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Vol 48, No 3 (2002)

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Discussion
Autoimmune thyroiditis: diagnosis and treatment (Discussion of the paper by V. V. Fadeev, G. A. Melnichenko, G. A. Gerasimov "Autoimmune Thyroiditis: First Step to Consensus")
Kasatkina E.P.
Abstract

Discussion about the article by V. V. Fadeev, G. A. Melnichenko, G. A. Gerasimov "Autoimmune thyroiditis: the first step to consensus" is published.

Problems of Endocrinology. 2002;48(3):3-6
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Clinical endocrinology
Role of antipituitary antibodies in the pathogenesis of hyperprolactinemia
Ilovaiskaya I.A., Kryukova I.V., Keda Y.M., Makarovskaya Y.Y., Kandror V.I., Marova Y.I.
Abstract

For evaluating the probable role of autoimmune disorders in the pathogenesis of hyperprolactinemia, humoral immunity parameters (antibodies to surface antigens of adenohypophysis cells - ASAG - and to prolactin - Prl) were studied in 26patients with idiopathic hyperprolactinemia (group 1), 32 with prolactinomas (group 2), and 12 pregnant women with physiological hyperprolactinemia (group 3). Using rat adenohypophysis and human prolactinoma cells, respectively, ASAG were detected in 38.5- 76.9% patients in group 1, IS. 7-29% in group 2, and in none of the women in group 3. The predominance of ASAG-positive patients in the idiopathic hyperprolactinemia group in comparison with prolactinoma patients was statistically significant (p < 0.001). Using lactotrophs instead of rat adenohypophysis cells, ASAG were also detected significantly more often in the patients with idiopathic hyperprolactinemia (p = 0.11). The presence of antibodies to Prl in the overwhelming majority of patients did not coincide with the presence of ASAG, which means that ASAG and autoantibodies to Prl are different antibody types. The presence of antibodies to surface lactotroph antigens detected in many patients of group 1 suggests that autoimmune disorders can be one of the causes of idiopathic hyperprolactinemia.

Problems of Endocrinology. 2002;48(3):6-9
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Prolactin-secretory function of the pituitary after hypotonic hemorrhage and lactation
Khashaeva T.K., Arslanbekova A.A., Omarov N.S., Abusueva Z.A.
Abstract

Relationship between blood loss in labor and pituitary prolactin secretory function was studied in 157 puerperants, 51 of these with blood loss of 0.5-0.7% body weight (group 1), 49 with blood loss of 0.71-1.2% b. w. (group 2), 27 with massive blood loss of more than 1.2% b. w. (group 3), and 30 healthy puerperae with normal blood loss (controls).

The results indicate that the higher was blood loss, the more marked was drop in the blood prolactin level. Hypoprolactinemia led to a decrease in breast milk volume. The incidence of hypogalactia was 37.3% in group 1, 67.3% in group 2, and 88.9% in group 3.

Adequate infusion therapy in the postpartum period, aimed at restoration of circulating blood volume, had a favorable impact on prolactin secretion. When circulating blood volume was not restored completely, a decrease in the breast milk volume was observed in parallel with a decrease in the serum prolactin concentration.

Hence, the pituitary prolactin secretory function deteriorates after severe blood loss in labor; adequate infusion therapy prevents the risk of hypogalactia.

Problems of Endocrinology. 2002;48(3):10-13
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Antithyroid autoimmune reactions and hyperprolactinemia in children and adolescents with allergic diseases
Shilin D.Y., Tsvetkova N.I., Gorokhova N.A., Bebisheva N.I.
Abstract

Endocrine status of 33 children suffering from allergic diseases (AD) was studied in order to detect the relationship between AD and autoimmune endocrinopathies and the probable effects of antihistaminic drugs on thyroid function and prolactin secretion. The group included 5 children with asthma, 8 with allergic dermatitis, 2 with allergic rhinitis, and 1 with relapsing angioneurotic edema. Asthma was concomitant with other allergic diseases in 17 children. Endocrinological study included evaluation of the thyroid morphology and function and two measurements of basal prolactin levels. 73% children with AD had a family history of autoimmune endocrinopathies. Autoimmune thyroiditis (AIT) predominated (30.3%) among thyroid diseases in the examined group. Diffuse endemic goiter was detected in 9.1% patients with AD. A combination of two and more AD and long allergic history were the most unfavorable factors promoting the development of AIT. Therapy for AD virtually did not influence the course of autoimmune endocrinopathy. Long therapy with H1 histamine receptor blockers led to a 4.8 times increase in the incidence of hyperprolactinemia (HPRL). HPRL was associated with subclinical hypothyrosis in all cases and did not require dopaminomimetic therapy.

Problems of Endocrinology. 2002;48(3):13-18
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Results of long observation of patients with moderate hyperprolactinemia
Melnichenko G.A., Marova Y.I., Romantsova T.I., Chernogolov V.A., Ilovaiskaya I.A.
Abstract

Effect of long (2-15 years) hyperprolactinemia (up to 100 ng/ml) on the reproductive status was studied in 40 female patients with pituitary microadenomas and 40 patients with idiopathic hyperprolactinemia. Adenopituitary status and efficiency of dopamine agonists were evaluated. Clinical manifestations of the disease did not deteriorate, prolactin level did not notably increase and (or) there were no negative changes in the sella turcica status during long observation. Patients with moderate hyperprolactinemia were less sensitive to dopaminomimetics in comparison with patients with hyperprolactinemia of more than 100 ng/ml, irrespective of pituitary microadenoma. On the other hand, in about half of all patients (irrespective of pituitary microadenoma) the menstrual cycle and fertility spontaneously recovered without drug therapy. Therapy with dopamine agonists is indicated for patients with moderate hyperprolactinemia with amenorrhea and/or sterility. Other patients with this condition should be regularly examined.

Problems of Endocrinology. 2002;48(3):18-22
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Magnetic resonance tomography of the pituitary in healthy women of reproductive age
Dedov I.I., Vorontsov A.V., Novolodskaya Y.V.
Abstract

The results of MR tomography of the pituitary in 294 healthy women are evaluated. The size, shape, structure, and variants of the pituitary are analyzed and the diagnostic and informative value of MR tomograms in different projections are assessed. Magnetic imaging was carried out on a Siemens Magnetom Impact MR tomographer with magnetic field tension of 1 T. MR tomography in three projections of 2 mm sections in Tl-SE and T2-SE modes provides the optimal information about the pituitary and parasellar structures. The size, shape, and structure of the pituitary in healthy women of reproductive age vary within a wide range, which should be borne in mind when interpreting the data of MR tomography. The maximum vertical size in women aged 21-40 years is no more than 9 mm. The so-called indirect signs of pituitary microadenoma in various combinations are often detected in healthy women, and hence, their presence cannot serve as the only reason for the diagnosis.

Problems of Endocrinology. 2002;48(3):22-26
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Orlistat therapy of young patients with hypothalamic obesity
Starkova N.T., Malygina Y.V., Murakhovskaya Y.V., Starostina Y.G., Polenova M.A.
Abstract

Thirty patients with hypothalamic obesity (HO) aged 18-29years were examined in order to evaluate the effect of orlistat on body weight and hormonal metabolic disorders and the tolerance of this agent in patients with HO. The duration of orlistat therapy was 6 months; the treatment was paralleled by low-caloric diet. Anthropometric parameters, arterial pressure, carbohydrate and lipid metabolism values, and insulin resistance index were evaluated initially and after 1, 3, and 6 months of treatment. Positive changes in arterial pressure and all anthropometric parameters, including those characterizing abdominal obesity, normalization of basal insulinemia, decrease of stimulated insulinemia, increase of insulin resistance, improvement of lipid spectrum of the blood with leveling of atherogenic shifts were observed during the treatment. Hence, the results demonstrated high efficiency of orlistat therapy in patients with HO.

 

Problems of Endocrinology. 2002;48(3):27-30
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Insulin secretion and insulin resistance: two sides of one medal
Ametov A.S.
Abstract

Diabetes mellitus is a serious medical and social problem, which is due to its high prevalence, a continuing upward trend in the number of patients, a chronic course that determines the cumulative nature of the disease, high disability of patients, and the need to create a specialized care system.

Problems of Endocrinology. 2002;48(3):31-37
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For practitioners
Clinical interpretation of testicular dysfunction
Ustinkina T.I.
Abstract

The article is devoted to clinical interpretation of testicular dysfunction.

Problems of Endocrinology. 2002;48(3):37-39
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Case Reports
Lethal outcome in hypothyroid coma
Balabolkin M.I., Petunina N.A., Levitskaya Z.I., Khasanova E.R.
Abstract

The article is devoted to lethal outcome in hypothyroid coma.

Problems of Endocrinology. 2002;48(3):40-42
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Experimental endocrinology
Hormonal characteristics of new modified estrogen 11α -hydroxyderivatives
Ivanenko T.I., Pluzhnikova G.N., Fedotov V.P.
Abstract

Antiestrogen activity in new 11α-hydroxy derivative estrogens was eval­uated. Estron and ethynylestradiol 11α-formoxy- and acetoderivatives and 11α-nitroxy- 17β-acetate ethynylestradiol showed pronounced anti­estrogen activity; for example, the antiactivity of the latter agent was 40- 55%, depending on its dose. These estrogens 11α-hydroxyderivatives and estradiol 11α-formiate showed no antiestrogen activity. Insertion of the cytotoxic group into the 3rd position of estron and ethynylestradiol 11α- formoxy- and acetoderivatives potentiated their antiestrogen activity. Study of these compounds on transplanted and induced tumors in mice and rats showed their higher antitumorous effects in comparison with tamoxiphene. Estron, estradiol, and ethynylestradiol 11α-formoxy- and 11α-acetoderivatives without cytotoxic group were inactive estrogens.

Problems of Endocrinology. 2002;48(3):42-43
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Effects of second-generation sulfanilamides on the activity of ATP-dependent K+-channels of pancreatic β-cells
Babichev V.N.
Abstract

The activity of ATP-dependent K+-channels of intact pancreatic β-cells and functionally weak β-cells after streptosotocin treatment is analyzed and the reaction of these channels to sulfonyl drugs (glybenclamide, glypiside, and glyclaside) is evaluated. The ionic channels specifically reacted to glucose and sulfonyl drugs. Analysis of the time course of electrophysiological processes in the channels showed a shorter duration of a discharge and a longer interval between discharges, which decelerated insulin secretion starting from the moment of glucose or sulfonyl treatment till exotocytosis of insulin quantum. Glybenclamide was the most effective of the tested drugs as regards secretory activity under experimental conditions.

Problems of Endocrinology. 2002;48(3):44-46
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Data presentation in original papers and their statistical processing
Fadeev V.V.
Abstract

The article is intended to discuss the most typical data presentation errors that are constantly encountered in scientific editing.

Problems of Endocrinology. 2002;48(3):47-48
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