Vol 19, No 4 (2017)

Интервью с академиком РАН, профессором, доктором медицинских наук, зам. директора по научной работе ФГБУ «Эндокринологический научный центр» Минздрава России, директором Института диабета Мариной Владимировной Шестаковой.

В Новосибирске 3 апреля 2017 г. состоялась международная конференция «Современный взгляд на цели и задачи терапии сахарного диабета 2-го типа», в которой приняли участие российские и зарубежные эксперты. Предлагаем вашему вниманию интервью с профессором кафедры неотложной терапии с эндокринологией и профпатологией факультета повышения квалификации и профессиональной переподготовки врачей Новосибирского государственного медицинского университета, доктором медицинских наук, профессором, врачом высшей категории Людмилой Александровной Руяткиной; эндокринологом, профессором кафедры эндокринологии и метаболизма Университета Пизы (Италия) Стефано Дель Прато; кардиологом, сотрудником лаборатории катетеризации сердца Техасского научного центра здоровья (США), профессором Робертом Чилтоном.

The review is devoted to the validity of taurine in patients with diabetes mellitus type 2. The data of numerous experimental and clinical studies have shown the positive effect of taurine on both the course of diabetes mellitus type 2 and on the comorbid pathology (heart disease, kidney disease).

The prognosis of the World Health Organization indicates that by 2020 non-alcoholic fatty liver disease (NAFLD) will occupy the first position within liver diseases. Liver transplantation in NAFLD patients with cirrhosis occupies second position after viral cirrhosis, nowadays. Mortality in NAFLD patients 1 month after surgery is significantly higher than mortality rate in patients with cirrhosis of different etiology. We also indicate the increased risk of other complications of liver transplantation, such as sepsis, transplant rejection and the development of cardiovascular pathology. According to modern point of view NAFLD is a liver damage, including fatty degeneration, fatty degeneration and inflammatory cell infiltration and injury of hepatocytes (non-alcoholic steatohepatitis/metabolic liver disease) and fibrosis (results in cirrhosis). Cause-effect relation of NAFLD and diabetes mellitus (DM) is the subject of numerous discussions. The connecting pathogenetic link between NAFLD and DM is insulin resistance. The realization of insulin resistance is primarily carried out in hepatocytes. Specific diagnostic criteria for NAFLD practically do not exist; the most likely NAFLD diagnosis is an "exclusion diagnosis". There is no standard therapy for patients with NAFLD, nowadays. None of the drugs used in the treatment of NAFLD has high evidential base. Correction of body-mass index, food addiction and physical activity is the most effective actions to prevent the development of NAFLD and diabetes mellitus.

Purpose - to assess the effectiveness of iodine deficiency prophylaxis in adult population of St. Petersburg. Materials and methods. We examined 542 residents of St. Petersburg aged 18-77 years. All participants were divided into 3 groups according to age (18-24, 25-44, 45 years and older). Pregnant women were evaluated separately. All participants were questioned, the values of urinary iodine concentration (UIC) were analyzed. Results. Median UIC of all participants was 91.2 mg/l and corresponded to mild iodine deficiency. Persons younger 25 years and older 44 years had iodine sufficiency, participants aged 25-44 were diagnosed with mild iodine deficiency. Median UIC in pregnant women was 112.4 mg/l and corresponded to insufficient iodine intake. Iodized salt was used by 41.1% of all surveyed persons and 52.2% of pregnant women. Iodine supplements were taken by half of pregnant women. The type of nutrition, education, family and financial situation as well as living conditions did not affect adherence to methods of prevention. Conclusions. The adult population of St. Petersburg had a different iodine status. Persons of reproductive age including pregnant women had mild iodine deficiency. Prophylaxis of iodine deficiency held in St. Petersburg in 2013-2015 was not effective enough. No social factors influencing adherence to iodine deficiency prevention methods were revealed.

The article presents the project of the Russian Association of Endocrinologists clinical guidelines for primary hyperaldosteronism (PH) diagnosis and treatment, which provides the modern algorithm for examining patients with PH and also is considered the basic principles of laboratory, instrumental diagnosis and pathogenetic treatment approaches.