[Study of genetic determination of base clinical components of metabolic syndrome].

Genetic analysis was carried out on the material including clinic and genealogical data about 510 patients with type 2 Diabetes Mellitus, 445 Essential Hypertension individuals, 239 abdominal obesity persons and their 1st degree relatives. It has been shown that the Essential Hypertension and abdominal obesity distribution in the population and families can be described by means of a variants polygene model with essential influence of the major genes. Gene complexes of predisposition to obesity, Essential Hypertension and Type 2 Diabetes Mellitus are independent, however, their liabilities are covered.

[Short- and long-term results of intensive insulin therapy in patients with severe forms of diabetes mellitus type I]. / Neposredstvennye i otdalennye rezul'taty intensivnoi insulinoterapii bol'nykh s tiazhelymi formami sakharnogo diabeta I tipa.

Short- (3-4 week) and long-term (1-4 yrs) results of the use of intensive insulin therapy schemes were used in 37 patients with severe forms of type I diabetes mellitus. Its beneficial effect on metabolism, remaining secretory beta-cell function, the frequency and expression of hypoglycemic reactions, manifestations of peripheral and visceral neuropathy, diabetic encephalopathy was proved.

[Role of the time factor in the pancreatic and extrapancreatic mechanisms of action of glibenclamide]. / Znachenie vremennogo faktora v realizatsii pankreaticheskogo i vnepankreaticheskogo mekhanizmov deistviia glibenklamida.

A study was made of the effect of short- and long-term administration of one of the sulfanilurea derivatives of the 2nd generation--glibenclamide on pancreatic beta-cell function and the sensitivity of peripheral tissues to insulin under clinical and experimental conditions. The authors established time correlation of the mechanisms of glibenclamide hypoglycemic action: beta-cytotropic action in acute administration of the drug and extrapancreatic influence in chronic administration. An idea of predominant significance of the postreceptor level in the realization of the extrapancreatic effect of long-term administration of glibenclamide was substantiated.

[Age-related pathomorphism of diabetes mellitus]. / K voprosu o vozrastnom patomorfoze sakharnogo diabeta.

Insulin supply of the body, activity of hormonal and nonhormonal insulin antagonists were studied and compared in subjects of different age with disordered carbohydrate tolerance. The role of hormonal and non-hormonal antagonists in the genesis of glucose intolerance was found to be different in different age periods in the presence of hyperinsulinemia and the reduced insulin-glucose index common to all the groups examined. Young age is marked by a distinct increase in glucocorticoid and, to a less degree, in androgenic functions of the adrenals. The elderly manifest activation of the angiotensin-renin-aldosterone system and more pronounced hypercholesterolemia and triglyceridemia in the presence of the changed body sensitivity to insulin. It is suggested that age-associated changes in the mechanisms of the glucose homeostasis control may be of importance in the formation of the features of individual patterns of diabetes mellitus.

[Sensitivity to insulin in patients with diabetes mellitus]. / Izuchenie chuvstvitel'nosti k insulinu u bol'nykh sakharnym diabetom.

The author studied insulin sensitivity in 69 patients with types I and II diabetes mellitus with a disease standing under one year. It was established that in insulin-dependent and insulin-independent diabetes mellitus, there are no significant differences in the indicators marking insulin sensitivity. Considerable heterogeneity of type II diabetes mellitus was recorded in terms of the above indicator. The dependence of the rate of the retarded curves of the insulin tolerance test on the degree of insulin deficiency is discussed.

[Clinical characteristics and hormonal-metabolic homeostasis in patients with insulin-dependent diabetes mellitus with stable and labile courses]. / Osobennosti kliniki i gormonal'no-obmennogo gomeostaza u bol'nykh insulinozavisimym sakharnym diabetom pri ego stabil'nom i labil'nom techenii.

Combined examination of 117 patients with insulin-dependent diabetes mellitus revealed the clinical and hormonal features of stable and labile diseases. Emphasis is laid on the complexity of the lability phenomenon; evidence is given for the necessity of differentiating between genuine lability and that of the iatrogenic type. The importance of hormonal shifts (depletion of the secretory capability of the insulin-producing apparatus and reduction of contrainsular effects) for the origin of destabilization of glucose homeostasis is discussed.

[Adrenal cortex glucocorticoid function in the early stages of the development of different forms of diabetes mellitus]. / Gliukokortikoidnaia funktsiia kory nadpochechnikov na rannikh stadiiakh razvitiia raznykh form sakharnogo diabeta.

An increase in the basal cortisol level in the blood plasma or the adrenal cortex reaction to insulin hypoglycemia was seen in patients in the early periods of diabetes mellitus (latent, initial manifest type). No considerable differences were found between the adrenals of juvenile and adult diabetic patients. Combined diabetes mellitus and obesity led to a significant rise in the indices studied. An intensification of the adrenocortical glucocorticoid function is not accompanied by an enhancement of the hypophysis adrenocorticotropic function.

[Various characteristics of energy metabolism in diabetes mellitus]. / Nekotorye osobennosti énergoobespecheniia organizma pri sakharnom diabete.

In the blood of patients (104) with diabetes mellitus of various severity some energy metabolic indices (lactate, pyruvate, nonesterified fatty acids, and in some patients also glycogen and glycogenolytic activity of the blood), tissue oxygen tension and immunoreactive insulin were studied simultaneously. The glycogen content, a and b phosphorylase activity were determined in the liver and the skeletal muscles, and lactate, glycogen, and pyruvate in the blood of animals with experimentally induced diabetes mellitus (alloxan and immune diabetes). Changes in the energy metabolism were revealed in all forms of diabetes mellitus: in hyperinsulinism accompanying early forms of diabetes mellitus there was activation of anaerobic processes and tissue hyperoxygenation, and at the late stages of the disease a tendency to tissue hypoxia. Experimental diabetes was accompanied by glycogen reduction in the skeletal muscles together with the growth of b phosphorylase activity. This could be due to the reduction of glucose-6-phosphate in the muscles and to a disturbed activity of the other systems regulating glycogen metabolism.

[Use of various preparations with beta-adrenergic blocking action in the overall therapy of thyrotoxicosis]. / Primenenie razlichnykh preparatov beta-adrenoblokiruiushchego deistviia v kompleksnoi terapii tireotoksikoza.

Three beta-adrenoblockers (trasicor, alpheprol, isoptin) were used in 68 patients with thyrotoxicosis in the complex therapy of the disease. Their effect on hemodynamic indices, urinary catecholamine excretion were studied, and the results of investigation were compared with the data obtained earlier with the use of anaprylin. The action of the latter on the thyroid metabolism was ascertained. Anaprylin proved to be the most effective of the aforementioned preparations. Trasicor, which was somewhat less effective, could be used in patients with thyrotoxicosis complicated by cardiovascular insufficiency due to its less pronounced inotropic action. Isoptin may be recommended as an anti-arrhythmic agent in thyrotoxicosis. The action mechanism of beta-adrenoblockers in thyrotoxicosis is suggested.

[Sensitivity of thyrotoxic heart to adrenergic influences]. / K voprosu o chuvstvitel'nosti tireotoksicheskogo serdtsa k adrenergicheskim vliianiiam.

Sensitivity of the cardiovascular system of patients suffering from thyrotoxicosis to exogenous adrenaline was studied. In difference from healthy persons, a single injection of 1 ml of 0.1% adrenaline solution to patients with thyrotoxicosis of moderate severity caused a significant elevation of the arterial pressure, frequency of cardiac contractions, systolic and minute output, myocardiac inotropism indices. An increased inderal reactivity was noted in these patients. Thus, greater sensitivity to adrenergic actions and to beta-adrenoblock was observed in conditions of an excess of thyroid hormones. A coincident administration of adrenaline and inderal balanced the positive chronoinotropic effect of the former, but failed to prevent the hypertensive effect of adrenaline.