Vol 52, No 1 (2006)

Clinical endocrinology
Relationship of the I/D-polymorphism of the ACE gene and the T174M-polymorphism of the AGT gene to diabetic microangiopathies in children and adolescents
Kravets Y.В., Yurchenko Y.V., Freidin M.В., Samoilova Y.G., Solodilova Y.A.

The purpose of the study was to examine a role of candidate genes of the renin-angiotensin system in the development of microangiopathies in children and adolescents with type 1 diabetes mellitus (DM) and to systematize the risk factors of development of diabetic microangiopathies in order to substantiate the optimal approaches to prevention and therapeutic correction. A hundred and thirty-eight children (73 boys and 65 girls) with type 1 DM were examined. Their mean age was 13.2±0.3 years. Based on the findings, it may be assumed that patients with type DM who are the carriers of the D allele are genetically predisposed to the development of diabetic nephropathy. An association of the ID polymorphism of the ACE gene with the development of diabetic nephropathy was established in children with type 1 DM in the Siberian population. Allele I of the ACE gene ACE less frequently occurs in DM patients with nephropathy (p > 0.05) and a factor that reduces the risk of its development. The association of the D allele with the development of diabetic nephropathy suggests that the polymorphism of the ACE gene contributes to the regulation of generation of angiotensin-converting enzyme that plays an important role in the pathogenesis of this complication. There was no association of the polymorphism in question with the concomitance of diabetic nephro- and retinopathy in the patient. Analysis of the associations of the T174M polymorphism of the AGT gene with diabetic microangiopathies revealed no statistically significant differences when the distribution of the AGT gene was compared in the groups of patients with and without microangiopathies. There was an association of the T allele of the AGT gene with Type 1 DM, as evidenced by a negative TDT test in with healthy sibs. An association of the T allele with diabetic nephropathy was also ascertained.

Problems of Endocrinology. 2006;52(1):3-6
Affective and personal determinants of formation of an attitude towards the disease in patients with type 1 diabetes mellitus
Wasserman L.I., Trifonova E.A., Shchelkovo O.Y.

A hundred and twenty-six outpatients (41 males and 75 females) with type 1 diabetes mellitus were examined to study the affective and personal determinants of their attitude towards the disease at the Saint Petersburg City Diabetes Center within the framework of cooperation of the V. M. Bekhterev Psychoneurological Research Institute and the Academician I. P. Pavlov Saint Petersburg State Medical University. The examinees' mean age was 31.8±10.1 years. The mean duration of the disease was 17.1±8.3 years. Most patients were found to have symptoms of late diabetic complications. The patients' attitude towards the disease and their affective and personal characteristics were examined, by using a test for the psychological diagnosis of the types of an attitude towards the disease, scales for the rapid psychological diagnosis of neurotization, and the questionnaire "Copying ways". Analysis of the results led to the following conclusions: the probability of hypemosognostic reactions in patients with type 1 diabetes mellitus is relatively independent of the objectively assessed severity of the disease; the affective and personality characteristics associated with hypemeurotization considerably increase the risk of the hypemosognostic type of the internal picture of the disease, which is largely mediated by a tendency for avoidance behavior and by the lack of stress-coping behavioral skills, mainly problem solution-planning and self-regulation skills. Psychological correction aimed at enhancing the emotional stability of a personality and developing stress-coping skills seems to improve the adaptation of patients with type 1 diabetes mellitus to their disease.

Problems of Endocrinology. 2006;52(1):6-10
The specific features of central nervous system lesions in children with type 1 diabetes mellitus
Chapova O.L., Bolotova N.V., Kats I.V.

The specific features of central nervous system lesions were studied in 100 children with type 1 diabetes mellitus (DM), by using the data of a survey, rheoencephalography (REG) and psychological tests (cognitive and emotional processes). The cerebroasthenic syndrome that manifested itself as headache (42%), dizziness (33%), overfatigability and weakness (49%) was diagnosed by the analysis of complaints. REG established that 42% of the children with DM have cerebral circulatory disorders. Psychological tests revealed cognitive disturbances in 74 children with DM, of them 54, 59, 21, and 30 children diminished thinking, mechanical and logical memory, and attention, respectively. Fifty children were found to have emotional disorders as anxiety in 50 children, depression in 32, and aggression in 25. The psychoneurological syndrome in the presence of DM was diagnosed in 33%; it appeared mainly as behavioral deviations (hypersexuality, autism, theft, and falseness). The level of cerebral circulation and cognitive and emotional processes in the examinees correlated with the values of HbA. Impairments of cerebral hemodynamics, cognitive and emotional' sphere were encountered in decompensated carbohydrate metabolism more frequently than in compensated and subcompensated DM (p < 0.01 and p < 0.05).

Problems of Endocrinology. 2006;52(1):11-14
Effect of desmopressin on the production of corticosteroids in patients with different forms of hypercorticism
Marova Y.Y., Goncharov N.P., Kolesnikova G.S., Arapova S.D.

То investigate the direct effect of desmopressin (DP), a vasopressin agonist, on the adrenal cortex, the authors studied a response of the pituitary and all three adrenal cortical areas in patients with different forms ofhypercorticism (active stage): ACTH-dependent Itsenko-Cushing syndrome, ectopic ACTH-dependent syndrome, corticosteroma. The levels of ACTH, cortisol, dehydroepiandros-terone sulfate, and aldosterone were used to assess a response to DP 15, 30, 60, 90, and 120 minutes after administration. There were several types of a response of corticosteroids to DP: 1) an increase in the level of ACTH and, subsequently, in the concentration of either all test steroids, one of the steroids, or two steroids in different combinations; 2) an elevation of the concentration of steroids in different combinations irrespective the response of ACTH to DP. Thus, there are patients with hypercorticism whose adrenals respond to DP by the higher synthesis and secretion of glucocorticoids (cortisol), mineralcorticoids (aldosterone), and adrenal androgens (dehydroepiandrosterone sulfate). The findings suggest that there are "ectopic" receptors to vasopressin in the adrenal cortex of patients.

Problems of Endocrinology. 2006;52(1):14-18
Efficiency of iodine prophylaxis in pregnant women with nontoxic diffuse goiter in a mild iodine-deficiency area
Dreval A.V., Shestakova T.P., Nechayeva O.A.

Thirty-four pregnant women with nontoxic diffuse goiter (NDG), living in a mild iodine-deficiency area, were examined. The absence of iodine prophylaxis causes a higher than normal increase in thyroid-stimulating hormone levels by the end of pregnancy and a high frequency (87.5%) of hypothyroxinemia In the second half of pregnancy. These unfavorable events are prevented by the administration of iodine in a daily dose of 150-200 g; the early initiation of iodine prophylaxis is most effective. In women with NDG, pregnancy is most commonly complicated as threatening miscarriage, particularly in those who have not received iodine prophylaxis. Smoking during pregnancy enlarges the thyroid, which is not prevented by iodine prophylaxis.

Problems of Endocrinology. 2006;52(1):19-22
For practitioners
Follicular thyroid neoplasia (a lecture)
Troshina E.A., Mazurina N.V., Abesadze I.A., Yushkov P.V., Yegorycheva Y.K.

Nodular thyroid formations are detected in approximately 4–7% of individuals living in regions with normal iodine supply. In regions of iodine deficiency, the prevalence of nodular goiter is significantly higher, especially in women older than 40 years, in which it can exceed 30%.

Problems of Endocrinology. 2006;52(1):22-25
Case Reports
A case of olfactogenital dysplasia (Kallmann's syndrome) in females
Babarina M.В., Sekinayeva A.V., Giniyatullina Y.N., Rozhinskaya L.Y.

Kallman syndrome develops as a result of impaired migration of neuronal (gonadotropin-releasing hormone) -producing cells from the medial olfactory zone of the brain into the preoptic nuclei of the hypothalamus. Currently, the connection between the development of olfactogenital dysplasia and a mutation of a gene located in the region of the p. 22.3 of the X chromosome has been proved.

Clinically, olfactogenital dysplasia in women is manifested by primary amenorrhea and, as a result, by primary infertility. On examination, a physique of the eunuchoid type can be detected, moderate development of the mammary glands is rarely observed. In men - hypoplastic testicles, eunuchoid appearance is formed by adolescence (high growth, prepubertal testicles, infantile penis, complete absence of secondary sexual characteristics). This article presents the own results of a patient with Kallman syndrome.

Problems of Endocrinology. 2006;52(1):26-27
Experimental endocrinology
Energy metabolic changes and nerve cell damage in rats exposed to multiple administration of large-dose insulin
Telushkin P.K., Nozdrachev A.D., Potapov P.P.

The brains of rats that had experienced 5-7 hypoglycemic comas on day 2 of the rehabilitative period after the last coma showed increases in the activity NAD-isocitrate dehydrogenase and in the catabolism of adenylonucleotides and decreases in the activities ofNADH dehydrogenase, mitochondrial NADP-isocitrate dehydrogenase, glucose-6-phosphate dehydrogenase, glutathione reductase, and superoxide dismutase, and no changes in the rate of glycolysis. Placing the brain slices in the hypoosmolar medium added by Fe2+ and ascorbate caused the higher yield oflactate dehydrogenase into the incubation medium. In this case, there was a significant elevation in the concentration ofmalonic dialdehyde in the brain slices from the experimental rats. The findings suggest that energy metabolic disturbances and activated lipid peroxidation are involved in the pathogenesis of postglycemic encephalopathy.

Problems of Endocrinology. 2006;52(1):28-31
Receptor mechanisms of action of sex hormones. Can the receptor work without a ligand?
Babichev V.N.

Among endocrinologists, it is generally accepted that most of the effects of steroid hormones are transmitted to the cell through their receptors located on intracellular sites, mainly on the nuclei of cells, and these mechanisms are intensively studied. A lot of information has been accumulated about the specific function of each hormone, changes of which were observed after removal of the gland and its hormonal compensation. The basis of the position of endocrinologists in this situation is the fact that the removal of the gland eliminates many physiological and behavioral responses depending on the secretory function in this gland. To restore a specific response, replacement therapy with the appropriate hormone is necessary. However, researchers are at a standstill when neurotransmitter or growth factors, acting through their own membrane receptors, are able to replace the effects of steroid hormones and activate steroid receptors through secondary messengers, even in the absence of steroid hormones.

Problems of Endocrinology. 2006;52(1):32-38
Aromatase: universal and complex enzymology
Yasinskaya I.M., Sumbayev V.V.

Cytochrome P-450 aromatase (cytochrome P-450 XIXA1, EC is a key enzyme of estrogen biosynthesis. This is the only enzyme that catalyzes the processes leading to aromatization of the first ring of the steroid nucleus, and, therefore, gives rise to estrogens - estrone, estradiol and estriol. Other estrogens - estriol, equiline and equilenine - are formed mainly by hydroxylation or dehydrogenation of estradiol, so aromatase can be considered the only enzyme that limits the formation of estrogen.

Problems of Endocrinology. 2006;52(1):39-47
Role of the renin-angiotensin system of the eye in the pathogenesis of diabetic retinopathy
Aznabayev M.Т., Altynbayev U.R., Serezhin I.N., Shamratova A.R.

Numerous experimental and clinical studies indicate the involvement of the renin-angiotensin system in the development and progression of diabetic organ pathology. ASD is the main biochemical mechanism by which vasomotor and angiogenic reactions are realized. It interacts closely with its antagonist, the kallikrein-kinin system. Both systems are a cascade of proteolytic reactions leading to the formation of vasoactive peptides of angiotensin II and bradykinin. These endogenous regulators have the opposite effect on hemodynamics and water-salt balance.

Problems of Endocrinology. 2006;52(1):47-49
Andrology (male health and reproductive dysfunction) edited by E. Nieschlang, H.M. Behre
Goncharov N.P.

The book organically and balanced presents almost all sections - physiology, pathophysiology, endocrinology, biochemistry - the reproductive system of the male body. This area of medicine is called "andrology". Together with the woman’s reproductive system, she formally and structurally forms a new area of reproductive medicine.

Problems of Endocrinology. 2006;52(1):50
Information on the Congress on Andrology

The 8th International Congress of Andrology was held in Seoul (South Korea) from June 12 to 16, 2005, in which about 450 scientists from all regions of the world participated. The next congress will be held in Barcelona (Spain). For the next 4 years, prof. A. Grootegoed (Netherlands) became the president. At the end of the congress, guidelines were made that are presented below by prof. N.P. Goncharov (Endocrinology Research Centre of RAMS).

Problems of Endocrinology. 2006;52(1):51-53
New uniform requirements for manuscripts formatting of submitted to the journal "Problems of Endocrinology" articles

The development by the editors of the journal "Problems of Endocrinology" of new requirements for the design of manuscripts is due to the desire to follow global trends in the development of evidence-based medicine. The requirements, which can be updated in the future, have been developed taking into account the “Uniform requirements for manuscripts submitted to biomedical journals” compiled by the International Committee of Medical Journal Editors (ECMJE).

Problems of Endocrinology. 2006;52(1):54-55

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