[Features of steroidogenesis and arterial hypertension in men in different types of "physiological" male hyperandrogenism].

AIM: To reveal the peculiarities of steroidogenesis and arterial hypertension in «physiological¼ hyperandrogenism in men. MATERIALS AND METHODS: One-stage simultaneous study. The groups of men with hyperandrogenism caused by increased total testosterone (n=34) and those with hyperandrogenism caused by increased dihydrotestosterone (DHT) (n=66) were compared. In determining the type of hyperandrogenism and allocating patients to groups, DHT and total testosterone levels were determined by enhanced chemiluminescence. Subgroups of men with and without arterial hypertension were compared in the group of patients with hyperandrogenism due to an increase in total testosterone. Body mass index, waist circumference, systolic and diastolic blood pressure, pulse, and LH, SBHG, estradiol, blood multisteroid levels by isotope dilution liquid chromatography/tandem mass spectrometry, glucose, blood lipid spectrum, uric acid, creatinine, renin, potassium, sodium, and blood chloride were assessed in all patients. Patients with arterial hypertension additionally underwent daily BP monitoring, albuminuria assessment, electrocardiography, ocular fundus examination. The baseline threshold level of significance was p<0.05. For multiple comparisons, the p significance level was calculated using the Bonferroni correction. RESULTS: Statistically significant differences were found in the levels of 17-hydroxypregnenolone, 17-hydroxyprogesterone, and androstenedione, which were higher in men with elevated levels of total testosterone. No statistically significant differences in other laboratory parameters were found. No cases of increased blood pressure were detected in the group of men with elevated DHT. In the group of men with elevated total testosterone, 23,5% of men with arterial hypertension without targetorgan lesions were identified, while hyperandrogenism was associated with 17,6% of cases. Arterial hypertension associated with hyperandrogenism was characterized by a rise in blood pressure in the early morning hours. Estradiol levels, while remaining within normal limits, were statistically significantly lower in patients with arterial hypertension compared with men with elevated testosterone but without hypertension. CONCLUSION: No cases of arterial hypertension were observed in «physiological¼ hyperandrogenism due to elevated DHT levels, whereas its incidence in «physiological¼ hyperandrogenism due to elevated total testosterone was 23,5%. The features of steroidogenesis were increased production of 17-hydroxypregnenolone, 17-hydroxyprogesterone, and androstenedione in men with testosterone hyperandrogenism and decreased estradiol production in patients with arterial hypertension compared with patients without testosterone hyperandrogenism.

[Features of hyperandrogenism in men].

BACKGROUND: Today the problem of hyperandrogenism in women is a widely studied and discussed while same issue in relation to men is barely raised. In clinical practice, hyperandrogenism can be the cause of a number of diseases. AIM: Provide characterization the variations of physiological hyperandrogenism in men. MATERIALS AND METHODS: Сontinuous cross-sectional study of 100 men with hyperandrogenism. The study assessed the volume and structure of the prostate, the volume of the testicles; the levels of luteinizing hormone (LH), total testosterone, sex hormone binding globulin (SHBG) were determined with further calculation of the level of free testosterone according to Vermeullen, and dihydrotestosterone (DHT). Based on the results of the analysis of the hormonal status of patients with hyperandrogenism, 4 groups of patients were formed: 1-patients with increased total testosterone and SHBG levels; 2-patients with elevated total testosterone levels and normal SHBG levels; 3-patients with an increased level of total testosterone, DHT with a normal level of SHBG; 4-patients with an increased level of DHT with normal levels of total testosterone and SHBG. The difference between groups of patients was determined, a p-value <0.05 was considered statistically significant. RESULTS: The age and volume of the prostate in group 1 patients were statistically significantly higher than in the other groups. This group, despite the high level of total testosterone, was not characterized by complaints of acne. Group 2 patients complained of acne more often, but the prevalence of this symptom even in this group was statistically significantly lower than in group 3 patients. At the same time, the frequency of occurrence of alopecia was statistically significantly lower in group 2 than in patients of both groups 3 and 4. Patients of group 3 had the most striking clinical manifestations of hyperandrogenism. Group 4 was characterized by alopecia. CONCLUSION: An increase of androgen levels can be detected at any age. At the same time, in men of the older age group, an increase in the level of total testosterone may be due to an increase in the secretion of SHBG and not be accompanied by an increase in the level of free testosterone. In young patients, the clinical manifestations of hyperandrogenism may differ: patients with elevated DHT levels are characterized by androgenic alopecia; acne is common in men with elevated total and free testosterone levels, and increased DHT exacerbates the problem.

[Diagnosis of disorders of rheological properties of blood and central and cerebral hemodynamics in infants with complicated pneumonia]. / Diagnostika narushenii reologicheskikh svoistv krovi, tsentral'noi i mozgovoi gemodinamiki u detei grudnogo vozrasta s oslozhnennoi pnevmoniei.

A study was made of the rheological blood properties, microcirculation, central and cerebral hemodynamics in children of the first year of life with complicated pneumonia. On admission to the department of intensive care and resuscitation the patients demonstrated pronounced hemorheological and hemodynamic disorders which might in many respects determine the disease gravity. Based on an analysis of the clinical observations and hemodynamic findings 3 periods of complicated pneumonia were distinguished in such children: the critical period, stabilization and repair. Each period is characterized by different compensatory adaptive and non-adaptive erythrocytic and hemodynamic reactions.