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Objective: To evaluate the possibility of using fibroblast growth factor 21 (FGF 21) as a marker of metabolic disorders and premature aging in polymorbid cardiovascular pathology. Research methods: 199 men aged 35-55 years who were stratified into 3 groups were examined: group A - 117 patients with type 2 diabetes mellitus (type 2 diabetes), polymorbid cardiovascular disease (PCVD), obesity, androgen deficiency and anxiety-depressive disorders (ADD); group B - 55 patients with PCVD, obesity and ADD; group C - control group (n = 27). The examination of patients included a laboratory study of the level of FGF 21, indicators of carbohydrate and lipid metabolism, hormonal status, as well as daily monitoring of blood pressure and ECG. Results and conclusions. When compared with the control group, the level of FGF 21 was 3 times higher in the presence of type 2 diabetes. The most intense increase in FGF 21 levels was observed in groups of patients with several diseases. An increase in the level of FGF 21 in young and middle-aged people is probably due to a compensatory reaction to the existing androgen deficiency, disorders of carbohydrate and lipid metabolism. Strong correlations between FGF 21 and glucose, HDL cholesterol, total testosterone, ALT, and SBP during the day allow FGF 21 to be considered an early marker of cardiovascular disease and premature aging (PA) in young and middle-aged people

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BACKGROUND: Gestational diabetes mellitus is a significant medical and social problem in most countries. Despite the relatively high level of development of modern medicine, following the growth of obesity and type 2 diabetes, the prevalence of gestational diabetes mellitus is also increasing worldwide. AIM: To identify the frequency and structure of carbohydrate metabolism disorders and to compare the level of blood pressure in a random sample of pregnant women registered in the Perinatal center. MATHERIALS AND METHODS: The analysis of the data of examination of carbohydrate metabolism of pregnant women who are registered in the Perinatal Center (Leningrad region, Gatchina), has been carried out. The analysis of medical documentation, survey, endocrinological and gynecological examination, calculation of the body mass index and the study of carbohydrate metabolism have been carried out. RESULTS: There is an increase in the number of pregnant women with impaired carbohydrate metabolism over the years of observation. Gestational diabetes on diet therapy was 64.4% in 2019, 31.0% in 2020, 65.1% in 2021, on insulin therapy 32.2, 62.3, 28.9% respectively. There was an increase in the number of women with type 1 and type 2 diabetes diagnosed before pregnancy and newly diagnosed diabetes during pregnancy. Body mass index and blood pressure levels are higher and glycated hemoglobin levels are lower in diet-treated pregnant women with gestational diabetes compared with insulin therapy. An increase in glycated hemoglobin was found annually in a group of women with gestational diabetes mellitus on insulin therapy. CONCLUSIONS: The high prevalence of carbohydrate metabolism disorders and the associated increase in blood pressure in pregnant women in Saint Petersburg and the Leningrad Region justifies a targeted search for carbohydrate metabolism disorders in pregnant women.

С возрастом происходят изменения в обмене веществ, репродуктивной и нервной системах, имеющие системный и взаимосвязанный характер. Цель работы - демонстрация эффективности аудиовизуальной коррекции и терапии препаратами тестостерона в дополнение к стандартной терапии полиморбидной патологии. Обследованы 89 мужчин 35-55 лет с сахарным диабетом 2-го типа, полиморбидной сердечно-сосудистой патологией, избытком массы тела или ожирением, андрогенным дефицитом и тревожно-депрессивными расстройствами, которых разделили на три группы в зависимости от проводимого лечения: 1-я - стандартная терапия и эсциталопрам/тофизопам; 2-я - стандартная терапия + аудиовизуальная коррекция; 3-я - стандартная терапия + аудиовизуальная коррекция + тестостерон ундеканоат. До начала лечения и через 9 мес после всем пациентам проведено лабораторное обследование. Выраженность андрогенодефицита и эректильной дисфункции определяли с помощью опросников МИЭФ-5 и Шкалы старения мужчины AMS. Выявлено снижение уровня тестостерона, признаки эректильной дисфункции и симптомы андрогенодефицита от умеренной степени выраженности до выраженной, повышение атерогенных и снижение антиатерогенных липопротеидов, повышение уровня глюкозы, гликированного гемоглобина, инсулина, индекса HOMA . После лечения выявлено более значимое улучшение липидного профиля при использовании аудиовизуальной коррекции, а аудиовизуальная коррекция и терапия андрогенами способствовали улучшению показателей эректильной функции и снижению степени выраженности симптомов старения у мужчин. There are changes in the metabolism, reproductive and nervous systems with ageing, which have a systemic and interrelated nature. The purpose of this work was to demonstrate the effectiveness of audiovisual correction and therapy with testosterone drugs in addition to the standard therapy in patients with polymorbid pathology. 89 men aged 35-55 years old with diabetes mellitus, polymorbid cardiovascular disease, obesity, anxiety and depressive disorders were examined. They were divided into 3 groups depending on the treatment: the 1 - standard therapy and escitalopram / tofisopam; the 2 - standard therapy + audiovisual correction; the 3 - standard therapy + audiovisual correction + testosterone undecanoate. Laboratory examination was carried out in all patients before the start of treatment and 9 months after the treatment. The severity of androgen deficiency was determined using IIEF-5 questionnaire and the AMS male aging scale. In was shown a decrease in testosterone levels, signs of erectile dysfunction and symptoms of moderate to severe androgen deficiency, increased proatherogenic and decreased antiatherogenic lipoproteins, increased glucose, glycated hemoglobin, insulin, HOMA index in our study. In group of audiovisual correction we saw a more significant improvement in the lipid profile after treatment. Audiovisual correction and androgen therapy contributed to the improvement of erectile function indices and a decrease in the severity of the symptoms of ageing in men.