E. Ershova, N. V. Frolkova, K. Komshilova, N. Mazurina
{"title":"Bariatric patient: what is the key to success? Case from practice","authors":"E. Ershova, N. V. Frolkova, K. Komshilova, N. Mazurina","doi":"10.14341/omet12983","DOIUrl":"https://doi.org/10.14341/omet12983","url":null,"abstract":"Surgical treatment in the scope of laparoscopic gastric bypass for morbid obesity and type 2 diabetes mellitus (DM 2) with careful preoperative preparation, a gradual expansion of the diet with the obligatory observance of the recommendations of a nutritionist on the balance of micro- and macronutrients, a gradual increase in the amount of available physical activity in the postoperative period allows not only significantly reduce body weight, but also achieve compensation for obesity-related diseases. The expected development of micro- and macronutrient deficiencies requires an active search for and compensation for these conditions both at the pre- and postoperative stages. The development of postbariatric hypoglycemia confirms the need to comply with dietary recommendations not only at the stage of conservative treatment of obesity and DM 2, but also, no less important, after bariatric surgery.","PeriodicalId":54700,"journal":{"name":"Obesity and Metabolism-Milan","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48011067","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}
M. Yukina, E. Troshina, N. Nuralieva, M. V. Degtyarev, M. G. Mokrysheva
{"title":"SPECT/CT with 99mTc-Tectrotide in the diagnosis of insulinoma","authors":"M. Yukina, E. Troshina, N. Nuralieva, M. V. Degtyarev, M. G. Mokrysheva","doi":"10.14341/omet12977","DOIUrl":"https://doi.org/10.14341/omet12977","url":null,"abstract":"BACKGROUND: Insulinoma is a pancreatic neuroendocrine tumor that manifests by impaired carbohydrate metabolism with the development of hypoglycemic syndrome. The instrumental methods used at the present stage do not always make it possible to identify a tumor; moreover, the data obtained often contradict each other. Thus, the search for new possibilities of visualization of insulinoma is relevant.AIM: Evaluation of diagnostic effectiveness of scintigraphy with single-photon emission computed tomography combined with X-ray computed tomography (SPECT/CT) with 99mTc-Tectrotide for insulinoma in a Russian cohort of patients.MATERIALS AND METHODS: A single-centre (Endocrinology Research Centre of the Ministry of Health of the Russia), experimental, single-stage, controlled study. In the years 2017–2021 patients with pancreatic insulinoma (group 1) and hyperinsulinemic hypoglycemia of a different genesis (group 2) with negative or contradictory results of the 1st line imaging methods (ultrasound, magnetic resonance imaging (MRI), computed tomography (CT)) were included. All participants underwent the whole-body scintigraphy and low-dose SPECT/CT with 99mTc-Tectrotide (500–900 MBq). The studies were performed on a tomograph of the SPECT/GE Discovery NM/CT 670 using low-energy high-resolution collimators (LEHR) in the «whole body» mode.RESULTS: In the group 1 (n=21), according to the results of a pathomorphological study, the presence of 26 insulin-producing tumors was confirmed. Group 2 included 9 patients. According to the SPECT/CT with 99mTc-Tectrotide, 14 tumors were diagnosed in group 1 out of 26 insulin-producing tumors of the pancreas, and negative results were obtained in group 2 in 100% of cases. Thus, the sensitivity and specificity of the method were: 54%, 95% CI [33%; 73%] and 100%, 95% CI [68%; 100%], respectively.CONCLUSION: SPECT/CT with 99mTc-Tectrotide can detect insulinoma in 54% of cases with negative or contradictory results of 1st-line imaging methods (ultrasound, MRI, CT). This study can be effectively used as an alternative to SPECT/CT with 111In-octreotide, as a 2nd-line method for topical search for an insulin-producing pancreatic tumor.","PeriodicalId":54700,"journal":{"name":"Obesity and Metabolism-Milan","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46887624","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}
A. Klimchuk, V. Beloglazov, I. Yatskov, Yu. M. Agzamova, A. A. Kamshii, A. Zayaeva
{"title":"Post-vaccination and post-infectious immune response against new coronavirus infection on the background of obesity and overweight","authors":"A. Klimchuk, V. Beloglazov, I. Yatskov, Yu. M. Agzamova, A. A. Kamshii, A. Zayaeva","doi":"10.14341/omet12966","DOIUrl":"https://doi.org/10.14341/omet12966","url":null,"abstract":"In the fall of 2019, global health was confronted with a new RNA virus — severe acute respiratory syndrome coronavirus 2 SARS-CoV-2. Against the background of the rapid spread of infection, research centers around the world began to develop specific vaccines against COVID-19, using the accumulated experience and empirical data on the stereotypes of the structure and physiology of other viral agents of this family (severe acute respiratory syndrome virus (SARS) and Middle East respiratory syndrome (MERS). However, even before the development of anti-COVID vaccines, it was suggested that they are probably less effective in a number of individuals, in particular, in people who are overweight or obese. This hypothesis arose on the basis of past studies using vaccines for other purposes in this categories of people, as well as in numerous experiments on mice, thanks to which scientists came to the conclusion that, due to an excess amount of adipose tissue in the body, there is a state of a permanent inflammatory process, some immune dysfunction, and, as a result, a reduced local and systemic response. resistance against bacterial and viral agents.In this literature review, using current publications obtained by searching for “covid-19 vaccination and obesity” and “vaccination and obesity” in the PubMed databases and “covid-19 vaccination and obesity” and “vaccination and obesity” in the e- Library discusses changes in the immune response both to infection itself and to immunization in the presence of overweight or obesity.","PeriodicalId":54700,"journal":{"name":"Obesity and Metabolism-Milan","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45878781","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}
L. Dzeranova, M. Yevloyeva, M. Perepelova, E. Pigarova, A. Shutova, A. Dorovskikh, V. Azizyan, E. Przhiyalkovskaya
{"title":"Efficacy of long-term octreotide therapy of acromegaly as the first-line medical treatment","authors":"L. Dzeranova, M. Yevloyeva, M. Perepelova, E. Pigarova, A. Shutova, A. Dorovskikh, V. Azizyan, E. Przhiyalkovskaya","doi":"10.14341/omet12960","DOIUrl":"https://doi.org/10.14341/omet12960","url":null,"abstract":"Acromegaly is a severe neuroendocrine disease characterized by hypersecretion of growth hormone (GH) caused in 95% of cases by pituitary adenoma, which leads to the development of pathology of various organs and systems. The severity of the condition is due not only to the direct effect of somatotropic hormone on the body and the effect of the adenoma on the surrounding structures, but also to the age of the patient and complications associated with the disease. Improvement in treatment methods allows for a personalized approach to patient management, taking into account various aspects of the clinical case. It is important for a specialist to take into account comorbidity in acromegaly, both in terms of pathological disorders and the impact on the patient’s psycho-emotional state. We present a clinical case of successful treatment with somatostatin analogues (ASS) in a patient who is afraid of surgery and has cardiovascular complications of acromegaly. Since the onset of acromegaly, confirmed by an elevated level of insulin-like growth factor-1 (IGF-1) and an endosellar pituitary macroadenoma measuring 11x9.5x8 mm, ASS therapy was initiated in the patient. The choice in favor of conservative treatment was due to a burdened cardiovascular history and the patient’s fear of surgery. Within three years from the start of drug therapy, there was a significant improvement in overall well-being, a tendency to reduce the size of the pituitary adenoma, and biochemical remission was achieved. The clinical case described by us confirms the possibility of successful primary treatment of ASS in a patient with acromegaly, taking into account all individual characteristics.","PeriodicalId":54700,"journal":{"name":"Obesity and Metabolism-Milan","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44003012","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}
Y. Dyleva, O. Gruzdeva, E. Belik, D. Borodkina, M. Sinitskiy, S. Ivanov, O. Barbarash
{"title":"Effect of metformin on transcriptome and adipokinome of adipocytes of local fat deposts of patients with ischemic heart disease","authors":"Y. Dyleva, O. Gruzdeva, E. Belik, D. Borodkina, M. Sinitskiy, S. Ivanov, O. Barbarash","doi":"10.14341/omet12743","DOIUrl":"https://doi.org/10.14341/omet12743","url":null,"abstract":"BACKGROUND: The information available to date on the effect of metformin on the transcriptome and secretory capacity of adipocytes in human adipose tissue (AT) is scarce and contradictory. The study analyzed whether metformin in vitro modulates gene expression and secretion of adiponectin and leptin in the AT of subcutaneous (SAT), epicardial (EAT) and perivascular (PVAT) localization of patients with ischemic artery disease (IHD).AIM: To assess the effect of metformin at various concentrations (1 and 10 mmol / L) on the level of expression of adiponectin and leptin genes and their content in adipocytes of subcutaneous, epicardial and perivascular AT of patients with IHD.MATERIALS AND METHODS: The study included 134 patients with IHD and indications for direct myocardial revascularization by coronary artery bypass grafting (CABG). During the operation, biopsies of SAT, EAT and PVAT were obtained for 3–5 gram, which served as a source of adipocytes. Isolated adipocytes were cultured for 24 hours with and without metformin (1 and 10 mmol / L). After a day of incubation, the expression of the ADIPOQ and LEP genes and the level of secretion of adiponectin and leptin in the culture medium of adipocytes were determined. Statistical processing was performed using the GraphPad Prism 6 software package (GraphPad Software, La Jolla, CA, USA) and Statistica software, 6.1 (Dell Software, Inc., Round Rock, TX, USA).RESULTS: The adipocytes of the EAT and PVAT of patients with IHD were characterized by an imbalance in the adipokine system, manifested by a low level of ADIPOQ expression and a high LEP expression in comparison with adipocytes of the SAT. Metformin increased the level of ADIPOQ expression and its secretion by adipocytes regardless of their location, while a low concentration (1 mmol / L) in adipocytes of EAT had a stronger effect compared to 10 mmol / L. Metformin had a multidirectional effect on the level of leptin in adipocytes, which depended on their localization: both in low (1 mmol / L) and high concentrations (10 mmol / L), the drug reduced the level of LEP expression and protein secretion in the culture medium of adipocytes of the SAT. EAT had no significant effect on adipocytes. In PVAT, metformin increased the expression and secretion of leptin regardless of concentration.CONCLUSION: Metformin has a direct effect on adipocytes in SAT, EAT, and PVAT and is able to modulate their activity, which is a promising strategy for maintaining the balance of adipokines in AT, especially epicardial and perivascular localization.","PeriodicalId":54700,"journal":{"name":"Obesity and Metabolism-Milan","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44761633","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}
N. V. Molashenko, N. Kalinchenko, V. Ioutsi, O. Gurinovich, D. M. Babaeva, A. A. Voznesenskaya, N. Platonova, M. Yukina, A. Kolodkina, T. A. Ponomareva
{"title":"A case of 17-beta-hydroxysteroid dehydrogenase deficiency type 3 in adult endocrinologist practice","authors":"N. V. Molashenko, N. Kalinchenko, V. Ioutsi, O. Gurinovich, D. M. Babaeva, A. A. Voznesenskaya, N. Platonova, M. Yukina, A. Kolodkina, T. A. Ponomareva","doi":"10.14341/omet12942","DOIUrl":"https://doi.org/10.14341/omet12942","url":null,"abstract":"17β-Hydroxysteroid dehydrogenase 3 deficiency (17HSD3) is a rare autosomal recessive cause of 46, XY disorders of sex development resulting from HSD17B3 gene mutations, in which conversion of androstenedione to testosterone is impared. The clinical signs of 17HSD3 deficiency depend on the residual activity of the enzyme. The diagnosis of 17HSD3 deficiency is based on reduced testosterone/androstenedione ratio (T/AD < 0.8). Patients are usually assigned at birth and raise as female. If the diagnosis is made before puberty, gonadectomy is recommended, taking into account the risk of masculinization during the puberty and estrogen therapy initiation in this period. If the diagnosis of 17HSD3 deficiency is established during puberty, when virilization manifests, the therapeutic strategy is based on the results of comprehensive psychological testing and gender identity of a patient. In patients with more pronounced masculinization or diagnosis established shortly after birth, who are assigned at birth and raise as male, testosterone therapy is used to achieve a male phenotype. The 17HSD3 deficiency and virilization often result in a change of gender identity during puberty. The article presents a clinical case of 17-βhydroxysteroid dehydrogenase type 3 deficiency with late diagnosis due to parental will. The diagnostic approaches and management of the disease are also described.","PeriodicalId":54700,"journal":{"name":"Obesity and Metabolism-Milan","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42684426","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":"Hypogonadism and visceral obesity in men are full–fledged components of the metabolic syndrome","authors":"E. Troshina, Р. A. Terekhov","doi":"10.14341/omet12980","DOIUrl":"https://doi.org/10.14341/omet12980","url":null,"abstract":"Hypogonadism in men can cause the development of obesity, primarily abdominal, associated with high cardio-metabolic risks. Chronic obesity, in turn, almost inevitably leads to the manifestation of hypogonadism, which requires treatment and aggravates cardiovascular risks. Testosterone therapy, prescribed according to indications, has a significant positive effect not only on a man’s sexual function, but also on body weight, carbohydrate and lipid metabolism, bone metabolism and the emotional component of men’s health. The improvement of many metabolic parameters in men with verified hypogonadism occurs against the background of fairly long-term testosterone therapy. Hypogonadism and visceral obesity are now considered as components of the metabolic syndrome, mutually burden each other and require a comprehensive therapeutic approach.","PeriodicalId":54700,"journal":{"name":"Obesity and Metabolism-Milan","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47926508","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}
N. Izmozherova, A. Popov, A. V. Ryabinina, A. A. Vikhareva, E. Safianik, A. Spevak, M. Shambatov, V. Bakhtin
{"title":"Metabolic syndrome components and vitamin D availability relationship in late postmenopausal women","authors":"N. Izmozherova, A. Popov, A. V. Ryabinina, A. A. Vikhareva, E. Safianik, A. Spevak, M. Shambatov, V. Bakhtin","doi":"10.14341/omet12737","DOIUrl":"https://doi.org/10.14341/omet12737","url":null,"abstract":"BACKGROUND: The global prevalence of vitamin D deficiency is currently a real threat due to association with major chronic non-communicable diseases. Abdominal obesity, hypertension, dyslipidemia, and hyperglycemia contribute significantly to cardiometabolic risk in late postmenopausal women.AIM: to assess the frequency of deficiency and insufficiency of 25(OH)D in late postmenopausal residents of Yekaterinburg; to establish associations of 25(OH)D serum concentration with components of metabolic syndrome and severity of menopausal symptoms.MATERIALS AND METHODS: During the period from October 2018 to March 2020 145 independently living late postmenopausal residents of Yekaterinburg were enrolled in a cross-sectional study. The following scope of data regarding each of the subjects was collected: complaints and anamnesis, anthropometry, diagnosis of metabolic syndrome, arterial hypertension and diabetes mellitus, assessment of 25 (OH)D level by the ECLIA method, LDL-C, HDL-C levels, serum TG by the enzymatic colorimetric method, as well as the evaluation of the modified menopausal index.RESULTS: Adequate serum level of 25(OH)D was detected in 20.6% patients, insufficiency and deficiency were found in 33.1 and 46.2% cases, respectively. In patients with vitamin D deficiency and insufficiency, the most frequent metabolic syndrome components were arterial hypertension (p=0.02; OR 3.5; CI 1.2–10.6) and abdominal obesity (p=0.03; OR 2.8; CI 1.1–7.2). Vitamin D deficient subjects had significantly lower serum HDL and increased TG levels (p=0.04), compared to the adequately provided 25(OH)D patients. Vitamin D levels were not associated with the severity of menopausal symptoms in late postmenopausal women. Regular daily intake of 400–2000 IU of colecalciferol contributed to higher serum 25(OH)D level.CONCLUSION: a high prevalence of vitamin D deficiency among postmenopausal women of Yekaterinburg was detected. Diagnosis and correction of vitamin D levels are necessary for timely reduction of cardiometabolic risk, primarily due to the potential pleiotropic effects of D-hormone on the renin-angiotensin-aldosterone system, carbohydrate and lipid metabolism.","PeriodicalId":54700,"journal":{"name":"Obesity and Metabolism-Milan","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44396503","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}