HORMONAL REGULATION OF CARBOHYDRATE AND FAT METABOLISM IN WOMEN WITH DIFFERENT OBESITY TYPES IN THE FOOD DEPRIVATION TEST.

CONTEXT: The dominant type of adipose tissue accumulation in the body is associated with the peculiarities of using key substrates in energy metabolism and their hormonal regulation. Hormonal and metabolic parameters were investigated in women with android and gynoid obesity before and after the short-term food deprivation test. RESULTS: At baseline, at gynoid obesity as compared to android obesity, the women's blood contained lower glucose and insulin levels and higher FFA levels. The reaction to food deprivation manifested by a decrease in glucose level and an increase in FFA level in the blood is less pronounced in women with gynoid obesity than in those with android obesity. At the same time, a similar (though varying in expression) decrease in insulin level and elevated levels of glucagon, growth hormone and thyroxine were revealed in women's blood in both groups. Blood cortisol level increased in women with gynoid obesity and remained unchanged in those with android obesity. CONCLUSIONS: More pronounced activation of hormonal mechanisms for maintaining blood glucose levels at gynoid obesity as compared to android one suggests that glucose is the preferable substrate for energy metabolism at gynoid obesity in women.

[Hormonal feature of the androgen status in different-aged males.]

The examined males (n=374) aged from 20 to 69 years were divided into five age groups: the 1st - 20-29 years; the 2nd - 30-39 years; the 3rd - 40-49 years; the 4th - 50-59 years; the 5th - 60-69 years. There was 16,1±7 nmol/l total testosterone level in serum of all aged group. Hormonal signs of androgen deficiency, increased elderly aged groups, were revealed in males of the 2nd group as compared with males of the 1st group. The frequency of androgen deficiency (total testosterone level less than 12,1 nmol/l) in the 1st group was 26,9%; in groups 2, 3 and 4 this index was similar, composed 30,6-33,9%. However, the frequency of androgen deficiency increased and amounted to 44% in the 5th group. The frequency of hypogonadism hormonal signs (total testosterone level less than 8 nmol/l) did not significantly differ in groups 1-4 (6,2-9,3%), and only in group 5 it increased and amounted to 28%. The age-related androgenic deficiency in males was associated with decrease in androgenic function both the gonads, and the adrenal glands, increased level of sex steroid-binding globulin, increased metabolism of testosterone in estradiol and was accompanied by compensatory increase of luteinizing hormone synthesis in the pituitary gland.

Circadian Rhythms of Carbohydrate Metabolism in Women with Different Types of Obesity.

Blood levels of glucose and immunoreactive insulin were assessed in women with android and gynoid types of obesity or normal body weight (control group) in the dynamics of oral glucose tolerance test in the morning and in the evening. In the control group, the mean concentrations of glucose and immunoreactive insulin were significantly higher in the evening at all test terms (0, 60 and 120 min), which is indicative of physiological insulin resistance in the evening. In the group of women with gynoid obesity, no difference in the levels of glucose and immunoreactive insulin was revealed in the morning and evening tests, but in the evening tests, glucose (60 and 120 min) and immunoreactive insulin (120 min) levels were lower than in the control group. In the group of women with android obesity, the evening glucose level on minutes 60 and 120 of the test was higher than in the morning, but immunoreactive insulin did not vary throughout the day and on minutes 60 and 120 it surpassed the corresponding parameter in the control group by 2-4 times. In case of gynoid obesity, glucose load was followed by hyperinsulinemia and hypoglycemia; in android obesity, it was followed by hyperinsulinemia, hyperglycemia, and insulin resistance irrespective of the time of the day.

[ASSOCIATION OF AGE OBESITY AND METABOLIC SYNDROME IN MEN].

The study included 253 men aged 22 to 74 years. Was shown that at the end of the first period of middle age the accumulation of adipose tissue was enhanced that was associated with the change of dominance from the gynoid to the android type of obesity. The most pronounced increase in the frequency of occurrence of individual components and the overall metabolic syndrome was diagnosed in men in the second period of middle age with a following decrease in the frequency such components as hypertriglyceridemia, low HDL cholesterol and hyperglycemia in elderly age. In the all three age groups the value of the index of visceral obesity was significantly higher in men with android type of obesity compared with gynoid. Thus, the men with gynoid compared with android type of obesity have a lower risk of development metabolic syndrome in all age groups.

[Adipokines and a risk for metabolic disturbances in different types of female obesity]. / Adipokiny i risk razvitiya metabolicheskikh narushenii pri raznykh tipakh ozhireniya u zhenshchin.

AIM: To investigate the effects of adiponectin and leptin on the development of metabolic disturbances in women with android and gynoid fat distribution. MATERIAL AND METHODS: A total of 101 women aged 40 to 65 years were examined. Anthropometric measurements were made; overweight and obese women with a waist/hip (W/H) ratio of less than 0.83 were referred to as a gynoid fat distribution (GFD) group; and those with a W/H ratio of 0.83 or more were to an android fat distribution (AFD) group. The serum concentrations of triglycerides, high-density lipoprotein cholesterol, and glucose were measured; the levels of insulin, leptin, and adiponectin were determined by enzyme immunoassay. Insulin resistance (IR), HOMA IR, and visceral obesity index (VOI) were calculated. RESULTS: With the same excess adipose tissue accumulation, the women with GFD had a less magnitude of hormonal and metabolic disturbances than those with AFD, whose HOMA-IR also pointed to the presence of IR. VOI was insignificantly higher in the women with GFD and 2.4-fold greater than that in normal weight (NW) women. In the women with GFD and AFD, the concentration of leptin was higher than that in the NW women, which was characteristic of obesity, but the concentration of adiponectin proved to be significantly lower in the patients with AFD and to be unchanged in those with GFD as compared with that in the NW women. CONCLUSION: The women with AFD are typified by a high VOI, hypoadiponectinemia, IR, and metabolic disturbances, which determine a high risk for cardiovascular events and type 2 diabetes mellitus. In the women with GFD, obesity is associated with normal adiponectinemia and a low VOI and, in terms of hormonal and metabolic characteristics, may be characterized as metabolically healthy obesity.

[Combination of arterial hypertension and type 2 diabetes mellitus with obesity].

The aim of the study was to elucidate dynamics of the incidence of arterial hypertension (AH), 2 type diabetes mellitus (DM), and obesity as the main risk factor of these conditions, combinations between them and certain circulation disorders in the patients admitted to our clinic from 2003 to 2011. We analysed 25,451 case histories. Patients were regarded as having AH, DM, obesity, coronary heart disease, cardiac rhythm disturbances and cerebovascular disorders if they had verified diagnosis of nosological forms corresponding to the respective ICD-10 codes. Their occurrence was calculatedfor 3 three-year periods with reference to the mean age of the patients in different groups. It was shown that increased incidence of AH in the above time periods was associated with the enhanced occurrence of combination of AH and obesity or AH, obesity and DM. Similarly, the increased incidence of DM was associated with the enhanced occurrence of combination DM, AH, and obesity. A significant increase of the mean age was documented only in women with AH and obesity and in men with AH or AH plus obesity. The presence of DM in AH patients had no appreciable effect on the frequency of cerebrovascular pathology that increased in the presence ofAH with obesity.

[Age dependence of metabolic syndrome association with obesity types among women].

The study included 335 women aged 21 to 74 years. Results showed that age appears to be associated with progressive accumulation of fat tissue and magnitude of the waist-to-hip circumference ratio, which are mostly expressed in the second period of middle age. Ratio of gynoid and android species frequency among women with overweight and obesity in the first and second period of middle age groups and elderly age was 2.7:1; 1.3:1 and 0.2:1, respectively. Occurrence of metabolic syndrome in this age groups of women with gynoid species was 16.3; 18.9 and 30.0%; but with android species 62.5; 47.9 and 83.0%, respectively. Our results allow to state that women with gynoid species have the lowest risk of metabolic syndrome even in elderly age.

[Nature of obesity and the rate of aging in women with reproductive function disturbances].

Anthropometrics and metabolic features of obesity were determined, the rate of aging was evaluated in young women (mean age of 25,5 years) with infertility (as a result of polycystic ovary syndrome, chronic anovulation and other reproductive non-inflammatory disturbances) compared to these in different age groups of women with obesity, who have already realized their reproductive potential up to the moment of the survey. The metabolic disturbances ordinarily peculiar to mature age women, were found in women with infertility due to increased visceral fat content, which has begun to accumulate already in pre- and pubertal periods of their ontogenesis. These women showed the highest aging rate coefficient and that results in biological age growth compared with chronological one. Thus, visceral obesity early development combined with reproductive function disturbances is associated with the rate of aging increase in young women.