[Genetic analysis of the structure of the predisposition to diabetes mellitus. II. The prevalence, morbidity and heritability of diabetes mellitus]. / Geneticheskii analiz struktury predraspolozheniia k sakharnomu diabetu. Soobshchenie II. Rasprostranennost', zabolevaemost' i nasleduemost' sakharnogo diabeta.

Prevalence of diabetes mellitus (D.M.) was estimated in several Moscow districts. The prevalence increases with the age from 0.073 in males and 0.085% in females at the age of 16-19 yrs to 4.9 in males and 6.2% in females at the age of 75 yrs and older. The overall prevalence of D.M. was 1.12%. The morbidity risks have the same patterns of increase: from 0.007 and 0.008% at the age of 0-4 yrs to 1.6 and 2.7% at the age of 75 yrs and older in males and females, respectively. The values of "cumulative" morbidity risk, for the population living long enough, derived from the estimates of age-specific morbidity risks were 6.57 for males and 11.93% for females. The estimate of correlation between first-degree relatives at onset-age of D.M. was 0.307. Accounted for the age-at-onset of the probands and for current ages of siblings, the estimates of recurrence risks, i.e. the probability to develop D.M. for siblings living long enough, were: 27.28 for sisters of the male-probands, 21.59 for sisters of the female-probands, 19.28 for brothers of male-probands and 9.62% for brothers of the female-probands. Thus, the family distribution of D.M., according to the sex of the probands and that of their relatives corresponds to the multifactorial model of inheritance for the diseases with sex-specific thresholds. The estimates of correlation in liability and that of heritability of D.M. calculated from the data on sibs, were 0.284 +/- 0.0351 and 0.568 +/- 0.0702, respectively. The data obtained show that hereditary factors play an essential role in the development of D.M. These results are of a practical interest for genetic counselling, as well as for establishing the preventive measures in the Public Health Service.

[Genetic analysis of the structure of predisposition to diabetes mellitus. III. Genetic heterogeneity of diabetes mellitus with different ages of onset]. / Geneticheskii analiz struktury predraspolozheniia k sakharnomu diabetu. III. Geneticheskaia geterogennost' sakharnogo diabeta s raznym vozrastom nachala zabolevaniia.

The results of genetical-epidemiological analysis of the three conventional forms of diabetes mellitus (DM) differentiated for age-at-onset are presented (the form I - from 0 to 29 y. the form II - from 30 to 59 y. the form III - 60 y. and older). The estimates of heritability of liability to the forms I, II and III of DM were 0.57, 0.70 and 0.65, respectively. It was shown that genetic components of the forms I and II are virtually different: genetic correlation between these forms was rA = 0.216 +/- 0.203, which is statistically insignificant. These data support the hypothesis assuming genetic independence of juvenile and adult forms of DM. On the other hand, the forms II and III were found to have an essential number of genes in common: genetic correlation was rA = 0.495 +/- 0.134, being significant at the 5% level. Thus, the forms II and III of DM are not to be considered as two genetically distinct diseases. The low recurrence risks of the form I for siblings (not more than 3.6%) allow to reject the hypothesis of simple monogenic inheritance of juvenile DM and to propose multifactorial nature of the disease.

[Genetic analysis of the structure of predisposition to diabetes mellitus. IV. Population-genetics study of two types of diabetes mellitus with onset at age 20-40]. / Geneticheskii analiz struktury predraspolozheniia k sakharnomu diabetu. Soobshchenie IV. Populiatsionno-geneticheskoe issledovanie dvukh tipov sakharnogo diabeta, voznikshego vozraste ot 20 do 40 let.

It was found that age-specific morbidity risks of type I diabetes mellitus (DM I) increased from the age of 0-4 yrs (0.012-0.013%) to the age of 10-14 yrs (0.04-0.045%) and then slightly decreased to 0.02-0.03%, remaining at this level up to 40 yrs. The "cumulative" morbidity risk of DM I (population risk of development of DM I for each born individual, irrespective of family history) was found to be 0.2% for the age from 0-4 to 40 yrs. Assuming the age-specific morbidity risks of DM I after the age of 40 yrs to be the same as that at 40 yrs (0.02-0.03%), the "cumulative" morbidity risk for this type of DM from birth to 75 yrs old was estimated to be 0.36-0.44%. First incidences of DM II in the population were only observed in 20 yrs olds. The morbidity risk level for DM II at the age 20-24 yrs was found to be lower than that for DM I at this age. The risk was about the same level both for DM I and for DM II at the age 25-34 yrs, the morbidity risk levels for DM II after 35 yrs exceeding that for DM I. The "cumulative" risk of DM II by the age of 40 yrs was 0.1% for men and 0.15% for women. Analysis of familial data revealed statistically significant increase in recurrent morbidity risk in relatives only for the types of DM presented in probands.(ABSTRACT TRUNCATED AT 250 WORDS)

[Genetic analysis of the structure of relations between certain physiologic traits. II. Analysis of glucose tolerance indices and plasma cholesterol levels]. / Geneticheskii analiz struktury sviazei mezhdu nekotorymi fiziologicheskimi priznakami. Soobshchenie II. Analiz pokazatelei tolerantnosti k gliukoze i urovnei kholesterina plazmy.

A genetic analysis of the characteristics of sugar curve (138 pairs) and cholesterol levels (CS) in the plasma (283) was carried out on a twin sample of 18-40 years old, taken from the Twin Register. Estimation of heritability were 0.66 for the sugar level in the blood before taking breakfast (S0), 0.5 for the sugar level 1 hour after taking 50 g of glucose (S1); 0.43 for the sugar level 2 hours after taking glucose (S2), and 0.38 for CS. There were genetic correlations between all the four characteristics, and they were 0.7 for S0-S1; 0.12 for S1-S2; 0.6 for S0-S2. Genetic correlation between the characteristics of sugar curve and the CS levels were 0.28 for CS-S0; 0.38 for CS-S1; 0.26 for CS-S2.

[HDL cholesterol lipoprotein levels and the atherogenicity coefficient in males with diabetes mellitus and ischemic heart disease]. / Uroven' kholesterina lipoproteidov vysokoi plotnosti i koéfficient aterogennosti u muzhchin s sakharnym diabetom i ishemicheskoi bolezn'iu serdtsa.

A hundred males aged 40-69 years receiving treatment at the Institute of Experimental Endocrinology and Hormone Chemistry for type I and II diabetes mellitus were examined. Thirty-eight patients had coronary heart disease (CHD). The diagnosis of CHD was based on the data of the WHO Cardiological Questionnaire and the presence of ECG changes corresponding to the categories of the Minnesota Code 1-1,2,7; 4-1,2 and 5-1,2 (without 3-1,3). The blood levels of total cholesterol (CS), triglycerides (TG), high density lipoprotein cholesterol (HDLC) and the atherogenicity coefficient (AC) were determined in all patients. The results of the study showed that males with diabetes mellitus irrespective of its type or the presence of CHD had significantly higher mean values of total CS, TG and AC than in control. The mean levels of HDLC in males with type I diabetes mellitus without CHD did not differ from those in normal subjects whereas the level of HDLC in patients with type II diabetes mellitus was lowered. The patients with CHD showed a significant decrease in HDLC in both type I and II diabetes. The highest mean values of TG, AC and the lowest levels of HDLC were characteristic of the males with type II diabetes mellitus and CHD.

[Prevalence of ischemic heart disease, arterial hypertension and dyslipoproteinemia in persons with disorders of glucose tolerance]. / Rasprostranennost ishemicheskoi bolezni serdtsa, arteria'lnoi gipertenzii, dislipoproteidemii u lits s narushennoi tolerant- nostiu k gliukoze.

Among 3490 males and females aged 20-69 years, oral glucose tolerance testing (GTT) revealed diabetes mellitus (DM) and abnormal glucose tolerance (AGT) in 94 and 401 persons, respectively. The prevalence of coronary heart disease (CHD), arterial hypertension (AH), and dyslipoproteinemias (DLP) was examined in groups of subjects that had normal GTT indices, patients with DM, and persons with AGT. In the latter, the prevalence of CHD was found to significantly higher than in those with normal GTT indices and be increased with severity of carbohydrate metabolic disturbances. The prevalence of AH did not drastically differ in persons with AGT and those with normal carbohydrate metabolism. The prevalence of DLP was significantly higher in subjects with AGT than in those with normal GTT values. It was also ascertained that DLP, as opposed to AH, was more meaningful as a risk factor for the development of CHD in persons with AGT and patients with DM.

[Role of blood insulin in the etiology of dyslipoproteinemias and ischemic heart disease in males aged 20-69 years]. / Znachenie urovnia insulinemii v rasprostranennosti dislipoproteidemii i ishemicheskoi bolezni serdtsa u muzhchin 20-69 let.

A random sample of males aged 20-69 years and living in one of the administrative districts of Moscow was studied. The total number of those enrolled was 1225, and they were studied for the incidence of dyslipoproteinemias and coronary heart disease (CHD) in relation to the level of glycemia, basal insulinemia, diabetes mellitus or impaired tolerance to glucose. It was shown that the effect of disorders of carbohydrate metabolism is largely determined by the level of insulinemia and is mediated through the development of dyslipoproteinemias. The prevalence of CHD without dyslipoproteinemias as well as in combination with arterial hypertension or an excessive body weight did not depend on the level of glycemia and baseline insulinemia or the presence of diabetes mellitus. Hyperinsulinemia was found to be associated with types of dyslipoproteinemias most unfavourable in terms of CHD development.

[Various aspects of the relation between blood sugar levels and the prevalence of ischemic heart disease among 20 to 69-year-old men and women (a simultaneous epidemiologic study)]. / Nekotorye osobennosti vzaimosviazi urovnia glikemii s rasprostranennost'iu ishemicheskoi bolezni serdtsa u muzhchin i zhenshchin 20-69 let (odnomomentnoe épidemiologicheskoe issledovanie).

A random sample of 1,225 male and 1,243 female residents of a Moscow district, aged 20 to 69, has been studied. Their carbohydrate metabolism was assessed by means of an oral glucose tolerance test, and the diagnosis of coronary heart disease (CHD) was made on the basis of a WHO questionnaire and electrocardiography. The incidence of CHD was shown to be unassociated with the distribution of glycemia (both fasting and provoked by the glucose tolerance test) in males, while the association was significant in females. It is suggested that hyperglycemia is important as a coronary risk factor in women only.

[Interrelation of alpha-cholesterol and triglycerides in the blood of diabetic patients with and without ischemic heart disease]. / Vzaimosviaz' al'fa-kholesterina i triglitseridov v krovi u bol'nykh sakharnym diabetom s ishemicheskoi bolezn'iu serdtsa i bez nee.

The blood content of total cholesterol and alpha-cholesterol, triglycerides and fasting glucose level were measured in 213 patients suffering from types I and II diabetes mellitus with and without coronary heart disease (CHD) and in 141 subjects with abnormal glucose tolerance test. The ratio of alpha-cholesterol level to these indicators and to the body mass was calculated. It was established that there is a negative correlation between the content of alpha-cholesterol and the level of triglycerides in patients aged 30-45 years with type I diabetes mellitus and in patients aged 45-65 years with type II diabetes mellitus with and without CHD regardless of the body mass. No such correlation was found in patients aged 45-65 years suffering from diabetes mellitus with and without CHD. Negative correlation between the content of alpha-cholesterol and absolute body mass was discovered only in subjects with abnormal glucose tolerance test and in patients aged 30-45 years with type I diabetes mellitus. None of the groups under examination showed any correlation between the content of alpha-cholesterol and relative body mass and the level of total cholesterol.

[Changes in the rate of surface blood microcirculation studied by photon-correlation spectroscopy in the practical treatment and diagnosis of diabetes mellitus]. / Izmenenie skorosti poverkhnostnykh mikrotsirkuliatsii krovi metodom foton-korreliatsionnoi spektroskopii v praktike lecheniia i diagnostiki sakharnogo diabeta.

The paper is concerned with the results of studies on the basal blood flow and responses of the microcirculatory channel to physiological and pharmacological loads in health and diabetes mellitus using the method of photon-correlation spectroscopy in the light fiber variant. The rate of the basal blood flow in patients with diabetes mellitus (irrespective of the diabetes type) as compared to that in health was significantly lower in the finger tip and tended toward reduction in the inner side of the forearm, lobule of the auricle and in the conjunctiva. The presence of retinopathies in patients with diabetes mellitus resulted in a significant decrease in the rate of the blood flow in the conjunctiva as compared to those in health and diabetes mellitus without retinopathy. The response of the blood flow to physiological (orthostatic and ischemic) and pharmacological (nitroglycerin and pentoxifyllin) tests in patients with diabetes mellitus was also low; the presence of angiopathies caused a more acute reduction of the reactive power of the microcirculatory channel to the orthostatic test. The nature of the nitroglycerin effect in health and diabetes mellitus was different: in the first case noticeable vascular reactions were observed, in the second case a persistent vasodilative effect was observed. The pentoxifyllin effect was characterized by an elevated rate of the blood flow in health and diabetes mellitus.

[Characteristics of disturbances in the hemostasis system in patients with insulin-dependent diabetes mellitus with angiopathies of the vessels of the lower extremities]. / Osobennosti narushenii v sisteme gemostaza u bol'nykh insulinnezavisimym tipom sakharnogo diabeta s angiopatiiami sosudov nizhnikh konechnostei.

Indices of the system of hemostasis, the levels of glycolysated hemoglobin were studied in 67 patients suffering from non-insulin-dependent diabetes mellitus with lower limb angiopathies (aged 40 to 60). Rheovasography of the lower limbs was performed. The patients were treated with antidiabetic drugs per os (with the exception of hydroxydione sodium succinate), platelet aggregation inhibitors (pentoxifylline, acetylsalicylic acid) and vasodilators (xanthinol nicotinate, solcoseryl and cinnarizine). The use of pentoxifylline after therapy increased the rate of platelet aggregation inhibition and decreased the prothrombin index, not influencing the other indices of the system of hemostasis. Pentoxifylline combined with acetylsalicylic acid at small doses normalized not only platelet indices but also the other indices of the system of hemostasis. Positive changes in the system of hemostasis were accompanied by a rise of the rheographic index in patients with vascular functional changes. In obliterating atherosclerosis the rheographic index was not on an increase indicating the necessity of corrective therapy of vascular lesions, first of all in the system of hemostasis, in the early period of diabetes mellitus.

[Evaluation of the photon correlation method of measuring skin blood flow and its use in the diagnosis of microcirculation disorders in patients with diabetes mellitus]. / Otsenka foton-korreliatsionnogo metoda izmereniia kozhnogo krovotoka i ego ispol'zovaniia v diagnostike narushenii mikrotsirkuliatsii u bol'nykh sakharnym diabetom.

A new photon-correlation method for measuring blood flow and traditional methods for blood flow measurements according to the clearance of 133Xe were studied and compared. The measurement data of the skin circulation by the photon-correlation method and according to the clearance of 133Xe are in linear relationship, the correlation ratio being equal to +0.93 (P less than 0.01). At the same time the photon-correlation method has some advantages. Particularly it is marked by non-invasiveness, high accuracy, good reproducibility of the data and short exposure time. Photon-correlation spectroscopy was used to perform clinical studies of the skin circulation in different anatomic areas of the skin in diabetes mellitus patients. Altogether 117 subjects aged 19-60 years were examined. There were 38 healthy subjects and 79 patients with diabetes mellitus. The skin circulation was measured from the finger tip and from the internal surface of the upper third of the forearm. In healthy subjects, the skin circulation appeared substantially higher in the finger tip than in the forearm. In diabetes mellitus patients, the circulation in the finger skin was also higher than in the skin of the forearm. As compared to healthy subjects, the patients manifested a significant lowering in the finger circulation and only the tendency towards its decrease in the forearm.

[Incidence of arterial hypertension in relation to the blood sugar level in men and women aged 20 to 69 (a 1-factor epidemiological study)]. / Rasprostranennost' arterial'noi gipertenzii v zavisimosti ot urovnia glikemii u muzhchin i zhenshchin v vozratse 20-69 (odnomomentnoe épidemiologicheskoe issledovanie).

Arterial blood pressure (BP) was measured in 1225 males and 1243 females aged 20 to 69 years, who were also screened for glycemia by means of the glucose tolerance test (GTT). According to WHO recommendations, arterial hypertension (AH) was defined as systolic BP elevated to or above 160 mm Hg or diastolic BP elevated to or above 95 mm Hg. The incidence of AH was shown to be significantly related to the degree of glycemia in both males and females, the relationship being much closer in the latter. The prevalence of systolic AH in the females showed highly significant correlation to glycemia at any point of the GTT, while that of diastolic AH was only correlated with basal and 1-hour glycemia. In the males, the prevalence of systolic AH was significantly related to basal and 1-hour glycemia, and that of diastolic AH was only related to the distribution of basal glycemia.