[Evaluation of glucose utilization in patients with insulin-independent diabetes mellitus by using breathing test]. / Kharakteristika utilizatsii gliukozy s pomoshch'iu 13C-neinvazibvnogo dykhatel'nogo testa pri insulinnezavisimom sakharnom diabete.

Commonly used clinical and biochemical parameters, such as the content of glucose, insulin, somatotropic hormone, triglycerides, lactate, pyruvate, and free fatty acids (FFA) in blood of practically healthy subjects and in patients with insulin-independent diabetes mellitus (IIDM), were compared with the parameters obtained by mass-spectrometric analysis of 13CO2 in expired air after 13C-glucose loading. It was shown that, as opposed to healthy subjects, the content of blood glucose and free fatty acids in patients with IIDM increased, the level of glucose dropped in progression upon short-term fasting, and the concentration of lactate changed both upon fasting and after the administration of small test doses of glucose. The use of the 13C-glucose breathing test (13C-GBT), which presupposes the loading of safe small doses of glucose enriched in 13C-isotope permitted one to reveal a number of novel quantitative diagnostic criteria for the evaluation of glucose metabolism in patients with IIDM: a decrease in the rate of 13C withdrawal as a constituent of expired carbon dioxide after the administration of 13C-glucose; a reduction in the amount of exogenous glucose metabolized to carbon dioxide; and increased oxidation of endogenous substrates participating in carbon dioxide formation. Small glucose loads proposed by the authors in 13C-GBT are safe for patients with diabetes mellitus and have no effect on the level of blood glucose in healthy persons. The parameters determined by noninvasive 13C-GBT are more sensitive for diagnosis than commonly used biochemical characteristics of blood in patients with IIDM. The diagnostic criteria obtained allow the prediction of the maximum prohibited glucose loading for every patient.

[Impaired fat tolerance as a risk factor of insulin resistance in young patients with obesity]. / Narushenie tolerantnosti k zhiru kak faktor razvitiia insulinrezistentnosti pri ozhirenii u lits molodogo vozrasta.

The study was undertaken to examine the nature and degree of postprandial lipemia during routine food fat loading (FFL) in young obese patients and the possible ways of correcting excessive body mass (BM) and hormonally metabolic disturbances. Fifty obese patients aged 18 to 25 years were examined. Group 1 comprised 20 patients with the BM index (BMI) of 33.4 +/- 0.8 kg/m2; Group 2 included 30 patients with the BMI of 33.05 +/- 5.22 kg/m2. The conventional glucose tolerance test was performed in all the examinees, by determining the degree of glycemia, the levels of immunoreactive insulin, and the insulin-resistance index (IRI). With FFL, lipid profile trends were studied in Group 1 patients. Before and 6 months after xenical therapy, anthropometric, lipid and carbohydrate metabolic parameters were determined and BMI was calculated in Group 2 patients. Group 1 patients were found to have impaired tolerance to FFL as compared with the control group. Postalimentary lipemia was accompanied by atherogenic changes in hormonally metabolic parameters. During xenical therapy, Group 2 patients were found to have positive changes in all anthropometric parameters, including those characterizing abdominal obesity, as well as normalized basal hyperinsulinemia, diminished stimulated insulinemia, increased insulin sensitivity, improved blood lipid profile with decreased atherogenic changes. Thus, the study has revealed that young obese patients show impaired fat tolerance with normal glucose tolerance. For therapy of obesity in young individuals, xenical may be recommended as an agent that not only decreases BM, but also improves hormonally metabolic parameters.

[Nervous system changes in adrenal failure]. / Izmenenie nervnoi sistemy pri nadpochechnikovoi nedostatochnosti.

AIM: To study nervous systems in chronic adrenal failure (CAF). MATERIAL AND METHODS: 262 patients with CAF were studied clinically, biochemically and electrophysiologically before and after treatment. RESULTS: The patients were found to have syndromes of vegetovascular dystonia by hypotonic type, syncopal paroxysms, myastenic, minor strokes, dyscirculatory-dysmetabolic encephalopathy, polyneuropathy. A direct correlation was established between the severity and duration of adrenal failure (AF), lowering of adrenal cortex hormones, coefficient Na/K and clinical manifestations of the neurological syndromes. Adequate hormone replacing and symptomatic therapy promoted a regress of neurological disorders in most of the patients especially in mild and moderate AF. CONCLUSION: Adequate therapy corrects neurological disturbances in patients with chronic NN.

[Intersensory correlations in diabetic neuropathy during adaptation to intervalic normobaric hypoxia]. / Mezhsensornye vzaimootnosheniia pri diabeticheskoi neiropatii v protsesse adaptatsii k interval'noi normobaricheskoi gipoksii.

The state of vibration sensitivity and of gustatory perception as well as the influence of interval hypoxic training on these indices were estimated in 21 patients with insulin-independent diabetes mellitus (IIDM) without neuropathic manifestations, in 21 analogous patients with neuropathic manifestations and in 16 individuals with neuropathies of nondiabetic genesis. The improvement of indices studied was observed in patients with neuropathies. Interval hypoxic training may be recommended for the treatment of distal neuropathies including the patients with IIDM in the state of compensation.

[Hyperinsulinemia and severity of cardiovascular disorders in generalized lipodystrophy syndrome]. / Giperinsulinemiia i vyrazhennost' serdechno-sosudistykh narushenii pri sindrome generalizovannoi lipodistrofii.

The examination of 40 patients with generalized lipodystrophy elucidated the dependence of the severity of cardiovascular disorders in these patients on the immunoreactive insulin/C-peptide index. In high values of the latter cardiovascular disorders occur more frequently. The role of insulin in pathogenesis of essential hypertension, chronic IHD is assessed.

[Erythrocyte membrane permeability for monovalent ions in pubertal juvenile dyspituitarism]. / Sostoianie membrannoi pronitsaemosti éritrotsitov dlia monovalentnykh ionov pri pubertatno-iunosheskom dispituitarizme.

Red cell membrane permeability was studied in 46 patients with pubertal juvenile dyspituitarism by measuring the rates of Na+/H,-Na+/Li(+)-metabolism, Na(+)-K(+)-contra-transport. The reference group consisted of 25 healthy adolescents and youths whose heredity was not aggravated for essential hypertension. No significant differences in the membrane permeability for monovalent cations in the reference subjects and the patients with the pubertal juvenile dyspituitarism were revealed. Thus analysis of the membrane characteristics may be helpful in the differential diagnosis of hypertension.

[C-peptide and insulin ratio in patients with juvenile dyspituitarism in varying symptomatology]. / Sootnoshenie C-peptida i insulina u bol'nykh s iunosheskim dispituitarizmom pri razlichnoi klinicheskoi simptomatike.

Altogether 24 adolescents with pubertal juvenile dyspituitarism (PJD) were investigated in the course of an oral GTT for 3 hours. The patients were divided into 3 groups: (1) with liver dysfunction and normal BP; (2) with normal liver and arterial hypertension; (3) with normal BP and normal liver function. The levels of glycemia, immunoreactive insulin, C-peptide and a molar C-peptide/insulin ratio were measured. All the examinees were characterized by basal and stimulated hyperinsulinemia against a background of a normal C-peptide value, the absence of a tendency to IRI reduction by the end of the GTT. A decrease in the C-peptide/IRI ratio was marked in the 1st group. One of the reasons of hyperinsulinemia in PJD in parallel with high insulin secretory pancreatic function can be a decrease in the metabolic clearance of liver insulin, especially noticeable in patients with hepatocyte dysfunction.

[Sex and pituitary hormone secretion in normal-height and tall adolescents with primary osteogenic sarcoma]. / Sekretsiia polovykh i gipofizarnykh gormonov u normoroslykh i vysokoroslykh podrostkov, bol'nykh pervichnoi osteogennoi sarkomoi.

The paper deals with a comparison of basal levels of secretion of total testosterone (T) and estradiol-17 beta (E2), their free and albumin and sex-steroid-binding globulin fractions as well as LH, FSH, prolactin and STH in blood serum of 60 normal height and 60 tall healthy adolescents and those with primary osteogenic sarcoma of bones at different stages of puberty. The study established a significantly higher level of testosterone and free androgen index and a lowered concentration of sex-steroid-binding globulin in blood serum of both normal and tall adolescent patients with osteogenic sarcoma at different stages of puberty. No significant differences were found in said indexes of estrogens between sarcoma patients and a specific group chosen for comparison, as far as physical status is concerned. The role of sex steroid hormones and, particularly, that of androgens in the pathogenetical mechanisms of osteogenic sarcoma growth is discussed.

[Potential for the clinical use of intranasal rifathyroin for diagnosis and treatment]. / O vozmozhnosti klinicheskogo ispol'zovaniia intranazal'nogo vvedeniia rifatiroina dlia diagnostiki i lecheniia.

It has been shown that stimulated TSH and prolactin levels in intranasal administration of rifathyroin are comparable with the results of i.v. administration of the drug. Intranasal administration can be used for both therapeutic and diagnostic purposes.

[Determination of the value of Na+/H+-metabolism in erythrocytes of patients with arterial hypertension of endocrine origin]. / Opredelenie velichiny Na+/H+-obmena v éritrotsitakh u bol'nykh s arterial'noi gipertenziei éndokrinnogo geneza.

The paper is concerned with the results of determination of a value of Na+/H(+)-metabolism in 66 patients with arterial hypertension of different genesis, including 21 patients with stage 11 essential hypertension, 8 patients with renal hypertension, 25 patients with Itsenko-Cushing syndrome or disease, 7 patients with pheochromocytoma, and 5 patients with primary hyperaldosteronism. The control group consisted of 11 healthy persons without predisposition to essential hypertension. It was shown that a value of Na+/H(+)-metabolism in patients with essential hypertension exceeded a 3.8-fold the control values. In patients with hyperglucocorticism, pheochromocytoma, arterial hypertension of renal genesis, the rate of Na+/H(+)-metabolism was significantly decreased as compared to that of a group of patients with essential hypertension. It could be used in differential diagnosis of the hypertensive syndrome. The problem of the diagnostic value of this indicator in primary hyperaldosteronism needs further investigation.

[The drug arginine aspartate (pargin) in the therapy of hyposomal states]. / Preparat arginina aspartat (parzhin) v terapii giposomal'nykh sostoianii.

Arginine aspartate (Pargine), a stimulator of endogenous STH, was given to 13 adolescents with retarded growth resulting from a relative deficiency of STH for 6 mos. Two patients discontinued treatment after 3 mos., two others are still on therapy. In 3 adolescents the rate of growth against a background of therapy was insufficient (1.3 cm over 6 mos.). Six patients demonstrated a positive effect: the rate of growth over 6 mos. was 4.13 +/- 0.39 cm, the basal level of STH increased by 6.3 +/- 2.46 ng/ml. The drug use did not accelerate skeletal differentiation in either of the patients. A conclusion is that the drug can be used to influence growth processes in patients with hyposomal conditions.

[Functional state of the hypothalamo-hypophyseal-thyroid system in euthyroid hyperplasia of the thyroid gland]. / Funktsional'noe sostoianie gipotalamo-gipofizarno-tireoidnoi sistemy pri éutireoidnoi giperplazii shchitovidnoi zhelezy.

Function of the hypothalamo-hypophyseal-thyroid system was investigated in 51 patients with euthyroid hyperplasia. Basal and TRH-stimulated levels of TSH and STH were investigated. Hyperergic ejection of STH and two pathological types of STH reaction (suggesting dysfunction of the hypothalamohypophyseal-thyroid system in euthyroid hyperplasia) were revealed. A group of patients with a low level of STH in response to TRH-stimulation demonstrated more pronounced changes of the hypothalamo-hypophyseal-thyroid system, characterized by a rise of a TSH level in response to stimulation up to 27.59 +/- 3.7 microU and a slightly reduced level of thyroid hormones. Changes in the level of STH indicated certain interest of growth hormone in the genesis of thyroid hyperplasia and could also serve an additional sign in the evaluation of a severity of disorders of the hypothalamo-hypophyseal-thyroid system.

[Morphofunctional features of the thyroid gland in patients with diffuse toxic goiter]. / Morfofunktsional'nye osobennosti shchitovidnoi zhelezy bol'nykh diffuznym toksicheskim zobom.

A study was made of the morphometric, ultrastructural and functional features of the thyroid in patients with diffuse toxic goiter (DTG) (women aged 16 to 12) with positive and negative dynamics of body mass (groups 1 and 2, respectively). Proliferation of the thyroid epithelium, detected in DTG patients of the 1st group, can be regarded as a morphological criterion for making a decision of a necessity of surgical intervention.

[The interaction of growth hormone secretion and gonadal function in adolescents with delayed physical development]. / Vzaimosviaz' sekretsii gormona rosta i funktsii polovykh zhelez u podrostkov s zaderzhkoi fizicheskogo razvitiia.

The studies conducted in adolescents with physical underdevelopment allowed a conclusion on reduced anabolic processes particularly growth process at the expense of both STH and sex steroids: T and E2. Studies of sex steroid and gonadotrophic hormone concentrations in blood serum revealed dysfunction of the hypothalamo-hypophyseal-gonadal system in this group of patients. Evaluation of androgen receptor level in protein cytosol fraction from the pubic skin of undersized youths with delayed sexual development demonstrated its significant reduction against the control group that may be explained by incomplete ability for androgen receptor synthesis due to relatively low T-level and its biologically active free fraction and low sensitivity of target tissues to androgens as a result of dissociation between functional activity of STH and T.