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Vol 66, No 1 (2020)

Editorial notice
Oncoendocrinology — the innovative interdisciplinary base for personalized medicine
Rumyantsev P.O.
Abstract

Oncoendocrinology is a new vector in personalized medicine based on the scientific and creative communication of endocrinologists, oncologists, morphologists, radiologists, geneticists, medical physicists, biologists, chemists, and mathematicians. A section «Oncoendocrinology» has been introduced in the Problems of Endocrinology journal by the editorial board. It is planned to publish reviews and original articles in the aforementioned scientific and applied fields. We invite all interested authors and readers to cooperation.

Problems of Endocrinology. 2020;66(1):4-6
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Endocrinology healthcare network and professional education
COVID-19 pandemic and endocrinopathies
Mokrysheva N.G., Galstyan G.R., Kirzhakov M.A., Eremkina A.K., Pigarova E.A., Melnichenko G.A.
Abstract

Many endocrinopathies have chronic course; patients with endocrinopathies (above all diabetes mellitus and thyroid diseases) who receive outpatient care on a regular basis amount up to 80% of patients with chronic diseases. Endocrinologists most likely play the role of general practitioners for these patients; therefore, they should quickly and efficiently explain the patients with diabetes, thyroid, hypophysis and adrenal diseases how to behave in new setting of COVID19 pandemic (coronavirus infection). The most severe course of the infection can be observed in patients older than 65 years with chronic diseases, especially endocrinopathies. This review sums up the currently available data on the disease pathogenesis and progression. It also provides information about patient responsibility to prevent infection, special aspects of communication between the patient and the physician in the setting of self-isolation and quarantine, additional care needed in case of COVID19 in patients with most severe endocrinopathies.

Problems of Endocrinology. 2020;66(1):7-13
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Pediatric Endocrinology
The efficacy of outpatient monitoring of children and adolescents with type 1 diabetes with regular use of professional continuous glucose monitoring
Peterkova V.A., Emelyanov A.O., Laptev D.N., Samoylova Y.G., Khramova E.B., Petriaikina E.E., Rybkina I.G., Filimonova A.Y.
Abstract

BACKGROUND: According to research, only 38% of patients reach glycated hemoglobin targets. It is possible to improve the effectiveness of medical care for children with T1D using modern technologies, including continuous glucose monitoring (CGM).

AIMS: To evaluate the effectiveness of outpatient monitoring of children and adolescents with T1D with regular use of professional continuous glucose monitoring.

METHODS: The inclusion criteria: age 8−12 years; T1D at least 1 year; insulin therapy by multiple injections of insulin; inadequate glycemic control of T1D: НbА level of 7.5% and higher and / or children and adolescents with frequent episodes of hypoglycemia (usually 4 times a week) or with a history of severe hypoglycemia; signed informed consent. All patients initially and 12 weeks after inclusion in the study conducted a study of the level of НbА, and also performed CGM for 6 days. Based on the results of CGM, glycemia indicators and daily doses of insulin were recorded, treatment was evaluated and corrected, and recommendations for self-monitoring were made. Glucose monitoring was carried 120−144 hours using the blind method iPro2 (Medtronic, USA).

RESULTS: In all, 99 children aged 8−18 years were included in the study in all centers. The decrease in the level of НbА by the end of the study was 0.72%, while the proportion of patients who reached the target level of НbА (defined as <7.5%) was statistically significantly higher at the end of the study (15.5% and 2%, respectively; p<0.05). During the study, patients showed a trend towards a decrease in the average level and variability of glycemia by the end of the study, however, statistical significance was achieved only in relation to the average level of glycemia (p=0.04). Conducted insulin therapy, determined by the average daily doses of long-acting and short-acting insulin, did not statistically significantly change at the end of the study. The frequency of DKA episodes and severe hypoglycemia did not statistically significantly differ from the initial level.

CONCLUSIONS: For children with poor glycemic control of T1D, the use of professional CGM is effective in terms of glycemic control and a safe method.

Problems of Endocrinology. 2020;66(1):14-22
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Bones & Adipose tissues diseases
Hereditary syndromal and nonsyndromal forms of primary hyperparathyroidism
Gorbacheva A.M., Eremkina A.K., Mokrysheva N.G.
Abstract

Primary hyperparathyroidism is a common disorder of mineral homeostasis, characterized by overproduction of parathyroid hormone and upper normal or elevated calcium levels due to hyperplasia or a tumor of parathyroid gland. 90−95% of cases of primary hyperparathyroidism are sporadic, while hereditary genetic forms occur in 5–10% of all cases. Primary hyperparathyroidism as the component of hereditary syndromes can present in various clinical forms (asymptomatic, symptomatic), can be associated with other endocrine or non-endocrine diseases, and require special approaches to treatment. Given that primary hyperparathyroidism is one of the most common components of these syndromes, it can be used as an important diagnostic tool in identifying affected families. This review is devoted to modern ideas about the clinical course and genetic characteristics of hereditary variants of primary hyperparathyroidism and the diagnostic and treatment algorithms recommended today. The review considers primary hyperparathyroidism as a component of hereditary syndromes including multiple endocrine neoplasias types 1, 2A and 4 and syndrome of hyperparathyroidism with a jaw tumor. Also non-syndromic hereditary forms are descripted, such as familial isolated hyperparathyroidism, familial hypocalciuric hypercalcemia, and severe neonatal primary hyperparathyroidism.

Problems of Endocrinology. 2020;66(1):23-34
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Carbohidrates metabolism disturbancies
Diabetes and COVID-19: analysis of the clinical outcomes according to the data of the russian diabetes registry
Shestakova M.V., Vikulova O.K., Isakov M.А., Dedov I.I.
Abstract

BACKGROUND: Data on the national level and worldwide show a higher rate of mortality in patients with diabetes mellitus (DM) due to COVID-19, which determines the high relevance of risk factor analysis for outcomes in DM patients to substantiate the strategy for this category of patients.

AIM: To assess the effect of clinical and demographic parameters (age, gender, body mass index (BMI), glycemic control (HbA1c), and antidiabetic and antihypertensive drugs, including ACE inhibitors and ARBs) on clinical outcomes (recovery or death) in patients with type 2 DM.

MATERIALS AND METHODS: A retrospective analysis of the Russian Register of Diabetes database was performed, including patients with type 2 DM (n=309) who suffered pneumonia/COVID-19 in the period from 01.02.2020 to 27.04.2020 and the indicated outcome of the disease (recovery or death)

RESULTS: The percentage of lethality was determined to be 15.2% (47 of 309 people). The degree of lethality was found to be significantly higher in males (OR=2.08; 95% CI 1.1–3.9; p=0.022) and in patients on insulin therapy (OR=2.67; 95% CI; 1.42–5.02; p=0.002), while it was significantly lower in patients with an age <65 years (OR=0.34; 95% CI 0.18–0.67; p=0.001) and in patients receiving metformin (OR=0.26; 95% CI 0.14–0,5; p<0.0001), antihypertensive therapy (OR=0.43; 95% CI 0.22–0.82; p=0.009), β-blockers (OR=0.26; 95% CI 0.08–0.86; p=0.018), diuretics (OR=0.4; 95% CI 0.17–0.93; p=0.028) and renin-angiotensin system blockers (ACE inhibitors or ARBs) (OR=0.36; 95% CI 0.18–0.74; p=0.004). A tendency to an increase in lethality at higher rates of HbA1c and BMI was present, but it did not reach a statistical significance. Differences between patients receiving insulin therapy and those who were not receiving the insulin therapy were observed as follows: a significantly longer duration of type 2 DM (13.4 vs. 6.8 years, respectively; p<0.0001), worse overall glyacemic control (HbA1c: 8.1% vs. 7.0%, resp.; p<0.0001), and three times more frequent failure to achieve the HbA1c goal by more than 2.5% (14.7% vs. 5.9%, resp.; p=0.04).

CONCLUSION: The identified risk factors for lethality in patients with type 2 DM indicate that good glycemic control and previous treatment with metformin and antihypertensive drugs (including RAS blockers) could reduce the frequency of deaths. In patients on insulin therapy, a higher lethality degree was associated with worse glycemic control.

Problems of Endocrinology. 2020;66(1):35-46
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The role of diabetes in the onset and development of endothelial dysfunction
Popyhova E.B., Stepanova T.V., Lagutina D.D., Kiriiazi T.S., Ivanov A.N.
Abstract

The vascular endothelium performs many functions. It is a key regulator of vascular homeostasis, maintains a balance between vasodilation and vasoconstriction, inhibition and stimulation of smooth muscle cell migration and proliferation, fibrinolysis and thrombosis, and is involved to regulation of platelet adhesion and aggregation. Endothelial dysfunction (ED) plays the critical role in pathogenesis of diabetes mellitus (DM) vascular complications. The purpose of this review was to consider the mechanisms leading to the occurrence of ED in DM. The paper discusses current literature data concerning the role of hyperglycemia, oxidative stress, advanced glycation end products in endothelial alteration. A separate section is devoted to the particularities of the functioning of the antioxidant system and their significance in the development of ED in DM. The analysis of the literature allows to conclude that pathological activation of glucose utilization pathways causes damage of endothelial cells, which is accompanied by disorders of all their basic functions. Metabolic disorders in DM cause a pronounced imbalance of free radical processes and antioxidant defense, accompanied by oxidative stress of endotheliocytes, which contributes to the progression of ED and the development of vascular complications. Many aspects of multicomponent regulatory reactions in the pathogenesis of the development of ED in DM have not been sufficiently studied.

Problems of Endocrinology. 2020;66(1):47-55
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Subclinical left ventricular dysfunction in patients with type 2 diabetes mellitus
Tsvetkov V.A., Krutikov E.S., Chistyakova S.I.
Abstract

BACKGROUND: Recent studies have shown a high prevalence of asymptomatic forms of heart failure in patients with type 2 diabetes mellitus. The presence of even subclinical forms of heart failure in type 2 DM is associated with a negative prognosis of the disease, leading to a significant increase in the frequency of hospitalizations and mortality.

AIMS: Identification of left ventricle subclinical dysfunction in terms of its diastolic function, deformation parameters and rotational properties of the myocardium in patients with type 2 diabetes.

METHODS: A prospective case-control single-center study, performed simultaneously in groups of patients with type 2 diabetes and hypertension. To identify left ventricular dysfunction (LV), an echocardiographic study was performed, including tissue dopplerography and Speckle Tracking Echocardiography in 2D and 3D modes.

RESULTS: We examined four groups of patients comparable in age and sex distribution, with no obvious clinical signs of heart failure. Group I comprised 56 patients with type 2 diabetes and moderate hypertension. Group II included 52 patients with type 2 diabetes without an increase of blood pressure. Group III (54 people) consisted of patients with essential II degree hypertension without diabetes. Group IV (control) — 30 healthy individuals. The use of tissue dopplerography and Speckle Tracking Echocardiography allows more often (p<0.05) to detect signs of LV dysfunction in patients with type 2 diabetes compared with routine echocardiography methods. It was found that in patients with a combination of type 2 diabetes and moderate hypertension, a prognostically unfavorable restrictive variant of diastolic dysfunction is more common (p<0.05) in contrast to patients with diabetes without hypertension or those with hypertension without diabetes. The combination of type 2 diabetes and hypertension to a greater extent leads to an increase in the longitudinal global deformation of the left ventricle compared with patients who had only one of these diseases (p<0.05). A decrease in the global area strain, an early marker of LV systolic dysfunction, was expressed (p<0.05) in patients with type 2 diabetes, regardless of the presence of concomitant hypertension.

CONCLUSIONS: This study shows the importance of using tissue dopplerography and Speckle Tracking Echocardiography in the diagnosis of subclinical heart failure. The results indicate a high prevalence of subclinical systolic-diastolic LV dysfunction in type 2 diabetes, which is aggravated in the presence of concomitant hypertension in patients without obvious clinical signs of heart failure and other cardiovascular diseases.

Problems of Endocrinology. 2020;66(1):56-63
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Clinical endocrinology
Allgrove syndrome: how to suspect the problem? Endocrinologists experience
Volkova N.I., Davidenko I.Y., Reshetnikov I.B., Brovkina S.S.
Abstract

Allgrove syndrome (Alacrimia, Achalasia, Adrenal insufficiency, AAAS) is a rare autosomal recessive multisystem disease characterized by chronic adrenal insufficiency, alacrimia and achalasia of the cardia. This disease is often associated with various neurological disorders, amyotrophy, in such cases, it is named 4A and 5A syndrome, but sometimes there is also 2A syndrom. The occurrence of the disease is due to a mutation in the gene AAAS (12q13), which encodes the protein ALADIN. Here is a clinical observation of a patient with Allgrove syndrome. The patient had a typical clinic: alacrimia, achalasia, adrenal insufficiency, convulsive syndrome. However, a neurological disorder, manifested by convulsive syndrome, passed with time. Despite the full clinical picture, the diagnosis was made only after 14 years. Allgrove syndrome was verified through genetic analysis revealed a pathogenic mutation c.43C>T gene AAAS. Progression of the severity of alacrimia and need of glucocorticoids over time was noted. We shown the difficulty of diagnosis is due to the lack of awareness of clinicians about the disease, the importance of interdisciplinary interaction, as well as the need for follow-up of such patients.

Problems of Endocrinology. 2020;66(1):64-69
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The rules for predicting remission in patients with Cushing disease after successful endoscopic transnasal adenomectomy
Nadezhdina E.Y., Rebrova O.Y., Grigoriev A.Y.
Abstract

BACKGROUND: The recurrence rate after successful transnasal adenomectomy in Cushing’s disease (CD) can reach 47%. We have previously shown that patients with ACTH levels less than 7 pg/ml recurred over 3 years 4.5 times less often than patients with higher levels of ACTH, patients with cortisol levels below 123 nmol/l — in 3.4 times less than at higher values of this hormone, however, these indicators are dissociated in 41% of cases, so it is not possible use them for prediction separately.

AIM: To develop a method for managing patients after successful transnasal adenomectomy depending on prognosis.

METHODS: A monocenter retrospective comparative study included 349 patients (52 men, 297 women) with a confirmed diagnosis of CD, who underwent effective endoscopic transsphenoidal adenomectomy in 2007−2014. Various combinations of postoperative morning levels of ACTH and cortisol were analyzed.

RESULTS: Based on the developed forecasting methods and their best characteristics, the following rules were formulated. If postoperative morning ACTH is less than 7 pg/ml and/or postoperative morning cortisol is less than 123 nmol/l, then the patient will remain in remission for 1 year with probability of 99% (95% CI 97%–100%) and for 3 years with probability of 86% (95% CI 80%–91%).

CONCLUSION: The rules for predicting remission for 1 and 3 years for patients after neurosurgical treatment for CD are proposed. These rules are based on combinations of ACTH and cortisol levels.

Problems of Endocrinology. 2020;66(1):70-77
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Endomorphins: structure, localization, immunoregulatory activity
Gein S.V., Baeva T.A.
Abstract

Endomorphins – endogenous tetrapeptides with the highest affinity for the µ-opioid receptor. Currently, two tetrapeptides that differ in one amino acid residue have been isolated and characterized. The structure of endomorphins differs from the structure of members of three main families of opioid peptides: endorphins, enkephalins, and dynorphins, which contain the same N-terminal sequence. In the central nervous system, endomorphins are distributed everywhere, where they are primarily responsible for antinociception. Distribution of endomorphins in the immune system, similar to that of other opioid peptides, has allowed to suggest their active participation in the processes of immune regulation. This review summarizes modern views on the structure of endomorphins, their localization, possible intracellular mechanisms of signal transmission and their effects on the processes of activation, proliferation and differentiation of cells of innate and adaptive immunity. Endomorphins actively modulate the functions of the cells of the immune system. Peptides predominantly suppress adaptive immunity reactions. There effects on the functions of innate immunity cells (granulocytes, macrophages, monocytes, dendritic cells) depending on the conditions and can have either an inhibitory or stimulating orientation. Thus, endomorphins can be promising compounds that can effectively regulate both nociceptive signals and processes in the immune system.

Problems of Endocrinology. 2020;66(1):78-86
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Epidemiology and results of surgical treatment of euthyroid and toxic goiter depending on the peculiarities of clinical course, tracheal compression and comorbidity
Ilyicheva E.A., Bersenev G.A., Makhutov V.N., Aldaranov G.Y., Grigoryev E.G.
Abstract

BACKGROUND: At the time of seeking medical help, some patients have nodular/multinodular goiter of large and gigantic sizes, which leads to compression of the neck organs. In the structure of benign diseases, neck compression is diagnosed in 10% of cases, and tracheal narrowing is found in 84% of patients in this group. It was experimentally established that narrowing of the trachea leads to the development of hypertension in the pulmonary circulation. Patients with nodular/multinodular goiter with compression of the neck organs belong to the age group of 50 years and older, the peculiarity of which is comorbidity of varying severity. Cardiopulmonary syndromes may mask compression of the organs of the neck by the thyroid gland. As a rule, patients come and/or go to a cardiologist, pulmonologist, gastroenterologist and other specialists, as a result of which the timelines for timely surgical treatment are missed. Often, patients are delivered to the endocrine surgeon urgently due to the development of asphyxiation. The symptoms of impaired external respiration and the initial manifestations of pulmonary hypertension, as a result of compression syndrome, preceding this condition are evaluated only retrospectively.

AIMS: To study the frequency of tracheal compression and symptoms of chronic hypoxia in the structure of benign thyroid diseases requiring surgical treatment, as well as an assessment of the nature of comorbid pathology and the results of surgical treatment.

METHODS: A retrospective analysis of the results of surgical treatment of benign thyroid diseases for the period from March to August 2019 was carried out (100 observations).

RESULTS: Toxic goiter prevailed in the structure of benign thyroid diseases (74%). Tracheal compression was observed in 69% of cases. When trachea was compressed, arterial hypertension statistically significantly prevailed (χ2, p≤0.01). The appearance of «wheezing» on inhalation/exhalation and an increase in its frequency were detected when the trachea narrowed to the thyroid gland to 10 mm or less in 10 cases (10%) with a statistically significant prevalence of pulmonary hypertension (χ2, p≤0.01). Thyroidectomy prevailed in the structure of operations (80%). There was no statistically significant increase in surgical complications depending on the severity of tracheal compression, age, and concomitant pathology. There were no fatal outcomes.

CONCLUSIONS: Surgical treatment of patients with benign thyroid diseases complicated by compression of the neck organs is also shown safely regardless of age and associated pathology.

Problems of Endocrinology. 2020;66(1):87-92
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Epidemiology, clinical manifestations and efficiency of different methods of treatment of acromegaly according to the United Russian Registry of Patients with Pituitary Tumors
Belaya Z.E., Golounina O.O., Rozhinskaya L.Y., Melnichenko G.A., Isakov M.А., Lutsenko A.S., Alekseeva T., Zenkova T.S., Przhiyalkovskaya E.G., Panyushkina G.M., Ilukhina O.B., Ivanova E.I., Krishtal E.A., Vachygova A.A., Pigarova E.A., Dzeranova L.K., Marova E.I., Arapova S.D., Mamedova E.O., Grebennikova T.A., Antsiferov M.B., Dreval A.V., Dedov I.I.
Abstract

BACKGROUND: The registry is the main source of information about patients with acromegaly for assessing the quality of medical care, effectiveness of treatment, determining the compliance of real clinical practice with existing standards and patient management protocols.

AIMS: To evaluate epidemiological, demographic and clinical characteristics of acromegaly in Russian Federation and effectiveness of treatment modalities.

MATERIALS AND METHODS: The object of the study was the database of the united Russian registry of patients with pituitary tumors with specific analysis of patients with acromegaly only. We analyzed the data of 4114 patients with acromegaly stored on the online system in February 2019.

RESULTS: Based on the data 32% of patients had complete clinical and laboratory remission of acromegaly; the percentage of patients with no remission was 68%, among them 22.5% had significant improvements in clinical symptoms and a decrease in growth hormone (GH) and insulin-like growth factor-1 (IGF-1) without IGF-1 normalization. The average age of patients at the onset of the disease was 42.7 years and at diagnosis – 45.8 years. The ratio of men to women was 1:2.6. In patients with acromegaly hypopituitarism was registered in 14.7% of cases and among them hypothyroidism (66%) and hypogonadism (52%) were registered more often. Among other complications the leading were diabetes mellitus (15.7%) and acromegalic arthropathy (15%). The proportion of patients receiving neurosurgical treatment increased from 35.7% to 49.6% in 2012–2019; the portion of patients undergoing radiation therapy decreased significantly from 17.7% in 2012 to 0.8% in 2019. Remission was achieved in 40.47% after neurosurgery and 28.95% after medical treatment as a first line therapy p<0.01. The number of patients receiving medical treatment at the time of the study was 1209. Among them 51% of patients treated with long-acting lanreotide and 24% receiving long-acting octreotide achieved remission (p<0.0001)

CONCLUSIONS: The remission rate of acromegaly remains suboptimal despite increased surgical activity, which corresponds to global trends. Long-acting lanreotide was significantly superior versus long-acting octreotide in the rate of acromegaly remission, which does not correspond with clinical trials.

Problems of Endocrinology. 2020;66(1):93-103
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Reproductive Endocrinology
Peculiarity of recovery of the hypothalamic-pituitary-gonadal (hpg) axis, in men after using androgenic anabolic steroids
Lykhonosov M.P., Babenko A.Y., Makarin V.A., Fedotov Y.N.
Abstract

BACKGROUND: Spontaneous recovery of the hypothalamic–pituitary–gonadal (HPG) axis after cessation of testosterone replacement therapy or after male contraception may take up to 24 months. There is insufficient data on the duration of recovery of HPG axis after abuse of androgenic anabolic steroids (AAS). AAS users use post-cycle therapy (PCT) to restore HPG axis, the effectiveness of which is unknown and needs further investigation.

AIMS: To evaluate the recovery of HPG axis in men, AAS users, after a 3-month of cessation of their use and after PCT.

METHODS: An observational, single-center, prospective, sampling, open, uncontrolled study was conducted among male AAS users. While using of AAS and 3 months after the refusal of their administration and PCT, the clinical symptoms of hypogonadism were evaluated, luteinizing hormone (LH), follicle-stimulating hormone (FSH), total testosterone (Tt), prolactin, estradiol, inhibin B, thyroid-stimulating hormone (TSH) were determined. The scheme of rehabilitation therapy was the same and did not change throughout the study. Recovery criteria: Tt >3.4 ng/ml and LH >1.24 mIU/ml. The study was conducted from January to August 2019. Fisher’s exact test, Mann-Whitney U-test, and Spearman’s rank correlation coefficient were used. The differences were considered statistically significant at p<0.05.

RESULTS: The study included 44 men, their age 29 years [27.75; 34], the duration of the use of AAS is 6 months [3.52; 7]. During the use of AAS: LH 0.2 mIU/ml [0.04; 0.47], Tt — 4.34 ng/ml [1.05; 8.81]. In this group, the number of men with a LH level <1.24 mIU / ml was 84% (n=37) and Tt <3.4 ng/ml was 47.7% (n=21). After 3 months, the LH level reached 4.12 mIU/ml [2.58; 5.84], Tt — 4.55 ng/ml [3.76; 6.24]. At the same time, the level of Tt <3.4 ng/ml remained in 20.5% (n=9), and LH <1.24 mIU/ml in 4.5% (n=2) men. According to the level of recovery of LH and Tt, patients were divided into two groups: with satisfying (n=35; 79.5%) and poor (n=9; 20.5%) recovery. A clear correlation was established between the duration of use (-0.857; p<0.0001), the amount (-0.443; p=0.003), the dose (-0.7825; p<0.0001), the type of AAS (-0.698; p<0.0001) and testosterone level recovery. A correlation between inhibin B and Tt (0.418; p=0.005) was revealed.

CONCLUSIONS: A three-month refusal to use AAS with PCT led to the restoration of HPG axis a in 79.5% of the volunteers. In 20.5% of cases, recovery did not occur. The negative effect of the duration of use, the number of simultaneously administered drugs, their dose and type of AAS on the restoration of HPG axis was established. The level of inhibin B may serve as a marker for the restoration of spermatogenic epithelium.

Problems of Endocrinology. 2020;66(1):104-112
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Anniversary
On the occasion of the anniversary of Nikolay P. Goncharov
 
Abstract

In January 2020, the famous scientist biochemist-endocrinologist, MD, professor Nikolay P. Goncharov turned 85 years old. Nikolay P. Goncharov — one of the leading experts in the field of biochemical endocrinology and hormonal analysis; he developed and introduced in the framework of the Human Reproduction program an experimental model for evaluating the pharmacokinetics, mechanism of action, efficacy and safety of new steroid drugs and regulators of endocrine secretion of steroid hormones. The editorial board of the journal “Problems of Endocrinology” congratulates NP Goncharov on his anniversary, wishes him good health, success, prosperity, vitality, fortitude and many more years of fruitful activity.

Problems of Endocrinology. 2020;66(1):113-114
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Short Messages
Corrigendum: hypoglycemic syndrome in patients with monoclonal gammopathy [problems of endocrinology 2020;65(6) doi: 10.14341/probl12266]
 
Abstract

The article «Hypoglycemic syndrome in patients with monoclonal gammopathy» published by Solovyev MV, Yukina MY, Troshina EA in Problems of Endocrinology 2020;65(6) (doi: 10.14341/probl12266) contains wrong data in «Conflict of interests» section. Correct information is: «Manuscript preparation and publication was supported by the Russian Science Foundation (project No. 17-75-30035).

The information given in the article about the sources of funding should not have any significant effect on the perception of information by readers and / or interpretation of the data presented. The authors regret the incorrect information in a previously published article.

Problems of Endocrinology. 2020;66(1):115-115
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