A. Neimark, M. A. Molotkova, E. Kravchuk, O. V. Kornyushimn
Sleeve gastrectomy, originally proposed as part of a two-stage operation, more than 15 years ago, is recognized as an independent, effective intervention for the treatment of obesity. The purpose of this review was to evaluate the effectiveness of sleeve gastrectomy based on data on long-term follow-up of patients. A search was performed in two databases, 33 literary sources were selected based on the results of the selection. In this review, the authors evaluated some parameters characterizing the effectiveness of sleeve gastrectomy in the long term after surgery. The percentage of follow-up of patients in the long-term period (follow up, %) varied from 5,6% to 97%, the expected decrease in % follow up over time did not occur. The authors have suggested similar results due to the heterogeneity of the data of the analyzed sources. By the five-year period, the detected average % of follow-up did not correspond to the optimal recommended level of follow-up for operated patients by this time. The most common criterion for assessing the return of weight is an increase in body weight by more than 10 kg from the lowest achieved. The prevalence of this phenomenon ranged from 26.3% to 44%. Among the reasons predisposing to weight loss are the initial high BMI, old age, dilatation of the formed stomach. In the absence of a universal definition of various terms (follow up, unsatisfactory result of surgery, weight loss, etc.), the results among the same patients when using different definitions will differ, there is a need to adopt standards when describing these phenomena. Despite the likelihood of weight loss after longitudinal resection, this operation is relatively simple from a technical point of view, safer, it can be used to improve the course of concomitant pathology (diabetes mellitus, hypertension), improve the quality and increase the life expectancy of patients.
{"title":"Evaluation of the effectiveness of weight loss and the return of lost weight after sleeve gastrectomy in the long term follow-up period","authors":"A. Neimark, M. A. Molotkova, E. Kravchuk, O. V. Kornyushimn","doi":"10.14341/omet12815","DOIUrl":"https://doi.org/10.14341/omet12815","url":null,"abstract":"Sleeve gastrectomy, originally proposed as part of a two-stage operation, more than 15 years ago, is recognized as an independent, effective intervention for the treatment of obesity. The purpose of this review was to evaluate the effectiveness of sleeve gastrectomy based on data on long-term follow-up of patients. A search was performed in two databases, 33 literary sources were selected based on the results of the selection. In this review, the authors evaluated some parameters characterizing the effectiveness of sleeve gastrectomy in the long term after surgery. The percentage of follow-up of patients in the long-term period (follow up, %) varied from 5,6% to 97%, the expected decrease in % follow up over time did not occur. The authors have suggested similar results due to the heterogeneity of the data of the analyzed sources. By the five-year period, the detected average % of follow-up did not correspond to the optimal recommended level of follow-up for operated patients by this time. The most common criterion for assessing the return of weight is an increase in body weight by more than 10 kg from the lowest achieved. The prevalence of this phenomenon ranged from 26.3% to 44%. Among the reasons predisposing to weight loss are the initial high BMI, old age, dilatation of the formed stomach. In the absence of a universal definition of various terms (follow up, unsatisfactory result of surgery, weight loss, etc.), the results among the same patients when using different definitions will differ, there is a need to adopt standards when describing these phenomena. Despite the likelihood of weight loss after longitudinal resection, this operation is relatively simple from a technical point of view, safer, it can be used to improve the course of concomitant pathology (diabetes mellitus, hypertension), improve the quality and increase the life expectancy of patients.","PeriodicalId":54700,"journal":{"name":"Obesity and Metabolism-Milan","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43112112","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}
E. Orlovskaya, E. Achkasov, Y. Yashkov, E. Zorin, N. Ermakov
Obesity is a global social and economic problem. The bariatric surgery is a most effective treatment for obesity. The presented clinical case demonstrates the usage of principles of enchanced perioperative rehabilitation for the preoperative preparation of a patient with super obesity and with severe obstructive sleep apnea and alveolar hypoventilation syndrome.A 54-year-old patient was hospitalized with complaints of obesity, impossibility of persistent weight loss conservatively, severe daytime sleepiness, frequent nocturnal awakenings (up to 8 times per night). The patient’s weight was 230 kg with a height of 157 cm (BMI 93.5 kg / m2). The examination revealed a syndrome of sleep apnea of mixed genesis of extremely severe degree, chronic night hypoxemia of an extremely severe degree. Preoperative preparation was performed in accordance with the program of enchanced perioperative rehabilitation. The duration of preoperative preparation was 19 days; weight loss — 40 kg (%WL -17,4), compensation of comorbidities was achieved as well. After that the patient underwent a laparoscopic sleeve gastrectomy. There were no complications in the postoperative period. Length of postoperative hospital stay was 6 days. At follow-up examination one year after surgery, body weight dropped from 230 to 153 kg (% WL-33.5), a significant improvement of the quality of life was achieved.The enchanced perioperative rehabilitation program can be successfully used as an effective method for preoperartive preparation of the patients with morbid obesity in combination with severe obstructive sleep apnea syndrome.and obesity hypoventilation. It can be a reasonable alternative to the standard program with preoperative intragastric balloon treatment. The use of this technique allows to increase the effectiveness of treatment of these high-risk patients, as well as to reduce the risk of perioperative complications.
肥胖是一个全球性的社会和经济问题。减肥手术是治疗肥胖最有效的方法。本临床病例展示了强化围手术期康复原则在超级肥胖和严重阻塞性睡眠呼吸暂停和肺泡低通气综合征患者术前准备中的应用。患者54岁，主诉肥胖，保守减肥无法持续，白天严重嗜睡，夜间频繁醒来(每晚多达8次)。患者体重230 kg，身高157 cm (BMI 93.5 kg / m2)。检查结果为重度混合原因的睡眠呼吸暂停综合征，重度慢性夜间低氧血症。术前准备按照强化围手术期康复计划进行。术前准备时间19天;体重减轻40公斤(%WL - 17.4)，合并症也得到了补偿。之后，患者接受了腹腔镜袖胃切除术。术后无并发症发生。术后住院时间6天。术后1年随访检查，体重从230 kg下降到153 kg (% WL-33.5)，生活质量明显改善。强化围手术期康复方案可成功作为病态肥胖合并严重阻塞性睡眠呼吸暂停综合征患者术前准备的有效方法。肥胖和呼吸不足。它可以作为术前胃内球囊治疗标准方案的合理替代方案。这项技术的使用可以提高这些高危患者的治疗效果，并降低围手术期并发症的风险。
{"title":"Enchanced preoperative rehabilitation as part of the complex perioperative rehabilitation of patients with super-obesity and obstructive sleep apnea syndrome (clinical outlook)","authors":"E. Orlovskaya, E. Achkasov, Y. Yashkov, E. Zorin, N. Ermakov","doi":"10.14341/omet12724","DOIUrl":"https://doi.org/10.14341/omet12724","url":null,"abstract":"Obesity is a global social and economic problem. The bariatric surgery is a most effective treatment for obesity. The presented clinical case demonstrates the usage of principles of enchanced perioperative rehabilitation for the preoperative preparation of a patient with super obesity and with severe obstructive sleep apnea and alveolar hypoventilation syndrome.A 54-year-old patient was hospitalized with complaints of obesity, impossibility of persistent weight loss conservatively, severe daytime sleepiness, frequent nocturnal awakenings (up to 8 times per night). The patient’s weight was 230 kg with a height of 157 cm (BMI 93.5 kg / m2). The examination revealed a syndrome of sleep apnea of mixed genesis of extremely severe degree, chronic night hypoxemia of an extremely severe degree. Preoperative preparation was performed in accordance with the program of enchanced perioperative rehabilitation. The duration of preoperative preparation was 19 days; weight loss — 40 kg (%WL -17,4), compensation of comorbidities was achieved as well. After that the patient underwent a laparoscopic sleeve gastrectomy. There were no complications in the postoperative period. Length of postoperative hospital stay was 6 days. At follow-up examination one year after surgery, body weight dropped from 230 to 153 kg (% WL-33.5), a significant improvement of the quality of life was achieved.The enchanced perioperative rehabilitation program can be successfully used as an effective method for preoperartive preparation of the patients with morbid obesity in combination with severe obstructive sleep apnea syndrome.and obesity hypoventilation. It can be a reasonable alternative to the standard program with preoperative intragastric balloon treatment. The use of this technique allows to increase the effectiveness of treatment of these high-risk patients, as well as to reduce the risk of perioperative complications.","PeriodicalId":54700,"journal":{"name":"Obesity and Metabolism-Milan","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46260497","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}
The obesity epidemic has led to the growing number of bariatric operations and the expansion of indications for this operation as the most effective method of treatment, that’s why endocrinologists are increasingly faced the challenge of late complications, including postbariatric hypoglycemia. Postbariatric hypoglycemia is a rare but severe metabolic disorder that occurs months or years after upper gastrointestinal surgery. Postbariatric hypoglycemia can be accompanied by severe clinical symptoms and lead to disability and decreasing of the life’s quality. It is difficult to assess the prevalence of hypoglycemia after bariatric surgery due to the lack of clear diagnostic criteria, often a hidden clinical picture and ignorance of doctors and patients about this complication. Hypoglycemia in this case has postprandial and hyperinsulinemic nature. The mechanisms of development of this complication have recently been actively discussed. The exchange of incretins and dysregulation of insulin secretion are the subject of constant research in this area. Understanding the mechanisms of development of this condition makes it possible to develop optimal methods of diagnosis and treatment. The issues of pathophysiology, basic principles of diagnosis and treatment of post-bariatric hypoglycemia will be considered in this review.
{"title":"A view at postbariatric hypoglycemia by endocrinologist","authors":"E. Kim, E. Ershova, N. Mazurina, K. Komshilova","doi":"10.14341/omet12785","DOIUrl":"https://doi.org/10.14341/omet12785","url":null,"abstract":"The obesity epidemic has led to the growing number of bariatric operations and the expansion of indications for this operation as the most effective method of treatment, that’s why endocrinologists are increasingly faced the challenge of late complications, including postbariatric hypoglycemia. Postbariatric hypoglycemia is a rare but severe metabolic disorder that occurs months or years after upper gastrointestinal surgery. Postbariatric hypoglycemia can be accompanied by severe clinical symptoms and lead to disability and decreasing of the life’s quality. It is difficult to assess the prevalence of hypoglycemia after bariatric surgery due to the lack of clear diagnostic criteria, often a hidden clinical picture and ignorance of doctors and patients about this complication. Hypoglycemia in this case has postprandial and hyperinsulinemic nature. The mechanisms of development of this complication have recently been actively discussed. The exchange of incretins and dysregulation of insulin secretion are the subject of constant research in this area. Understanding the mechanisms of development of this condition makes it possible to develop optimal methods of diagnosis and treatment. The issues of pathophysiology, basic principles of diagnosis and treatment of post-bariatric hypoglycemia will be considered in this review.","PeriodicalId":54700,"journal":{"name":"Obesity and Metabolism-Milan","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46531924","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}
I. Dedov, N. Mokrysheva, G. Melnichenko, R. Rozhivanov, A. Kamalov, А. M. Mkrtumyan, Y. Khalimov, N. Vorokhobina
Hypogonadism in males, defined as a decrease in serum testosterone levels in combination with characteristic symptoms and/or signs, can be observed with pathological changes in the testicles and/or pituitary gland, such as Klinefelter’s syndrome, Kallman’s syndrome, as well as in men with metabolic (obesity, diabetes mellitus) or iatrogenic disorders leading to a decrease in androgen production. The draft guidelines cover the extensive range of pathologies that cause hypogonadism development (testosterone deficiency) and focus on its clinical variants, which make up the majority of cases of hypogonadism observed in men. The authors and reviewers are an interdisciplinary group of experts, consisting of endocrinologists, andrologists, urologists - members of the «Russian Association of Endocrinologists» and «Men’s and Reproductive Health» public organizations.Clinical guidelines contain the most reliable evidence available to experts at the time of writing. Nevertheless, recommendations cannot replace clinical experience, and deciding on the start of treatment, choosing a method of therapy, or a drug should always consider the individual characteristics of a specific patient.
{"title":"Draft of Russian Clinical Practice Guidelines «Male hypogonadism»","authors":"I. Dedov, N. Mokrysheva, G. Melnichenko, R. Rozhivanov, A. Kamalov, А. M. Mkrtumyan, Y. Khalimov, N. Vorokhobina","doi":"10.14341/omet12817","DOIUrl":"https://doi.org/10.14341/omet12817","url":null,"abstract":"Hypogonadism in males, defined as a decrease in serum testosterone levels in combination with characteristic symptoms and/or signs, can be observed with pathological changes in the testicles and/or pituitary gland, such as Klinefelter’s syndrome, Kallman’s syndrome, as well as in men with metabolic (obesity, diabetes mellitus) or iatrogenic disorders leading to a decrease in androgen production. The draft guidelines cover the extensive range of pathologies that cause hypogonadism development (testosterone deficiency) and focus on its clinical variants, which make up the majority of cases of hypogonadism observed in men. The authors and reviewers are an interdisciplinary group of experts, consisting of endocrinologists, andrologists, urologists - members of the «Russian Association of Endocrinologists» and «Men’s and Reproductive Health» public organizations.Clinical guidelines contain the most reliable evidence available to experts at the time of writing. Nevertheless, recommendations cannot replace clinical experience, and deciding on the start of treatment, choosing a method of therapy, or a drug should always consider the individual characteristics of a specific patient.","PeriodicalId":54700,"journal":{"name":"Obesity and Metabolism-Milan","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43410762","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}
Г. Павлова, Ю. Целовальникова, А. Е. Юдина, О. О. Голоунина, А. В. Зилов, Н. А. Мазеркина, О.Г. Желудкова, В. В. Фадеев, Сеченовский Университет, Maria G. Pavlova, Tatiana Tselovalnikova, Alla E. Yudina, O. Golounina, Alexey V. Zilov, N. Mazerkina, O. Zheludkova, Valentin V. Fadeev
Thanks to modern treatment protocols, childhood cancer survivors (CCS) are a very fast-growing population nowadays. Cancer therapy inevitably leads to different late adverse effects, where endocrine disorders are highly prevalent, including growth hormone deficiency (GHD) which is the most common endocrine outcome after cancer treatment in childhood and contributes to impaired growth. Short stature is a big issue, which leads to problems in psychological and social adaptation of patients and reduces their quality of life. Impact of GH treatment on various physiological processes and global outcome of CCS is of great interest. Several studies have demonstrated an influence of GH and IGF-1 on the development/tumour growth, cell proliferation. In this regard, the issue of increasing the risk of cancer recurrence and/or the development of secondary neoplasms in CCS, causes a lot of controversy and is the subject of continuous evaluation. In this review, we went through the available data on the prevalence and pathogenesis of GHD following chemo- and radiotherapy, in particular after treatment of brain tumors and acute lymphoblastic leukaemia in childhood. In addition, here we discuss the existing problems in the diagnosis of GHD, the safety of GH replacement therapy, as well as the treatment algorithm of the GHD in adults.
{"title":"Growth hormone deficiency in childhood brain tumors and acute lymphoblastic leukemia survivors","authors":"Г. Павлова, Ю. Целовальникова, А. Е. Юдина, О. О. Голоунина, А. В. Зилов, Н. А. Мазеркина, О.Г. Желудкова, В. В. Фадеев, Сеченовский Университет, Maria G. Pavlova, Tatiana Tselovalnikova, Alla E. Yudina, O. Golounina, Alexey V. Zilov, N. Mazerkina, O. Zheludkova, Valentin V. Fadeev","doi":"10.14341/omet12786","DOIUrl":"https://doi.org/10.14341/omet12786","url":null,"abstract":"Thanks to modern treatment protocols, childhood cancer survivors (CCS) are a very fast-growing population nowadays. Cancer therapy inevitably leads to different late adverse effects, where endocrine disorders are highly prevalent, including growth hormone deficiency (GHD) which is the most common endocrine outcome after cancer treatment in childhood and contributes to impaired growth. Short stature is a big issue, which leads to problems in psychological and social adaptation of patients and reduces their quality of life. Impact of GH treatment on various physiological processes and global outcome of CCS is of great interest. Several studies have demonstrated an influence of GH and IGF-1 on the development/tumour growth, cell proliferation. In this regard, the issue of increasing the risk of cancer recurrence and/or the development of secondary neoplasms in CCS, causes a lot of controversy and is the subject of continuous evaluation. In this review, we went through the available data on the prevalence and pathogenesis of GHD following chemo- and radiotherapy, in particular after treatment of brain tumors and acute lymphoblastic leukaemia in childhood. In addition, here we discuss the existing problems in the diagnosis of GHD, the safety of GH replacement therapy, as well as the treatment algorithm of the GHD in adults.","PeriodicalId":54700,"journal":{"name":"Obesity and Metabolism-Milan","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46527293","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. B. Lyasnikova, N. Belyakova, I. Tsvetkova, A. Rodionov, N. Milaya
BACKGROUND: alimentary-constitutional obesity due to it’s high prevalence, is the key problem of modern healthcare system. However, obesity is not always accompanied with metabolic disorders, leading to early invalidization and mortality. That’s why it is important to study risks of metabolical nonhealth in obesity.AIM: to detect factors, increasing risks of development of metabolic disbalance in alimentary-constitutional obesity.MATERIALS AND METHODS: In patients with alimentary-constitutional obesity there was performed an examination including anthropometry (body mass index, Waist Circumference, Hip Circumference,waist to hip ratio), blood pressure measurement, laboratory tests – metabolic indexes: glucose, insulin, insulin resistance indexes, leptin, cholesterol, cholesterol of lipoproteins, triglycerides, aspartate aminotransferase, alanine aminotransferase, gamma-glutamiltransferase), body composition measurement by bioelectrical impedance analysis; patients were also interviewed on their behavior (food habits) and physical activity.RESULTS: There were formed two groups depending on metabolic health indexes: main group – metabolically non-healthy obesity (MNHO) - 241 persons (aged 41±12,09, duration of obesity 12,5±9,51 years) with alimentary-constitutional obesity and two or more signs of MS, a comparison group – of metabolically healthy obesity (MHO) – 120 persons (aged 35,5±10,03; p<0,05, duration of obesity 8,0±7,39 years; p<0,05) with alimentary-constitutional obesity and one sign of MS or without it. Data analysis of studied risk factors for development of metabolically non-healthy alimentary-constitutional obesity confirmed that most relevant factor in development of MNHO is abdominal fat mass distribution (increasing of Waist Circumference over 88 sm in females and over 102 sm in mails). At the same time MNHO had correlation not only with classical signs of MS, but also with blood insulin level, insulin resistance indexes, fat metabolism disbalance and liver disfunction. More severed risk for appearance of metabolic disorders have patients over 45 years old with decreased active cell mass (less than 45%), duration of obesity above 10 years and obesity-burdened heredity. In food habits risk of development of metabolically non-healthy obesity was increased in taking of fat milk food, and, on the contrary, - frequent snacks, alcohol free sweet drinks didn’t affect it.CONCLUSION: Development of MNHO is associated not only with the age of patient, duration of obesity, carbohydrate and fat metabolism indexes, but also with decreased percentage of metabolically active tissues and some food habits.
{"title":"Risks for development of metabolic disorders in alimentary constitutional obesity","authors":"M. B. Lyasnikova, N. Belyakova, I. Tsvetkova, A. Rodionov, N. Milaya","doi":"10.14341/omet12705","DOIUrl":"https://doi.org/10.14341/omet12705","url":null,"abstract":"BACKGROUND: alimentary-constitutional obesity due to it’s high prevalence, is the key problem of modern healthcare system. However, obesity is not always accompanied with metabolic disorders, leading to early invalidization and mortality. That’s why it is important to study risks of metabolical nonhealth in obesity.AIM: to detect factors, increasing risks of development of metabolic disbalance in alimentary-constitutional obesity.MATERIALS AND METHODS: In patients with alimentary-constitutional obesity there was performed an examination including anthropometry (body mass index, Waist Circumference, Hip Circumference,waist to hip ratio), blood pressure measurement, laboratory tests – metabolic indexes: glucose, insulin, insulin resistance indexes, leptin, cholesterol, cholesterol of lipoproteins, triglycerides, aspartate aminotransferase, alanine aminotransferase, gamma-glutamiltransferase), body composition measurement by bioelectrical impedance analysis; patients were also interviewed on their behavior (food habits) and physical activity.RESULTS: There were formed two groups depending on metabolic health indexes: main group – metabolically non-healthy obesity (MNHO) - 241 persons (aged 41±12,09, duration of obesity 12,5±9,51 years) with alimentary-constitutional obesity and two or more signs of MS, a comparison group – of metabolically healthy obesity (MHO) – 120 persons (aged 35,5±10,03; p<0,05, duration of obesity 8,0±7,39 years; p<0,05) with alimentary-constitutional obesity and one sign of MS or without it. Data analysis of studied risk factors for development of metabolically non-healthy alimentary-constitutional obesity confirmed that most relevant factor in development of MNHO is abdominal fat mass distribution (increasing of Waist Circumference over 88 sm in females and over 102 sm in mails). At the same time MNHO had correlation not only with classical signs of MS, but also with blood insulin level, insulin resistance indexes, fat metabolism disbalance and liver disfunction. More severed risk for appearance of metabolic disorders have patients over 45 years old with decreased active cell mass (less than 45%), duration of obesity above 10 years and obesity-burdened heredity. In food habits risk of development of metabolically non-healthy obesity was increased in taking of fat milk food, and, on the contrary, - frequent snacks, alcohol free sweet drinks didn’t affect it.CONCLUSION: Development of MNHO is associated not only with the age of patient, duration of obesity, carbohydrate and fat metabolism indexes, but also with decreased percentage of metabolically active tissues and some food habits.","PeriodicalId":54700,"journal":{"name":"Obesity and Metabolism-Milan","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44034326","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, A. Shutova, E. Pigarova, P. A. Starostina, N. Khutsishvili, S. Vorotnikova, A. Grigoriev, O. V. Ivashchenko, V. N. Azyan, A. Lapshina
Thyrotoxicosis, which characteristics are increased excitability, emotional lability, tachycardia episodes, increasing of free fractions of tetraiodothyronine (T4) and triiodothyronine (T3) is one of the most common endocrinological syndromes. However, during the interpretation of thyroid status it is very important to take into account the possibility that a patient has TSH-secreting pituitary adenoma. Timely diagnosis of TSH-secreting adenomas plays prominent role in guiding the treatment course since it is associated with an improvement of long-term prognosis and an increase of the patient’s total life expectancy. Needed to underline that in some patients with TSH-secreting adenomas manifestations of the other pituitary hormones hypersecretion (first of all — somatotropin and prolactin) come to the fore, that lead to the development of acromegaly and hyperprolactinemia accordingly. Our work basing on two clinical cases presents main principles of diagnosis and specific clinical manifestations of TSH-secreting pituitary adenomas and demonstrates efficacy of somatostatin analogues in the treatment of this pathology.
{"title":"Long action somatostatin analogues in patients with TSH-secreted pituitary adenomas: treatment experience","authors":"L. Dzeranova, A. Shutova, E. Pigarova, P. A. Starostina, N. Khutsishvili, S. Vorotnikova, A. Grigoriev, O. V. Ivashchenko, V. N. Azyan, A. Lapshina","doi":"10.14341/omet12768","DOIUrl":"https://doi.org/10.14341/omet12768","url":null,"abstract":"Thyrotoxicosis, which characteristics are increased excitability, emotional lability, tachycardia episodes, increasing of free fractions of tetraiodothyronine (T4) and triiodothyronine (T3) is one of the most common endocrinological syndromes. However, during the interpretation of thyroid status it is very important to take into account the possibility that a patient has TSH-secreting pituitary adenoma. Timely diagnosis of TSH-secreting adenomas plays prominent role in guiding the treatment course since it is associated with an improvement of long-term prognosis and an increase of the patient’s total life expectancy. Needed to underline that in some patients with TSH-secreting adenomas manifestations of the other pituitary hormones hypersecretion (first of all — somatotropin and prolactin) come to the fore, that lead to the development of acromegaly and hyperprolactinemia accordingly. Our work basing on two clinical cases presents main principles of diagnosis and specific clinical manifestations of TSH-secreting pituitary adenomas and demonstrates efficacy of somatostatin analogues in the treatment of this pathology.","PeriodicalId":54700,"journal":{"name":"Obesity and Metabolism-Milan","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44962593","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}
The COVID-19 pandemic is a challenging problem of the present. Another essential problem causing serious health consequences is the global obesity epidemy. Our article notes the importance of studying the combinations and correlations of mentioned pandemic processes. We analyzed scientific reports of co-presence of obesity, diabetes and coronavirus infection. According to the analyzed data combination of COVID-19 with obesity and diabetes leads to the higher rate of the hospitalisation. These patients more often required the transfer to the intensive care unit and artificial lung ventilation. Our review contains scientific observations of the first reported cases of higher mortality rate of obese and diabetic patients during the period of previous influenza pandemics (including H1N1). The results of the 2020 year shows that the outcomes of coronavirus infection with underlying obesity much more threatening and harmfull. In our article, we present the correlation of the average body mass and mortality rate index in different countries (according to the WHO and the World Obesity Federation). Comparative results in the Central Asia countries are given as well. The paper analyzes the suggestions for obesity policy and advocacy provided by World Obesity Federation in “ROOTS: A framework for action”. The conclusions marks the importance of implementing the proposed measures against obesity during a pandemic and in the post-COVID era.
{"title":"Obesity and covid-19 — signs of convergence of two pandemiсs. Guidelines to fight obesity based on the principles of «ROOTS»","authors":"Alexandr B. Fursov, O. Ospanov, R. Fursov, Astana","doi":"10.14341/omet12745","DOIUrl":"https://doi.org/10.14341/omet12745","url":null,"abstract":"The COVID-19 pandemic is a challenging problem of the present. Another essential problem causing serious health consequences is the global obesity epidemy. Our article notes the importance of studying the combinations and correlations of mentioned pandemic processes. We analyzed scientific reports of co-presence of obesity, diabetes and coronavirus infection. According to the analyzed data combination of COVID-19 with obesity and diabetes leads to the higher rate of the hospitalisation. These patients more often required the transfer to the intensive care unit and artificial lung ventilation. Our review contains scientific observations of the first reported cases of higher mortality rate of obese and diabetic patients during the period of previous influenza pandemics (including H1N1). The results of the 2020 year shows that the outcomes of coronavirus infection with underlying obesity much more threatening and harmfull. In our article, we present the correlation of the average body mass and mortality rate index in different countries (according to the WHO and the World Obesity Federation). Comparative results in the Central Asia countries are given as well. The paper analyzes the suggestions for obesity policy and advocacy provided by World Obesity Federation in “ROOTS: A framework for action”. The conclusions marks the importance of implementing the proposed measures against obesity during a pandemic and in the post-COVID era.","PeriodicalId":54700,"journal":{"name":"Obesity and Metabolism-Milan","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45284707","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}
Physiologically, autophagy is a major protective mechanism of β-cells from apoptosis, through can reserve normal β- cell mass and inhibit the progression of β-cells destruction. Beta-cell mass can be affected by differentiation from progenitors and de-differentiation as well as self-renewal and apoptosis. Shred evidence indicated that hypoglycemic drugs can induce β-cell proliferation capacity and neogenesis via autophagy stimulation. However, prolonged use of selective hypoglycemic drugs has induced pancreatitis besides several other factors that contribute to β-cell destruction and apoptosis initiation. Interestingly, some nonhypoglycemic medications possess the same effects on β-cells but depending on the combination of these drugs and the duration of exposure to β-cells. The paper comprehensively illustrates the role of the hypoglycemic drugs on the insulin-producing cells and the pathogeneses of β-cell destruction in type 2 diabetes mellitus, in addition to the regulation mechanisms of β-cells division in norm and pathology. The grasping of the hypoglycemic drug’s role in beta-cell is clinically crucial to evaluate novel therapeutic targets such as new signaling pathways. The present paper addresses a new strategy for diabetes mellitus management via targeting specific autophagy inducer factors (transcription factors, genes, lipid molecules, etc.).
{"title":"Beta-cell autophagy under the scope of hypoglycemic drugs; possible mechanism as a novel therapeutic target","authors":"B. Marzoog, T. Vlasova","doi":"10.14341/omet12778","DOIUrl":"https://doi.org/10.14341/omet12778","url":null,"abstract":"Physiologically, autophagy is a major protective mechanism of β-cells from apoptosis, through can reserve normal β- cell mass and inhibit the progression of β-cells destruction. Beta-cell mass can be affected by differentiation from progenitors and de-differentiation as well as self-renewal and apoptosis. Shred evidence indicated that hypoglycemic drugs can induce β-cell proliferation capacity and neogenesis via autophagy stimulation. However, prolonged use of selective hypoglycemic drugs has induced pancreatitis besides several other factors that contribute to β-cell destruction and apoptosis initiation. Interestingly, some nonhypoglycemic medications possess the same effects on β-cells but depending on the combination of these drugs and the duration of exposure to β-cells. The paper comprehensively illustrates the role of the hypoglycemic drugs on the insulin-producing cells and the pathogeneses of β-cell destruction in type 2 diabetes mellitus, in addition to the regulation mechanisms of β-cells division in norm and pathology. The grasping of the hypoglycemic drug’s role in beta-cell is clinically crucial to evaluate novel therapeutic targets such as new signaling pathways. The present paper addresses a new strategy for diabetes mellitus management via targeting specific autophagy inducer factors (transcription factors, genes, lipid molecules, etc.).","PeriodicalId":54700,"journal":{"name":"Obesity and Metabolism-Milan","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44168909","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: Vitamin D deficiency and insufficiency are widespread medical abnormalities, but their frequency in endocrine diseases has generally not been studied.AIM: To provide a comparative assessment of vitamin D levels in patients with diabetes mellitus type 2, primary hyperparathyroidism (PHPT), central hypercortisolism (Cushing’s disease; CD) and acromegaly.MATERIALS AND METHODS: Total 25(OH)D was determined using the immunochemiluminescent method (the laboratory participates in the DEQAS program). All patients had GFR > 60 ml/min, no history of use of vitamin D supplementation within previous month.RESULTS: The study included 365 patients who, after applying the inclusion/exclusion criteria, were divided into 5 main research groups: 33 patients with diabetes mellitus type 2, 23 patients with PHPT, 68 patients with CD, 22 patients with acromegaly, and 141 apparently healthy patients. Significantly low levels of vitamin D were found in patients with diabetes mellitus type 2 (14.8 ng/ml), acromegaly (14.9 ng/ml), CD (14.6 ng/ml), and PHPT (15.9 ng/ml) compared with a group of otherwise healthy patients (18.8 ng/ml).CONCLUSION: The results of the study demonstrate a high prevalence of vitamin D deficiency not only in groups of patients with chronic diseases, but also among practically healthy patients. Further studies are needed to address the causes of high vitamin D deficiency in the described endocrine diseases.
{"title":"High prevalence of low vitamin D levels in endocrine disorders","authors":"E. Pigarova, L. Dzeranova","doi":"10.14341/omet12799","DOIUrl":"https://doi.org/10.14341/omet12799","url":null,"abstract":"BACKGROUND: Vitamin D deficiency and insufficiency are widespread medical abnormalities, but their frequency in endocrine diseases has generally not been studied.AIM: To provide a comparative assessment of vitamin D levels in patients with diabetes mellitus type 2, primary hyperparathyroidism (PHPT), central hypercortisolism (Cushing’s disease; CD) and acromegaly.MATERIALS AND METHODS: Total 25(OH)D was determined using the immunochemiluminescent method (the laboratory participates in the DEQAS program). All patients had GFR > 60 ml/min, no history of use of vitamin D supplementation within previous month.RESULTS: The study included 365 patients who, after applying the inclusion/exclusion criteria, were divided into 5 main research groups: 33 patients with diabetes mellitus type 2, 23 patients with PHPT, 68 patients with CD, 22 patients with acromegaly, and 141 apparently healthy patients. Significantly low levels of vitamin D were found in patients with diabetes mellitus type 2 (14.8 ng/ml), acromegaly (14.9 ng/ml), CD (14.6 ng/ml), and PHPT (15.9 ng/ml) compared with a group of otherwise healthy patients (18.8 ng/ml).CONCLUSION: The results of the study demonstrate a high prevalence of vitamin D deficiency not only in groups of patients with chronic diseases, but also among practically healthy patients. Further studies are needed to address the causes of high vitamin D deficiency in the described endocrine diseases.","PeriodicalId":54700,"journal":{"name":"Obesity and Metabolism-Milan","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42098564","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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