[Type 1 diabetes in children: Prevalence, morbidity and mortality in the Russian Federation].

Over the past 10 years, the results of epidemiological studies in different countries indicate an increase in the incidence of type 1 diabetes mellitus (DM) among children. According to IDF, currently 430,000 children with diabetes are registered in the world. Annual growth is 3%. In 2003, 65,000 new cases of diabetes were reported. In the Russian Federation, epidemiological studies have begun relatively recently. In 1996, the State Register of SD (GDSD) was created. Monitoring of the main epidemiological indicators of type 1 diabetes in the children's population of the Russian Federation is an integral part of the organization of medical and preventive care for children. GDSD allows you to objectively assess the epidemic situation in Russia, individual federal districts and regions located in different geographical areas, to assess the quality of the provision of medical and preventive care to children, to predict the incidence rate and to plan measures aimed at improving the effectiveness of the children's diabetes service. Since 2001, the Institute of Pediatric Endocrinology of the State Research Center of the Russian Academy of Medical Sciences has been analyzing the incidence and prevalence of type 1 diabetes in children in the Russian Federation using specially designed questionnaires.

[Polymorphic locus D6S392 near the Mn-dependent superoxide dismutase gene is associated with diabetes mellitus in the Moscow population]. / Polimofnyi lokus D6S392 riadom s genom Mn-zavisimoi superoksiddismutazy sviazan s sakharnym diabetom v Moskovskoi populiatsii.

AIM: Distribution of alleles of tetranucleotide microsatellite D6S392 located nearby the gene of Mn-dependent superoxide dismutase (SOD2) was studied in healthy donors (n = 143), patients with insulin-dependent (n = 166) and insulin-independent (n = 101) diabetes mellitus (IDDM and IIDM). MATERIALS AND METHODS: Alleles of the polymorphic locus D6S392 were amplified using polymerase chain reaction (PCR) on the basis of genome DNA isolated from the venous blood of the examinees. PCR products were analysed with gel-electrophoresis in polyacrylamide gel. Significance of differences of allele and genotypes distribution in the population control and patients were assessed with Fisher's criterion and Bonferroni's corrections. RESULTS: Locus D6S392 contains 31 allele from 210 to 330 pn in length and 37 to 67 tandem repeats. Compared to controls, IDDM patients had less frequent incidence of low molecular allele 41 and 42 as well as allele 62. CONCLUSION: Polymorphic locus D6S392 is closely associated with development of DM in Moscow population. This may indicate possible participation of the gene SOD2 in development of this pathology.

[Analysis of polymorphism of the D11S2008 locus of the catalase gene in patients with hypertension and ischemic heart disease in non-insulin-dependent diabetes mellitus in the Muscovite population]. / Analiz polimorfizma lokusa D11S2008 riadom s genom katalazy u bol'nykh gipertoniei i ishemicheskoi bolezn'iu serdtsa pri insulinnezavisimom sakharnom diabete v Moskovskoi populiatsii.

The allele and genotype frequency distributions of the D11S2008 tetranucleotide microsatellite linked with the catalase (CAT) gene were compared between patients with insulin-dependent diabetes mellitus (IDDM) with (N = 72) and without (N = 82) coronary heart disease (CHD), and between IDDM patients with normal arterial tension (N = 82) and with arterial hypertension (N = 42). In total, eight alleles were found. The alleles varied in length from 120 to 148 bp and included from 15 to 22 tetranucleotide repeats. The groups did not differ in D11S2008 allele and genotype frequencies; the only exception was that the frequency of genotype 18/19 in patients with CHD (31.9%) was significantly higher than in the controls (18.3%). Thus, the D11S2008 polymorphic locus located in proximity to the catalase gene proved to be weakly associated with CHD, but not associated with arterial hypertension, in IDDM patients. Genotype 18/19 was associated with a higher risk of CHD.

[Activities of antioxidant defense enzymes in children with insulin-dependent diabetes mellitus]. / Aktivnost' fermentov antioksidantnoi zashchity pri insulinzavisimom sakharnom diabete u detei.

Activities of superoxide dismutase and glutathione peroxidase were measured in 60 children aged 5 to 15 with insulin-dependent diabetes of various degrees of compensation and duration. Measurements of glutathione peroxidase were found to be the most informative marker of the status of antioxidant defense system.

[Level of R-proteins in blood during development of diabetes mellitus]. / Uroven' R-belkov v krovi pri razvitii sakharnogo diabeta.

R-proteins were studied in children with diabetes mellitus and in the risk group. The highest titre of the pattern was found in the children group where diabetes was the first to be detected. Normalization of the R-proteins high titre after insulin therapy was more typical for patients with first detected diabetes as compared with children impaired by the disease within 1-2 years. Content of immunoreactive insulin and titre of R-proteins correlated in the risk group. Estimation of the R-proteins titre simultaneously with other markers may be used for early diagnosis of diabetes mellitus as well as in control of the disease compensation.

The effects of sera obtained from children with insulin-dependent diabetes mellitus on cultivated islet cells: cytotoxicity and insulin release.

Sera were obtained from 24 patients with newly-diagnosed insulin-dependent diabetes mellitus (IDDM) and 14 children with a high risk of diabetes. The influence of the decomplementated sera on basal and stimulated insulin secretion was studied in a mixed culture of newborn rat islet cells. In addition, complement-dependent antibody-mediated cytotoxicity (C'AMC) was measured by 51Cr-release from pre-labelled islet cells. Incubation of the islet cells with sera from ten IDDM patients did not affect the basal insulin release. Sera from other children with IDDM (n = 14) either significantly increased (n = 7) or inhibited (n = 7) basal IRI secretion was compared with the sera of control donors. Nearly half of the sera from the high-risk children was found to be insulin-stimulating. Preincubation of islet cells with sera from IDDM children caused a significant decrease of insulin response to 16.5 mM glucose plus 5 mM theophylline (P less than 0.001). Sera from the high-risk children did influence the response of pancreatic cells to secretagogues. C'AMC was found in 45% of the patients with IDDM and in 33% of the high-risk children, however, there was no correlation between C'AMC and serum effect upon basal insulin secretion. These results suggest the presence of B-cytotropic factors in serum from children with IDDM or with a risk of diabetes. Opposite effects of different sera on insulin secretion may reflect the variety of pathogenetic mechanisms involved in islet cell destruction.

[Functional activity of the insular apparatus of the pancreas in children with newly diagnosed diabetes mellitus]. / Funktsional'naia aktivnost' ostrovkovogo apparata podzheludochnoi zhelezy u detei s vpervye vyiavlennym sakharnym diabetom.

It has been shown that before insulin treatment children with diabetes mellitus diagnosed for the first time manifested heterogenous endogenous secretion of insulin, which did not correlate with the disease standing before diagnosis establishment.

[Immunoenzyme detection of autoantibodies to the surface of pancreatic islet cells in diabetes mellitus and in increased risk of its development]. / Immunofermentnoe vyiavlenie autoantitel k poverkhnosti ostrovkovykh kletok podzheludochnoi zhelezy pri sakharnom diabete i pri povyshennom riske ego razvitiia.

The authors described the use of an enzyme-linked immunosorbent assay to determine islet cell surface antibodies (ICSA) in persons at high risk of developing insulin dependent diabetes (IDD) and different types of manifest disease. Among I degree healthy relatives of probands with IDD antibodies were detected in 16%. In disorder of the oral GTT (a small group) ICSA were found in 57% of examinees. In the group of IDD patients which was heterogeneous in duration of disease and age at its onset, the frequency of ICSA was 38%. The least frequency (10%) of antibodies was observed in patients with non-insulin dependent (NIDD) compensated by a diet and oral hypoglycaemic drugs. Among non-compensated NIDD patients 62% were ICSA-positive. Thus, ICSA determined by the enzyme-linked immunosorbent assay, could be employed as a marker of autoimmune damage of the insular apparatus for prognosis of the development of "primary" and "secondary" insulin dependence.

[Clinico-electromyographic characteristics of spinal cord and peripheral nerve function in diabetic children]. / Kliniko-élektromiograficheskaia kharakteristika funktsional'nogo sostoianiia spinnogo mozga i perifericheskikh nervov u detei, bol'nykh sakharnym diabetom.

By means of stimulating electromyography it was shown that children suffering from diabetes had a decrease in segmental motoneurone stimulation. It was manifested in the in the diminishing ratio of maximum reflex responses of the musculus soleus to the motor ones, in the delay of stimulation recovery, an inhibition of the Achilles tendon reflex. The changes mentioned were less pronounced in children with a history of hypoglycemic comas than in the rest children suffering from diabetes. It is suggested that some of EMG readings (the curve of motoneurone stimulation recovery, duration and asymmetry of the Achilles tendon reflex, rate of nervous impulse transmission may be of value for earlier revealing spinal motoneurone and peripheral nerve injuries in diabetes mellitus.

[Spinal cord reflex activity characteristics of children with a diabetic heredity]. / Osobennosti reflektornoi deiatel'nosti spinnogo mozga u detei s otiagoshchennoi po diabetu nasledstvennost'iu.

Stimulation electromyography has shown that children with hereditary diabetes mellitus develop functional disorders of the spinal cord reflex activity, manifesting in a decrease in correlations between musculus soleus reflex responses and motor ones, the delay of restoration of its segmental motoneuron stimulation, the disturbance of the tendon- and N-reflex supraspinal regulation. The most distinctive sign of these disorders is the curve of segmental motoneuron stimulation recovery. This phenomenon may be valuable for revealing the latent neurological disturbances in persons with diabetes predisposition. It is suggested that the neurological changes revealed may be resultant of the hereditable metabolic specificity.

[Serum immunoglobulins in children with diabetes mellitus]. / Syvorotochnye immunoglobuliny u detei, bol'nykh sakharnym diabetom.

The authors present the results of studying immunoglobulins of classes A, M, and G in 40 children with diabetes mellitus; immunoglobulin level was analyzed depending on a number of clinical diabetes mellitus indices and insulin antibody titres. The III type of dysgammaglobulinemia was found to be characteristic of patients with microangiopathies; changes in the immunoglobulin content were directly opposite to the changes revealed in patients with microangiopathies. With increasing the duration of diabetes there was an aggravation of dysgammaglobulinemia characteristic of these two groups of patients. The level of immunoglobulins under study was greater in the patients with lipoatrophies and in those without any hereditary predisposition to diabetes than in patients without lipoatrophies and without any hereditary predisposition to diabetes, respectively. A regular reduction of all the immunoglobulins level was observed only in patients with glucosuria of not less than 100 g/24 hours. Immunoglobulin content showed no significant association with the patients' sex, age, the insulin antibody titre, and the age at which diabetes developed, or with hyper cholesterolemia and enlargement of the liver.