Vol 13, No 2 (2016)

Review
Incretins role in Latent autoimmune diabetes of adults pathogenesis, the possibility of therapy with combination of glucagon-like peptide-1 agonist (GLP-1) and insulin.
Silko I.V., Nikonova T.V., Shestakova M.V.
Abstract

Recently, the bihormonal theory of the autoimmune diabetes development is discussed in the world literature. The abnormal suppression of glucagon and reduced incretin response are considered in the development and progression of type 1 diabetes mellitus in addition to insulin deficiency. Animal studies demonstrate a GLP-1 – role in beta cell-proliferation and decrease in apoptosis. The information concerning the functioning of the incretin system in patients with type 1 diabetes and LADA is systematized in the present review. We also discuss the studies of the use of GLP-1 agonists in patients with autoimmune diabetes.

Obesity and metabolism. 2016;13(2):3-6
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Genetic predictors of obesity development
Borodina S.V., Gapparova K.M., Zainudiniv Z.M., Grigorian O.N.
Abstract

The most common reasons that cause obesity are eating disorders (overeating), genetic predisposition, sedentary lifestyle (lack of exercise), disorders of the endocrine system, and environmental factors. There is evidence of an obvious relationship of high consumption of sugary drinks and weight gain. Since 1990, there has been considerable growth in the number of obese people in the first place associated with the promotion of soft drinks. According to a study in Finnish diabetes prevention average physical activity and change of diet (1200-1800 kcal) of total fat intake with less than 30% saturated fat, including less than 10%, leading to long-term loss of excess weight (within 4 years). Many studies have demonstrated the impossibility of a single template approach to the determination of optimal diets for patients with overweight and obesity which has been shown in various studies on gene polymorphisms are associated with obesity, and their interaction. This article provides an overview of current data on the genetics of obesity covering the main provisions of the study of candidate genes, such as PPARG, FABP2, ADRB 2, ADRB3. The role nutrigenetics in the creation of individual programs of weight control and weight loss. But the question of the direct role of genetic factors in the development of obesity remains controversial, since one can not ignore the impact of environmental factors, such as lifestyle, diet, physical activity, stress, and harmful habits. To understand the mechanism of the relationship between genetic factors, environmental factors, and obesity, one needs to carry out research not only on the population level, but also in certain groups of people (ethnic, racial, age).

Obesity and metabolism. 2016;13(2):7-13
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Original paper
The data of national medical interview on hyperprolactinemia treatment in real clinical practice
Melnichenko G.A., Dzeranova L.K., Pigarova E.A., Vorotnikova S.Y., Tarasova T.S.
Abstract

Hyperprolactinemia is one of the most common endocrine pathology, which doctors of different specialties face in real clinical practice.

Aim of the study was to determine the features of management and treatment of patients with hyperprolactinemia in different regions of Russian Federation.

Material and methods. The national medical interview on hyperprolactinemia treatment was conducted in 2014-2015 among 74 endocrinologists from 30 regions of Russia.

Results. Endocrinologists in regions of Russian Federation have satisfactory access to various methods of diagnostics of the disease and its complications, knowledge of different dopamine agonists for treatment, and have practice in management of patients with drug-induced hyperprolactinemia.

Conclusion. According the data of the interview majority of doctors have insufficient level of knowledge in management and treatment of patients with hyperprolactinemia that is why additional lectures and seminars should be conducted by specialists of that problem.

Obesity and metabolism. 2016;13(2):14-19
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Type 2 diabetes mellitus and the clinical course of acute stroke
Antonova K.V., Tanashyan M.M., Romantsova T.I., Maksimova M.Y.
Abstract

We carried out a comparative analysis of the clinical course of acute stroke in patients with and without type 2 diabetes mellitus (T2DM). The prevalence of carotid atherosclerosis (incl. those with plaques and hemodynamically significant [≥60%] carotid stenosis) was higher in patients with T2DM. With relatively similar baseline brain damage and neurological deficits patients with T2DM had a higher rate of symptom worsening, which leads to poorer outcome. A less favourable post-stroke prognosis was found to be associated with the presence of T2DM, but not with transient changes in glycemic levels. Most patients with T2DM presented with acute stroke showing elevated levels of both plasma glucose and glycated haemoglobin, the latter indicating a long period of hyperglycemia preceding the acute cerebrovascular event.

Obesity and metabolism. 2016;13(2):20-24
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The efficiency of obesity treatment in patients with insomnia and obstructive sleep apnea syndrome
Strueva N.V., Mel'nichenko G.A., Poluektov M.G., Savel'eva L.V.
Abstract

The aim of this study was to investigate the relationship between the dynamics of body weight and sleep disorders in the treatment of obesity.

Materials and methods. The study included 200 obese patients: 83 men and 117 women.

Results. Complaints about problems sleeping (snoring, hypersomnia, insomnia, etc.) were present in 78% of obese patients. 89 patients were under the observation of an endocrinologist for 7 ± 1 months, they were divided into three matched by age, sex and BMI groups: patients with obstructive sleep apnea syndrome (OSAS) (n = 42), the second – with the syndrome of insomnia (n = 19), the third (control group) – patients without sleep disorders (n = 24). After treatment of obesity the weight loss in patients with insomnia syndrome was -2.5 [-4; 0]kg, in patients with OSAS -7 [-18; -2] kg, in patients without sleep disorders -6.5 [-12; -2.25] kg. Clinically significant weight reduction was reached in 25 (59.5%) patients with OSAS; 3 (16%) – with insomnia syndrome; 15 (62.5%) – without sleep disorders.

Conclusion. Thus, the insomnia syndrome essentially influences the obesity treatment results – most of patients with this sleep disorder (81.2%) do not achieve clinically significant weight loss. The presence and severity of breathing disorders during sleep do not prevent weight loss. However, with the regular use of CPAP-therapy in patients with OSAS has a tendency of greater reduction of body weight. 

Obesity and metabolism. 2016;13(2):25-32
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Lifestyle in children and adolescents with obesity: results of the survey of patients and their parents
Vitebskaya A.V., Pisareva E.A., Popovich A.V.
Abstract

Introduction. Growth of obesity prevalence in children and adolescents is a serious problem of modern medicine. To learn characteristics of patient’s behaviour, their dietary preference, feeding time and physical loads one can use specialized questionnaires.

Aim. Evaluation of lifestyle, physical activity, dietary regimen and consumption of some meals according to results of questioning children

and adolescents with obesity and their parents.

Materials and methods. Hundreds of children and adolescents with obesity 10–17 years and their parents answered the questionnaire on

age of obesity onset, its causes, physical activity and nutrition.

Results and conclusion. Obesity develops more often at the age of 7–10 years. The most commonly insufficient physical activity and heredity. Specific characteristics of sedentary lifestyle and impared dietary regimen were identified. Comparison of patients’ and parents’ answers allowed to demonsrate the differense in attitude to the problem of obesity and to diminish the influence of not transparant answers on the results of investigation.

 

Obesity and metabolism. 2016;13(2):33-40
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Lecture
Iatrogenic lesions of the skeleton
Melnichenko G.A., Mamedova E.O.
Abstract

Osteoporotic fractures are an important public health problem due to their negative impact on the quality of life and life expectancy, as well as high cost of treatment and rehabilitation. Along with the major risk factors for osteoporotic fractures, such as low bone mineral density (BMD), age, low body weight, frequent falls and previous fractures, an important secondary risk factor, especially among susceptible individuals, is taking certain medications. The difficulty in assessing fracture risk when taking various drugs, as well as the development of appropriate methods of prevention and treatment, is often due to the absence of large randomized trials with a sufficient level of evidence, as well as the heterogeneity of the main risk factors for fractures in studied groups of patients. We focus on the main groups of drugs for which there is evidence of a negative impact on bone metabolism, BMD and fracture risk. In addition to drugs, bone metabolism is also influenced by bariatric surgery, transplantation of solid organs, gonadectomy for various diseases.

Obesity and metabolism. 2016;13(2):41-47
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Case Report
Correction of mineral and bone disorders in a patient with long-standing diabetes mellitus type 1 on hemodialysis therapy
Sklyanik I.A., Egorova D.N., Dzeranova L.K., Pigarova E.A.
Abstract

Osteoporosis and diabetes mellitus (DM) – chronic diseases with constantly growing prevalence. Patients with DM have the increased risk of bones fractures. Risk of fracture in the patient with diabetes mellitus type 1 (DM1) is increased by more than 6 times. There are several mechanisms leading to the development of osteoporosis in DM: chronic hyperglycemia, insulin deficiency, genetic factors, and complications of DM. Moreover, the chronic kidney disease in DM impacts not only progression of osteoporosis, but also leads to emergence of other bone disorders, that considerably complicate a choice of antiosteoporotic treatment. This article describes a clinical case of the mineral and bone disorders of a phosphorus-calcium metabolism, which developed in patient with long history of DM1 receiving therapy by a program hemodialysis.

Obesity and metabolism. 2016;13(2):48-55
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