Vol 14, No 1 (2017)

Review
Obesity and reproductive health of women
Gorbatenko N.V., Bezhenar V.F., Fishman M.B.
Abstract

Obesity has a negative impact on female reproductive health. The review presents literature data on current views on the etiology, pathogenesis of obesity and its impact on the reproductive health of women. Particular attention is paid to problems arising in women of reproductive age who are obese.

Obesity and metabolism. 2017;14(1):3-8
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Metabolic disorders in adipocytokine imbalance and gestational complications
Chabanova N.B., Mataev S.I., Vasilkova T.N., Troshina I.A.
Abstract

Adipose tissue as an endocrine organ synthesizes a large number of biologically active substances, adipocytokines, which have both local and systemic effects influencing the vascular wall, tissue sensitivity to insulin, glucose metabolism, and systemic inflammation. The data obtained from clinical and experimental studies demonstrate the close relationship between the imbalance of adipocytokines and pregnancy complications such as insulin resistance, gestational diabetes, and preeclampsia. In this connection, close attention of obstetrician-gynecologists and endocrinologists is focused on etiopathogenic aspects of the formation of gestational complications with metabolic disorders caused by an imbalance of adipocytokines with maternal obesity and to the search for markers of these disorders. The review presents the current literature data on adipose tissue hormones and their influence on the course of a gestational process.

Obesity and metabolism. 2017;14(1):9-16
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Drugs for the treatment of central diabetes insipidus: historical background and modern opportunities
Mikhaylova D.S., Pigarova E.A., Dzeranova L.K.
Abstract

Central diabetes insipidus is a severe disease with disturbance of arginine vasopressin secretion, which leads to excretion of large amounts of hypotonic urine. The polyuria-polydipsia syndrome is essential as a clinical presentation and high impact condition. Desmopressin, a synthetic analog of arginine vasopressin, is used to compensate a water-electrolyte balance is available in forms of tablets and intranasal spray. Free drug choice is obligated for proper treatment.

Obesity and metabolism. 2017;14(1):17-23
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Original paper
Cytogenetic effects of tick-borne encephalitis in residents of the north of Western Siberia with alimentary-constitutional obesity depending on the polymorphism of the genes of glutathione-S-transferase
Ilyinskikh E.N., Ilyinskikh N.N.
Abstract

Backgraund. Tick-borne encephalitis (TBE), one of the large-scale public health problems of the Siberian region, can cause significant cytogenetic damage in humans by stimulating oxidative stress. Active functioning of the detoxification system including enzymes of glutathione-S-transferase is intended to protect the genetic structure of cells in the body, while at the same time, there are studies showing the defective functioning of this system in individuals with obesity.

Aims. Aim of this work is to study the longevity of term of TBE-induced cytogenetic damage in patients with different alleles of genes of glutathione-S-transferase, suffering from alimentary-constitutional obesity compared with the control.

Materials and methods. We were examined 133 female residents of the northern areas of Tomsk region from 35 to 44 years old who were hospitalized for infection TBE at local medical clinics. All individials were divided into two subgroups. Patients of the 1st subgroup (control) had a body mass index (BMI) within 21–26, the 2nd subgroup had BMI showing severe obesity (BMI 35–45). Buccal cells for cytogenetic and molecular analysis were taken several times: 1–2 days after hospitalization, 1 week, 1 month, 3 months, and 6 months after beginning of the disease. Methods of immunoassay and polymerase chain reaction (PCR) was used to confirm the diagnosis of TBE. As an untreated control were examined 126 healthy female residents of the same age groups. All individuals signed informed consent. In the analysis of deletions in the genes GSTM1 and GSTT1 was used multiplex PCR. We studied at least 1000 epithelial buccal cells from each individual.

Results. In patients with high BMI rates revealed a significant increase in the frequency of the buccal cells with cytogenetic damage, compared to the control group. TBE disease was significantly increased the frequency of the cytogenetically damaged cells in this group of patients. The cytogenetic aberrations persisted in their body for six months after hospitalization. In patients with normal BMI rates TBE induced significantly less changes. The recovery of normal cytogenetic status was observed in this group 3 months after hospitalization. Analysis of the glutathione-S-transferase gene variants showed that in TBE patients with normal BMI and non-active alleles of these genesthe frequency of micronucleated epithelial cellswere significantly increased compared to the patients with the activeGSTM1 (+) / GSTT1 (+)genes. In the patients with alimentary obesity such patterns were not observed.

Conclusions. Thus,infection with TBE in patients with obesity induced significant increase in both the frequency of cytogenetically damaged cells and the longevity of their persistency in the body compared to these in control group. Polymorphisms in genes of glutathione-S-transferase had no significant effect on the indices.

Obesity and metabolism. 2017;14(1):24-29
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Leptin, soluble leptin receptor, and free leptin index in patients with metabolic syndrome
Smirnova E.N., Shulkina S.G.
Abstract

Aim. To assess the levels of leptin, its soluble receptor, and index of the formation of free leptin in metabolic syndrome (MS).

Materials and methods. The study included 110 individuals with obesity and overweight. The group 1 consisted of 70 patients with MS (IDF, 2005), the average body mass index (BMI) 38.4 ± 4.4 kg/m2, aged 48.2 ± 2.4 years, with arterial hypertension (AH) 1–2 degree, without regular antihypertensive therapy. Group 2 – "healthy" obesity accounted for 40 patients aged 38.4 ± 6.2 years, BMI 36.0 ± 5.5 kg/m2 without hypertension and metabolic disorders. Group 3 consisted of 30 healthy persons, BMI 27.1 ± 1.3 kg/m2. All patients were evaluated for insulin, HOMA index, leptin, leptin receptor, leptin free index (calculated as the ratio of leptin (ng/ml) to the leptin receptor (ng/ml), multiplied by 100).

Results: In patients with MS as compared to other two groups there were higher levels of HOMA IR index, leptin and free leptin index. Values of leptin receptor in groups 1 and 2 did not differ significantly and were lower than in healthy persons. The free leptin index was significantly higher in MS group relative to the group 2 and 15 times higher than in the healthy individuals. Free leptin index correlated with values of BMI (R = 0.32; p = 0.02), blood pressure (R = 0.3; p = 0.04), uric acid (R = 0.27; p = 0.04), triglycerides (R = 0.42; p = 0.02), index HOMA-IR (R = 0.45; p = 0.02).

Conclusions:

  1. Reduction of soluble leptin receptor, depending on the degree of abdominal obesity, may cause progression of leptin resistance in patients with MS.
  2. The levels of leptin and soluble leptin receptor appears to have dramatical gender differences.
  3. Calculation of free leptin index should be used for the objective evaluation of leptin resistance, regardless of gender, degree of obesity, and other metabolic parameters.
Obesity and metabolism. 2017;14(1):30-34
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Adipokines, myokines and cytokines in endometrial cancer patients: relations to obesity phenotype of excessive body mass and features of the tumor
Berstein L.M., Poroshina T.E., Vasilyev D.A.
Abstract

Aim. To study serum content of a number of known adipokines, myokines and cytokines and compare obtained data with overweight phenotype and characteristics of tumor in untreated patients with endometrial cancer (EC)

Materials and methods. The study included 88 patients with a mean age 60.08±0.67 years and a mean body mass index (BMI) 32.90±0.83. Patients were subjected to anthropometry and analysis of laboratory parameters, including serum level of leptin, adiponectin, omentin, prefilin (Pref-1), myostatin, irisin, IL-6 as well as insulinemia and insulin resistance index (HOMA-IR). On the basis of combination of anthropometric and laboratory data patients with overweight (BMI >25.0) were subdivided into the groups with "standard" (S) and conditionally "metabolically healthy" (MH) phenotype.

Results. Levels of leptin, insulin and adiponectin in the serum of patients with EC are associated with BMI value and demonstrate significant differences between S and MH groups. Levels of prefilin, myostatin, and IL-6 are not associated with an increase in BMI, but are also different in patients with S and MH phenotype of overweight.For levels oа irisin, omentin, and TNF-alphathere is no peculiar dependence both, the BMI, and of belonging to a group with S or MH phenotype. Omentin level in the serum is associated with less favorable tumor differentiation (MH group), while IL-6 level – with a more advanced stage of the tumor (all patients and group S).

Conclusion. Adipokines, myokines and cytokines circulating in blood of EC patients vary in their connections with BMI or with "standard" or "metabolically healthy" phenotype of its excess. They vary also in relation to EC features, which in sum may have practical importance.

Obesity and metabolism. 2017;14(1):35-40
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Lecture
Foot disorders in diabetes mellitus
Tokmakova A.Y., Egorova D.N., Doronina L.P.
Abstract

Diabetes mellitus is one of the most common chronic diseases in the world. According to the International Diabetes Federation (IDF), by 2035 the number of diabetes patients will reach 592 million people. Various disorders of the structure and function of the soft tissues and skeleton of the lower extremities is the most common reason that patients seek medical care. The paper presents the modern concept of the pathogenesis, diagnosis, therapeutic and prevention tactics used in the specialized endocrinological and surgical clinics.

Obesity and metabolism. 2017;14(1):41-47
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Case Report
Metabolic changes in patients with familial pituitary adenomas associated with mutations in the AIP gene
Tarasova T.S., Pigarova E.A., Dzeranova L.K., Tiulpakov A.N., Dedov I.I.
Abstract

Currently, many AIP mutations responsible for the development of pituitary adenomas have been described. Penetence of pituitary adenomas in AIP-positive FIPA families is incomplete and varies widely. Data on the characteristics of metabolic changes in patients with familial pituitary adenomas associated with mutations in the AIP gene continues to be inadequate. Evaluation of the results of molecular genetic studies, as well as a thorough analysis of metabolic changes in these clinical cases, will help to develop and improve diagnostic and treatment algorithms, identify patient groups that require special attention of endocrinologists, timely screening, aggressive treatment, and careful dynamic observation.

Obesity and metabolism. 2017;14(1):48-51
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