Pub Date : 2023-09-03DOI: 10.22141/2224-0721.19.5.2023.1301
M. Orel, L. Martynyuk
Background. According to epidemiological studies, the prevalence of subclinical hypothyroidism is about 6 % and it depends on age, gender, region of residence and, at the same time, significantly exceeds the frequency of primary hypothyroidism. Within one year, 5 % of cases of subclinical hypothyroidism turn into the manifested form. Delayed diagnosis of the disease increases the risk of serious complications. It is still controversial whether subclinical hypothyroidism affects blood pressure because of conflicting results in published studies. Thus, the aim of this study was to assess the effects of levothyroxine replacement therapy in patients with subclinical hypothyroidism and hypertension on lipid metabolism, functional state of the endothelium and cognition. Materials and methods. Thirty-one patients with subclinical hypothyroidism and stage 2 hypertension participated in the study, among them 12 (38.71 %) men and 19 (61.29 %) women. The average age of participants was 63.19 ± 1.93 years. The study examined lipid profile, functional state of the endothelium, and cognitive functions based on the results of the Montreal Cognitive Assessment before and after 3 months of additional administration of the levothyroxine replacement therapy at a dose 25–50 µg daily. Results. The lipid analysis revealed a significant decrease in total cholesterol for 10.08 % (5.54 ± 0.17 mmol/L against 6.23 ± 0.25 mmol/L, Р < 0.05), low-density lipoprotein cholesterol for 24.5 % (3.39 ± 0.17 mmol/L against 4.49 ± 0.27 mmol/L, Р < 0.01), triglycerides for 19.42 % (1.66 ± 0.11 mmol/L against 2.06 ± 0.16 mmol/L, Р < 0.05) compared to those at baseline. At the same time, patients with subclinical hypothyroidism and hypertension showed a reliable decrease in atherogenic dyslipidemias, 64.52 against 74.19 %. We also observed a reliable improvement of the functional state of the endothelium: the mean value of the endothelium-dependent vasodilation of the brachial artery increased for 11 % (6.56 ± 0.10 % against 5.91 ± 0.05 %, Р < 0.001). The results of the neuropsychological testing showed a reliable improvement of the cognitive functions among examined patients: the average score on the Montreal Cognitive Assessment raised from 23.77 ± 0.60 at baseline to 26.65 ± 0.47 after three months of taking levothyroxine, Р < 0.001. Conclusions. Levothyroxine replacement therapy in patients with subclinical hypothyroidism and hypertension was followed by a normalization of lipid profile and a decrease in atherogenic dyslipidemias, an improvement of the functional state of the endothelium and state of cognition.
背景。根据流行病学研究，亚临床甲状腺功能减退症的患病率约为6%，与年龄、性别、居住地区有关，同时显著超过原发性甲状腺功能减退症的发病率。在一年内，5%的亚临床甲状腺功能减退症的病例转变为表现形式。疾病的延迟诊断增加了严重并发症的风险。亚临床甲状腺功能减退是否影响血压仍存在争议，因为已发表的研究结果相互矛盾。因此，本研究的目的是评估左旋甲状腺素替代治疗对亚临床甲状腺功能减退和高血压患者脂质代谢、内皮功能状态和认知的影响。材料和方法。31例亚临床甲状腺功能减退合并2期高血压患者参与了研究，其中男性12例(38.71%)，女性19例(61.29%)。参与者平均年龄为63.19±1.93岁。该研究根据蒙特利尔认知评估的结果，在给予左旋甲状腺素替代治疗(每日25-50µg) 3个月前后，检测了血脂、内皮细胞功能状态和认知功能。结果。脂质分析显示，与基线相比，总胆固醇下降10.08%(5.54±0.17 mmol/L, 6.23±0.25 mmol/L， Р < 0.05)，低密度脂蛋白胆固醇下降24.5%(3.39±0.17 mmol/L, 4.49±0.27 mmol/L， Р < 0.01)，甘油三酯下降19.42%(1.66±0.11 mmol/L, 2.06±0.16 mmol/L， Р < 0.05)。同时，亚临床甲状腺功能减退和高血压患者的动脉粥样硬化性血脂异常下降可靠，分别为64.52%和74.19%。我们还观察到内皮功能状态的可靠改善:肱动脉内皮依赖性血管舒张的平均值增加了11%(6.56±0.10%对5.91±0.05%，Р < 0.001)。神经心理测试结果显示，接受检查的患者的认知功能得到了可靠的改善:蒙特利尔认知评估的平均得分从基线时的23.77±0.60提高到服用左甲状腺素三个月后的26.65±0.47，Р < 0.001。结论。对亚临床甲状腺功能减退和高血压患者进行左旋甲状腺素替代治疗后，血脂水平正常化，动脉粥样硬化性血脂异常减少，内皮功能状态和认知状态改善。
{"title":"The pleiotropic effects of levothyroxine replacement therapy in patients with subclinical hypothyroidism and hypertension","authors":"M. Orel, L. Martynyuk","doi":"10.22141/2224-0721.19.5.2023.1301","DOIUrl":"https://doi.org/10.22141/2224-0721.19.5.2023.1301","url":null,"abstract":"Background. According to epidemiological studies, the prevalence of subclinical hypothyroidism is about 6 % and it depends on age, gender, region of residence and, at the same time, significantly exceeds the frequency of primary hypothyroidism. Within one year, 5 % of cases of subclinical hypothyroidism turn into the manifested form. Delayed diagnosis of the disease increases the risk of serious complications. It is still controversial whether subclinical hypothyroidism affects blood pressure because of conflicting results in published studies. Thus, the aim of this study was to assess the effects of levothyroxine replacement therapy in patients with subclinical hypothyroidism and hypertension on lipid metabolism, functional state of the endothelium and cognition. Materials and methods. Thirty-one patients with subclinical hypothyroidism and stage 2 hypertension participated in the study, among them 12 (38.71 %) men and 19 (61.29 %) women. The average age of participants was 63.19 ± 1.93 years. The study examined lipid profile, functional state of the endothelium, and cognitive functions based on the results of the Montreal Cognitive Assessment before and after 3 months of additional administration of the levothyroxine replacement therapy at a dose 25–50 µg daily. Results. The lipid analysis revealed a significant decrease in total cholesterol for 10.08 % (5.54 ± 0.17 mmol/L against 6.23 ± 0.25 mmol/L, Р < 0.05), low-density lipoprotein cholesterol for 24.5 % (3.39 ± 0.17 mmol/L against 4.49 ± 0.27 mmol/L, Р < 0.01), triglycerides for 19.42 % (1.66 ± 0.11 mmol/L against 2.06 ± 0.16 mmol/L, Р < 0.05) compared to those at baseline. At the same time, patients with subclinical hypothyroidism and hypertension showed a reliable decrease in atherogenic dyslipidemias, 64.52 against 74.19 %. We also observed a reliable improvement of the functional state of the endothelium: the mean value of the endothelium-dependent vasodilation of the brachial artery increased for 11 % (6.56 ± 0.10 % against 5.91 ± 0.05 %, Р < 0.001). The results of the neuropsychological testing showed a reliable improvement of the cognitive functions among examined patients: the average score on the Montreal Cognitive Assessment raised from 23.77 ± 0.60 at baseline to 26.65 ± 0.47 after three months of taking levothyroxine, Р < 0.001. Conclusions. Levothyroxine replacement therapy in patients with subclinical hypothyroidism and hypertension was followed by a normalization of lipid profile and a decrease in atherogenic dyslipidemias, an improvement of the functional state of the endothelium and state of cognition.","PeriodicalId":13962,"journal":{"name":"INTERNATIONAL JOURNAL OF ENDOCRINOLOGY (Ukraine)","volume":"32 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81274061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-03DOI: 10.22141/2224-0721.19.5.2023.1298
M. Gorobeiko, A. Dinets
Background. The recurrent laryngeal nerve (RLN) damage and parathyroid gland injury are the most severe complications of thyroid surgery. The possibility of RLN confirmation in the near-infrared spectrum after the injection of indocyanine green (ICG) was not yet been studied. Aim: to evaluate the ICG angiography for the identification of RLN during thyroid and parathyroid surgery. Materials and methods. ICG angiography of RLN was performed in 7 patients. An intraoperative neuromonitoring was applied as a method of controlling RLN. During the operation, parathyroid glands and RLN were identified by visual inspection (naked eye). To further confirm the location of the parathyroid glands by autofluorescence, an intravenous injection of ICG was performed with a concentration of 0.25 mg/kg followed by the application of the image-based system. Results. A good signal was achieved in the near-infrared spectrum from the RLN in all cases after the ICG injection. Sufficient blood perfusion of the RLN could be considered as a reasonable explanation for the exhibition of a good ICG near-infrared signal. Conclusions. ICG use might be a helpful approach for the confirmation of the RLN in addition to routine visual identification. Such function could be applied during fluorescence-guided surgery to evaluate the parathyroid gland autofluorescence. Visualization of RLN by ICG angiography is considered as an additional useful feature to prevent RLN injury.
{"title":"Unexpected mapping of recurrent laryngeal nerve by fluorescence-guided surgery using near-infrared indocyanine green angiography","authors":"M. Gorobeiko, A. Dinets","doi":"10.22141/2224-0721.19.5.2023.1298","DOIUrl":"https://doi.org/10.22141/2224-0721.19.5.2023.1298","url":null,"abstract":"Background. The recurrent laryngeal nerve (RLN) damage and parathyroid gland injury are the most severe complications of thyroid surgery. The possibility of RLN confirmation in the near-infrared spectrum after the injection of indocyanine green (ICG) was not yet been studied. Aim: to evaluate the ICG angiography for the identification of RLN during thyroid and parathyroid surgery. Materials and methods. ICG angiography of RLN was performed in 7 patients. An intraoperative neuromonitoring was applied as a method of controlling RLN. During the operation, parathyroid glands and RLN were identified by visual inspection (naked eye). To further confirm the location of the parathyroid glands by autofluorescence, an intravenous injection of ICG was performed with a concentration of 0.25 mg/kg followed by the application of the image-based system. Results. A good signal was achieved in the near-infrared spectrum from the RLN in all cases after the ICG injection. Sufficient blood perfusion of the RLN could be considered as a reasonable explanation for the exhibition of a good ICG near-infrared signal. Conclusions. ICG use might be a helpful approach for the confirmation of the RLN in addition to routine visual identification. Such function could be applied during fluorescence-guided surgery to evaluate the parathyroid gland autofluorescence. Visualization of RLN by ICG angiography is considered as an additional useful feature to prevent RLN injury.","PeriodicalId":13962,"journal":{"name":"INTERNATIONAL JOURNAL OF ENDOCRINOLOGY (Ukraine)","volume":"15 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84417076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cardiovascular diseases have been the leading cause of death worldwide for a long time. Despite numerous studies on the pathogenetic mechanisms of cardiovascular diseases, there are many debatable issues. In recent years, an increasing number of scientific reports have appeared regarding the presence of common mechanisms in the development of bone tissue and arterial calcification. One of the connecting links in this interaction is considered to be the impact of osteocalcin. Osteocalcin is a vitamin K-dependent protein of the bone matrix, synthesized by osteoblasts. The main function of osteocalcin is the synthesis of hydroxyapatites as main mineral component of bone tissue. In addition, osteocalcin has a wide range of extraosseous effects, the most studied is participation in the regulation of glycolipid and energy metabolism. Research on the osteocalcin role in the development and progression of cardiovascular diseases are scarce, the available data is contradictory. For a deeper understanding of this problem, we conducted a systematic analysis of modern literature based on data from the scientific databases Medline (Pubmed), Scopus, Web of Science, Google Scholar, and Cochrane Library for 2013–2023. According to its results, osteocalcin is a potential biomarker of cardiovascular status, its increased values are associated with a potentially protective mechanism against the development of cardiovascular diseases. Contradictory views on the understanding of the pathogenetic mechanism of influence of general osteocalcin and its forms on the course of cardiovascular diseases necessitate conduction of further research.
长期以来，心血管疾病一直是世界范围内导致死亡的主要原因。尽管对心血管疾病的发病机制进行了大量研究，但仍存在许多争议性问题。近年来，越来越多的科学报道出现在骨组织和动脉钙化的发展中存在共同的机制。在这种相互作用中的一个连接环节被认为是骨钙素的影响。骨钙素是一种依赖维生素k的骨基质蛋白，由成骨细胞合成。骨钙素的主要功能是合成羟基磷灰石作为骨组织的主要矿物成分。此外，骨钙素具有广泛的骨外作用，研究最多的是参与糖脂和能量代谢的调节。关于骨钙素在心血管疾病发生发展中的作用的研究很少，现有的数据相互矛盾。为了更深入地了解这一问题，我们基于2013-2023年科学数据库Medline (Pubmed)、Scopus、Web of Science、Google Scholar和Cochrane Library的数据，对现代文献进行了系统分析。根据其结果，骨钙素是心血管状态的潜在生物标志物，其升高的值可能与预防心血管疾病发展的潜在保护机制有关。一般骨钙素及其形态对心血管疾病病程影响的发病机制的认识存在矛盾，需要进行进一步的研究。
{"title":"Osteocalcin role in the development and progression of cardiovascular diseases","authors":"A.V. Кovalchuk, О.V. Zinich, N.M. Кushnareva, О.В. Prybyla, K.O. Shishkan-Shishova","doi":"10.22141/2224-0721.19.5.2023.1305","DOIUrl":"https://doi.org/10.22141/2224-0721.19.5.2023.1305","url":null,"abstract":"Cardiovascular diseases have been the leading cause of death worldwide for a long time. Despite numerous studies on the pathogenetic mechanisms of cardiovascular diseases, there are many debatable issues. In recent years, an increasing number of scientific reports have appeared regarding the presence of common mechanisms in the development of bone tissue and arterial calcification. One of the connecting links in this interaction is considered to be the impact of osteocalcin. Osteocalcin is a vitamin K-dependent protein of the bone matrix, synthesized by osteoblasts. The main function of osteocalcin is the synthesis of hydroxyapatites as main mineral component of bone tissue. In addition, osteocalcin has a wide range of extraosseous effects, the most studied is participation in the regulation of glycolipid and energy metabolism. Research on the osteocalcin role in the development and progression of cardiovascular diseases are scarce, the available data is contradictory. For a deeper understanding of this problem, we conducted a systematic analysis of modern literature based on data from the scientific databases Medline (Pubmed), Scopus, Web of Science, Google Scholar, and Cochrane Library for 2013–2023. According to its results, osteocalcin is a potential biomarker of cardiovascular status, its increased values are associated with a potentially protective mechanism against the development of cardiovascular diseases. Contradictory views on the understanding of the pathogenetic mechanism of influence of general osteocalcin and its forms on the course of cardiovascular diseases necessitate conduction of further research.","PeriodicalId":13962,"journal":{"name":"INTERNATIONAL JOURNAL OF ENDOCRINOLOGY (Ukraine)","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83144236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background. Impaired homeostasis of the retinal tissue in diabetes primarily involves microglia, which triggers a cascade of inflammatory reactions, one of the main mechanisms of diabetic retinopathy (DR). The purpose of the study was to determine the state of microglia in experimental DR and the effect of the tyrosine protein kinase blocker imatinib. Materials and methods. In 45 three-month-old male Wistar rats, diabetes was simulated by a single injection of streptozotocin (50 mg/kg; Sigma-Aldrich). The rats were divided into 3 groups: controls; short-acting insulin; insulin and imatinib (Grindex, Latvia). Immunohistochemically, CD68-positive cells were detected in the retina, and the levels of ionized calcium-binding adapter molecule 1 (Iba-1) and matrix metalloproteinase 9 (MMP-9) was evaluated by immunoblotting. Results. The retinal content of Iba-1 progressively increased and exceeded the initial level by 2.0 times after 7 days, and by 3.55 times after 28 days (p < 0.05). The insulin introduction inhibited the Iba-1 increase, which, although exceeding the initial level by 1.8 times, was significantly lower than the protein level in the control group after 28 days. The administration of imatinib together with insulin prevented the accumulation of Iba-1 in the retinal tissue: the protein content did not differ from the initial level (p > 0.05). CD68-positive cells in the retina were noted in the vessels of the choroid plexus throughout the observation, from the 14th day — in the dilated venules of the outer plexiform layer (monocytic pool), and from day 28 — diffusely in the parenchyma of the inner layers (microglial pool). The latter had either a rounded or a ramified shape, which corresponded to the morphology of amoeboid (phagocytic) or activated microglia. Tyrosine protein kinase blockade prevented the microglial activation in the retina. Signs of inflammation in the form of retinal MMP-9 increase and fibrotic retinal proliferations were absent on the 28th day when using insulin and imatinib. Conclusions. The blockade of retinal inflammation and microglial activation by imatinib indicated the prospects of tyrosine protein kinases inhibition in DR and substantiated the prospect of further research with the clarification of such an effect on other mechanisms of DR development.
{"title":"Effect of tyrosine protein kinase blockade on the state of retinal microglia in diabetic retinopathy","authors":"V.V. Vodianyk, S.V. Ziablitzev, V.I. Andrushchenko","doi":"10.22141/2224-0721.19.5.2023.1296","DOIUrl":"https://doi.org/10.22141/2224-0721.19.5.2023.1296","url":null,"abstract":"Background. Impaired homeostasis of the retinal tissue in diabetes primarily involves microglia, which triggers a cascade of inflammatory reactions, one of the main mechanisms of diabetic retinopathy (DR). The purpose of the study was to determine the state of microglia in experimental DR and the effect of the tyrosine protein kinase blocker imatinib. Materials and methods. In 45 three-month-old male Wistar rats, diabetes was simulated by a single injection of streptozotocin (50 mg/kg; Sigma-Aldrich). The rats were divided into 3 groups: controls; short-acting insulin; insulin and imatinib (Grindex, Latvia). Immunohistochemically, CD68-positive cells were detected in the retina, and the levels of ionized calcium-binding adapter molecule 1 (Iba-1) and matrix metalloproteinase 9 (MMP-9) was evaluated by immunoblotting. Results. The retinal content of Iba-1 progressively increased and exceeded the initial level by 2.0 times after 7 days, and by 3.55 times after 28 days (p < 0.05). The insulin introduction inhibited the Iba-1 increase, which, although exceeding the initial level by 1.8 times, was significantly lower than the protein level in the control group after 28 days. The administration of imatinib together with insulin prevented the accumulation of Iba-1 in the retinal tissue: the protein content did not differ from the initial level (p > 0.05). CD68-positive cells in the retina were noted in the vessels of the choroid plexus throughout the observation, from the 14th day — in the dilated venules of the outer plexiform layer (monocytic pool), and from day 28 — diffusely in the parenchyma of the inner layers (microglial pool). The latter had either a rounded or a ramified shape, which corresponded to the morphology of amoeboid (phagocytic) or activated microglia. Tyrosine protein kinase blockade prevented the microglial activation in the retina. Signs of inflammation in the form of retinal MMP-9 increase and fibrotic retinal proliferations were absent on the 28th day when using insulin and imatinib. Conclusions. The blockade of retinal inflammation and microglial activation by imatinib indicated the prospects of tyrosine protein kinases inhibition in DR and substantiated the prospect of further research with the clarification of such an effect on other mechanisms of DR development.","PeriodicalId":13962,"journal":{"name":"INTERNATIONAL JOURNAL OF ENDOCRINOLOGY (Ukraine)","volume":"51 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75143788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-03DOI: 10.22141/2224-0721.19.5.2023.1295
Z.Ya, Kotsiubiichuk A.A, Antoniv O.S, Khukhlina, Z. Kotsiubiichuk
Background. State of carbohydrate metabolism and severity of insulin resistance in the comorbid course of non-alcoholic steatohepatitis (NASH) and diabetic kidney disease (DKD) in patients with type 2 diabetes mellitus (DM2) is due to the cascade of possible transformation of NASH into liver cirrhosis. The purpose is to study the interaction of changes in glucose and insulin homeostasis, the degree of insulin resistance and insulin sensitivity, the degree of hemoglobin glycosylation on the clinical course of NASH associated with DM depending on the presence of DKD and its stage. Materials and methods. One hundred and eight patients with NASH and comorbid DM2 were examined. The average age of patients was 58.2 ± 6.1 years. There were 63 women (58.3 %) and 45 men (41.7 %). Depending on the presence of DKD, 4 groups of patients were formed, who were randomized by age, sex, activity of cytolytic syndrome. The comparison group consisted of 30 healthy individuals of the appropriate age and sex. The degree of hepatic steatosis and its nature were determined using SteatoTest, ASH and NASH-Test kits (BioPredictive, France). The stage of liver fibrosis was determined using FibroTest (BioPredictive, France), a set of markers for quantitative biochemical evaluation of fibrosis. Results. In patients with NASH, DM2 and DKD stage I–II, we found a significant decrease in serum albumin by 9.0 % (p < 0.05); glomerular filtration rate (GFR) and urine albumin, on the contrary, increased significantly, by 1.5 times (p < 0.05) compared to those in the control group, which indicates the phenomenon of hyperfiltration and is specific to the initial stage of DKD. When NASH is combined with DM2 and DKD stage III, a significant decrease in serum albumin by 1.2 times (p < 0.05) is reported; GFR and albuminuria were significantly increased, by 1.4 and 11.7 times (p < 0.05), respectively, compared to the control group. In patients with NASH, DM2 and DKD stage IV, we found a significant decrease in serum albumin by 1.4 times (p < 0.05), it was significantly increased by 30.2 times (p < 0.05) compared to the indicator in the control group, and the GFR, on the contrary, was significantly reduced by 1.7 times (p < 0.05), which indicates the progression of DKD. Conclusions. Disorders of glucose homeostasis due to insulin resistance are one of the probable risk factors for the progression of non-alcoholic steatohepatitis and type 2 diabetes mellitus in the presence of stage I–IV diabetic kidney disease.
{"title":"The glycemic profile in patients with non-alcoholic steatohepatitis and type 2 diabetes depending on diabetic kidney disease","authors":"Z.Ya, Kotsiubiichuk A.A, Antoniv O.S, Khukhlina, Z. Kotsiubiichuk","doi":"10.22141/2224-0721.19.5.2023.1295","DOIUrl":"https://doi.org/10.22141/2224-0721.19.5.2023.1295","url":null,"abstract":"Background. State of carbohydrate metabolism and severity of insulin resistance in the comorbid course of non-alcoholic steatohepatitis (NASH) and diabetic kidney disease (DKD) in patients with type 2 diabetes mellitus (DM2) is due to the cascade of possible transformation of NASH into liver cirrhosis. The purpose is to study the interaction of changes in glucose and insulin homeostasis, the degree of insulin resistance and insulin sensitivity, the degree of hemoglobin glycosylation on the clinical course of NASH associated with DM depending on the presence of DKD and its stage. Materials and methods. One hundred and eight patients with NASH and comorbid DM2 were examined. The average age of patients was 58.2 ± 6.1 years. There were 63 women (58.3 %) and 45 men (41.7 %). Depending on the presence of DKD, 4 groups of patients were formed, who were randomized by age, sex, activity of cytolytic syndrome. The comparison group consisted of 30 healthy individuals of the appropriate age and sex. The degree of hepatic steatosis and its nature were determined using SteatoTest, ASH and NASH-Test kits (BioPredictive, France). The stage of liver fibrosis was determined using FibroTest (BioPredictive, France), a set of markers for quantitative biochemical evaluation of fibrosis. Results. In patients with NASH, DM2 and DKD stage I–II, we found a significant decrease in serum albumin by 9.0 % (p < 0.05); glomerular filtration rate (GFR) and urine albumin, on the contrary, increased significantly, by 1.5 times (p < 0.05) compared to those in the control group, which indicates the phenomenon of hyperfiltration and is specific to the initial stage of DKD. When NASH is combined with DM2 and DKD stage III, a significant decrease in serum albumin by 1.2 times (p < 0.05) is reported; GFR and albuminuria were significantly increased, by 1.4 and 11.7 times (p < 0.05), respectively, compared to the control group. In patients with NASH, DM2 and DKD stage IV, we found a significant decrease in serum albumin by 1.4 times (p < 0.05), it was significantly increased by 30.2 times (p < 0.05) compared to the indicator in the control group, and the GFR, on the contrary, was significantly reduced by 1.7 times (p < 0.05), which indicates the progression of DKD. Conclusions. Disorders of glucose homeostasis due to insulin resistance are one of the probable risk factors for the progression of non-alcoholic steatohepatitis and type 2 diabetes mellitus in the presence of stage I–IV diabetic kidney disease.","PeriodicalId":13962,"journal":{"name":"INTERNATIONAL JOURNAL OF ENDOCRINOLOGY (Ukraine)","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91104499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-03DOI: 10.22141/2224-0721.19.5.2023.1300
A. Herashchenko, S. Fedorov, M. Bielinskyi, N. Seredyuk, B.L. Henyk
Background. Heart failure with preserved ejection fraction is a common disease affecting more than half of people with heart failure. Among the extracardiac proinflammatory conditions, type 2 diabetes mellitus, which occurs in approximately 30–40 % of patients with heart failure, deserves special attention. The purpose of the study is to evaluate the effect of empagliflozin on the left ventricular diastolic function in patients with type 2 diabetes mellitus and concomitant heart failure with preserved ejection fraction. Materials and methods. One hundred and twenty patients met the study criteria and were randomized in a 1 : 1 ratio to the empagliflozin group (n = 60) or the control group (n = 60), which received other antidiabetic drugs. The follow-up period lasted 12 weeks. A transthoracic echocardiogram was performed and functional and structural changes of the heart in these diseases were identified. Results. The data showed a marked improvement in several cardiac parameters. One important result was a decrease in the left ventricular mass index, which indicates a reduction in the left ventricular size and hypertrophy. This reduction shows a favorable course of remodeling and a potential regression of cardiac remodeling under the influence of empagliflozin. In addition, the study demonstrated an improvement in the left ventricular diastolic function. In particular, deceleration time and the E/e’ ratio showed favorable changes. Deceleration time, which reflects the relaxation and compliance of the left ventricle, decreased significantly, indicating an improvement in diastolic function. The E/e’ ratio, a marker of the left ventricular filling pressure, also showed positive changes, indicating a decrease in cardiac tension and improved ventricular relaxation. Conclusions. The results of the study demonstrated that empagliflozin treatment has a positive effect on various cardiovascular parameters in patients with the studied diseases, in particular on the left ventricular diastolic function. These findings contribute to our understanding of the therapeutic potential of empagliflozin in the management of cardiovascular diseases.
{"title":"Effect of empagliflozin on the left ventricular diastolic function in patients with type 2 diabetes mellitus and concomitant heart failure with preserved ejection fraction","authors":"A. Herashchenko, S. Fedorov, M. Bielinskyi, N. Seredyuk, B.L. Henyk","doi":"10.22141/2224-0721.19.5.2023.1300","DOIUrl":"https://doi.org/10.22141/2224-0721.19.5.2023.1300","url":null,"abstract":"Background. Heart failure with preserved ejection fraction is a common disease affecting more than half of people with heart failure. Among the extracardiac proinflammatory conditions, type 2 diabetes mellitus, which occurs in approximately 30–40 % of patients with heart failure, deserves special attention. The purpose of the study is to evaluate the effect of empagliflozin on the left ventricular diastolic function in patients with type 2 diabetes mellitus and concomitant heart failure with preserved ejection fraction. Materials and methods. One hundred and twenty patients met the study criteria and were randomized in a 1 : 1 ratio to the empagliflozin group (n = 60) or the control group (n = 60), which received other antidiabetic drugs. The follow-up period lasted 12 weeks. A transthoracic echocardiogram was performed and functional and structural changes of the heart in these diseases were identified. Results. The data showed a marked improvement in several cardiac parameters. One important result was a decrease in the left ventricular mass index, which indicates a reduction in the left ventricular size and hypertrophy. This reduction shows a favorable course of remodeling and a potential regression of cardiac remodeling under the influence of empagliflozin. In addition, the study demonstrated an improvement in the left ventricular diastolic function. In particular, deceleration time and the E/e’ ratio showed favorable changes. Deceleration time, which reflects the relaxation and compliance of the left ventricle, decreased significantly, indicating an improvement in diastolic function. The E/e’ ratio, a marker of the left ventricular filling pressure, also showed positive changes, indicating a decrease in cardiac tension and improved ventricular relaxation. Conclusions. The results of the study demonstrated that empagliflozin treatment has a positive effect on various cardiovascular parameters in patients with the studied diseases, in particular on the left ventricular diastolic function. These findings contribute to our understanding of the therapeutic potential of empagliflozin in the management of cardiovascular diseases.","PeriodicalId":13962,"journal":{"name":"INTERNATIONAL JOURNAL OF ENDOCRINOLOGY (Ukraine)","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81376387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-03DOI: 10.22141/2224-0721.19.5.2023.1299
V. Tkachenko, T. Bagro
Background. The significant spread of obesity stimulates researchers to search for etiopathogenic treatment by studying the relationships and dependencies of the hormonal, neurochemical and psychosomatic components. The purpose of the study is to determine the correlation between body weight, serotonin level, mental health status, sleep disorders and metabolism in obese patients. Materials and methods. In a cohort, prospective study, 75 patients with obesity were observed for 6 months. They were divided into 2 groups depending on the detected psychosocial characteristics and sleep disorders with the appropriate treatment using a patient-oriented approach. The examination included studying body mass index (BMI), abdominal obesity indices (body surface area, waist/hip ratio, conicity index, a body shape index, abdominal volume index), blood pressure, lipid profile, fasting glucose, insulin, leptin, serotonin, assessment of psychosocial status and sleep quality with Hospital Anxiety and Depression Scale (HADS), Beck’s Depression Inventory (BDI), Hamilton Anxiety Rating Scale (HAM-A), Epworth Sleepiness Scale (ESS), Pittsburgh Sleep Quality Index (PSQI), quality of life using the SF-36 questionnaire. Statistical analysis was performed using IBM SPSS Statistics, Statistica 12, Excel 2010. Results. At baseline, the patients had obesity class I and II. Тhe calculated indices of abdominal obesity, indicators of lipid and carbohydrate metabolism, scores of questionnaires of eating behavior, anxiety and depression, quality of sleep, sleepiness and leptin level exceeded the recommended values, while the level of serotonin, the scores of the SF-36 had low values that significantly improved in dynamics. Strong direct correlations at baseline were found between BMI, abdominal obesity indices, blood pressure, indicators of lipid and carbohydrate metabolism, leptin, HADS, BDI, HAM-A, ESS, PSQI global score; a strong inverse (negative) relationship was noted between BMI and the levels of high-density lipoprotein and serotonin. A high negative correlation was found between serotonin and BMI, abdominal obesity indices (body surface area, a body shape index, abdominal volume index, conicity index), blood pressure, indicators of lipid and carbohydrate metabolism, HADS, HAM-A, BDI, PSQI global score, sleep quality, latency, duration, efficiency and the ESS. Conclusions. The high BMI correlates with a low level of serotonin, increased level of anxiety and depression, drowsiness, deterioration of the quality of sleep and life, disorders of lipid and carbohydrate metabolism, which are mutually aggravating factors for the development of obesity and other non-infectious diseases; it must be taken into account when determining approaches to comprehensive patient-oriented treatment of obesity.
{"title":"The correlation between body weight, serotonin levels, mental health status, sleep disorders and metabolism in patients with obesity","authors":"V. Tkachenko, T. Bagro","doi":"10.22141/2224-0721.19.5.2023.1299","DOIUrl":"https://doi.org/10.22141/2224-0721.19.5.2023.1299","url":null,"abstract":"Background. The significant spread of obesity stimulates researchers to search for etiopathogenic treatment by studying the relationships and dependencies of the hormonal, neurochemical and psychosomatic components. The purpose of the study is to determine the correlation between body weight, serotonin level, mental health status, sleep disorders and metabolism in obese patients. Materials and methods. In a cohort, prospective study, 75 patients with obesity were observed for 6 months. They were divided into 2 groups depending on the detected psychosocial characteristics and sleep disorders with the appropriate treatment using a patient-oriented approach. The examination included studying body mass index (BMI), abdominal obesity indices (body surface area, waist/hip ratio, conicity index, a body shape index, abdominal volume index), blood pressure, lipid profile, fasting glucose, insulin, leptin, serotonin, assessment of psychosocial status and sleep quality with Hospital Anxiety and Depression Scale (HADS), Beck’s Depression Inventory (BDI), Hamilton Anxiety Rating Scale (HAM-A), Epworth Sleepiness Scale (ESS), Pittsburgh Sleep Quality Index (PSQI), quality of life using the SF-36 questionnaire. Statistical analysis was performed using IBM SPSS Statistics, Statistica 12, Excel 2010. Results. At baseline, the patients had obesity class I and II. Тhe calculated indices of abdominal obesity, indicators of lipid and carbohydrate metabolism, scores of questionnaires of eating behavior, anxiety and depression, quality of sleep, sleepiness and leptin level exceeded the recommended values, while the level of serotonin, the scores of the SF-36 had low values that significantly improved in dynamics. Strong direct correlations at baseline were found between BMI, abdominal obesity indices, blood pressure, indicators of lipid and carbohydrate metabolism, leptin, HADS, BDI, HAM-A, ESS, PSQI global score; a strong inverse (negative) relationship was noted between BMI and the levels of high-density lipoprotein and serotonin. A high negative correlation was found between serotonin and BMI, abdominal obesity indices (body surface area, a body shape index, abdominal volume index, conicity index), blood pressure, indicators of lipid and carbohydrate metabolism, HADS, HAM-A, BDI, PSQI global score, sleep quality, latency, duration, efficiency and the ESS. Conclusions. The high BMI correlates with a low level of serotonin, increased level of anxiety and depression, drowsiness, deterioration of the quality of sleep and life, disorders of lipid and carbohydrate metabolism, which are mutually aggravating factors for the development of obesity and other non-infectious diseases; it must be taken into account when determining approaches to comprehensive patient-oriented treatment of obesity.","PeriodicalId":13962,"journal":{"name":"INTERNATIONAL JOURNAL OF ENDOCRINOLOGY (Ukraine)","volume":"15 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78972947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-18DOI: 10.22141/2224-0721.19.4.2023.1287
V.S. Djuryak, A. Mikheev, L. Sydorchuk, I. Pankiv
Background. Gestational diabetes is a condition that arises due to impaired metabolic processes against the background of insulin resistance and an increase in blood glucose levels during pregnancy. This pathology leads to a significant number of pregnancy and childbirth complications, high child perinatal morbidity and mortality, and its prevalence varies throughout the world. The aim of the work was to determine the taxonomic composition, population level and microecological indicators of the macroorganism-microbiome ecosystem of the symbiotic colon microbiota in women with gestational diabetes. Materials and methods. The microbiological examination of the colon contents was carried out in 26 pregnant women aged 18 to 35 years. The clinical material for microbiological examination was the fresh colon contents (faeces) taken from medium portions, which were collected in sterile (after autoclaving) vials. Results. According to the results of the work, it was found that during gestational diabetes, the taxonomic composition and microecological parameters of the macroorganism-microbiome ecosystem of the colon microbiota in women are impaired due to the biotope contamination with pathogenic microorganisms (E.coli HLy+) and opportunistic pathogens (E.coli Lac-, P.mirabilis, P.vulgaris, E.cloacae, C.diversus, S.marcescens), enterobacteria, C.albicans, P.niger and bacteria of the genus Clostridium. Alterations in the taxonomic composition and microecological indicators of the colon microbiome in women with gestational diabetes lead to multidirectional changes depending on the taxon: a decrease in the population level of bacteria, which are the most important in terms of representation in the human colon microbiome, with a multifunctional role in maintaining microecological homeostasis (bacteria of the genus Bifidobacterium — by 17.59 %, Lactobacillus — by 38.37 %) and an increase or a stable trend towards an increase in the population level of opportunistic enterobacteria P.mirabilis by 26.67 %; among other enterobacteria, the population reaches high levels (from 6.390 ± 0.009 lg CFU/g to 7.46 ± 0.17 lg CFU/g), the level of Staphylococcus in increased by 35.94 %, C.albicans — by 26.74 %, P.melaninogenicus — by 55.93 %.
背景。妊娠期糖尿病是由于妊娠期间胰岛素抵抗和血糖水平升高的背景下代谢过程受损而引起的一种疾病。这种病理导致大量的妊娠和分娩并发症，儿童围产期发病率和死亡率高，其患病率在世界各地各不相同。目的:研究妊娠期糖尿病患者结肠微生物群的微生物群生态系统的分类组成、种群水平和微生态指标。材料和方法。对26例18 ~ 35岁的孕妇进行了结肠内容物的微生物学检查。微生物学检查的临床材料是从培养基中取出的新鲜结肠内容物(粪便)，这些内容物是在无菌(经过高压灭菌)的小瓶中收集的。结果。研究结果表明，妊娠糖尿病期间，由于病原菌(大肠杆菌HLy+)和条件致病菌(大肠杆菌Lac-、mirabilis、p.a vulgaris、阴沟杆菌、多样梭菌、粘质梭菌)、肠杆菌、白色梭菌、黑孢杆菌和梭菌属细菌)的污染，妇女结肠微生物群的微生物生态系统的分类组成和微生态参数受到损害。妊娠期糖尿病妇女结肠微生物组的分类组成和微生态指标的改变导致了根据分类群的多向变化:在人类结肠微生物群中最重要的代表，在维持微生态稳态方面发挥多功能作用的细菌(双歧杆菌属细菌-减少17.59%，乳酸杆菌-减少38.37%)的种群水平下降，机会性mirabilis肠杆菌种群水平增加或稳定增长26.67%;其他肠道菌群中，葡萄球菌水平较高(从6.390±0.009 lg CFU/g上升至7.46±0.17 lg CFU/g)，其中葡萄球菌水平上升35.94%，白色念珠菌上升26.74%，黑素假单胞菌上升55.93%。
{"title":"The state of the colon microbiome in women with gestational diabetes","authors":"V.S. Djuryak, A. Mikheev, L. Sydorchuk, I. Pankiv","doi":"10.22141/2224-0721.19.4.2023.1287","DOIUrl":"https://doi.org/10.22141/2224-0721.19.4.2023.1287","url":null,"abstract":"Background. Gestational diabetes is a condition that arises due to impaired metabolic processes against the background of insulin resistance and an increase in blood glucose levels during pregnancy. This pathology leads to a significant number of pregnancy and childbirth complications, high child perinatal morbidity and mortality, and its prevalence varies throughout the world. The aim of the work was to determine the taxonomic composition, population level and microecological indicators of the macroorganism-microbiome ecosystem of the symbiotic colon microbiota in women with gestational diabetes. Materials and methods. The microbiological examination of the colon contents was carried out in 26 pregnant women aged 18 to 35 years. The clinical material for microbiological examination was the fresh colon contents (faeces) taken from medium portions, which were collected in sterile (after autoclaving) vials. Results. According to the results of the work, it was found that during gestational diabetes, the taxonomic composition and microecological parameters of the macroorganism-microbiome ecosystem of the colon microbiota in women are impaired due to the biotope contamination with pathogenic microorganisms (E.coli HLy+) and opportunistic pathogens (E.coli Lac-, P.mirabilis, P.vulgaris, E.cloacae, C.diversus, S.marcescens), enterobacteria, C.albicans, P.niger and bacteria of the genus Clostridium. Alterations in the taxonomic composition and microecological indicators of the colon microbiome in women with gestational diabetes lead to multidirectional changes depending on the taxon: a decrease in the population level of bacteria, which are the most important in terms of representation in the human colon microbiome, with a multifunctional role in maintaining microecological homeostasis (bacteria of the genus Bifidobacterium — by 17.59 %, Lactobacillus — by 38.37 %) and an increase or a stable trend towards an increase in the population level of opportunistic enterobacteria P.mirabilis by 26.67 %; among other enterobacteria, the population reaches high levels (from 6.390 ± 0.009 lg CFU/g to 7.46 ± 0.17 lg CFU/g), the level of Staphylococcus in increased by 35.94 %, C.albicans — by 26.74 %, P.melaninogenicus — by 55.93 %.","PeriodicalId":13962,"journal":{"name":"INTERNATIONAL JOURNAL OF ENDOCRINOLOGY (Ukraine)","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80599707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-18DOI: 10.22141/2224-0721.19.4.2023.1284
L. Netrebin, V. Pankiv, M. Kyryliuk
Background. In modern medicine, modeling of pathological processes is actively implementing in clinical endocrinology and ophthalmology. This process provides an opportunity to predict the risk of occurrence, course, prognosis and development of complications of type 2 diabetes mellitus (T2DM), in particular diabetic retinopathy (DR). Nowadays, special attention is paid to the course of DR against the background of vitamin D deficiency. But in the scientific literature, there are no mathematical models for assessing the risk of DM progression in patients with type 2 diabetes against the background of vitamin D deficiency. Aim of the study is to develop an adequate mathematical model for assessing the prognostic significance of 25(OH)D deficiency in the progression of diabetic retinopathy in patients with type 2 diabetes. Materials and methods. An open observational single-center one-stage selective study was conducted. It was approved by the Local Ethics Committee. Seventy-one patients (138 eyes) with T2DM and DR (men and women; mean age 61.9 ± 2.4 years; mean HbA1c 8.12 ± 0.91 %) were divided into 3 groups, based on the stage of DR (according to fundus instrumental examination). The inclusion of patients in groups with DR was carried out in accordance with the ETDRS protocol (2019). Statistical processing included ANOVA, MANOVA and regression analysis with the construction of logistic regression models. Results. A statistically significant (p < 0.001) decrease in the risk of a high degree of DR was found with an increasing concentration of 25(OH)D in the blood plasma for each 1 ng/ml (odds ratio = 0.46 (0.32–0.67)). The pseudocorrelation index (Nagelkerke) R2 is 0.54, area under a receiver operating characteristic curve is 0.92 (95% confidence interval (CI) 0.85–0.97), which indicates the presence of a strong relationship between the risk of a high degree of DR and the concentration of 25(OH)D in the blood, gender and HbA1c level. The obtained multifactorial model was represented by the appropriate mathematical formula. The sensitivity (according to the Youden index) of the obtained logistic regression model is 84.4 % (95% CI 73.1–92.2), specificity is 92.3% (95% CI 74.9–99.1). Conclusions. An adequate mathematical model of logistic regression was developed to assess the prognostic significance of total vitamin D deficiency in the progression of DR in patients with T2DM. Its prognostic significance is 96.4 % (95% CI 87.7–99.0).
背景。在现代医学中，病理过程的建模正在临床内分泌和眼科中积极实施。这一过程为预测2型糖尿病(T2DM)，特别是糖尿病视网膜病变(DR)的发生、病程、预后和并发症发展的风险提供了机会。目前，在维生素D缺乏的背景下，DR的病程受到了特别的关注。但在科学文献中，没有数学模型来评估维生素D缺乏背景下2型糖尿病患者糖尿病进展的风险。该研究的目的是建立一个适当的数学模型来评估25(OH)D缺乏在2型糖尿病患者糖尿病视网膜病变进展中的预后意义。材料和方法。进行了一项开放观察性单中心单阶段选择性研究。经当地伦理委员会批准。T2DM合并DR患者71例(138眼)(男女均有);平均年龄61.9±2.4岁;平均糖化血红蛋白(HbA1c)为8.12±0.91%)，根据DR分期(根据眼底仪器检查)分为3组。根据ETDRS方案(2019)将患者纳入DR组。统计处理包括方差分析、方差分析和回归分析，并建立了logistic回归模型。结果。血浆中25(OH)D浓度每增加1 ng/ml，发生高度DR的风险显著降低(p < 0.001)(优势比= 0.46(0.32-0.67))。伪相关指数(Nagelkerke) R2为0.54，受试者工作特征曲线下面积为0.92(95%可信区间(CI) 0.85 ~ 0.97)，表明高DR风险与血液中25(OH)D浓度、性别、HbA1c水平存在较强的相关性。得到的多因子模型用适当的数学公式表示。所得logistic回归模型的敏感性为84.4% (95% CI 73.1 ~ 92.2)，特异性为92.3% (95% CI 74.9 ~ 99.1)。结论。建立了一个适当的逻辑回归数学模型来评估总维生素D缺乏在T2DM患者DR进展中的预后意义。其预后意义为96.4% (95% CI 87.7 ~ 99.0)。
{"title":"Mathematical model for assessing the prognostic significance of 25(OH)D deficiency in the progression of diabetic retinopathy in type 2 diabetes patients","authors":"L. Netrebin, V. Pankiv, M. Kyryliuk","doi":"10.22141/2224-0721.19.4.2023.1284","DOIUrl":"https://doi.org/10.22141/2224-0721.19.4.2023.1284","url":null,"abstract":"Background. In modern medicine, modeling of pathological processes is actively implementing in clinical endocrinology and ophthalmology. This process provides an opportunity to predict the risk of occurrence, course, prognosis and development of complications of type 2 diabetes mellitus (T2DM), in particular diabetic retinopathy (DR). Nowadays, special attention is paid to the course of DR against the background of vitamin D deficiency. But in the scientific literature, there are no mathematical models for assessing the risk of DM progression in patients with type 2 diabetes against the background of vitamin D deficiency. Aim of the study is to develop an adequate mathematical model for assessing the prognostic significance of 25(OH)D deficiency in the progression of diabetic retinopathy in patients with type 2 diabetes. Materials and methods. An open observational single-center one-stage selective study was conducted. It was approved by the Local Ethics Committee. Seventy-one patients (138 eyes) with T2DM and DR (men and women; mean age 61.9 ± 2.4 years; mean HbA1c 8.12 ± 0.91 %) were divided into 3 groups, based on the stage of DR (according to fundus instrumental examination). The inclusion of patients in groups with DR was carried out in accordance with the ETDRS protocol (2019). Statistical processing included ANOVA, MANOVA and regression analysis with the construction of logistic regression models. Results. A statistically significant (p < 0.001) decrease in the risk of a high degree of DR was found with an increasing concentration of 25(OH)D in the blood plasma for each 1 ng/ml (odds ratio = 0.46 (0.32–0.67)). The pseudocorrelation index (Nagelkerke) R2 is 0.54, area under a receiver operating characteristic curve is 0.92 (95% confidence interval (CI) 0.85–0.97), which indicates the presence of a strong relationship between the risk of a high degree of DR and the concentration of 25(OH)D in the blood, gender and HbA1c level. The obtained multifactorial model was represented by the appropriate mathematical formula. The sensitivity (according to the Youden index) of the obtained logistic regression model is 84.4 % (95% CI 73.1–92.2), specificity is 92.3% (95% CI 74.9–99.1). Conclusions. An adequate mathematical model of logistic regression was developed to assess the prognostic significance of total vitamin D deficiency in the progression of DR in patients with T2DM. Its prognostic significance is 96.4 % (95% CI 87.7–99.0).","PeriodicalId":13962,"journal":{"name":"INTERNATIONAL JOURNAL OF ENDOCRINOLOGY (Ukraine)","volume":"23 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72623585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-18DOI: 10.22141/2224-0721.19.4.2023.1280
O. Bolshova, M. Ryznychuk, D. Kvachenyuk
Background. The nuclear receptor for vitamin D mediates most of the biological functions of this vitamin. It belongs to the steroid hormone receptor family, the gene for which (vitamin D receptor — VDR) is located on chromosome 12q13.1. Genetic variability has been reported in the VDR gene, in which more than 470 single nucleotide polymorphisms have been identified. One of the most common polymorphisms in the VDR gene is rs731236 (TaqI). The purpose was to study the TaqI polymorphism of the VDR gene in children with growth hormone deficiency (GHD). Materials and methods. The TaqI polymorphism of the VDR gene (rs731236) was determined using the polymerase chain reaction, followed by analysis of the length of restriction fragments detected by agarose gel electrophoresis in 28 prepubescent children with GHD. Results. In the group of patients with GHD, the proportion of heterozygotes for T/C TaqI polymorphism of the VDR gene (rs731236) is 1.28 times higher than among healthy individuals. There were 0.68 and 0.90 times fewer patients carrying T/T and C/C genotypes than in the control group. The presence of a homozygous TT genotype increases the risk of developing GHD, but not significantly (odds ratio (OR) = 1.89, 95% confidence interval (CI) 0.66–5.39; p = 0.23), and the presence of a homozygous CC genotype is protective (OR = 0.75, 95% CI 0.17–3.22; p = 0.70). When analyzing alleles in patients with GHD, the following data were obtained: carriage of the T allele for the polymorphic loci TaqI rs731236 of the VDR gene is associated with the risk of GHD (OR = 1.24, 95% CI 0.65–2.36; p = 0.52) but not significantly. The ratio of allele (pТ = 0.554, qС = 0.446) frequencies practically does not differ from 1 : 1, which indicates the preservation of allele frequencies in the Ukrainian population. Conclusions. In children with GHD, the proportion of the T/C genotype is 1.28 times higher than in the group of healthy persons. The presence of a homozygous TT genotype increases the risk of developing GHD but not significantly (OR = 1.89, 95% CI 0.66–5.39; p = 0.23). Carriage of the T allele for the polymorphic locus TaqI rs731236 of the VDR gene is associated with the risk of the growth hormone deficiency (OR = 1.24, 95% CI 0.65–2.36; p = 0.52) but not significantly.
{"title":"TaqI polymorphism of the vitamin D receptor gene in children with growth hormone deficiency","authors":"O. Bolshova, M. Ryznychuk, D. Kvachenyuk","doi":"10.22141/2224-0721.19.4.2023.1280","DOIUrl":"https://doi.org/10.22141/2224-0721.19.4.2023.1280","url":null,"abstract":"Background. The nuclear receptor for vitamin D mediates most of the biological functions of this vitamin. It belongs to the steroid hormone receptor family, the gene for which (vitamin D receptor — VDR) is located on chromosome 12q13.1. Genetic variability has been reported in the VDR gene, in which more than 470 single nucleotide polymorphisms have been identified. One of the most common polymorphisms in the VDR gene is rs731236 (TaqI). The purpose was to study the TaqI polymorphism of the VDR gene in children with growth hormone deficiency (GHD). Materials and methods. The TaqI polymorphism of the VDR gene (rs731236) was determined using the polymerase chain reaction, followed by analysis of the length of restriction fragments detected by agarose gel electrophoresis in 28 prepubescent children with GHD. Results. In the group of patients with GHD, the proportion of heterozygotes for T/C TaqI polymorphism of the VDR gene (rs731236) is 1.28 times higher than among healthy individuals. There were 0.68 and 0.90 times fewer patients carrying T/T and C/C genotypes than in the control group. The presence of a homozygous TT genotype increases the risk of developing GHD, but not significantly (odds ratio (OR) = 1.89, 95% confidence interval (CI) 0.66–5.39; p = 0.23), and the presence of a homozygous CC genotype is protective (OR = 0.75, 95% CI 0.17–3.22; p = 0.70). When analyzing alleles in patients with GHD, the following data were obtained: carriage of the T allele for the polymorphic loci TaqI rs731236 of the VDR gene is associated with the risk of GHD (OR = 1.24, 95% CI 0.65–2.36; p = 0.52) but not significantly. The ratio of allele (pТ = 0.554, qС = 0.446) frequencies practically does not differ from 1 : 1, which indicates the preservation of allele frequencies in the Ukrainian population. Conclusions. In children with GHD, the proportion of the T/C genotype is 1.28 times higher than in the group of healthy persons. The presence of a homozygous TT genotype increases the risk of developing GHD but not significantly (OR = 1.89, 95% CI 0.66–5.39; p = 0.23). Carriage of the T allele for the polymorphic locus TaqI rs731236 of the VDR gene is associated with the risk of the growth hormone deficiency (OR = 1.24, 95% CI 0.65–2.36; p = 0.52) but not significantly.","PeriodicalId":13962,"journal":{"name":"INTERNATIONAL JOURNAL OF ENDOCRINOLOGY (Ukraine)","volume":"112 1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89344763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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