A new clinically suitable method has been developed to calculate the rate of blood glucose elimination and hepatic glucose production (HGP) by the results of intravenous glucose tolerance test (IGTT). A subpopulation of non-diabetic persons was identified in whom substantially increased HGP is compensated for high blood glucose elimination, which prevents the development of hyperglycemia in them. This abnormality is designated impaired glucose balance and may be referred to as an early prehyperglycemic stage of diabetes (prediabetes). The results of IGTT analysis correlate with the types of diabetes mellitus and the degree of carbohydrate metabolic disturbance, which allows one to recommend the proposed method for diagnosing diabetes and its types and assessing the degree of metabolic disturbances in diabetes. Four types of glucose imbalance may be identified from the ratio of the degree of impaired HGP to glucose elimination. As a result, a combination of 2 types of diabetes mellitus and 4 types of glucose imbalance makes it possible to divide the population of diabetes mellitus into 7 subgroups (subtypes), which may be subsequently of importance in optimizing sugar-reducing therapy. A computer program has been developed, which automatically calculates the glucose kinetics in IGTT according to the tatter's results and which is free available in the Internet at www.diabet.ru/Dreval/ivgtt_eng.exe .

The study was undertaken to assess the functional activity of the classical and alternative pathways of complement activation in type 2 diabetes mellitus (DM-2) at late stages of the disease. For this purpose, the total hemolytic activity of the classical and alternative pathways of complement activation and the hemolytic activities of the complement components C1, C2, C3, and C4 were determined in the blood of patients with DM-2 and healthy individuals. According to the data obtained, patients with DM-2 at late stages of the disease have statistically significant increases in both the total hemolylical activity of the classical pathway of complement activation (by 1.5 times; p < 0 01; t = 2.54) and the hemolytic activities of individual complement components - C1 and C3 by 2.2 times (t - 2.05;p < 0 046 and t = 3.9; p < 0 0004, respectively) and C4 by 1.8 times (t - 2.05; p < 0.046) whereas the total hemolytic activity of the alternative pathway and the hemolytic activity of the complement component C2 remain in the normal range (p > 0 5). The findings suggest that the alternative pathway of complement activation is most likely to make no contribution to the activation of C3-convertase and the subsequent generation of C3d, and the further formation of the cytolytic and membrane-attacking complex

The autonomic nervous system and the adaptive mechanisms associated with neuroautonomic cardiac rhythm regulation were studied in obese children. The study covered 187 untreated children aged 6-16 years who had exogenous constitutional (n = 68), diencephalic (n = 20) obesity and hypothalamic puberty syndrome (n = 99). The study was conducted by computer-aided (statistic, spectral) analysis of cardiac rhythm variability. The regulatory system activity index was calculated to assess the tension of adaptive mechanisms. The results were compared with those obtained in 107 apparently healthy children matched by gender and age. The enhanced activity of subcortical nerve centers with a predominance of sympathetic effects was observed in 38.7% of children with puberty obesity. The state of adaptive processes was regarded as a pronounced functional strain, overstrain, and exhaustion of regulatory systems in 31.1% of 6-10-year-old children and 29.5% of 11-16-year-old ones with obesity.

The medical community of our country is extremely concerned about the significant deterioration in the state of health, the decline in the intellectual potential of the population and the low birth rate in Russia. Of course, this circumstance cannot but affect the social and spiritual development of society and the state of the demographic situation in the country. As a rule, the deterioration in health is explained by the decline in recent decades, the social level and quality of life of a significant segment of the population of our country. One cannot disagree with this. At the same time, it should be recognized that in the same years in Russia the situation with endemic goiter sharply worsened: almost the entire territory of the country is currently endemic for goiter.

Adequate iodine prophylaxis in women living in an iodine-deficiency region, startingfrom early pregnancy, positively affects its course and in their babies' neonatal period, somatic and psychoneurological status (increased the mean neuropsychological status by 4-5 scores, by Improving the parameters of cognitive functions). This necessitates the use of potassium iodine agents in a dose of at least 200 fig/day, as recommended by the WHO (2001), in all early pregnancy women living in an iodine-deficient region.

The high prevalence of obesity in children is one of the factors contributing to an increase in the frequency of development of the metabolic syndrome and related diseases. A key role in the development of the metabolic syndrome in both children and adults is played by insulin resistance - a violation of the biological effect of insulin and the reaction of insulin-sensitive tissues to it at the pre-, post- and receptor levels.

Deficiency of 17α-hydroxylase is a rare variant of congenital adrenal cortical dysfunction. The defect was first described by E. Biglieri et al. in 1966 in patients with sexual infantilism, pronounced excess mineralocorticoids with salt retention and arterial hypertension.

Currently, several variants of the nonclassical course of the disease are described (with an increased level of aldosterone and without the development of hypertension and hypokalemia), the pathophysiological mechanism of which could not be explained. Cases of isolated deficiency of 17,20-lyase activity associated with mutations of R347H and R358Q in the CYP17 gene are also described.

Here is the observation of a patient with a new mutation in the CYP17 gene with 17α-hydroxylase/17,20-lyase deficiency.

Primary chronic adrenal insufficiency is a relatively rare disease. To date, according to various authors, the prevalence of Primary chronic adrenal insufficiency in the world varies significantly.

The celebrated endocrinologist Alexander Ametov, doctor of medical sciences, professor, head of the department of endocrinology and diabetology of the Russian Medical Academy of Postgraduate Education, is 65 years old.

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