[Natriuretic peptide--independent marker of cardiovascular diseases in patients with diabetes mellitus].

The review depicts the findings of the foreign and Ukrainian researches focused on high blood level of natriuretic peptide (NP), which possesses, by itself, the risk of cardiovascular diseases in patients with diabetes mellitus regardless of its stage.

[Effect erythropoietin-beta on parameters of erythropoiesis and immunity in patients with diabetes mellitus complicated with diabetic neuropathy and anemia]. / Vliianie éritropoétina-beta na pokazateli éritropoéza i immuniteta u bol'nykh sakharnym diabetom, oslozhnennym diabeticheskoi nefropatiei i anemiei.

Erythropoiesis indices, number of leucocytes in 1 ml of blood, leukocytic formula, lymphocytes immunophenotype in the patients' blood with diabetes mellitus complicated with diabetic neuropathy and marked normochromal anemia after the treatment with Erythropoietin b have been analyzed in the study. Significant increase in haemoglobin, erythrocytes content, hematocrit indices of peripheral blood has been observed during the treatment. The patients felt better, their quality of life improved, CD3+, CD4+, CD5+ cells and granule-contained lymphocytes content normalized. Serious adverse affects of the medication haven't been observed in the study.

[Sulfonylurea receptors and their interaction with glimepiride]. / Retseptory k sul'fonilmochevine i ikh vzaimodeistvie s glimepiridom.

In the review, data are presented on glymepiride (amaril), a 3-d generation sulphanylamide. The drug interacts with receptors to sulphonylurea--SUR X, that are found only in B-cells of the pancreas, which fact has been shown to be associated with a higher secretion of insulin, an increased sensitivity of peripheral tissues to this hormone and with insulin-like extrapancreatic effects as well. Amaril does not affect SUR of the myocardium, myocytes of cerebral vessels and nervous cells. The use of the above drug combined with metformin, insulin, repaglynide, and nateglynide has been shown to be an optimum treatment option, however in the latter case, hypoglycemic states may come to be seen more frequently along with a rapid exhaustion of B-cells. In view of the fact that in many instances, type 2 diabetes mellitus runs its course concurrently with other illness, it is necessary that interaction of amaril with other drugs be taken into account.

[Immunomodulating effect of berlithione in clean-up workers of the Chernobyl nuclear plant accident]. / Immunomoduliruiushchii éffekt berlitiona u likvidatorov posledstvii avarii na ChAES.

Effects of the antioxidant berlithione (alpha-lipoic acid) on indices for the immune system, such as complement titer, C3-component of the complement, reaction of the autorosette formation were studied together with those on parameters characterizing cell-bound and humoral immunity. 11-12 years following the Chernobyl accident, nine liquidators of its aftermaths were examined, aged 51.8 +/- 7.2 years, body mass (BM) 27.3 +/- 4.2 kg/m2, radiation dose 73.2 +/- 35.3 rem, who took part in the elimination of the effects of the accident for no more than 3 months in 1986--at the beginning of 1987. All examinees were prescribed the drug berlithione (alpha-lipoic acid), 600 mg per day over two months. A two-month treatment with berlithione, 600 mg/day, resulted in normal levels of indices for unspecific defence; among these were phagocytic activity of neutrophiles, content of the complement, its C3-component, and reaction of autorosette formation in the accident effects liquidators, but no impact was found on cell-mediated and humoral immunity.

[Effect of eprex in therapy of anemia of nephrogenic genesis in patients with chronic renal failure concurrent with diabetic glomerulosclerosis before hemodialysis]. / Opyt primeneniia épreksa pri anemii nefrogennogo geneza u bol'nykh s khronicheskoi pochechnoi nedostatochnost'iu na fone diabeticheskogo glomeruloskleroza v dodializnom periode.

Data are submitted of results of treatment of anemia of nephrogenic genesis in 44 patients with diabetes mellitus complicated by diabetic glomerulosclerosis and chronic renal failure (CRF). In the patients, blood count was determined together with the corpuscular volume, blood serum level of creatinine, total protein, trace elements (calcium, sodium, potassium), total cholesterin, and beta-lipoproteins (beta-LP). Two drug regimens were adopted: 21 patient received iron preparations, folic acid, cyanocobalamin, calcium preparations, those preparations to be employed to reduce blood level of creatinine, antihypertensives, and eprex, 1000 u. four times daily for up to 4 weeks; these very preparations were given to 23 patients during the same time range but without eprex in the regimen. Four weeks later, those patients having taken eprex demonstrated significant (though not very high) elevation of the content of hemoglobin, corpuscular volume, erythrocytes and drop in total cholesterin and beta-LP in the blood serum. In those patients having had no eprex in their regimen, there were no changes in the studied parameters. Patients with diabetic glomerulosclerosis concurrent with CRF and nephrogenous anemia should be prescribed eprex and preparations of iron, folic acid, cyanocobalamin combined in correction of the above anemia even in the predialysis period. Iron preparations are not to be administered in those settings where there is no reduction in its level.

[Analysis of irradiation dose, body mass index and insulin blood concentration in personnel cleaning up after the Chernobyl nuclear plant accident]. / Analiz dozy oblucheniia, kontsentratsii insulina v krovi i indeksa massy tela u likvidatorov posledstvii avarii na ChAES.

Liquidators of aftermaths of the Chernobyl accident (LCA) who had worked within the 30-km zone for not more then 3 months in 1986 and early in the year 1987 were examined in 1988-1992, 1997-1998. They were divided into two groups of persons with normal body mass index (BMI) and abnormal BMI. The dose of irradiation received, BMI and insulin concentration in the blood were analysed. The comparison group consisted of persons having been exposed to acute psychogenic stress--they were servicemen in their first year of military service. The control group comprised normal subjects. Hyperinsulinemia was recordable in LCA with normal and abnormal BMI for the space of 3 to 12 years after the accident. The above hyperinsulinemia, as we see it, is related to direct or indirect action of irradiation because those persons with prior acute psychogenic stress and healthy people have been found to be free from hyperinsulinemia. The possibility cannot be ruled out that hyperinsulinemia is a predictor of increased body weight gain and obesity in LCA reported by other authors.

[Ceruloplasmin, transferrin and insulin blood levels in those with diabetes mellitus type II and in nondiabetics who participated in the clean-up after the Chernobyl accident]. / Uroven' tseruloplazmina, transferrina i insulina v krovi likvidatorov posledstvii avarii na ChAES, bol'nykh i ne bol'nykh sakharnym diabetom tipa 2.

In those persons who had taken part in the elimination of the effects of the Chernobyl accident (AEEP), an oxidative stress with disturbed functioning of the antioxidant defence extracellular factors ceruloplasmin and transferrin is recordable over a long time range together with direct and indirect manifestations of insulin resistance. Submitted in the paper is an analysis of indices for ceruloplasmin, transferrin, free iron (FI), and insulin in the blood plasma of AEEP in different age groups and in those AEEP suffering from type II diabetes mellitus (DM) as well. The group of comparison was participants in the military operations (MOP) in Afghanistan. In the older age group AEEP (beyond 40 years of age) and in those AEEP presenting with type II DM similar alterations have been shown to be the case, such as decrease in the content of transferrin and augmentation of ceruloplasmin against the background of hyperinsulinemia. The above alterations can be regarded as a risk factor for origination of type II DM in Chernobyl AEEP.

[Hyperinsulinemia as a factor preceding body mass increase in liquidators of the Chernobyl nuclear accident]. / Giperinsulinemiia kak faktor, predshestvuiushchii povysheniiu massy tela u likvidatorov posledstvii avarii na ChAES.

Basal hyperinsulinemia has been recordable over several years in liquidators of the effects of Chernobyl Accident (ChAEL). There was no dependence of hyperinsulinemia on age, body mass or lenght of service of those persons having worked within the 30-km zone. The findings secured suggest to us that increase in the body mass index (BMI) in ChAEL is preceded by a rise in the blood level of insulin; there is no relatedness of the basal level of insulin in the blood to BMI.

[Correction of diabetic neuropathies using aldose reductase inhibitors and pikamilon]. / Korrektsiia diabeticheskikh neiropatii s pomoshch'iu ingibitorov al'dozoreduktazy i pikamilona.

Streptosotocin-induced diabetes in rats is accompanied by the development of diabetic complications such as neuropathies. [2-14C]serotonin and [U-14C]GABA release from the neurotransmitter pre-loaded synaptosomes showed significant elevation. Aldose reductase inhibitors (AL-1576, sorbinil) administration leads to partial restoration of serotonin and GABA release, while picamilon restored only GABA release. It was shown that Na+,K(+)-ATPase activities decreased in synaptosomes, synaptic membranes and sciatic nerve of diabetic rats compared to control. Administration of AL-1576 normalized Na+, K(+)-ATPase activity, while sorbinil and picamilon less effectively. Sorbitol level are increased in streptozotocin-diabetic rats as compared to control. The picamilon and aldose reductase inhibitors administration to diabetic rats is accompanied by the partial reduction of brain sorbitol level. The findings confirm the important role of picamilon and aldose reductase inhibitors in the prevention and treatment of diabetic neuropathy.

[Role of aldose reductase inhibitors in the development of peripheral neuropathy in experimental diabetes]. / Rol' ingibitorov al'dozoreduktazy v razvitii perifericheskikh neiropatii pri éksperimental'nom diabete.

Streptozotocin-induced diabetes in rats is accompanied by development of diabetic complications such as neuropathies. It was shown that aldose reductase inhibitors (A1-1576, sorbinil and unithiol) administration partially normalized not only polyol pathway. Aldose reductase inhibitors partially restored Na+, K(+)-ATP-ase activity in sciatic nerve of diabetic rats and redox state of nicotinamide adenine dinucleotides. The sorbitol level increases in streptozotocin-diabetic rats as compared to control. Administration of aldose reductase inhibitors to diabetic rats is accompanied by partial reduction of sorbitol level in sciatic nerve. The results obtained confirm the important role of a dose reductase inhibitors, as antidiabetic drugs, in the improvement of diabetic neuropathy.

[Effect of nicotinamide on the uptake and release of serotonin and GABA by cerebral cortex synaptosomes in rats with diabetes induced by streptozotocin]. / Vliianie nikotinamida na zakhvat i vysvobozhdenie serotonina i GAMK sinaptosomami kory golovnogo mozga krys s diabetom, vyzvannym vozdeistviem streptozototsina.

Studies of neurotransmitter uptake and release by isolated rats brain cortex synaptosomes demonstrated that [2-14C]serotonin uptake was by 41% lower in streptozotocin-diabetic rats as compared to control. The [U-14C]GABA uptake was considerably elevated. [2-14C]serotonin and [U-14C]GABA release from the neurotransmitter pre-loaded synaptosomes showed significant elevation, especially during the first 3 minutes. Nicotinamide (NAm) administration (200 mg/kg body weight daily, 14 days) to diabetic rats restored synaptosomal serotonin uptake up to control levels, while the GABA uptake tended to decrease in diabetic rats. With this dose of NAm the partial restoration of serotonin and GABA release was achieved. The modulating effect of in vivo administered NAm acts via NAD which binds specifically with synaptic membranes. It has been shown that brain NAD(P)/NAD(P)H decreased while sorbitol level increased in streptozotocin-diabetic rats as compared to control. The NAm administration to diabetic rats is accompanied by the increase of NAD(P)/NAD(P)H and the reduction of brain sorbitol level. Data obtained confirm the important role of NAm in the pathogenesis of diabetic encephalopathies.

[The theory of the sanatogenesis (the mechanism of the therapeutic effect) of microwave resonance therapy]. / Teoriia sanogeneza (mekhanizma lechebnogo éffekta) mikrovolnovoi rezonansnoi terapii.

On the basis multiannual personal experience in millimeter resonance therapy in the treatment of several diseases (diabetes mellitus, ulcers, etc. [correction of and oth]) data are reported on substantiating the theory of sanogenesis of this method. Various biochemical, immunological, hormonal studies in the experiment and clinic indicate that the basis of the treatment effect of electromagnetic radiation is restoration of homeostasis by activation of compensatory systems. The levels and systems influenced by electromagnetic radiation are indicated. The stage-like character of these influences is stressed.

[Carbohydrate metabolism in patients with Itsenko-Cushing disease following the vascular-pedicle transplantation of the adrenal gland]. / Sostoianie uglevodnogo obmena u bol'nykh bolezn'iu Itsenko-Kushinga posle transplantatsii nadpochechnika na sosudistoi nozhke.

The study was aimed at the evaluation of functional condition of pancreatic islet apparatus in patients with Cushing's disease who underwent adrenal microsurgical transplantation after bilateral adrenalectomy. The examination of 19 patients included immunological tests as well as calculation of insulin level increase, insulin ejection rate and insulin level excess over the baseline after glucose loading. The results suggest that patients with Cushing's disease in active stage reveal increased sensitivity to glucose and functional capacity of pancreatic beta-cells. After unilateral adrenalectomy insulin base level was observed to fall while increased beta-cells responsiveness to glucose remained unchanged. At the same time adrenal autotransplantation on the vascular stem in patients with the Cushing's disease resulted not only in normalization of insulin base level but also in the improvement of the functional indices of the islet cells.

[Activity of membrane-bound protein kinase C and ATPase in erythrocytes in diabetic angiopathy]. / Aktivnost' membranosviazannoi proteinkinazy C i ATFaz eritrotsitov pri diabeticheskoi angiopatii.

The activities of protein kinase C, total, Mg2 and Na+, K(+)-dependent ATPases in red cell membranes were compared in 46 patients with insulin independent, 30 ones with insulin dependent diabetes mellitus with various degrees of vascular disorders, and in 17 patients with atherosclerosis with the predominant involvement of the main vessels of the lower limbs. Diabetes mellitus and the progress of vascular disorders were associated with a more marked depression of protein kinase C, total and Na+, K(+)-dependent ATPase activities, this being particularly characteristic of the patients with insulin-independent diabetes and macrovascular disorders. Inhibited activities of protein kinase C and ATPases in red cell membranes in the course of diabetic vascular disorders progress evidence their contribution to the pathogenesis of diabetic angiopathy.

[The effect of insulin therapy on the level of natural killer cells of different immunological phenotypes (CD16+, CD56+ and CD57+) in the blood of patients with diabetes mellitus type I]. / Vliianie insulinoterapii na soderzhanie estestvennykh kletok-killerov razlichnogo immunologicheskogo fenotipa (CD16+, CD56+ i CD57+) v krovi bol'nykh sakharnym diabetom I tipa.

Flow cytometry with monoclonal antibody Leu-7 (CD57), Leu-11 (CD56) and Leu-19 (CD56) were used to study the content of different subpopulations of natural killer cells (NK-cells) in the blood of type I diabetes mellitus patients before and after insulin treatment and in healthy people. After a course of insulin therapy most patients showed restoration of the total cell number with antigens on their surface characteristic of NK-cells, especially CD56, that indicates the essential role of hypoinsulin in the depression of the NK-system. At the same time a small group of patients was distinguished who did not show such normalization. This may indicate participation of other mechanisms in the formation of natural immunity failure, in particular, the genetic.

[Nicotinamide coenzymes in the regulation of cellular metabolism in various types of diabetes]. / Nikotinamidnye kofermenty v reguliatsii kletochnogo metabolizma pri raznykh tipakh diabeta.

Hypoglycemic and hypolipidemic effects of nicotinamide in insulin-dependent and noninsulin-dependent types of diabetes have been investigated. Hypoglycemic effect of nicotinamide in alloxan- and streptozotocin-induced diabetes resulted in activation of NAD+ biosynthesis and corresponding alterations in the redox state of free nicotinamide coenzymes. Increase in the free NAD+/NADH ratio was accompanied by inhibition of key gluconeogenic enzymes and by a decrease in the rate of 2-14C-incorporation into glucose in liver tissue and by inhibition of sorbitol formation in lens tissue. Nicotinamide exhibited hypolipidemic effect in db/db mice with noninsulin-dependent diabetes. The agent inhibited the enzyme of primary steps of lipogenesis, altered the structure of intercellular CoA pool and lowered the rate of lipid biosynthesis in liver tissue, thus normalizing blood lipoprotein compositions.

[Atrial natriuretic peptide in diabetes mellitus patients with arterial hypertension]. / Predserdnyi natriiureticheskii peptid pri arterial'noi gipertenzii u bol'nykh sakharnym diabetom.

The basal level of atrial natriuretic peptide (ANP) of the venous blood plasma was investigated in 105 diabetic patients with concomitant arterial hypertension (AH) as well as in 20 healthy persons of the same age. Analysis of the results of investigation was performed with respect to AH type (essential, atherosclerotic, nephrogenic) and expression of cardiac changes. An ANP level in diabetic patients without AH did not differ from that of the controls. In the presence of AH this level was increased 2-10-fold. The highest level of ANP was observed in patients with nephrogenic hypertension and marked cardiac disorders. The results obtained suggest the role of ANP in AH pathogenesis.