Pub Date : 2023-07-18DOI: 10.22141/2224-0721.19.4.2023.1291
S. Rybakov
Epidemiology of medullary thyroid cancer is presented in the literature review. Thyroid cancer is the most common form of endocrine oncological pathology. It accounts for 96–97 % of all malignant tumors of endocrine organs. According to the Surveillance, Epidemiology, and End Results Program (USA), the incidence of thyroid cancer in 1975–2009 increased approximately threefold, from 4.9 to 14.3 cases per 100,000 population. At the same time, the mortality rate remained low, approximately at the same level, 0.5 cases per 100,000. Such a situation can be explained to some extent by the improvement of diagnostic capabilities of the early, often preclinical, stage of thyroid tumors. Medullary thyroid cancer ranks third after papillary and follicular cancer, but surpasses them in terms of aggressiveness. It is a relatively rare disease. This type of tumor makes up 1–9 % of all thyroid cancers. Against the background of the general tendency to increase the incidence of thyroid cancer, the absolute number of cases of medullary cancer according to various data remains relatively stable. Epidemiological characteristics of medullary thyroid cancer deserve attention in the age aspect, as well as when considering the frequency of detecting these tumors at autopsy of people who had no signs during their lifetime. In clinical practice, medullary thyroid cancer occurs in two main forms — sporadic and hereditary. The latter is represented as part of the combined syndrome of multiple endocrine neoplasia type 2 (MEN-2), which, in turn, is divided into two subtypes: MEN-2A and MEN-2B syndromes. MEN-2 syndrome is a rare combined hereditary pathology. Sporadic medullary thyroid cancer accounts for approximately 70–80 % of such tumors. It is accompanied by other types of endocrinopathies. Most cases of medullary thyroid cancer occur in the fifth decade of life. The presented data on the epidemiology of medullary thyroid cancer allow for a more detailed and in-depth study of this pathology and contain a certain amount of useful and necessary information.
{"title":"Medullary thyroid cancer: epidemiology","authors":"S. Rybakov","doi":"10.22141/2224-0721.19.4.2023.1291","DOIUrl":"https://doi.org/10.22141/2224-0721.19.4.2023.1291","url":null,"abstract":"Epidemiology of medullary thyroid cancer is presented in the literature review. Thyroid cancer is the most common form of endocrine oncological pathology. It accounts for 96–97 % of all malignant tumors of endocrine organs. According to the Surveillance, Epidemiology, and End Results Program (USA), the incidence of thyroid cancer in 1975–2009 increased approximately threefold, from 4.9 to 14.3 cases per 100,000 population. At the same time, the mortality rate remained low, approximately at the same level, 0.5 cases per 100,000. Such a situation can be explained to some extent by the improvement of diagnostic capabilities of the early, often preclinical, stage of thyroid tumors. Medullary thyroid cancer ranks third after papillary and follicular cancer, but surpasses them in terms of aggressiveness. It is a relatively rare disease. This type of tumor makes up 1–9 % of all thyroid cancers. Against the background of the general tendency to increase the incidence of thyroid cancer, the absolute number of cases of medullary cancer according to various data remains relatively stable. Epidemiological characteristics of medullary thyroid cancer deserve attention in the age aspect, as well as when considering the frequency of detecting these tumors at autopsy of people who had no signs during their lifetime. In clinical practice, medullary thyroid cancer occurs in two main forms — sporadic and hereditary. The latter is represented as part of the combined syndrome of multiple endocrine neoplasia type 2 (MEN-2), which, in turn, is divided into two subtypes: MEN-2A and MEN-2B syndromes. MEN-2 syndrome is a rare combined hereditary pathology. Sporadic medullary thyroid cancer accounts for approximately 70–80 % of such tumors. It is accompanied by other types of endocrinopathies. Most cases of medullary thyroid cancer occur in the fifth decade of life. The presented data on the epidemiology of medullary thyroid cancer allow for a more detailed and in-depth study of this pathology and contain a certain amount of useful and necessary information.","PeriodicalId":13962,"journal":{"name":"INTERNATIONAL JOURNAL OF ENDOCRINOLOGY (Ukraine)","volume":"10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79482983","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 : 2023-06-01DOI: 10.22141/2224-0721.19.3.2023.1269
Z.O. Shayenko, O. Akimov, K. Neporada, O. V. Ligonenko, M. Spivak
Background. In the pathogenesis of complications of diabetes mellitus (DM), in addition to glucotoxicity, the development of oxidative stress plays a leading role. Antioxidants have been of great interest for physicians in recent years. Contemporary diabetology have been focused on the search and practical implementation of pathogenetic medications that can affect the main chains of DM and prevent its negative consequences. Purpose of the study is to determine the effect of nanodispersed cerium oxide (NCO) on the production of nitric oxide (NO), the activity of antioxidant enzymes and the intensity of lipid peroxidation in the blood of patients with type 2 diabetes mellitus. Materials and methods. Seventy-two patients aged 36 to 66 years, average age of 55.20 ± 6.82 years, who received treatment at the Municipal Clinical Hospital 2 in Poltava from July to December 2022 have been involved in the study. They have been divided into 2 groups: controls (n = 35), which included people without diabetes; experimental group (n = 37), which consisted of patients diagnosed with type 2 DM. Results. The use of NCO in patients with type 2 DM significantly reduces the activity of inducible NO synthase in the blood by 34.70 % and the activity of arginases by 52.17 % compared to the levels before treatment. The use of nanodispersed cerium oxide in the treatment of type 2 DM increases the activity of superoxide dismutase in the blood by 102.74 %, and the activity of catalase by 103.04 % compared to same indicators in the experimental group before therapy. Notably, blood malondialdehyde was significantly lower (by 2.35 times) compared to the same indicator before treatment. Conclusions. The use of NCO in patients with type 2 diabetes mellitus leads to an increase in antioxidant protection and a decrease in the intensity of lipid peroxidation in blood. NCO reduces the production of nitric oxide from the inducible NO synthase and weakens the competition between NO synthases and arginases for the reaction substrate. The findings of the study justify the need to include antioxidants in the pathogenetic therapy of diabetes mellitus and its complications.
{"title":"The influence of nanodispersed cerium oxide on the development of oxidative stress and the production of nitric oxide in patients with type 2 diabetes mellitus","authors":"Z.O. Shayenko, O. Akimov, K. Neporada, O. V. Ligonenko, M. Spivak","doi":"10.22141/2224-0721.19.3.2023.1269","DOIUrl":"https://doi.org/10.22141/2224-0721.19.3.2023.1269","url":null,"abstract":"Background. In the pathogenesis of complications of diabetes mellitus (DM), in addition to glucotoxicity, the development of oxidative stress plays a leading role. Antioxidants have been of great interest for physicians in recent years. Contemporary diabetology have been focused on the search and practical implementation of pathogenetic medications that can affect the main chains of DM and prevent its negative consequences. Purpose of the study is to determine the effect of nanodispersed cerium oxide (NCO) on the production of nitric oxide (NO), the activity of antioxidant enzymes and the intensity of lipid peroxidation in the blood of patients with type 2 diabetes mellitus. Materials and methods. Seventy-two patients aged 36 to 66 years, average age of 55.20 ± 6.82 years, who received treatment at the Municipal Clinical Hospital 2 in Poltava from July to December 2022 have been involved in the study. They have been divided into 2 groups: controls (n = 35), which included people without diabetes; experimental group (n = 37), which consisted of patients diagnosed with type 2 DM. Results. The use of NCO in patients with type 2 DM significantly reduces the activity of inducible NO synthase in the blood by 34.70 % and the activity of arginases by 52.17 % compared to the levels before treatment. The use of nanodispersed cerium oxide in the treatment of type 2 DM increases the activity of superoxide dismutase in the blood by 102.74 %, and the activity of catalase by 103.04 % compared to same indicators in the experimental group before therapy. Notably, blood malondialdehyde was significantly lower (by 2.35 times) compared to the same indicator before treatment. Conclusions. The use of NCO in patients with type 2 diabetes mellitus leads to an increase in antioxidant protection and a decrease in the intensity of lipid peroxidation in blood. NCO reduces the production of nitric oxide from the inducible NO synthase and weakens the competition between NO synthases and arginases for the reaction substrate. The findings of the study justify the need to include antioxidants in the pathogenetic therapy of diabetes mellitus and its complications.","PeriodicalId":13962,"journal":{"name":"INTERNATIONAL JOURNAL OF ENDOCRINOLOGY (Ukraine)","volume":"10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84530437","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 : 2023-06-01DOI: 10.22141/2224-0721.19.3.2023.1274
N. Pashkovska
Literature data on epidemiology, mechanisms of development, features of the course of cognitive disorders in type 2 diabetes mellitus (T2DM), as well as prospects for their treatment and prevention were analyzed. Diabetes mellitus is recognized as an independent factor for cognitive impairment and is associated with an increased risk of dementia, the main causes of which are Alzheimer’s disease and vascular dementia. Results of recent research have shown that T2DM due to insulin resistance and a number of other mechanisms accelerates the aging of the brain and the decline of cognitive functions from mild cognitive impairment to dementia, the risk of which is almost doubled. Epidemiological, neuroimaging, and autopsy studies confirm the presence of both cerebrovascular and neurodegenerative mechanisms of brain damage in T2DM. Poor glycemic control is associated with cognitive decline while longer course of diabetes — with deterioration of cognitive functions. According to current guidelines, annual screening is indicated for adults aged 65 and older for early detection of mild cognitive impairment or dementia. The strategy for the treatment and prevention of cognitive impairment in diabetes should be individualized in such a way as to minimize the occurrence of both hyperglycemia and hypoglycemia, and should also be effective in preventing the development of vascular complications. Elderly patients with cognitive impairment should have less stringent glycemic goals (such as glycated hemoglobin < 8.0 %). The results of experimental and clinical studies proved that metformin has a whole range of neurospecific properties, which generally prevent the progression of diabetic cerebral disorders and provide a nootropic effect. It has been found that the drug can improve cognitive functions and mood in patients with T2DM, and also prevents the development of dementia, including Alzheimer’s type. The use of metformin allows you to preserve cognitive functions due to a powerful hypoglycemic effect, a low risk of hypoglycemia, as well as a positive effect on other pathogenetic links in the development of diabetic cerebral changes — insulin resistance, hyperinsulinemia, dyslipidemia, inflammation, micro- and macrovascular disorders, which makes it a priority in the treatment of patients with diabetes of any age.
{"title":"Cognitive impairment in type 2 diabetes mellitus: prospects for the use of metformin","authors":"N. Pashkovska","doi":"10.22141/2224-0721.19.3.2023.1274","DOIUrl":"https://doi.org/10.22141/2224-0721.19.3.2023.1274","url":null,"abstract":"Literature data on epidemiology, mechanisms of development, features of the course of cognitive disorders in type 2 diabetes mellitus (T2DM), as well as prospects for their treatment and prevention were analyzed. Diabetes mellitus is recognized as an independent factor for cognitive impairment and is associated with an increased risk of dementia, the main causes of which are Alzheimer’s disease and vascular dementia. Results of recent research have shown that T2DM due to insulin resistance and a number of other mechanisms accelerates the aging of the brain and the decline of cognitive functions from mild cognitive impairment to dementia, the risk of which is almost doubled. Epidemiological, neuroimaging, and autopsy studies confirm the presence of both cerebrovascular and neurodegenerative mechanisms of brain damage in T2DM. Poor glycemic control is associated with cognitive decline while longer course of diabetes — with deterioration of cognitive functions. According to current guidelines, annual screening is indicated for adults aged 65 and older for early detection of mild cognitive impairment or dementia. The strategy for the treatment and prevention of cognitive impairment in diabetes should be individualized in such a way as to minimize the occurrence of both hyperglycemia and hypoglycemia, and should also be effective in preventing the development of vascular complications. Elderly patients with cognitive impairment should have less stringent glycemic goals (such as glycated hemoglobin < 8.0 %). The results of experimental and clinical studies proved that metformin has a whole range of neurospecific properties, which generally prevent the progression of diabetic cerebral disorders and provide a nootropic effect. It has been found that the drug can improve cognitive functions and mood in patients with T2DM, and also prevents the development of dementia, including Alzheimer’s type. The use of metformin allows you to preserve cognitive functions due to a powerful hypoglycemic effect, a low risk of hypoglycemia, as well as a positive effect on other pathogenetic links in the development of diabetic cerebral changes — insulin resistance, hyperinsulinemia, dyslipidemia, inflammation, micro- and macrovascular disorders, which makes it a priority in the treatment of patients with diabetes of any age.","PeriodicalId":13962,"journal":{"name":"INTERNATIONAL JOURNAL OF ENDOCRINOLOGY (Ukraine)","volume":"44 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87507653","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 : 2023-06-01DOI: 10.22141/2224-0721.19.3.2023.1277
V. Katerenchuk, A.V. Katerenchuk
The article is a summary of personal experience and literature data from PubMed, Scopus, Web of Science, ClinicalTrials.gov databases. As a result of the analysis, the main problems faced by practical endocrinologists when administering insulin therapy to patients with type 2 diabetes mellitus (T2DM) have been determined. Insulin therapy remains an important component of glucose-lowering therapy in T2DM. A significant increase in the number of oral hypoglycemic agents has allowed delaying the start of insulin therapy but the treatment for T2DM without insulin is not real today. The current problems of insulin therapy are as follows: untimely start, insufficient titration of the dose of basal insulin, excessive use of basal and bolus insulins, the irrationality of the use of premixes and the basis bolus regimen of insulin therapy. There are methods to overcome each of these issues that have proven their effectiveness according to clinical trials and real clinical practice data. The combination of insulin and oral therapy plays an important role, the addition of oral hypoglycemic agents is effective at different stages of insulin therapy. One of the most promising options is the use of fixed combinations of basal insulin with glucagon-like peptide-1 receptor agonists. Fixed combinations can be used as initial therapy and are often the first step when changing other insulin therapy regimens. The use of fixed combinations can be an option for modification (simplification) of complex insulin therapy regimens, including the basal bolus regimen. Authors review current evidence and circumstances in which insulin can be used, consider individualized choices of alternatives and combination regimens, and offer some guidance on personalized targets and approaches to glycemic control in type 2 diabetes. In general, most of the modern problems of insulin therapy have options for successful overcome.
这篇文章是对个人经历和来自PubMed、Scopus、Web of Science、ClinicalTrials.gov数据库的生活数据的总结。作为分析的结果，实际内分泌学家在对2型糖尿病(T2DM)患者进行胰岛素治疗时面临的主要问题已经确定。胰岛素治疗仍然是T2DM降血糖治疗的重要组成部分。口服降糖药数量的显著增加推迟了胰岛素治疗的开始，但目前没有胰岛素治疗2型糖尿病。目前胰岛素治疗存在的问题有:不及时开始、基础胰岛素剂量滴定不足、基础胰岛素和灌注胰岛素使用过量、预混料使用不合理、胰岛素治疗基础灌注方案不合理。根据临床试验和真实的临床实践数据，有一些方法可以克服这些问题。胰岛素联合口服治疗起着重要的作用，在胰岛素治疗的不同阶段，口服降糖药的加入是有效的。最有希望的选择之一是使用基础胰岛素与胰高血糖素样肽-1受体激动剂的固定组合。固定组合可作为初始治疗，通常是改变其他胰岛素治疗方案的第一步。固定组合的使用可作为复杂胰岛素治疗方案的一种修改(简化)选择，包括基础大剂量方案。作者回顾了目前使用胰岛素的证据和情况，考虑了替代方案和联合方案的个性化选择，并为2型糖尿病的个性化目标和血糖控制方法提供了一些指导。一般来说，大多数胰岛素治疗的现代问题都有成功克服的选择。
{"title":"Issues of insulin therapy for type 2 diabetes and ways to solve them","authors":"V. Katerenchuk, A.V. Katerenchuk","doi":"10.22141/2224-0721.19.3.2023.1277","DOIUrl":"https://doi.org/10.22141/2224-0721.19.3.2023.1277","url":null,"abstract":"The article is a summary of personal experience and literature data from PubMed, Scopus, Web of Science, ClinicalTrials.gov databases. As a result of the analysis, the main problems faced by practical endocrinologists when administering insulin therapy to patients with type 2 diabetes mellitus (T2DM) have been determined. Insulin therapy remains an important component of glucose-lowering therapy in T2DM. A significant increase in the number of oral hypoglycemic agents has allowed delaying the start of insulin therapy but the treatment for T2DM without insulin is not real today. The current problems of insulin therapy are as follows: untimely start, insufficient titration of the dose of basal insulin, excessive use of basal and bolus insulins, the irrationality of the use of premixes and the basis bolus regimen of insulin therapy. There are methods to overcome each of these issues that have proven their effectiveness according to clinical trials and real clinical practice data. The combination of insulin and oral therapy plays an important role, the addition of oral hypoglycemic agents is effective at different stages of insulin therapy. One of the most promising options is the use of fixed combinations of basal insulin with glucagon-like peptide-1 receptor agonists. Fixed combinations can be used as initial therapy and are often the first step when changing other insulin therapy regimens. The use of fixed combinations can be an option for modification (simplification) of complex insulin therapy regimens, including the basal bolus regimen. Authors review current evidence and circumstances in which insulin can be used, consider individualized choices of alternatives and combination regimens, and offer some guidance on personalized targets and approaches to glycemic control in type 2 diabetes. In general, most of the modern problems of insulin therapy have options for successful overcome.","PeriodicalId":13962,"journal":{"name":"INTERNATIONAL JOURNAL OF ENDOCRINOLOGY (Ukraine)","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73068242","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 : 2023-06-01DOI: 10.22141/2224-0721.19.3.2023.1267
T. Antofiichuk, O. Khukhlina, M. Antofiichuk, N. Kaspruk
Background. The urgency of the problem of comorbidity of alcoholic steatohepatitis (ASH) and non-alcoholic steatohepatitis (NASH) with anaemic conditions and the need for their differentiated correction is determined by the significant frequency of these diseases in the world and Ukraine and the presence of the syndrome of the mutual burden. Anaemia is a marker for the progression of steatohepatitis to liver cirrhosis, in which anaemic conditions is often a manifestation of hypersplenism with the increased destruction of red blood cells in the spleen, as well as frequent complications of liver cirrhosis caused by posthemorrhagic anaemia, which occurs due to bleedings from the oesophageal and gastric varices, portal hypertension and decreased biosynthesis of coagulation factors by the liver. The purpose of the study was to find out metabolic prerequisites for the formation and progression of steatohepatitis of alcoholic, mixed and non-alcoholic aetiology and comorbid anaemic conditions. Materials and methods. One hundred and twenty-five patients with steatohepatitis of alcoholic, non-alcoholic and mixed aetiology were examined for comorbidities of anaemic conditions with lipid metabolism and glycemic regulation disorders. Results. The results of investigations demonstrate hyperlipidemia (by 1.35–1.5 times) in patients with steatohepatitis of mixed aetiology and ASH, although in anaemic conditions, the content of blood total cholesterol and low-density lipoprotein (LDL) cholesterol decreased (p < 0.05). Increased blood levels of triglycerides (in the range of 1.6–2.2 times) and decreased blood levels of high-density lipoprotein cholesterol (by 1.45–1.55 times) in all groups of patients with steatohepatitis and comorbidity with anaemic conditions deepened (p < 0.05). In NASH with anaemic conditions, there is an increase in the blood LDL cholesterol and total cholesterol levels, with the rise of the atherogenic index by 2.8 times (p < 0.05). Рatients with NASH and obesity have high values of glucose, insulin and degree of insulin resistance (by 2.6 times, p < 0.05), and with anaemic conditions, insulinemia and degree of insulin resistance are increased (by 2.9 and 3.0 times, respectively; p < 0.05). In patients with ASH and steatohepatitis of mixed aetiology associated with alcohol consumption, insulin deficiency is formed (by 1.4 and 1.2 times, p < 0.05), which develops in addition to anaemic conditions (blood insulin content is below the lower values by 1.8 and 1.6 times). Conclusions. The consequence of metabolic pathology (hyperlipidemia, hyperglycemia, insulin resistance), which developed under the comorbidity of steatohepatitis with anaemic conditions, was an increase in the degree of hepatocyte steatosis (p < 0.05).
{"title":"Metabolic preconditions for the formation and progression of steatohepatitis of alcoholic, mixed, non-alcoholic aetiology and their comorbidity with obesity and anaemic conditions","authors":"T. Antofiichuk, O. Khukhlina, M. Antofiichuk, N. Kaspruk","doi":"10.22141/2224-0721.19.3.2023.1267","DOIUrl":"https://doi.org/10.22141/2224-0721.19.3.2023.1267","url":null,"abstract":"Background. The urgency of the problem of comorbidity of alcoholic steatohepatitis (ASH) and non-alcoholic steatohepatitis (NASH) with anaemic conditions and the need for their differentiated correction is determined by the significant frequency of these diseases in the world and Ukraine and the presence of the syndrome of the mutual burden. Anaemia is a marker for the progression of steatohepatitis to liver cirrhosis, in which anaemic conditions is often a manifestation of hypersplenism with the increased destruction of red blood cells in the spleen, as well as frequent complications of liver cirrhosis caused by posthemorrhagic anaemia, which occurs due to bleedings from the oesophageal and gastric varices, portal hypertension and decreased biosynthesis of coagulation factors by the liver. The purpose of the study was to find out metabolic prerequisites for the formation and progression of steatohepatitis of alcoholic, mixed and non-alcoholic aetiology and comorbid anaemic conditions. Materials and methods. One hundred and twenty-five patients with steatohepatitis of alcoholic, non-alcoholic and mixed aetiology were examined for comorbidities of anaemic conditions with lipid metabolism and glycemic regulation disorders. Results. The results of investigations demonstrate hyperlipidemia (by 1.35–1.5 times) in patients with steatohepatitis of mixed aetiology and ASH, although in anaemic conditions, the content of blood total cholesterol and low-density lipoprotein (LDL) cholesterol decreased (p < 0.05). Increased blood levels of triglycerides (in the range of 1.6–2.2 times) and decreased blood levels of high-density lipoprotein cholesterol (by 1.45–1.55 times) in all groups of patients with steatohepatitis and comorbidity with anaemic conditions deepened (p < 0.05). In NASH with anaemic conditions, there is an increase in the blood LDL cholesterol and total cholesterol levels, with the rise of the atherogenic index by 2.8 times (p < 0.05). Рatients with NASH and obesity have high values of glucose, insulin and degree of insulin resistance (by 2.6 times, p < 0.05), and with anaemic conditions, insulinemia and degree of insulin resistance are increased (by 2.9 and 3.0 times, respectively; p < 0.05). In patients with ASH and steatohepatitis of mixed aetiology associated with alcohol consumption, insulin deficiency is formed (by 1.4 and 1.2 times, p < 0.05), which develops in addition to anaemic conditions (blood insulin content is below the lower values by 1.8 and 1.6 times). Conclusions. The consequence of metabolic pathology (hyperlipidemia, hyperglycemia, insulin resistance), which developed under the comorbidity of steatohepatitis with anaemic conditions, was an increase in the degree of hepatocyte steatosis (p < 0.05).","PeriodicalId":13962,"journal":{"name":"INTERNATIONAL JOURNAL OF ENDOCRINOLOGY (Ukraine)","volume":"94 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77125714","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 : 2023-06-01DOI: 10.22141/2224-0721.19.3.2023.1273
O. Bukach, I. Buzdugan, L. Voloshina
Background. Connective tissue disease, in particular rheumatoid arthritis (RA), is characterized by a progressive joint damage and polymorphism of extra-articular lesions that affect the patient’s quality of life. Although the widespread implementation of basic therapy through the use of disease-modifying antirheumatic drugs has a positive effect on social consequences, the experience gained shows the impossibility of achieving a stable remission of the disease or reducing the activity of autoimmune inflammation against the background of using these medicines in all patients for a number of reasons. One of these reasons is the presence of comorbid pathology, which requires a personalized approach to each person. The objective was to study the quality of life of patients with RA in combination with type 2 diabetes mellitus (T2DM), hypertension and obesity depending on the T-786C polymorphism of the endothelial nitric oxide synthase gene promoter. Materials and methods. A laboratory and instrumental examination involved 110 patients who were treated at the clinical base of the Department of Internal Medicine of Bukovinian State Medical University, Chernivtsi Regional Endocrinology Center, Chernivtsi Regional Clinical Hospital, and Reference Center for Molecular Genetic Research of the Ministry of Health of Ukraine. Results. When assessing the quality of life in the studied groups, a decrease in indicators on all scales was detected. Thus, in RA combined with hypertension and obesity, PF was 1.73 times lower, RP — 1.97 times, BP — 1.44 times, SF — 1.46 times, MH — 1.26 times , RE — 1.66 times, GH — 1.35 times (p < 0.05) lower than in patients with isolated RA. Taking into account the T-786C polymorphism of the eNOS gene, it can be asserted that all indicators of quality of life were reduced in the carriers of the СС genotype, in contrast to the carriers of the T-allele: PF — by 2.06 (pTT < 0.05) and 2.46 times (pTС < 0.05); RP — by 2.0 (pTT < 0.05) and 2.87 times (pTС < 0.05); BP — by 1.86 (pTT < 0.05) and 2.52 times (pTС < 0.05); SF — by 1.55 and 2.07 times (рTС < 0.05); MH — by 1.42 (pTT < 0.05) and 1.53 times (pTС < 0.05); RE — by 1.30 (pTT < 0.05) and 1.54 times (pTС < 0.05); VT — by 3.34 (pTT < 0.05) and 3.72 times (pTС < 0.05); GH — by 2.32 (pTT < 0.05) and 2.38 times (pTС < 0.05), respectively. Conclusions. When comparing the quality of life in the studied groups, it can be stated that the lowest indicators on all scales were in patients with RA combined with hypertension, obesity and T2DM and in carriers of the СС genotype of the analyzed gene, which reflected the worst physical condition and psychosocial status.
{"title":"Effect of treatment on genetic predictors and quality of life in rheumatoid arthritis patients with type 2 diabetes, hypertension, and obesity","authors":"O. Bukach, I. Buzdugan, L. Voloshina","doi":"10.22141/2224-0721.19.3.2023.1273","DOIUrl":"https://doi.org/10.22141/2224-0721.19.3.2023.1273","url":null,"abstract":"Background. Connective tissue disease, in particular rheumatoid arthritis (RA), is characterized by a progressive joint damage and polymorphism of extra-articular lesions that affect the patient’s quality of life. Although the widespread implementation of basic therapy through the use of disease-modifying antirheumatic drugs has a positive effect on social consequences, the experience gained shows the impossibility of achieving a stable remission of the disease or reducing the activity of autoimmune inflammation against the background of using these medicines in all patients for a number of reasons. One of these reasons is the presence of comorbid pathology, which requires a personalized approach to each person. The objective was to study the quality of life of patients with RA in combination with type 2 diabetes mellitus (T2DM), hypertension and obesity depending on the T-786C polymorphism of the endothelial nitric oxide synthase gene promoter. Materials and methods. A laboratory and instrumental examination involved 110 patients who were treated at the clinical base of the Department of Internal Medicine of Bukovinian State Medical University, Chernivtsi Regional Endocrinology Center, Chernivtsi Regional Clinical Hospital, and Reference Center for Molecular Genetic Research of the Ministry of Health of Ukraine. Results. When assessing the quality of life in the studied groups, a decrease in indicators on all scales was detected. Thus, in RA combined with hypertension and obesity, PF was 1.73 times lower, RP — 1.97 times, BP — 1.44 times, SF — 1.46 times, MH — 1.26 times , RE — 1.66 times, GH — 1.35 times (p < 0.05) lower than in patients with isolated RA. Taking into account the T-786C polymorphism of the eNOS gene, it can be asserted that all indicators of quality of life were reduced in the carriers of the СС genotype, in contrast to the carriers of the T-allele: PF — by 2.06 (pTT < 0.05) and 2.46 times (pTС < 0.05); RP — by 2.0 (pTT < 0.05) and 2.87 times (pTС < 0.05); BP — by 1.86 (pTT < 0.05) and 2.52 times (pTС < 0.05); SF — by 1.55 and 2.07 times (рTС < 0.05); MH — by 1.42 (pTT < 0.05) and 1.53 times (pTС < 0.05); RE — by 1.30 (pTT < 0.05) and 1.54 times (pTС < 0.05); VT — by 3.34 (pTT < 0.05) and 3.72 times (pTС < 0.05); GH — by 2.32 (pTT < 0.05) and 2.38 times (pTС < 0.05), respectively. Conclusions. When comparing the quality of life in the studied groups, it can be stated that the lowest indicators on all scales were in patients with RA combined with hypertension, obesity and T2DM and in carriers of the СС genotype of the analyzed gene, which reflected the worst physical condition and psychosocial status.","PeriodicalId":13962,"journal":{"name":"INTERNATIONAL JOURNAL OF ENDOCRINOLOGY (Ukraine)","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75565499","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 : 2023-06-01DOI: 10.22141/2224-0721.19.3.2023.1271
S. Tkach, V. Pankiv, A. Dorofeev
Background. Today, non-alcoholic fatty liver disease (NAFLD) is a very common condition that affects ~ 25 % of the world’s population. The prevalence of NAFLD is expected to increase further in the coming years due to the obesity pandemic, rising incidence of diabetes and other factors. The search for modifiable risk factors for NAFLD is relevant and urgent to prevent the spread, morbidity and progression of this disease. Recent studies have shown that vitamin D may be a risk factor, which, due to its pleiotropic effects, modulates liver inflammation and fibrogenesis and can improve the liver response to insulin. But there is no definitive opinion on the relationship between vitamin D level and the risk of NAFLD. The purpose of the study was to investigate the serum level of 25(OH)D in patients with NAFLD and to establish its possible relationship with the development and progression of this disease. Materials and methods. A total of 120 patients (78 women, 42 men) with a diagnosis of NAFLD aged 18 to 60 years were examined. The diagnosis of NAFLD was made based on multimodal ultrasound with steatometry and elastography, increased transaminases in 2 or more measurements, the presence of risk factors such as type 2 diabetes mellitus and/or obesity. Serum 25-hydroxyvitamin D deficiency was considered at its serum level ≥ 20 and < 30 ng/ml, and deficiency at < 20 ng/ml. Results. The mean level of 25-hydroxyvitamin D (25.7 ± 2.6 ng/ml) in all patients with NAFLD was significantly and reliably lower than in the control group (52.2 ± 6.8 ng/ml, P < 0.01), and in people with non-alcoholic steatohepatitis (NASH), it was lower than in those with simple steatosis (24.3 ± 3.0 vs. 27.1 ± 2.2), although the difference was non-significant (P > 0.05). In patients with NASH and liver fibrosis, the mean level of 25-hydroxyvitamin D was also lower than in all patients with NAFLD/NASH, especially in severe F3–4 fibrosis, although this difference was also non-significant. Normal vitamin D status was observed in only 42 (35 %) patients with NAFLD/NASH, while most people (78 patients, 65 %; P < 0.005) had a decrease in serum vitamin D levels in the form of its insufficiency or deficiency: 66 (55 %) and 12 individuals (10 %), respectively. Conclusions. An open-label study found an inverse relationship between 25(OH)D levels and the risk of NAFLD development and progression. Because vitamin D is considered a modifiable risk factor for NAFLD, this finding may be of clinical significance due to the possible preventive effect of vitamin D in this disease.
{"title":"Relationship between serum 25-hydroxyvitamine D and non-alcoholic fatty liver disease","authors":"S. Tkach, V. Pankiv, A. Dorofeev","doi":"10.22141/2224-0721.19.3.2023.1271","DOIUrl":"https://doi.org/10.22141/2224-0721.19.3.2023.1271","url":null,"abstract":"Background. Today, non-alcoholic fatty liver disease (NAFLD) is a very common condition that affects ~ 25 % of the world’s population. The prevalence of NAFLD is expected to increase further in the coming years due to the obesity pandemic, rising incidence of diabetes and other factors. The search for modifiable risk factors for NAFLD is relevant and urgent to prevent the spread, morbidity and progression of this disease. Recent studies have shown that vitamin D may be a risk factor, which, due to its pleiotropic effects, modulates liver inflammation and fibrogenesis and can improve the liver response to insulin. But there is no definitive opinion on the relationship between vitamin D level and the risk of NAFLD. The purpose of the study was to investigate the serum level of 25(OH)D in patients with NAFLD and to establish its possible relationship with the development and progression of this disease. Materials and methods. A total of 120 patients (78 women, 42 men) with a diagnosis of NAFLD aged 18 to 60 years were examined. The diagnosis of NAFLD was made based on multimodal ultrasound with steatometry and elastography, increased transaminases in 2 or more measurements, the presence of risk factors such as type 2 diabetes mellitus and/or obesity. Serum 25-hydroxyvitamin D deficiency was considered at its serum level ≥ 20 and < 30 ng/ml, and deficiency at < 20 ng/ml. Results. The mean level of 25-hydroxyvitamin D (25.7 ± 2.6 ng/ml) in all patients with NAFLD was significantly and reliably lower than in the control group (52.2 ± 6.8 ng/ml, P < 0.01), and in people with non-alcoholic steatohepatitis (NASH), it was lower than in those with simple steatosis (24.3 ± 3.0 vs. 27.1 ± 2.2), although the difference was non-significant (P > 0.05). In patients with NASH and liver fibrosis, the mean level of 25-hydroxyvitamin D was also lower than in all patients with NAFLD/NASH, especially in severe F3–4 fibrosis, although this difference was also non-significant. Normal vitamin D status was observed in only 42 (35 %) patients with NAFLD/NASH, while most people (78 patients, 65 %; P < 0.005) had a decrease in serum vitamin D levels in the form of its insufficiency or deficiency: 66 (55 %) and 12 individuals (10 %), respectively. Conclusions. An open-label study found an inverse relationship between 25(OH)D levels and the risk of NAFLD development and progression. Because vitamin D is considered a modifiable risk factor for NAFLD, this finding may be of clinical significance due to the possible preventive effect of vitamin D in this disease.","PeriodicalId":13962,"journal":{"name":"INTERNATIONAL JOURNAL OF ENDOCRINOLOGY (Ukraine)","volume":"19 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90071834","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 : 2023-06-01DOI: 10.22141/2224-0721.19.3.2023.1266
M. Kucheriava, G.B. Mankovskyi
Background. Thyroid hormones play a fundamental role in the homeostasis of the cardiovascular system. Cardiovascular diseases are among the most common diseases worldwide, causing a significant percentage of mortality, hospitalizations, and disability. The purpose of the study is to evaluate the impact of hypothyroidism on the course of atherosclerotic lesions of coronary arteries and major cardiovascular events in patients with heart failure with reduced left ventricular ejection fraction after myocardial revascularization using percutaneous coronary intervention (PCI). Materials and methods. This prospective observational one-center study included 103 patients with ischemic cardiomyopathy, heart failure with reduced left ventricular ejection fraction, with and without hypothyroidism who underwent PCI. The result of revascularization was evaluated within 2 years. Inclusion criteria: age over 18 years, coronary artery disease, left ventricular ejection fraction less than 40 %. Results. Patients with hypothyroidism had a worse lipid profile and, as expected, a higher baseline thyroid-stimulating hormone (TSH). According to echocardiography, patients with hypothyroidism had thickening of the left ventricular myocardium walls, which is indicated by a probable increase in the dimensions of the left ventricular posterior wall (11.40 ± 0.98 mm; p < 0.001). In the first group, patients had higher myocardial mass indicators as one of the criteria for left ventricular hypertrophy (172.73 ± 12.72 g/m2; p < 0.001). After multivariate analysis using Cox proportional hazards regression, an elevated TSH level was still associated with significantly higher rates of cardiovascular mortality (risk ratio (RR) 0.85; 95% confidence interval (CI) 0.75–0.95; p < 0.001), repeat PCI (RR 0.75; 95% CI 0.65–0.85; p < 0.05) and decompensation due to heart failure (RR 0.88; 95% CI 0.78–0.96; p < 0.05). Conclusions. Hypothyroidism is associated with a higher incidence of the primary composite endpoint of repeat PCI, hospitalizations for decompensated heart failure, and the secondary endpoint of cardiovascular mortality compared to euthyroid patients over two years of follow-up. Maintaining adequate control of TSH in patients with coronary artery disease and heart failure with reduced ejection fraction is prognostically important for preventing cardiovascular events.
{"title":"The influence of hypothyroidism on the course of coronary artery disease in patients with reduced left ventricular ejection fraction","authors":"M. Kucheriava, G.B. Mankovskyi","doi":"10.22141/2224-0721.19.3.2023.1266","DOIUrl":"https://doi.org/10.22141/2224-0721.19.3.2023.1266","url":null,"abstract":"Background. Thyroid hormones play a fundamental role in the homeostasis of the cardiovascular system. Cardiovascular diseases are among the most common diseases worldwide, causing a significant percentage of mortality, hospitalizations, and disability. The purpose of the study is to evaluate the impact of hypothyroidism on the course of atherosclerotic lesions of coronary arteries and major cardiovascular events in patients with heart failure with reduced left ventricular ejection fraction after myocardial revascularization using percutaneous coronary intervention (PCI). Materials and methods. This prospective observational one-center study included 103 patients with ischemic cardiomyopathy, heart failure with reduced left ventricular ejection fraction, with and without hypothyroidism who underwent PCI. The result of revascularization was evaluated within 2 years. Inclusion criteria: age over 18 years, coronary artery disease, left ventricular ejection fraction less than 40 %. Results. Patients with hypothyroidism had a worse lipid profile and, as expected, a higher baseline thyroid-stimulating hormone (TSH). According to echocardiography, patients with hypothyroidism had thickening of the left ventricular myocardium walls, which is indicated by a probable increase in the dimensions of the left ventricular posterior wall (11.40 ± 0.98 mm; p < 0.001). In the first group, patients had higher myocardial mass indicators as one of the criteria for left ventricular hypertrophy (172.73 ± 12.72 g/m2; p < 0.001). After multivariate analysis using Cox proportional hazards regression, an elevated TSH level was still associated with significantly higher rates of cardiovascular mortality (risk ratio (RR) 0.85; 95% confidence interval (CI) 0.75–0.95; p < 0.001), repeat PCI (RR 0.75; 95% CI 0.65–0.85; p < 0.05) and decompensation due to heart failure (RR 0.88; 95% CI 0.78–0.96; p < 0.05). Conclusions. Hypothyroidism is associated with a higher incidence of the primary composite endpoint of repeat PCI, hospitalizations for decompensated heart failure, and the secondary endpoint of cardiovascular mortality compared to euthyroid patients over two years of follow-up. Maintaining adequate control of TSH in patients with coronary artery disease and heart failure with reduced ejection fraction is prognostically important for preventing cardiovascular events.","PeriodicalId":13962,"journal":{"name":"INTERNATIONAL JOURNAL OF ENDOCRINOLOGY (Ukraine)","volume":"58 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84150878","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 : 2023-06-01DOI: 10.22141/2224-0721.19.3.2023.1270
N. Pasyechko, V. Kulchinska, Kulchinska Veronika Mykolaiivna
Background. In recent years, in Ukraine and other countries of the world, there has been an increase in the frequency of autoimmune thyropathies. A significant role in the pathogenesis of autoimmune thyroiditis (AIT) is played by cytokines whose production is increased significantly during immunopathological reactions. The purpose of study was to investigate the effect of the combined use of myo-inositol, vitamin D and selenium on the cytokine status of women with euthyroidism, subclinical hypothyroidism and overt hypothyroidism against the background of autoimmune thyroiditis. Materials and methods. One hundred and forty-seven women aged 18–43 with AIT and 30 women of the control group were under observation. Patients of first group (n = 74) received myo-inositol at a dose of 2000 mg/day, cholecalciferol 2000 IU/day, and selenium 100 μg/day additionally to the main treatment. Patients of the second group (n = 73) received only cholecalciferol at a dose of 2000 IU/day and selenium 100 μg/day additionally to the main treatment. The functional state of the thyroid gland was studied by determining the levels of thyroid-stimulating hormone, free thyroxine, free triiodothyronine, antibodies to thyroid peroxidase (Ab-TPO) and antibodies to thyroglobulin (Ab-TG). The state of the systemic and local inflammatory process was evaluated according to parameters of tumor necrosis factor α, interleukins 6, 10, 17, and 23. Results. It should be noted all patients with AIT had changes in cytokine status, with some differences depending on the clinical variant of autoimmune thyroid disease. After three months of treatment of patients of the first group with myo-inositol at a dose of 2000 mg/day, cholecalciferol 2000 IU/day and selenium 100 μg/day, and patients of the second group only with cholecalciferol at a dose of 2000 IU/day and selenium at 100 μg /day, a significant difference was found between the indicators in both studied cohorts. Conclusions. The administration of myo-inositol, vitamin D, and selenium had a combination effect on the reduction of cytokine indicators, Ab-TPO and Ab-TG levels, which contributed to the compensation of the underlying disease.
{"title":"The effect of the combined use of myo-inositol, vitamin D and selenium on the cytokine status in women of reproductive age with autoimmune thyroiditis","authors":"N. Pasyechko, V. Kulchinska, Kulchinska Veronika Mykolaiivna","doi":"10.22141/2224-0721.19.3.2023.1270","DOIUrl":"https://doi.org/10.22141/2224-0721.19.3.2023.1270","url":null,"abstract":"Background. In recent years, in Ukraine and other countries of the world, there has been an increase in the frequency of autoimmune thyropathies. A significant role in the pathogenesis of autoimmune thyroiditis (AIT) is played by cytokines whose production is increased significantly during immunopathological reactions. The purpose of study was to investigate the effect of the combined use of myo-inositol, vitamin D and selenium on the cytokine status of women with euthyroidism, subclinical hypothyroidism and overt hypothyroidism against the background of autoimmune thyroiditis. Materials and methods. One hundred and forty-seven women aged 18–43 with AIT and 30 women of the control group were under observation. Patients of first group (n = 74) received myo-inositol at a dose of 2000 mg/day, cholecalciferol 2000 IU/day, and selenium 100 μg/day additionally to the main treatment. Patients of the second group (n = 73) received only cholecalciferol at a dose of 2000 IU/day and selenium 100 μg/day additionally to the main treatment. The functional state of the thyroid gland was studied by determining the levels of thyroid-stimulating hormone, free thyroxine, free triiodothyronine, antibodies to thyroid peroxidase (Ab-TPO) and antibodies to thyroglobulin (Ab-TG). The state of the systemic and local inflammatory process was evaluated according to parameters of tumor necrosis factor α, interleukins 6, 10, 17, and 23. Results. It should be noted all patients with AIT had changes in cytokine status, with some differences depending on the clinical variant of autoimmune thyroid disease. After three months of treatment of patients of the first group with myo-inositol at a dose of 2000 mg/day, cholecalciferol 2000 IU/day and selenium 100 μg/day, and patients of the second group only with cholecalciferol at a dose of 2000 IU/day and selenium at 100 μg /day, a significant difference was found between the indicators in both studied cohorts. Conclusions. The administration of myo-inositol, vitamin D, and selenium had a combination effect on the reduction of cytokine indicators, Ab-TPO and Ab-TG levels, which contributed to the compensation of the underlying disease.","PeriodicalId":13962,"journal":{"name":"INTERNATIONAL JOURNAL OF ENDOCRINOLOGY (Ukraine)","volume":"32 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81928475","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 : 2023-06-01DOI: 10.22141/2224-0721.19.3.2023.1272
I. Dronyk, R. Dutka, N. Chmyr, R. Pshyk, R. Falion
Background. Today, there are difficulties with the prevention and diagnosis of early stages of hypertension, especially in active and able-bodied young people. Among the factors that potentiate an increase in blood pressure, one of the components is chronic stress, which a person often faces in modern society. The purpose of study is to evaluate and compare blood cortisol and plasma malondialdehyde content in healthy individuals and in patients with stage II hypertension before and after dosed exercises. Materials and methods. Thirty patients with stage II hypertension and 10 practically healthy persons were examined. Subjects performed two-stage physical exercises on a bicycle ergometer with an intensity corresponding to 50 and 75 % of the appropriate maximum oxygen consumption of the body. The duration of the load was equal to 5 minutes at each stage with a three-minute rest between them. Blood was taken from the ulnar vein before cycling ergometry and 5 minutes after it. Blood cortisol and plasma malondialdehyde content were determined in patients before and after exercises. Results. A significant increase in cortisol content after exercises was noted in healthy individuals against the background of some decrease in patients with hypertension. It has been suggested that since people with high blood pressure already have an elevated initial level of cortisol, their threshold of stress sensitivity to physical exertion is increased. Submaximal bicycle ergometric load does not lead to an increase in blood cortisol levels in hypertensive patients. Conclusions. The background higher level of cortisol in individuals with hypertension does not increase under the influence of submaximal dosed exercises. An increase in the level of malondialdehyde can be considered a marker of the degree of stress for assessing the power of physical exertion. In view of the above, it can be stated that the activation of the sympathoadrenal system under the influence of emotional stress leads to an increase in blood pressure. There is sufficient evidence that psycho-emotional stress is a cause of white-coat hypertension and hypertension in the workplace.
{"title":"Changes in the cortisol level under the influence of physical exertion in patients with hypertension and in practically healthy individuals","authors":"I. Dronyk, R. Dutka, N. Chmyr, R. Pshyk, R. Falion","doi":"10.22141/2224-0721.19.3.2023.1272","DOIUrl":"https://doi.org/10.22141/2224-0721.19.3.2023.1272","url":null,"abstract":"Background. Today, there are difficulties with the prevention and diagnosis of early stages of hypertension, especially in active and able-bodied young people. Among the factors that potentiate an increase in blood pressure, one of the components is chronic stress, which a person often faces in modern society. The purpose of study is to evaluate and compare blood cortisol and plasma malondialdehyde content in healthy individuals and in patients with stage II hypertension before and after dosed exercises. Materials and methods. Thirty patients with stage II hypertension and 10 practically healthy persons were examined. Subjects performed two-stage physical exercises on a bicycle ergometer with an intensity corresponding to 50 and 75 % of the appropriate maximum oxygen consumption of the body. The duration of the load was equal to 5 minutes at each stage with a three-minute rest between them. Blood was taken from the ulnar vein before cycling ergometry and 5 minutes after it. Blood cortisol and plasma malondialdehyde content were determined in patients before and after exercises. Results. A significant increase in cortisol content after exercises was noted in healthy individuals against the background of some decrease in patients with hypertension. It has been suggested that since people with high blood pressure already have an elevated initial level of cortisol, their threshold of stress sensitivity to physical exertion is increased. Submaximal bicycle ergometric load does not lead to an increase in blood cortisol levels in hypertensive patients. Conclusions. The background higher level of cortisol in individuals with hypertension does not increase under the influence of submaximal dosed exercises. An increase in the level of malondialdehyde can be considered a marker of the degree of stress for assessing the power of physical exertion. In view of the above, it can be stated that the activation of the sympathoadrenal system under the influence of emotional stress leads to an increase in blood pressure. There is sufficient evidence that psycho-emotional stress is a cause of white-coat hypertension and hypertension in the workplace.","PeriodicalId":13962,"journal":{"name":"INTERNATIONAL JOURNAL OF ENDOCRINOLOGY (Ukraine)","volume":"65 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78821049","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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