bluuebunny/crossref_metadata_2025 huggingface dataset:
The differences of clinical picture of macroprolactinomas and their response to medicamental therapy with dopamine agonists between men and women
Authors: Astaf'eva L I , Kadashev B A , Dedov I I , Kalinin P L , Kutin M A , Tenedieva V D , Tropinskaia O F
Published: March 2014

The data about sex-specific differences of clinical signs and symptoms of macroprolactinomas and their response to medicamental therapy with dopamine agonists between men and women are reported. The present study included 306 patients (the men to women ratio 1.4:1) presenting with macroprolactinomas. Large and giant neoplasms were shown to predominate in men regardless of their age accompanied by clinical symptoms associated with the so-called «mass effect» of the tumour. The occurrence of macroprolactinomas of different size depended on the age of the patients. The majority of the young women had tumours of large and intermediate size and exhibited clinical features of hyperprolactinemic hypogonadism while those aged above 40 years had large and giant tumours accompanied by the symptoms of their «mass effect». The medicamental treatment with cabergolin was equally efficacious in both men and women.
The clinical course of endocrine ophthalmopathy in patients presenting with Graves' disease depending on the effect of radioiodine therapy
Authors: Sheremeta M S , Sviridenko N Iu , Belovalova I M , Garbuzov P I
Published: March 2014

The primary objective of the present work was to study the clinical course of endocrine ophthalmopathy (EOP) following radioiodine therapy (RIT) of Graves' disease (GD) and depending on its effect (development of post-radiation hypothyroidism). The secondary objective was to determine risk factors of EOP progression after radioiodine therapy. This prospective study included 38 patients (76 eyes) allocated to two groups. The patients of group 1 (n=19/38 eyes) presented with thyrotoxicosis at each visit and continued to use thyrostatic agents; those in group 2 (n=19/38 eyes) had hypothyroidism at its early stages (3 and 6 months) and were given substitution therapy with levothyroxin. The development of post-radiation hypothyroidism was shown to strongly influence the clinical course of EOP. In the patients of group 1, EOP remained active throughout the entire observation period (12 months) in the absence of appreciable variations of its integral severity index. In group 2, the same index decreased significantly, but active forms of EOP could be detected by the time of onset of hypothyroidism (6 months) (p=0.0000). After 12 months, the level of anti-TSH receptor antibodies in the patients of group 1 was significantly higher than in those of group 2 (10.8±8.3 and 2.9±2.0 respectively, p=0.0003). The regression rate of EOP symptoms following radioiodine therapy (RIT) of Graves' disease was a function of the efficacy of thyroid 131I radioablation. It is concluded that persistence of anti-TSH receptor antibodies was responsible for the deterioration of the clinical picture of endocrine ophthalmopathy after radioiodine therapy.
Specific features of hemodynamics in the patients of different age groups presenting with autoimmune thyroiditis and subclinical hypothyroidism
Authors: Nekrasova T A , Ledentsova O V , Strongin L G , Kazakova L V , Lukushkina A Iu
Published: March 2014

This study was designed to elucidate the relationship between the age of the patients presenting with autoimmune thyroiditis and subclinical hypothyroidism and the changes in their cardiovascular system. The following characteristics were estimated: the structure of the left ventricle, its overall and segmental diastolic function (by tissue Doppler echocadiography), and rigidity of the arterial walls (from the Young's modulus of elasticity, by ultrasonography). The patients were 95 women at the age of 20 to 50 years of whom 47 presented with autoimmune thyroiditis and subclinical hypothyroidism and 48 with euthyroidism (controls). They were divided into 3 age groups to be compared in the «subclinical hypothyroidism vs control» mode. Group 1 comprised 12 ad 13 women respectively aged 20-30 years, Group 2 contained 12 and 10 patients (31-40 years), group 3 included 23 and 25 patients (41-50 years). Young women with subclinical hypothyroidism were characterized by high values of Young's modulus and a large number of dysfunctional left ventricular segments (p<0.05). In the patients of the intermediate age, subclinical hypothyroidism also tended to have high values of Young's modulus in the absence of diastolic dysfunction. The oldest patients showed no signs of left ventricular dysfunction or arterial wall rigidity compared with controls (p<0.05). The results of the study indicate that the patient's age influences manifestations of changes in the cardiovascular system characteristic of subclinical hypothyroidism. In young women, this condition is associated with more pronounced disturbances of both overall and segmental diastolic functions and arterial elasticity than in control subjects. The women of older age groups show less apparent cardiovascular and metabolic abnormalities while the role of subclinical hypothyroidism as a cardiovascular risk factor is relatively insignificant.
Epidemiology of primary hyperparathyroidism in Russia (the first results from the database of Federal state institution «Endocrinological Research Centre»)
Authors: Dedov I I , Mokrysheva N G , Mirnaia S S , Rostomian L G , Pigarova E A , Rozhinskaia L Ia
Published: March 2014

To elucidate specific features of epidemiology of various forms of primary hyperparathyroidism (PHPT) in this country using the information about 561 patients accumulated for 19 years in the database of Federal state institution «Endocrinological Research Centre». The incidence of PHPT in Moscow estimated from the database of Endocrinological Research Centre for 2007 was 6.8 per 1 000 000 adult population and the prevalence as per 2009 was 3.1/100 000. These values are significantly lower than those reported by foreign authors. The men to women ratio among the patients with PHPT was 1:8. The disease largely affects subjects at the age from 50 to 60 years. By the year of 2004, the frequency of the mild form of PHPT did not exceed 20% of the total (based on 2002 Consensus criteria). It increased to 37% during the past 5 years. Conservative treatment of PHPT can be recommended to 14% of the patients presenting with sporadic disease and to 32% of those with MEN syndrome. The frequency of asymptotic PHPT and its normocalcemic forms is estimated at 5% and 9% respectively. The above results are the first data on epidemiology of PHPT in this country; however, they are insufficient to comprehensively evaluate the real significance of the problem. Large-scale epidemiological studies are needed to ensure adequate assessment of the situation.
Androgen deficiency in women and possibilities for its hormonal diagnostics
Authors: Goncharov N P , Katsiia G V , Melikhova O A , Smetnik V P
Published: March 2014

The authors describe the distribution patterns of free testosterone concentrations in the saliva of women who previously underwent ovariectomy, in postmenopausal women, in those presenting with clinical signs of hyperandrogenism, and in healthy women in the follicular phase of the menstrual cycle. The level of salivary free testosterone in postmenopausal women and after ovariectomy was lower than in younger premenopausal patients. Women with clinical signs of hyperandrogenism showed higher free testosterone levels than the age-matched young healthy subjects. The salivary free testosterone levels in 60-75% of the ovariectomzed, postmenopausal, and hyperandogenic women remained within their normal range in young healthy women. It is concluded that high analytical sensitivity of the chemiluminescent method for the measurement of free testosterone in the saliva makes possible its application to the screening for androgen status of the women at risk of testosterone deficiency.
Synthesis of new exenatide analogs and investigation of their influence on glycemia and renal function in rats
Authors: Bogolepova A E , Kutina A V , Marina A S , Nikol'skaia S K , Shakhmatova E I , Titov M I , Natochin Iu V
Published: March 2014

New analogs of exenatide with amino acid substitutions at 14, 35, and 39 have been synthesized. They were shown to be more stable than original exenatide in aqueous solutions. In vivo testing on rat models of glucose loading showed that exenatide and its novel analogs possess hypoglycemic activity and stimulate renal excretion of sodium and magnesium ions and osmotically free water but have virtually no effect on the elimination of potassium ions. Experiments with isolated skin and urinary bladder preparations from male frogs showed that exenatide and its analogs promote biosynthesis of physiologically active compounds modulating renal functions.
How can we avoid the danger of hypoglycemia, one of the most serious complications of therapy of type 2 diabetes mellitus? The role of DPP-4 inhibitors
Authors: Pavlova M G , Zilov A V
Published: March 2014

Optimal or near-optimal compensation of diabetes mellitus is almost inevitably fraught with the risk of hypoglycemia. In patients with type 2 diabetes (DM2), especially in those of old-age groups, the development of hypoglycemia increases the risk of CV death, cardiac rhythm disturbances, dementia, and depressive states. Whether absolutely all diabetic patients should be treated so as to ensure blood glucose levels close the physiological values thus far remains a matter of controversy. The results of large-scale clinical studies carried out in the recent years suggest the necessity to revise the existing algorithms for the treatment of patients with DM2. Highly efficacious agents for the purpose should be chosen with reference to both their glucose-normalizing activity and "the safety profile" (i.e. reduced risk of hypoglycemia). A panel of experts for the Russian Association of Endocrinologists (RAE) developed and published «Consensus Algorithm on the initiation and intensification of therapy of type 2 diabetes mellitus». Its main provisions emphasize the necessity of treating diabetics on an individual basis and establish target levels of glycemia for each patient. Special attention should be given to the patients belonging to high risk groups, i.e. those with manifest macrovascular pathology, unable to recognize hypoglycemia, and having serious concomitant diseases. The following first line preparations are recommended to enhance the safety of DM2 therapy: metformin, dipeptidyl peptidase-4 (DPP-4) inhibitors and agonists of glucagon-like peptide-1 (GLP-1) receptors. The results of both national and international clinical studies of vildaglyptin give reason to recommend this DPP-4 inhibitor for a wider application to the treatment of patients with type 2 diabetes mellitus.
The classical case of the treatment of an adult patient with the salt-losing form of congenital adrenal cortical dysfunction
Authors: Sazonova A I , Molashenko N V , Iarovaia I S , Kalinchenko N Iu , Troshina E A
Published: March 2014

This case report illustrates peculiarities of the clinical course of congenital adrenal cortical dysfunction in adult patients presenting with the salt-losing form of the disease. Analysis of this case confirmed the necessity of dynamic observation of adults with this pathology in order to avoid complications that are likely to develop in case of inadequate treatment.
Evaluation of the efficacy of gonadotrophic inductors of ovulation in rats with hyperandrogenemia given flutamide
Authors: Reznikov A G , Nosenko N D , Boris E N , Poliakova L I , Sinitsyn P V , Tarasenko L V
Published: March 2014

The objective of the present work was to study the influence of antiandrogen flutamide (flutapharm) at a dose of 1.0 mg/kg b.w., human chorionic gonadotropin (choragon, 5 IU), and folliculostimulating hormone (menopur, 0.01 IU) on the morphofunctional characteristics of ovaries. These products were administered either alone or sequentially to sexually mature female rats after the implantation of testosterone-containing polymeric capsules. The presence of hyperandogenism was confirmed by the five-fold rise in the blood testosterone levels. Analysis of the oestrus cycle, the weight and histological structure of the ovaries gave evidence of disturbed folliculogensis, degenerative changes in follicular epithelium, the development of ovarian polycystosis and anovulatory state in the hyperandrogenic animals. It is concluded neither flutamide nor gonadotrophic hormones administered at the above doses promoted normalization of the generative function of rat ovaries. At the same time, stimulation with gonadotropins following glutamide administration restored folliculogenesis, ovulation, an formation of luteal bodies. The results of this study indicate that flutamide can be used to enhance the stimulating action of gonadotropic hormones on the ovaries in hyperandrogenic individuals.
About informative value of very high prolactin levels in patients presenting with prolactin-secreting pituitary macroadenomas (clinical observations)
Authors: Astaf'eva L I , Kadashev B A , Tenedieva V D , Moshkin A V , Shifrin M A
Published: March 2014

The mean blood prolactin level in patients with microprolactinomas is usually 3000-4000 mU/l compared with 10 000-20 000 mU/l in cases presenting with macroprolactinomas. It may be as high as 1 mln mU/l and more in patients with a giant tumour. The measurement of prolactin levels requires laboratory studies of strongly diluted plasma samples. Significant dilution is fraught with erroneous prolactin levels: nevertheless, this approach allows a tendency toward decreasing concentration of prolactin to be revealed which may be important for taking rapid decision concerning the choice of the treatment strategy (either surgical or medicamental) especially in critical situations. A few clinical cases of giant prolactinomas with an unusually high blood prolactin level are described with reference to its dynamics during treatment with cabergoline.
Regulation of the adenilate cyclase signal system by peptides of the insulin family, epidermal growth factor, and leptin and its functional disturbances in lymphocytes from patients presenting with type 2 diabetes mellitus
Authors: Kuznetsova L A , Plesneva S A , Chistiakova O V , Sharova T S , Pertseva M N
Published: March 2014

This study showed for the first time the stimulating action of peptides of the insulin family, insulin-like growth factor-1, relaxin, and epidermal growth factor (EGF) on the activity of the adenilate cyclase signal system (ACSS) in lymphocytes from the subjects of the control group. These hormonal effects were enhanced in the presence of guanylimidodiphosphate (GIDP). Moreover, leptin was for the first time shown to increase adenilate cyclase activity in lymphocytes from the control subjects and inhibition of this action by antibodies against leptin receptors. The patients presenting with type 2 diabetes mellitus (DM2) showed the enhanced baseline activity of adenilate cyclase in their lymphocytes whereas its stimulation by the above hormones, both in the presence and absence of GIDP, sharply declined. The influence of leptin on adenilate cyclase activity in patients with DM2 was apparent only at its concentrations above 10–8 M; it was inhibited by antibodies to leptin receptors. The results of this study indicate that disturbances of hormonal stimulation of adenilate cyclase activity in lymphocites of diabetic patients may be due to functional defects located at the receptor level in the case of leptin and at the level of Gs protein and its coupling to adenulate cyclase in case of peptides of the insulin family and GF. These findings confirm the concept being developed by the author according to which molecular defects in the hormone-dependent ACSS system constitute one of the main causes underlying the development of DM2.
Growth hormone and the cardiovascular system
Authors: Volevodz N N
Published: March 2014

This review highlights current concepts of physiological and pathophysiological effects of growth hormone on the heart. The data of international clinical studies concerning the influence of GH deficit and excess on the cardiovascular system are discussed with special reference to such clinical conditions as somatotrophic pituitary insufficiency and acromegaly. Result of analysis of parameters of the cardiovascular system in the patients receiving growth hormone substitution therapy for somatotrophic insufficiency and GH-suppressive therapy of acromegaly are presented
Disturbed balance of steroid hormones in men under 40 years of age presenting with obesity and metabolic syndrome
Authors: Katsiia G V , Goncharov N P , Chagina N A
Published: March 2014

We have studied steroid hormone profiles in young men with normal body mass index suffering obesity and metabolic syndrome. They showed a consistent tendency toward a shift in blood aldosterone level to the upper normal level and beyond. It was higher in patients with metabolic syndrome than with obesity. The testosterone levels displayed the downward trend from normal through obesity to metabolic syndrome values. The main predictors of testosterone dynamics in the course of development of obesity and metabolic syndrome were insulin concentration and BMI. Dynamics of dehydroepiandrosterone levels followed that of testosterone. It significantly decreased in men with metabolic syndrome compared with health subjects. Young men presenting with obesity and metabolic syndrome did not experience changes in morning and evening cortisol levels in peripheral blood. The study revealed the relationship between aldosterone levels and the development of metabolic syndrome mediated through the body mass index and the direct relationship between metabolic syndrome and testosterone dynamics.
Calcium and vitamin D metabolism in the patients presenting with morbid obesity including those after biliopancreatic diversion bypass
Authors: Dedov I I , Troshina E A , Mazurina N V , Iashkov Iu I , Ogneva N A , Il'in A V , Mel'nichenko G A
Published: March 2014

The present work was designed to study parameters of calcium and vitamin D metabolism in the patients presenting with morbid obesity (MO) including those who had undergone biliopancreatic diversion bypass (BPD). The patients were allocated to three groups. Group 1 was comprised of the patients with BMI in excess of 40 kg/sq.m. (n=22), group 2 included the patients after BPD (n=23), and group 3 (control) consisted of the healthy volunteers having normal body weight in the absence of signs of obesity (n=22). The three groups were significantly different in terms of consumption of vitamin D (p<0.001). Four 4 (18%) patients with morbid obesity and 12 (52%) patients in group 2 had elevated parathyroid hormone (PTH) levels that remained normal in all the subjects of group 3. The comparison of the incidence of secondary hyperparathyroidism (SHPT) in the patients of groups 1 and 2 confirmed its higher occurrence among the operated patients (p=0.029). In other words, the patients with MO significantly more frequently experience deficiency of vitamin D than the subjects of the control group (p=0.007). Examination of the patients who had undergone biliopancreatic diversion bypass demonstrated a higher incidence of SHPT developing in the late postoperative period.
Carcinoid syndrome in a child presenting with pancreatic somatotropinoma
Authors: Kareva M A , Orlova E M , Kuznetsov N S , Kats L E , Gurevich L E , Abrosimov A Iu , Peterkova V A
Published: March 2014

Carcinoid syndrome develops as a sequel of enhanced secretion of vasoactive substances from neuroendocrine tumours (NET). Somatostatinoma is an extremely rare variant of NET that manifests itself in cholelithiasis, steatorea, and diabetes mellitus. Somatostatinoma is usually diagnosed in adult subjects. Carcinoid syndrome is not a typical consequence of somatostatinoma. We present the first case report of somatostatinoma that was diagnosed in a child having carcinoid syndrome. The diagnosis was made difficult by the negative results of the search for biochemical markers of carcinoid syndrome and the small size of the primary tumour that could not be visualized by computed tomography. The immunohistochemical studies demonstrated secretion of somatostatin and calcitonin. The treatment of the child with somatostatin analogs proved inefficient which can be accounted for by the late diagnosis of the disease and the extensive metastatic process.
The role of chorionic gonadotropin in the formation of immunological tolerance during pregnancy
Authors: Shirshev S V , Zamorina S A
Published: March 2014

We have studied the role of pregnancy hormone (chorionic gonadotropin, CG) in the control of expression of Foxp3 (a marker of T-regulatory lymphocytes, Treg), synthesis of interleukin-4 (IL-4) and interferon-gamma (IFH-γ) in lymphocytes, and secretion of indolamine-2,3-dioxygenase (IDO) by monocytes. Moreover, we evaluated the phagocytic and oxidative activities of these cells. It was shown that incubation of CG at a dose of 100 IU/ml with mononuclear cells from peripheral blood (MPC) resulted in a rise in the relative number of IL-4+CD3+CD4+T-lymphocytes whereas the number of IFN-γ+CD3+CD4+T-cells remained unaltered; the intracellular production of IFN-γ and IL-4 in the subpopulation of CD3+CD8+T-lymphocytes did not change either. In vitro, CG (10 and 100 IU/ml) significantly increased percentage of CD4+CD25 brightFoxp3+ cells and enhanced activity of indolamine-2,3-doxygenase in lipopolysaccharide-stimulated MPC. CG suppressed phagocitosis of E. coli lux+ by monocytes and simultaneously inhibited the production of active oxygen species in the reaction of spontaneous luminol-dependent chemiluminescence. Taken together, these properties of CG account for its role in the promotion of the formation of immunological tolerance during pregnancy.
Levitra: multiple action, prospects for application
Authors: Vertkin A L , Morgunov L Iu , Zviagintseva E I
Published: March 2014

Vardenafil (Levitra) is a phosphodiesterase type V inhibitor traditionally used for the treatment of erectile dysfunction. The use of Levitra by the subjects free of a concomitant pathology (including combined therapy) is believed to be safe, however its action awaits further investigation. It is expected that Levitra will find a wider application in the future for the management of various somatic disorders.
A case of type 1 diabetes mellitus and concomitant Hajdu-Cheney syndrome
Authors: Dreval' A V , Kamynina T S , Volodina M N , Kotalevskaia Iu Iu , Demikova N S
Published: March 2014

The first case of type 1 diabetes mellitus with concomitant rare genetically determined Hajdu-Cheney syndrome has been documented among the Russian population. The patient was a 26 year-old subject at the early stage of diabetes.
Diagnostics of medullary thyroid cancer and the strategy of its management in the absence of biochemical remission
Authors: Gazizova D O , Bel'tsevich D G , Tiul'pakov A N , Simakina O V , Soldatova T V
Published: March 2014

Early diagnosis greatly facilitates successful treatment of medullary thyroid cancer. The present paper is designed to report the results of analysis of the studies carried out with the use of various diagnostic techniques and the data obtained during the long-term treatment of the patients with this pathology in the absence of biochemical remission.
Oxidative stress in type 2 diabetes mellitus and methods for its correction
Authors: Ametov A S , Solov'eva O L
Published: March 2014

Recent publications concerning mechanisms of late vascular complications of type 2 diabetes mellitus lay emphasis on oxidative stress as a major factor contributing to their development. Moreover, oxidative stress induced by hyperglycemia is considered to be the main cause underlying beta-cell lesion that accelerates progression of diabetes. Modern hypoglycemic agents must have additional properties preventing the development of vascular complications. Gliclazide MV is considered to be a medicine displaying anti-atherogenic and anti-oxidative properties that promote the survival of beta-cells exposed to oxidative stress and increase the resistance of low-density lipoproteins to oxidation.
Thiazolidinediones: a long way to clinical practice
Authors: Aleksandrov A A , Kukharenko S S , Iadrikhinskaia M N , Shatskaia O A , Drozdova E N
Published: March 2014

The clinical application of thiazolidinediones has an almost 12 year history. The correction of carbohydrate metabolism achieved by the treatment with hiazolidinediones is associated with the reduction of many risk factors of coronary heart disease and the improvement of prognosis for the patients presenting with type 2 diabetes mellitus. The possible mechanisms underlying complications encountered in the clinical practice in connection with the use of thiazolidinediones are discussed.
Peculiarities of the clinical course, diagnostics, and therapy of premature sexual development in the children presenting with its idiopathic form and with hypothalamic hamartoma
Authors: Bolmasova A V , Kareva M A , Orlova E M
Published: March 2014

The idiopathic form of premature sexual development (PSD) is the commonest variety among the central forms of PSD (accounting for 30 to 70% of the total). It occurs primarily in the girls. The prevalence of hypothalamic hamartoma (HH) as a cause of premature sexual development is on the whole lower, but it is most frequently diagnosed in the children of either sex under the age of 3 years with the clinical manifestations of true PSD. Diagnostics and treatment of different forms of premature sexual development constitute an appreciable part of the practical work of a pediatric endocrinologist. The efficacy of PSD therapy with luliberin analogs has been definitively demonstrated in the context of increasing the final height of the children and suppressing the progression of their sexual development. Moreover, the reversibility of the effects of luliberin analogs on the gonadostatic activity has been confirmed. Nevertheless, peculiarities of the clinical course of various etiological variants of central PSD, principles of its treatment, and its efficacy remain a matter of debate. In the present paper, the special emphasis is laid on the consequences of PSD therapy using luliberin analogs including the recovery of the process of normal puberty, effects on the reproductive function, body weight, and the dependence of the treatment on the clinical form of central PSD. The data on the peculiarities of the clinical course of premature sexual development and the efficacy of its treatment in the children with the idiopathic form of gonadotropin-dependent PSD and hamartoma-associated PSD are presented
The estimation of the quality of diagnostics of post-menstrual osteoporosis in the Moscow region from the results of a questionnaire study
Authors: Dreval' A V , Marchenkova L A , Grigor'eva E A
Published: March 2014

The present questionnaire study including female residents of the Moscow region (MR) above the age of 55 years with the confirmed diagnosis of post-menopausal osteoporosis (OP) was designed to obtain an insight into the procedure employed to diagnose post-menopausal OP, categories of specialists involved in diagnostics of this condition, and the methods they use for the purpose. The results of the study indicate that 57.4% of the patients with OP in the first place applied for advice in connection with this disease to an endocrinologist, 19.7% to an orthopedist-traumatologist, 13.% to a rheumatologist, and 4.9% to a neurologist. The endocrinologists referred such patients for bone densitometry and made the diagnosis of post-menopausal osteoporosis in 79% and 70% of the cases respectively. Only a small fraction of orthopedists-traumatologists and rheumatologists practicing in the Moscow region are engaged in diagnostics of post-menopausal osteoporosis as a part of their major activities. At the same time, therapists, gynecologists, and general practitioners do not practically encounter the patients complaining of post-menopausal OP. 38%, 30% and 28% of the respondents reported to have applied to two, three, and one physicians respectively to have the diagnosis of this condition confirmed. However, in the majority of the cases the period from the first visit to a specialist till the establishment of the definitive diagnosis was as long as 1 year (39%). The diagnosis of OP in a small number of the patients was made with the use of a single method, e.g. X-ray densitometry (12%), ultrasonometry (4%), and X-radiography of the skeletal bones (2%). The remaining patients were examined by more than one method; most of them had the primary diagnosis verified by means of X-ray densitometry (77%), blood biochemical analysis (77%), X-radiography of the spinal column (67%), and either by the detection of the serum bone turnover markers or ultrasonometry (16%). The majority of densitometric procedures were performed based at the Moscow Therapeutic and Prophylactic Department and M.F. Vladimirsky Moscow Regional Research Clinical Institute (73% and 17% respectively) for the lack of densitometers in the local medical facilities of the Moscow region.
Endogenous hypercorticism as a prothrombogenic state
Authors: Khodakova Iu V , Rozhinskaia L Ia , Sukhanova G A , Arapova S D , Il'in A V , Chirkova L D
Published: March 2014

The patients in the active phase of endogenous hypercorticism not infrequently present with hypercoagulation syndrome characterized by abnormal blood clotting in conjunction with slowed fibrinolysis, elevated fibrinogen and D-dimer concentrations. In addition, such patients exhibit endotheliosis manifest as a rise in the PAI-1 and Willebrand factor levels. The remission of the Cushing's disease (CD) is associated with a higher fibrinogen, thrombomodulin, endothelin-1, and D-dimer levels compared with CD patients in the active phase of this disease and healthy subjects (control). This suggests the continuing progression of endotheliosis, enhanced thrombogenicity, and the increased risk of cardiovascular complications.
The influence of sibutramine therapy on the body composition and metabolic characteristics of the patients presenting with exogenous constitutional obesity
Authors: Vlasova Iu Iu , Ametov A S
Published: March 2014

The treatment of 36 patients suffering exogenous constitutional obesity (ECO) with sibutramine during 12 weeks resulted in the substantial reduction of body weight, waist circumference (WC), hip circumference (HC), and waist-to-hip ratio (WHR). Simultaneously, the total cholesterol level in the blood decreased. The reduction in the body weight had positive effect on carbohydrate metabolism. Medicamental treatment of obesity caused a drop in systolic arterial pressure and a substantial change in the body composition. Specifically, percentage of both total and visceral fat as well as basal metabolism decreased, water retention in the body increased while the muscular mass remained unaltered. It is concluded that the introduction of Sibutramine into the combined treatment of exogenous constitutional obesity effectively promotes the reduction of the body weight, improvement of the body composition and metabolic characteristics.
The health and endocrine status of the children born through assisted reproductive technologies (a literature review)
Authors: Kopylova I V , Vitiazeva I I
Published: March 2014

The authors review the publications devoted to the problem of health quality in the children born through assisted reproductive technologies. The data on the state of somatic and psychic health of such children are discussed. The main lines of investigations into the possible consequences of extracorporeal fertilization and its modifications are proposed. Special attention is given to the problem of comparability of different studies, the relevance and reliability of conclusions based on their results.
Dipeptidyl peptidase-4 inhibitors: Comparative analysis of members of the group
Authors: Shestakova E A , Galstian G R
Published: March 2014

Dipeptidyl peptidase-4 inhibitors (DPP-4) is a new class of hypoglycemic drugs developed based on the knowledge of incretin physiology acquired in the 21st century. Currently, five members of this group are in use three of which are available on the Russian market. The hypoglycemic effect of dipeptidyl peptidase-4 inhibitors is due to reduction of fasting and postprandial hyperglycemia without a rise in the body weight and acceptable profile of side effects. Dipeptidyl peptidase-4 inhibitors differ in terms of pharmacodynamics and pharmacokinetics which implies different indications and duration of their use in different groups of patients as well as different character of their drug interaction. This paper compares three dipeptidyl peptidase-4 inhibitors, viz. vildagliptin, sitagliptin, and saxagliptin.
Anti-Mullerian hormone (AMH) in the adolescent girls presenting with hyperandrogenism
Authors: Bogdanova P S , Kareva M A , Iarovaia I S , Zlotnikova O A , Il'in A V , Dedov I I
Published: March 2014

Anti-Mullerian hormone (AMH) is known to be a reliable marker of disturbances in folliculogenesis. The present paper is designed to report the results of AMH determination in 57 adolescent girls differing in the clinical course of hyperandogenism depending on the severity of its symptoms and androgen levels in the peripheral blood.
Potential of liraglutide (Victoza) in multifactor treatment approach in type 2 diabetes mellitus
Authors: Pashkova E Iu
Published: March 2014

To study the efficacy of treatment with liraglutide in women with type 2 DM and NAFLD. A group of 10 women with type 2 DM and obesity, with T2DM duration 6 months - 2 years, drug naïve or getting 1000-2500 gr metformin for at least 6 months with ultrasound markers of fatty liver and elevated ALT without hepatic insufficiency. Weight, BMI, HbA1C, ALT, AST, hepatic elasticity were measured before liraglutide 1.2 mg daily and 6 month after treatment. We got significant reduction of weight, BMI, HbA1C, in all treated women. In 7 women ALT level normalization was seen, in 3 women - ALT level reduction by 43, 37, 40% respectively. In 5 patients with initial fibrosis elasticity normalization was seen. In 1 - decrease of fibrosis degree and only in 1 - no improvement. Liraglutide in women with T2DM and NAFLD for 6 month helps to achieve weight, BMI, HbA1C reduction as well as elevated ALT normalization and hepatic fibrosis decrease.
The action of metformin on the production of pro-inflammatory cytokines and insulin resistance (NF-kB signal pathway)
Authors: Lavrenko A V , Kutsenko N L , Kutsenko L A , Mamontova T V , Kaĭdashev I P
Published: March 2014

The objective of the present study was to estimate the role of the NF-kB signal pathway in the realization of the anti-inflammatory and insulin-synthesizing activities of metformin in the patients presenting with coronary heart disease (CHD) associated with metabolic syndrome (MS). It was shown that the introduction of a one-month course of metformin therapy in the combined treatment of CHD resulted in the decreased production of pro-inflammatory cytokines, such as IL-1-beta, IL-6, IL-8, and TNF-alpha. Simultaneously, the serum C-peptide level decreased. These effects of metformin were mediated through the NF-kB-signal pathway. It is concluded that the inclusion of metformin in the combined treatment of coronary heart disease in the patients with metabolic syndrome prevent activation of NF-kB under the influence of endogeneous pro-inflammatory cytokines.
Selective blood sampling from the inferior petrosal sinuses for differential diagnostics of ACTH-dependent hypercortisolism (the original clinical experience)
Authors: Dreval' A V , Komerdus I V , Murzina A V , Nechaeva O A , Demidov I N , Britvin T A , Tishenina R S , Gegenava B B , Vishniakova M V , Denisova L B
Published: March 2014

This paper summarizes the original clinical experience of the authors concerning differential diagnostics of ACTH-dependent hypercortisolism. A total of 8 patients were available for the estimation of the potential of such diagnostics with the use of the high-dose dexamethasone suppression test, pituitary MRI, and selective blood sampling from the inferior petrosal sinuses for the determination of the ACTH concentration gradient between central and peripheral compartments. It turned out that neither the high-dose dexamethasone suppression test nor pituitary MRI provided unambiguous information about the source of ACTH hypersecretion whereas the use of selective blood sampling allowed to confirm the primary diagnosis of Cushing's disease in 4 patients and revise it in 2 others. In all the patients having the diagnosis established based on the results of selective blood sampling, it was confirmed after transsphenoidal adenomectomy. At the same time, the diagnosis of ACTH-ectopic syndrome was confirmed by an immunohistochemical method only in 1 of the 2 patients. Thus, the results of the present study indicate that selective blood sampling from the inferior petrosal sinuses is a valuable diagnostic tool which should be recommended for a wider application in endocrinological practice. However, this method failed to reveal lateralization of the tumours in all the examined patients.
Von Hippel-Lindau disease (VHL-syndrome)
Authors: Iukina M Iu , Tiul'pakov A N , Troshina E A , Bel'tsevich D G
Published: March 2014

Von Hippel-Lindau disease is a hereditary tumour syndrome associated with the earlier development of a variety of benign and malignant neoplasms, such as hemangioblastomas of the central nervous system and retina, tumours of the internal ear, renal carcinoma and cysts, pheochromocytoma, neuroendocrine tumours, pancreatic cysts, epididymal and broad ligament cystadenomas in men and women respectively. Von Hippel-Lindau disease is considered to be the most common cause of hereditary renal cancer.
Therapy of diabetes mellitus and the risk of malignization
Authors: Smirnova O M , Ivannikova E V
Published: March 2014

The safety of therapy of diabetes mellitus with hyperglycemic agents is a challenging problem in modern diabetology extensively discussed in the last years, with the special emphasis being laid on the associated risk of formation and development of various neoplasms. The main forms of cancer known to occur in association with type 2 diabetes mellitus are related to obesity and insulin resistance. It suggests the important role of various factors, besides hyperinsulinism and hyperglycemia, in cancer pathogenesis. The present review is designed to analyse the influence of insulin analogs, sulphonylurea derivatives, metformin, and thiazolidindiones on the risk of malignization in the patients with diabetes mellitus.
The development of severe osteomalacia following biliopancreatic diversion surgery for the management of morbid obesity
Authors: Mel'nichenko G A , Troshina E A , Mazurina N V , Ogneva N A , Iashkov Iu I
Published: March 2014

Biliopancreatic diversion (BPD) surgery is one of the most efficacious bariatric procedures employed to manage morbid obesity. However, apart from a stable reduction of the body weight and beneficial action on the clinical course of various diseases associated with obesity, this method creates the risk of inducing osteometabolic disorders following the surgical intervention. We present here a clinical case of osteomalacia that developed in the late post-BPD period in the absence of regular intake of medicines and adequate medical care.
Carney complex - multiple endocrine neoplasia syndrome
Authors: Orlova E M , Kareva M A
Published: March 2014

Carney complex is a rare hereditary syndrome characterized by an autosomal-dominant mode of inheritance and associated with multiple neoplasias affecting endocrine organs. The typical manifestations of this syndrome include pigmented micronodular adrenal dysplasia, lentiginosis, heart and skin myxomas, giant cell sertoliomas, and some other neoplasias. To date, a few hundred patients with this pathology have been described worldwide. A review of the available data about Carney complex is presented.
Insulin resistance in regulation of metabolism
Authors: Gordiunina S V
Published: March 2014

This paper highlights the main causes leading the development of insulin resistance (IR), its mechanisms, and the role it plays in living activity. The analysis of the available literature gives reason to believe that the source of IR is the constant requirement for plastic and high-energy compounds to be mobilized from the body's internal reserves. The mechanisms underlying the development IR involve all organ systems that interact between themselves and thereby govern the origin and evolution of insulin resistance via regulation of the energy generation and consumption processes. This concept is in excellent agreement with the laws of thermodynamics. The vital activity is based on the principle of continuous variations of IR. This inference provides a basis for addressing a number of clinical problems.
Melatonin and diabetes mellitus (an overview of current experimental data)
Authors: Arushanian É B
Published: March 2014

Melatonin secreted by the epiphysis and synthesized in adipocytes of the gastrointestinal tract participates in the regulation of carbohydrate metabolism by modulating activities of alpha- and beta cell of Langerhans islets in the pancreas; melatonin acts via its specific receptors (MT1 and MT2). Reciprocal interactions between melatonin and insulin have been demonstrated while melatonin deficiency is known to be one of the factors predisposing to the development of diabetes mellitus. It was shown that melatonin provides protection against diabetes through a variety of intracellular and systemic mechanisms.
The use of ultra-short acting insulin preparations for insulin pumps
Authors: Andrianova E A
Published: March 2014

The data on the efficacy of using ultra-short acting insulin preparations in insulin pumps for children and adolescents presenting with diabetes mellitus. Insulin pump therapy in the patients of these age groups is finding an increasingly wider application as being more convenient for the users and leading to the improvement of glycemic control. One of the main advantages of modern insulin pump therapy is the possibility to maximally imitate the physiological profile of insulin secretion. The flexibility of both basal and bolus dosing regimens of insulin administration can be further increased by using ultra-short acting insulin preparations in insulin pumps. The choice of any of the three currently available analogs of ultra-short acting insulin guarantees their identical efficacy and safety in the children and adolescents with type 1 diabetes mellitus. They can be recommended as insulins of choice for the use in pump therapy
The importance and advantages of the timely prescription of insulin to the patients with type 2 diabetes mellitus
Authors: Iarek-Martynova I R
Published: March 2014

The onset of insulin therapy is an important stage in the treatment of type 2 diabetes mellitus. Its timely beginning ensures better control of glycemia and reduces the negative consequences of chronic glucose cytotoxicity and lipotoxicity. The achievement and maintenance of the stable compensation of the disease are the indispensable conditions for successful prophylaxis and adequate treatment of chronic complications of diabetes mellitus. The ADA guidelines recommend to initiate insulin therapy at the early stages of the disease provided it is dictated by the clinical situation or combine it with the use of oral hypoglycemic agents if the targeted HbA1c levels fail to be reached despite the intake of one or more tableted preparations.
The clinical application of glibenclamide: the problem of safety and efficacy
Authors: Reshed'ko G K , Khaĭkina E V
Published: March 2014

Well-timed, effective, and safe therapy of type 2 diabetes mellitus (DM2) is a challenging problem for public healthcare systems all over the world. Glibenclamide is currently the most popular sulfanylurea derivative prescribed to the patients presenting with DM2. High requirements to the safety profile of modern medications including oral hypoglycemic agents imply the necessity of close attention to the potential problems associated with the long-term application of glibennclamide. The present review is focused on the topical problems of safety and efficacy of glibenclamide arising from its use in the clinical practice.
Association of the polymorphous marker G6230A of the CTLA4 gene with type 1 diabetes mellitus in the patients of Russian descent
Authors: Kopylova O I , Kuraeva T L , Lavrikova E Iu , Titovich E V , Nikitin A G , Smirnova G E , Peterkova V A , Dedov I I , Nosikov V V
Published: March 2014

The risk of devolvement of type 1 diabetes mellitus (DM1) remains a challenging problem because neither etiology of the disease nor its prognosis and genetic predisposition to this condition are clearly understood. The development of any autoimmune process starts from the disturbance of subtle molecular mechanisms involved in the regulation of the immune system. Therefore, the genes controlling the function of its major components are at the same time the potential candidate genes encoding for the predisposition to DM1. Their association with the disease was studied by means of comparative analysis of the frequency distribution of alleles and genotypes of the polymorphous rs3087243 (G6230A) marker of the CTLA4 gene encoding for antigen-4 of cytotoxic T-lymphocytes. The present study included 257 patients presenting with type 1 diabetes mellitus and 526 healthy subjects. Genotypes were identified by the "real time" amplification technique. The AA genotype was found to occur less frequently in the diabetic patients than in the control group (11.3% and 22.1% respectively). In contrast, the frequency of the GG genotype was higher in the patients with DM1 than in the healthy subjects (44.7% and 37.5% respectively). It is concluded that the polymorphous rs3087243 marker of the CTLA4 gene is significantly associated with the predisposition to the development of type 1 diabetes mellitus in the patients of Russian descent.
Anomalous lipoprotein-X in type 2 diabetes mellitus
Authors: Ovsepian M R , Ébragimzade M G , Gabrielian A B , Oganesian M G , Gevorkian A A , Mamikonian A A , Boiadzhian A S
Published: March 2014

Type 2 diabetes mellitus (DM2) is the most common form of diabetes characterized by the disturbances of carbohydrate, protein, and lipid metabolism including dyslipidemia and elevation of the low-density lipoprotein (LDLP) levels. Lipoprotein-X (LP-X) represents an anomalous subclass of LDLP a distinctive feature of which is the high content of phospholipids and non-esterified cholesterol coupled with the low level of cholesterol ethers, triglycerides, and proteins. LP-X was detected in the blood of the patients with various diseases of the liver and biliary ducts associated with cholestasis. The results of our previous investigations suggest the presence of LP-X in the blood of the patients with familial Mediterranean fever and ischemic stroke complicated by concomitant diabetes mellitus. The objective of the present work was to elucidate whether LP-X actually occurs in the blood of the patients presenting with type 2 diabetes mellitus. We used the method of polyanionic precipitation of LDLP preliminarily separated by agar gel electrophoresis. The study has demonstrated for the first time the presence of LP-X in the blood of the patients with type 2 diabetes mellitus. Its possible pathogenetic role and mechanisms of LP-X generation in DM2 are discussed.