Problemy endokrinologii最新文献

This review is an abridged translation of selected chapters of the report "Prevention and control of iodine deficiency in the WHO European Region: adapting to changes in diet and lifestyle", published by the WHO Regional Office for Europe and the Iodine Global Network (IGN) in 2024. Iodine deficiency, especially mild iodine deficiency, remains a widespread problem in the WHO European Region. Since the last WHO report on iodine deficiency in the Region 15 years ago, much new data on iodine status has become available, especially for vulnerable populations. This review presents data on the iodine status of the population in 53 WHO European Member States (and Kosovo), the adverse effects of mild iodine deficiency and the effectiveness of salt iodization in preventing iodine deficiency. Mainly due to progress in salt iodization, the number of countries with iodine deficiency has decreased from 23 in 2003 to 2 in 2023. Mandatory salt iodization ensures adequate iodine intake in all population groups, with the exception of a few countries where these programs are poorly implemented. The positive cost-benefit ratio for preventing mild iodine deficiency in the European Region is plausible given the high prevalence of thyroid disease and the low cost of salt fortification programs.

This article traces the history of the development of radioiodine therapy (RIT) as one of the leading methods for treating thyroid disorders. The relevance of the topic is determined by the high efficacy of RIT in managing thyrotoxicosis and differentiated thyroid cancer, as well as the ongoing efforts to refine dosimetric strategies and molecular imaging techniques. Based on a systematic review of historical publications and monographs from 1923 to 2022, the study analyzes key milestones in the clinical implementation of iodine-131 - from the pioneering experiments of Hertz and Seidlin in the United States in 1937 to the widespread adoption of the method in the USSR beginning in the 1950s and its subsequent advancement at the National Medical Research Center for Endocrinology of the Ministry of Health of the Russian Federation. The reviewed literature highlights the significant contributions of Russian researchers to the formation of personalized theranostic approaches and underscores the need for further improvement in planning methods, dynamic treatment monitoring, and the broader expansion of radionuclide therapies for thyroid diseases.

Background: Currently, due to the lack of clear criteria for predicting the aggressive course of pituitary adenomas (APA), the search for diagnostic markers is highly relevant. Genetic markers, among others, may serve as such markers since their identification is possible at early stages of the pathological process.

Objective: To study the prevalence of genotypic polymorphisms G634C of the VEGFA gene (locus rs2010963), C/T of the TP53_2 gene (locus rs17884159), C/T of the HIF1A gene (locus rs11549465), and G-197A of the IL-17A gene in a sample of patients with APA and their association with the development of various clinical variants of the aggressive course of the disease.

Materials and methods: The study included 100 patients with a clinically confirmed diagnosis of pituitary adenoma (main group) and 83 practically healthy individuals (control group). The polymorphism of the studied genes was analyzed using allele-specific polymerase chain reaction (PCR) with SNP-Express reagent kits in real-time mode ("Sintol", Russia). The interpretation of the results was carried out using the "RotorGene" software of the PCR-RV device. The study also included general clinical, biochemical, and hormonal tests, as well as instrumental and neuroimaging methods, including magnetic resonance imaging (MRI) of the chiasmatic-sellar region and statistical analysis.

Results: The study showed that the heterozygous mutation (G/C) of the G634C VEGFA polymorphism was recorded in 21 cases (26%), and the homozygous mutation with a complete replacement of guanine (G) by cysteine (C) at position 634 (C/C) was detected in 4 cases. In patients with invasive pituitary adenomas (PA), the heterozygous variant (G/C) was twice as frequent - 32.7% (n=17) compared to the control group - 15.7% (n=13). The homozygous genotype (C/C) was also more frequently observed in patients with invasive PA growth - 7.7% (n=4) compared to the control group.The heterozygous variant (C/T) of the HIF1A gene was significantly more common (p=0.02) in patients with invasive adenomas compared to the control group: 25% (n=13) and 9.8% (n=8), respectively. In non-invasive PAs, this genotype was observed three times less frequently. The study of TP53_2 polymorphism (locus rs17884159) showed that in patients with invasive PAs, the frequency of the heterozygous variant (C/T) was significantly higher - 15.4% (n=8) compared to the control group - 4.8% (n=4).

Conclusion: The conducted genetic analysis of polymorphisms in the VEGFA, HIF1A, TP53_2, and IL-17A genes revealed significant deviations, confirming their practical significance in the early diagnosis of aggressive pituitary adenomas.

Background: To optimize androgen replacement therapy for male hypogonadism to improve reproductive prospects.

Aim: To compare the effectiveness of restoring the quality of ejaculate in men receiving androgen replacement therapy (AZT) and patients receiving course combination therapy with testosterone and chorionic gonadotropin (AZT/HG).

Materials and methods: In observational prospective study was included 53 men observed at The National Medical Research Center for Endocrinology and AZT (n=19) or AZT/HG (n=34) more than 5 years, followed by stimulating gonadotropin therapy. The qualitative parameters of ejaculate were evaluated in all patients. The basic level of statistical significance was p<0,05.

Results: The patient groups were comparable in age, BMI, duration of therapy used, type of testosterone preparation, as well as the etiology of hypogonadism. Sperm concentration in the AZT group there was a statistically significant negative dynamics, while in the ART/HG group, there were no statistically significant differences in the dynamics of sperm concentration. Statistically significant differences in the value of sperm concentration change were revealed. In both groups was observed statistically significant negative dynamics for sperm motility and morphology. There were no statistically significant differences in the value of changes motility and sperm morphology in both studied groups.

Conclusion: Course combination therapy with testosterone and chorionic gonadotropin is characterized by better results for sperm concentration restoration compared with androgenic replacement therapy. For the restoration of sperm motility and morphology both methods do not show satisfactory results.

Background: Determination of body composition components - muscle and fat mass - is an important step in clinical and epidemiological studies. The most common methods for quantitative determination of body composition are indirect methods. However, the variety of methods and models of devices used makes direct comparison of data at both group and individual levels difficult.

Aim: The aim of the study is to analyze the consistency of estimates of absolute values of fat and lean body mass, as well as the proportion of body fat mass, obtained using bioimpedance analyzers ABC-02 «Medas» (STC Medas, Russia), 770InBody (InBody, Korea) and ultrasound scanner BodyMetrix BX2000 (IntelaMetrix, USA) in a group of men and women.

Materials and methods: An observational, single-center, cross-sectional, uncontrolled study was conducted. The main anthropometric characteristics (height and weight, waist circumference) were measured. Body composition was determined by bioimpedancemetry (BIA) using the octopolar scheme on the 770InBody device and the tetrapolar scheme on the ABC-02 Medass device and ultrasound scanning using the BodyMetrix BX2000 (BM) ultrasound scanner. The absolute (FM) and relative amount of body fat (PBF) and lean body mass were calculated.

Results: A total of 48 people (38 women and 10 men) aged 24 to 74 years were examined. The anthropometric characteristics of the examined subjects were presented in a wide range. A strong correlation was found for all pairs of body composition components: the minimum value for the pair PBF ABC-BM was 0.853 [0.730, 0.913], the maximum was 0.988 [0.977, 0.993] for the pair FM ABC-InBody. Also, significant statistical differences (p<0.001) were found for all pairs of measurements, except for PBF determined by the BIA method. High agreement (CCC>0.95) of BIA estimates of the absolute amount of fat mass was shown, moderate agreement (CCC 0.9-0.95) is characteristic of the PBF determined by different BIA analyzers, and for all other pairs the agreement of measurements can be assessed as weak (CCC<0.90).

Conclusion: The best agreement at the group and individual levels was found for FM estimates by two different BIA analyzers (InBody and ABC).

Background: The main treatment for primary hyperparathyroidism (PHPT) is parathyroidectomy (PTE), conservative therapy, including bisphosphonates, can be used for preoperative correction of hypercalcemia, as well as to improve bone tissue condition among individuals for whom surgery should be postponed or cannot be performed due to high perioperative risks. The question of the effect of bisphosphonates on bone tissue after surgery remains open.

Aim: To study the effect of preoperative bisphosphonate therapy on BMD parameters assessed in DXA and 3D-DXA in patients with PHPT one year after radical PTE.

Materials and methods: The study was conducted on the basis of the Department of pathology of the parathyroid glands and disorders of mineral metabolism of "Endocrinology Research Center" state-funded research facility of the Ministry of Health of the Russian Federation. The study included 50 patients (2 men, 48 women), divided into two groups depending on the presence or absence of preoperative bisphosphonate (BF) therapy. The methods of DXA and 3D-DXA using 3D-Shaper Medical software were used to evaluate BMD and bone microarchitectonics. The statistical analysis was performed using the R language and the Statistica v.13 package.

Results: At the time of the disease's manifestation, both groups were comparable in terms of the main indicators of calcium phosphorus metabolism, with the exception of the level of beta-crosslapse, which was higher in the group without preoperative BPh therapy (p<0,001). There were also no differences in the parameters of DXA and 3D-DXA. After surgery, both groups showed a comparable increase in BMD based on the results of DXA in the main parts of the skeleton and 3D-DXA in the femur. Changes at the level of the statistical trend were obtained for the 3D-DXA parameters, the final absolute values of which were slightly higher in the second group, including the thickness of the cortical layer in the femur as a whole and in the neck. When comparing the results of DXA before and after PTE in patients receiving BPh, statistically significant differences in absolute BMD values were obtained only in the lumbar spine (p<0,001).According to 3D-DXA data, statistically significant differences were found only in the volume of mineral density of the trabecular bone of the femur as a whole (p=0,001).When analyzing up to - in the second group, statistically significant differences in absolute BMD values were observed in the lumbar region (p<0,001), in the hip as a whole (p<0,001) and in its neck (p=0,001).According to 3D-DXA data, statistically significant differences were found in three of the eight analyzed indicators, the volume of mineral density of the trabecular bone of the femur as a whole and in the neck (p<0,001 for both), as well as the volume of mineral density of the cortical bone in the neck, (p=0,001).

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