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Aim: The study aim was to determine and compare daytime/night-time differences of serum melatonin, leptin and ghrelin in women with metabolic syndrome in their division by groups based on homeostasis model assessment of insulin resistance (HOMA-IR). Material and methods: 57 women with metabolic syndrome were studied: 30 with HOMA-IR ≥ 2.5 and 27 with HOMA-IR < 2.5. In all women measurements of waist circumference took place and indices of body mass and HOMA-IR were calculated. Venous blood was collected at 03:00 and 08:00 to determine the melatonin, leptin and ghrelin levels. Routine hematological and biochemistry parameters and insulin were studied from the blood collected at 08:00. Results: At 03:00 women with HOMA-IR ≥ 2.5 had higher melatonin (P = 0.023) and leptin (p = 0.050) and lower ghrelin (p = 0.014). At 08:00 both groups did not differ in their values of melatonin, leptin and ghrelin (p < 0.05). Women with HOMA-IR ≥ 2.5 have a smaller night-time/daytime difference of melatonin compared to women with HOMA-IR < 2.5 (6.53 ± 11.28 pg/ml vs 54.43 ± 15.76 pg/ml, р = 0.0151). The two groups did not differ in night-time/daytime difference of leptin (р = 0.0557) and ghrelin (Р = 0.0686). In the women with HOMA-IR < 2.5 ghrelin measured at 03:00 is higher than 08:00 (р = 0.006); no difference between the daytime and night-time values of melatonin (р = 0.069) and leptin (R = 0.496) is present. In the woman with HOMA-IR ≥ 2.5 no differences between the daytime and night-time concentrations of studied parameters is present. Conclusion: In women with metabolic syndrome and proven insulin resistance the daytime/night-time rhythm of secretion of melatonin and ghrelin is impaired. The established non-significant difference between the daytime and nigh-time leptin suggests that adipose tissue is not the only determiner of serum leptin concentration. In women without laboratory data of insulin resistance, a reversed daytime/night-time rhythm of melatonin is present, while the secretion of ghrelin and leptin is close to physiological secretion, with an underlined daytime/night-time rhythm of ghrelin and lack of a similar rhythm in leptin. In a practical aspect, not only the one-time measured concentration of these hormones but also the rhythm of their secretion should be considered. [ABSTRACT FROM AUTHOR]

BACKGROUND: Considering the role of visceral adipose tissue deposition in the pathogenesis of heart failure with preserved ejection fraction (HFpEF) and the positive effect of metformin on weight loss, the effect of this drug on adipose tissue compartments in patients with HFpEF is interest.AIM: To study the effect of extended-release metformin (XR) on various fat depots and parameters of insulin-glucose homeostasis in patients with HFpEF, prediabetes and abdominal obesity (AO).MATERIALS AND METHODS: Study design: single-center, open-ended, randomized, prospective, controlled. The registration numbers of the study in the NARNIS register RNI.25.004. The study included 64 people (50% men, median age 58 [55.25; 59.75] years) with HFpEF, prediabetes and AO. All patients (groups A and B) received optimal HFpEF therapy. In group A (n=32), metformin XR 1000–1500 mg/day was additionally prescribed. All patients underwent general clinical examination, calculation of insulin resistance indices, ultrasound lipometry to determine the thickness of epicardial, preperitoneal and subcutaneous fat initially and after 6 months.RESULTS: In group A patients, there was a decrease in waist circumference by 0.9% (p=0.002), hip circumference by 1.25% (p=0.001), body weight by 4.7% (p

BACKGROUND. Glucose metabolism disorders (GMD) were detected both in acute and in post-COVID, however, its pathogenic aspects remain unclear.AIM. To analyze the occurrence of GMD in post-COVID patients who have had moderate and severe COVID-19 without previously known GMD disorders, and evaluate expression of SARS-CoV-2 proteins and its entry factors in pancreas in acute COVID-19.METHODS. Among 187 hospitalized patients with confirmed COVID-19 141 patients without previously diagnosed GMD underwent follow-up post-COVID visits. The examination for all patients included anthropometric measurement with calculation of BMI, level of HbA1c and fasting plasma glucose, for 106 patients level of insulin and HOMA-IR index was analyzed. For histological examination, pancreas fragments of 20 patients with fatal outcome were selected. Immunohistochemical study was performed with antibodies to SARS-CoV-2, ACE2, DPP4, as well as double-labeled immunofluorescence microscopy (insulin-SARS-CoV-2, insulin-ACE2, insulin-DPP4).RESULTS. Among 141 patients in post-COVID period, 9 (6.3%) had HbA1c or fasting plasma glucose levels that met criteria for diabetes mellitus, 38 (26.9%) — exceeded normal values (WHO), and 84 (59.6%) had GMD according to criteria of the ADA. In post-COVID, patients with GMD had a higher BMI and HOMA-IR index (p=0.001) compared to patients with normal glycemic levels. Only 40.4% of people had HOMA-IR index above 2.7. Patients with GMD had higher level of CRP (p=0.007) and a maximum glucose level (p=0.019) in the acute period. Positive relationship was found between BMI and HOMA index both in acute (p

Objective – to identify obesity/overweight phenotypes in patients with systemic lupus erythematosus (SLE) based on the body mass index (BMI) and serum leptin levels assessment, and to clarify the relationship of these phenotypes with different metabolic disorders.Material and methods. The study included 51 patients with SLE (48 women, 3 men) without diabetes mellitus. The median age of patients was 40 [31; 48] years, disease duration was 3.0 [0.6; 9.0] years. Glucocorticoids were received by 84% of patients, hydroxychloroquine – by 76%, immunosuppressants – by 20%, biological agents – by 10%. BMI was calculated and the fasting leptin level in serum was determined (ELISA) in all patients. Leptin concentrations >11.1 ng/ml in women and >5.6 ng/ml in men corresponded to hyperleptinaemia. There were three main obesity/overweight phenotypes: “classic” (BMI≥25 kg/m2 + hyperleptinemia), “healthy” (BMI≥25 kg/m2 , without hyperleptinemia), “hidden” or “latent” (BMI˂ 25 kg/m2 + hyperleptinemia), as well as “normal weight” (BMI˂ 25 kg/m2 , without hyperleptinemia).Results. The “classic” phenotype of obesity/overweight was diagnosed in 22 (43%) patients, the “healthy” – in 1 (2%), the “hidden” – in 14 (27.5%) patients with SLE. Insulin concentrations were: 10.0 [7.5; 17.9] μU/mL in the “classic” phenotype, 8.3 [6.0; 11.9] μU/mL in the “hidden” phenotype, and 5.3 [4.2; 6.3] μU/ml at “normal weight” (p=0.001). HOMA-IR index were: 2.18 [1.70; 4.23], 1.78 [1.23; 2.41] and 1.18 [0.95; 1.52], respectively (p=0.002). The levels of glucose, total cholesterol, ApoB did not differ in the groups. The uric acid concentrations were the highest in the “classic” phenotype group (334 [365; 388] μmol/l), the lowest in the group of “hidden” obesity/overweight (257 [214; 296] μmol/l), and intermediate in “normal weight” group (286 [236; 377] μmol/l) (p=0.04).Conclusion. The majority of SLE patients hade the “classic” obesity/overweight phenotype, while the “healthy” phenotype was extremely rare. In 27.5% of patients, the presence of a “latent” phenotype was confirmed, which, in terms of metabolic disorders, is an intermediate stage between “normal weight” and “classic” obesity. For rational and timely prevention of insulin resistance, metabolic syndrome and related complications, it is necessary to actively identify the “hidden” phenotype.

Objective. To clarify the frequency of insulin resistance (IR) in patients with systemic lupus erythematosus (SLE), traditional and associated with rheumatic disease risk factors for its development, to assess the possibility of using the Finnish Type 2 Diabetes Risk Assessment Score (FINDRISC) questionnaire to detect IR.Material and methods. The cross-sectional study included 49 patients with SLE (46 women, 3 men) without diabetes mellitus and hyperglycemia, observed at the V.A. Nasonova Research Institute of Rheumatology in 2019–2020. The median age of the patients was 40 [33; 48] years, the duration of the disease was 3.0 [0.7; 8.0] years. Glucocorticoids (GC) were received by 41 (84%) patients, hydroxychloroquine – by 38 (78%), immunosuppressive drugs – by 10 (20%), biological agents – by 5 (10%). The glucose and fasting immunoreactive insulin levels were examined, and the Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) index was calculated in all patients. HOMA-IR value ≥2.77 corresponded to IR. Traditional risk factors for type 2 diabetes and the risk of its development in the next 10 years in patients with SLE were assessed using the Russian version of the FINDRISC questionnaire.Results. The median HOMA-IR level in SLE patients was 1.7 [1.2; 2.5]. IR was detected in 10 (20%) of 49 patients with SLE. Patients with and without IR were comparable in terms of sex, age, duration and activity of SLE, therapy, and type 2 diabetes traditional risk factors. BMI, WC and insulin levels were higher in patients with IR. HOMA-IR correlated with body mass index (BMI) (r=0.6; p

Aim. To determine the association of prehypertension (PHTN) with cardiometabolic and hormonal factors in a population sample of St. Petersburg residents.Material and methods. As part of the ESSE-RF epidemiological study, a random sample of 1600 residents of St. Petersburg at the age of 25-64 was examined. All participants signed informed consent and completed the questionnaires. Anthropometry, fasting venous blood sampling, blood pressure (BP) measurements were performed. BP was measured by the OMRON BP monitor (Japan) twice on the right hand in a sitting position. Mean BP was calculated. Respondents, depending on the BP level and availability of antihypertensive therapy, were divided into 3 groups: optimal BP (173,0 pmol/L (2,99 [1,22; 7,36], p=0,017), HOMA-IR >2,9 (2,12 [1,42; 3,19], p173,0 pmol/L (2,14 [1,30; 3,54], p=0,003), HOMA-IR >2,9 (1,83 [1,39; 2,42 ], p536 nmol/L (1,59 [1,25; 2,05], p125 pg/ml (2,05 [1,32; 3,20], p=0,002).Conclusion. In a random sample of St. Petersburg residents, the presence of hyperinsulinemia increases the risk of PHTN and insulin resistance by 3 and 2 times, respectively.

Background: The biomechanical changes in foot among people with type 2 diabetes mellitus often leads to various foot complications which could further add to diabetes related morbidity & mortality. These changes could be seen due to musculoskeletal factor like reduction in intrinsic foot muscle strength, tightness of lower limb muscles, postural changes, etc. Aim: To design and determine the efficacy of a structured exercise program on foot kinetics and kinematics among type 2 participants Materials and methods: A total of 35 participants with type 2 diabetes (n=15, type 2 diabetes mellitus without neuropathy and n=20, type 2 diabetes with peripheral neuropathy) were recruited. All participants were screened clinically & biochemically and given a set of structured exercise program, three times a week for 12weeks along with standard medical care. Results: The mean age of the participants was 56±10.5 (Non neuropathy) 62.3±7.35 (Neuropathy) years, mean duration of diabetes was 8.7±8.95 (Non neuropathy), 10.97±8 (Neuropathy) years, mean Body mass index was 26.54± 4.83(Non neuropathy), 24.39±3.58 (Neuropathy), Significant differences have been observed in kinetic and kinematic variables. Conclusion: The present study shows that the structured exercise protocol is very effective in improving the biomechanics of foot in people with type 2 diabetes with and without neuropathy. It could help to correct the structure and function of the foot and eventually could reduce the risk of foot complications like diabetic foot ulcers.

This article presents the results of a survey of 40 women with physiological pregnancy cesarean delivery at the age of 21-40 years and 12 non-pregnant women. The level of content of adiponectin, resistin, insulin and glucose levels in the blood plasma by ELISA. Calculated BMI and HOMA-IR. The study found that multiparous women develop more severe insulin resistance, characterized by increasing levels of insulin, glucose, HOMA-IR compared with nulliparous. However, pregnancy is characterized by physiological changes in endocrine activity of adipose tissue, expressed in decreased level of adiponectin and resistin concentration is increased.

Aim. To study the association between antiischemic effects (AIE) of metoprolol (MP), glucose tolerance, and insulin sensitivity in patients with stable angina (SA). Material and methods. The study included 28 male patients, aged 46-68 years, with stable effort angina, Functional Class II-III, and positive exercise stress test (EST). The time of the ST segment depression by ≥1 mm defined the threshold exercise stress time. MP in a selected dose was administered twice a day, for one month. Its hemodynamic effects were assessed by the dynamics of heart rate (HR), blood pressure (BP), and double product (DP). Glucose tolerance test (GTT) was performed at baseline (before MP administration) and after one month of MP treatment. Tissue insulin sensitivity and insulin resistance (IR) were assessed by ISI0.120 and HOMA-IR parameters, respectively. Results. AIE was registered in 57% of the patients, while 43% failed to demonstrate it. Both groups did not differ by the extent of MP impact on the levels of HR, BP, and DP. The presence or absence of AIE was linked to selected parameters of glucose metabolism. In patients with AIE, the pre-treatment levels of glucose and insulin 2 hours after glucose load were higher (p=0,028 and 0,043, respectively) and ISI1,120 values lower than in patients without AIE (p=0,023). Among participants with AIE, impaired glucose tolerance (IGT) was observed in 4 at baseline and in 8 one month later; among patients without AIE, IGT was not registered. Conclusion. For the first time, the presence of AIE during MP therapy of SA patients was linked to the decreased insulin sensitivity of peripheral tissues (ISI0.120). Paired EST with a single MP dose at baseline provides an opportunity to identify the patients with a higher risk of metabolic disturbances during the longer-term MP treatment.

Purpose: To investigate levels of adipokines and indicators of carbohydrate metabolism in the blood of women with a true threat of pregnancy termination (isthmico-cervical insufficiency). Materials and Methods: The study involved women in the period of 16 – 26 weeks of gestation – 18 women with a true threat of termination of pregnancy and 52 women with physiological pregnancy. Both groups were compared with levels of leptin, resistin, adiponectin, fasting glucose, fasting insulin and homeostasis model assessment of insulin resistance (HOMA-IR). Results: In the blood of women with a real threat of pregnancy termination are revealed significant changes in carbohydrate metabolism – the increase in levels of fasting insulin and glucose, and also increase the value of the index of insulin resistance HOMA-IR (p

The aim of this study was to investigate the effectiveness of tetrapeptide pankragen-forte in older people with prediabetic state. A total of 150 healthy people of different ages, including 39 young people (20-39 years), 42 people. middle-aged (40-59 years) and 69 older adults (60 years and older). As a result of screening, 69 seniors were selected 12 patients with impaired glucose tolerance, which, for the correction of glucose metabolism used Pankragen-forte as follows: 500 mkg 2 times a day (morning and evening) for 4 weeks. All included surveyed was defined indicator of glycosylated hemoglobin, conducted a standard oral glucose tolerance test with determination of glucose, insulin in plasma glucose and venous blood at 30, 60 and 120 min after ingestion of 75 g glucose. Pro-insulin levels were determined in plasma, venous blood glucose and 30-min OGTT. Also calculated an index of insulin resistance (HOMA-IR), insulin sensitivity index (Matsuda index) and functional activity of β cells of the pancreas (HOMA- %). In 50 percent older people with impaired glucose tolerance use of pankragen forte led to a significant decrease in the concentration of plasma glucose during a standard oral glucose tolerance test, which indicates the normalizing effect of peptide drug in the violation of carbohydrate metabolism, which is consistent with the improvement of the lipid composition of serum blood, endothelial function, decreased platelet aggregation. The use of peptide drug pankragen forte is promising correction prediabetic status in the elderly.