A hundred and eighteen patients aged 45-60 years who had type 2 diabetes (T2D) with and without coronary heart disease (CHD) were examined to study the frequency of the methylenetetrahydrofolate reductase (MTFR) C677T gene polymorphism in T2D and its association with the level of homocysteine (HC) and the development of myocardial infarction (MI). A control group included 89 blood donors. Statistically significant differences were found in the frequency of alleles T677 and C677, genotype C677C between the groups of patients with T2D, CHD, and prior MI and the control group. Allele T677 of the MTFR gene was associated with a higher risk of MI in patients with T2D (OR = 1.879; p = 0.029). A combination of genotype T677T of the MTFRgene with hyper-homocysteinemia in patients with T2D is closely related to other risk factors of cardiovascular diseases and may have a significant impact on the course of CHD.

The impact of monotherapy with an enteric lipase inhibitor (orlistat) on postprandialglycemia in the oral glucose tolerance test (OGTT) and on other metabolic parameters was studied in obese patients with type 2 diabetes (T2D). The study included 26 patients aged S3.07±6.70 years, who had a 2.60±2.91-year history of mild T2D. All the patients were given orlistat, 120 mg, as a capsule thrice daily before meals. Orlistat treatment was performed along with a low-calorie (as high as 1200 kcal daily) diet whose keeping was monitored by an individual dietary diary. During orlistat therapy, significant reductions were found in body weight (BW), body mass index, and waist circumference. At the same time, just within the first month and most patients were observed to lose up to 5% of the В W, but by the end of treatment there was a weight reduction by more than 5% of the baseline. Orlistat therapy caused a significant decrease in the fasting and postprandial blood levels of glucose and, accordingly, glycated hemoglobin. Orlistat induced a significant reduction in the total level of total cholesterol and low-density lipoproteins. By the end of the study, there was a significant decrease in systolic and diastolic blood pressures.

The purpose of the study was to evaluate the efficacy of orlistat versus metformin on the time course of changes in body weight (BW), lipid metabolism, blood pressure (BP), glycated hemoglobin (HbA_1c, the kinetic parameters of'the oral glucose tolerance test (OGTT), and insulinemia in patients with type 2 diabetes (T2D). Two groups of patients with mild T2D with overweight or obesity were selected. Group 1 comprised 25 patients aged 53.16±8.92 years, who had a 2.50±3.06-year history. In this group, all the patients were given metformin in the daily starting dose of 500 mg. Group 2 patients (n = 26) aged 53.07±6.70 years, who had a 2.60±2.91-year history, took orlistat (xenical) (F. Hoffman-La Roche, Switzerland) in a dose of 120 mg thrice daily with meals. In addition, to exclude the impact of the time course of changes in body mass index (BMI) on carbohydrate and fat metabolic parameters, the twin method was used to select from each group 12 patients with similar ВW changes, matched by age, gender, the history of T2D, and the time course of changes in all anthropometric indices. The study revealed that orlistat and metformin exerted a comparable beneficial effect on carbohydrate and lipid metabolisms, BP in overweight or obese patients with T2D. Orlistat produced a significantly more pronounced effect on BW than did metformin. Unlike, orlistat, metformin significantly lowered fasting blood glucose levels due to the known inhibitory effect of hepatic glucose hyperproduction in overweight or obese patients with T2D. By excluding the Impact of BW loss on carbohydrate metabolism in overweight or obese patients with T2D, orlistat had a more marked sugar-lowering effect evaluated by the level of HbA_1c This may be accounted for by the fact that with the specific suppression of fat absorption, orlistat may diminish intestinal carbohydrate absorption.

Hyperandrogenism has a considerable negative impact on the course of pregnancy. The measurement of the levels of 17-hydroxy-progesterone and dehydroepiandrosterone sulfate as markers of adrenal hyperandrogenism, without taking into account the gestational metabolism of the hormones, promotes the hyperdiagnosis of nonclassical forms of congenital adrenal cortex dysfunction and involves inadequate treatment policy. The isolated elevation of dehydroepiandrosterone sulfate is not attended by an increase in the incidence of androgen-dependent complications of pregnancy

A retrospective study covered 272 patients (mean age 54 years) admitted for different forms of toxic goiter concurrent with cardiac arrhythmias and/or sings with heart failure (HF), which was undertaken to explore risk factors of thyrotoxic cardiomyopathy (TTCM). Cardiac arrhythmias following the pattern of sinus tachycardia and/or supraventricular extrasystole without signs of HF were observed ПРОБЛЕМЫ ЭНДОКРИНОЛОГИИ. 2007. Т. 53, № 4. in S3 (19.5%) out of the 272 patients (a mild TTCM group - TTCM-1) whereas cardiac arrhythmias as atrial fibrillations and/or flutters and/or the devebpment of HF In the presence of thyrotoxicosis (TT) were detected in 219 (80.5%) of the 272 patients (a severe TTCM group - TTCM-2). Indices, such as admission age, an interval between TT detection and the initiation of treatment, a history of endocrine ophthalmopathy and cardiovascular pathology, were examined in the regression analysis considering the severe course of TTMC as a poor predictor. Comparison of the groups revealed statistically significant differences in such Indices, as the interval between TT identification to therapy (OR = 1.8; 95% CI = 1.06-3.13; p = 0.02) and the patients' age at the moment of admission (OR = 1.1, 95% CI = 1.02-1.15; p= 0.01).

The thyroidal status of childbearing-aged females who had no manifest thyroid pathology and lived in a moderate iodine-deficient region was studied 6 years after resumption of lodine prevention.

The cohort study examined the incidence of thyropathy within the first 11-12 years of life among 560 children irradiated in utero and within the first 13 birth weeks via incorporation of iodine-131, who lived in a south-western iodine-deficient area of the Kaluga Region. Incidence rates in the irradiated children were compared with those among 199 non-irradiated children of the same age, who lived in the same region. Among the irradiated children, the incidence of thyropathy was generally 2.3 times higher than that among the non-irradiated ones. It is much higher (by 3.9 times) among 140 children irradiated in utero and partially within the first weeks of life (up to week 13). Thyropathy morbidity was ascertained to be higher in the girls than in the boys. This difference was particularly great among the children irradiated in utero and partially within the first weeks of postnatal life

Thirty-two cases of hereditary medullary thyroid carcinoma (HMTC) and 95 sporadic HMTC (SHMTC), 44 familial papillary TC (FPTC), and 172 sporadic cases were comparatively analyzed to improve the diagnosis and treatment of familial thyroid cancer. A hundred and one DNA samples from patients with MTC and their relatives were examined. BRAF and RET/PTC gene mutations were investigated in 6 patients with FPTC. The frequencies of familial TC, HNTC, and FPTC were 6 6, 26.5, and 4.3%, respectively. The mean age of patients with HMTC and SHMTC was 30.J±13.6 and 46.3±J3.1 years, respectively (p < 0.0001); tumor multicentricity was 87.5 and 36.8% (p < 0 0001) and bilaterality was 87.5 and 0%, respectively (p < 0.001). Inheritable RET mutations were detected in 16 families. Eight asymptomatic carriers of RET mutations were revealed; 3 of them underwent preventive thyroidectomy. There was the commonest (63.6%) codon 634 mutation in which the earliest manifestation and aggressive course of the disease were observed. The efficiency of screening for type 2 multiple endocrine neoplasia syndrome Increased by 1.8 times (from 31.2 to 51.2%). In the mother and daughter with FPTC, silent mutation was found in codon 891 of RET gene exon 15. Genetic examination of the relatives of patients with HMTC made it possible to diagnose the disease at its early stage and to perform preventive surgical treatment. The aggressiveness of HMTC makes it necessary to make total thyroidectomy. The absence of differences in the clinical course of familial and sporadic PTC predetermines uniform treatment policy.

Acromegaly is a serious disease of the hypothalamic-pituitary system, caused by chronic overproduction of growth hormone (GH) in individuals with completed physiological growth, affecting mainly people of working age. The disease is characterized by significant disability of patients and a reduction in life expectancy, the main reasons for which are complications caused by prolonged hypersecretion of GH. These include primarily damage to the cardiovascular system, respiratory system, metabolic disorders, malignant neoplasms of the gastrointestinal tract. At the same time, timely diagnosis and adequate treatment can reduce mortality several times, significantly improve the quality of life of patients.
Until now, the problem of optimizing the diagnosis of acromegaly, especially the so-called “soft” form, as well as the choice of the most effective and safe treatment method, is relevant all over the world and in our country in particular.
At the V Russian Congress of Endocrinology, a draft consensus on the management of patients with acromegaly was discussed. Subject to the provisions of the international agreement and Russian experience, recommendations are offered for the diagnosis, treatment and monitoring of this disease for further discussion, followed by the adoption of a final consensus.

Dysfunction of the hypothalamus causes a significant polymorphism of the clinical symptomatology of diseases of the hypothalamic-pituitary system, associated with an excess or deficiency of pituitary hormones and the corresponding hyper- or hypofunction of the peripheral endocrine glands. In particular, a violation of the integrity of the hypothalamic-neurohypophysial tract, synthesis, transportation, and release of vasopressin leads to disorders of the water balance in the form of central diabetes insipidus. In 15-30% of all cases of diabetes insipidus, its primary (idiopathic) forms are detected. Other causes of neurogenic diabetes insipidus can be genetic abnormalities, infections, vascular diseases, pituitary surgery, tumors, traumatic brain injury, autoimmune and infiltrative processes. We present a case of a combination of central diabetes insipidus with histiocytosis from Langerhans cells (histiocytosis X) and pregnancy.

Histiocytosis X is a disease of the hematopoietic system, in which local or disseminated abnormal proliferation of macrophages occurs without signs of atypia with the formation of granulomas, eosinophilic infiltration in the internal organs, osteolytic foci. Since proliferating macrophages have structural and functional similarities with Langerhans cells, a new term was introduced in 1986 - histiocytosis from Langerhans cells.

The purpose of this publication is to acquaint a wide circle of doctors (therapists, endocrinologists, diabetologists, cardiologists, etc.) with the new domestic metabolic drug dibicor, which can restore the metabolism in the body and positively affect both diabetes and cardiovascular pathology.

Thyroid lesions after radiation and chemotherapy include thyroid tumors and thyroiditis, which occur in violation of its function, as well as secondary hypothyroidism due to damage to the pituitary region. Hereinafter, we will use the term 'chemoradiotherapy', since in the treatment of malignant neoplasms, schemes are most often used that include both radiation exposure and drug treatment, and it is almost impossible to single out the influence of each of these components individually.

The multifaceted nature of the development of such a biomedical discipline as endocrinology in recent years is due to the achievements of molecular endocrinology. The results are impressive: in addition to traditional topics related to neuro- and immuno-endocrine relationships, the problem of obesity is being successfully developed in connection with the discovery of the hormone actively involved in this process - leptin.

Russian endocrinology suffered a bereavement - Ninella T. Starkovaon died on May 7, 2007, after a serious illness. Professor Ninella T. Starkovaon was a leading endocrinologist, doctor of medical sciences and honored worker of science of the Russian Federation.