[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 steroidogenesis in men with hypogonadism and type 2 diabetes].

BACKGROUND: Type 2 diabetes mellitus (DM2) in men is associated with a high incidence of hypogonadism. Testosterone is a steroid hormone and one of the final metabolites of steroidogenesis, which causes interest in assessing the content of key steroid hormones, their precursors and metabolites in hypogonadal and eugonadal men with T2DM. AIMS: Assessment of the features of steroidogenesis in men with hypogonadism in T2DM using tandem mass spectrometry. MATERIALS AND METHODS: A full-design, cross-sectional, screening, single-center, non-interventional study included men with T2DM, who were he was treated in Endocrinology Research Centre, Moscow. The study was conducted from October 2021 to January 2022. Medical history assessment, physical examination with determination of body mass index (BMI), measurement of key steroid hormones, their precursors and metabolites by isotope dilution liquid chromatography/tandem mass spectrometry, glycated hemoglobin (HbA1c) were performed. The groups were compared using the Mann-Whitney U-test for quantitative indicators and χ² with Yates' correction for qualitative ones. Correlation analysis was performed by the Spearman correlation method. When determining the criterion of statistical significance, the Bonferroni correction was applied. RESULTS: Patients with hypogonadism had statistically significantly more pronounced obesity compared with eugonadal men. In a comparative analysis of patients, depending on the presence of hypogonadism, there were statistically significantly lower levels of androgen precursors 17-hydroxypregnenolone and 17-hydroxyprogesterone in hypogonadal men. At the same time, a positive statistically significant correlation was found between total testosterone and 17-hydroxyprogesterone. In addition, 17-hydroxyprogesterone, although to a lesser extent, but positively correlated with other androgens - androstenedione (r=0,328; p<0,001) and dehydroepiandrosterone (r=0,183; p=0,004). >< 0,001) and dehydroepiandrosterone (r=0,183; p=0,004). CONCLUSIONS: In this investigation the prevalence of male hypogonadism in type 2 diabetes, determined by high-precision tandem mass spectrometry, was 69,5%. There was no effect of the disease on the mineralocorticoid and glucocorticoid links of adrenal steroidogenesis. Hypogonadism was associated with decreased levels of a number of testosterone precursors. The most significant of them was 17-hydroxyprogesterone, which can be considered as a marker of testicular steroidogenesis.

[Development of destructive thyroiditis and diabetes mellitus after three injections of pembrolizumab for skin melanoma].

The exponential rise in the use of immune checkpoint inhibitors (Ipilimumab, Nivolumab, Pembrolizumab, Atezolizumab, Durvalumab, and Avelumab) as the new standard for cancer treatment increase the incidence the immune-related adverse events due to immune activation. Endocrine immune-related adverse events are the third most commonly reported. Thyroid gland is most susceptible to autoimmune dysfunctions from immune checkpoint inhibitors and associated with the use of anti-PD-1 monoclonal antibodies. Hypophysitis develops more often during therapy with anti-CTLA-4 monoclonal antibodies. But such immune-related adverse events as diabetes mellitus, hypoparathyroidism are rare (about 1% of cases).We present a clinical case of the patient with skin melanoma who was prescribed therapy with immune checkpoints inhibitors (Pembrolizumab). Immune-related adverse events developed with damage to the endocrine organs after 3 Pembrolizumab injections. Of greatest interest is the development of two endocrine immune-related adverse events at once: destructive thyroiditis (with a short phase of thyrotoxicosis and subsequent persistent hypothyroidism) and diabetes mellitus. We tried to reflect the chronology of diseases and their features as fully as possible for endocrinologists, oncologists, therapists, family doctors and other medical doctors of related specialties.

[The role of glucose and insulin in the metabolic regulation of growth hormone secretion].

The exact physiological basis for the suppression of growth hormone secretion by oral glucose intake remains unknown, despite the widespread use of the oral glucose tolerance test in endocrinology. Lack of growth hormone suppression by glucose occurs in about a third of patients with acromegaly, as well as in other disorders. It is currently known that the secretion of growth hormone is affected by various factors, such as age, gender, body mass index, and the redistribution of adipose tissue. There is also evidence of the impact of overeating as well as being overweight on the secretion of growth hormone. It is known that both of these conditions are associated with hyperinsulinemia, which determines the possibility of its predominant role in suppressing the secretion of growth hormone. The purpose of this review is to discuss the accumulated data on the isolated effects of hyperglycemia and hyperinsulinemia on growth hormone secretion, as well as other metabolic regulators and conditions affecting its signaling. Understanding of the pathophysiological basis of these mechanisms is essential for further research of the role of glucose and insulin in the metabolic regulation of growth hormone secretion. However, the studies in animal models are complicated by interspecific differences in the response of growth hormone to glucose loading, and the only possible available model in healthy people may be the hyperinsulinemic euglycemic clamp.

[Iodine deficiency disorders as a non-infectious epidemic: a look at the problem at the tome of COVID-19 pandemic].

Radioactive iodine, flying out of the destroyed reactor of the Chernobyl nuclear power plant, like a corona virus quickly spread throughout Europe. Iodine deficiency in the regions of Ukraine, Belarus and Russia adjacent to nuclear power plants became a factor in increased uptake of radioactive iodine by the thyroid gland in children and after 5 years led to an epidemic of thyroid cancer. Optimal iodine intake could become a kind of vaccination, which sharply reduces the risk of developing thyroid cancer, as has happened after the accident at the Fukushima nuclear power plant in Japan. Endemic goiter was eliminated 50 years ago, but returned to the country in the early 1990s after the collapse of iodized salt production and has not been eliminated to this day due to the lack of a legislative framework for mandatory salt iodization. The actual average consumption of iodine by residents of Russia is from 40 to 80 mcg per day, which is 23 times less than the recommended norm. Mild and moderate iodine deficiency was detected throughout the Russian Federation, and it is more typical for the the rural population. The iodine deficiency has the greatest negative effect on the psychomotor development of the child during the critical period the first 1000 days of life from the moment of conception to the end of the second year of life. According to WHO, over the past 20 years, iodine deficiency has been eliminated in 115 countries of the world, and the number of iodine-deficient countries has dropped to 25, but Russia is still among them. We believe that after the COVID-19 pandemic, it will no longer be necessary to prove the need for effective support for the prevention of both infectious and non-infectious diseases, and the declared preventive direction of Russian medicine will indeed become such.

Somatic Mutations in the BRAF, KRAS, NRAS, EIF1AX, and TERT Genes: Diagnostic Value in Thyroid Neoplasms.

The feasibility of using molecular genetic markers associated with thyroid neoplasms and more aggressive course of the disease is now actively studied. We analyzed the diagnostic value of somatic mutations in the hot spots of BRAF, KRAS, KRAS, EIF1AX, and TERT genes in histological material from 153 patients with thyroid gland neoplasms. BRAF mutations (exon 15, codon area 600-601) were found in 54 patients, NRAS mutations (exon 3, codon 61) were detected in 12 patients; mutations KRAS, TERT, and EIF1AX genes were not detected.

[Primary hyperparathyroidism in Russia according to the registry].

BACKGROUND: There are no large-scale epidemiological studies on primary hyperparathyroidism (PHPT) in Russia. The high prevalence of the disease, the high risk of disability and death in this cohort of patients requires the study of the epidemiological and clinical structure of PHPT to determine the extent of medical care. AIM: Evaluate the frequency of PHPT detection and characterize its clinical forms in Russia using an online registry. METHODS: The object of the study is the database of the State Register of Patients with PHPT 1914 patients from 71 regions of the Russian Federation. New cases of the disease, as well as dynamic indicators are recorded when patients visit outpatient clinics or medical institutions. The analysis of data made at the end of December 2017 was carried out. The following parameters were evaluated: demographic and clinical indicators; indicators of phosphorus-calcium metabolism, the main forms of PHPT and its course, the primary characteristic of PHPT in hereditary syndromes and parathyroid carcinoma. Results are presented as mean and standard deviations, or medians and quartiles; descriptive statistics of qualitative attributes absolute and relative frequencies. RESULTS: the total number of patients with PHPT in the registry on 31 of December 2017 was 1914 cases (0.001% of the population of the Russian Federation). Identification of PHPT was 1.3 cases per 100 thousand of the population in Russia, 7.6 cases in Moscow, 6.1 cases per 100 thousand in the Moscow region. The average age of patients at the time of diagnosis was 55.6 10 years. The active phase of the disease was registered in 84.6% of patients (1620/1914), most of whom had a symptomatic PHPT 67.1% (1087/1620), and 32.9% a asymptomatic disease (533/1620). Symptomatic disease with visceral complications was detected in 15.8% cases (172/1087), with bone complications in 48.4% (526/1087). The mixed form of the disease was detected in 35.8% of patients with manifest form (389/1087). Normocalcemic variant PHPT (nPHPT) was registered in 14.5% cases (234/1620). Sporadic PHPT occurs in 83% of cases (1592/1914). 326 patients (17%) had a suspicion for hereditary form of the disease: average age was 31.2 12.3 years. A genetic analysis was conducted in 61 patients (3.2%): showed the mutation in the MEN1 gene in 2.9% of cases (55/1914) and the mutation in the CDC73 gene in 0.3% of cases (6/1914) (HPT-JT syndrome). Parathyroid carcinoma was confirmed in 1.8% of all patients (35/1914). Surgical treatment was performed in 64.5% of patients (1234/1914). Remission was achieved in 94% of cases (1160/1234), in 6% of cases relapse after surgical treatment or persistence of PHPT was recorded. CONCLUSION: detection of PHPT in the Russian Federation raised in comparison to 2016, which is associated with an active start of registration of patients in the regions. At this stage, it is necessary to modify the principles of registration and control, to make a platform for gathering information and calculating the necessary volumes of medical care for PHPT patients.

Syndrome of thyrotoxicosis. Differential diagnosis and treatment.

Since the middle of the twentieth century, there has been a significant change in methods of the diagnosis and treatment of thyroid diseases with thyrotoxicosis syndrome. Previously doctors did not have trouble just with diagnosing diseases that occur with a typical clinical presentation (the Merzeburg triad, a multinodal goiter with fibrillation) because of no possible to determine thyroid hormones. Then in the early 70s years the appearance of immunological methods for estimating hormones in the blood has led to significant changes in our understanding of the variants of thyroid pathology with thyrotoxicosis (TT). Today, the diagnosis of the fact of thyrotoxicosis as a whole is not difficult (except for the confusion of preanalytical errors), but differential diagnosis within the declared syndrome remains extremely relevant to this day. Unfortunately, in the minds of many doctors, these diseases are sometimes perceived as a whole, and in the conditions of the "century of speeds", a modern doctor, extremely limited in time, often unjustifiably prescribes thyreostatic therapy, treatment with radioactive iodine or even surgical intervention after detecting thyrotoxicosis. The old truth "remember that a patient with thyrotoxicosis is a person with a sick heart..." has not lost relevance today. It is very important for the practicing physician be able to navigate in the spectrum of pathologies manifested by the thyrotoxicosis pattern because of the influence of excess thyroid hormones on the cardiovascular system and the hemostasis system. Hereinafter we tried to show diagnostic aspects focusing on differences in pathologies with TT syndrome in a lot of thyroid diseases and even nonthyroid diseases.

[Epigenetic Aspects of Osteoporosis].

This review describes the epigenetic regulation of osteoblastogenesis and osteoclastogenesis and its future implementation in the diagnosis and treatment of osteoporosis. A considerable part of the review is dedicated to the microRNAs (miRNAs). miRNAs are small regulatory factors that regulate gene expression, by post-transcriptional regulation of genes playing an important role in numerous cellular processes, including cell differentiation and apoptosis. Recently, a number of studies have revealed that miRNAs participate in bone homeostasis and their role in the pathogenesis of osteoporosis is practically evident. In this review, we highlight the miRNAs involved in bone remodelling and their roles in osteoporosis. miRNAs are stable molecules which make them promising potential markers for bone remodeling and osteoporosis.

[Abnormal calcium metabolism in the remote period after bariatric surgery].

Calcium metabolism in the long-term period after bariatric surgery is reviewed in the present article. The study of calcium metabolism parameters and vitamin D status was performed in The Endocrinology Research Center. Morbidly obese patients (BMI > 40) were included in the 1st group (n = 22), patients who underwent biliopancreatic diversion for morbid obesity (n = 23) were included in the 2nd group, healthy normal weight controls (n = 22) were included in the 3rd group. 25 (OH) D level was different in the 3 groups (p < 0.001). Vitamin D deficiency prevailed in morbidly obese patients compared to healthy controls (p = 0.007). Elevated parathyroid hormone (PTH) level was found in 4 (18%) morbidly obese patients, in 12 (52%) operated patients. Not a single case of PTH over reference interval was found in the controls. The frequency of secondary hyperparathyroidism was significantly higher in the operated patients.

["Other types" of diabetes: contra-insular hormones and genetic predisposition, new horizons of diagnostics and treatment].

This article deals with various specific types of diabetes mellitus and other carbohydrate metabolism distortions occurring against the background of different endocrinopathies: hypercorticism, acromegaly, hyperparathyroidism, pheochromocytoma and other. Epidemiology of carbohydrate metabolism distortions as well as pathophysiological mechanisms of hyperglycemia development in various endocrinopathies are included in the article, the necessity of endocrinopathy screening among patients with refractory carbohydrate metabolism distortions is substantiated, objectives and tactics of glucose-reduction-therapy in these patients are defiend. This article also contains data upon prevalence and prevention of long-term complications of diabetes mellitus.

[The saliva cortisol level test using the automatic immunochemical analyzer Cobas e601 (Roche) to diagnose endogenous hypercorticalism in patients with obesity].

The saliva cortisol level test applies to diagnose endogenous hypercorticalism. However the methods of die format immunoassay traditionally used do not make it possible to get the study results on-the-fly. Also, reference interval and optimal takeoffs differ under implementing various techniques of cortisol tests. The purpose of actual study is to investigate the possibilities of electrochemiluminescent technique of testing free cortisol in saliva. The device Cobas e601 was applied to diagnose endogenous hypercorticalism in patients with obesity. The saliva samples were collected at 11 PM from 98 healthy volunteers and 123 patients with obesity (in 45 cases endogenous hypercorticalism was diagnosed). In total, 205 persons donated saliva at 11 PM two days running to evaluate the technique reproducibility. The samples of 197 individuals were frozen to implement the immune-enzyme assay. The minor test with dexamethasone was applied to patients with suspected endogenous hypercorticalism. The diagnosis of endogenous hypercorticalism was finally confirmed after the results of histological analysis of post-operative material or autopsy. Among healthy volunteers, the reference interval on indicators consisted 0.5-9.4 nMol/l. The correlation coefficient under free cortisol measuring at the same time two days running was -0.785. The optimal takeoff to diagnose endogenous hypercorticalism in patients with obesity consisted 9.4 nMol/l, sensitivity--84.4% (95% confidence band 71.2-92.2%), specificity--92.3% (95% confidence band 84.2-96.4%), predictive value of positive result--11.0 (95% confidence band 5.0-23.9), predictive value of negative result--0.17 (95% confidence band 0.08-0.33) and likelihood ratio for positive result--65.1 (95% confidence band 20.4-207.6). The two-fold cortisol test in saliva using immune-enzyme assay and minor test with dexamethasone with their diagnostic capabilities corresponded to one-fold saliva free cortisol test using electrochemiluminescent technique. The one-fold free cortisol test in saliva collected in 11 PM using the analyzer Cobas e601 for electrochemiluminescent immunoanalysis is a convenient and informative endogenous hypercorticalism screening technique in patients with obesity.

[Dynamics of prevalence of functional thyroid dysfunctions among pregnant women in Moscow from 1999 to 2008].

The objective of this study was to study dynamics of prevalence of functional thyroid dysfunctions among pregnant women. The levels of TSH, free T4, and antithyroid peroxidase antibodies (ATP-AB) were measured in randomly selected women of different gestational age who applied to be registered in a maternity welfare centre in 1999-2003 (n = 215) and 2006-2008 (n = 325). The available data indicate that iodine consumption by the study populations increased during the above periods even if still remains subnormal. No statistically significant decrease in the occurrence of ATP-AB and hypothyroidism was recorded. Women carrying ATP-AB in the first and seconds trimesters of pregnancy had significantly higher TSH levels compared to those without ATP-AB. A change of diagnostic criteria for hypothyroidism (lowering the reference TSH threshold from 4.0 to 2.5 mU/l accounts for a several-fold rise (by a factor of 2-7) in the prevalence of hypothyroidism among pregnant women.

[A screening algorithm for patients with adrenal incidentalomas].

Integrated clinical and economic analysis of the efficiency of screening was made in patients with adrenal incidentalomas under the established practical conditions; the average cost of screening of a patient with adrenal incidentalomas and the cost of one detected case were determined under these conditions. Based on the clinical and economic analysis, the authors have elaborated and scientifically substantiated an algorithm for screening of patients with adrenal incidentalomas, the use of which will permit, with high clinical efficacy, a significant reduction in the cost of screening.

[Postpartum thyroiditis: risk factors, differential diagnosis, clinical features].

Postpartum thyroiditis (PT), one of the commonest causes of disturbed thyroid function (TF), is believed to occur in 5% of the women. The present study involving 57 patients with PT was designed to study risk factors and clinical features of this pathology as well as approaches to its diagnosis. Two control groups comprised female carriers of anti- thyroid peroxidase antibodies (TPO-AB) without PT and women having symptoms of Graves disease (GD) in the postpartum period, respectively. Patients with PT were shown to have significantly elevated TPO-AB levels during pregnancy compared with controls. Postpartum GD manifested itself later than PT, it was associated with a significantly higher freeT4 level and a greater thyroid volume. In twenty of the 57 women with PT, it was manifest in the thyrotoxic phase and in the remaining 37 in the hyperthyroid state. The TSH level in the first half of pregnancy was significantly higher in the women that eventually developed a monophasic hypothyroid variant of PT. In the same group, the TPO-AB level at the time of PT diagnosis was significantly higher than in the biphasic variant of PT. Forty (70%) of the 57 women with PT recovered to an euthyroid state by the end of the study whereas in 17 (30%) hypothyroidism persisted. The biphasic variant of PT was manifest starting from the thyrotoxic phase and more frequently ended in the recovery to the euthyroid state (90%) than the monophasic one, the difference being statistically significant. In contrast, the monophasic hypothyroid variant more frequently resulted in persistent hypothyroidism (40%).

[Gender-specific features of hyperprolactinemia syndrome].

The objective of the present work was to study specific clinical features of hyperprolactinemia in men and women. A total of 148 men and 138 women with hyperprolactinemia of tumorous and non-tumorous etiology were examined. Analysis of medical histories demonstrated that the period between the appearance of the first clinical symptoms and the establishment of diagnosis of hyperprolactinemia in men was longer than in women. The frequency, size, and invasiveness of macroprolactinomas were also different in the two sexes. Prolactin-secreting pituitary tumours in men showed more aggressive growth than in women. All the patients included in the study were examined for the measurement of monomeric prolactin (PRL) by separation of individual fractions in the precipitation reaction with 25% polyethyleneglycol. Macroprolactinemia occurred more frequently in women than in men. Total and monomeric PRL levels were higher in men with hyperprolactinemia of tumorous origin compared with women.

[Comparison of the effects of carbohydrate metabolism compensation and atorvastatin treatment on lipid metabolism and C-reactive protein in type 2 diabetes mellitus].

AIM: To compare effects of atorvastatin treatment and carbohydrate metabolism compensation on lipid spectrum and a C-reactive protein (CRP) level in patients with type 2 diabetes mellitus (DM). MATERIAL AND METHODS: The lipid spectrum was studied in a random sample of 165 patients (66 males, 99 females) with type 2 DM (age median 57 years, duration of the disease 7 years). Out of this sample 26 patients with LDLP cholesterol >3 mmol/l were randomized into 2 groups. The study group received 20 mg/day atorvastatin for 3 months, the control group received no inhibitors of GMG-Coa-reductase. The patients' blood was tested for glycosylated hemoglobin, aminotransferase, creatinphosphokinase, total, HDLP, LDLP cholesterol. RESULTS: Changes in the lipid spectrum were detected in 98.2% patients, 42.4% of them had combined dyslipidemia: elevated total cholesterol (TC), LDLP cholesterol, triglycerides (TG) and low HDLP cholesterol. After 3 months of therapy both groups demonstrated the same significant lowering of HbA(1c). The control group had also elevated level of HDLP cholesterol, unchanged levels of TC, LDLP cholesterol, TG. 3-month therapy with atorvastatin lowered TC from 6.41 to 4.76 mmol/l, LDLP cholesterol from 4.19 to 1.87 mmol/l, TGfrom 2.69 to 1.62 mmol/l, apo B from 1.64 to 1.13 mg/dl, raised HDLP from 0.99 to 1.21 mmol/l (p < 0.05). CRP fell from 5.65 to 2.33 mg/dl (p=0.026) irrespective of carbohydrate metabolism compensation (CRP in the control group did not change). CONCLUSION: More than 98% type 2 diabetics have atherognic impairment of the lipid spectrum. Atorvastatin produces an antiatherogenic effect due to both improvement of the lipid metabolism and CRP level reduction irrespective of the degree of compensation of carbohydrate metabolism in type 2 DM

[The diagnostic value of macroprolactin in hyperprolactinemia].

Macroprolactinemia (MP) in which there is a discrepancy between prolactin (P) levels and clinical symptoms has recently generated great interest among physicians of various specialties since not the whole of P is biologically active. The diagnosis of this condition is a topical problem. The purpose of the investigation was to detect high molecular-weight or big big P in patients with hyperprolactinemia (HP) of various genesis and to define its clinical importance. A hundred and one females with HP (P > 700 mU/l) were examined. In each patient, biologically active monomeric P was measured via treatment of polyethylene glycol (PEG) 6000. MP was detected in 23% of the examinees. Among them, only 11 females had clinical symptoms of the disease: 72.7% complained about menstrual irregularities; galactorrhea and headache were observed in 18.3 and 9.0%, respectively. The remaining 12 females had no clinical symptoms of HP. MP in which the clinical symptoms are feebly marked has been found to be not a rare condition. The determination of big big P in HP is of diagnostic value. It is recommended that the serum separation diagnostic technique using PEG should be made routine in the examination of patients with HP, particularly in the discrepancy of biochemical and clinical data and in idiopathic HP.

[Obesity in adolescents. Results of Russian epidemiological trial].

AIM: To study prevalence of overweight and obesity among Russian 12-17 year-olds. MATERIAL AND METHODS; A total of 11977 adolescents (forms 6-11) from schools randomly selected for one-stage trial were examined. The protocol included filling in questionnaires, measurements of body mass, height, waste circumference. Overweight and obesity were verified by international BMI criteria regarding age and gender. Statistic processing was made with SPSS program package. RESULTS: The analysis covered 10223 questionnaires (46.5% boys, 53.5% girls). Overweight was registered in 11.8%. Of them, 2.3% had obesity. Overall incidence of overweight and obesity in Russia among 12-17-year-old girls is 7.7 and 1.6%, among boys 8.7 and 2.5% cases, respectively. Both in girls and boys overweight is maximal in 12-13 years (15.5-12.1%), it goes down to 7.7% to 17 years. Obesity at the age of 12 years is recorded in 3.1% adolescents, at the age of 17 years--in 1.4%. CONCLUSION: Sedentary life style and improper nutrition are leading causes of obesity in adolescence.