BACKGROUND : Obesity is considered one of the leading global health issues. According to a meta-analysis published in the Lancet, in 2024 there were 880 million adults and 159 million children with obesity worldwide. Surgical treatment is one of the main methods for managing morbid obesity. There are several options for surgical treatment, but mini-gastric bypass is gaining popularity among bariatric surgeries. The operation is considered effective in reducing body mass and achieving remission of obesity-related comorbidities. The main advantage of this type of surgical intervention is the combination of relative simplicity and safety of the operation compared to other shunting bariatric interventions with sufficient efficacy on the course of type 2 diabetes mellitus. Despite the advantages of this technique, there is limited research published in this area. AIM : Assess the long-term outcomes of mini-gastric bypass in patients with morbid obesity. MATERIALS AND METHODS: The study presents the results of a 2-year follow-up of 30 patients who underwent mini-gastric bypass surgery. The patients' average age was 52.5 [50–56.5] years, and their preoperative BMI was 50.0 kg/m 2 [46.2–59.6]. Follow-up assessments were conducted at 6, 12, 18, and 24 months over a two-year period post-surgery. During the observation period, anthropometric data (BMI, waist circumference, hip circumference, excess weight loss percentage — EWL, total weight loss percentage — TWL), fasting blood glucose level, glycated hemoglobin (HbA1c), and postoperative adverse events were evaluated. RESULTS: After two years post-surgery, the median BMI value was 33.6 kg/m2 [28.4–36.5] (p<0.001) with an excess weight loss of 33.6% [28.4–36.4] (p<0.001). The greatest excess weight loss of 35.6% [26.6–54.2] (p<0.001) and 56.0% [39.0–56.0] (p<0.001) was observed at 6 and 12 months of the study, respectively. Similar results were also noted for other parameters. During the study period, remission of type 2 diabetes was achieved in 40% of patients (n=12) at 12 months of observation and in 80% of patients (n=24) at 24 months of observation. A significant reduction in adverse events was observed in the second year of the study compared to the first year. CONCLUSION : Therefore, mini-gastric bypass surgery is an effective bariatric procedure that leads to weight loss and remission of type 2 diabetes.

BACKGROUND . Changes in the human nutrition profile have led to excessive consumption of fats and carbohydrates, which is accompanied by the development of metabolic syndrome (MS). The main studies of the mechanisms of MS are performed on males, the features of MS in females have not been sufficiently studied. OBJECTIVE . The objective was to assess the state of lipid and carbohydrate metabolism, the functional state of the mesenteric arteries in intact and ovariectomized female Wistar rats under a high-fat dietary load. MATERIALS AND METHODS . Four groups of female rats were used: HFD (high fat diet, n=14), intact, receiving 50% fat in the diet, HFD (n=14) — ovariectomized, receiving 50% fat, CG (n=12) — intact, receiving a standard diet, OvCG (n=12) — ovariectomized, receiving a standard diet. After 10 weeks, the responses of mesenteric arteries precontracted with phenylephrine to acetylcholine (ACh) in the absence and with the use of an NO synthase blocker (L-NAME), as well as to sodium nitroprusside (NP), were studied using microphoto- and video recording of the vessel diameter in vivo. The state of carbohydrate and lipid metabolism, arterial pressure (BP), and the level of visceral obesity were assessed. The study refers to an interventional single-sample controlled study. RESULTS . In the absence of differences in body weight in HFD and OvHFD rats, excess fat intake leads to visceral obesity, increased triglyceride and LDL levels, increased blood pressure, and insulin resistance compared to CG and OvCG. Evaluation of mesenteric artery dilation at an ACh concentration of 10–5 mol/L showed that in HFD females the relaxation amplitude was 19.9% lower than in CG, and in OvHFD it was 21.3% lower than in OvCG. Compared with the magnitude of dilation on ACh without blockers, pre-incubation of vessels with L-NAME led to a decrease in the amplitude of ACh-induced vascular relaxation in CG by 68.0±3.6%, in OvCG by 70.1±3.4%, in HFD by 48.4±2.9%, in OvHFD by 55.1±3.9%. NP-induced vasodilation was reduced in HFD rats by 32.3%, in OvHFD by 32.2% compared with CG and OvCG. CONCLUSION . Excessive fat consumption by female rats is accompanied by visceral obesity, increased blood pressure, dyslipidemia, and impaired carbohydrate metabolism, dyslipidemia. The development of MS is accompanied by endothelial dysfunction, manifested by a decrease in ACh-induced dilation due to both the suppression of NO production by the endothelium and a decrease in the sensitivity of SMC to NO, while in ovariectomized females, visceral obesity without a decrease in vascular reactivity compared to intact animals.

BACKGROUND : Androgen deficiency associated with type 2 diabetes mellitus (T2DM) is one of the components of the metabolic syndrome, which is followed by visceral obesity. The pathogenetic features of the functioning of adipose tissue in patients with a combination of pathologies such as T2DM and hypogonadism have been studied extremely little. AIMS : To measure the effect of testosterone (T) deficiency on metabolic parameters and secretory activity of adipose tissue in men suffering from T2DM. MATERIALS AND METHODS : Patients with T2DM and hypogonadism were subjected to a series of general clinical studies, studied the degree of disturbance of carbohydrate and lipid metabolism, as well as the lipid accumulation index LAP, and also the level of hormones produced by adipose tissue (resistin, adiponectin and leptin) and sex hormones. RESULTS : The study involved 276 male patients with T2DM (aged 54.0 (8.0) years), divided into 2 groups: group 1 consisted of patients with hypogonadism (n=124); 2nd — eugonadal patients (n=152). Along with insulin resistance, men suffering from T2DM in combination with hypogonadism have hyperinsulinemia and dyslipidemia, more significant disturbances in the secretory activity of adipose tissue: an increase in leptin concentration by 18.4% (p=0.03), resistin by 2 times (p < 0.001), and a 1.7-fold decrease in the level adiponectin (p=0.006). This pattern clearly demonstrates the fundamental importance T deficiency in men with T2DM in the formation of metabolic disorders, as well as dysfunction of adipose tissue. CONCLUSIONS : Decreased T production in patients with T2DM worsens the disturbance of carbohydrate and lipid metabolism, and also the dysfunction of adipose tissue, the main pathophysiologic basis for cardiometabolic diseases.

AIM search for new genetic predictors of autoimmune adrenal insufficiency (AAI). MATERIALS AND METHODS : In n=54 patients with AAI (isolated and as part of type 2 autoimmune polyglandular syndrome (APS-2; group 1)) and n=32 healthy individuals (group 2) we analyzed polymorphisms in IL28B (rs12979860, rs8099917), TLR9 (rs5743836, rs352140), TLR2 (rs5743708). RESULTS : In group 1, compared with group 2, a predominance of CT genotype of rs12979860 polymorphism of IL28B (p=0.024), and T allele of rs5743836 polymorphism of TLR9 (p=0.044) was revealed. The allele C of rs5743836 polymorphism of TLR9 (p=0.044) was more common in group 2 than in group 1. With respect to other genotypes, alleles and haplotypes, no significant differences (or differences at the level of statistical trend) were found between groups 1 and 2. CONCLUSION : Thus, it is possible that the CT genotype according to the polymorphic locus rs12979860 of the IL28B gene and the allele T of the rs5743836 polymorphism of the TLR9 gene are prognostic markers that increase the likelihood of developing AAI due to violation the peripheral immune tolerance (IT), whereas the allele C of the rs5743836 polymorphism of the TLR9 gene performs a protective role in this disease in the Russian population.

Acromegaly and gigantism are rare neuroendocrine diseases caused by excessive secretion of growth hormone (GH) and/ or high levels of insulin-like growth factor (IGF-1). Gigantism develops when excess GH or IGF-1 leads to accelerated linear growth before the completion of puberty and the closure of the epiphyses, most commonly caused by a somatotropic pituitary adenoma. The diagnosis of somatotropinoma in childhood is particularly challenging due to its subtle and nonspecific clinical presentation. Somatotropinomas at a young age are more often caused by genetic abnormalities and have a more aggressive course. The article presents a clinical case of acrogigantism in a patient with two identified heterozygous variants in the PRKAR1A and SDHB genes. The scientific interest of the described observation is due to the debut of gigantism in childhood, complex pathogenetic treatment, as well as the experience of using the growth hormone receptor antagonist pegvisomant in a teenager in Russia.

Obesity is a significant healthcare problem worldwide. It is associated with a multitude of comorbidities and significantly reduces the quality of life. Success in the study of the pathogenesis of metabolic disorders contribute to development and introduction of innovative technologies into the clinical practice to combat the epidemic of obesity. However, so far the mechanisms involved in weight regain remain not fully understood. Maintaining body weight is regulated by the interaction of many physiological processes. The purpose of this review is to analyze existing studies dedicated to the biological mechanisms leading weight regain after successful treatment of obesity.

BACKGROUND : Childhood overweight and obesity are associated with diseases in adulthood: metabolic syndrome, type 2 diabetes, coronary heart disease, hypertension, and some types of cancer. In 2006, WHO initiated the European Childhood Obesity Surveillance Initiative (COSI), according to which a survey of Moscow first-graders was conducted in 2017. The publications of the Initiative participants presented general characteristics of the Russian sample along with similar indicators of other countries participating in the Initiative, while the collected Russian data allow for a more detailed analysis. AIM : To characterize the nutrition of 7-year-old children in Moscow at home and at school. MATERIALS AND METHODS : The epidemiological study was conducted at the National Medical Research Center of Endocrinology of the Ministry of Health of the Russian Federation in 2017 as part of the COSI program. The study included 7-year-old children studying in one of the first grades of 68 randomly selected Moscow schools. The study was conducted in accordance with the COSI study protocol; parent and school questionnaire forms were filled in. RESULTS : The study included 2,166 7-year-old children (1,068 boys and 1,098 girls). At home, 82% of children receive fresh fruit daily or 4–6 times a week, 72% receive vegetables, 64% receive dairy products, and 81% receive meat. 37% of children never receive soft drinks with added sugar, 62% — flavored milk, 79% — diet or "light" soft drinks, 55% — low-fat milk, and 29% — whole fat milk. 46% of children receive fish 1–3 times a week. At school, water is freely available for 86% of children, tea for 35%, fresh fruit for 67%, and vegetables for 55% of children. For 61% of children, a course on rational nutrition is conducted at school, or this topic is presented as a separate lesson, or is integrated into other educational activities. Two thirds of children at school are free from exposure to advertising and marketing. CONCLUSION : For the first time, detailed results of an epidemiological study of 7-year-old children in Moscow under the COSI program are presented: assessment of the frequency of consumption of various food products at home and at school.

Hypogonadism syndrome in men is a symptom complex of clinical and/or hormonal changes associated with a deficiency of sex hormones. The hypothalamic-pituitary-gonadal axis plays an important role in many processes, which is associated with both the development, maturation, and aging of the male body. With the help of this axis, there is a consistent relationship of processes aimed at maintaining the endocrine function of the testicles, ensuring the production of testosterone by the gonads, as well as ensuring the exocrine function associated with the formation of spermatozoa. Under the influence of a variety of both exogenous and endogenous factors, there is a gradual decrease in testosterone levels, which subsequently leads to the development of hypogonadism. Testosterone deficiency is a fairly common problem in men. Often, low androgen levels are not taken seriously at the primary level, and in some cases by specialized specialists, especially in older men. But it should be noted that not all patients present characteristic complaints, probably not giving them due importance. The combination of these factors indicates low awareness among both medical professionals and patients. Given the combination of various aspects that influence the formation of hypogonadism, in this article we consider the combination of type 2 diabetes in men with a history of long-term work experience in an industrial environment. BACKGROUND : Hypogonadism plays an important role in the course of somatic diseases. Harmful working conditions in combination with type 2 diabetes mellitus (DM 2) have a mutually potentiated effect in the formation of androgen deficiency, which in the long run leads to sexual and reproductive dysfunction and early loss of working capacity and disability in the male population of our country. AIM : The goal is to determine the frequency of testosterone deficiency (TD) in long-term exposure to industrial vibration in men with type 2 diabetes. MATERIALS AND METHODS : In the period from 06.2024 to 06.2025, a one-stage, non-interventional, single-center screening study was conducted in the endocrinology department of the City Clinical Polyclinic No. 8 in Chelyabinsk, involving 896 men with type 2 diabetes. These included employees from steel, defense, and engineering industries. The patients were aged between 40 and 70 years. The participants were divided into two groups. The first group consisted of individuals who had never worked in hazardous production conditions (SD, n=88). The second group included individuals with a confirmed diagnosis of vibration disease (VD), with an average work experience in hazardous industries of 23 years [16.0; 31.0] years of SD 2 and vibration disease (SDVBD, n=96). Both groups had a duration of SD 2 disease of more than 10 years. RESULTS : As a result of statistical processing of the initial data, the parameters of carbohydrate metabolism in the form of glycated hemoglobin were 7.70 [6.90; 8.60] in the DM group versus the ADHD group 7.85 [7.30; 8.80] (p=0.100), as well as glucose 8.10 mmol/l [7.10; 9.88] in DM and 8.93 mmol/l [7.24; 11.6] in the ADHD group (p=0.151), there were no significantly significant differences. Clinical and laboratory indicators of androgenic status, on the contrary, showed statistically significant changes, testosterone (T) in the DM group was 15.3 [9.66; 22.7] nmol/l versus 9.25 [6.26; 15.7] nmol/l in the ADHD group (p< 0.001). Thus, the industrial vibration potentiated the DT in the SDB group. CONCLUSION : Industrial vibration in combination with SD 2 contributes to the formation of DT, which is confirmed by clinical and laboratory data in the SDVB group.

ВACKGROUND . Obesity and overweight occupy one of the leading places in the structure of morbidity in the population around the world. Of particular relevance is the task of developing effective methods for treating this pathology, including diet therapy using biologically active substances with antioxidant and anti-inflammatory properties. AIM was to study the effect of capsaicinoids on the immune status in a model of nutritional obesity in rats. MATERIALS AND METHODS . The study was carried out on male Wistar rats, which were randomized by body weight into 3 groups (10 animals each, initial body weight 350±10 g). The rats received a semisynthetic standard diet (group 1) and a high-calorie choline-deficient diet (HCChDD) (groups 2 and 3). Animals were intragastrically administered (3.33 ml/kg body weight) 3 times a week sunflower oil (groups 1 and 2) or hot pepper extract (capsaicin — 59%, dihydrocapsaicin — 31%, nordihydrocapsaicin — 4%) in sunflower oil (group 3) in a single dose of 15 mg capsaicinoids/kg body weight. Hematological studies were performed on a Coulter ACT TM 5 diff OV hematological analyzer (Beckman Coulter, USA). The study of the subpopulation composition of lymphocytes was carried out using a flow cytometer FC-500 (Beckman Coulter, USA). The content of cytokines in the blood plasma of rats was determined by multiplex immunoassay using a Luminex 200 analyzer (Luminex Corporation, USA). RESULTS . In rats of the 2nd group, compared with the control, the presence of neutrophilic leukocytosis (1.20±0.13 vs 0.72±0.07 x10 9 /l; p < 0.05). A study of the subpopulation composition of lymphocytes in rats of the 2nd group revealed an increase in the relative content of T-helpers (61.41±1.31 vs 53.30±3.25%; p < 0.05) and the value of the immunoregulatory index (IRI): (1.94±0.15 vs 1.55±0.14; 0.05<p < 0.10) compared to the control group. Administration of capsaicinoids to rats of the 3rd group led to the normalization of these indicators. In animals of the 2nd group, a significant increase in the blood plasma levels of cytokines was found: IFN-γ, IL-1β, IL-5, IL-10, IL-17A, and MCP-1 and a decrease in the content of IL-2 and TNF-α according to compared with the control group. Capsaicinoids administered to rats of group 3 provided an increase (p < 0.05) in the levels of: IL-2, IL-4, IL-5, IL-6, IL-10, IL-17A, MIP-1α and TNF-α and a decrease (p < 0.05) in the content of IL-12(p70) and MIP-2 compared to groups 2 and 1. Due to this influence, the median ratio of the level of IL-10 to IL-12(p70) increased significantly (1.52 vs 0.29 and 0. 23), but the median IL-10/17A remained significantly lower than the control value (1.54 vs 3.07). CONCLUSION . The anti-inflammatory effect of capsaicinoids in the extract of hot capsicum on nutritional obesity in rats has been established.

Multiple endocrine neoplasia type 1 (MEN-1) is a rare hereditary disorder characterized by the development of multifocal tumors in endocrine organs. This article presents a clinical case of a female patient with a confirmed MEN1 mutation (c.203delC p.T70fsX118), who exhibited manifestations of various syndrome components over more than 10 years, including parathyroid adenomas, pancreatic neuroendocrine tumors, and a pituitary microprolactinoma. The patient underwent multiple surgical interventions: duodenopancreatectomy, parathyroidectomy with autotransplantation, adrenal resection, and esophageal leiomyoma removal. The study discusses the challenges in diagnosing the primary source of parathyroid hormone secretion, the difficulties in achieving optimal glycemic control due to absolute insulin deficiency following fulminant diabetes mellitus development after total pancreatectomy, as well as aspects of reproductive health and quality of life. This case highlights the importance of a personalized approach and multidisciplinary management in patients with MEN-1 syndrome.