[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.

[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.

[Induced and spontaneous prolactin secretion in young, obese women]. / Osobennosti indutsirovannoi i spontannoi sekretsii prolaktina u molodykh zhenshchin, stradaiushchikh ozhireniem.

Prolactin reactions in response to insulin hypoglycemia and prolactin levels were examined in 20 obese women of reproductive age at various time of the day. In one group prolactin response to stimulation with insulin hypoglycemia was normal, in another group an increase in the level of prolactin was unnoticed. Both groups were compared with healthy controls. Two types of obesity (upper and lower) were investigated. A conclusion has been made that the absence of prolactin reaction in response to insulin hypoglycemia and an insufficient rise of prolactin at night are noted more frequently in women with upper type of obesity suggesting more profound endocrine derangements in them as compared to women with lower type obesity.

[Potential for the clinical use of intranasal rifathyroin for diagnosis and treatment]. / O vozmozhnosti klinicheskogo ispol'zovaniia intranazal'nogo vvedeniia rifatiroina dlia diagnostiki i lecheniia.

It has been shown that stimulated TSH and prolactin levels in intranasal administration of rifathyroin are comparable with the results of i.v. administration of the drug. Intranasal administration can be used for both therapeutic and diagnostic purposes.

[The effect of luliberin and sulpiride on the secretion of gonadotropic hormones and prolactin in patients with obesity]. / Vliianie liuliberina i sul'pirina na sekretsiiu gonadotropnykh gormonov i prolaktina u bol'nykh ozhireniem.

The role of dopamine (DA) in the secretion of gonadotropic hormones was studied in women with obesity and normal body mass. Tests with sulpiride (peripheral antagonist of DA-receptors), sulpiride LH-RH and thyroliberin were made. Basal and LH-RH-stimulated secretion of gonadotropins and prolactin (PRL) was studied to reveal the relationship of their secretion with the status of the hypothalamohypophyseal system. It was shown that the blockade of peripheral DA receptors did not result in an increase in the basal and LH-RH-stimulated secretion of LH either in healthy women or in women with obesity at the normal basal level of gonadotropic hormones. Hyperprolactinemia caused by sulpiride or LH-RH, did not lower LH secretion during the entire period of investigation. There were no differences either in the basal level of gonadotropic hormones or in their ejection in response to LH-RH administration in women with normal and excess body mass. Stimulation of PRL secretion in response to LH-RH was found in patients with exogenous-constitutional obesity and minimum signs of diencephalic pathology. Slight inhibition of PRL secretion after LH-RH administration was noted in women with obesity of hypothalamic type and unstable type of disorder of EEG. The absence of changes in PRL secretion was noted in women with strongly marked hypothalamic signs of the disease.

[Sensitivity of the hypothalamo-hypophyseal system to dexamethasone administered at different times of the day in obesity]. / Chuvstvitel'nost' gipotalamo-gipofizarnoi sistemy k deksametazonu, vvedennomu v razlichnoe vremia sutok, pri ozhirenii.

The paper is concerned with the results of a study of the circadian rhythm of cortisol secretion and sensitivity of the hypothalamohypophyseal system to small doses of dexamethasone administered in different time of a day to patients with obesity. Disturbance of the circadian rhythm of cortisol secretion resulting in change of the nature of cortisol discharge in the second half of a day, was revealed. Three groups of patients were defined with relation to the type of response of the hypothalamohypophyseal system to dexamethasone administration: with normal, paradoxical and hypersensitive reactions. The results of the study of the circadian rhythm and response of the hypothalamohypophyseal system to dexamethasone were indicative of hypothalamic disturbances in obesity. The authors emphasized the relationship between the nature of sensitivity of the hypothalamohypophyseal system to dexamethasone and age at which the disease developed.

[Effect of teralen on brain bioelectrical activity in Itsenko-Cushing disease and hypothalamic syndrome patients]. / Vliianie teralena na bioélektricheskuiu aktivnost' golovnogo mozga u bol'nykh s bolezn'iu Itsenko-Kushinga i gipotalamicheskim sindromom.

Theralen effect on the brain electric activity was studied in 12 patients with Icenko-Cushing's disease and 8 persons with the hypothalamic syndrome. Theralen was shown to potentiate theta-activity in patients suffering from the diseases of short duration in contrast to healthy subjects. Patients with Icenko-Cushing's disease showed a delayed reaction to theralen as compared to subjects with the hypothalamic syndrome. Theralen was ineffective in both groups of patients suffering from above diseases for over 3 years.

[Effect of large doses of reserpine on the hypothalamo-hypophyseal-adrenal system in Itsenko-Cushing's disease]. / Vliianie bol'shikh doz rezerpina na gipotalamo-gipofizarno-nadpochechnikovuiu sistemu pri bolezni Itsenko-Kushinga.

The results of study of the hypothalamo-hypophysio-adrenal system in patients with Itsenko-Cushing's disease under the influence of high reserpine doses are presented. An increase of plasma ACTH and cortizol level and disturbance of the 24-hour rhythm of their secretion was noted in the patients. High reserpine doses led to the fall of ACTH and cortizol secretion, without any normalization of their secretion rhythm in the course of 24 hours. A test with metopyron carried out before and after the reserpine prescription pointed to the increase of the ACTH reserve under the influence of high reserpine doses.