RESUMEN

In the article there are presented the results of research on naturally conditioned insufficiency of trace elements, particularly iodine, in the Republic of Mordovia. Iodine deficiency disorders are referred to the most common non-infectious human pathology. According to WHO data, about two billion people on Earth live in conditions of in iodine deficiency. In the Russian Federation there are no areas in which the population would not be at risk for the development of iodine deficiency disorders. To these regions and the Republic of Mordovia is referred. The prevalence of diseases caused by iodine deficiency among the urban population accounted for 100-150, among rural--130-350. In some regions of endemic goiter rate reaches 800. Analysis of the morbidity rate of the population in the Republic of Mordovia, associated with the iodine deficiency, shows that in the structure of diseases related to micronutrient deficiency, by 2013 diffuse goiter plays a leading role, beingfollowed by a multi-node (endemic) goiter onward thyroiditis, subclinical hypothyroidism and hyperthyroidism. Thus, the analysis of indices of new cases of diseases associated with the iodine deficiency, allows to make the conclusion that diffuse goiter is the most significant pathology. In the structure of diseases related to the micronutrient deficiency, out of the most frequently detected iodine deficiency disorders, the greatest fraction are diffuse and multinodular goiter. The study was conducted with the support of the project, performed in the framework of the basic part of the State assignment (project 2859) and a RHSF grant.

Asunto(s)

Bocio Endémico/epidemiología , Higiene , Yodo/deficiencia , Población Rural , Población Urbana , Bocio Endémico/sangre , Humanos , Morbilidad/tendencias , Estudios Retrospectivos , Federación de Rusia/epidemiología

RESUMEN

To achieve glycemic targets, as the main preventive measure for vascular complications, patients with type 1 diabetes need lifelong administration of insulin in a regimen that allows them to have euglycemia both before and after eating. For this, optimal insulin therapy regimens have been created, which necessarily include short-acting insulin (with the main meal) and medium or long-acting insulin as basal. This mode of administration allows you to maximize bring the daily fluctuations of insulin administered to the natural rhythm of insulin secretion in healthy people.

Asunto(s)

Diabetes Mellitus Tipo 2/epidemiología , Diabetes Mellitus Tipo 2/prevención & control , Accidente Cerebrovascular/epidemiología , Accidente Cerebrovascular/prevención & control , Inhibidores de la Enzima Convertidora de Angiotensina/uso terapéutico , Anticoagulantes/uso terapéutico , Humanos , Hipertensión/epidemiología , Factores de Riesgo

RESUMEN

In groups of type 1 diabetes mellitus patients with and without clinical signs of diabetic nephropathy (n = 62 and n = 68, respectively), a search was made for associations between diabetic nephropathy and the polymorphic marker epsilon2/epsilon3/epsilon4 of apolipoprotein E gene (APOE), I/D marker of apolipoprotein B gene (APOB), and Ser447Ter marker of lipoprotein lipase-encoding gene (LPL). The risk of diabetic nephropathy was higher in the carriers of allele epsilon3 and genotype epsilon3/epsilon3 of the polymorphic marker epsilon2/epsilon3/epsilon4 of APOE gene as well as in the carriers of allele 1 and APOB genotype/gene (OR = 2.08 and 2.16; 1.91 and 2.11, respectively). Conversely, the carriers of allele D showed a reduced risk of this complication (OR = 0.52). No significant differences in distribution of alleles and genotypes of the polymorphic marker Ser447Ter of LPL gene were found between the groups. Our results indicate that the genes encoding two major components of lipid metabolism are involved in the development of diabetic nephropathy in patients with type 1 diabetes mellitus.

Asunto(s)

Apolipoproteínas B/genética , Apolipoproteínas E/genética , Diabetes Mellitus Tipo 1/complicaciones , Nefropatías Diabéticas/genética , Predisposición Genética a la Enfermedad/genética , Lipoproteína Lipasa/genética , Polimorfismo Genético , Adulto , Femenino , Frecuencia de los Genes , Marcadores Genéticos/genética , Humanos , Metabolismo de los Lípidos , Masculino , Persona de Mediana Edad , Factores de Riesgo

RESUMEN

Early studies of the association of a large group of gene candidates indicated that only the polymorphic markers of angiotensin-converting enzyme (ACE) I gene and endothelial vascular cell NO-synthetase (NOS3) gene were associated with diabetic nephropathy (DN) in type 1 diabetes mellitus. The purpose of this study was to examine DN predisposition in patients with type 1 DM, by using the polymorphic markers of the genes of apolipoproteins Е (АРОЕ) and В (АРОВ) which encode for lipid metabolic proteins, as well as polymorphic microsatellites in the chromosomal region 3q21-q25. Two groups of patients of patients with type 1 DM with (n = 54) and without (n = 65) DN were examined to analyze the gene association with DN. Analyzing the frequencies of the alleles and genotypes of the polymorphic marker E2/E3/E4 ofAPOR gene has indicated that the carriers of the allele E3 and the genotype E3/ E3 have a higher risk for DN (OR = 2.08 and 2.16, respectively). In case of АРОВ gene, the carriers of allele I and genotype II of the polymorphic marker I/D have been ascertained to have a higher risk for DN (OR = 1.91 and 2.11, respectively) while those of allele Dhave, on the contrary, a lower risk for DN (OR = 0.52). The authors have revealed an association of a group of polymorphic microsatellites with DN in the chromosomal region 3q21-q25. There is the greatest association for the marker D31550. The carriers of allele 12 (OR = 4.85) and genotype 12/14 (OR = 6.25) have a much higher risk for DN. In all probability, in the chromosomal region 3q21-q25, there is a major gene that initiates the development of DN whereas other genes associated with DN affect the rate of its progression to a greater extent. Thus, among the Moscow Russian dwellers suffering from type 1 DM, the progression of DN is mainly associated with the genes of ACE, NOS3, APOE, and АРОВ while the major gene that determines the first stages of DN development in type 1 DM is likely to be located in the chromosomal region 3q21-q25.

RESUMEN

AIM: To study allele polymorphism of two variable regions [C1167T substitution in the catalase (CAT) gene D6S392 microsatellite near the Mn-dependent superoxide dismutase (SOD2) gene] was studied in insulin-dependent diabetic (IDDM) patients with (n = 36) or without (n = 56) diabetic nephropathy, and with (n = 30) or without (n = 44) diabetic retinopathy. MATERIAL AND METHODS: Both polymorphic regions were amplified using polymerase chain reaction (PCR). PCR products were separated using polyacrylamide (D6S366) or agarose (C1167T) gel electrophoresis. In a case of C1167, PCR-amplified products were digested with BstXI restriction endonuclease before electrophoresis. A significance of the difference between allele distributions in complicated and uncomplicated IDDM patients was estimated using the exact Fisher's test. RESULTS: No significant difference was observed in allele and genotype frequencies in complicated and uncomplicated IDDM subjects. CONCLUSION: C1167 polymorphism in the CAT gene and D6S366 near the SOD2 gene are not associated with the development of diabetic nephropathy and diabetic retinopathy in IDDM.

Asunto(s)

Catalasa/genética , Nefropatías Diabéticas/genética , Retinopatía Diabética/genética , Mutación , Polimorfismo Genético , Superóxido Dismutasa/genética , Adolescente , Adulto , Alelos , Femenino , Humanos , Masculino , Reacción en Cadena de la Polimerasa

RESUMEN

Polymorphic tetranucleotide microsatellites D3S1512, D3S1744, D3S1550, and D3S232 were used to study the association of chromosome region 3q21-q25 neighboring the angiotensin II receptor type 1 gene (AT2R1) with diabetic nephropathy (DN) in diabetes mellitus type 1 (DM1). Allele and genotype frequencies were compared for DM1 patients with (N = 39) or without (N = 62) DN. Fisher's exact test with Bonferroni's correction revealed significant differences in frequencies of two D3S2326 alleles, one D3S1512 allele, and one allele and one genotype of D3S1550. No significant difference was observed with D3S1744. Thus, region 3q21-q25 proved tightly associated with DN in ethnic Russians with DM1 from Moscow.

Asunto(s)

Cromosomas Humanos Par 3 , Diabetes Mellitus Tipo 1/genética , Nefropatías Diabéticas/genética , Predisposición Genética a la Enfermedad , Adulto , Estudios de Casos y Controles , Femenino , Frecuencia de los Genes , Humanos , Masculino , Repeticiones de Microsatélite , Moscú/etnología , Receptor de Angiotensina Tipo 1 , Receptores de Angiotensina/genética

RESUMEN

Polymorphism A1166C of the AT1R gene encoding angiotensin vascular receptor [replacement of C (cytosine) for A (adenine)) at position 1166] was compared in patients with insulin-dependent diabetes mellitus (IDDM) complicated by diabetic nephropathy (DN) and in noncomplicated patients (n = 27 and n = 41, respectively) and also in patients with IDDM complicated by diabetic retinopathy (DR) and in correspondent noncomplicated individuals (n = 30 and n = 44, respectively). The frequency of AT1R gene alleles and genotypes in patients with IDDM complicated by DN did not differ significantly from that observed in patients with noncomplicated IDDM. In contrast, in patients with IDDM complicated by retinopathy, a significant decrease in the content of A allele (68.3% against 82.6%) and a significant increase in the content of C allele (31.7% against 17.4%) was found as compared with the control group. Thus, in the Moscow population, A1166C polymorphism of the AT1R gene is not associated with diabetic renal complications but indeed associated with diabetic retinal complications. C allele is a risk factor of DR (the relative risk, RR, is equal to 2.17), and A allele is, in contrast, a protective factor against early retinopathy development (RR is equal to 0.49).

Asunto(s)

Alelos , Diabetes Mellitus Tipo 1/genética , Retinopatía Diabética/genética , Polimorfismo Genético , Receptores de Angiotensina/genética , Adolescente , Adulto , Niño , Preescolar , Diabetes Mellitus Tipo 1/fisiopatología , Nefropatías Diabéticas/genética , Femenino , Humanos , Masculino

RESUMEN

AIM: To reveal factors accelerating development of chronic renal failure (CRF) in patients with insulin-dependent diabetes mellitus type I (DM-I). MATERIALS AND METHODS: A retrospective analysis of case histories was made for 40 patients with DM-I exhibiting progression of proteinuric stage of diabetic nephropathy prior to CRF stage. Clinical-laboratory indices were compared for patients with slow (group 1, n = 17) and fast (group 2, n = 23) development of CRF. RESULTS: Patients of group 2 had significantly higher levels of glycosylated hemoglobin, total cholesterol, triglycerides in the blood, urine protein excretion, systolic and diastolic blood pressure than patients of group 1. Also, patients of group 2 had not taken antihypertensive drugs regularly. CONCLUSION: Factors of risk of CRF early development of DM-I patients comprise unsatisfactory compensation of carbohydrate metabolism, hyperlipidemia, high proteinuria, arterial hypertension and inadequate antihypertensive therapy.

Asunto(s)

Diabetes Mellitus Tipo 1/complicaciones , Nefropatías Diabéticas/complicaciones , Fallo Renal Crónico/etiología , Adolescente , Adulto , Presión Sanguínea , Colesterol/sangre , Creatinina/sangre , Diabetes Mellitus Tipo 1/sangre , Diabetes Mellitus Tipo 1/orina , Nefropatías Diabéticas/metabolismo , Nefropatías Diabéticas/fisiopatología , Progresión de la Enfermedad , Femenino , Estudios de Seguimiento , Hemoglobina Glucada/metabolismo , Humanos , Hiperlipidemias/sangre , Hiperlipidemias/complicaciones , Hipertensión Renal/complicaciones , Hipertensión Renal/metabolismo , Hipertensión Renal/fisiopatología , Fallo Renal Crónico/metabolismo , Fallo Renal Crónico/fisiopatología , Masculino , Pronóstico , Proteinuria/sangre , Proteinuria/complicaciones , Proteinuria/orina , Estudios Retrospectivos , Factores de Riesgo , Triglicéridos/sangre

Asunto(s)

Diabetes Mellitus Tipo 1/enzimología , Diabetes Mellitus Tipo 2/enzimología , Angiopatías Diabéticas/enzimología , Peptidil-Dipeptidasa A/genética , Polimorfismo Genético , Diabetes Mellitus Tipo 1/complicaciones , Diabetes Mellitus Tipo 1/genética , Diabetes Mellitus Tipo 2/complicaciones , Diabetes Mellitus Tipo 2/genética , Angiopatías Diabéticas/complicaciones , Angiopatías Diabéticas/genética , Humanos , Mutagénesis Insercional , Eliminación de Secuencia

RESUMEN

A novel pathogenetic approach to treatment of diabetic nephropathy (DN) as a severe complication of diabetes mellitus is aimed at inhibiting DN progression or its involution by means of reestablishment of heparan sulfate synthesis by glycosaminoglycane drug. In the study of 9 patients with microalbuminuria and 9 with proteinuria this drug was low-molecular heparin-sulodexide (Alfa-Wasserman, Italy). The treatment course of 3 weeks resulted in albuminuria fall in 89% of patients. In patients with microalbuminuria protein excretion returned to normal values in a week of treatment. This effect was persistent after the drug discontinuation. This was not so for protein excretion in proteinuria patients which became low after 3 weeks of treatment, but the effect was not long-lasting. The authors believe that glycosaminoglycanes hold great promise in DN, especially at early stages of renal diabetic affection.

Asunto(s)

Albuminuria/tratamiento farmacológico , Nefropatías Diabéticas/tratamiento farmacológico , Glicosaminoglicanos/uso terapéutico , Heparina de Bajo-Peso-Molecular/uso terapéutico , Hipoglucemiantes/uso terapéutico , Adolescente , Adulto , Albuminuria/orina , Enfermedad Crónica , Diabetes Mellitus Tipo 1/complicaciones , Diabetes Mellitus Tipo 1/orina , Nefropatías Diabéticas/orina , Humanos , Persona de Mediana Edad , Factores de Tiempo

RESUMEN

To evaluate the secretion of vasoactive factors in vascular endothelium of patients with non-insulin-dependent diabetes mellitus (NIDDM) the authors examined 31 NIDDM patients. Of them, 18 had no signs of renal involvement, 13 patients showed apparent diabetic nephropathy (DN). In the former patients the blood contained much greater content of vasodilating factor prostacyclin than of vasoconstricting factor endothelin-1 (ET-1) and thromboxan A2 (TxA2). In diabetic nephropathy the balance of vasoactive factors shifted to predominance of vasoconstrictors ET-1 and TxA2. Such rearrangement of vasoactive factors to higher quantities of vasoconstrictors in diabetes mellitus may initiate or promote progression of diabetic nephropathy with resultant spasm of afferent glomerular vessels, reduced glomerular filtration and renal blood flow rates, arterial hypertension, increased thrombogenesis. Thus, elevated levels of ET-1 and TxA2 in diabetics and their rise with progression of diabetic nephropathy are likely to act as pathogenetic factors underlying onset and progression of nephroangiopathy.

Asunto(s)

Diabetes Mellitus Tipo 2/sangre , Nefropatías Diabéticas/sangre , Endotelina-1/sangre , Endotelio Vascular/metabolismo , Epoprostenol/sangre , Tromboxano A2/sangre , Albuminuria/sangre , Albuminuria/fisiopatología , Enfermedad Crónica , Diabetes Mellitus Tipo 2/fisiopatología , Nefropatías Diabéticas/fisiopatología , Progresión de la Enfermedad , Endotelina-1/metabolismo , Epoprostenol/metabolismo , Femenino , Humanos , Masculino , Persona de Mediana Edad , Tromboxano A2/metabolismo

RESUMEN

Twenty-five diabetics with insulin-dependent condition were examined at the debut of the disease before insulin therapy, as were 10 healthy donors. Under study were relative and absolute counts of T lymphocytes, NK cells, B lymphocytes, DR-T lymphocytes, Th, Ts, and Th/Ts index. Patients' and donors' sera were tested for autoantibodies to P64-69kD antigenic complex. Characteristic features of cellular immunity of patients with newly-detected diabetes were disclosed. Counts of B lymphocytes and Dr-T lymphocytes were increased in all patients. A relationship was revealed between immunoregulatory Th/Ts index and clinical features of insulin-dependent diabetes. Autoantibodies to p64-68 kD andigenic complex were detected in 63-88% of patients with newly detected insulin-dependent diabetes.

Asunto(s)

Diabetes Mellitus Tipo 1/inmunología , Adolescente , Adulto , Autoanticuerpos/sangre , Diabetes Mellitus Tipo 1/diagnóstico , Femenino , Humanos , Inmunidad Celular , Recuento de Leucocitos , Subgrupos Linfocitarios , Masculino

RESUMEN

To clarify the value of autoantibodies as risk factors of complications in various endocrine abnormalities, the incidence of autoantibodies to thyroid microsomal antigen (ATMA), thyroglobulin, and the surface antigens of the rat islet, adrenal cortex, adenohypophyseal cells and human skin fibroblasts was studied in patients with insulin-dependent mellitus (IDDM), at the onset of the disease and during one-year insulin therapy, non-insulin-dependent diabetes mellitus (NIDDM), Hashimoto thyroiditis, Graves' disease, diabetes associated with thyroidal dysfunction, euthyroid polynodular goiter, Schmidt and polyglandular syndromes and in the population. The antibodies were determined by ELISA. Polyclonal activation of the immune system was found in all abnormalities, except in polyglandular in children. The proportion of patients with more than one type of antibodies was minimal (26.4%) in IDDM and maximal (62.0%) in Graves' disease. Among IDDM patients, polyclonal activation of the immune system was observed more often in women than in men (48.5 vs 8.5%). The persistence of antibodies to fibroblasts in IDDM patients was associated with the development of vascular complications. The latter were observed in 4 of 7 patients who had these antibodies during a year and in none of negative patients. Thus, fibroblast antibodies may have a predicative significance for the development of late diabetic complications. The highest prevalence of these antibodies was discovered in Graves' disease (37.9%) wherein the antibodies may be involved in the development of exophthalmus and pretibial mixedema. Thyroidal dysfunction developed in all IDDM patients with ATMA preserved during a year and in none ATMA-negative patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Asunto(s)

Enfermedades Autoinmunes/inmunología , Diabetes Mellitus Tipo 1/inmunología , Diabetes Mellitus Tipo 2/inmunología , Bocio Nodular/inmunología , Enfermedad de Graves/inmunología , Tiroiditis Autoinmune/inmunología , Adulto , Formación de Anticuerpos , Biomarcadores , Niño , Femenino , Fibroblastos/inmunología , Humanos , Masculino

RESUMEN

The clinical onset of insulin-dependent diabetes (IDD) is characterized by the onset of circulation of autoantibodies to beta-cells. Thirty-three newly detected IDD patients and 14 newly detected patients with noninsulin-dependent diabetes mellitus were examined for autoantibodies to antigen P 64-69, to surface antigen of islet cells, to thyrocyte microsomal fraction, thyroglobulin, hypophysis, fibroblasts; the levels of circulating immune complexes were measured as well. IDD debut was found associated with the appearance of antibodies to pancreatic islet cells, thyroid, thyroglobulin, hypophysis, fibroblasts, this indicating a polyclonal activation of the immunity system. A relationship was revealed between antifibroblast antibody and anti-islet-cell antibody. Antihypophyseal antibodies were detected in 43% of patients with noninsulin dependent diabetes. Nine per cent of IDD patients and 24% of patients with noninsulin dependent condition were negative in the tests.

Asunto(s)

Autoanticuerpos/sangre , Diabetes Mellitus Tipo 1/inmunología , Diabetes Mellitus Tipo 2/inmunología , Islotes Pancreáticos/inmunología , Hipófisis/inmunología , Glándula Tiroides/inmunología , Adolescente , Adulto , Femenino , Fibroblastos/inmunología , Humanos , Masculino , Persona de Mediana Edad , Factores de Tiempo