No abstract

Introduction: Combined endocrine pathology is a serious healthcare problem in Ukraine. This prospective study assessed the blood levels of 25-hydroxyvitamin D [25(OH)D] and markers of immune function in response to vitamin D intervention in patients with type 1 and type 2 diabetes mellitus (T1DM and T2DM, respectively) and autoimmune thyroiditis (AIT).Objective: This study evaluated the relationship between the metabolic and immune status of DM + AIT patients with respect to their vitamin D status and changes after vitamin D3 supplementation.Material and Methods: Patients with type 1 or type 2 DM in combination with AIT and decreased circulating levels of 25(OH)D were divided into two groups of 30 patients each. All patients with AIT were euthyroid and receiving hormonal replacement therapy. The levels of carbohydrate and fat metabolism markers, Immunologic markers, namely, Th1-type cytokines [interferon (IFN)-γ, tumor necrosis factor (TNF)-α, interleukin (IL)-2, IL-6, IL-12], Th2-type cytokines (IL-4, IL-5), IL-10, and IL-17 were measured before and after vitamin D3 supplementation. The vitamin D status was assessed according to the level of 25(OH)D.Results: Patients with combined endocrine disorders (DM and AIT) with a decreased vitamin D status had significantly increased background concentrations of Th1-type cytokines and reduced concentrations of Th2-type cytokines (IL-4 and IL-5), IL-10, and IL-17. The results of our study showed that vitamin D3 supplementation in patients with T1DM and T2DM reduced the concentrations of the inflammatory Th1-type cytokines and increased the levels of Th2-type cytokines.Conclusion: The presence of two endocrine diseases, aggravated by decreased circulating levels of 25(OH)D, leads to disorders wherein the immune status is markedly changed. These decreased levels of 25(OH)D contribute to an autoimmune inflammatory process and to the progression of complications in addition to the metabolic disorders. A vitamin D intervention resulted in significant changes in the blood levels of 25(OH)D that are related to parameters of autoimmunity and glucose metabolism. Vitamin D3 supplementation should be considered for the prevention and treatment of combined endocrine pathology.

Клінічне керівництво з гіпопаратиреозу Європейського товариства ендокринологів схвалено Європейським конгресом ендокринологів (травень 2015 р.) і було опубліковано в European Journal of Endocrinology в червні 2015 р.Автори рекомендують скринінг на гіпопаратиреоз усім пацієнтам, у яких була операція в ділянці шиї. При наявності гіпокальціємії і низького рівня паратгормона необхідно провести обстеження на хронічний гіпопаратиреоз.

The paper presents the current data on the effect of the presence of autoantibodies on the management of autoimmune diseases: autoimmune thyroiditis, diabetes mellitus, states of carriage of antithyroid and diabetes-associated autoantibodies, 2016 algorithm for the management of pregnant women with antibodies to thyroid peroxidase, approaches to the assessment of the immune status in patients with diabetes mellitus and the presence of vitamin D deficiency, describes the impact of the correction for D-deficiency on the immune status at concomitant endocrine diseases.

The aim: The revealing of the development of stress-related disorders in patients with type 2 diabetes mellitus (DM 2) to: identify the prevalence of stress-related disorders, particularly, posttraumatic stress disorder (PTSD); study the influence of psychosocial factors on the occurrence and course of stress-related disorders and increase the effectiveness of treatment in DM 2. Materials and methods: Research papers have been found by searching the PubMed database using the keywords ``ptsd and diabetes 2 type” with the result of 74 studies. Totally 25 of selected publications were analysed based on our criteria about the mechanisms through which the influence of psychosocial factors, permanent stressful or traumatic events on the probable risk of PTSD development and their analysis and relationships for the improvement of treatment effectiveness in DM 2 patients who have not been the veterans. Conclusions: Given the complex neurophysiological relationships between the long-term stress and pathophysiological mechanisms of DM 2 — this group of patients has the higher risk of developing stress-related disorders, including PTSD.

The aim: The revealing of the consequences of the long-term postcovid effects on the particular cognitive domains in patients with diabetes mellitus type 2 (DM 2) by comparing the characteristics of patients with DM 2 without postcovid disorders and the characteristics of cognitive impairment in patients with long-therm postcovid without DM 2 by forming the research hypothesis to improve the adherence to treatment of patients. Materials and methods: Literature search was performed using PubMed search criteria “covid AND cognitive AND domain” 217 articles, as a result, and separately “diabetes mellitus 2 type AND cognitive impairment AND domain” with the result of 164 articles. There were 26 remaining studies included in this review. The hypothesis about the relationships between the particular cause factors and the defeating of specific cognitive domains in patients with DM 2 in the long-term postcovid period has been formed. Conclusions: This is important in the terms of the influence of cognitive impairment on the concordance to treatment process and quality of life level in patients with DM 2 in general. So, involving specialists of different profiles in a multidisciplinary approach is the solution to this issue.

ВступСечокам'яна хвороба (СКХ) -одне з найпоширеніших урологічних захворювань, що характеризується складною етіологією і патогенезом [1]. За сучасними уявленнями, СКХ -це поліетіологічне захворювання, зумовлене порушенням обмінних процесів в організмі у поєднанні з локальними змінами в сечовій системі, що характеризується формуванням із компонентів сечі у нирках і/або сечових шляхах каменів [2]. СКХ посідає друге місце у структурі патології нирок і сечових шляхів, третє місце в структурі причин смерті та четверте -в структурі інвалідності при урологічній патології. СКХ реєструється в населення всіх країн світу з частотою 10-30 випадків на 1000 осіб дорослого населення і становить 30-40 % усіх урологічних захворювань. Аналіз загальної кількості хворих на СКХ в Україні свідчить, що з 2004 по 2012 р. в Україні їх стало більше на 26,9 %. У 73 % хворих відзначають рецидивуючий перебіг СКХ. З приводу СКХ в Україні щороку виконують близько 2000 нефректомій [3]. При цьому, спостерігаючи за хворими з єдиною ниркою, що залишилась після видалення контралатеральної, урологи діагностують порівняно швидке порушення функціонального стану та виникнення патологічного процесу в єдиній нирці, яка залишилась після нефректомії [4]. Після виконання нефректомії найчастіше в нирці, що залишилась, виникають пієлонефрит (47-89 %) і нефролітіаз (12-50 %). Нефролітіаз нерідко виявляється вже через 1-4 роки після нефректомії, тобто в період функціональної реабілітації єдиної нирки [5]. © «Міжнародний ендокринологічний журнал» / «Международный эндокринологический журнал» / «International Journal of Endocrinology» («Mìžnarodnij endokrinologìčnij žurnal»), 2018 Ключові слова: єдина нирка; нефролітіаз; реносцинтиграфія; цукровий діабет 2-го типу; функціональний стан нирки; клубочкова фільтрація

In a broad sense, insulin resistance (IR) is the impairment of the biological response of target tissues to insulin stimulation. IR plays a leading role in the development of metabolic syndrome, the global prevalence of which continues to grow, despite the significant efforts of medical systems. The multicomponent nature of metabolic syndrome implies its complex and heterogeneous pathogenesis, knowledge about which is annually updated with new details as a result of scientific research.This review systematizes the results of recent studies on risk factors and pathogenetic links in the development of IR, prospects and existing experience of using these data in clinical practice with an emphasis on assessing the level of melatonin and vitamin D. The issue of timely and reliable laboratory confirmation of IR is relevant not only for endocrinologists, but also for specialists in almost all areas. In clinical use apart from indirect methods of IR-assessment like HOMA-IR, there is an informative test intact proinsulin.Recently, the increasing attention of researchers is attracted by such factors of the development of IR as vitamin D deficiency and disturbances in chrono- and biorhythms. Today, their role in the pathogenesis of IR can be considered proven, which makes it possible to consider vitamin D and melatonin as therapeutic agents in an integrated approach to the prevention and correction of IR. Statistical analysis of the research results of the “DILA” Medical Laboratory and clinical data provided by the Department of Endocrinology of the O.O. Bogomolets National Medical University also showed an association of vitamin D and melatonin levels with IR.Thus, a review of scientific sources over the last 5 years clearly demonstrates the growing urgency of the problem of IR and metabolic syndrome, the need to reconsider their management from assessing traditional etiopathogenetic factors (alimentary) to taking into account the maximum spectrum of genetic aspects and exogenous impacts. An important place among the latter belongs to an objective assessment of the vitamin D and melatonin levels for adequate pharmacological correction.