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Vol 49, No 4 (2003)

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Clinical endocrinology
Plasma protein peroxidation in patients with type 1 diabetes mellitus
Flerov M.A., Smirnova N.N., Svetlova Z.V.


Oxidative plasma protein destruction was studied in children with type 1 diabetes mellitus and healthy children. The duration of the disease was 3-5 years. The degree of spontaneous and metal-catalyzed protein oxidation was determined by the interaction of oxidized amino acid residues with 2.4-dinitrophenylhydrazine. The plasma from children with type 1 diabetes mellitus showed a higher level ofperoxidation products than that from healthy children.

Problems of Endocrinology. 2003;49(4):3-4
Serum lipoproteins in type 2 diabetes mellitus
Poteryaeva O.N., Panin L.Y., Shevkoplyas O.P., Voronova O.S., Kostina N.Y., Polyakov L.M.


The qualitative and quantitative composition of serum lipoproteins was studied in patients with type 2 diabetes mellitus. A correlation analysis was made between lipid metabolic and other indices (Quetie index, a history of diabetes, the degree of its compensation, age, carbohydrate metabolism). The patients were found to have higher levels of atherogenic lipoprotein fractions [very low-density lipoproteins (VLDL) and low-density lipoproteins (LDL)], their lipid (cholesterol and triglycerides) and protein (apolipoprotein B) components being increased. On the contrary, the antiatherogenic fractions of high-density lipoproteins (HDL22 and HDL1) are decreased. The changes in the qualitative composition are associated with the higher levels of HDL triglycerides and with the lower levels of apoliprotein A-1. The correlation found between the content of lipoproteins of different classes and their components (proteins and lipids) and the indices of carbohydrate metabolism, the duration of disease, the body mass index, the stage of diabetes decompensation supports the hypothesis that the atherogenic lipoprotein fractions are involved in the etiology and pathogenesis of type 2 diabetes mellitus. 

Problems of Endocrinology. 2003;49(4):4-8
Diabetic nephropathy: new capacities of pharmacological correction
Sarvilina I.V., Maklyakov Y.S., Karkishchenko N.N.


The present study aimed to develop the effective regimen of drug prevention of diabetic nephropathy. The efficacy of the angi­otensin-converting enzyme (ACE) inhibitorfozinopril and the bi­ological response modifier glutoxim used in 86 patients with type 1 diabetes mellitus was evaluated by 24-hour blood pressure monitoring, by evaluating renal hemodynamics (radioisotopic re­nography; the Jaffe test for blood creatinine; the Rehberg- Tareyev test), by measuring the content of capillary blood glucose by the glucose oxidase test, the level of Hb Ak by the colorimetric assay, the urinary concentration of protein by the sulfosalicylic acid test, by examiming the time course of changes in the albumin/creatitine in the morning urinary sample. The assessment of the hormonal profile included immunoradiometric assay of the levels of cortisol, ardenocorticotropic hormone, transport proteins or cortisol/albumin and transcortin. The evaluation of the pa­tients ’ status involved isolation of lymphocytes, measurement of IgG, IgA, and IgM, circulating immune complexes, detecton of cell membrane surface markers, synthesis of interleukin-1 and tissue necrosis factor-a. The combined use of fozinopril and glu­toxim was found to be highly effective in normalizing renal he­modynamic parameters in type 1 diabetes mellitus and arterial hypertension (p < 0.001) and in eliminating microalbuminuria (p < 0.001). Glutoxim promoted normalization of the hormonal and metabolic profile in the patients by significantly ameliorating the symptoms of imunodeficiency. The possible mechanism of poten­tiating the nephroprotective effect of fozinopril with glutoxim in­cluded into the treatment regimen was the low rates of apoptotic processes in the glomerular and renal epitheliocytes due to to the elimination of their triggering hormonal, metabolic, immune, and hemodynamic factors.

Problems of Endocrinology. 2003;49(4):8-12
Adrenal and gonadal steroidogenesis in patients with ovarian polycystosis during buserelin test
Goncharov N.P., Dobracheva A.L., Pishchulin A.A., Todua T.N., Shlykova V.G.


Relationships between the secretion of gonadotropic hormones of the pituitary gland, the androgenic and glucocorticoidal functions of the adrenals and the steroidogenic function of the ovaries were studied in 21 patients with the ovarian polycystic syndrome (OPS) and in 7 healthy women in test with buserelin, a gonadotropin-releasing agonist. When stimulated with corti- sole, the secretion remained unchanged. Depending on the baseline level of dehydroepiandrosterone sulfate (DHAS), a change was found in the secretion of dehydroepiandrosterone (DHA) and its precursor 17-OH-pregnenolone. With the nor­mal baseline level of DHAS, the content of hormones increases while with its high level, their content does not change. The stimulation of gonadotropic secretion results in a higher disso­ciation in the secretion of luteinizing hormone (LH) and folli­cle-stimulating hormone (FSH) in patients with OPS, by in­creasing the LH/FSH ratio that is most significant in patients with the normal level of DHAS. Under stimulation, aromatase activity becomes higher in patients with high DHAS levels and remains unchanged in the other group of patients. The findings may lead to the conclusion that buserelin-induced stimulation of gonadotropic secretion may be accompanied by the activated synthesis of adrenal androgens in some patients with OPS. De­pending on the baseline androgenic activity of the adrenals, buserelin-induced stimulation of gonadotropic secretion is at­tended by a higher aromatase activity.

Problems of Endocrinology. 2003;49(4):12-16
Serum leptin levels in obese children operated on for craniopharyngioma
Solntseva A.V.


The study was undertaken to investigate the concentrations of leptin after surgical treatment of craniopharyngioma. Patients with obesity were studied. There were the following 3 groups: 1) 8 boys and 2 girls aged 15.6+0.8 years after surgical treatment of craniopharyngioma; 2) 10 boys and 10 girls aged 8.48±0.45 years who had constitutional obesity and stage i puberty (after tanner);and3) loboysand logirlsaged 12.31+0.44years who had constitutional obesity and tanner stages ii-v puberty. There were no significant changes in the levels of leptin in pre­pubertal children. There was an age-related change in the con­centration of leptin in girls, i.e. A significant increase in puberty. After surgical treatment of craniopharyngioma, the obese boys had lower levels of leptin than the comparison group boys with the same degree of sexual development and body weight values. There was a positive correlation of the levels of leptin and the body mass index in all age groups of patients with exogenous con­stitutional obesity.

Problems of Endocrinology. 2003;49(4):16-18
Anthropometric and hormonal-andmetabolic parameters in abdominal obesity
Plokhaya A.A., Vorontsov A.V., Novolodskaya Y.V., Butrova S.A., Dedov I.I.


То examine the distribution of fatty tissue in patients with ab­dominal obesity by magnetic resonance imaging (MRI) and to evaluate the relationship between the area of visceral fatty tis­sue and their anthropometric and hormonal-and-metabolic parameters, 31 individuals aged 20-40 years were examined. There were 15 females with a waist circumference (WC) of > 80 cm and a waist-hip ratio (WHR) of > 0.85 and 16 males with > 94 cm and 0.95, respectively. In the course of this study, the  authors estimated anthropometric parameters such as body mass, body mass index, WC, and WHR, and meas­ured blood pressure. In all the patients, the areas of visceral and subcutaneous fatty tissues at the level of LIV were deter­mined by MRI; the levels of lipids, lipoproteins, glucose, and insulin were measured. Our study has indicated that predom­inantly abdominal and visceral obesity was generally combined with hyperinsulinemia and hypercholesterolemia in patients with Stages I and II arterial hypertension. It has been ascertained that it is impossible to diagnose predominant visceral obesity in females, unlike males, by using anthropometric parameters. MRI is the method of choice in verifying the diagnosis of fe­male visceral obesity

Problems of Endocrinology. 2003;49(4):18-22
Hormonal and metabolic disturbances and their correction in children with obesity
Bolotova N.V., Averyanov A.P., Lazebnikova S.V., Dronova Y.G.


The paper deals with the prevalence and specific features of the metabolic syndrome (MS) in children with different forms of obesity and with the capacities of its correction. Ninety-eight children aged 9-17years, including 44 children with exogenous constitutional obesity and 54 with pubertal juvenile dyspituitarism, were examined. For the diagnosis of MS, clinical exami­nations methods were used. These included: estimation of the body mass index, circumferences of the waist and hips, their ra­tio, the levels of total cholesterol, triglycerides, coagulogram, fasting insulin, the routine glucose tolerance test, and fasting glucose/insulin ratio. The incidence of MS in obese children was 42.9%. A combination of 5 components of MS, such as in­sulin resistence, abdominal obesity, hyperlipidemia, hyperco- agulative changes, and aterial hypertension, was noted in 23.8% of the children and that of 4 and 3 (incomplete MS) components in different combinations was in 52.4 and 23.8%, respectively.

The combined therapy low-calorie diet and metformin (Siofor, Berlin-Chemie) was used to correct the metabolic disturbances detected in 28 children aged above 13 years. The use of Siofor in children with MS, unlike dietary monotherapy, substantially improved the values of total cholesterol, fibrinogen, and blood pressure and normalized a response to glycemic load in most patients

Problems of Endocrinology. 2003;49(4):22-26
Intellectual development of children with congenital hypothyroidism
Filimonova N.A., Shilin D.Y., Pechora O.L., Andreichenko A.P., Kasatkina E.P.


The purpose of the study was to search for causes that exert a negative effect on the mental development of patients with con­genital hypothyroidism (CH). A total of 85 children aged 5-17 years (65 patients with CH and 20 healthy individuals of the same age from their families) were examined. Their mental de­velopment was assessed by the D. Veksler test in the presence of clinical and hormonal compensation. The results have demon­strated that the start of therapy at month 1 of life provides high adaptive capacities and results in the normal level of mental development in children with CH (the mean IQ, 103±4 scores). The adequacy of the therapy performed also affects the mental development of patients with CH in future: children with normal intellect (IQ > 90 scores) received adequate hormonal replace­ment therapy within the first year of life in 90% of cases whereas hormonal compensation within the first year of life was noted only in 38% of the children with borderline intellectual deficiency (IQ = 70-89 scores). Perinatal pathology was more frequently de­tected in children with mental retardation: in children with oli­gophrenia and those with normal intellect, their maternal path­ological pregnancy was observed in 56 and 22%, respectively. Birth asphyxia was noted in 33% versus 15%. Familial and so­cialfactors played a role (but not decisive) in the formation of the intellectual level of a child with CH. It is concluded that the time of initiation and the adequacy of therapy play the leading role in the formation of intellect. The authors 'findings show it necessary to optimize a follow-up system for children with CH: a stricter clinical and hormonal monitoring of patients by an endocrinol­ogist and consulting of children with CH by a neurologist and a medical psychologist from their infancy.

Problems of Endocrinology. 2003;49(4):26-32
Efficiency of iodine deficiency prevention in Moscow in case of SouthWestern Administrative Okrug
Okminyan G.F., Samsonova L.N., Pykov M.I., Kurtseva T.G., Veldanova M.V., Antsiferov M.B., Sapelnikova V.A., Patoka N.A., Yakovleva N.V., Kasatkina E.P.


The paper deals with the remonitoring of goiter endemia and the evaluation of the efficiency of iodine deficiency prevention in the South- Western Administrative Okrug of Moscow. This paper us­es the data available in the literature and the authors ’ own data obtained in the examination of 514pupils aged 6-12 years. Rou­tine monitoring methods, such as thyroid palpation and ultra­sonography, determination of neonatal thyroid-stimulating hor­mone levels, ioduria median, and the incidence of decreased uri­nary iodine excretion), were used as indicators of goiter endemia and iodine provision. The iodine prevention programme imple­mented in Moscow since 1997 has been found to be rather ef­fective and to lower the strain of goiter endemia in the city; how­ever, it failed to eliminate it completely. The reasons reducing the efficiency of iodine prevention were identified. These included: the short time and difficulties of the initial stage of iodine pre­vention and/or the involvement of other strumogenic environ­mental factors in the formation of goiter endemia in Moscow.

Problems of Endocrinology. 2003;49(4):33-36
A new soluble formulation of the human recombinant growth hormone "Norditropin Simplex": Results of a clinical study of children and adolescents with somatotropic deficiency in Russia
Dedov I.I., Peterkova V.A., Fofanova O.V., Goncharov N.P.


Two formulations of the human recombinant growth hormone Norditropin (Novo Nordisk, Denmark), namely the liquid dos­age form Norditropin Simplex and the lyophilized dosage form Norditropin PenSet, by using 2 different pen-syringe systems (NordiPen and Nordiject, respectively) were studied in an open randomized crossover study of children with somatotropic defi­ciency. The new soluble formulation of growth hormone Nord­itropin Simplex was developed due to a need for a liquid, stable dosage form that requires no mixing and permits simple and easy- to-use daily injections. Norditropin Simplex is the first liquid growth hormone drug in a milligram dose, which meets the new WHO standards and the European Pharmacopoeia. The purpose of the study was to evaluate the capacities of the new liquid growth hormone formulation Norditropin Simplex, which re­quires no mixing, the pen-syringe NordiPen versus the lyophi­lized growth hormone formulation Norditropin PenSet and the pen-syringe Nordiject in children with somatotropic deficiency. The efficiency and safety of Norditropin Simplex used in the study group of children were also evaluated. Eleven patients with somatotropic deficiency received daily injections of Norditropin Simplex, 5 mg/10 mg, or Norditropin PenSet 12 for 6 weeks, the drug being replacedfor the following 6 weeks. Following 12 weeks of therapy, the preference of one formulation to the other was as­sessed by a questionnaire filled in by a patient or his/her parents. The patients who preferred Norditropin Simplex received an ad­ditional treatment with this drug for as long as 21 months. Ten of the 11 patients noted the advantage of Norditropin Simplex and Nordi pen over Norditropin PenSet and Nordiject continued treatment with the former drug for as long as 21 months. One pa­tient found no significant differences in the use of both dosage forms, but he preferred to continue therapy with Norditropin Sim­plex after a 12-week comparison period. Norditropin Simplex was ascertained to show a high growth-stimulating effect and safety, painless injections, and the easiness of using the pen-sy­ringe NordiPen in children and adolescents with somatotropic deficiency.

Problems of Endocrinology. 2003;49(4):36-41
Case Reports
Impaired sexual differentiation
Dzeranova L.K., Yarovaya I.S., Sergeyeva N.I., Derkach D.A., Marova Y.I.


The article is devoted to the violation of sexual differentiation.

Problems of Endocrinology. 2003;49(4):41-43
Familial nonmedullar thyroid cancer in sibling boys
Polyakov V.G., Shilin D.Y., Pavlovskaya A.I., Shishkov R.V.


This article focuses on familial non-immediate thyroid cancer in boys siblings.


Problems of Endocrinology. 2003;49(4):44-45
18F-Fluorodeoxyglucose positron emission tomography in terms of present-day diagnosis, follow-up, and treatment of differential thyroid cancer
Zaplatnikov K., Menzel C., Diel M., Debert N., Hamcho N., Grunwald F.


Positron emission tomography with “F-fluorodsoxyglucose (“ F-FDG-PET) - one of the types of radionuclide research methods that can determine the increased glucose metabolism in neoplastic cells - has recently taken a strong place among other methods for diagnosing malignant good diseases.

Problems of Endocrinology. 2003;49(4):46-50
Estrogen therapy for arterial hypertension in menopansal females
Karachentsev A.N., Kuznetsova I.V.


Arterial hypertension, according to many experts, "is the greatest non-infectious pandemic in the history of mankind that determines the structure of cardiovascular morbidity and mortality"; Thus, only in Russia AG about 40% of the population suffers. Due to the wide prevalence of hypertension, it has become an interdisciplinary problem, and today doctors of different specialties need practical recommendations for rational pharmacotherapy of high blood pressure in specialized patients.

Problems of Endocrinology. 2003;49(4):51-54
Neurological disorders in endocrine diseases
Solun M.N., Kalinin A.P., Kotov S.V.


The publication of the peer-reviewed monograph can be considered as an event in the scientific life, which is of particular importance for representatives of two medical specialties: neurology and endocrinology.

Problems of Endocrinology. 2003;49(4):55-55

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