[The new approaches to understanding of neurohumoral regulation in overweight and ways of its correction]. / Novye podkhody k ponimaniiu neirogumoral'noi reguliatsii pri izbytochnoi masse tela i sposoby ee korrektsii.

The clinical study reflex of food specific dynamic effect food SDE reflex phase in various forms of obesity permit differential diagnosing and choosing of special diet therapy with the use of various biologically active food supplements.

[Food dietary supplement efficacy in complex therapy of patients with type 2 diabetes with obesity]. / Issledovanie éffektivnosti BAD v kompleksnom lechenii bol'nykh sakharnym diabetom tipa 2 s izbytochnoi massoi tela.

The dynamic of glycemia, insulin, C peptide, glycosylated hemoglobin, fructosamine, parameters of serum lipids, lipid peroxidation and system of antioxidant defense in 28 patients with diabetes mellitus type 2 associated with obesity was studied of influence of hypoglycemic hypocaloric diet. Besides favorable influence to a clinical picture of the disease universal normalizing influence of hypoglycemic hypocaloric diet with food dietary supplement "Cogent DB+" on parameters of carbohydrate, lipid and oxidative metabolism. The scheme of investigation of efficacy of food dietary supplements in complex treatment of patients with diabetes mellitus type 2 associated with obesity was offered on basis of study of influence "Cogent DB+" on mechanisms of metabolic disorders in these patients.

[Screening of mutations in genes of pro-opiomelanocortin in patients with constitutional exogenous obesity]. / Skrining mutatsii v gene proopiomelanokortina u bol'nykh konstutsional'no-ékzogennym ozhireniem.

Proopiomelanocortin (POMC) is a precursor of ACTH, beta- and gamma-liportopins, alpha-, beta- and gamma-MSH, beta-endorphin. alpha-, beta- and gamma-MSH are synthesized by hypothalamus neurons, and leptin stimulates their synthesis. These hormones regulate food consumption and energy metabolism by via melanocortin receptors (MC3-R and MC4-R) in hypothalamus. Screening mutations in the coding region of human POMC has been carried out with PCR, SSCP and DNA sequencing and the association study of these mutations and human obesity has been performed. Group of patients with the exogenous obesity (BMI 37.8 +/- 6.8 kg/m2) consisted of 228 persons (173 women and 55 men). 145 blood donors (67 women and 78 men) without obesity (BMI J25 kg/m2, 23.1 +/- 2.2 kg/m2) and 170 women without apparent obesity at the beginning of the study were included in the control group. 8 polymorph sites: insertions; missense and silent mutations have been identified in the coding region of POMC. Among them 1) two heterozygous mutations: the insertion of 6 b.p. (GGGCCC) in codon 176 inducing the insertion of two amino acid residues (Arg-Ala) in POMC and nonsense mutation (G-7316-T) in codon 180 of gamma-LTH coding region of the same DNA chain were identified in 4 women (5.8%) out of 69 patients with morbid obesity (BMI 40-53 kg/m2). These mutations were not found in control (n = 315). 2) The new heterozygous mutation T-7130-C (Phe118Leu) in active site of alpha-MSH has been identified in POMC gene of a woman suffering with obesity since the early childhood. 3) Mutation A-7341-G (Glu188Gly) seemed to have a protective effect because it was revealed more frequently in control (3.9%) than in obese patients (0.66%). The results of genetic study of two pedigrees suggested the dominant influence of the first two mutations (1 and 2) on woman obesity.

[Study of the association between constitutional exogenous obesity and polymorphism of the apolipoprotein B gene]. / Issledovanie sviazi konstitutsional'no-ékzogennogo ozhireniia s polimorfizmom v lokuse gena apolipoproteina B.

An attempt was made to associate the insertion-deletion (Ins/Del) polymorphism of the apolipoprotein B gene (apoB) with obesity and to identify alleles and genotypes predisposing to this disorder. The apoB Ins/Del allele frequencies observed in the Russian population were similar to those in West European populations and significantly differed from frequencies reported for Asian populations. Patients with obesity did not differ from healthy individuals in allele and genotype frequencies regardless of whether total or sex-stratified samples were compared. Estimation of relative risk for individuals with genotype Ins/Ins did not reveal a significant association between obesity and this genotype. Thus, constitutional exogenous obesity did not prove to be associated with the Ins/Del polymorphism of the apoB gene in the Russian population.

[Evaluation of the efficacy of biologically active dietary supplements in the diet therapy of patients with diabetes mellitus type II associated with obesity]. / Otsenka éffektivnosti biologicheski aktivnykh dobavok k pishche v dietoterapii bol'nykh sakharnym diabetom 2 tipa s soputstvuiushchim ozhireniem.

The dynamic of glycemia, insulin, C peptide, glycosylated hemoglobin, fructosamine, parameters of serum lipids, lipid peroxidation and system of antioxidant defense in 38 patients with diabetes mellitus type II associated with obesity was studied against hypocaloric diet No. 9 R. Besides favorable influence on a clinical picture of the diseas universal normalizing influence of hypoglycemic hypocaloric diet with food dietary supplement "Temarox" on parameters of carbohydrate, lipid and oxidative metabolism was disclosed. The scheme of investigation of efficacy of food dietary supplements in complex treatment of patients with diabetes mellitus type II associated with obesity was offered on basis of study of influence "Temarox" on mechanisms of metabolic disorders in these patients.

[The nutrition of patients who have undergone vertical gastroplasty for severe forms of obesity]. / Pitanie bol'nykh, perenesshikh vertikal'nuiu gastroplastiku po povodu tiazhelykh form ozhireniia.

The energy ration value and supply of the main nutrients were studied by 24-h reproduction before and after operations in 33 morbid obesity patients who had undergone vertical gastroplastic surgery. The surgery was accompanied by reducing of surplus mass of the body by 25-71.7% and at the same time by reducing caloric content of the ration from average 4726.9 kcal before the operation to 1087 kcal during the first three months after the operation followed by a rise to 1490.0 kcal in 12-24 months. The deficient quota of protein and stable reduction of consumption of vitamins E, PP, B2, B1, potassium, magnesium, phosphorus were stated in postoperative rations (to 40-50% from recommended rates). The diet recommended after restricting operations on the stomach for obese patients on principles of diets for obesity patients was designed. The need to use protein-vitamin-mineral additives with individually adjusted compositions and dosages is shown.

[Thermal skin reaction to food intake and its changes in certain forms of obesity]. / Temperaturnaia reaktsiia kozhi na priem pishchi i ee izmeneniia pri nekotorykh formakh ozhireniia.

The authors review data on recently discovered temperature response of deep skin layers to the meal. The reaction is of a reflex nature and is one of the mechanisms regulating heat exchange in the body. In healthy people this reaction is weak. In alimentary obesity, it becomes much stronger, probably due to impaired heat exchange because of accumulated fat. In obesity related to diencephalic syndrome skin reaction is similar to control. In this obesity, pituitory seems to lose ability to regulate circulation in the blood. The above reaction can be used as a test differentiating the two forms of obesity.

[Experience in using the biologically active additive "miprovit" in the treatment of various metabolic diseases]. / Opyt primeneniia biologicheski aktivnoi dobavki "miprovit" v lechenii nekotorykh boleznei metabolizma.

Using of protein and vitamin enriched preparation "Miprovit" in treatment of 90 patients with obesity showed decreasing effect on serum cholesterol and glucose levels and coefficient of atherogenity which were increased in these patients. Decreasing of appetite and feeling of hungry were noted in 75% of patients. "Miprovit" favoured more comfortable feeling of patients during course of body weight reduction.

[Lipid peroxidation and various parameters of mineral metabolism in patients with alimentary obesity during therapy with monosodium glutamate]. / Issledovanie perekisnogo okisleniia lipidov i nekotorykh pokazatelei mineral'nogo obmena u bol'nykh alimentarnym ozhireniem pri ispol'zovanii v dietoterapii mononatriia glutamata.

Lipid peroxidation and mineral metabolism were studied in patients with III degree of obesity and bad standing of sodium restricted diet before and after treatment with including in diet of monosodium glutamate (MSG). It was established well being of MSG and absence of negative effect on loss of body mass in course of dietary treatment. MSG caused normalization of level of diene conjugates and some minerals in serum of patients.

[Thermal reaction of subcutaneous tissue to food intake in patients with obesity]. / Termicheskaia reaktsiia podkozhnoi kletchatki na priem pishchi u bol'nykh ozhireniem.

Investigating the temperature of deep layers of skin and in the main of subcutaneous tissue in patients with obesity we found the close connection between changes of this temperature and food intake. In patients who are in postabsorptive period the intake of the small portion of test food (220 kcal) induces in 3-4 min a marked increase of the subcutaneous tissue temperature (often by 1.0-1.5 degrees C in comparison with the initial level). Further the temperature still rises some what and then keeps at increased level for 30-45 min. At the end of the treatment course of patients in the clinic (and the body weight loss by 10-14 kg) these changes of the temperature become much less intensive or do not quite manifest. The above thermic reaction is developed apparently as a result of the dilatation of blood vessels of the skin and filling the venous plexus with the arterial blood. Probably in depends upon the regulatory activity of hypothalamus which is directed on an increase of heat loss into environment.

[Reflex of food-induced thermogenesis in normal subjects and its changes in patients with obesity]. / Reflektornyi period vyzvannogo pishchei termogeneza v norme i ego izmeneniia u bolnykh ozhireniem.

Dog experiments have established that an initial period of food-induced thermogenesis (FIT) has a reflex nature. This is proved by FIT appearance in sham feeding and disappearance after atropine administration. Various food substances proved capable of evoking this reflex. It was also registered in humans. Oxygen consumption rose within 3-10 minutes after a test meal reaching a 25% maximal increment. However, no or minimal manifestations of the reflex occurred in obese patients. They had to undergo a 30-day weight-reducing treatment to reacquire the lost reflex. Physiological value of FIT as a mechanism stimulating tissue metabolism and preparing food substances assimilation are discussed.

[Feasibility of predicting the dynamics of human body mass]. / Vozmozhnosti prognozirovaniia dinamiki massy tela cheloveka.

An original mathematical model of human energy exchange was developed and implemented on a PC. Energy exchange of healthy volunteers on a free diet and physical activity was simulated by inputting examinees' individualized parameters in the model: total body mass, fatty and lean tissue, nutritional energy capacity, power inputs. The main purpose was to study the reliability of prediction of the time course of total body mass with relation to a dietary caloric value and physical activity of an examinee, which was found to be necessary for working out an optimum metabolic diet, e.g. for patients with diabetes mellitus and adiposity. The authors propose a complete text of a computer program which can be used in research institutes and hospitals.

[Control of obesity]. / Bor'ba s ozhireniem.

Basic directions in obesity control are considered in relation to age, complications and form of the disease. Therapeutic potential of diets, surgery and chemotherapy are analyzed. It is hold, that a combined approach to obesity management may be most beneficial, that obese subjects should be placed under outpatient observation.

[The dietetic correction of disorders in the digestive functions in youthful obesity]. / Dieticheskaia korrektsiia narushenii pishchevareniia pri ozhirenii v molodom vozraste.

The state of the digestive system was investigated in more than 300 women patients with obesity, aged 16-25 years. Significant shifts have been revealed in the biliferous system and in the gastrointestinal tract of 40% of the investigated patients. The shifts detected necessitate correction of the conventional reduced regimens of nutrition.

[Excess body weight at a young age as a risk factor for developing metabolic diseases]. / Izbytochnaia massa tela v molodom vozraste - faktor riska razvitiia boleznei metabolisma.

A total of 100 patients, aged 16-25 years, suffering from metabolic-alimentary obesity were investigated under clinical conditions. An analysis was made of deviations from the normal parameters of arterial pressure, blood serum lipids, and other risk factors of the development of atherosclerosis, coronary heart disease, essential hypertension and other metabolic diseases. The shifts detected could be directly dependent of the disorders in nutrition. Alimentary correction of the disorders noted, reduction of body mass resulted in the improvement of the subjective conditions of patients, and in normalization of the above parameters. However, in some patients significant improvement in the metabolic status of the patients (lipid, in particular) was not achieved. The necessity of dispensary follow-up of young patients with obesity has been considered.

[Protein metabolism in obesity patients]. / Sostoianie belkovogo obmena u bol'nykh ozhireniem.

Protein metabolism was studied in patients with alimentary obesity. It was found that the reduction of excessive body weight under the action of a complex of measures, including dietetics, exercise therapy and physiotherapy, induced positive shifts in the amino acid spectrum of blood. The blood serum creatinine content and urinary excretion of creatinine and creatine remained unchanged. The nitrogenous balance was maintained even in cases of highly restricted diets.