INTERNATIONAL JOURNAL OF ENDOCRINOLOGY (Ukraine)最新文献

{"title":"Hyporeninemic hypoaldosteronism as a manifestation of autonomic neuropathy in a patient with type 2 diabetes mellitus against the background of coronavirus disease. A clinical case","authors":"N. Pertseva, T. Chursinova, A.A. Gryshniakova","doi":"10.22141/2224-0721.19.2.2023.1261","DOIUrl":"https://doi.org/10.22141/2224-0721.19.2.2023.1261","url":null,"abstract":"Coronavirus disease (COVID-19) is often associated with endocrine complications. The article describes a clinical case of the patient with type 2 diabetes mellitus and COVID-19 after which, for the first time, there was a need for basal-bolus insulin therapy, and secondly, a significant arterial hypotension occurred. The mechanism of damage to β-cells of the pancreas in the patient is debatable. After analyzing the features of diabetes course, we found an acute onset of the disease at the age of 44 years with pronounced hyperglycemia and ketosis, which required insulin therapy. Then for a long time there was no need in insulin therapy, and the patient took metformin, having overweight, no antibodies to β-cell antigens. It is also impossible to exclude the effect of SARS-CoV-2 on the secretory function of β-cells of the pancreas. Accordingly, clinical cases are interesting, as their analysis helps to understand not only the mecha­nism of development and progression of this infection, but also the diagnosis and treatment of its complications. We have described a rare clinical case of the hyporeninemic hypoaldosteronism in the patient with type 2 diabetes mellitus after COVID-19 infection. A feature of the hyporeninemic hypoaldosteronism course was the absence of electrolyte disorders in the patient, with severe arterial hypotension, suppression of renin and aldosterone. We believe that the hyporeninemic hypoaldosteronism has been associated with the progression of chronic diabetes complications, mainly autonomic neuropathy against the background of COVID-19. To improve the identified disorders, replacement therapy with mineralocorticoids was prescribed. The blood pressure, symptoms of fluid retention and electrolyte levels were monitored when selecting the dose of fludrocortisone. The patient has been under observation for 14 months, the need for fludrocortisone replacement therapy persists to this day. Practicing doctors need to pay attention to the diagnosis of autonomic disorders, which reduce the patients’ quality of life and are an independent risk factor for cardiovascular mortality.","PeriodicalId":13962,"journal":{"name":"INTERNATIONAL JOURNAL OF ENDOCRINOLOGY (Ukraine)","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83050216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiotrophin-1 as a prognostic biomarker of hypertension and a key regulator of cardiac glucose metabolism","authors":"І. Dunaieva","doi":"10.22141/2224-0721.19.2.2023.1254","DOIUrl":"https://doi.org/10.22141/2224-0721.19.2.2023.1254","url":null,"abstract":"Background. Hypertension, type 2 diabetes mellitus (T2DM), and obesity are among the most common diseases in the world, and their growth rates are of a pandemic nature. Since cardiovascular diseases still occupy a leading place in the structure of mortality, the study of biomarkers continues that can be key in the diagnosis of early signs of cardiovascular pathology. Such promising molecule is cardiotrophin-1 (CTF-1). CTF-1 is a protein with a molecular weight of 21.5 kDa, which belongs to the interleukin-6 (IL-6) family. The purpose of this study is to evaluate the circulating level of CTF-1 in comorbid patients with hypertension, and to conduct a comparative analysis of its serum concentration in the presence of various comorbidities. Materials and methods. One hundred and eleven patients with hypertension (men/women — 50/61) aged (54.37 ± 1.18) years and 20 persons of the control group were examined. In the process of examination, they were divided into 4 groups depending on the presence of comorbid pathology: hypertension — group 1 (n = 22); hypertension combined with obesity — group 2 (n = 30); hypertension and T2DM — group 3 (n = 31); hypertension, T2DM and obesity — group 4 (n = 28). In all patients, body weight and height were measured, body mass index (BMI) was calculated, glycated hemoglobin (HbA1c) levels, lipid metabolism indicators were determined, systolic and diastolic blood pressure levels were measured. CTF-1 content in blood serum was determined by enzyme-linked immunosorbent assay. Results. A direct correlation of CTF-1 level with weight, BMI, HbA1c level, systolic and diastolic blood pressure was found (p < 0.001). The data obtained prove that CTF-1 can be a trigger for the occurrence of cardiovascular complications, since its level progressively increases with increasing severity of comorbid pathology, and its highest serum concentration is found in patients with hypertension, concomitant T2DM and obesity. The detected changes demonstrate the role of CTF-1, the adipose tissue hormone, in the development of comorbid pathology and make it possible to assert that CTF-1 is a potential biomarker of cardiovascular complications. Conclusions. The level of CTF-1 was significantly higher in patients with hypertension, T2DM, obesity compared to those with hypertension, hypertension and obesity, as well as compared to this indicator in the control group. The concentration of CTF-1 in blood serum positively correlates with the levels of systolic and diastolic blood pressure, body weight, BMI, total cholesterol and HbA1c level. The study of the relationship between the serum level of CTF-1 and metabolic and hormonal indicators in comorbid patients is a promising direction for further research.","PeriodicalId":13962,"journal":{"name":"INTERNATIONAL JOURNAL OF ENDOCRINOLOGY (Ukraine)","volume":"357 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75502842","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of polycystic ovary syndrome with multiple health factors and adverse pregnancy outcomes","authors":"L. Markin, O.O. Korutko, T. Fartushok, N. Fartushok, Yuriy Fedevych, E. A. Dzhalilova, V. Zhykovskiy","doi":"10.22141/2224-0721.19.2.2023.1259","DOIUrl":"https://doi.org/10.22141/2224-0721.19.2.2023.1259","url":null,"abstract":"Polycystic ovary syndrome (PCOS), an endocrine and metabolic disorder in women of reproductive age, is characterized by high androgen levels, irregular periods, and small cysts in the ovaries. PCOS affects approximately 10 % of reproductive age women of all races and ethnicities. PCOS has been recognized to affect women of reproductive age since antiquity and in the 21st century, it emerges as the most widespread and serious reproductive metabolic disorder in the world. PCOS is a multifactorial disorder that affects both the reproductive and metabolic health of women. In addition, PCOS is a leading symptom of infertility in women. Nevertheless, women with PCOS who become pregnant unfortunately have an increased risk of complications, such as gestational diabetes mellitus (GDM), preterm birth. Many people believe GDM disappears after childbirth, despite the fact that GDM is a war­ning symptom of type 2 diabetes mellitus, metabolic syndrome, and cardiovascular disease. According to growing evidence, GDM complicates 40 % of PCOS pregnancies, suggesting that PCOS is a risk factor for GDM. Hence, PCOS is a lifelong disorder that can eventually lead to various long-term health complications, including chronic menstrual irregularity, infertility, endometrial hyperplasia, and endometrial cancer. Thus, it’s a scientific fact that both PCOS and GDM are significantly associated with each other. However, most studies on the risk of GDM in PCOS patients are retrospective. Therefore, there is no strong evidence whether PCOS is a risk factor for GDM or any other related factor. PCOS, a polygenic endocrinopathy, is in a true sense a set of diseases that worsen the state of the body. Reproductive and metabolic disorders associated with PCOS cause several clinical symptoms, such as irregular and painful periods, hirsutism, acanthosis nigricans, acne, psoriasis, anxiety, mood swings, patterned baldness, cardiovascular problems, type 2 diabetes, infertility, pelvic pain, low libido, low self-esteem, etc. Further studies are needed to understand the genetic and epigenetic contributions of PCOS, PCOS-related comorbidities, the role of placenta in nutrient availability, and influence of medications that may affect the long-term offspring health.","PeriodicalId":13962,"journal":{"name":"INTERNATIONAL JOURNAL OF ENDOCRINOLOGY (Ukraine)","volume":"48 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78916965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Functional activity of the adrenal glands in type 2 diabetes patients with different hormonal and metabolic phenotypes","authors":"O. Prybyla, O. Zinych, N. Kushnarova, A. Kovalchuk, K. Shyshkan-Shyshova","doi":"10.22141/2224-0721.19.2.2023.1252","DOIUrl":"https://doi.org/10.22141/2224-0721.19.2.2023.1252","url":null,"abstract":"Background. Clinical trials showed a number of additional phenotypes of metabolic syndrome. All of them differ in the type of metabolic disorders and the composition of subcutaneous and visceral adipose tissue. Some of phenotypes have a number of clinical and metabolic similarities with endogenous or exogenous hypercorticism syndromes. The purpose was to characterize the functional activity of the adrenal glands in type 2 diabetes depen­ding on the phenotypic features: the degree of general obesity and the level of visceral fat. Material and methods. Our trial included 89 patients with type 2 diabetes (46 men and 43 women) aged 32 to 85 years. The examination included evaluation of anthropometric parameters, body composition by the bioelectrical impedance method, assessment of the lipid and carbohydrate metabolism, the level of cortisol, dehydroepiandrosterone sulfate (DHEAS) in blood serum, and the activity of 11-beta-hydroxysteroid dehydrogenase (11β-HSD) enzyme. Results. Insulin and C-peptide levels were significantly lower in the non-obese group. The cortisol/DHEAS ratio was elevated in both subgroups with high levels of visceral fat as possible marker of imbalance of anabolic and catabolic hormones. In addition, the concentration of the cortisol, measured in the blood serum of the patients after waking up, was within the normal range. However, the average value in both groups was closer to its upper ranges. This may suggest the presence of subclinical hypercortisolism caused by an increased activity of 11β-HSD, which contributes to the local production of cortisol in visceral adipose tissue. Conclusions. The hormonal and metabolic changes that we found in our groups of patients with type 2 diabetes may indicate anabolic-catabolic imbalance, which is manifested both in the features of the topography of adipose tissue and in changes of metabolic processes, i.e. form the special metabolic phenotype with a catabolic or anabolic axis. Detection the subgroups at high risk allows to develop pathogenetic approaches to the most targeted comprehensive correction of existing violations.","PeriodicalId":13962,"journal":{"name":"INTERNATIONAL JOURNAL OF ENDOCRINOLOGY (Ukraine)","volume":"68 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86120089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The level of vitamin D in the first trimester of pregnancy and its effect on the anthropometric parameters of а newborn","authors":"T.O. Budnik, A. Boychuk","doi":"10.22141/2224-0721.19.1.2023.1239","DOIUrl":"https://doi.org/10.22141/2224-0721.19.1.2023.1239","url":null,"abstract":"Background. The prevalence of vitamin D deficiency appears to be increasing worldwide. Pregnant women are at risk of developing vitamin D deficiency. Vitamin D status has a great impact on both pregnancy and the fetus. Vitamin D deficiency during pregnancy has been associated with several adverse pregnancy outcomes. The purpose of the study was to evaluate serum vitamin D level during the first trimester of pregnancy and its effect on the neonatal anthropometric measures. Material and methods. A prospective study among 71 pregnant women aged 19 to 42 years in the first trimester was carried out between October 2018 to April 2020. A survey of pregnant women (socio-demographic characteristics, anamnestic data and diet) was conducted, and the maternal serum total vitamin D level was determined by enzyme immunoassay. Neonatal anthropometric parameters (weight, body length, weight/length ratio) were measured. Results. Vitamin D deficiency was observed in 41 (57.7 %) of pregnant women, insufficiency in 7 (9.9 %), and the optimal level in 23 (32.4 %) of examined women. Women with vitamin D deficiency were more likely to have a history of miscarriage than those with optimal D status (odds ratio 9.06, 95% confidence interval 1.11–73.86, Р = 0.0396). We have not found the influence of other factors (age, social status, body mass index, number of pregnancies) on the maternal vitamin D level. There were no significant differences between indicators of weight by age, body length of a child by age, and Apgar scores depending on the vitamin D levels of pregnant women. Conclusions. The study showed that the optimal vitamin D level is observed only in 32.4 % of cases, and its deficiency or insufficiency occurs in 67.6 % of pregnant women in the first trimester. The study did not reveal the correlation between maternal vitamin D level during the first trimester of pregnancy and neonatal anthropometric measures. Given the trend towards lower weight/length ratio to gestational age of the newborns from mothers with vitamin D deficiency, further studies are needed.","PeriodicalId":13962,"journal":{"name":"INTERNATIONAL JOURNAL OF ENDOCRINOLOGY (Ukraine)","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76068725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Сімейна поведінкова терапія в лікуванні ожиріння в дітей шкільного віку","authors":"T. Sorokman, S. V. Sokolnyk, N.O. Popeluk","doi":"10.22141/2224-0721.19.1.2023.1238","DOIUrl":"https://doi.org/10.22141/2224-0721.19.1.2023.1238","url":null,"abstract":"Актуальність. Ожиріння вражає 27–34 % дітей і вважається головною проблемою громадського здоров’я. Оскільки все більше дітей страждають від надмірної маси тіла, медичним працівникам необхідно шукати ефективні методи профілактики та лікування ожиріння. Мета: оцінити ефективність сімейної поведінкової терапії в лікуванні дітей із ожирінням. Матеріали та методи. Впродовж одного року під спостереженням перебувало 57 дітей віком 7–12 років з ожирінням, які були рандомізовані в дві групи: основну (інтервенційна) — 34 особи (I) та порівняння — 23 особи (II). Діти I групи включені в програму сімейного поведінкового лікування, що полягала в гіпокалорійному харчуванні, контролі за сімейним середовищем та дозованому контрольованому фізичному навантаженні. Ліпідний спектр крові вивчався за рівнем загального холестерину (ЗХС), тригліцеридів (ТГ), холестерину ліпопротеїнів низької (ХС ЛПНЩ) і високої щільності (ХС ЛПВЩ). Результати. У дітей з ожирінням як систолічний (САТ), так і діастолічний арте­ріальний тиск (ДАТ) був підвищений (становив у середньому 125,9 ± 0,9 мм рт.ст. i 66,9 ± 1,2 мм рт.ст. відповідно), також виявлено зростання концентрації ЗХС, ТГ, ХС ЛПНЩ. Через рік після проведення сімейної поведінкової терапії ІМТ у дітей з ожирінням знизився з 26,8 до 25,1 кг/м2, міжгрупові зміни САТ та ДАТ були статистично значущі (I група: до програми САТ становив 124,9 ± 0,8 мм рт.ст., після — 118,9 ± 0,9 мм рт.ст., р < 0,05; ДАТ — 65,7 ± 1,2 мм рт.ст. і 62,1 ± 1,0 мм рт.ст. відповідно, р < 0,05; II група: до програми САТ був 125,1 ± 0,7 мм рт.ст., після — 126,9 ± 0,8 мм рт.ст., р > 0,05; ДАТ — 66,6 ± 1,1 мм рт.ст. і 67,7 ± 1,2 мм рт.ст. відповідно, р > 0,05). Також відбулися достовірні зміни в ліпідному спектрі крові: рівень ЗХС знизився в 0,87 разa, ТГ — у 0,94 разa, при тенденції до зниження ХС ЛПНЩ та підвищення ХС ЛПВЩ. Висновки. Полікомпонентна сімейна поведінкова терапія є ефективною щодо зниження індексу маси тіла дітей з ожирінням. Отримані результати вказують на необхідність застосування запропонованої лікувальної програми в клінічній практиці.","PeriodicalId":13962,"journal":{"name":"INTERNATIONAL JOURNAL OF ENDOCRINOLOGY (Ukraine)","volume":"184 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80688907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship between vitamin D deficiency and metabolic disorders","authors":"O. Tsyryuk, Yu. V. Tseyslyer, K. Strubchevska, M. Kozyk, D. Ostapchenko, O. Korotkyi, I. Tymoshenko","doi":"10.22141/2224-0721.19.1.2023.1241","DOIUrl":"https://doi.org/10.22141/2224-0721.19.1.2023.1241","url":null,"abstract":"The relationship between vitamin D deficiency and the metabolic syndrome has recently been revealed. Vitamin D deficiency was hypothesized to cause increased insulin resistance and decreased insulin secretion, which can result in the development of diabetes mellitus and obesity. Cardiovascular diseases are also closely related to the metabolic syndrome. Vitamin D has been shown to have complex multistep metabolism and act as a hormone at many extraskeletal targets. In this literature review, a comprehensive analysis of publications from Scopus, Web of Science, MedLine, The Cochrane Library, EMBASE, Global Health databases, as well as scientific libraries of Ukraine, European Union, Great Britain, USA and other countries was performed. Our goal is to identify and analyze scientific publications discussing various biological effects of vitamin D and its use in the comprehensive treatment of various diseases. In addition to the previously known role of vitamin D in calcium metabolism and the musculoskeletal system functionality, a wide range of its pleiotropic effects has been discovered recently. Modern studies have shown a relationship between low levels of vitamin D and development of neurocognitive dysfunction, mental and neurological disorders, infertility, immune reactivity and autoimmune disorders, various types of cancer, and cardiovascular pathologies. More recent data also revealed a relationship of vitamin D deficiency with practically all aspects of metabolic syndrome, namely diabetes mellitus type 2 and type 1, hyperglycemia, dyslipidemia, obesity, hypertension, and insulin resistance. It was concluded that the data of the modern literature regarding the effectiveness of vitamin D in the treatment and prevention of metabolic disorders and structural and functional changes of the liver in diabetes and non-alcoholic fatty liver disease are quite contradictory: at the same level as the numerous publications on the effective use of vitamin D, there are studies with unconfirmed effectiveness of therapy and even its toxicity for the indicated pathologies.","PeriodicalId":13962,"journal":{"name":"INTERNATIONAL JOURNAL OF ENDOCRINOLOGY (Ukraine)","volume":"477 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78587784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-classical congenital adrenal hyperplasia. Clinical case","authors":"P. Liashuk, R. Liashuk, Yulia Marchuk, N. I. Stankova, PhD Liashuk Ruslana","doi":"10.22141/2224-0721.19.1.2023.1245","DOIUrl":"https://doi.org/10.22141/2224-0721.19.1.2023.1245","url":null,"abstract":"Congenital adrenal hyperplasia (CAH) is an autosomal recessive disease emerging from mutations of genes for enzymes that lead to the biochemical shifts in the production of glucocorticoids, mineralocorticoids, or sex steroids from cholesterol by the adrenal glands. Universal newborn screening for CAH is recommended for early diagnosis and initiation of therapy. The development of CAH is due to a defect in the CYP21 gene, which encodes 21-hydroxylase enzyme involved in the synthesis of cortisol. This leads to an increase in the secretion of adrenocorticotropic hormone and the accumulation of cortisol precursors, which are converted into adrenal androgens — the classical form of the disease develops. With a point mutation of the CYP21 gene, an incomplete defect occurs in 21-hydroxylase, which leads to an unpronounced disorder of adrenal steroidogenesis — a non-classical form of congenital adrenal hyperplasia, which happens more often. In this form, the clinical symptoms are erased with moderate hirsutism, acne vulgaris, infertility. In comparison to the classical form of the disease, which is diagnosed at birth or during the neonatal period because of ambiguous genitalia and/or salt-wasting symptoms or through screening programs used in some countries, most cases of non-classical CAH are not easy to detect. Additionally, many individuals remain asymptomatic during childhood and adolescence, have normal reproductive function, and only become aware of non-classical CAH due to the diagnosis of another family member and consequent testing. However, most women with non-classical CAH seek medical assistance when they experience symptoms of androgen excess and, when clinical suspicion prompts testing, elevated basal 17-OH progesterone levels may primarily point to the diagnosis of non-classical CAH. A case of a non-classical form of the disease which manifested itself in infertility is given. Pregnancy occurred after 4 months treatment with prednisolone (5 mg/day).","PeriodicalId":13962,"journal":{"name":"INTERNATIONAL JOURNAL OF ENDOCRINOLOGY (Ukraine)","volume":"46 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84726598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Basal insulin titration algorithms in patients with type 2 diabetes: the simplest is the best (?)","authors":"V. Katerenchuk","doi":"10.22141/2224-0721.19.1.2023.1244","DOIUrl":"https://doi.org/10.22141/2224-0721.19.1.2023.1244","url":null,"abstract":"Basal insulin is the first and main component of insulin therapy in patients with type 2 diabetes mellitus (T2DM). Based on the shortcomings of human NPH insulin and the advantages provi­ded by long-acting basal insulin analogues, they are recommended for priority use in patients with T2DM. The leading factor in the success of insulin therapy is titration of its dose with the achievement of the target range of glycemia. Data from clinical trials and real clinical practice indicate that simpler dose titration algorithms ensure better achievement of glycemic goals with a lower risk of hypoglycemia. In addition, simple dose titration algorithms are better accepted by patients and increase satisfaction with treatment. The leading societies of diabetologists ADA/EASD and AACE/ACE re­commend the use of simple dose titration algorithms. Recent clinical trials on the effectiveness of the insulin glargine dose titration based on the INSIGHT algorithm, which, unlike the traditional options for changing the dose 1–2 times a week, involves a daily correction of the insulin glargine dose by 1 Unit, have proven its effectiveness and safety. Most patients prefer this type of insulin dose titration. The same titration algorithm can be used for a fixed combination of glargine with li­xisenatide, which was also confirmed by the results of clinical trials. In general, simplified options for correcting the basal insulin dose have demonstrated their effectiveness and allow increa­sing the percentage of patients who manage to achieve the glycemic goal without increasing the risk of hypoglycemia. When prescribing basal insulin, physician must determine the target range of glycemia, demonstrate the titration algorithm that is acceptable for each insulin and which a patient will use to achieve the glycemic goal.","PeriodicalId":13962,"journal":{"name":"INTERNATIONAL JOURNAL OF ENDOCRINOLOGY (Ukraine)","volume":"21 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77858633","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The complex influence of the combination of the BDNF (rs6265), VDR (rs2228570), and NMDA (rs4880213) genotypes on the development of cognitive disorders in patients with autoimmune thyroiditis and hypothyroidism","authors":"I. Kamyshna, L. Pavlovych, I. Pankiv, V. Pankiv, V. Maslyanko, N. Bytsko, A. Kamyshnyi","doi":"10.22141/2224-0721.19.1.2023.1235","DOIUrl":"https://doi.org/10.22141/2224-0721.19.1.2023.1235","url":null,"abstract":"Background. Numerous studies have demonstrated that thyroid conditions can affect cognitive function. Gene polymorphisms associated with pathology of the endocrine and nervous system have ethnic and population specificity, which determines the need to study them in a certain region. The purpose of the study was to investigate the combined impact of the BDNF (rs6265), VDR (rs2228570), and NMDA (rs4880213) gene polymorphisms on cognitive impairment in patients with autoimmune thyroiditis and hypothyroidism among the population of Western regions of Ukraine, and to predict the onset of cognitive disorders. Materials and methods. The study involved a total of 153 patients with autoimmune thyroiditis and hypothyroidism. Genotyping of the VDR (rs2228570), BDNF (rs6265), and NMDA (rs4880213) gene polymorphism using TaqMan probes and TaqMan Genotyping Master Mix (4371355) was performed on CFX96™ Real-Time PCR Detection System (Bio-Rad Laboratories, Inc., USA). Polymerase chain reaction for TaqMan genotyping was carried out according to the kit instructions (Applied Biosystems, USA). We detect a decline in cognitive function using the Mini-Mental State Examination. Results. Carrying a combination of CC/AG/CC genotypes significantly reduces the risk of developing cognitive impairment (odds ratio (OR) = 0.1410; 95% confidence interval (CI) 0.0181–1.0965; p = 0.0416). At the same time, carrying a combination of CT/AG/CT genotypes increases the risk of cognitive impairment by more than 5 times (OR = 5.1915; 95% CI 1.2471–21.6107; p = 0.0214) and a combination of CT/AG/TT genotypes — by 10 times (OR = 10.1224; 95% CI 1.1037–92.8401; p = 0.0281). Carriers of the CT/AA/CT genotype combination have a 6.4-fold increased risk of cognitive impairment (OR = 6.4062; 95% CI 1.2019–34.1471; p = 0.0253). Conclusions. Among patients with autoimmune thyroiditis and hypothyroidism, carriers of the CC/AG/CC genotype combination of the BDNF (rs6265), VDR (rs2228570) and NMDA (rs4880213) genes have a reduced risk of developing cognitive disorders, while carriers of the CT/AG/CT, CT/AG/TT and CT/AA/CT have an increased risk of cognitive impairment.","PeriodicalId":13962,"journal":{"name":"INTERNATIONAL JOURNAL OF ENDOCRINOLOGY (Ukraine)","volume":"18 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84679060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}