Impaired Carbohydrate Tolerance Research Articles

Itch prevalence analysis and its characteristics among acne patients

Introduction. Acne is a multifactorial chronic inflammatory disease of the pilosebaceous follicle, which manifests itself as open and closed comedones, papules, pustules and nodules.Purpose of the study. Studying of itch prevalence among patients with acne, as well as assessing its impact on their quality of life and psychoemotional status.Materials and methods. Under observation were 249 patients diagnosed with acne aged from 12 to 50 years, of which 143 women (57.4%), 106 men (42.6%). Patients were diagnosed based on complaints, anamnesis and clinical picture of the disease. To assess the impact of itching on the quality of life, the Acne Psychological and Social Effect Scale (APSEA), the Dermatological Life Quality Index (DLQI), the Cardiff Social Disadaptation Index (CADI), the Rosenberg self-esteem scale, and a self-developed questionnaire were used to assess the impact of itching on the quality of life. Questionnaire, YOUR itch.Results. To solve these problems, based on the criteria for inclusion, non-inclusion and exclusion, two clinical comparison groups were formed, comparable in terms of main clinical diagnostic indicators. The first group consisted of patients with itching due to acne (64 people, 26% of subjects), the second group consisted of patients with no itching (185 people, 74% of subjects). According to the results of the study, a statistically significant relationship between the presence of itching in acne and age, gender, the presence of obesity, impaired carbohydrate tolerance, iron deficiency anemia, hyperprolactinemia was revealed, various characteristics of itching in the subjects were described, and a close correlation of the indicators of the indices used was revealed.Conclusions. Studying the prevalence of itching in acne is a relevant area and allows us to expand our understanding of the role of subjective sensations in the development of acne and further evaluate the impact of this dermatosis on the quality of life of patients.

Significance of the rs754635 variant of the cholecystokinin gene in the development of obesity in children

So far, the possible influence of single nucleotide variants (SNV) of the cholecystokinin (CCK) gene on the likelihood of developing obesity and metabolic disorders in children has not been demonstrated. The aim of the study SNV associations of the CSK gene to predict the probability of obesity and personalize the development trajectory of various metabolic disorders associated with obesity in children. Materials and methods. 252 obese children aged 6-18 years were examined. The main group (n=152) was represented by children with metabolically unhealthy obesity (MUO). The control group (n=100) consolidated of children with metabolically healthy obesity (MHO). Whole genome sequencing (CeGat, Germany) was performed in 31 children of the main and 21 children of the control group. Serum levels of interleukin-1β were measured using a chemiluminescent immunoassay (CLIA) method, interleukin-6 - by enzyme-linked immunosorbent assay (ELISA), Synevo, Ukraine. Results. The G allele of SNV rs754635 of the CCK gene was significantly more frequent among children with both MHO (t=10.93; p<0.05) and MUO (t=12.96; p<0.05) compared to healthy individuals. The G allele of SNV rs754635 of the CCK gene was associated with basal hyperglycemia (r=0.44) and impaired carbohydrate tolerance (r=0.33) in the MHO phenotype and with the atherogenicity index of the lipid spectrum (r=0.40) and was inversely correlated with the level of high-density lipoproteins (HDL) (r=-0.58) in children with MUO phenotype, p<0.05. Conclusions. The G allele SNV rs754635 of the CCK gene is associated with obesity and the development of metabolic disorders. The research was carried out in accordance with the principles of the Declaration of Helsinki. The research protocol was approved by the Local Ethics Committee of the institution mentioned in the work. Informed consent of parents or their guardians was obtained for conducting research. No conflict of interests was declared by the author.

KISSPEPTIN SIGNALING IN MENSTRUAL DISORDERS IN OBESE ADOLESCENT GIRLS

Background. Menstrual cycle disorders (MCD) are common among adolescent girls.Objective. To study the level of plasma kisspeptin in adolescent girls with obesity and MCD.Design and methods. The study included 80 adolescent girls with obesity. Group 1 — with MCD, group 2 — without MCD. Inclusion in groups 1 year or more after menarche. Laboratory examination included assessment of carbohydrate and lipid metabolism, hormonal examination.Results. There were no significant differences in SDS BMI between the groups (p = 0.486 and p = 0.459). Significantly higher in group 1: impaired carbohydrate tolerance (NTU), hypertriglyceridemia (p = 0.022), levels of kisspeptin, luteinizing hormone (LH), total testosterone, anti-muller hormone (AMH), free androgen index (ISA) (p = 0.001, p = 0.008, p = 0.026, p = 0.014, p = 0.027, respectively). The estradiol level in group 2 was significantly higher than in group 1 (p = 0.012). According to the results of the ROC analysis, the optimal value of the plasma kisspeptin level was found to be 53.56 pg/ml.Conclusion. Obese and MCD patients have significantly higher levels of kisspeptin, as well as LH, AMH, and testosterone than adolescent girls with similar severity of obesity without MCD. The plasma kisspeptin level is 53.56 pg/ml. It can be used as a new diagnostic criterion for predicting the risk of MCD in obese girls. Obese and MCD patients are significantly more likely to have NTU and hypertriglyceridemia compared to obese patients without MCD.

Overweight and dysregulation of the autonomic nervous system in young persons

Background. More than 1 billion people worldwide are obese, and this number is growing. Obesity at an early age is accompanied by impaired carbohydrate tolerance and the development of type 2 diabetes, lipid metabolism pathology, obstructive apnea, hypercoagulability, chronic inflammation and the development of insulin resistance in the future. In modern literature, there is no single point of view regarding the role of the autonomic nervous system in the coordination of hormonal, nervous and metabolic factors in the body.Aim. The article presents the results of studying the functional state of the sympathetic and parasympathetic parts of the autonomic nervous system in overweight persons and presents an assessment of the central hemodynamic parameter depending on the type of autonomic reactivity of the cardiovascular system.Methods. The study involved measuring systolic and diastolic blood pressure, heart rate, and anthropometric measurements for calculating the corresponding indices. An active orthostatic test to determine the functional state of reflex mechanisms for regulating hemodynamics. Statistical methods were used for data analysis.Results. Based on anthropometric indicators and calculated indices, boys and girls with overweight differed from the control group in abdominal and total distribution of fat. However, there were no differences in terms of vegetative tone (sympathicotonic, vagotonic, eutonic). The distribution of eutonic and vagotonic types of the autonomic nervous system and sympathicotonia was similar in both groups. Most overweight individuals had insufficient reactivity of the parasympathetic autonomic nervous system. Paradoxical reactivity in both groups was observed with the same frequency. In the group of people with paradoxical autonomic reactivity among overweight people, a significantly lower increase in heart rate was found than in the control group. In persons with overweight and increased autonomic reactivity, minute blood volume and pulse pressure increased 1.5-fold, there was a tendency to increase stroke volume and inotropic function of the heart. The increase in this characteristic indicated a hyperkinetic type of hemodynamics in overweight persons in the group with normal autonomic reactivity. In groups with paradoxical and increased autonomic reactivity of the cardiovascular system, a normokinetic type of hemodynamics was observed.Conclusions. Signs of altered autonomic reactivity found in most overweight individuals indicate dysfunction of the parasympathetic autonomic nervous system and possible dysfunction of nonspecific regulatory (limbic-reticular) parts of the brain.

Коморбідні стани при ожирінні у дітей

Background. The unfavorable demographic situation in Ukraine is due to the spread of diseases of civilization (obesity, diabetes mellitus (DM), dyslipidemia, arterial hypertension, metabolically associated fatty liver disease) and requires early diagnosis, personalized treatment, and improvement of ways to prevent these diseases especially in childhood. About 15 million people die from non-communicable diseases every year. The mortality rate caused by the diseases of civilization is increased in a certain category of people who are included in the group of "high risk" regarding metabolic disorders. The aim of the study: to identify the contribution of comorbid conditions (impaired fasting glycemia/car-bohydrate tolerance, dyslipidemia, metabolically-associated fatty liver disease (MAFLD), arterial hypertension) to the development of meta-bolically unhealthy obesity (MUO) in children. Materials and methods. 210 obese children aged 6-18 years were examined. The main group (n = 128) were children with MUO according to the criteria of IDEFICS 2014. The control group (n = 82) were children with metabolically healthy obesity (metabolically healthy obesity — MHO). All children underwent a general clinical, immunobiochemical examination with electroche-miluminescence detection, enzymatic colorimetric method in the certified laboratory "Synevo" (Dnipro, Ukraine), sonographic and bioimped-ance examination. Static analysis included variational analysis with calculation of Student’s test (t); sequential Wald analysis with calculation of relative risk (RR); Spearman’s correlation analysis by calculating the Spearman’s rank correlation coefficient (ρ). The critical value of the level of statistical significance (p) for all types of analysis was accepted at the level of p < 0.05 (5 %). Results: In patients with MUO, violations of tolerance to carbohydrates are registered in 26.7 %, dyslipidemia — in 53.3 %, metabolic-associated fatty liver disease — in 66.6 %, arteri-al hypertension — in 46.6 % of cases. Whereas among patients with MHO, metabolic-associated fatty liver disease is diagnosed in 10 % and dyslipidemia in 5 % of cases. The relative risk of developing MUO is most associated with basal hyperinsulinemia (9,33); sonographic criteria of heterogeneity of liver tissue according to Saverymuttu (6.33); extreme obesity (6); ALT/AST ratio ≥ 1 (3.56); sonographic criteria of hep-atomegaly (3.33); an increase in diastolic (3.07) and systolic blood pressure (2.27) and a decrease in high-density lipoproteins. Conclusions: The metabolic-associated fatty liver disease is the most frequent comorbid condition found in various phenotypes of obesity in children.Keywords: metabolically unhealthy obesity, metabolically healthy obesity, impaired carbohydrate tolerance, arterial hypertension, dyslipidemia, metabolically associated fatty liver disease.

Impaired carbohydrate tolerance as a risk factor for ischemic heart disease among the population of the Fergana Valley of the Republic of Uzbekistan

In the Fergana Valley of the Republic of Uzbekistan, where about 70% of the population is engaged in agriculture, epidemiological studies on IHD in connection with the combination of risk factors among rural men and women of working age have not been carried out, which makes it impossible to fully assess the epidemiological situation in our region. The aim of the research was to study the epidemiological conditions in relation to IHD in connection with ICT and other risk factors. To identify IHD and risk factors, we chose a continuous method of epidemiological examination using the Rose questionnaire, blood pressure measurements, ECG decoding according to the Minnesota code, glucose tolerance test, anthropometric and biochemical studies. When analyzing the prevalence of IHD in the quintile distribution of risk factors among men and women, a high correlation was found with an increase in blood glucose levels on an empty stomach and 2 hours after exercise. To determine the group for the prevention of IHD, we used a logistic model that allows us to calculate the individual risk, considering the presence and potential of risk factors. Evaluation of the informativeness of each risk factor showed that both in men and women, ICT has the highest prognostic value for IHD. In a mass survey of the rural population of the Fergana Valley, to identify IHD and the contingent “threatened” in relation to IHD, it is necessary to widely conduct a carbohydrates tolerance test.

The risk of hepatocellular carcinoma of the liver in non-alcoholic fatty liver disease: features of prevention and treatment

Relevance. Non-alcoholic fatty liver disease (NAFLD) is a multidisciplinary problem and occupies a significant place among chronic non-communicable diseases (CNCDs). The main causes of death from this nosology are cardiovascular pathology and neoplasms. This article discusses the main problems of underestimation of diagnosis in patients with high cardiovascular risk of NAFLD. In particular, attention is paid to the risks of developing hepatocellular carcinoma without previous cirrhosis. The aim of the study was to describe a typical portrait of a patient with a very high cardiovascular risk (CVR) with NAFLD and the features of the prevention of hepatocellular carcinoma (HC) in this category of patients. Research materials. The case history of a patient with stage 3 arterial hypertension, functional class II (FC) angina pectoris, postinfarction cardiosclerosis in combination with NAFLD in the stage of liver steatosis, stage 1 obesity, and impaired carbohydrate tolerance is presented. Results. Against the background of corrected antihypertensive therapy, blood pressure and heart rate returned to normal. The level of transaminases approached the reference values, there was a tendency to reduce total cholesterol, low density lipoproteins, triglycerides. According to volumetric sphygmography, vascular age began to approach the passport age, the augmentation index became within negative values, the ankle-brachial index remained unchanged, and an increase in endothelial function was observed. Conclusion. This clinical case provides an example of successful treatment of NAFLD and dyslipidaemia in a patient with very high CV risk. With this in mind, it is necessary to timely use drugs that directly affect the stages of the formation and progression of NAFLD, which should be actively prescribed for the prevention of GC.

PECULIARITIES OF THE ORGANISM'S REACTION TO DOSED HYPOXIA IN ELDERLY PEOPLE WITH IMPAIRED GLUCOSE TOLERANCE

Background. The incidence of carbohydrate metabolism disorders increases with age, resulting in a significantly increased risk of cardiovascular disease. Hypoxia plays an important role in the pathogenesis of carbohydrate metabolism disorders. The aim – to establish the features of carbohydrate metabolism in hypoxia in the elderly with impaired carbohydrate tolerance.
 Materials and methods. 20 elderly people with impaired glucose tolerance and 23 elderly people with preserved glucose tolerance were examined. Determined the concentration of glucose and insulin in the blood when breathing air with an oxygen content of 12%.
 Results. With hypoxia in people with impaired glucose tolerance, the decrease in saturation is more significant than in people with preserved glucose tolerance. Shifts in glucose concentration in hypoxia in people with impaired glucose tolerance are greater, but the ratio of Δ glucose concentration/ΔSpO2 is higher than in people with preserved glucose tolerance. Shifts in the concentration of insulin in the blood during hypoxia did not differ in people with different glucose tolerance, but the ratio of Δinsulin concentration /ΔSpO2 in people with impaired glucose tolerance is less. In people with impaired glucose tolerance, a relationship was found between glucose levels after 120 minutes of glucose tolerance test and SpO2 shifts in hypoxia, as well as a relationship between HOMA index and SpO2 shifts in hypoxia.
 Conclusions. Elderly people with impaired glucose tolerance have reduced resistance to hypoxia and increased utilization of glucose in hypoxia, due to smaller changes in insulin concentrations. At the same time at them disturbance of a carbohydrate metabolism depends on resistance to a hypoxia.

Diabetes mellitus postoperatif hipoparatiroidizm için bir risk faktörü olabilir mi?

Aim: Postoperative hypoparathyroidism (postop hypoPT) is usually seen after aggressive neck surgery, and can be fatal if left untreated. To the best our knowledge there is no study in literature that directly investigates the association between diabetes mellitus (DM) and postop hypoPT. In this study, we aimed to determine whether DM increases the risk of permanent postop hypoPT. Materials and Methods: Patients presenting to endocrinology outpatient clinic with a diagnosis of permanent postoperative hypoparathyroidism, were studied retrospectively. Patients older than 18 years of age were included in the study if one year had passed after the neck operation. Results: The average age of 131 patients who met the inclusion criteria was 49 ± 12. 93.9% of the patients were women and the patients were generally obese or overweight (mean body mass index= 30±5.29 kg/m2). While 14.5% of the patients were diabetic and 32.8% prediabetic (47.3% had impaired carbohydrate tolerance), 52.7% had normal glucose metabolism. Conclusion: The rate of DM / prediabetes (preDM) in patients diagnosed with postop hypoPT and the prevalence of DM / preDM in Turkish population were similar. Even though DM is associated with endothelial dysfunction, our findings suggest that DM is not a risk factor for postop hypoPT.

Rationale for the use of hypo-hyperoxic training in patients with metabolic syndrome

Recently, the interest of scientists around the world in studying the relationship of metabolic disorders and obesity with the growth of cardiovascular diseases has increased significantly. Pharmacological medicine does not yet have effective drugs with which it is possible to solve the problem of metabolic syndrome in a complex, therefore, drugs are most often used to reduce cholesterol levels in the blood, blood pressure, appetite suppression to reduce body weight, etc. In recent years, the method of interval hypoxic and hypoxic-hyperoxic training has been very intensively researched and applied in clinical practice as a modern highly effective physical method of prevention and treatment of various diseases. It was found that with the course use of IGT, a complex of compensatory responses develops: optimization of the functioning of the sympatho-adrenal system; changes in the metabolism of lipids and lipoproteins due to the activation of key enzymes that catalyze the esterification of cholesterol and regulate the formation of high-density lipoproteins. Such a systemic response of the body is very important in people with insulin resistance, metabolic syndrome and impaired carbohydrate tolerance.

Первый российский опыт применения касиривимаба/имдевимаба при COVID-19

The lack of effective etiotropic therapy is a serious challenge in the treatment of patients with COVID-19. The recent emergence of a new class of medications neutralizing monoclonal antibodies against the SARS-CoV-2 spike protein allows to partially solve this problem. This article presents a clinical case of a patient with an increased risk of COVID-19 complications (paroxysmal atrial fibrillation, atherogenic dyslipidemia, impaired carbohydrate tolerance) who was treated with 600 mg casirivimab and 600 mg imdevimab by intravenous infusion. A significant improvement in the patient's well-being was noted within the first 24 hours: normalization of body temperature, stool, reduction of weakness, disappearance of arthralgia and myalgia. After 48 hours, a negative test result for SARS-CoV-2 RNA was obtained, which altogether made it possible to state the recovery. There were no adverse events during and after therapy. The casirivimab and imdevimab monoclonal antibody combination may be considered as a promising etiotropic treatment for COVID-19. Key words: COVID-19, monoclonal antibodies, casirivimab, imdevimab, treatment

КОМОРБИДНЫЕ СОСТОЯНИЯ ПРИ ОЖИРЕНИИ У ДЕТЕЙ И ПОДРОСТКОВ И СОВРЕМЕННЫЕ ТЕХНОЛОГИИ ИХ ДИАГНОСТИКИ

The review presents modern views of not only the long-known comorbid conditions and obesity in children and adolescents, including arterial hypertension, dyslipidemia, steatohepatosis, impaired carbohydrate tolerance and type 2 diabetes, but also less studied comorbid associations with overweight in childhood: ectopic deposition of fatty tissue, reproductive and psychological disorders, orthopedic problems and disorders of the gastrointestinal tract. It is emphasized that only a comprehensive interdisciplinary approach to the observation and treatment of obesity can help in the development and implementation of a personalized and therefore more effective selection of therapeutic and preventive interventions.

Thermogenesis, aging and obesity in the LA Ntul/-cp (corpulent) rat

Obesity and mild to moderate impaired carbohydrate tolerance develops in the obese phenotype of the LA/Ntul//-cp (corpulent) rat strain by 6 weeks of age. Groups (n=12-20 rats/phenotype] of female congenic lean and obese LA/Ntul//-cp (corpulent) rats were fed ad libitum standardized Purina #5012 diet ad house water for 4, 14, or 24 months of age. Measures of Body weight (BW) and of resting oxygen consumption (RMR; VO2) at thermal neutrality and for up to 45 minutes of (4°C) spontaneous cold exposure, and norepinephrine-stimulated thermogenesis (100 ug. s.c.) were determined at each age. Body weights of lean rats increased only gradually during the study (p=n.s.), but weights of obese phenotype were ~2-fold greater at 4 months (p=<0.05), 14 months (p-<0.01), and ~3.5 to 4-fold greater at 24 months of age (p=<0.01). Resting metabolic rates in the lean phenotype trended to decrease modestly by 24 months (p=<0.05) and were greater than resting metabolic rates in the obese phenotype at all ages studied (p=<0.05). Cold exposure at 4°C resulted in a dramatic ~5-fold increase in the oxygen consumption after 5 minutes in 4-month-old rats, which subsided to ~2x resting metabolic rate within 15 minutes and remained constant thereafter in the lean phenotype. In 14-months old lean rats the increase in oxygen consumption at 5 minutes averaged ~4-fold increase over resting levels and returned to ~2x resting levels from 15 to 45 minutes 4°C exposure. In 24-month-old lean rats however, the cold induced increases in metabolism were markedly diminished to only ~3x resting metabolic rates at 5 minutes cold exposure but remained similar to the other lean age groups thereafter. In the obese phenotype, the peak responses at 5 minutes were lower than those of lean rats at 5 minutes in 4- and 14-month-old rats and were significantly impaired in 24-month-old rats at all times measured. Norepinephrine resulted in a >1.5-fold increase in oxygen consumption in the lean phenotype at all ages studied, while in obese rats norepinephrine resulted in a~1.4-fold increase in oxygen consumption at 4 months of age with non-significant ~1.1 to 1.2-fold increases at the two older ages. In both phenotypes, the resting and the norepinephrine-stimulated oxygen consumption responses tended to decrease with increasing age. The results of this study demonstrate that the body weights of the obese phenotype are significantly greater than their lean littermates throughout the age spectrum studied, and that both resting metabolic rates, 4°C cold, and norepinephrine-stimulated thermogenesis are decreased in the obese compared to the lean phenotype and become further decreased with advancing age

Meta-Analysis: Effects of Obesity and Family History of Diabetes Mellitus on the Risk of Gestational Diabetes Mellitus

Background: Gestational diabetes mellitus is a serious complication of pregnancy, this is due to impaired carbohydrate tolerance which results in increased blood sugar levels and was first noticed during pregnancy. Gestational dia­betes mellitus is a global problem in terms of its incidence and impact. Studies suggest that obe­sity and a family history of diabetes mellitus are important risk factors for diabetes mellitus. This study aimed to analyze the influ­ence of obesity and family history of diabetes mellitus on the incidence of dia­betes mellitus by meta-analysis. Subjects and Method: This was a systematic review and meta-analysis carried out by follow­ing the PRISMA flow diagram. The electronic database for article searches is as follows: Pub­Med, Science Direct, Springer Link, Scopus, and Google Scholar. The search for articles was carried out on articles published from 2010 to 2020. The keywords used were gestational dia­betes mellitus AND gestational dia­betes mellitus AND family history. The inclu­sion criteria were full text articles, used Eng­lish, cross-sectional study design, and results reported in adjusted odds ratio (aOR). P= Preg­nant mother. I= Obesity and family history of diabetes mellitus. C= No obesity and no family history of diabetes mellitus. O= dia­betes mellitus. Articles that meet the require­ments are analyzed using the Revman 5.3. Results: Nine articles were reviewed in this study with a total of 11,657 subjects. The results of the meta-analysis showed that obesity incre­ased the risk of diabetes mellitus 1.81 times compared with non-obese (aOR= 1.81; 95% CI= 1.53 to 2.15; p <0.001). Having a family history of diabetes mellitus increased the risk of diabetes mellitus 2.08 times compared with those without a family history of diabetes mellitus (aOR= 2.08; 95% CI= 1.34 to 3.22; p <0.001). Conclusion: Obesity and a family history of diabetes mellitus increase the risk of gesta­tional diabetes mellitus. Keyword s : obesity, family history of diabetes mellitus, diabetes mellitus Correspondence: Galuh Sitorukmi. Masters Program in Public Health. Universitas Sebelas Maret, Jl.Ir. Sutami 36A, Surakarta 57126, Central Java. Email: galuh.sitorukmi1210@gmail.com. Mobile: 085­799333013. Indonesian Journal of Medicine (2021), 06(01): 1-13 https://doi.org/10.26911/theijmed.2021.06.01.01.

The screening study of the hypoglycemic activity of herbal mixtures (presentation 3)

Diabetes mellitus is an important social and medical problem as it causes the development of dangerous complications leading to disability and mortality. This disease is characterized by a multi-vector pathogenesis that requires a comprehensive approach to the treatment. Due to the use of mixtures of medicinal plants in the treatment of diabetes it is possible to cover all aspects of the development of this disease and its complications.Aim. To study the hypoglycemic activity of herbal mixtures used in folk medicine for the prevention and treatment of diabetes mellitus type 2, and determine their conditional therapeutic dose.Materials and methods. The study was performed on male albino rats weighing 180-200 g. For the preventive treatment within 20 days they received orally the aqueous extracts (1:10) of the herbal mixtures studied in the doses of 6 mL/kg/day, 9 mL/kg/day and 12 mL/kg/day and the reference drugs – the official herbal mixture “Arfazetin” in the dose of 9 mL/kg/day and metformin tablets in the dose of 60 mg/kg/day. The study of hypoglycemic properties and determination of the conditional therapeutic dose of the mixtures studied were performed using glucose loading tests (oral glucose tolerance test – OGTT and intraperitoneal glucose tolerance test– IPGTT). All experiments were performed in accordance with general ethical principles with the recommendations of the EEC Council Directive 2010/63/EU about the protection of animals used for scientific purposes.Results and discussion. The results of the study showed that the 20-day preventive treatment with the herbal mixtures reduced alimentary hyperglycemia 30 minutes after OGTT and regulated carbohydrate tolerance disorders by reducing hyperglycemia 15 minutes after IPGTT. The herbal mixture No. 13 in the dose of 12 mL/kg/day showed the highest hypoglycemic activity, which was almost similar with the reference drug – metformin tablets, but exceeded the official herbal mixture “Arfazetin” by its efficiency. In addition, the dose-dependence of the effectiveness of all five herbal mixtures studied was determined.Conclusions. For the first time, the screening study of the hypoglycemic activity of herbal mixtures used in folk medicine for the prevention and treatment of diabetes mellitus type 2 has been conducted. It has been determined that the herbal mixture No. 13 containing Cichorii radices, Elymi repens rhizomata, Helichrysi arenarii flores, Rosae fructus, Maydis style cum stigmatis shows the highest effectiveness by the ability to reduce alimentary hyperglycemia during OGTT and reduce impaired carbohydrate tolerance during IPGTT. Its conditional therapeutic dose, which is 12 mL/kg/day, has been determined.

Peculiar features of glucose homeostasis in patients suffering from non-alcoholic steatohepatitis with comorbid obesity and osteoarthritis on the background of metadoxine and guar gum administration

To determine the probable effect of metadoxine and guar gum on glucose homeostasis during the comorbid course of non-alcoholic steatohepatitis (NASH) with obesity and osteoarthritis (OA).Material and methods. 60 patients (30 men and 30 women) with the indicated comorbidity were examined and divided into three groups: patients of group 1 - control (C) (n = 20) took Essentiale H 1 capsule 3 times a day, patients in group 2 - main group 1 (M1) (n = 20) - received metadoxine (Liveria IC) at 0.5 g twice daily, in 3 - main group 2 (M2) (n = 20) - in addition to metadoxine patients received guar gum (Guarem) 1 sachet (5 g) 2 times a day. The groups were randomized to age, sex, obesity and cytolytic syndrome activity. The control group consisted of 30 practically healthy individuals of the same age and gender. The average age of patients was (62,3 ± 5,7) years.Conclusions. The conducted analysis showed that the course of treatment with metadoxine and guar gum proved the ability to achieve stable normalization of carbohydrate metabolism over a long period of time, since guar gum together with metadoxine enhance rapid compensation of carbohydrate metabolism with impaired carbohydrate tolerance, ability to resensitize insulin receptors and eliminate insulin resistance syndrome.

X-ray computer densitometry in the diagnosis of fat hepatosis

Currently, the problem of reducing the risk of developing fat liver hepatosis from exposure to household and industrial toxicants among the working-age population continues to be an important medical and social problem, since not timely diagnosis of the disease can lead to its progressive course with the development of inflammatory changes, necrosis and liver fibrosis up to cirrhosis and hepatocellular cancer. In this regard, the search for methods and techniques that optimize the diagnosis of fat hepatosis is relevant. Modern methods of radiation diagnostics of liver density characteristics can significantly reduce subjectivity in the assessment of changes due to the use of quantitative indicators. The aim of study - improving the quality of x-ray diagnostics of fat liver disease based on a precision assessment of the density of the liver parenchyma using computed tomography. A comparative retrospective analysis of the results of a comprehensive clinical and radiological examination of 115 men of working age in the range of 40-55 years was performed. The main group (48 people) - employees of machine-building plants: shapers, stumpers, fitters-assemblers who had industrial contact with such factors as local vibration, dust, noise, muscle strain, burdened with a long alcoholic history and the presence of signs of metabolic syndrome: hyperlipidemia, impaired tolerance to carbohydrates, diabetes, abdominal obesity. The comparison group included representatives of auxiliary professions without clinical signs of pathology (47 people), comparable in age and experience with the main group. X-ray examinations were performed using computer tomographs: "HI Spead CT/e Dual" by GE Medical Systems and "Aqulion 64" by Toshiba. To measure the liver density in Hounsfield units (HU), the ROI (zone of interest) tool was used, which allows determining the desired value over areas of different dimensions. Measurements were performed on computer screens in 4 zones of interest at 4 levels of scanning of the liver lobes (apex, level of the caval gate, level of the left lobe, level of the portal gate) with the calculation of the average values of the density index (IDH) and density gradients (IDG) relative to the aorta, spleen and kidney. Analysis of the results of a posteriori CT densitometry of various parts of the liver within the framework of the developed algorithm, including the use of absolute and relative (gradient) x-ray density indicators of hepatic, vascular (aorta),splenic and renal structures, allowed us to expand our understanding of the quantitative density characteristics both in normal and in patients with signs of diffuse fat hepatosis (FH). It was found that the liver parenchyma density indicators can be a kind of (conditional), sometimes the only indicators of the degree of severity of changes that objectively manifest positive or negative dynamics of pathophysiological processes and, in particular, at the initial stages of the development of the studied pathology. Density differences in the right and left liver parenchyma in the control group (conditional norm) in terms of absolute density and its gradient, regardless of the level of scanning, were insignificant (statistically unreliable). In patients with clinical signs of fatty liver infiltration at the stage of steatosis, in the absence of x-ray morphologically detectable structural changes, a decrease in IDH and the dynamics of its increase (recovery) at various stages of observation were revealed. Even with comparatively equal IDH of the evaluated departments, the IDG of different people differed, manifesting the individuality of metabolic processes occurring in the body, in particular in the liver, is a kind of indicator of their direction and severity. The significance of density indicators as predictors of the subsequent stages of the pathology under consideration was particularly evident in the analysis of the results of primary diagnostics and its development in the dynamics of observations. The application of the developed methodological approach allowed us to expand our understanding of the possibilities of KT-liver densitometry in patients with metabolic syndrome (hyperlipidemia, impaired carbohydrate tolerance, diabetes mellitus, abdominal obesity) in the diagnosis of fatty liver disease (FLD) at various stages of examination, including in the early subclinical phases of pathology development. The results obtained indicate the predominant role of ethyl alcohol as a hepatotoxicant in the development of FLD in the estimated cohort of the working-age population. The use of an original algorithm for evaluating tissue density makes it possible to significantly ensure the objectivity of the interpretation of research results.

Макросомія плода: акушерські, психологічні та соціальні аспекти

One of the main markers of socially unfavorable pregnancy is anthropometric indicators of newborns. They reflect not only the narrow medical problems of complicated gestation but also social problems in general, the quality and access to the medical care. The objective: to determine the risk factors for fetal macrosomia in pregnancy with high levels of psychosocial stress. Materials and methods. The course of pregnancy and childbirth, demographic and medical risk factors for a fetal macrosomia were analyzed in 140 pregnant women with different levels of psychosocial stress. They were divided into 2 groups: 1 group (main) – 56 women-forced migrants from Luhansk and Donetsk regions, 2 group – 84 women with low and moderate level stress according to the questionnaires and psychological tests (L. Reeder, Spielberg–Khanin scale). Results. Gestational diabetes was the main reason for the birth of heavy children in both groups. Women–forced migrants had late manifestation of impaired tolerance to carbohydrates and a higher frequency of pathological weight gain. Male neonates are at risk for macrosomia. Childbirth in women with macrosomia is accompanied by a high frequency of complications and abnormal births. Conclusions. The frequency of births of macrosomic children in women - forced migrants is higher than in women at low risk of psychosocial stress. Risk factors in this group of pregnants include: the level of stress and behavioral responses to stress, impaired carbohydrate tolerance due to gestational diabetes, abnormal weight gain due to malnutrition and male sex of the fetus. Keywords: macrosomia, pregnancy, childbirth, women–forced migrants psychosocial stress, gestational diabetes, weight gain.

Screening of hypoglycemic activity of herbal mixtures (message ІІ)

Topicality. Diabetes mellitus is an important social and medical problem, as it causes the development of dangerous complications that lead to disability and mortality. This disease is characterized by a multi-vector pathogenesis that requires a comprehensive approach to treatment. Due to the use of mixtures of medicinal plants in the treatment of diabetes, it is possible to cover all aspects of the development of this disease and its complications. In addition, the niche of the pharmaceutical market of Ukraine with phytomixtures is almost empty.Aim. To study the hypoglycemic activity of the herbal mixtures, which are used in folk medicine for diabetes mellitus type 2 prevention and treatment, but do not have a scientific basis and to establish their conditional therapeutic dose.Materials and methods. The study has been performed in male albino rats weighing 180-200 g, during 20 days they have been receiving orally for preventive treatment aqueous extracts (1:10) of the studied herbal mixtures at a dose 6 mL/kg/day, 9 mL/kg/day and 12 mL/kg/day and comparison drugs – the official herbal mixtures “Arfazetin” at a dose 9 mL/kg/day and tablets metformin at a dose 60 mg/kg/day. The study of hypoglycemic properties and the establishment of a conditional therapeutic dose of the studied mixtures was carried out using glucose loading tests. All experiments have been performed in accordance with general ethical principles with the recommendations of the EEC Council directive 2010/63/EU about the protection of animals used for scientific experiment.Results and discussion. The results of the study showed the 20-day preventive treatment by the herbal mixtures reduced alimentary hyperglycemia at the 30th minutes of OGTT and helped regulate carbohydrate tolerance disorders by reducing hyperglycemia at the 15th minutes of IPGTT. The highest hypoglycemic activity showed the herbal mixture No. 7 in a dose 12 mL/kg/day, which was almost on a par with the comparison drug – tablets metformin, but exceeded the official herbal mixture “Arfazetin”. In addition, the dose-dependence of the effectiveness of all five studied herbal mixtures was established.Conclusions. For the first time, it was conducted the screening study of hypoglycemic activity of the herbal mixtures, which are used in folk medicine for the prevention and treatment of diabetes mellitus type 2. It was determined that the greatest effectiveness in terms of the ability to reduce alimentary hyperglycemia during OGTT and reduce impaired carbohydrate tolerance during IPGTT show the herbal mixture No. 7, which includes Inulae rhizomata et radices, Helichrysi arenarii flores, Maydis style cum sigmatis, Origani herba, Rosae fructus, Taraxaci radices. It was established its conditional therapeutic dose 12 mL/kg/day.

Screening study of hypoglycemic activity of the herbal mixtures (message 1)

The aim. To study the hypoglycemic activity of the herbal mixtures, which are used in folk medicine for the prevention and treatment of diabetes mellitus type 2, but do not have a scientific basis and to establish their conditional therapeutic dose.Materials and methods. The study was performed on male albino rats weighing 180-200 g, which for preventive treatment during 20 days orally received aqueous extracts (1:10) of the studied herbal mixtures at a dose 6 mL/kg/day, 9 mL/kg/day and 12 mL/kg/day and comparison drugs – the officinal herbal mixtures “Arfazetin” at a dose 9 mL/kg/day and metformin tablets at a dose 60 mg/kg/day. The study of hypoglycemic properties and the establishment of a conditional therapeutic dose of the studied mixtures was carried out using glucose loading tests. All experiments were performed in accordance with general ethical principles with the recommendations of the EEC Council directive 2010/63/EU about the protection of animals, which are used for scientific purposes.Results. The results of the study showed that the 20-day preventive treatment by the herbal mixtures reduced alimentary hyperglycemia at the 30th minutes of OGTT and helped regulate carbohydrate tolerance disorders by reducing hyperglycemia at the 15th minutes of IPGTT. The highest hypoglycemic activity showed the herbal mixtures No. 3 (12 mL/kg/day) and No. 4 (12 mL/kg/day), which was almost on a par with the comparison drug –metformin tablets, but exceeded the officinal herbal mixture “Arfazetin”. In addition, the dose-dependence of the effectiveness of all five studied herbal mixtures was established.Conclusions. For the first time, it was conducted the screening study of hypoglycemic activity of the herbal mixtures, which are used in folk medicine for the prevention and treatment of diabetes mellitus type 2. It was determined that the greatest effectiveness in terms of the ability to reduce alimentary hyperglycemia during OGTT and reduce impaired carbohydrate tolerance during IPGTT show the herbal mixtures No. 3 (which includes Urticea folia, Cichorii radices, Rosae fructus, Elymi repens rhizomata, Taraxaci radices) and No. 4 (which includes Arctii lappae radices, Elymi repens rhizomata, Maydis style cum sigmatis, Helichrysi arenarii flores, Rosae fructus). It was established their conditional therapeutic dose of 12 mL/kg/day