Type 2 diabetes mellitus (T2DM) is recognized as a non-infectious epidemic of our time. According to the WHO, in 2007 there were about 246 million patients with diabetes in the world, experts predict that by 2025 there will be about 380 million, of which more than 90% will be patients with type 2 diabetes [23]. The age of patients at the time of the onset of T2DM is gradually decreasing, there is an alarming increase in the risk of developing this disease in young people, adolescents and children [1]. The study of the pathophysiological basis for the development of T2DM made it possible to present the future extent of its prevalence and their causes.

Type 2 diabetes mellitus (T2DM) - the "non-infectious epidemic" of our time - now occupies one of the leading positions in the world in terms of the severity of the disease (death + disability). Mortality of patients with T2DM is 2.3 times higher than mortality among the general population. Every year, diabetes is the cause of death of approximately 3.8 million people.

The purpose of study was to comparatively assess the incidence of metabolic syndrome (MS) diagnosed by the NCEP A TP III (2002) and IDF (2005) criteria in menopausal women. The case-control study included 849 normal-weight, overweight, and obese females. Their anthropometric characteristics, glucose levels, and lipid metabolic parameters were estimated. In the overweight women, MS was significantly more frequently diagnosed by the IDF criteria than by the NCEP ATP III ones (z² = 9.283; p = 0.002). No differences were found in the incidence of cardiovascular diseases. It has been concluded that in overweight women the IDF criteria allows a larger number of individuals at increased cardiovascular risk to be identified than the NCEP ATP III criteria.

The efficiency of the iodine deficiency prevention and monitoring system was evaluated in the Western Siberian Region. A total of 20,327 individuals living in the south of the Tyumen Region, Khanty-Mansi and Yamal-Senets Autonomous Districts were examined. The diagnostic criteria (ioduria median, goiter frequency, as evidenced by ultrasonography, neonatal thyroid-stimulating hormone screening, iodine-containing salt quality control) for iodine deficiencies were studied. Preventive measures implemented in the Western Siberian Region caused an increase in ioduria median up to levels of more than 100 ukg/l by 2006. At the same time, there was a persistently increased frequency of goiter in schoolchildren and that of hypenhyrotropinemia (more than 5 m U/l) In neonatal infants. The efficiency of iodine prophylaxis reflects the comprehensive assessment of the results of soclohygienic and biomedical monitoring of iodine deficiencies. Iodine-deficiencies can be completely eliminated in the Western Siberian Region if there is a state Iodine-deficiency preventing system involving the compulsory iodine fortification of dietary salt.

Amiodarone is an effective iodine-rich antiarrhythmic agent that is able to cause thyroid dysfunctions that may substantially worsen health and may be life-threatening. The structure and function of the thyroid was evaluated in 232 patients living in Saint Petersburg who had been receiving amiodarone long (0.6-20 years). During long amiodarone therapy, there were no significant thyroid structural changes; 187 (80%) of the 232 patients had euthyroidism. Thyroid dysfunctions were detected in 45 (20%) patients; amiodarone-induced hypothyroidism (AlH) and amiodarone-induced thyrotoxisis (AIT) were present in 20 (9%) and 25 (119c), respectively. Before amiodarone use, the presence of thyroid peroxidase antibodies significantly increased the risk of AlH (relative risk (RR) 10.0; 95 CI, 8.0-12.0). That of diffuse goiter significantly increased the risk of thyrotoxicosis (RR 5.7; 95% Cl, 4.1-5.9). The serum concentration of thyroid-stimulating hormone receptor antibodies, which had been measured in 23 of the 25 patients with AlT, was used for the differential diagnosis of types I and 2 AIT. As a result, 13 and 10 patients were found to have types 1 and 2 AlT, respectively. The results of other differential diagnostic tests were compared in the groups of patients with types 1 and 2 AlT. Thyroid ultrasonography revealed goiter more frequently in patients with type 1 AlT (10 (779c) of the 13 patients) than in those with type 2 AIT(1 (10%) of the 10 patients; p = 0.01). Color Doppler mapping showed normal or increased thyroid blood flow in all the patients with type 1 AIT and drastically decreased thyroid blood flow in patients with type 2 AIT. In the latter, the serum concentration of free T₄ [43.8±3.4 (23.8-62.8)/ pmol/l and the free T/free T, ratio [8.3±0.6 (5.7-12.3) pmol/t were significantly greater than those in patients with type 1AlT[3I.3± 1.3 (25.1- 40.2) and 5.2+0.4 (3.1- 7.7) pmol/l, respectively (p < 0.05). The h ighest sensitivity and specificity in the differential diagnosis of types 1 and 2 AIT were shown by thyroid ultrasonography (SO and 909c), color Doppler mapping (99 and 99%), as well as free T/free T₃ ratio (86 and 80%), respectively.

Magnetic resonance imaging (MRI) has indicated that about 30% of patients with Cushing's disease (CD) are detected to have no pituitary adenoma despite the hormonal findings suggesting the central genesis of hypercorticism. Choice of treatment policy of such patients remains ambiguous all over the world. In Russia, the Endocrinology Research Center uses the radiosurgical techniques to irradiate the pituitary, by applying a proton beam. The efficiency of pituitary proton irradiation was evaluated in CD patients with undetectable MRI cdenopituitary focal changes versus those with detectable pituitary adenoma. A comparison was made in 2 groups of patients without pituitary adenoma, as evidenced by MRI (Group I; n = 59) and those with identified pituitary adenoma (Group 2; n = 66) who received proton therapy in 1997 to 2002. Clinical improvement was achieved in 88.6 and 95.9% of Groups 1 and 2 patients, respectively; a complete clinical and hormonal remission was observed in 81.8% in Group 1 and in 70% in Group 2. A relapse was recorded in two patients from Group 2 (during a 5-year follow-up). The study has demonstrated that proton therapy for CD is a highly effective and adequate treatment. \\Ъеп MRI detects only the diffuse ambiguous structure of the adenopituitary or the normal structure of the pituitary without signs of focal changes, proton therapy is an alternative to subtotal hypophysectomy.

Comparative studies were conducted to define the informative value of the noninvasive technique for determining free Cortisol in saliva and daily urine, by applying ultrasensitive immunoassay technologies, and for evaluating total Cortisol in blood from healthy individuals and patients with Cushing's syndrome. The studies were made during functional tests and glucocorticoid replacement therapy before and after treatment. To evaluate the pattern of diurnal rhythm, the level of total Cortisol in the blood and that of its free form in the saliva were simultaneously measured in the morning, in the afternoon, and in the evening. The normal daily salivary free Cortisol values were established in healthy individuals in the morning (6.8-25.9 nmol/l) and in the evening (0.6-3.3 nmol/l). There is evidence that salivary free Cortisol is highly sensitive in the assessing functional tests with adrenocorticotropic hormone and dexamethasone. The noninvasiveness, accessibility, and easiness-to-use of obtaining salivary samples in combination with the high analytical sensitivity and specificity of the technique in determining the free biologically active fraction of Cortisol make it promising in evaluating adrenal hormonal function.

Age is one of the most significant risk factors for the development of thyroid disease (thyroid gland). So, autoimmune thyroiditis is much more common in women over 60 years of age compared with young people. The prevalence of the disease in the elderly reaches 6-11% compared with 0.1-1.2% at a young age. Among patients with thyrotoxicosis syndrome, persons over 65 years of age account for 15%. Screening of a “healthy” population over the age of 60 years, conducted as part of the Framingham study, revealed the presence of thyrotoxicosis syndrome in 2.3% of men and 5.9% of women.

Idiopathic edema (IO), that is, fluid retention that is not associated with the menstrual cycle or any disease, occurs in 12–33% of women of reproductive age [1, 2, 4] and often leads to abuse of diuretics [7], which can cause a paradoxical increase in edema (diuretic-induced edema - DIO). The pathogenesis of AI is unclear; perhaps it involves both the central mechanisms of regulation of water-salt metabolism, and the expansion and increase of capillary permeability due to changes in the tone of autonomic nerve endings, orthostatic retention of sodium and water, etc.

With endogenous hypercorticism syndrome of various origins (Itsenko-Cushing's disease, corticosteroma, ACTH-ectopic syndrome) trophic changes in the skin (ulcerative lesions, erosion, hemorrhage in the skin and subcutaneous fat, thinning of the skin) are often observed. The basis of these changes is, as a rule, vascular damage resulting from immunodeficiency. In a study by N. Chung et al. [3] it was shown that glucocorticosteroids negatively affect the interaction of endothelial cells with lymphocytes and worsen the penetration of the latter into the sites of active inflammation. Corticosteroids have a suppressive effect on the antigen-presenting function of lymphocytes, growth, differentiation and function of monocytes and lymphocytes, inhibit the production of cytokines, and block the activity of epidermal Langerhans cells.

Dyshormonal goiter (DZ) is a congenital disease associated with a hereditary defect of enzymes involved in the synthesis of thyroid hormones [9, 13, 14]. The literature describes a wide variety of genetically determined disorders of hormonal metabolism, leading to a lack of an adequate thyroid response to the stimulating effect of the thyroid stimulating hormone (TSH) of the pituitary gland [3, 4, 6, 8, 10-12]. Clinically, DZ is characterized by congenital hypothyroidism and its characteristic symptoms - from a delay in the child's psychomotor development to the development of cretinism in the absence of timely appointment of hormone replacement therapy.

When hyperthyroidism develops, there are increases in the level of reduced glutathione and in the activities of glutathione peroxidase (GP) and glutathione reductase (GR) in the rat liver, heart, and serum. The activity of glucose-6-phosphate dehydrogenase (G-6-PDH) also increases, which is likely to be associated with the necessity of delivering of NADPH for the GP/GR system. The activity of NADP isocitrate dehydrogenase (IDН) changes slightly. With administration of melatonin for thyrotoxicosis, the content of reduced glutathione Increases in the examined tissues to a greater extent, the activities of GP and GR become normal. With melatonin being administered in hyperthyroidism, the changes in G-6-PDH and IDH activities are tissue-specific and more pronounced for G-6-PDH. Melatonin appears to act as an adaptogen that regulates the activity of the glutathione system and NADPH-generating enzymes in accordance with the influence of pathogenic factors on the body.

Osteoporosis (OP) is a progressive systemic disease of the skeleton, characterized by a decrease in density and a violation of bone microarchitectonics, with a constant increase in bone fragility and the risk of fractures. The relevance of the problem of OP in modern medicine is due primarily to the social and economic consequences of fractures. Moreover, the problem of OP in the future will become even more serious and global, since in modern society there is an increase in life expectancy, the general aging of the population, and already in 2002 the number of residents over 50 years old doubled.