromegaly
Authors: Ilovaĭskaia I A
Published: March 2014

The early diagnosis of acromegaly and timely initiation of the adequate treatment are of primary importance for the prevention of the undesired long-term effects of chronic overproduction of growth hormone and insulin-like growth factor-1. Over half of the patients presenting with acromegaly are in need of sustainable treatment with somatostatin analogs that reduces the risk of premature death and helps to maintain quality of life. The new somatostatin analog lanreotide autogel recently introduced into clinical practice is known to effectively diminish secretion of both growth hormone and insulin-like growth factor-1. Moreover, it shows the ability to decrease the volume of somatotropinoms and is well tolerated by the patients. The intervals between injections of lanreotide autogel can be prolonged from 4 to 6-8 weeks. Its subcutaneous administration is technically easy which enables the majority of the patients to perform self-injections. Taken together, these advantages of lanreotide autogel considerably extend the opportunities for medical aid to the patients with acromegaly.
Approaches to the rational choice of type 5 phosphodiesterase inhibitors in patients presenting with cardiovascular and endocrine diseases
Authors: Rafal'skiĭ V V , Baglikov A N
Published: March 2014

After the advent of four type 5 phosphodiesterase inhibitors (PDEI 5), viz. sildenafil, tadalafil, vardenafil, and udenafil, designed for the treatment of erectile dysfunction both physicians and patients found themselves faced with the problem of choosing an optimal therapeutic option. This paper contains comparative data on the efficacy and safety of different PDEI 5. The approaches to the rational choice of these preparations for the treatment of patients presenting with cardiovascular and endocrine diseases are discussed. Comparative controlled clinical studies failed to yield definitive information about advantages of one or another agent representing this group of pharmaceutical products. Nevertheless, the currently available data permit to draw the conclusion that the use of vardenafil and tadalafil ensures better compliance of patients with the prescribed therapy. Certain authors advocate the desirability of vardenafil application to the treatment of patients presenting with a background pathology. It is emphasized that all available PDEI 5 have a beneficial safety profile, with wardenafil being virtually free from adverse side effects.
Genetic factors accounting for different type 1 diabetes morbidity levels in Europe and Russian Federation
Authors: Kuraeva T L , Shiriaeva T Iu , Titovich E V , Prokof'ev S A
Published: March 2014

Type 1 diabetes mellitus (DM1) is characterized by varying levels of morbidity in different populations and its overall increase in the majority of developed countries during the last 30 years. According to IDF, as many as 218,000 new cases of DM1 are registered annually all over the world of whom 75,800 (49%) are children at the age from 0 through 14 years. The yearly incremental increase of DM1 morbidity in this group is estimated at 3%. The marked ethnic variability of DM1 morbidity may be attributed to the different living conditions (environmental factors), population-related differences in the frequency of diabetes-predisposing and protective genetic markers, and the presence of specific markers in different populations. The population-based studies on the occurrence of molecular-genetic markers of DM1 in different ethnic groups confirmed the important role of genetic factors as predictors of diabetes and promoted the understanding of their contribution to the development of the disease in different ethnoses. The results of relevant original and published investigations are discussed.
The role of molecular genetics in diagnostics and treatment of endocrine diseases. Brief characteristic of monogenic forms of hereditary endocrinopathies diagnosed in Endocrinological Research Centre during the 15 year period (1996-2010)
Authors: Tiul'pakov A N
Published: March 2014

Recent years have witnessed great progress in molecular genetics leading to impressive breakthroughs in medical sciences at large and in endocrinology in particular. The objective of the present article is to summarize information on the cases of monogenic hereditary endocrinopathies verified in the Endocrinological Research Centre during the 15 year period (1996-2010). These data are based on the analysis of 36 different genes associated with endocrine pathologies, such as hereditary forms of hypopytuitarism, disturbances of steroid hormone biosynthesis, abnormal gender formation, monogenic forms of diabetes mellitus, endocrine tumours, etc. The importance of molecular-genetic investigations for the treatment and prevention of endocrine diseases is discussed.
Iodine-deficiency disorders: lessons of history and time to make decisions
Authors: Troshina E A
Published: March 2014

There are several lessons from the history of IDD control in the USSR that are of relevance for future IDD control programs in Russia and beyond. Sustainability of such programs is based on several pillars, including: Existence and rigorous enforcement of legislation or other legal acts regulating mandatory iodization of salt for human consumption; An effective monitoring system to track production, distribution and quality of iodized salt, as well as impact education, information and communication activities to ensure that IDD would not become a "forgotten" problem as happened in Russia at the end of the XX century.
Adrenogenital syndrome: past, present, and future
Authors: Kareva M A , Orlova E M
Published: March 2014

Adrenogenital syndrome is a group of pathological conditions with autosomal recessive inheritance underlain by the deficit of one of the enzymes involved in cortisol biosynthesis. The first clinical reports of patients with adrenogenital syndrome date back to the XIXth century. The literature of the early XXth century offers comprehensive clinical characteristics of the disease along with the first attempts at its classification. The progress in biochemistry and pharmacology in the mid-XX century provided knowledge for the explanation of the nature of adrenogenital syndrome and the development of methods of pathogenetically-grounded therapy of this pathology. The advent of the era of breakthroughs in molecular genetics was marked by the elucidation of underlying causes of congenital adrenal dysfunction. At present, neonatal screening makes it possible to diagnose adrenogenital syndrome in 100% of the patients and thereby ensure prevention of mortality from salt-losing crisis. Modern techniques are used not only for prenatal diagnostics but also for preimplantation prophylaxis of adrenogenital syndrome. At the same time, extensive investigations bring to light new forms of the disorder. Recent progress in genetics gives hope that even more efficacious methods of genotherapeutic modalities will be proposed for the management of chronic pathology in question.
Growth hormone - 20 years of clinical practice
Authors: Nagaeva E V
Published: March 2014

Recombinant growth hormone (rGH) synthesized by the DNA recombination technology is available commercially since 1985. The advent of this product has greatly promoted a wider application of growth hormone therapy throughout the world and gave a powerful impetus to the investigations of its clinical efficiency, improved dosing schedules and methods of administration, facilitated reaching a final height, resulted in marked amelioration of the patients' quality of life, and extended the range of indications for the use of growth hormone preparations. A vast experience with the clinical use of rGH for the treatment of a variety of pathological conditions has been gained for the last 20 years. These include growth hormone deficiency in children and adults, syndromal and idiopathic short stature, intrauterine growth retardation, chronic renal insufficiency, juvenile idiopathic arthritis, and diseases of the hematopoietic system. Therapy with recombinant growth hormone is generally recognized to be efficacious and safe although the experience with its application for the treatment of certain diseases is insufficient and further accumulation of relevant data is needed.
A new approach to the screening for early disturbances in carbohydrate metabolism
Authors: Misnikova I V , Dreval' A V , Barsukov I A
Published: March 2014

The results of a population-based study involving 2 638 adult subjects residing in two districts of the Moscow region are considered in terms of the currently available screening models for detection of disturbances in carbohydrate metabolism; a new screening modality is proposed. The merits and demerits of different screening models were evaluated based on the comparison of validity of different diagnostic tests deduced from the estimation of sensitivity, specificity, and prognostic value of positive and negative results; the ROC-curve was constructed. It was shown that screening based on diagnostics of disturbances in carbohydrate metabolism from the fasting blood glucose level (FBGL) alone according to 2006 WHO diabetes criteria fails to reveal type 2 diabetes mellitus (DM2) in every fifth patient. Screening with partial exclusion of the oral glucose tolerance test (OGTT), i.e. confining it to subjects with impaired fasting glycemia (IFG) according to WHO criteria, allows up to 92.5% of DM2 cases to be diagnosed. However, this approach grossly underestimates the incidence of impaired glucose tolerance (IGT). The application of the 2003 ADA diagnostic criteria leads to a significant increase in the fraction of IFG subjects (up to 40%) while 18.2% of the patients with DM2 remain unidentified. Because the probability of diagnosis of DM2 (from 2-h point time of OGTT) and IGT increases in subjects with OGTT over 5.0 mmol/l, it appears desirable to use OGTT in the screening of cases with FBGL in excess of 5.0 mmol/l. This model may simplify the screening procedure (by avoiding OGTT) in 23.3% of those to be examined.
Molecular-genetic, immunological bases and prophylaxis of diabetes mellitus in children
Authors: Titovich E V
Published: March 2014

Since the autoimmune nature of type 1 diabetes mellitus came to become known some 40 years ago, continuous investigations have been carried out in an attempt to improve approaches to prognostication of this disease and develop new safe and efficacious methods for its prevention. For all that, many aspects of diabetes pathogenesis still remain far from clear. In most cases (roughly 85%), type 1 diabetes mellitus (DM1) develops sporadically in the absence of a relevant familial or hereditary history of this condition. Accordingly, the first-degree relatives account for only 15% of all DM1 patients. The risk of development of DM1 in the Russian population estimated by the researchers of the Children' Department, Endocrinological Research Centre, is relatively low (0.2%). It depends on many factors, such as the number of ill and healthy relatives, the chronological age of a given patient and the age of onset of clinical manifestations in his (her) relatives. Type 1 diabetes-predisposing and protective haplotypes were identified in the Russian population based on the results of molecular-genetic studies involving 599 children and adolescents with DM1. These and immunological data were used to distinguish between risk groups in the families of diabetic patients and the rationale was proposed for the dynamic follow-up of these subjects. It is concluded that estimation of the risk of type 1 diabetes mellitus based on the results of molecular-genetic studies and monitoring immunological markers constitutes the first step in the elaboration of preventive measures designed to prevent or delay the development of the disease.
Molecular-genetic verification and treatment of neonatal diabetes mellitus related to the defects in ATP-dependent potassium channels: Results of the observation of 9 patients and the first description of ABCC8 gene mutations in Russia
Authors: Dedov I I , Tikhonovich Iu V , Petriaikina Elena E , Rybkina I G , Volkov I É , Stotikova O V , Chernykh L G , Tiulpakov A N
Published: March 2014

Introduction of the methods for molecular-genetic analysis into clinical practice has opened up new prospects for both diagnosis and pathogenetically sound therapy of neonatal diabetes mellitus. It is currently known that the overwhelming majority of the cases of diabetes mellitus developing in children during the first six month of life are associated with defects of the genes controlling formation, development, and functional activity of pancreatic beta-cells whereas type 1 diabetes mellitus of autoimmune origin accounts for less than 1% of this pathology. This paper reports the results of a molecular-genetic study of 14 patients presenting with neonatal diabetes mellitus. Nine cases are shown to have developed as a result of mutations in KCNJ11 and ABCC8 genes. ABCC8 mutations are described for the first time in Russia. Analysis of clinical forms of neonatal diabetes mellitus revealed correlation between the type of mutations, clinical features of the disease, and susceptibility of the patients to sulfonylurea drugs.
A case of familial acromegaly
Authors: Verbovoĭ A F , Sul'dina T V
Published: March 2014

A case of familial acromegaly affecting mother and daughter is reported.
Differential diagnostics of primary hyperaldosteronism: The role and significance of comparative selective blood sampling from adrenal veins
Authors: Sitkin I I , Fadeev V V , Bel'tsevich D G , Rogal' E Iu , Molashenko N V , Kolesnikova G S
Published: March 2014

Primary hyperaldosteronism is known to be one of the commonnest causes of arterial hypertension. The authors propose a diagnostic protocol for primary hyperaldosteronism and a method for comparative selective blood sampling from adrenal veins. This method is described as the sole tool for differential diagnostics of different nosological forms of primary hyperaldosteronism. A clinical case of idiopathic hyperaldosteronism is presented.