[Changes the level of differentiating growth factor - GDF 15 in patients with sleep apnea syndrome after aPAP-therapy: pilot study]. / Izmenenie urovnya differentsirovochnogo faktora rosta ­ GDF 15 u patsientov s sindromom apnoe sna na fone aPAP-terapii: pilotnoe issledovanie.

OBJECTIVE: Comparative assessment of the level of differentiating growth factor 15 (GDF 15 ) against the background of a 6-month course of respiratory support in the mode of automatic positive pressure in the airways therapy (aPAP therapy) in patients with obstructive sleep apnea syndrome (OSA). MATERIAL AND METHODS: 59 men participated in the study, the average age was 51.9±2.4 years. The main group (MG1) consisted of 30 patients with a verified diagnosis of moderate OSA. 29 men of comparable age and body weight made up the control group (CG) without an objectively confirmed diagnosis of OSA. After the stage of introduction into the study, the type of respiratory support with individual pressure settings was selected for patients with MG1. After 6 months of aPAP therapy with high compliance (at least 85%), the same patients who made up MG2 after treatment underwent repeated polysomnography (PSG) and the GDF 15 content was evaluated. Methods: questionnaire, examination, polysomnography, enzyme immunoassay of blood serum to determine the content of GDF 15. RESULTS: A 6-month course of aPAP therapy with a high degree of compliance significantly improved the sleep structure and breathing pattern: the representation of NREM 3 increased from 79.2±15.6 to 102.6±21.6 minutes and the REM phase from 56.9± 13.6 to 115.6±26.8. Episodes of apnea were eliminated - apnea-hypopnea index decreased from 21.1 [17.3; 39.1] to 2.5 [1.8; 4.6] and the average values of SaO2 increased from 85.9% to 91.5%. At the same time, a statistically significant excess of GDF 15 was revealed in MG1 - 20.4 [14.16; 31.71] and MG2 - 17.2 [13.63; 24.44]) in comparison with CG - 13.65 [10.7; 17.09]. Despite the lack of statistical significance, a change in the level of GDF 15 was revealed in the form of a decrease in its concentration after a 6-month course of aPAP therapy. CONCLUSION: A 6-month course of aPAP therapy made it possible to eliminate intermittent nocturnal hypoxia and improve sleep structure in patients with OSA, as well as reduce the content of GDF 15 protein in blood serum in patients with OSA. However, the tendency to decrease the content of this protein, despite the lack of statistical reliability, confirms the effectiveness of OSA therapy and the possibility of preventing early and pathological aging from the standpoint of somnology and molecular biogerontology.

[Neuroendocrine changes among 45-60 years old women with COVID-19 and 12 months after the disease.]

Climacteric women have the post-COVID period clinical features, which can lead to an acceleration of the aging. The study consists in assessing individual parameters of the neuroendocrine system in climacteric women with a moderate course of COVID-19 and 12 months after the disease. Under observation were women aged 45-69 years, who were divided into groups: women who did not have COVID-19, not vaccinated, with no antibodies to COVID-19 (IgG) - control group (n=16); women in the acute phase of COVID-19 with a moderate course, accompanied by pneumonia - main group (n=63); patients from the main group who agreed to be examined 12 months after COVID-19 (n=15). The prolactin, luteinizing hormone (LH), follicle-stimulating hormone (FSH), estradiol, cortisol, testosterone, 17-OH-progesterone, dihydroepiandrosterone sulfate (DHEA-S) levels were assessed. In women with COVID-19 compared with the control the prolactin level was increased (p=0,0002) and the estradiol (р=0,032), testosterone (p=0,004), cortisol (p=0,009), 17-OH-progesterone (p=0,025) and DHEA-S (p=0,003) levels were reduced. Intragroup comparison of hormones showed a decrease in the prolactin level (р=0,041) and increase in the 17-OH-progesterone (р=0,011) and DHEA-S (р=0,0006) levels 12 months after the disease. With a personalized consideration of this group a decrease in the prolactin level is observed in 73,3% of these patients. In the same period, there was an increase in testosterone levels in 46,7% of women, cortisol - in 73,3% of women, 17-OH-progesterone - in 80% of women, DHEA-S - in 100% of cases. When comparing these hormonal parameters between the group of patients who recovered from COVID-19 12 months ago and the control, no statistically significant differences were found, however, patients were identified in whom prolactin and cortisol exceeded the reference values, although in the acute phase of COVID-19 the values of these indicators corresponded to the reference values.

Inflammatory Proteins as Molecular Markers in the Diagnosis of Cervical Oncopathology.

Imperfection of cytological diagnostics of cervical cancer has prompted the search for alternative methods of pathology detection. The aim of the study was to evaluate the effectiveness of inflammatory proteins as molecular markers in the diagnosis of cervical oncopathology. MATERIALS AND METHODS: A prospective controlled trial was conducted with three groups of women: group 1 (n=13) - with precancerous pathology (cervical intraepithelial neoplasia of grade III); group 2 (n=49) - patients with cervical cancer; group 3, control (n=13) - gynecologically healthy women (mean age - 30.0±4.4 years).The material for the study was cervical epithelium, which was taken according to the standard technique using a cytobrush from the junction zone of cervical. The levels of inflammatory proteins (SAA, ICAM-1, VCAM-1, and sCD27) in the cervical epithelium were determined by flow cytometry. RESULTS: Molecular criteria for the presence of precancerous pathology and cervical cancer have been found to be a 3.10 [1.31; 3.28] fold increase in SAA values (U=41.0, p=0.02), 2.62 [2.79 3.50] fold (U=137.0, p=0.001) in ICAM-1, 5.20 [3.84; 12.37] fold (U=138.5, p=0.001) in VCAM-1, and 4.32 [2.07; 5.02] fold (U=109.0, p<0.001) in sCD27 in cervical epithelium compared with the control group data. The COP (cervical oncoproblem) coefficient was developed to calculate the probability of cervical oncological pathology presence with the accuracy of 90%. An application for Android was created in Delphi development environment to simplify its calculation. CONCLUSION: The created technology makes it possible to establish the diagnosis in the shortest possible time and to optimize the treatment and diagnostic process by accelerating the examination period and improving its accuracy.

Changes in the Lipid Peroxidation-Antioxidant Protection System in Women with Ovarian Hyperandrogenism at Different Periods of Reproductive Age.

We studied changes in LPO processes and antioxidant protection system in women with ovarian hyperandrogenism at various periods of reproductive age 18-45 years. An age-related decrease in total antioxidant activity and accumulation of secondary LPO products, ketodiens and coupled trienes, were found; these changes were accompanied by an increase in the level of superoxide dismutase and a decrease in the concentrations of reduced glutathione, α-tocopherol, and retinol. Women of early reproductive age (18-35 years) with hyperandrogenism were characterized by increased content of oxidized glutathione accompanied by a decrease in the level of α-tocopherol and retinol in comparison with the control group. In women of late reproductive age (35-45 years) with hyperandrogenism, increased superoxide dismutase activity in comparison with the control group was revealed.

[Pathophysiological aspects of neuro-endocrine regulation system in patients with obstructive sleep apnea syndrome]. / Patofiziologicheskie aspekty funktsionirovaniia sistemy neiroéndokrinnoi reguliatsii pri sindrome obstruktivnogo apnoé sna.

AIM: To reveal the changes in the pituitary-thyroid, pituitary-gonadal, adrenal components and in the prolactinergic system of neuroendocrine regulation in patients with severe obstructive sleep apnea syndrome (OSAS). MATERIAL AND METHODS: The study involved 51 men aged 46-55 years. The main group (BG) included 37 patients with severe OSAS. The duration of clinical manifestations of OSAS was 10.5±1.5 years. OSAS was verified on the basis of clinical and functional studies and polysomnographic monitoring in accordance with the AASM criteria (2014). The control group (CG) consisted of 14 age-matched men without sleep-disordered breathing. The body mass index in BG was 34.2±1.8 compared to 28.2±2.1 kg/m2 in CG. Serum concentrations of thyroid-stimulating hormone (TTG), free thyroxine (T4), triiodothyronine (T3), cortisol, prolactin, testosterone, luteonizing (LH) and follicle-stimulating (FSH) hormones were determined by the immunoradiological method using the standard DIA test system (Russia) and the analyzer 'Immunotest-800'. RESULTS: Patients with severe OSAS had decreased concentration of free thyroxine (T4) and decreased activity of thyroid stimulating hormone (TSH) (р<0.001), increased concentration of prolactin and cortisol (р<0.001), decreased concentration of luteinizing hormone (LH), follicle-stimulating hormone (FSH) and testosterone compared to the controls (р<0.001). CONCLUSION: The changes in the hypothalamic-pituitary-gonadal system are a manifestation of disturbances of the mechanisms of self-regulation and compensation that indicates the presence of maladaptive reactions of the neuroendocrine system.

[INDICATORS OF PITUITARY-THYROID SYSTEM AND LIPID METABOLISM IN REPRESENTATIVES OF BURYAT ETHNOS AND EUROPEOIDS].

Characteristic features of indicators of the thyroid status and lipoprotein content were found in blood serum of girls and women representing Buryat ethnos and europeoids. In representatives of Buryat ethnos, as compared to europeoids, a development of adaptive reactions from the side of pituitary-thyroid part of the neuroendocrine regulation system was noted (increased concentrations of free T3 fraction in girls and decreased TTH levels in women). Changes in lipid metabolism parameters lie in lower concen- trations of atherogenic fractions of cholesterol in Buryat girls and increased level of cholesterol-contai- ning blood components in adolescent europeods. At older age period a reverse tendency is observed, cha- racterized by an increased activity of lipid metabolism in representatives of the indigenous nationality.

[The characteristics of changes of indicators of hypophyseal-thyroid system and lipid metabolism in adolescents of different ethnic groups].

The girls and boys (the ethnic tofs) residing in the village of Alykdjer of Nijneudinsky district of Irkutsk oblast have been examined. The Irkutsk girls and boys (the Caucasians) made the comparison groups. In tof boys the activation of hypophyseal-thyroid system and activity increase of lipoprotein spectrum of blood serum was established. Furthermore, in the tof adolescents the level of liposoluble vitamin alpha-tocopherol is increased as compared with the Caucasians adolescents.

[Changes in the processes of the lipid peroxidation and antioxidant defense system in patients with obstructive sleep apnoea syndrome].

The objective of this study was to evaluate the lipid peroxidation (LPO) and antioxidant defense (AoD) system in patients with varying hypoxia in obstructive sleep apnoea/hypnoea syndrome (OSA/HS). The study of the LPO-AOD system in patients with OSA/HS revealed the specific features of some metabolic reactions that could reflect the development of adaptive-compensatory processes. The patients with upper airway hyperresistance syndrome were found to have increases in general blood antioxidant activity (AOA) and dienic conjugate levels, which might be interpreted as an initial stress reaction or prompt (emergency) adaptation. Mild OSAS and hypoxia characterized by a reduction in general AOA and a higher concentration of primary lipid peroxidation products reflect the development of adaptive-compensatory processes and are defined as a transitional stage between prompt and long-term adaptation. With higher hypoxic action on the body, which is observed in the moderate OSA/HS group, it may be said that there is a long-term adaptation to chronic exposure of hypoxia. The lower indices of general AOA with a reduction in LPO products, which were observed in the severe OSA/HS group, demonstrate another functioning level, suggesting the depletion of functional reserves.