Vol 56, No 6 (2010)

Expression of the adiponectin gene (ADIPOQ) in the subcutaneous and visceral fatty tissues and the serum adiponectin level in children
Kosygina A.V., Sosunov V.V., Peterkova V.A., Dedov I.I.
Abstract
The primary objective of the present work was to study specific features of adiponectin gene (ADIPOQ) expression in the subcutaneous and visceral fatty tissues along with the serum adiponectin level in children. The secondary objective was to elucidate the relationship between these variables and the basic anthropometric characteristics. The study included a total of 62 patients (31 boys and 31 girls at the age from 2.5 to 18 (median 13.6 (8.5-15.1) years] after they underwent planned surgical interventions. The expression of the adiponectin gene ADIPOQ was determined in paired samples of adipose tissue using the polymerase chain reaction in the real time; in addition, the serum adiponectin levels were measured. The expression of the adiponectin gene ADIPOQ was shown to be unrelated either to the age or to the sex of the children. Nor was there any significant difference between its expression in the subcutaneous and visceral tissues. The highest expression of mRNA encoding for adiponectin was recorded in the children at the Tanner stages 2-3 of sexual development. The ADIPOQ gene expression in the subcutaneous and visceral tissues of overweight children was 22% and 22.6% higher respectively than in the same tissues of normal weight children. Gene expression in the subcutaneous adipose tissue negatively correlated with the serum adiponectin level ( R = –0.38, p = 0.002), BMI SD (R = –0.35, p = 0.004 ), and the waist circumference (R = –0.36, p = 0.004). The results of the study suggest the necessity of further studies to clarify the pathophysiological role of adiponectin in the development of obesity and the related metabolic disturbances.
Problems of Endocrinology. 2010;56(6):3-8
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Comparison of different reference tables and threshold values of body mass indices for the estimation of the prevalence of overweight, underweight, and obesity in schoolchildren
Vaĭnilovich E.G., Danilova L.I., Sretenskaia Z.L., Zapol'skiĭ S.A.
Abstract
The objective of the present work was to compare the prevalence of overweight, underweight, and obesity in 725 children and adolescents residing in the city of Minsk based on a variety of reference tables and criteria for body mass index ( BMI ). It was shown that the prevalence of overweight (including obesity) in the total group varied from 17.3% (Centre for disease Control and Prevention, CDC) to 25.6% (France) and that of obesity from 3.9% (International Obesity Task Force, IOTF) to 13.8% (France). The prevalence of underweight was estimated at 2.6% to 8.4% (WHO SD and IOFT respectively). There was an excellent agreement between the data of the BMI percentile tables constructed at Grodno, Republic of Belarus (2000) and WHO (2007). The study has demonstrated the high prevalence of overweight in Belorussian schoolchildren whatever type of reference BMI tables is used whereas the prevalence of obesity and underweight varies considerably depending on the BMI criteria employed for its estimation.
Problems of Endocrinology. 2010;56(6):9-13
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The efficacy and safety of recombinant growth hormone in children with idiopathic short stature (two-year experience)
Shandin A.N., Nagaeva E.V., Peterkova V.A., Dedov I.I.
Abstract
This study was designed to evaluate the efficacy and safety of the treatment of children with idiopathic short stature using recombinant growth hormone (rGH); in addition, the factors influencing its therapeutic efficiency were analysed. A total of 93 patients aging from 3 to 12 years were available for the observation. They were divided into three groups. The children in group 1 (n=38 ) were given rGH at a dose of 0.033 mg/kg/24 hours and in group 2 (n=18 ) at 0.05 mg/kg/24 hr; the control group 3 was comprised of 37 children. The duration of therapy was 6 months in 56 children, 12 months in 41, 18 months in 24, and 24 months in 18 children. The end points of the study were bone age variations; dynamics of insulin-like growth factor-1 levels; characteristics of carbohydrate, lipid, and phosphorus-calcium metabolism; hepatic, renal, and thyroid function. The growth rate within the first year after the onset of the treatment increased from 4.5±1.2 to 7.9±1.5 cm/year in group 1 (0.033 mg/kg/24 hours) and from 9.1±1.5 cm/year in group 2 (0.05 mg/kg/24 hr). In the second year, the growth rate under effect of the same GH doses was 7.1±1.4 and 7.9±1.6 cm/year respectively. The total growth rate ΔSDS for the first year of therapy was 0,56±0,28 (0,033 mg/kg/24 hr) and 0,71±0,22 (0,05 mg/kg/24 hr), the respective ΔSDS values in the second year were 0,94±0,29 and 1,06±0,67. Neither the growth rate nor the failure to thrive changed significantly in the control group. The growth rate in the treated children correlated with their age at the onset of therapy (r = –0.28, p= –0.045; n=56) and the dose of GH (r=0.32, p<=0.043; n=41); in addition, there was correlation between the growth rate ΔSDS values and the age at the onset of therapy (r=–0.50, p=0.0002; n=56). 21% of the children reached the normal growth range (>–2ΔSDS) 6 months after the beginning of therapy, 30% and 37% after 1 and 2 years respectively. None of the patients in the control group showed the normal growth. Some of them underwent accelerated bone maturation, and their growth prognosis (calculated according to Bayley-Pinneau) was improved. The IGF-1 level in the treated patients increased within the normal range but did not correlate with the efficacy of therapy. Nor were apparent changes recorded in the characteristics of carbohydrate, lipid, and phosphorus-calcium metabolism. It is concluded that the growth-stimulating treatment of children with idiopathic short stature using rGH at a dose range from 0.033 to 0.05 mg/kg/24 hours significantly increased the growth rate and dynamics. The main factors determining the therapeutic efficacy of rGH are the age of the patients at which the treatment is initiated and the calculated rGH dose.
Problems of Endocrinology. 2010;56(6):14-23
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The relationship between the level of glycemia, the length of the QT-interval, and locomotor activity in children and adolescents presenting with type 1 diabetes mellitus
Laptev D.N., Riabykina G.V., Sobolev A.V., Kirillov K.K., Seid-Guseĭnov A.A.
Abstract
In this study, we investigated the relationship between the blood glucose level and the length of the QT-interval as well as the influence of locomotor activity on these characteristics in children and adolescents presenting with type 1 diabetes mellitus during the long-term monitoring of ECG, the level of glycemia, and locomotor activity. The daily dynamics of these parameters was elucidated along with the measurements of the lengths of QT and RR intervals. Specifically, the correlation between the length of the QTc interval and the blood glucose level appears from the fact that the maximum QTc length occurred when glycemia dropped below 4 mmol/l. It also significantly increased at glycemia in excess of 16 mmol/l (and up to 21 mmol/l). Moreover the length of the QTc interval directly depended on the duration of the disease. The locomotor activity was shown to significantly affect the blood glucose level within 3-4 hours after its onset.
Problems of Endocrinology. 2010;56(6):24-31
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"Intrauterine programming" of hormonal and metabolic processes and intrauterine growth retardation syndrome
Nagaeva E.V., Shiriaeva T.I.
Abstract
According to the "intrauterine programming" hypothesis, the fetus responses to nutritional deficiency by adaptation in the form of long-standing changes of metabolism that eventually create predisposition to cardiovascular, metabolic, and endocrine diseases. Up to now, a wealth of catamnestic data have been gathered indicating that individuals having the history of growth retardation in the prenatal period are likely to develop a variety of hormonal and metabolic disorders when they reach their mature age. Specifically, there is the close relationship between the intrauterine growth retardation syndrome and elevated arterial pressure, impaired glucose tolerance, and metabolic syndrome. The present review summarizes the results of epidemiological and experimental studies that confirm the above hypothesis.
Problems of Endocrinology. 2010;56(6):32-40
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Congenital hyperinsulinism
Melikian M.A.
Abstract
Congenital hyperinsulinism (CHI) is one of the main causes underlying the development of persistent hypoglycemic conditions in children. Biochemically, CHI is characterized by inadequate insulin secretion from pancreatic β-cells. CHI is a heterogeneous pathology in terms of clinical manifestations, morphological features, and molecular-genetic defects contributing to its development. The present paper is focused on the current views of CHI pathogenesis; the clinical characteristic of the disease is given and the internationally accepted protocols for the examination and treatment of children with congenital hyperinsulinism are described.
Problems of Endocrinology. 2010;56(6):41-47
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Syndrome of hyperandrogenism in girls of pubertal age
Bogdanova P.S., Kareva M.A.
Abstract
Syndrome of hyperandrogenism in women is one of the commonest disease of the adult age. It is associated with a high risk of metabolic disturbances, cardiovascular disorders, and infertility. Taken together, these factors dictate the necessity of in-depth investigations of this pathology. At present, both etiology and pathogenesis of the syndrome of hyperandrogenism remain obscure. As a rule, its clinical manifestations become apparent at puberty. The present review summarizes the data on the development and clinical course of female hyperandrogenism with special reference to its occurrence, diagnostic tools, and therapeutic modalities in adolescent girls.
Problems of Endocrinology. 2010;56(6):48-54
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The application of lanreotide autogel for the treatment of acromegaly
Ilovaĭskaia I.A.
Abstract
The early diagnosis of acromegaly and timely initiation of the adequate treatment are of primary importance for the prevention of the undesired long-term effects of chronic overproduction of growth hormone and insulin-like growth factor-1. Over half of the patients presenting with acromegaly are in need of sustainable treatment with somatostatin analogs that reduces the risk of premature death and helps to maintain quality of life. The new somatostatin analog lanreotide autogel recently introduced into clinical practice is known to effectively diminish secretion of both growth hormone and insulin-like growth factor-1. Moreover, it shows the ability to decrease the volume of somatotropinoms and is well tolerated by the patients. The intervals between injections of lanreotide autogel can be prolonged from 4 to 6-8 weeks. Its subcutaneous administration is technically easy which enables the majority of the patients to perform self-injections. Taken together, these advantages of lanreotide autogel considerably extend the opportunities for medical aid to the patients with acromegaly.
Problems of Endocrinology. 2010;56(6):55-62
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Approaches to the rational choice of type 5 phosphodiesterase inhibitors in patients presenting with cardiovascular and endocrine diseases
Rafal'skiĭ V.V., Baglikov A.N.
Abstract
After the advent of four type 5 phosphodiesterase inhibitors (PDEI 5), viz. sildenafil, tadalafil, vardenafil, and udenafil, designed for the treatment of erectile dysfunction both physicians and patients found themselves faced with the problem of choosing an optimal therapeutic option. This paper contains comparative data on the efficacy and safety of different PDEI 5. The approaches to the rational choice of these preparations for the treatment of patients presenting with cardiovascular and endocrine diseases are discussed. Comparative controlled clinical studies failed to yield definitive information about advantages of one or another agent representing this group of pharmaceutical products. Nevertheless, the currently available data permit to draw the conclusion that the use of vardenafil and tadalafil ensures better compliance of patients with the prescribed therapy. Certain authors advocate the desirability of vardenafil application to the treatment of patients presenting with a background pathology. It is emphasized that all available PDEI 5 have a beneficial safety profile, with wardenafil being virtually free from adverse side effects.
Problems of Endocrinology. 2010;56(6):63-72
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