E. Ershova, N. V. Frolkova, K. Komshilova, N. Mazurina
Surgical treatment in the scope of laparoscopic gastric bypass for morbid obesity and type 2 diabetes mellitus (DM 2) with careful preoperative preparation, a gradual expansion of the diet with the obligatory observance of the recommendations of a nutritionist on the balance of micro- and macronutrients, a gradual increase in the amount of available physical activity in the postoperative period allows not only significantly reduce body weight, but also achieve compensation for obesity-related diseases. The expected development of micro- and macronutrient deficiencies requires an active search for and compensation for these conditions both at the pre- and postoperative stages. The development of postbariatric hypoglycemia confirms the need to comply with dietary recommendations not only at the stage of conservative treatment of obesity and DM 2, but also, no less important, after bariatric surgery.
{"title":"Bariatric patient: what is the key to success? Case from practice","authors":"E. Ershova, N. V. Frolkova, K. Komshilova, N. Mazurina","doi":"10.14341/omet12983","DOIUrl":"https://doi.org/10.14341/omet12983","url":null,"abstract":"Surgical treatment in the scope of laparoscopic gastric bypass for morbid obesity and type 2 diabetes mellitus (DM 2) with careful preoperative preparation, a gradual expansion of the diet with the obligatory observance of the recommendations of a nutritionist on the balance of micro- and macronutrients, a gradual increase in the amount of available physical activity in the postoperative period allows not only significantly reduce body weight, but also achieve compensation for obesity-related diseases. The expected development of micro- and macronutrient deficiencies requires an active search for and compensation for these conditions both at the pre- and postoperative stages. The development of postbariatric hypoglycemia confirms the need to comply with dietary recommendations not only at the stage of conservative treatment of obesity and DM 2, but also, no less important, after bariatric surgery.","PeriodicalId":54700,"journal":{"name":"Obesity and Metabolism-Milan","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48011067","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}
M. Yukina, E. Troshina, N. Nuralieva, M. V. Degtyarev, M. G. Mokrysheva
BACKGROUND: Insulinoma is a pancreatic neuroendocrine tumor that manifests by impaired carbohydrate metabolism with the development of hypoglycemic syndrome. The instrumental methods used at the present stage do not always make it possible to identify a tumor; moreover, the data obtained often contradict each other. Thus, the search for new possibilities of visualization of insulinoma is relevant.AIM: Evaluation of diagnostic effectiveness of scintigraphy with single-photon emission computed tomography combined with X-ray computed tomography (SPECT/CT) with 99mTc-Tectrotide for insulinoma in a Russian cohort of patients.MATERIALS AND METHODS: A single-centre (Endocrinology Research Centre of the Ministry of Health of the Russia), experimental, single-stage, controlled study. In the years 2017–2021 patients with pancreatic insulinoma (group 1) and hyperinsulinemic hypoglycemia of a different genesis (group 2) with negative or contradictory results of the 1st line imaging methods (ultrasound, magnetic resonance imaging (MRI), computed tomography (CT)) were included. All participants underwent the whole-body scintigraphy and low-dose SPECT/CT with 99mTc-Tectrotide (500–900 MBq). The studies were performed on a tomograph of the SPECT/GE Discovery NM/CT 670 using low-energy high-resolution collimators (LEHR) in the «whole body» mode.RESULTS: In the group 1 (n=21), according to the results of a pathomorphological study, the presence of 26 insulin-producing tumors was confirmed. Group 2 included 9 patients. According to the SPECT/CT with 99mTc-Tectrotide, 14 tumors were diagnosed in group 1 out of 26 insulin-producing tumors of the pancreas, and negative results were obtained in group 2 in 100% of cases. Thus, the sensitivity and specificity of the method were: 54%, 95% CI [33%; 73%] and 100%, 95% CI [68%; 100%], respectively.CONCLUSION: SPECT/CT with 99mTc-Tectrotide can detect insulinoma in 54% of cases with negative or contradictory results of 1st-line imaging methods (ultrasound, MRI, CT). This study can be effectively used as an alternative to SPECT/CT with 111In-octreotide, as a 2nd-line method for topical search for an insulin-producing pancreatic tumor.
背景:胰岛素瘤是一种胰腺神经内分泌肿瘤，表现为碳水化合物代谢受损并发展为低血糖综合征。现阶段使用的仪器方法并不总是能够识别肿瘤;此外，获得的数据往往相互矛盾。因此，寻找胰岛素瘤可视化的新可能性是相关的。目的:评价99mTc-Tectrotide单光子发射计算机断层扫描联合x射线计算机断层扫描(SPECT/CT)对俄罗斯一组胰岛素瘤患者的诊断效果。材料和方法:单中心(俄罗斯卫生部内分泌学研究中心)，实验性，单阶段，对照研究。在2017-2021年期间，包括胰腺胰岛素瘤(1组)和不同原因的高胰岛素血症性低血糖(2组)患者，其一线成像方法(超声、磁共振成像(MRI)、计算机断层扫描(CT))结果为阴性或相互矛盾。所有参与者都接受了99mTc-Tectrotide (500-900 MBq)的全身显像和低剂量SPECT/CT。研究是在SPECT/GE Discovery NM/CT 670的断层扫描上进行的，使用“全身”模式的低能高分辨率准直器(LEHR)。结果:1组(n=21)，根据病理形态学研究结果，确认存在26个产生胰岛素的肿瘤。第二组9例。使用99mTc-Tectrotide进行SPECT/CT检查，26例胰腺胰岛素产生性肿瘤中，1组确诊14例，2组阴性率100%。因此，该方法的敏感性和特异性分别为:54%，95% CI [33%;73%]和100%，95% CI [68%;分别为100%)。结论:SPECT/CT应用99mTc-Tectrotide能在54%的一线影像学(超声、MRI、CT)阴性或结果矛盾的病例中检出胰岛素瘤。这项研究可以有效地作为SPECT/CT与111In-octreotide的替代方法，作为局部搜索产生胰岛素的胰腺肿瘤的二线方法。
{"title":"SPECT/CT with 99mTc-Tectrotide in the diagnosis of insulinoma","authors":"M. Yukina, E. Troshina, N. Nuralieva, M. V. Degtyarev, M. G. Mokrysheva","doi":"10.14341/omet12977","DOIUrl":"https://doi.org/10.14341/omet12977","url":null,"abstract":"BACKGROUND: Insulinoma is a pancreatic neuroendocrine tumor that manifests by impaired carbohydrate metabolism with the development of hypoglycemic syndrome. The instrumental methods used at the present stage do not always make it possible to identify a tumor; moreover, the data obtained often contradict each other. Thus, the search for new possibilities of visualization of insulinoma is relevant.AIM: Evaluation of diagnostic effectiveness of scintigraphy with single-photon emission computed tomography combined with X-ray computed tomography (SPECT/CT) with 99mTc-Tectrotide for insulinoma in a Russian cohort of patients.MATERIALS AND METHODS: A single-centre (Endocrinology Research Centre of the Ministry of Health of the Russia), experimental, single-stage, controlled study. In the years 2017–2021 patients with pancreatic insulinoma (group 1) and hyperinsulinemic hypoglycemia of a different genesis (group 2) with negative or contradictory results of the 1st line imaging methods (ultrasound, magnetic resonance imaging (MRI), computed tomography (CT)) were included. All participants underwent the whole-body scintigraphy and low-dose SPECT/CT with 99mTc-Tectrotide (500–900 MBq). The studies were performed on a tomograph of the SPECT/GE Discovery NM/CT 670 using low-energy high-resolution collimators (LEHR) in the «whole body» mode.RESULTS: In the group 1 (n=21), according to the results of a pathomorphological study, the presence of 26 insulin-producing tumors was confirmed. Group 2 included 9 patients. According to the SPECT/CT with 99mTc-Tectrotide, 14 tumors were diagnosed in group 1 out of 26 insulin-producing tumors of the pancreas, and negative results were obtained in group 2 in 100% of cases. Thus, the sensitivity and specificity of the method were: 54%, 95% CI [33%; 73%] and 100%, 95% CI [68%; 100%], respectively.CONCLUSION: SPECT/CT with 99mTc-Tectrotide can detect insulinoma in 54% of cases with negative or contradictory results of 1st-line imaging methods (ultrasound, MRI, CT). This study can be effectively used as an alternative to SPECT/CT with 111In-octreotide, as a 2nd-line method for topical search for an insulin-producing pancreatic tumor.","PeriodicalId":54700,"journal":{"name":"Obesity and Metabolism-Milan","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46887624","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}
A. Klimchuk, V. Beloglazov, I. Yatskov, Yu. M. Agzamova, A. A. Kamshii, A. Zayaeva
In the fall of 2019, global health was confronted with a new RNA virus — severe acute respiratory syndrome coronavirus 2 SARS-CoV-2. Against the background of the rapid spread of infection, research centers around the world began to develop specific vaccines against COVID-19, using the accumulated experience and empirical data on the stereotypes of the structure and physiology of other viral agents of this family (severe acute respiratory syndrome virus (SARS) and Middle East respiratory syndrome (MERS). However, even before the development of anti-COVID vaccines, it was suggested that they are probably less effective in a number of individuals, in particular, in people who are overweight or obese. This hypothesis arose on the basis of past studies using vaccines for other purposes in this categories of people, as well as in numerous experiments on mice, thanks to which scientists came to the conclusion that, due to an excess amount of adipose tissue in the body, there is a state of a permanent inflammatory process, some immune dysfunction, and, as a result, a reduced local and systemic response. resistance against bacterial and viral agents.In this literature review, using current publications obtained by searching for “covid-19 vaccination and obesity” and “vaccination and obesity” in the PubMed databases and “covid-19 vaccination and obesity” and “vaccination and obesity” in the e- Library discusses changes in the immune response both to infection itself and to immunization in the presence of overweight or obesity.
{"title":"Post-vaccination and post-infectious immune response against new coronavirus infection on the background of obesity and overweight","authors":"A. Klimchuk, V. Beloglazov, I. Yatskov, Yu. M. Agzamova, A. A. Kamshii, A. Zayaeva","doi":"10.14341/omet12966","DOIUrl":"https://doi.org/10.14341/omet12966","url":null,"abstract":"In the fall of 2019, global health was confronted with a new RNA virus — severe acute respiratory syndrome coronavirus 2 SARS-CoV-2. Against the background of the rapid spread of infection, research centers around the world began to develop specific vaccines against COVID-19, using the accumulated experience and empirical data on the stereotypes of the structure and physiology of other viral agents of this family (severe acute respiratory syndrome virus (SARS) and Middle East respiratory syndrome (MERS). However, even before the development of anti-COVID vaccines, it was suggested that they are probably less effective in a number of individuals, in particular, in people who are overweight or obese. This hypothesis arose on the basis of past studies using vaccines for other purposes in this categories of people, as well as in numerous experiments on mice, thanks to which scientists came to the conclusion that, due to an excess amount of adipose tissue in the body, there is a state of a permanent inflammatory process, some immune dysfunction, and, as a result, a reduced local and systemic response. resistance against bacterial and viral agents.In this literature review, using current publications obtained by searching for “covid-19 vaccination and obesity” and “vaccination and obesity” in the PubMed databases and “covid-19 vaccination and obesity” and “vaccination and obesity” in the e- Library discusses changes in the immune response both to infection itself and to immunization in the presence of overweight or obesity.","PeriodicalId":54700,"journal":{"name":"Obesity and Metabolism-Milan","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45878781","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}
L. Dzeranova, M. Yevloyeva, M. Perepelova, E. Pigarova, A. Shutova, A. Dorovskikh, V. Azizyan, E. Przhiyalkovskaya
Acromegaly is a severe neuroendocrine disease characterized by hypersecretion of growth hormone (GH) caused in 95% of cases by pituitary adenoma, which leads to the development of pathology of various organs and systems. The severity of the condition is due not only to the direct effect of somatotropic hormone on the body and the effect of the adenoma on the surrounding structures, but also to the age of the patient and complications associated with the disease. Improvement in treatment methods allows for a personalized approach to patient management, taking into account various aspects of the clinical case. It is important for a specialist to take into account comorbidity in acromegaly, both in terms of pathological disorders and the impact on the patient’s psycho-emotional state. We present a clinical case of successful treatment with somatostatin analogues (ASS) in a patient who is afraid of surgery and has cardiovascular complications of acromegaly. Since the onset of acromegaly, confirmed by an elevated level of insulin-like growth factor-1 (IGF-1) and an endosellar pituitary macroadenoma measuring 11x9.5x8 mm, ASS therapy was initiated in the patient. The choice in favor of conservative treatment was due to a burdened cardiovascular history and the patient’s fear of surgery. Within three years from the start of drug therapy, there was a significant improvement in overall well-being, a tendency to reduce the size of the pituitary adenoma, and biochemical remission was achieved. The clinical case described by us confirms the possibility of successful primary treatment of ASS in a patient with acromegaly, taking into account all individual characteristics.
{"title":"Efficacy of long-term octreotide therapy of acromegaly as the first-line medical treatment","authors":"L. Dzeranova, M. Yevloyeva, M. Perepelova, E. Pigarova, A. Shutova, A. Dorovskikh, V. Azizyan, E. Przhiyalkovskaya","doi":"10.14341/omet12960","DOIUrl":"https://doi.org/10.14341/omet12960","url":null,"abstract":"Acromegaly is a severe neuroendocrine disease characterized by hypersecretion of growth hormone (GH) caused in 95% of cases by pituitary adenoma, which leads to the development of pathology of various organs and systems. The severity of the condition is due not only to the direct effect of somatotropic hormone on the body and the effect of the adenoma on the surrounding structures, but also to the age of the patient and complications associated with the disease. Improvement in treatment methods allows for a personalized approach to patient management, taking into account various aspects of the clinical case. It is important for a specialist to take into account comorbidity in acromegaly, both in terms of pathological disorders and the impact on the patient’s psycho-emotional state. We present a clinical case of successful treatment with somatostatin analogues (ASS) in a patient who is afraid of surgery and has cardiovascular complications of acromegaly. Since the onset of acromegaly, confirmed by an elevated level of insulin-like growth factor-1 (IGF-1) and an endosellar pituitary macroadenoma measuring 11x9.5x8 mm, ASS therapy was initiated in the patient. The choice in favor of conservative treatment was due to a burdened cardiovascular history and the patient’s fear of surgery. Within three years from the start of drug therapy, there was a significant improvement in overall well-being, a tendency to reduce the size of the pituitary adenoma, and biochemical remission was achieved. The clinical case described by us confirms the possibility of successful primary treatment of ASS in a patient with acromegaly, taking into account all individual characteristics.","PeriodicalId":54700,"journal":{"name":"Obesity and Metabolism-Milan","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44003012","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}
Y. Dyleva, O. Gruzdeva, E. Belik, D. Borodkina, M. Sinitskiy, S. Ivanov, O. Barbarash
BACKGROUND: The information available to date on the effect of metformin on the transcriptome and secretory capacity of adipocytes in human adipose tissue (AT) is scarce and contradictory. The study analyzed whether metformin in vitro modulates gene expression and secretion of adiponectin and leptin in the AT of subcutaneous (SAT), epicardial (EAT) and perivascular (PVAT) localization of patients with ischemic artery disease (IHD).AIM: To assess the effect of metformin at various concentrations (1 and 10 mmol / L) on the level of expression of adiponectin and leptin genes and their content in adipocytes of subcutaneous, epicardial and perivascular AT of patients with IHD.MATERIALS AND METHODS: The study included 134 patients with IHD and indications for direct myocardial revascularization by coronary artery bypass grafting (CABG). During the operation, biopsies of SAT, EAT and PVAT were obtained for 3–5 gram, which served as a source of adipocytes. Isolated adipocytes were cultured for 24 hours with and without metformin (1 and 10 mmol / L). After a day of incubation, the expression of the ADIPOQ and LEP genes and the level of secretion of adiponectin and leptin in the culture medium of adipocytes were determined. Statistical processing was performed using the GraphPad Prism 6 software package (GraphPad Software, La Jolla, CA, USA) and Statistica software, 6.1 (Dell Software, Inc., Round Rock, TX, USA).RESULTS: The adipocytes of the EAT and PVAT of patients with IHD were characterized by an imbalance in the adipokine system, manifested by a low level of ADIPOQ expression and a high LEP expression in comparison with adipocytes of the SAT. Metformin increased the level of ADIPOQ expression and its secretion by adipocytes regardless of their location, while a low concentration (1 mmol / L) in adipocytes of EAT had a stronger effect compared to 10 mmol / L. Metformin had a multidirectional effect on the level of leptin in adipocytes, which depended on their localization: both in low (1 mmol / L) and high concentrations (10 mmol / L), the drug reduced the level of LEP expression and protein secretion in the culture medium of adipocytes of the SAT. EAT had no significant effect on adipocytes. In PVAT, metformin increased the expression and secretion of leptin regardless of concentration.CONCLUSION: Metformin has a direct effect on adipocytes in SAT, EAT, and PVAT and is able to modulate their activity, which is a promising strategy for maintaining the balance of adipokines in AT, especially epicardial and perivascular localization.
背景:迄今为止，关于二甲双胍对人类脂肪组织(AT)中脂肪细胞转录组和分泌能力的影响的信息是稀缺和矛盾的。本研究分析二甲双胍是否在体外调节缺血性动脉疾病(IHD)患者皮下(SAT)、心外膜(EAT)和血管周围(PVAT)定位AT中脂联素和瘦素的基因表达和分泌。目的:探讨不同浓度二甲双胍(1和10 mmol / L)对IHD患者皮下、心外膜和血管周围at脂肪细胞脂联素和瘦素基因表达水平及含量的影响。材料与方法:本研究纳入134例IHD患者，并采用冠状动脉旁路移植术(CABG)直接心肌血运重建。术中取3-5克的SAT、EAT和PVAT活检，作为脂肪细胞的来源。将分离的脂肪细胞分别添加1和10 mmol / L二甲双胍和不添加二甲双胍培养24小时，培养1 d后，检测脂肪细胞培养液中ADIPOQ和LEP基因的表达以及脂联素和瘦素的分泌水平。使用GraphPad Prism 6软件包(GraphPad software, La Jolla, CA, USA)和Statistica软件6.1 (Dell software, Inc.， Round Rock, TX, USA)进行统计处理。结果:IHD患者的EAT和PVAT脂肪细胞的特点是脂肪因子系统失衡，表现为与SAT脂肪细胞相比，ADIPOQ表达水平低，LEP表达水平高。二甲双胍增加了脂肪细胞的ADIPOQ表达水平和分泌水平，而与脂肪细胞的位置无关。而低浓度(1更易/ L)吃的脂肪细胞有更强的影响相比,更易与10 L .二甲双胍多向的影响瘦素在脂肪细胞的水平,这取决于他们的定位:在低(1更易/ L)和高浓度(10更易/ L),药物减少地蜡表达水平和蛋白质的分泌脂肪细胞培养基的坐,吃脂肪细胞没有明显影响。在PVAT中，二甲双胍增加瘦素的表达和分泌，而与浓度无关。结论:二甲双胍对SAT、EAT和PVAT中的脂肪细胞有直接影响，并能调节其活性，这是维持AT中脂肪因子平衡的一种有希望的策略，特别是心外膜和血管周围定位。
{"title":"Effect of metformin on transcriptome and adipokinome of adipocytes of local fat deposts of patients with ischemic heart disease","authors":"Y. Dyleva, O. Gruzdeva, E. Belik, D. Borodkina, M. Sinitskiy, S. Ivanov, O. Barbarash","doi":"10.14341/omet12743","DOIUrl":"https://doi.org/10.14341/omet12743","url":null,"abstract":"BACKGROUND: The information available to date on the effect of metformin on the transcriptome and secretory capacity of adipocytes in human adipose tissue (AT) is scarce and contradictory. The study analyzed whether metformin in vitro modulates gene expression and secretion of adiponectin and leptin in the AT of subcutaneous (SAT), epicardial (EAT) and perivascular (PVAT) localization of patients with ischemic artery disease (IHD).AIM: To assess the effect of metformin at various concentrations (1 and 10 mmol / L) on the level of expression of adiponectin and leptin genes and their content in adipocytes of subcutaneous, epicardial and perivascular AT of patients with IHD.MATERIALS AND METHODS: The study included 134 patients with IHD and indications for direct myocardial revascularization by coronary artery bypass grafting (CABG). During the operation, biopsies of SAT, EAT and PVAT were obtained for 3–5 gram, which served as a source of adipocytes. Isolated adipocytes were cultured for 24 hours with and without metformin (1 and 10 mmol / L). After a day of incubation, the expression of the ADIPOQ and LEP genes and the level of secretion of adiponectin and leptin in the culture medium of adipocytes were determined. Statistical processing was performed using the GraphPad Prism 6 software package (GraphPad Software, La Jolla, CA, USA) and Statistica software, 6.1 (Dell Software, Inc., Round Rock, TX, USA).RESULTS: The adipocytes of the EAT and PVAT of patients with IHD were characterized by an imbalance in the adipokine system, manifested by a low level of ADIPOQ expression and a high LEP expression in comparison with adipocytes of the SAT. Metformin increased the level of ADIPOQ expression and its secretion by adipocytes regardless of their location, while a low concentration (1 mmol / L) in adipocytes of EAT had a stronger effect compared to 10 mmol / L. Metformin had a multidirectional effect on the level of leptin in adipocytes, which depended on their localization: both in low (1 mmol / L) and high concentrations (10 mmol / L), the drug reduced the level of LEP expression and protein secretion in the culture medium of adipocytes of the SAT. EAT had no significant effect on adipocytes. In PVAT, metformin increased the expression and secretion of leptin regardless of concentration.CONCLUSION: Metformin has a direct effect on adipocytes in SAT, EAT, and PVAT and is able to modulate their activity, which is a promising strategy for maintaining the balance of adipokines in AT, especially epicardial and perivascular localization.","PeriodicalId":54700,"journal":{"name":"Obesity and Metabolism-Milan","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44761633","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}
N. V. Molashenko, N. Kalinchenko, V. Ioutsi, O. Gurinovich, D. M. Babaeva, A. A. Voznesenskaya, N. Platonova, M. Yukina, A. Kolodkina, T. A. Ponomareva
17β-Hydroxysteroid dehydrogenase 3 deficiency (17HSD3) is a rare autosomal recessive cause of 46, XY disorders of sex development resulting from HSD17B3 gene mutations, in which conversion of androstenedione to testosterone is impared. The clinical signs of 17HSD3 deficiency depend on the residual activity of the enzyme. The diagnosis of 17HSD3 deficiency is based on reduced testosterone/androstenedione ratio (T/AD < 0.8). Patients are usually assigned at birth and raise as female. If the diagnosis is made before puberty, gonadectomy is recommended, taking into account the risk of masculinization during the puberty and estrogen therapy initiation in this period. If the diagnosis of 17HSD3 deficiency is established during puberty, when virilization manifests, the therapeutic strategy is based on the results of comprehensive psychological testing and gender identity of a patient. In patients with more pronounced masculinization or diagnosis established shortly after birth, who are assigned at birth and raise as male, testosterone therapy is used to achieve a male phenotype. The 17HSD3 deficiency and virilization often result in a change of gender identity during puberty. The article presents a clinical case of 17-βhydroxysteroid dehydrogenase type 3 deficiency with late diagnosis due to parental will. The diagnostic approaches and management of the disease are also described.
{"title":"A case of 17-beta-hydroxysteroid dehydrogenase deficiency type 3 in adult endocrinologist practice","authors":"N. V. Molashenko, N. Kalinchenko, V. Ioutsi, O. Gurinovich, D. M. Babaeva, A. A. Voznesenskaya, N. Platonova, M. Yukina, A. Kolodkina, T. A. Ponomareva","doi":"10.14341/omet12942","DOIUrl":"https://doi.org/10.14341/omet12942","url":null,"abstract":"17β-Hydroxysteroid dehydrogenase 3 deficiency (17HSD3) is a rare autosomal recessive cause of 46, XY disorders of sex development resulting from HSD17B3 gene mutations, in which conversion of androstenedione to testosterone is impared. The clinical signs of 17HSD3 deficiency depend on the residual activity of the enzyme. The diagnosis of 17HSD3 deficiency is based on reduced testosterone/androstenedione ratio (T/AD < 0.8). Patients are usually assigned at birth and raise as female. If the diagnosis is made before puberty, gonadectomy is recommended, taking into account the risk of masculinization during the puberty and estrogen therapy initiation in this period. If the diagnosis of 17HSD3 deficiency is established during puberty, when virilization manifests, the therapeutic strategy is based on the results of comprehensive psychological testing and gender identity of a patient. In patients with more pronounced masculinization or diagnosis established shortly after birth, who are assigned at birth and raise as male, testosterone therapy is used to achieve a male phenotype. The 17HSD3 deficiency and virilization often result in a change of gender identity during puberty. The article presents a clinical case of 17-βhydroxysteroid dehydrogenase type 3 deficiency with late diagnosis due to parental will. The diagnostic approaches and management of the disease are also described.","PeriodicalId":54700,"journal":{"name":"Obesity and Metabolism-Milan","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42684426","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}
Hypogonadism in men can cause the development of obesity, primarily abdominal, associated with high cardio-metabolic risks. Chronic obesity, in turn, almost inevitably leads to the manifestation of hypogonadism, which requires treatment and aggravates cardiovascular risks. Testosterone therapy, prescribed according to indications, has a significant positive effect not only on a man’s sexual function, but also on body weight, carbohydrate and lipid metabolism, bone metabolism and the emotional component of men’s health. The improvement of many metabolic parameters in men with verified hypogonadism occurs against the background of fairly long-term testosterone therapy. Hypogonadism and visceral obesity are now considered as components of the metabolic syndrome, mutually burden each other and require a comprehensive therapeutic approach.
{"title":"Hypogonadism and visceral obesity in men are full–fledged components of the metabolic syndrome","authors":"E. Troshina, Р. A. Terekhov","doi":"10.14341/omet12980","DOIUrl":"https://doi.org/10.14341/omet12980","url":null,"abstract":"Hypogonadism in men can cause the development of obesity, primarily abdominal, associated with high cardio-metabolic risks. Chronic obesity, in turn, almost inevitably leads to the manifestation of hypogonadism, which requires treatment and aggravates cardiovascular risks. Testosterone therapy, prescribed according to indications, has a significant positive effect not only on a man’s sexual function, but also on body weight, carbohydrate and lipid metabolism, bone metabolism and the emotional component of men’s health. The improvement of many metabolic parameters in men with verified hypogonadism occurs against the background of fairly long-term testosterone therapy. Hypogonadism and visceral obesity are now considered as components of the metabolic syndrome, mutually burden each other and require a comprehensive therapeutic approach.","PeriodicalId":54700,"journal":{"name":"Obesity and Metabolism-Milan","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47926508","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}
N. Izmozherova, A. Popov, A. V. Ryabinina, A. A. Vikhareva, E. Safianik, A. Spevak, M. Shambatov, V. Bakhtin
BACKGROUND: The global prevalence of vitamin D deficiency is currently a real threat due to association with major chronic non-communicable diseases. Abdominal obesity, hypertension, dyslipidemia, and hyperglycemia contribute significantly to cardiometabolic risk in late postmenopausal women.AIM: to assess the frequency of deficiency and insufficiency of 25(OH)D in late postmenopausal residents of Yekaterinburg; to establish associations of 25(OH)D serum concentration with components of metabolic syndrome and severity of menopausal symptoms.MATERIALS AND METHODS: During the period from October 2018 to March 2020 145 independently living late postmenopausal residents of Yekaterinburg were enrolled in a cross-sectional study. The following scope of data regarding each of the subjects was collected: complaints and anamnesis, anthropometry, diagnosis of metabolic syndrome, arterial hypertension and diabetes mellitus, assessment of 25 (OH)D level by the ECLIA method, LDL-C, HDL-C levels, serum TG by the enzymatic colorimetric method, as well as the evaluation of the modified menopausal index.RESULTS: Adequate serum level of 25(OH)D was detected in 20.6% patients, insufficiency and deficiency were found in 33.1 and 46.2% cases, respectively. In patients with vitamin D deficiency and insufficiency, the most frequent metabolic syndrome components were arterial hypertension (p=0.02; OR 3.5; CI 1.2–10.6) and abdominal obesity (p=0.03; OR 2.8; CI 1.1–7.2). Vitamin D deficient subjects had significantly lower serum HDL and increased TG levels (p=0.04), compared to the adequately provided 25(OH)D patients. Vitamin D levels were not associated with the severity of menopausal symptoms in late postmenopausal women. Regular daily intake of 400–2000 IU of colecalciferol contributed to higher serum 25(OH)D level.CONCLUSION: a high prevalence of vitamin D deficiency among postmenopausal women of Yekaterinburg was detected. Diagnosis and correction of vitamin D levels are necessary for timely reduction of cardiometabolic risk, primarily due to the potential pleiotropic effects of D-hormone on the renin-angiotensin-aldosterone system, carbohydrate and lipid metabolism.
{"title":"Metabolic syndrome components and vitamin D availability relationship in late postmenopausal women","authors":"N. Izmozherova, A. Popov, A. V. Ryabinina, A. A. Vikhareva, E. Safianik, A. Spevak, M. Shambatov, V. Bakhtin","doi":"10.14341/omet12737","DOIUrl":"https://doi.org/10.14341/omet12737","url":null,"abstract":"BACKGROUND: The global prevalence of vitamin D deficiency is currently a real threat due to association with major chronic non-communicable diseases. Abdominal obesity, hypertension, dyslipidemia, and hyperglycemia contribute significantly to cardiometabolic risk in late postmenopausal women.AIM: to assess the frequency of deficiency and insufficiency of 25(OH)D in late postmenopausal residents of Yekaterinburg; to establish associations of 25(OH)D serum concentration with components of metabolic syndrome and severity of menopausal symptoms.MATERIALS AND METHODS: During the period from October 2018 to March 2020 145 independently living late postmenopausal residents of Yekaterinburg were enrolled in a cross-sectional study. The following scope of data regarding each of the subjects was collected: complaints and anamnesis, anthropometry, diagnosis of metabolic syndrome, arterial hypertension and diabetes mellitus, assessment of 25 (OH)D level by the ECLIA method, LDL-C, HDL-C levels, serum TG by the enzymatic colorimetric method, as well as the evaluation of the modified menopausal index.RESULTS: Adequate serum level of 25(OH)D was detected in 20.6% patients, insufficiency and deficiency were found in 33.1 and 46.2% cases, respectively. In patients with vitamin D deficiency and insufficiency, the most frequent metabolic syndrome components were arterial hypertension (p=0.02; OR 3.5; CI 1.2–10.6) and abdominal obesity (p=0.03; OR 2.8; CI 1.1–7.2). Vitamin D deficient subjects had significantly lower serum HDL and increased TG levels (p=0.04), compared to the adequately provided 25(OH)D patients. Vitamin D levels were not associated with the severity of menopausal symptoms in late postmenopausal women. Regular daily intake of 400–2000 IU of colecalciferol contributed to higher serum 25(OH)D level.CONCLUSION: a high prevalence of vitamin D deficiency among postmenopausal women of Yekaterinburg was detected. Diagnosis and correction of vitamin D levels are necessary for timely reduction of cardiometabolic risk, primarily due to the potential pleiotropic effects of D-hormone on the renin-angiotensin-aldosterone system, carbohydrate and lipid metabolism.","PeriodicalId":54700,"journal":{"name":"Obesity and Metabolism-Milan","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44396503","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: Influence of obesity on the body at whole and with regard to metabolic changes is still unclear. In Russia there are a few data about prevalence of metabolic phenotypes among population based on epidemiological data.AIM: to assess the prevalence of metabolic phenotypes among citizens of Arctic area of the Russian Federation (in the Arkhangelsk city setting).MATERIALS AND METHODS: a cross-sectional study was conducted using a random sample of Arkhangelsk citizens (n=2380) 35–69 years old, which was obtained within a population study of cardiovascular diseases («Know your heart» (KYH)). The participants were divided into metabolic phenotypes according to the presence of obesity (BMI≥30 kg/m2) and metabolic syndrome (AHA/NHBLI): phenotype 1 — metabolically healthy normal weight, phenotype 2 — metabolically unhealthy normal weight, phenotype 3 — metabolically healthy obesity, phenotype 4 — metabolically unhealthy obesity.RESULTS: 2352 participants of KYH were included in the study, 982 (41,8%) men and 1370 (58,3%) women. Mean age was 53,9 (SD 9,7) years. The distribution of participants by metabolic phenotypes was as follows: 1167 (49,6%) persons had phenotype 1, 489 (20,8%) — phenotype 2, 248 (10,5%) — phenotype 3, 448 (19,1%) — phenotype 4. In men, the second common after the first phenotype was phenotype 2, while in women, the second position was shared by the 2nd and 4th phenotypes, which had approximately the same frequency. «Arterial hypertension» was the most prevalent component of metabolic syndrome and seen in 68–96% men and 38–94% women in the study with different phenotypes. The proportions of phenotypes with metabolic disorders increased with age.CONCLUSION: in a study of a random population sample within the framework of the concept of metabolic phenotypes, a half of the participants had no obesity and metabolic syndrome. Proportions of participants with metabolic disorders with and without obesity was 20% each. Only 10% of participants had «metabolically healthy» obesity. If excluding individuals without obesity and metabolic syndrome, the phenotype characterized by metabolic disorders in the absence of obesity was the most common among men. Phenotypes with metabolic disorders on the background of obesity or without obesity were equally common among women. The most common component of metabolic syndrome was «arterial hypertension». There was a tendency of accumulation of metabolic disturbances with age.
BACKGROUND: The model of obesity under experimental conditions is reproduced by using high-calorie diets in animals. It has been established that metabolic disorders cause meta-inflammation not only in peripheral organs and tissues, but also in brain structures. The search for effective neuroprotective antioxidants to suppress inflammatory processes in the cerebral cortex in obesity is an urgent task due to the widespread prevalence of this disease.AIM: to evaluate the effect of minor biologically active substances — carnosine (CAR) and α-lipoic acid (ALA) on the cytokine profile of the frontal cortex of the left hemisphere of the brain in Wistar male rats with obesity induced by a high-calorie choline-deficient diet.MATERIALS AND METHODS: The studies were carried out on male Wistar rats with an initial body weight of 150±10 g. The animals were randomized by body weight into 5 groups. For 8 weeks, rats of the 1st (control) group received a complete modified diet of AIN93M; rats of the 2nd group consumed a high-calorie choline-deficient diet (HCHDR), the fat content of which was 45%, fructose — 20% of the energy value of the diet; rats of the 3rd group received HCHDR with the addition of CAR at a dose of 75 mg per 1 kg of body weight; rats of the 4th group received HCHDR with the addition of ALA at a dose of 75 mg per 1 kg of body weight; rats of the 5th group received HCHDR with the addition of the CAR + ALA complex in a total dose of 150 mg per 1 kg of body weight. Animals were removed from the experiment by decapitation under ether anesthesia. The levels of triglycerides (Tg) and free fatty acids (FFA) in blood plasma (mmol) were determined on a biochemical analyzer (Konelab 20i, Thermo Clinical Labsystems Oy, Finland). Content of cytokines and chemokines (pg/ml): GM-CSF, IL-10, IL-17A, IL-12p40, IL-12p70, IL-1α, IL-2, IL-4, IL-5, IFN-γ, MCP-1, M-CSF, MIP-1α, MIP-2, MIP-3α, RANTES, and TNF-α in cerebral cortex lysates were determined by multiplex immunoassay using a Luminex 200 analyzer (Luminex Corporation, USA). To assess the relationship between the level of cytokines in blood plasma and changes in their concentrations under the influence of HCCDR in lysates of the cortex of the frontal lobe of the left hemisphere of the brain, the ratio was calculated: the level of cytokines pg/ml in blood plasma [1]/the content of cytokines pg/ml in lysates (pl/ lys) for each sample.RESULTS: On the model of obesity in rats, the presence of an inflammatory process in the cerebral cortex was established, as evidenced by an increase in the content of pro-inflammatory factors: IL-2, M-CSF, MIP-1α and RANTES and a decrease in the content of immunoregulatory cytokines of varying severity: IL-10, IL17A, IL-12p40, IL-12p70, TNF-a, MIP-2 and MIP-3α in group 2 rats. (HCHDR) compared with the control group. Enrichment of HCHDR with biologically active substances: CAR, ALA or their complex, ensured the normalization of lipid metabolism, as evidenced by the decrease in
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