bluuebunny/crossref_metadata_2025 huggingface dataset:
Radioiodine therapy for Graves disease as a risk factor of endocrine ophthalmopathy
Authors: Sheremeta M S , Belovalova I M , Sviridenko N Yu
Published: March 2014

In 1973 and 1976 2 cases of endocrine ophthalmopathy (EO) after external irradiation of the anterior surface of the neck due to a tumor (Hodgkin's lymphoma) was described. Further observations showed that treatment of Graves' disease (BG) with radioactive iodine (131I) can worsen the course of EO. So, L. De Groot et al., Observing 264 patients after exposure to 131I for BG, found progression of EO in 4% of patients after the 1st course of therapy and in 12% after subsequent sessions.

Later the appearance or significant progression of EO in  patients treated with 131I has been observed. Some studies have shown that the progression of EO after treatment with 131I without glucocorticoids administration can be observed in 18–30% of cases. Along with this, there is an opinion that 131I does not affect the incidence of clinical symptoms in the orbit and that hypothyroidism that occurs after it does not lead to the progression of eye symptoms. The relationship between treatment and the onset or progression of EO is not clear. Nevertheless, there is evidence of an adverse effect of an elevated level of antibodies to the thyroid stimulating hormone receptor in the blood serum after 131I training for EO.
Insulin growth factor-I-based dosing of growth hormone therapy in children: a randomized, controlled study
Authors: Cohen P , Rogol A D , Howard C P , Bright G M , Kappelgaard A.-M , Rosenfeld R G
Published: March 2014

Weight-based dosing of growth hormone (GH) is the standard of therapy in short children although insulin-like growth factor-I (IGF-I) is a major mediator of GH actions on growth. Objective: to test whether the IGF-I levels achieved during GH therapy are determinants of the growth responses to GH therapy. This was a two-year open-label, randomized IGF-I concentration-controlled trial. Prepubertal short children [n = 172; mean age 7.53 years; mean height SD score (HT-SDS - 2.64] with low IGF-I levels (mean IGF-I SDS - 3.56) were randomized to receive one of two GH dose-titration arms in which GH dosage was titrated to achieve an IGF-I SDS at the mean [IGF(low) group, n = 70) or the upper limit of the normal range [+2 SDS, IGF(high) group, n = 68] or to a comparison group of conventional GH dose of 40 mg/kg/day (n = 34). The multicenter study was performed in the outpatient centers. The primary outcome measure was to determine changes in HT-SDS during 2-year therapy. One hundred and forty-seven patients completed the trial. Target IGF-I levels were achieved in the dose-titration arms within 6-9 months. The changes in HT-SDS were +1.0, +1.1, and +1.6 for conventional, IGF(low), and IGF(high), respectively, with IGF(high) showing significantly greater linear growth response (p < 0.001), compared with the two other groups). The IGF-I(high) arm required higher doses ( > 2.5 times) than the IGF-I(low) arm, and these GH doses were highly variable (20-346 mg/kg/day). Multivariate analyses suggest that the rise in IGF-I SDS significantly impacted height outcome along with the GH dose and the pretreatment peak-stimulated GH level. IGF-I-based GH dosing is clinically feasible and allows maintaining serum IGF-I concentrations within the desired target range. Titrating the GH dose to achieve higher IGF-I target results in improved growth responses, although at higher average GH doses.
Study of gustatory sensitivity to phenylthiocarbamide in thyroid diseases
Authors: Malenchenko A F , Makhlina E S , Tatchikhin V V , Khlusova I V , Lukovskaya N D
Published: March 2014

The aim of the study was to reveal a relationship between gustatory sensitivity to phenylthiocarbamide (PTC) and thyroid disease. The distribution of PTC sensitivity was studied in 198 healthy individuals, 100 patients with autoimmune thyroiditis (AIT), 139 patients with nodular euthyroid goiter, and 100 patients operated on for thyroid cancer. There was a statistically significant decrease in the number of PTC-resistant male and females patients in the thyroid cancer group and an increase in the proportion of PTC-resistant male patients in the AIT and nodular euthyroid goiter groups.
Insulin resistance in obese children: debate on assessment
Authors: Vasyukova Olga V. , Vitebskaya A V
Published: March 2014

No age- and gender-adjusted criteria remain to be a main problem the investigators face when studying insulin resistance in children. This paper compares insulin resistance (IR) indices in 63 children and adolescents with simple (constitutionally exogenous) obesity. The authors demonstrated a low reproducibility of individual baseline values of insulin (not more than 26% as shown by Pearsons correlation analysis). Estimation of IR by means of the design indices calculated from the fasting concentration of immunoreactive insulin and glucose: 40% of obese children and adolescents had no fit of baseline IR indices with the results of an oral glucose tolerance test (OGTT), which may result in a diagnostic error - both hyperdiagnosis (in 12% of patients) and hypodiagnosis (18% of children). According to the results of this study, the values of stimulated insulin release and the Matsuda index, which were determined from the OGTT data, are of the highest diagnostic value in the assessment of insulin resistance in obesity in children and adolescents.
The levels of thyroid hormones in hemorrhagic stroke
Authors: Elfimov A V , Spirin N N , Nozdrachev A D , Fateev M M , Ivanov A. O.
Published: March 2014

Radioimmunoassay using was used to study the blood concentrations of thyroid hormones (thyroid-stimulating hormone (TSH), T3, and T4) in patients with hemorrhagic stroke as intracerebral hematoma. The authors analyzed two patient groups: 1) those operated on for intracerebral hematoma removal; 2) those receiving medical treatment. Surgical intervention resulted in local fibrinolysis of a hematoma remnant. The level of thyroid hormones was studied over time from the 1st day to the 28th day of therapy. Each group was then divided into 2 subgroups: survivors and dead patients. Mortality group was 77.2% in the medical treatment group and 17.2% in the surgical treatment group. The performed studies established elevated concentrations in cases of good outcome of stroke. All the patients were found to have low T3 concentrations that were more pronounced in patients with a poor outcome. The level of T4 did not differ from the control values in patients with good results. Hematoma removal contributed to an increase in the concentrations of TSH and triiodothyronine
Pharmacoepidemiological analysis of outpatient therapy for type 2 diabetes
Authors: Verbovoy A F , Barabanova N A
Published: March 2014

The paper presents the results of studying the actual treatment of patients with type 2 diabetes (T2D) receiving oral glucose-reducing agents. The case reports of 291 patients with T2D were analyzed. Poor adherence to the international and Russian guidelines for the management of T2D, unsatisfactory control of cardiovascular risk factors, and untimely correction of glucose-reducing therapy were revealed.
Delayed sexual development in boys
Authors: Bolotova Nina Viktorovna , Raygorodskaya Nadezhda Yur'evna
Published: March 2014

This paper presents results of examination of 59 boys aged from 14 to 16 years with delayed sexual development (DSP). All children were allocated to 3 groups depending on specific clinical features of the disorder. Group 1 comprised boys (n = 20) with retardation of growth and sexual development, group 2 (n = 14) boys with DSP and cryptorchidism, group 3 (n = 25) boys with DSP and obesity. The examination included evaluation of the patients' physical and pubertal development, measurement of serum sex hormones, and difereline stimulation test. Constitutional form of DSP was diagnosed in 90% of the boys in group 1. Hypogonadotropic hypogonadism occurred in 42.8% of the patients in group 2, and boys of group 3 suffered DSP etiologically associated with excessive body weight. It is concluded that correlation between clinical and hormonal characteristics of the examined boys reflects the cause behind DSP.
Effect of glycorazmulin on blood biochemical characteristics in alloxan diabetes
Authors: Fayzieva Z T
Published: March 2014

The objective of this study was to evaluate the influence of glycorazmulin on carbohydrate and lipid metabolism and on the function of liver in animals with alloxan-induced diabetes. It was shown that glycorazmulin produces a well-apparent decrease in blood glucose level and has beneficial effect on lipid metabolism. In addition, the preparation contributes to the normalization of liver function.
Immunotherapy of type 1 diabetes mellitus: current state-of-the-art and prospects. Part 2
Authors: Laptev D N
Published: March 2014

This review summarizes experimental findings obtained in immunological studies of diabetes mellitus. Principal immunotherapeutic approaches to the treatment of diabetes are described. Putative mechanisms behind the development of immunotolerance are considered. A brief summary of previously reported and on-going clinical studies is presented.
Postpartum thyroiditis: risk factors, differential diagnosis, clinical features
Authors: Fadeyev V V , Topalyan S P , Lesnikova S V , Mel'nichenko G A
Published: March 2014

Postpartum thyroiditis (PT), one of the commonest causes of disturbed thyroid function (TF), is believed to occur in 5% of the women. The present study involving 57 patients with PT was designed to study risk factors and clinical features of this pathology as well as approaches to its diagnosis. Two control groups comprised female carriers of anti- thyroid peroxidase antibodies (TPO-AB) without PT and women having symptoms of Graves disease (GD) in the postpartum period, respectively. Patients with PT were shown to have significantly elevated TPO-AB levels during pregnancy compared with controls. Postpartum GD manifested itself later than PT, it was associated with a significantly higher freeT4 level and a greater thyroid volume. In twenty of the 57 women with PT, it was manifest in the thyrotoxic phase and in the remaining 37 in the hyperthyroid state. The TSH level in the first half of pregnancy was significantly higher in the women that eventually developed a monophasic hypothyroid variant of PT. In the same group, the TPO-AB level at the time of PT diagnosis was significantly higher than in the biphasic variant of PT. Forty (70%) of the 57 women with PT recovered to an euthyroid state by the end of the study whereas in 17 (30%) hypothyroidism persisted. The biphasic variant of PT was manifest starting from the thyrotoxic phase and more frequently ended in the recovery to the euthyroid state (90%) than the monophasic one, the difference being statistically significant. In contrast, the monophasic hypothyroid variant more frequently resulted in persistent hypothyroidism (40%).
New understanding of the problem of management of type 2 diabetes mellitus - novel prospects (ADA/EASD consensus, 2008)
Authors: Biryukova E V
Published: March 2014

Type 2 diabetes mellitus is a severe progressive disease associated with the high incidence of complications. The worldwide incidence of type 2 diabetes mellitus is known to be steadily growing which makes the management of this disease a topical medical problem. The majority of the patients all over the world fail to achieve recommended treatment end-points. The scientifically-sound choice of an adequate pharmacotherapeutic modality based on the available data on type 2 diabetes pathophysiology is of utmost importance under conditions of real clinical practice. The new updated ADA/EASD consensus of 2008 provides a well-grounded practical algorithm for the initiation and further adjustment of drug therapy in patients with type 2 diabetes mellitus. The HbA1c level of 7.0% or higher at any stage of the treatment should be regarded as a signal for active correction of the previous therapeutic regime. The early prescription of basal insulin contributes to the efficacious glycemic control and decreases the risk of long-term diabetic complications. Treatment with a combination of insulin and metformin is a highly effective approach to the management of patients with hyperglycemia and simultaneously slows down weight gain. The present algorithm enables clinicians to choose the most adequate hypoglycemic agents and combine different therapeutic modalities to the benefit of each individual patient.
Hematological and urological aspects of the safety of androgen substitution therapy using long-acting testosterone undecanoate in patients with hypogonadism
Authors: Rozhivanov R V , Kurbatov D G
Published: March 2014

The objective of this work was to evaluate hematological and urological safety of androgen substitution therapy by retrospective analysis of 40 medical histories of patients with hypogonadism. It was shown that treatment with testosterone undecanoate resulted in a significant increase of hemoglobin concentration and packed cell volume that did not however cause serious adverse events and did not require withdrawal of therapy. No statistically significant changes in prostate size or prostate specific antigen (PSA) level were documented in patients receiving androgen therapy. Clinically significant elevation of PSA was apparent in 12.5% of the patients in whom its initial level exceeded 2.5 ng/ml and also in patients with acromegaly. To conclude, the data obtained in this study point out to hematological and urological safety of androgen substitution therapy.
Effect of female sex hormones on microbicidal activity of neutrophils
Authors: Shirshev S V , Nekrasova I V
Published: March 2014

The objective of the present work was to study effects of estradiol and progesterone on enzymatic, oxidative, and phagocytic function of human neutrophils. It was shown that sex hormones applied at the doses equivalent to their concentrations in pregnant women selectively stimulated spontaneous activity of neutrophilic elastase and increased myeloperoxidase enzymatic activity. Neither estradiol nor progesterone had apparent effect on baseline spontaneous hemiluminescence of neutrophils but stimulated E.coli-induced luminol-dependent hemiluminescence. Simultaneously, both steroids inhibited phagocytic activity of these cells. It is concluded that this modulating action of female sex steroids on neutrophil functions is likely to come out during pregnancy.
Adrenal masses (diagnosis and differential diagnosis)
Authors: Molashenko N V , Iukina M Iu , Soldatova T V , Rogal' E A
Published: March 2014

This review of the literature is focused on diagnosis and differential diagnosis of adrenal incidentalomas with special reference to diagnostic steps, major pharmacological tests, radiologic and instrumental studies. Strategies of treatment and management of patients with this pathology are described.
Multiple immunoregulatory disturbances in the progeny of rats with experimental gestational diabetes
Authors: Kolesnik Iu M , Kamyshnyĭ A M , Abramov A V , Gancheva O V , Liubomirskaia V A
Published: March 2014

The objective of the present work was to study the morphofunctional state of insulin-expressing, antigen-presenting, Treg cells, epithelioreticulocytes, thymic cells expressing c-Fos and Bcl-2+ in the progeny of rats with experimental gestational diabetes (EGD). The methods employed included immunohistochemical staining with direct and indirect immunofluorescence using monoclonal antibodies against insulin, MHC-II antigen, CD25 antigen, cytokeratins, rat Bcl-2 and c-Fos proteins. The off-springs of rats with experimental gestational diabetes were shown to have multiple disturbances of immunoregulation in the thymus, such as abnormalities of Treg cell differentiation, impaired expression of early response proteins (c-Fos), reduced number of epithelioreticulocytes, antigen-presenting and insulin-immunopositive cells, hyperexpression of anti-apoptotic Bcl-2 protein. These changes interfere with the normal apoptotic process, selection of thymocytes, and development of central tolerance to pancreatic antigens.
Diagnosis of primary hyperaldosteronism
Authors: Rogal' E Iu , Bel'tsevich D G , Fadeev V V , Molashenko N V , Mel'nichenko G A
Published: March 2014

The present review is concerned with the problem of diagnosis of primary hyperaldosteronism and differential diagnosis of various nosological forms of this disease. Individual diagnostic steps are described along with main functional (verification) tests and instrumental methods used in the studies of this pathology.
Laboratory diagnostics of pheochromocytoma
Authors: Troshina E A , Bel'tsevich D G , Iukina M Iu
Published: March 2014

Biochemical diagnosis of pheochromocytoma is based on the measurement of altered levels of normetanephrine and metanephrine in plasma or 24-hour urine samples. Plasma normetanephrine and metanephrine levels four times the upper limit of the normal value or metanephrine and normetanephrine excretion in urine above 700 and 1500 mcg/24 hours respectively makes further testing unnecessary and subsequent examination must be focused on the determination of tumour localization. In patients presenting with the above parameters elevated within the "grey zone", effect of medicinal products needs to be excluded and the diagnosis confirmed in the clonidine test or by the measurement of chromogranin A level.
Late consequences of long-term glucocorticoid therapy in patients with congenital adrenal cortical dysfunction
Authors: Molashenko N V , Sazonova A I , Troshina E A , Kalinchenko N Iu
Published: March 2014

Novel information concerning the management of adult patients with congenital adrenal cortical dysfunction is presented. New methods for the treatment of this pathology are described along with evaluation of its outcomes. Late consequences of long-term glucocorticoid therapy of congenital adrenal cortical dysfunction are considered.
Epidemiology of primary hyperparathyroidism
Authors: Dedov I I , Vasil'eva T O , Rozhinskaia L Ia , Mokrysheva N G
Published: March 2014

Up to the mid-1970s, primary hyperparathyroidism (PHPT) was considered to be a rare pathology. The introduction of methods for the measurement of blood calcium levels into the clinical practice substantially extended knowledge about diverse forms of PHPT and its prevalence. The present review presents results of those sparse epidemiological investigations of PHPT that were carried out in different countries.
Peculiarities of pathogenesis, diagnostics and treatment of erectile dysfunction in patients presenting with hypogonadism
Authors: Gamidov S I , Tazhetdinov O Kh , Pavlovichev A A , Popova A Iu , Tkhagapsoeva R A
Published: March 2014

Different authors estimate the prevalence of hypogonadism and erectile dysfunction at 1.7% to 35%. The contribution of androgens playing an important role in regulation of erection remains the subject of extensive investigations. To date, experimental and clinical studies have demonstrated that androgen deficiency leads to degeneration and apoptosis of smooth muscle cells followed by fibrosis of cavernous bodies, impaired expression of endothelial and neuronal NO synthase, decreased arterial inflow and increased venous drainage of the cavernous bodies, enhanced sensitivity to mediators of vasoconstriction, impaired NO-mediated relaxation of smooth muscles in response to sexual stimulation, reduced expression of type 5 phosphodiesterase (PDE-5). Moreover, hypogonadism and erectile dysfunction are frequently associated with cardiovascular disorders, diabetes mellitus, metabolic syndrome, dyslipidemia, hypercholesterolemia, hypertriglyceridemia, and obesity. The main purpose of hormonal substitution therapy is to maximally normalize the physiological concentration of plasma testosterone and to eliminate clinical manifestations of androgen deficiency. The treatment with testosterone-containing preparations is indicated only for patients with clinical symptoms and laboratory findings suggestive of hypogonadism. The testosterone-based preparations for intramuscular administration currently find wide application for this purpose. Testosterone substitution therapy enhances libido, increases the frequency of morning erection, and improves sexual quality of life at large. It is worthy of note that treatment with these preparations is well tolerated by the patients. Control over hormonal substitution therapy with testosterone preparations implies evaluation of the clinical response and achievement of the target testosterone level in blood plasma. Also. it is necessary to measure PSA, perform digital rectal examination, and determine the hematocrit level prior to the initiation of the treatment, 3 and 6 months after its termination, and every 6 months thereafter. To conclude, androgens are natural stimulators maintaining sexual function in men. Patients with hypogonadism and erectile dysfunction should be managed by combined therapy with androgens and PDE-5 inhibitors.
Results of the observational program on the use of insulin glargine (Lantus) in combination with oral hypoglycemic agents or prandial insulins for the treatment of type 2 diabetes mellitus in routine clinical practice
Authors: Glinkina I V
Published: March 2014

The objective of this observational program was to evaluate the efficiency and safety of insulin glargine used to treat patients with type 2 diabetes mellitus (DM2) who failed to achieve adequate compensation of carbohydrate metabolism during therapy with NPC insulin in combination with oral hypoglycemic agents or prandial insulins. The secondary objective was to estimate satisfaction of physicians with the results of insulin glargine therapy. The open, prospective non-randomized multicentre observational study included 7.334 patients of the mean age 58.3±9.0 years presenting with type 2 diabetes mellitus and treated using a combination of NPC insulin and oral hypoglycemic agents or prandial insulins. The mean duration of the disease was 10.5±4.7 years, HbA1c level 9.6±1.7%, fasting blood glucose level 10.3±2.5 mmol/l. The total duration of the study was 6 months. After inclusion in the program, the patients were transferred from NPC insulin to insulin glargine with subsequent titration of the dose. The HbA1c level decreased from 9.6±1.7% to 8.0±1.2% and 7.2±1.0% within 3 and 6 months after the inclusion into the study respectively (p<0.001 for both values). The fasting blood glucose levels exhibited a similar trend. The target HbA1c level of ≤ 7% was achieved within 3 months in 29.2% of the patients and within 6 months in 53.8%. Simultaneously a reduction in the incidence of mild and severe hypoglycemic symptoms was documented both during the daytime and at night. The physicians described the results of the treatment as "good" and "very good" in 80.7% and 93.2% of the patients 3 and 6 months respectively after transfer from NPC insulin to insulin glargine in combination with oral hypoglycemic agents. It is concluded that substitution of NPC insulin by insulin glargine for the treatment of patients presenting with type 2 diabetes mellitus not only improves the quality of glycemic control but also significantly reduces the frequency of mild and severe hypoglycemic symptoms.
"Intrauterine programming" of hormonal and metabolic processes and intrauterine growth retardation syndrome
Authors: Nagaeva E V , Shiriaeva T Iu
Published: March 2014

According to the "intrauterine programming" hypothesis, the fetus responses to nutritional deficiency by adaptation in the form of long-standing changes of metabolism that eventually create predisposition to cardiovascular, metabolic, and endocrine diseases. Up to now, a wealth of catamnestic data have been gathered indicating that individuals having the history of growth retardation in the prenatal period are likely to develop a variety of hormonal and metabolic disorders when they reach their mature age. Specifically, there is the close relationship between the intrauterine growth retardation syndrome and elevated arterial pressure, impaired glucose tolerance, and metabolic syndrome. The present review summarizes the results of epidemiological and experimental studies that confirm the above hypothesis.
Osteoporosis: from a rare symptom of endocrine diseases to the tacit epidemic of XX-XXI centuries
Authors: Dedov I I , Mel'nichenko G A , Belaia Zh E , Rozhinskaia L Ia
Published: March 2014

This article describes the history of knowledge management with special reference to primary and secondary osteoporosis, its epidemiology and diagnostics of different forms of this disease. The discussion is focused on therapeutic modalities for the treatment of osteoporosis based on the principles of evidence-based medicine. Special attention is given to the choice of optimal medicinal preparations for the management of primary osteoporosis taking into account results of multicenter randomized placebo-controlled clinical studies and the results of evaluation of the efficacy of various pharmaceutical for the treatment of secondary osteoporosis and its mixed forms. Some of these studies are carried out based at the Endocrinological Research Centre. Peculiarities of analysis of their results are discussed along with comparative characteristics of selected pharmaceuticals.
Modern methods of hormonal analysis
Authors: Goncharov N P
Published: March 2014

Characteristics of the main methods for hormone detection and measurement including radioimmune and immunoenzyme assays are presented along with the detailed description of up-to-date highly sensitive immunoassays of the third generation. These methods are described as allowing determination of virtually the entire range of hormones and biologically active compounds. Their application opens up new opportunities for diagnostics of subclinical forms of endocrine pathology.
The influence of insulin resistance and disturbances of carbohydrate metabolism in the acute period of myocardial infarction
Authors: Kvitkova L V , Elenskaia T S , Blagoveshchenskaia O P , Zinchuk S F , Zinchuk V G , Barbarash O L
Published: March 2014

This work was designed to study parameters of carbohydrate metabolism and insulin resistance (IR) in patients presenting with myocardial infarction (MI) and elucidate their relation to MI complications. Special attention was given to the relationship between disturbances of carbohydrate metabolism (DCM), the clinical course of myocardial infarction in the acute and cicatrization phases, characteristics of coronary arteries in the patients with and without diabetes mellitus (groups 2 and 1 respectively). Insulin resistance was documented in 83.2% of the patients. Multiple lesions in the coronary arteries were shown to be directly related to the immunoreactive insulin (IRI) level (r=0.277; p=0.0008) and HOMA index (r=0.304; p=0.0001). They were more common in patients with IR (86%; p<0.001). The clinical course of MI was more frequently complicated by early post-infarction angina, MI relapses, and heart failure (Killip functional class II) in the patients presenting with a combination of IR and DCM than in those showing normal sensitivity to insulin regardless of the characteristics of carbohydrate metabolism. It is concluded that the detection and correction of insulin resistance and disturbances of carbohydrate metabolism are the indispensable prerequisites for the successful prevention of myocardial infarction.
Basal insulin therapy in patients with type 2 diabetes mellitus: aspects of early initiation, advantages, constraints, and prospects
Authors: Vikulova O K
Published: March 2014

Intensive control of glycemia starting from the onset of type 2 diabetes mellitus (DM2) is of primary importance for the long-term prognosis of the disease and the reduction of risk of cardiovascular complications. The strategy of early intensive therapy of DM2 thus far remains a matter of fierce dispute among diabetologists. The problem of choice of an optimal regime for the start of insulin therapy does not have an unambiguous solution either. Hypoglycemia is the main factor that traditionally hampers wide application of insulin therapy in patients with type 2 diabetes mellitus. The choice in favour of basal therapy with insulin analogs has the advantage of reaching the target parameters of carbohydrate metabolism at a significantly lower risk of hypoglycemia compared with other strategies of insulin therapy.
The efficacy and safety of the application of the soluble form of Rastan in the children suffering from growth hormone deficiency
Authors: Dedov I I , Peterkova V A , Shiriaeva T Iu , Nagaeva E V , Volevodz N N , Malievskiĭ O A , Svinarev M Iu
Published: March 2014

The objective of the present study was to evaluate the efficacy and safety of the application of the new soluble pharmaceutical form of Rastan for subcutaneous injections at a dose of 15 IU/ml and compare its action with that of Rastan lyophilisate, 4 IU, designed to prepare solutions for subcutaneous administration. The two dosage forms are used to treat children suffering from growth hormone deficiency. The study included patients at the age from 4 to 12 years presenting with idiopathic growth hormone deficiency; they were randomized into two groups. During the first three months, the patients of both groups were treated with different pharmaceutical forms of recombinant growth hormone (rGH). The children in group 1 were given Rastan for subcutaneous injections and those in group 2 received Rastan lyophilysate for the preparation of solutions for the subcutaneous administration. Either form of GH was used at an equal daily dose of 0.033 mg/kg b.w. The patients of both groups showed marked improvement of the parameters of linear growth within the first three months. The difference in the growth rates was not significantly different between the two groups which suggests the identical effect of the two forms of rGH. During the next 9 months when the patients of both groups were treated only with the rGH for subcutaneous injections, the absolute growth response, height SDS, and the level of insulin-like growth factor 1 (IGF-1) continued to increase. It points out to the stable growth-promoting effect of Rastan for subcutaneous injections. No clinically significant abnormal changes in the results of complete blood cell count and biochemical analysis of blood were apparent during 12 months of therapy with this form of rGH. The same was true of the levels of free T4, cortisol, and prolactin in the blood. No adverse effects attributable to the therapy with rGH were documented.
The role of anti-Mullerian hormone in the differentiation, development, and functioning of the reproductive system
Authors: Ustinkina T I , Shustov S B
Published: March 2014

The integral analysis of the available information concerning the role of anti-Mullerian hormone (AMH) in the differentiation, development, and functioning of the reproductive system allows to make the following conclusion. The germ cells predetermine AMH biosynthesis from beginning to end of functioning of the reproductive system. The onset of germ cell meiosis restricts biosyhthesis of anti-Mullerian hormone that is maintained at a constant level throughout the rest of the period of reproductive maturity. AMH biosynthesis becomes arrested with the decrease of gametogenesis.
Inflammation of adipose tissue (Part 5). The relationship with physiological insulin resistance
Authors: Shvarts V Ia , Kolberg B
Published: March 2014

This review contains the results of investigations representing insulin resistance as a physiological factor that ensures supply of macroergic substrates for the functioning organs and tissues. Physical activity promotes the development of insulin resistance in adipose and renal cells with the resulting enhancement of the secretion of glucose and lipids into blood. Simultaneously, the insulin action in muscular cells increases which facilitates utilization of these compounds. The opposite change in insulin sensitivity of different cells is mediated through a rise in interleukin-6 secretion during muscular activity. The immune processes are associated with the development of insulin resistance in adipocytes, hepatocytes, and myocytes leading to the elevation of blood glucose and lipid levels that accounts for the enhanced requirement of immune cells in these compounds. The mechanism underlying the development of insulin resistance during immune processes consists of activation of Toll-like receptors. Increased secretion of placental hormones in the course of gestation causes disturbances in the insulin action in the peripheral tissues and thereby ensures supply of energy-rich and plastic substrates for the growing fetus. Inflammation of adipose tissue is associated with physiological and pathological insulin resistance. This condition is discussed as a factor contributing to the transformation of physiological insulin resistance to pathological one.
The sexual function of peri- and post-menopausal women presenting with type 2 diabetes mellitus
Authors: Pogorelova A S , Berketova T Iu , Mel'nichenko G A , Ragozin A K
Published: March 2014

The objective of the present work was to estimate the influence of the compensation of type 2 diabetes mellitus (DM2) and its late complications on the sexual function of the women presenting with type 2 diabetes mellitus during the peri- and post-menopausal periods. The sexual function was studied in 368 women with DM2 and in 314 ones without disturbances of carbohydrate metabolism (controls) using the Women's Sexual Function Questionnaire developed by F.H. Quirk in 2002. The prevalence of sexual dysfunction in the groups of DM2 women and controls was estimated at 52.2% and 30.9% respectively (p<0.001). The women with DM2 reported the lower quality of intimate relationships with the partner (p = 0.003) and lower satisfaction with the sexual quality of life (p=0.007) compared with the control respondents. The risk of sexual dysfunction in the women with type 2 diabetes mellitus increased by 2.4 times (p<0.001), in those with diabetic polyneuropathy by 4.8 times, and in the women with the blood glycated hemoglobin (HbA1c) level in excess of 7.0% by 2.3 times (p=0.012). It is concluded that type 2 diabetes mellitus is an independent risk factor of sexual dysfunction during the peri- and post-menopausal periods. Other risk factors are constituted by diabetic polyneuropathy and elevated HbA1c level (>7.0%).
Molecular genetic investigations of the cases of idiopathic short stature
Authors: Vorontsova M V , Pankratova M S
Published: March 2014

Idiopathic short stature is the commonest form of growth retardation making up a heterogeneous group of pathological conditions characterized by a highly variable clinical picture. The molecular genetic investigations into the nature of idiopathic short stature encompass a combination of the accompanying clinical symptoms and laboratory findings. The present review is concerned with the principles of diagnostic studies pertaining to idiopathic short stature and the most widespread molecular gene defects in the growth hormone-insulin-like growth factor-1 system.
Inflammation of adipose tissue (Part 6). The effects of medicamental preparations
Authors: Shvarts V Ia
Published: March 2014

This review is focused on the influence of salicylates as well as preparations used for the treatment of obesity, diabetes mellitus, arterial hypertension, and atherosclerosis on the functional state of the adipose tissue and the inflammatory processes affecting it. Many of these medicines show the anti-inflammatory activity mediated through a variety of mechanisms. There is thus far no medicamental preparations for the specific treatment of adipose tissue inflammation. Nevertheless, the anti-inflammatory action of certain drugs should be taken into consideration when they are prescribed for the treatment of clinical conditions with concomitant obesity and suspicion of inflammation of the adipose tissue.
Congenital hyperinsulinism. Results of molecular-genetic investigations in a Russian population
Authors: Melikian M A , Kareva M A , Petriaĭkina E E , Volkov I É , Aver'ianova Iu V , Kolomina I G , Gurevich L E , Peterkova V A , Brusgaard K , Christesen H T , Dedov I I
Published: March 2014

Congenital hyperinsulinism (CHI) is a most frequent cause of persistent hypoglycemia in the children during the first year of life. This pathology is biochemically characterized by inadequate secretion of insulin by beta-cells of the pancreas. Congenital hyperinsulinism is a highly heterogeneous condition in terms of clinical manifestations, histological features, and molecular-genetic defects underlying the development of this disorder. A total of 9 genes are known to be involved in pathogenesis of CHI. The majority of the cases (40-60%) are attributable to the defects in KCNJ11 and ABCC8 genes encoding for the ATP-dependent potassium channels in the pancreatic cells. Approximately 15-20% cases are associated with the mutations of GCK and GLUD1 genes participating in the regulation of intracellular glucose metabolism. The results of clinical, hormonal, molecular-genetic, and histological examination of 42 children presenting with congenital hyperinsulinism are reported. These data were used to analyse the genotype-phenotype relationships.
Inflammation of the adipose tissue (part 7). Non-medicamental treatment
Authors: Shvarts V Ia
Published: March 2014

This review contains experimental and clinical data on the suppression of inflammatory processes in the adipose tissue under effect of regular physical activity and low-calorie diet. An important role in the suppression of the inflammatory processes is played by the reduction of the degree of obesity, stimulation of glucocorticoid secretion, improvement of glucose tolerance, and activation of hormesis. The beneficial effects of low-calorie fat mimetics, such as omega-3-fatty acids and resveratol, naringenin, hesperidin, curcumin, and Mediterranian diet, are discussed.
Insulin pump therapy with the function of automatic stopping delivery of insulin in response to hypoglycemia
Authors: Laptev D N
Published: March 2014

The advent of the new insulin pump with the function of automatic stopping delivery of insulin in response to hypoglycemia marks a new stage in the development of closed-loop devices for insulin administration. This review is devoted to insulin pump therapy with the use of this function. The results obtained up to now with the use of this technology with special reference to its efficacy and safety are presented.
The prevalence of diabetes mellitus among the patients with acromegaly
Authors: Dreval' A V , Trigolosova I V , Vinogradova A V , Ilovaĭskaia I A
Published: March 2014

To estimate the prevalence of diabetes mellitus (DM) among the patients with acromegaly residing in the Moscow region (MR). A total of 93 patients aged from 48.0 to 64.5 (mean 57.5) years presenting with acromegaly from 7.5 to 20.25 (mean 13.0) years in duration were available for the examination. Twenty seven of these patients developed diabetes mellitus prior to acromegaly. Oral glucose tolerance test (OGTT) for diagnostics of DM was performed in 66 patients. The overall prevalence of diabetes mellitus among the patients with acromegaly was estimated at 51.6% which is higher than that in the general population of the Moscow region and worldwide (2.3% and 8.3% respectively). The prevalence of DM among women was higher than in men (55.1% and 33.5% respectively; p<0.05). It increased with age (from 14.3% in the patients aged between 36 and 45 years to 48.3% at the age above 56 years) and with duration of acromegaly (from 40.6% in the patients with the duration of the disease up to 8 years to 60.5% in those with acromegaly during more than 15 years; p<0.05). Asymptomatic diabetes was diagnosed in 34.8% of the 69 patients which is also higher than the prevalence of asymptomatic type 2 diabetes mellitus in a random sample from the adult population of MR and in the group with the enhanced risk of DM2. The prevalence of DM among the patients in the controllable and uncontrolled phases of acromegaly was 57.1% and 49.2% respectively (p>0.05). The prevalence of DM2 among the patients with acromegaly is significantly higher than in the world's general population; it depends on the patients' age and sex and as well as on the duration of acromegaly.
Metabolic signs of abdominal obesity in the patients presenting with acute myocardial infarction and normal or excess body weight
Authors: Kvitkova L V , Borodkina D A , Gruzdeva O V , Silonova A A , Zharkova O N , Barbarash O L
Published: March 2014

This work was designed to study the relationship between the disturbances of carbohydrate metabolism (DCHM) and insulin resistance (IR) on the one hand and body mass index (BMI) and waist circumference (WC) on the other hand in the patients presenting with acute and cicatrical myocardial infarction (MI). It was shown that WC in all the patients exceeded the upper gender norm. The clinical manifestations of metabolic syndrome were documented in 65.6% of the patients with normal BMI, 85,7% of those with excess BMI, and in 96.3% of the patients with obesity. In all the groups the WC measures positively correlated with the glucose blood level at admittance to the hospital and on days 1 (r=0.34; p=0.01), 2 (r=0.38; p =0.0002), and 3 (r=0.68; p=0.002) after it. Similar correlation was observed with the insulin level 2 hours post-prandially on days 1 (r=0.42; p=0.01), 2 (r=0.5; p=0.0002), and 3 (r=-0.95; p=0.0003). The relationship between metabolic disorders and WC values indicates that visceral fat plays an important role in the regulation of metabolic processes and suggests the necessity of the treatment for the correction of WC.
The role of specific chaperons in pathogenesis of obesity and related diseases
Authors: Vasiukova O V , Okorokov P L
Published: March 2014

Obesity, type 2 diabetes mellitus, and atherosclerosis are associated with the development of "metabolic" inflammation. The proinflammatory mechanisms in adipocytes and macrophages are initiated by both extracellular mediators (cytokines, saturated fatty acids) and intracellular processes (endoplasmic reticulum stress, excessive production of free radicals). An important role in the development of "metabolic" inflammation is played by protein transporters of fatty acids ("fatty acid-binding proteins").
Stress of endoplasmic reticulum: the cytological "scenario" of pathogenesis of human diseases
Authors: Dedov I I , Smirnova O M , Gorelyshev A S
Published: March 2014

The phenomenon of stress of endoplasmic reticulum (ER) attracts an increasingly higher attention of the researchers. The available data suggest that ER dysfunction is a common component of many human pathologies including oncological diseases and neurodegenerative viral diseases. Stress of ER is of special significance in the cell populations actively secreting proteins because protein folding disturbances play an important role in its development. This fact opens up prospects for the better understanding of pathogenesis of diabetes mellitus and some other diseases. The present work summarizes the current concepts of biochemical mechanisms underlying stress of endoplasmic reticulum and elucidates the key signal pathways for its compensation and proapoptosis.
The experience with the use of the GLP-1 analog liraglutide (Victoza) for the optimization of metabolic control and correction of the body mass in the patients with type 2 diabetes mellitus
Authors: Saprina T V , Gudkova T K , Stoliarova V A , Martynova S Iu , Dudar'kova N G , Iaroshevskaia T G , Latypova V N
Published: March 2014

The optimal control of diabetes mellitus (DM) should ensure not only the achievement and maintenance of the targeted blood glucose level but also the reduction of other cardiovascular risks. Obesity is a key risk factor of the development of type 2 diabetes mellitus (DM2) and an independent risk factor of cardiovascular complications. The agonists of glucagon-like peptide-1 (GLP-1) are currently considered to be the sole hypoglycemic agents that not only effectively correct hyperglycemia but also reduce the excessive body weight. Liraglutide (Victoza, Novo Nordisk) is the first long-acting analog of human GLP-1 approved for the application in the treatment of DM2 at the early stages of the disease in the form of both mono- and combined therapy. We present the literature review of the results of randomized clinical studies and our own experience with the use of Victoza for glycemic control and correction of the body weight in the patients presenting with type 2 diabetes mellitus.
Predictors of the development of chronic wound defects in the soft tissues of the lower extremities in the patients with type 1 diabetes mellitus and lipoid necrobiosis
Authors: Semenova D. A. , Repina E. A. , Stepanova S. M. , Prokofiev S. A. , Matushevskaya E. V. , Tokmakova A. Yu.
Published: March 2014

A total of 50 patients presenting with type 1 diabetes mellitus (DM1) were available for the clinical and immunological examination. They were allocated to two groups, one comprised of 25 patients with DM1 and lipoid necrobiosis (LN), the other consisting of 25 patients with DM1 without LN. Expression of Toll-like receptors (TLR2, TLR3, and TLR4) was evaluated in monocytes and neutrophils obtained from peripheral blood. In addition, the state of peripheral circulation and innervation of the lower extremities was evaluated. It was shown that the impairment of expression and fluorescence of TLR2 and TLR4 in monocytes as well as TLR3 in neutrophils was associated with the manifestations of skin lesions in the patients with DM1 and LN. It is concluded that the measurement of Toll-like receptors in the patient presenting with type 1 diabetes mellitus and lipoid necrobiosis can be used in clinical practice for the prediction of the development of dermatosis.
The incretin system in type 2 diabetes mellitus: cardiovascular effects
Authors: Sukhareva O. Yu. , Shmushkovich I. A. , Shestakova E. A. , Shestakova M. V.
Published: March 2014

Cardiovascular diseases are the commonest cause of high mortality rate among the patients with type 2 diabetes mellitus. (DM2). The safety of hypoglycemic agents considered as potential risk factors of cardiovascular pathology becomes an increasingly important concern in the choice of the strategy for the treatment of DM2 as recommended in the relevant domestic and international guidelines. The data of multifaceted action exerted by incretins on the cardiovascular system have recently become available. The potential cardioprotective properties of incretin-based pharmaceutical products and mechanisms of their action are discussed
The use of dipeptidyl peptidase-4 inhibitors for the treatment of patients with type 2 diabetes mellitus and chronic renal disease
Authors: Shamkhalova M. Sh. , Shestakova M. V.
Published: March 2014

The rapid increase in the number of patients with type 2 diabetes mellitus and renal pathology necessitates the revision of the presently adopted approaches to renal replacement therapy with a view of relieving the economic and financial burden imposed by the use of expensive therapeutic methods on the health budgets of the developed countries. The importance of achievement and maintenance of the target blood sugar levels for the prevention of the development and progression of renal lesions has been demonstrated in a series of large-scale clinical studies. Compensation of disorders of carbohydrate metabolism at the late stages of chronic renal disease in the patients presenting with diabetes mellitus encounters difficulties arising from the danger of hypoglycemia associated with the impairment of renal gluconeogenesis, cumulation of antiglycemic agents and their metabolites, decreased clinical significance of glycated hemoglobin levels under conditions of developing anemia and marked hyperglycemia. Discontentedness with the currently available means for the control of carbohydrate metabolism that fail to meet the up-to-date-requirements for the effectiveness and safety in a given clinical situation accounts for the ever increasing interest in the possibility of using innovative incretin-based medicines taking into account their pharmacological profile (they are known to change insulin secretion in response to variations in blood glucose levels, improve the function of beta-cells, have beneficial effect on the cardiovascular system, and control body weight).