Vol 12, No 1 (2015)

Review
The risk of metabolic syndrome and nutrition
Kuntsevich A.K.
Abstract

In the present literature review modern epidemiological studies the role of nutrition in the prevalence of the metabolic syndrome. Were analyzed mainly work on the association of certain types of dietary intake of the population to the risk of metabolic syndrome in several Western and Asian countries. The purpose of these studies was to determine deemed "good" type and the "bad" type of food, risk assessment and exchange of metabolic disorders to determine the optimal dietary recommendations.  Application of factor and cluster analysis allowed in a number of studies to identify groups of products associated with a decrease in the prevalence of metabolic syndrome and to estimate the odds ratios of metabolic syndrome when compared with the "bad" diet.  A number of papers were obtained confirm the effectiveness of the Mediterranean diet in the prevention of metabolic disorders. Commitment to the traditional Western diet is associated with deterioration in health, compared with the recommended "healthy" diet.  Data from epidemiological studies nutrition and metabolic disorders associated with a number of diseases, may be useful in determining how the recommendations on the best type of feeding the population, so to identify ways to further research. 

Obesity and metabolism. 2015;12(1):3-10
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Aspects of androgen replacement therapy for the treatment of hypogonadism in men with diabetes and metabolic syndrome.
., .
Abstract

The article presents the results of studies of efficacy and safety of androgen therapy for hypogonadism, metabolic syndrome and type 2
diabetes mellitus in men. In the study was used testosterone undecanoate therapy which causes reduction of obesity, a decrease in the
severity of the other components of the metabolic syndrome, improving glycemic profile without significant side effects. Nevertheless,
this therapy requires monitoring and management for risk factors.

Obesity and metabolism. 2015;12(1):11-14
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Original paper
Glucose-dependent insulinotropic polypeptide - a new link in the development of obesity
Shestakova E.A., Il'in A.V., Shestakova M.V., Dedov I.I.
Abstract

Objective. Glucose-dependent insulinotropic polypeptide (GIP) as well as glucagon-like peptide-1 (GLP-1) is intestinal incretin hormone that stimulates insulin secretion in response to feeding. Much evidence of GIP contribution to obesity development has been found recently.

Aim. The aim of the study was to evaluate glucose-stimulated GIP and GLP-1 secretion in people with type 2 diabetes (T2D) risk factors and different body mass index (BMI).

Materials and methods. Total GIP and GLP-1 secretion was estimated in 127 patients with T2D risk factors during OGTT (75 g glucose) on 0, 30 and 120 minutes.

Results. Patients with BMI≥ 35 kg/m2 had significantly higher fasting and stimulated GIP levels than participants with less BMI. GIP secretion was also higher in patients was insulinresistance, estimated by HOMA-IR, comparing to non-insulinresistant patients. Difference in GLP-1 secretion in patients within several BMI groups was nonsignificant.

Conclusion. Our results suggest GIP is related to obesity degree, that means it can play a role in lipid metabolism and obesity development. 

Obesity and metabolism. 2015;12(1):16-19
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Efficiency of Laparoscopic sleeve gastrectomy at patients with obesity
Yashkov Y.I., Lutsevich O.E., Bordan N.S., Ivleva O.V.
Abstract

Introduction. Laparoscopic Sleeve Gastrectomy (SG) is a relatively new bariatric operation popularity of which is increasing yearly. However many questions regarding this operation are still unclear.

Aim of this study is an assessment of efficacy of SG in the patients of different BMI-groups, evaluation of early and late postoperative complications and possible side effects.

Materials and methods. From 2004 г. to August 2014 primary laparoscopic SG in CELT-clinic (Moscow) was performed in 263 patients aged 39,1 ± 10,7 yrs, male/female rate - 55:208, initial weight -113,9± 21,34 kg, mean BMI - 40,1± 6,1 kg/m2.

Results. There was no mortality, early complications rate was 4,2%. 92,7 % of pts were follow-uped one year and more after surgery. In the entire group maximal excess weight loss (EWL) was 75,8% at 12 months and 63,7% at 60 months postoperatively. EWL depended on initial BMI. In patients with BMI < 35 ( n=39) EWL was 94,1 % at 9 months and remained at level of 90 % to 4 year while in the super-obese patients (BMI>50, n=10), maximal mean EWL didn’t exceed 40 % at 2 years. Late complications were: reflux- oesophagitis - 5,7 %, cholelithiasis - 2,7 %, iron-deficiency anemia - 16,3%. 4 (1,5%)of ptsunderwent second-step Duodenal Switch in the late period, but actually more patients need second-step surgery due to insufficient effect of SG.

Conclusion. SG is prospective, safe and effective operation and may be considered as stand-alone operation as well as first step of more complex operations. Further evaluation of late (>5 years) results is necessary as well as a comparison of results with other bariatric operations. 

Obesity and metabolism. 2015;12(1):20-28
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Glucose metabolism and production of incretins in patients with obesity and type 2 diabetes mellitus after Biliopancreatic bypass surgery in the modification of Hess-Marceau the early stages of postoperative monitoring
Dedov I.I., Troshina E.A., Ershova E.V., Yashkov Y.I.
Abstract

Introduction: a significant improvement was shown in metabolic control at the early stages after BPD, which was associated with GLP-1 and was regardless of weight loss.

Aim: to study the secretion of GLP-1, GIP, insulin and glucagon and their relationship to the parameters of the carbohydrate metabolism among patients with obesity and type 2 diabetes before and 3 months after BPD.

Materials and Methods: the check-up involved 22 patients with obesity (BMI 50.1 [41.3; 53.8] kg/m²) and type 2 diabetes. Determined: glucose, HbA1c, insulin, glucagon, GLP-1, GIP.

Results: after the surgery for weight loss of 15.8% was showed a reduction of fasting and postprandial glycemia, a reduction of AUCglucose, HbA1c, НОМА-IR and hyperinsulinemia. The secretion of GLP-1 with a peak at 30' (test with a standard breakfast) increased, AUCGLP-1 – to 1.8-fold, the basal secretion of GIP – almost 2-fold and AUCGIP – to 1.7-fold; decreased of a secretion of glucagon with a minimum at 60' and AUCglucagon. A negative correlation was revealed between GIP and glucagon, AUCglucose and AUCglucagon; a positive correlation was revealed between GLP-1 and insulin. The weight loss was accompanied by an inversely proportional increase of GLP-1.

Conclusion: More than 90% of the surveyed patients achieved a satisfactory glycemic control as early as 3 months after BPD. The significant improvement of the parameters of the carbohydrate metabolism was associated with elevated levels of GLP-1 and this improvement does not depend of weight loss. 

Obesity and metabolism. 2015;12(1):29-39
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Comparative efficacy and safety of generic (Bergolak) vs. brand cabergoline in the treatment of patients with prolactin-secreting tumors
Melnichenko G.A., Dzeranova L.K., Pigarova E.A., Vorotnikova S.Y.
Abstract

Objective: To evaluate the effectiveness and safety of cabergoline drug Bergolak («Veropharm», Russia) in the treatment of patients with prolactin-secreting tumors.

Materials and methods: The study included 14 patients (14 women, mean age 46±12) diagnosed with prolactinoma. The patients were switched to Bergolak after 1 month of treatment by original cabergoline. Dose of cabergoline varied from 0,125 mg to 3,25 mg per week. Prolactin level, symptoms of hyperprolactinemic hypogonadism, side-effects were evaluated at the baseline, after 1 month of original cabergoline treatment and 1 and 2 months of Bergolak therapy.

Results: Statistical differences in the level of prolactin (p> 0.05), and the incidence of side-effects (p> 0.43) during Bergolak therapy in comparison with the original drug was not registered.

Conclusions: Bergolak showed to be effective drug for  treatment of patients with prolactin-secreting tumors. The incidence of side-effects during Bergolak therapy is equal to the original cabergoline treatment.

Obesity and metabolism. 2015;12(1):40-44
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Lecture
Сircadian rhythm and metabolic effects of melatonin
Burchakov D.I.
Abstract

Sleep is a highly important process, required for normal organ and system function. Researchers assume, that during sleep brain shifts to internal body signals. Therefore, any sleep disturbance will disrupt health. Industrial and post-industrial society links high stress level and sleep problems. Excess light stimulation in living space, including bedroom, disorganize circadian rhythm of melatonin. Besides regulation this hormone has antioxidant and adaptogen functions. From psychological standpoint the same high-stress social context depletes the adaptation resources. To normalize sleep function we can utilize both sleep hygiene measures and modern pharmacotherapy. There are melatonin-based drugs, which help to restore sleep-wake cycle, augment adaptive capability and in some cases empower the existing treatment for specific somatic maladies. From a clinical and chronobiological standpoint melatonin is useful in broad spectrum of disorders.

Obesity and metabolism. 2015;12(1):46-51
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Case Report
ACTH overexpressing pituitary hyperplasia in a patient with ectopic ACTH-syndrome due to carcinoid of the lung
Dzeranova L.K., Skuridina D.V., Voronkova I.A., Rozhinskaya L.Y., Manchenko O.V., Ablitsov Y.A., Ablitsov A.Y., Bolevich S.S., Grigor'ev A.Y., Pigarova E.A., Ankvab M.K.
Abstract
Ectopic ACTH-syndrome is the most diagnostically challenging  variant of endogenous hypercortisolism. Particularly difficult differential diagnosis of this syndrome is from Cushing's disease (CD), as currently there is no single test sufficiently accurate to differentiate accurately ectopic ACTH production from the pituitary. The main functional tests are based on the fact that the vast majority of ectopic ACTH production is autonomous and suppresses one from pituitary. But in some cases this is not observed, and then the data obtained all necessary laboratory and instrumental research evidence in favor of central genesis of CD in a patient with ACTH ectopic secretion, which can lead to inappropriate treatment. If you confirm the ectopic ACTH-syndrome, it may take quite a long time of searching for the pathological focus, as there is no sufficiently precise imaging and diagnostic method for determining the localization of ectopic source of ACTH production. Thus, the differential diagnosis of ACTH-dependent hypercortisolism and localization of the ectopic tumor is the cornerstone of early and radical treatment of patients. We present a difficult clinical case of a patient having a pituitary hyperplasia with excessive ACTH expression with primary ectopic ACTH syndrome caused by lung carcinoid.
Obesity and metabolism. 2015;12(1):52-59
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News
Bariatric surgery in Russia in 2011-2013
Khatsiev B.B., Kuzminov A.N., Yashkov Y.I., Uzdenov N.A.
Abstract

Within three years (2011 - 2013), we collected data on the operations carried out by sending a questionnaire to members of the Russian Society of Bariatric Surgeons. In the questionnaire were asked to fill in a table on the total number of operations, their structure, subject to the applicable access and report on fatal cases indicating the cause of death.

The number of executed operations (excluding installation gastric balloon) increased from 989 to 1525.

In 2012, steel longitudinal gastrectomy performed more often than banding. The share gastroshuntirovany continues to decline throughout the period.

In 2013, against the backdrop of a significant increase in the number of bariatric interventions deaths were recorded.

Obesity and metabolism. 2015;12(1):60-61
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Orlistat induces weight loss and improves fertility in patients with PCOS
Vorotnikova S.Y.
Abstract

Orlistat induces weight loss and improves fertility in patients with PCOS

Obesity and metabolism. 2015;12(1):62
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A new monomeric triagonist corrects obesity and diabetes in rodents
Andreeva S.I.
Abstract
A new monomeric triagonist corrects obesity and diabetes in rodents
Obesity and metabolism. 2015;12(1):63-65
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Effect of metformin in a maternal mouse model in prenatal period
Borodich T.S.
Abstract
Effect of metformin in a maternal mouse model in prenatal period
Obesity and metabolism. 2015;12(1):66
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Relationship between metformin and frailty syndrome in elderly people with type 2 diabetes
Andreeva S.I.
Abstract
Relationship between metformin and frailty syndrome in elderly people with type 2 diabetes
Obesity and metabolism. 2015;12(1):68-69
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