The patients in the active phase of endogenous hypercorticism not infrequently present with hypercoagulation syndrome characterized by abnormal blood clotting in conjunction with slowed fibrinolysis, elevated fibrinogen and D-dimer concentrations. In addition, such patients exhibit endotheliosis manifest as a rise in the PAI-1 and Willebrand factor levels. The remission of the Cushing's disease (CD) is associated with a higher fibrinogen, thrombomodulin, endothelin-1, and D-dimer levels compared with CD patients in the active phase of this disease and healthy subjects (control). This suggests the continuing progression of endotheliosis, enhanced thrombogenicity, and the increased risk of cardiovascular complications.

Anti-Mullerian hormone (AMH) is known to be a reliable marker of disturbances in folliculogenesis. The present paper is designed to report the results of AMH determination in 57 adolescent girls differing in the clinical course of hyperandogenism depending on the severity of its symptoms and androgen levels in the peripheral blood.

The idiopathic form of premature sexual development (PSD) is the commonest variety among the central forms of PSD (accounting for 30 to 70% of the total). It occurs primarily in the girls. The prevalence of hypothalamic hamartoma (HH) as a cause of premature sexual development is on the whole lower, but it is most frequently diagnosed in the children of either sex under the age of 3 years with the clinical manifestations of true PSD. Diagnostics and treatment of different forms of premature sexual development constitute an appreciable part of the practical work of a pediatric endocrinologist. The efficacy of PSD therapy with luliberin analogs has been definitively demonstrated in the context of increasing the final height of the children and suppressing the progression of their sexual development. Moreover, the reversibility of the effects of luliberin analogs on the gonadostatic activity has been confirmed. Nevertheless, peculiarities of the clinical course of various etiological variants of central PSD, principles of its treatment, and its efficacy remain a matter of debate. In the present paper, the special emphasis is laid on the consequences of PSD therapy using luliberin analogs including the recovery of the process of normal puberty, effects on the reproductive function, body weight, and the dependence of the treatment on the clinical form of central PSD. The data on the peculiarities of the clinical course of premature sexual development and the efficacy of its treatment in the children with the idiopathic form of gonadotropin-dependent PSD and hamartoma-associated PSD are presented

The present questionnaire study including female residents of the Moscow region (MR) above the age of 55 years with the confirmed diagnosis of post-menopausal osteoporosis (OP) was designed to obtain an insight into the procedure employed to diagnose post-menopausal OP, categories of specialists involved in diagnostics of this condition, and the methods they use for the purpose. The results of the study indicate that 57.4% of the patients with OP in the first place applied for advice in connection with this disease to an endocrinologist, 19.7% to an orthopedist-traumatologist, 13.% to a rheumatologist, and 4.9% to a neurologist. The endocrinologists referred such patients for bone densitometry and made the diagnosis of post-menopausal osteoporosis in 79% and 70% of the cases respectively. Only a small fraction of orthopedists-traumatologists and rheumatologists practicing in the Moscow region are engaged in diagnostics of post-menopausal osteoporosis as a part of their major activities. At the same time, therapists, gynecologists, and general practitioners do not practically encounter the patients complaining of post-menopausal OP. 38%, 30% and 28% of the respondents reported to have applied to two, three, and one physicians respectively to have the diagnosis of this condition confirmed. However, in the majority of the cases the period from the first visit to a specialist till the establishment of the definitive diagnosis was as long as 1 year (39%). The diagnosis of OP in a small number of the patients was made with the use of a single method, e.g. X-ray densitometry (12%), ultrasonometry (4%), and X-radiography of the skeletal bones (2%). The remaining patients were examined by more than one method; most of them had the primary diagnosis verified by means of X-ray densitometry (77%), blood biochemical analysis (77%), X-radiography of the spinal column (67%), and either by the detection of the serum bone turnover markers or ultrasonometry (16%). The majority of densitometric procedures were performed based at the Moscow Therapeutic and Prophylactic Department and M.F. Vladimirsky Moscow Regional Research Clinical Institute (73% and 17% respectively) for the lack of densitometers in the local medical facilities of the Moscow region.

The objective of the present work was to estimate the influence of the compensation of type 2 diabetes mellitus (DM2) and its late complications on the sexual function of the women presenting with type 2 diabetes mellitus during the peri- and post-menopausal periods. The sexual function was studied in 368 women with DM2 and in 314 ones without disturbances of carbohydrate metabolism (controls) using the Women's Sexual Function Questionnaire developed by F.H. Quirk in 2002. The prevalence of sexual dysfunction in the groups of DM2 women and controls was estimated at 52.2% and 30.9% respectively (p<0.001). The women with DM2 reported the lower quality of intimate relationships with the partner (p = 0.003) and lower satisfaction with the sexual quality of life (p=0.007) compared with the control respondents. The risk of sexual dysfunction in the women with type 2 diabetes mellitus increased by 2.4 times (p<0.001), in those with diabetic polyneuropathy by 4.8 times, and in the women with the blood glycated hemoglobin (HbA1c) level in excess of 7.0% by 2.3 times (p=0.012). It is concluded that type 2 diabetes mellitus is an independent risk factor of sexual dysfunction during the peri- and post-menopausal periods. Other risk factors are constituted by diabetic polyneuropathy and elevated HbA1c level (>7.0%).

The treatment of 36 patients suffering exogenous constitutional obesity (ECO) with sibutramine during 12 weeks resulted in the substantial reduction of body weight, waist circumference (WC), hip circumference (HC), and waist-to-hip ratio (WHR). Simultaneously, the total cholesterol level in the blood decreased. The reduction in the body weight had positive effect on carbohydrate metabolism. Medicamental treatment of obesity caused a drop in systolic arterial pressure and a substantial change in the body composition. Specifically, percentage of both total and visceral fat as well as basal metabolism decreased, water retention in the body increased while the muscular mass remained unaltered. It is concluded that the introduction of Sibutramine into the combined treatment of exogenous constitutional obesity effectively promotes the reduction of the body weight, improvement of the body composition and metabolic characteristics.

The accumulation of components of extracellular matrix in the glomerular and interstitial compartments of the kidneys is a characteristic feature of diabetic nephropathy. The leading role in the extracellular matrix catabolism is played by matrix metalloproteinases (MMP). The activity of these enzymes is regulated by a group of inhibitors including tissue metalloproteinase inhibitors, plasminogen activator inhibitor-1, etc. Both in vivo and in vitro studies have demonstrated that a reduction of MMP activities and/or an increase of expression of MMP tissue inhibitors in the glomerular and tubular cells result in the suppression of catabolism of the components of extracellular matrix under the hyperglycemic conditions. Both circulating and urinary MMP as well as their inhibitors are considered to be new potential markers of renal fibrosis associated with diabetes mellitus. It is concluded that the directed activation of MMP and neutralization of their inhibitors provide a promising tool for the treatment of diabetic nephropathy.

Idiopathic short stature is the commonest form of growth retardation making up a heterogeneous group of pathological conditions characterized by a highly variable clinical picture. The molecular genetic investigations into the nature of idiopathic short stature encompass a combination of the accompanying clinical symptoms and laboratory findings. The present review is concerned with the principles of diagnostic studies pertaining to idiopathic short stature and the most widespread molecular gene defects in the growth hormone-insulin-like growth factor-1 system.

The authors review the publications devoted to the problem of health quality in the children born through assisted reproductive technologies. The data on the state of somatic and psychic health of such children are discussed. The main lines of investigations into the possible consequences of extracorporeal fertilization and its modifications are proposed. Special attention is given to the problem of comparability of different studies, the relevance and reliability of conclusions based on their results.

Dipeptidyl peptidase-4 inhibitors (DPP-4) is a new class of hypoglycemic drugs developed based on the knowledge of incretin physiology acquired in the 21st century. Currently, five members of this group are in use three of which are available on the Russian market. The hypoglycemic effect of dipeptidyl peptidase-4 inhibitors is due to reduction of fasting and postprandial hyperglycemia without a rise in the body weight and acceptable profile of side effects. Dipeptidyl peptidase-4 inhibitors differ in terms of pharmacodynamics and pharmacokinetics which implies different indications and duration of their use in different groups of patients as well as different character of their drug interaction. This paper compares three dipeptidyl peptidase-4 inhibitors, viz. vildagliptin, sitagliptin, and saxagliptin.

This review is focused on the influence of salicylates as well as preparations used for the treatment of obesity, diabetes mellitus, arterial hypertension, and atherosclerosis on the functional state of the adipose tissue and the inflammatory processes affecting it. Many of these medicines show the anti-inflammatory activity mediated through a variety of mechanisms. There is thus far no medicamental preparations for the specific treatment of adipose tissue inflammation. Nevertheless, the anti-inflammatory action of certain drugs should be taken into consideration when they are prescribed for the treatment of clinical conditions with concomitant obesity and suspicion of inflammation of the adipose tissue.