Molecular endocrinology is one of the fastest growing modern sciences. Therefore, it is very difficult to fully cover its problems in one journal article, and this publication will be devoted to the consideration of individual examples of recent advances in the study of hormonal regulation, reflecting some general trends in its development. The author will try not to touch upon the problems that have already been covered in previous publications [3-5].
Clinical endocrinology
Forty-six patients (25 men and 21 women) with newly diagnosed insulin-dependent diabetes (IDDM) aged 27.2 + 2.7 years were examined. HLA phenotype and titers of antibodies to epidemic parotitis and Coxsakie viruses were assessed. The incidence of HLA DR3, DR4, DQ2, and DQ3 was significantly increased in IDDM patients. No persuasive data on relationship between IDDM manifestation and parotitis were obtained. Diagnostically significant titers of antibodies to Coxsakie viruses were detected in diabetics more often in normal subjects. A close association between high titers of anti-Coxsakie antibodies and specific HLA antigens carriership was revealed. Vaccination of immunological marker carriers is proposed for primary prevention of IDDM.
Structure and function of platelet membranes was studied in 358 patients (186 males and 172 females) aged 29.1 ± 0 1.3 years with insulin-dependent diabetes. Control group consisted of 53 age-matched normal subjects. Phospholipid fractions and cholesterol level of platelet membranes were studied by thin-layer chromatography. Primary and secondary LPO products, superoxide dismutase, catalase, glucose- 6-phosphate dehydrogenase, and activities of Na+, K^, Mg2+, and Ca2+ transmembrane transport ATPase were measured. ATP-inducedplatelet aggregation was assessed by photometry.
Structural and functional destabilization of platelet membrane, activation of lipid peroxidation, and decreased antiradical protection in patients with insulin-dependent diabetes mellitus depend on clinical features, duration, and compensation of disease. Imbalance of the prooxidant-antioxidant system towards LPO intensification in the platelets modify platelet aggregation, thus leading to development of the DIC syndrome which determines the progress of angiopathies.
The aim of this study is to assess the incidence and structure of urogenital disorders in postmenopausal patients with type II diabetes mellitus, evaluate the efficacy of substitute hormone therapy of this disorders with estriol (ovestin, Organon, Netherlands), and investigate estriol effects on carbohydrate metabolism. Fifty patients with type II diabetes aged 64.96 ±0.6 years (M ± SD), disease duration 13.44 ± 7.25 years (M ± SD), and Hb Ajc 9.15 ± 0.16% were examined. Comprehensive clinical and gynecological examinations were carried out. Urogenital manifestations were evaluated using a 4-point score, vaginal pH was assessed, bacteriological analysis of vaginal microflora and microbiological analysis of urine were carried out, and karyopycnotic index and level of Hb Ajc were assessed. Patients complained of false incontinence (82%), dry vagina (70%)), and itching in the vulva (66%). Seventy-four percent of women developed urogenital disorders 2-5 years after the onset of menopause, 12%) after 1-1.5 years, and 14%) with the onset of menopause; in 65% these symptoms were evident before diabetes manifestation. After 6-month substitute therapy the incidence of urogenital symptoms decreased, only 6.7%) patients still complained of dryness in the vagina, 26.7%) of itching in the vulva, and 26.7%) of false incontinence. Vaginal pH decreased from 7.1 ± 0.17 to 5.8 ± 0.25 (p < 0.05), the content of lactobacilli increased and of E. coli dropped from 46.6 to 6.6%.
А total of 167 case histories of patients operated on for adrenal diseases are analyzed. There were 23 (13.7%) so-called incidentalomas, 12 patients with hormone-inactive tumors were not operated and are followed up, 22 patients were subjected to traditional adrenalectomy, and 1 to laparoscopic operation. The study included analysis of complaints, physical examination, study of hormone profiles (ACTH, hydrocortisone, 11-hydroxycorticosteroids, 17-ketosteroids, aldosterone, renin, adrenaline, noradrenaline, and vanillylmandelic acid), and instrumental examinations (ultrasonography, computer-aided tomography, magnetic imaging, superselective phlebography with differentiated catheterization of adrenal veins and blood collection at different levels, and fine needle aspiration biopsy monitored by ultrasonography). Results of comprehensive clinical examination were compared with morphological findings in removed adrenals. Polypositional ultrasonic examination, computer-aided tomography, and magnetic imaging helped make a correct topical diagnosis in many cases, and superselective phlebography with blood collection at several levels helped assess the functional activity of involved and contralateral adrenal. Studies of hormonal profiles of patients with so-called incidentalomas showed no changes in the majority of patients. Slight increases of blood hydrocortisone and urinary hydroxy corticosteroids were noted in patients with light-cell adenomas. On the other hand, measurements of hormones in blood specimens collected at different levels revealed a significant increase of hydrocortisone and aldosterone in all patients operated on. Twelve patients were not operated on after comprehensive clinical and instrumental examinations and are followed up for 6 months to 3 years. Surgical treatment was considered not indicated for patients with small (less than 3 cm) tumors and in cases without signs of malignant growth and hormone activity confirmed by instrumental studies. Such patients were repeatedly examined after 6 and 12 months. No changes in the clinical picture and tumor characteristics were detected.
The aim of this study was to assess the function and reserve potentials of the sympathoadrenal system of obese youths. Urinary excretion of adrenaline, noradrenaline, dopamine, and DOPA during 24 h before and after oral L- DOPA test was measured. Increased noradrenaline (p < 0.05) and decreased dopamine (p < 0.05) excretion was detected in youths with abdominal obesity in comparison with controls. This level of catecholamines did not depend on the degree of total obesity. The levels of basal hyperinsulinemia and insulin resistance in obese youths did not correlate with the severity of total obesity. No catecholamine reaction to L-DOPA test in youths with abdominal obesity suggest a decreased synthetic and reserve potential of the sympathoadrenal system under conditions of its stressed functioning.
The secretion of bioactive LH and the ratio of biologically to immunologically active LH (bLH/iLH) were assessed in 54 healthy girls in the course of sexual development, in 25 girls with primary hypogonadism over the course of development and growth, in 16 girls with early sexual development (ESD), in 12 girls with the polycystic ovaries syndrome (POS), and in 5 girls with early adrenarche. In addition, time course of bLH/iLH was followed up in girls with endocrine diseases during gonadotroph stimulation by gonadotrophin releasing hormone (GnRH). In health, the content of bLH increased more than that of iLH. In girls with primary hypogonadism, the bLH/iLH ratio before puberty is the same as in age-matched healthy controls. With the onset of puberty, quantitative changes in LH are paralleled by changes in its qualitative composition, manifesting by increase of the bLH/iLH ratio. The bLH/iLH ratio in girls with ESD and POS is increased as against age-matched healthy controls. However, in girls with ESD the bLH/iLH ratio does not differ from the value characteristic of elder girls, whereas in POS it is increased even in comparison with healthy women. LH secretion in girls with early adrenarche does not differ from that in healthy controls. GnRH stimulation of gonadotrophs in all groups examined resulted in quantitative and qualitative changes in LH secretion and/or production. Time course of bLH/iLH ratio is characterized by specific features in each of the groups examined.
For practitioners
Ultrasound is a very common disease of the thyroid gland (thyroid gland): the probability of development of a palpable ultrasound during life is on average 5-10%. With approximately the same frequency, ultrasound is common among adults, especially women. The use of modern thyroid imaging methods, primarily ultrasound (ultrasound), significantly increased the detection of focal organic changes in the thyroid gland. According to some estimates, up to 1/3 of women over 30 can have certain focal changes in thyroid tissue during ultrasound. Obviously, traditional ideas about the nature, methods of diagnosis and treatment of ultrasound currently require reevaluation.
Experimental endocrinology
Physical working capacity decreases and resistance to acute hypoxia (asphyxia) increases in rats 72 h after alloxan diabetes induction. These shifts are paralleled by decrease of glycogen content and lactic acid in skeletal muscles and an increase theirof in brain tissue. A probable relationship between these shifts and suppressed glucose metabolism in insulin-dependent muscle tissue during intensified glucose supply to non-insulindependent nerve tissue is discussed.
Growth of adrenals during weeks 4-9 of postnatal life in male and female Wistar rats is studied. A statistically significant delay of gland growth was observed in males starting from week 6 in comparison with females. Disproportion in body and adrenal weight increase was observed in males but not in females in the course of experiment. Sex-specific differences in adrenal weight is mainly due to growth rate delay in the bundle zone in males. Cell volume in the bundle zone of male adrenals was lower than in females, but there were no differences in the levels of mitotic division or cell counts.
Reviews
Endocrine ophthalmopathy (EO) is an interesting disease, not only theoretically as insufficiently studied, but also practically, due to the increasing number of autoimmune thyroid diseases, often occurring with ophthalmopathy. To date, a generally accepted classification of this pathology does not exist.
Current Events
A conference with international participation "Endocrine mechanisms of regulation of functions in norm and pathology" was held on December 1-15, 1997 in the Academic campus of the Novosibirsk Scientific Center, dedicated to the 75th anniversary of the birth of Professor Mikhail G. Kolpakov (1922-1974).
ISSN 2308-1430 (Online)