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Етіопатогенез автоімунного тиреоїдиту (АІТ) заснований на складній і погано вивченій взаємодії між генетичними та тригерними факторами навколишнього середовища. Існують дані про важливу роль в імунних реакціях мікроелементів (мікроЕ) та макроелементів (макроЕ), однак їх участь у патогенезі АІТ не досліджена. Мета: дослідити вміст мікроЕ та макроЕ на початку розвитку автоімунного ушкодження щитоподібної залози (ЩЗ). Матеріал і методи. Обстежено 119 мешканців північного регіону України: із них 32 з діагностованим латентним автоімунним тиреоїдитом (ЛАІТ) — (дослідна група) та 87 без тиреоїдної патології (контрольна група). Латентний перебіг захворювання був позначений високим рівнем титрів антитіл до тиреопероксидази (АТПО) — медіана 262,2 [80,0-1630,3] мО/мл, діагностичними змінами ультрасонографічної картини, рівнем тиреотропного гормону (ТТГ) та вільного тироксину (ВТ4) в межах норми. Результати. При дослідженні екскреції йоду (I) з сечею встановлено наявність йододефіциту слабкого ступеня: медіана йодурії в контрольній групі становила 72,5 [41,3-119,6] мкг/л, у дослідній групі — 52,6 [42,4-93,7] мкг/л. В обох групах був знижений рівень йодного забезпечення. Як у дослідній, так і в контрольній групі був значно знижений рівень селену: показник медіани селену в крові становив відповідно 0,05 [0,03-0,07] і 0,04 [0,03-0,07] мг/л. У обстежених пацієнтів із ЛАІТ встановлено знижений вміст макЕ кальцію (75,8 [64,0-95,1] мг/л), магнію (16,7 [14,8-18,8] мг/л, p

Дефіцит йоду в харчуванні населення — глобальна проблема, характерна для багатьох країн світу, що призводить до виникнення широкого спектра йододефіцитних захворювань (ЙДЗ). В Україні на відміну від багатьох країн світу проблема профілактики ЙДЗ не вирішена. Для прийняття законодавчих рішень стосовно проблеми профілактики йодного дефіциту необхідні ширші дослідження йодного забезпечення населення в різних регіонах України. Метою роботи було в межах проєкту Steps «Вивчення поширеності факторів ризику неінфекційних захворювань» Всесвітньої організації охорони здоров’я (ВООЗ) дослідити йодне забезпечення населення України. Матеріал і методи. Методом багатоступеневої репрезентативної загальнонаціональної вибірки з випадковим відбором на кожному етапі зі всіх регіонів України відібрано 263 респондентів віком 18-69 років, серед яких було 203 жінки та 60 чоловіків. Після заповнення анкет (100%-на повнота заповнення даних досягнута для 256 осіб) і взяття крові для досліджень респондентам надавали 5-літровий контейнер та пропонували їм зібрати сечу протягом 24 годин. Польовий збір даних проводився протягом 13 тижнів зі середини червня до середини вересня 2019 року. Всього було відібрано та направлено в ДУ «Інститут ендокринології та обміну речовин ім. В.П. Комісаренка НАМН України» (далі — Інститут) 263 зразки сечі для визначення крапельною пробою концентрації йоду в сечі (КЙС), за якою та добовим об’ємом сечі (ДОС) розраховували добову екскрецію йоду з сечею (ДЕЙС). Результати. За результатами дослідження КЙС і ДЕЙС рівень йодного забезпечення у всіх регіонах України знаходився в межах йододефіциту слабкого ступеня. Медіана КЙС становила 75,17 мкг/л (1-й та 3-й персентилі 47,47 та 115,5 мкг/л відповідно). Медіана ДЕЙС становила 113,9 мкг/добу (1-й та 3-й персентилі 69,2-208,6 мкг/добу), що також вказувало на наявність йодного дефіциту легкого ступеня. Практично 70% проб знаходилося в зоні йододефіциту легкого і середнього ступеня. Найбільш виражений йододефіцит, що наближався до середнього ступеня йодної недостатності, спостерігався в північному регіоні України. Значно краще йодне забезпечення зафіксовано в південному, східному та центральному регіонах. Висновки. За даними КЙС і ДЕЙС встановлено наявність йодного дефіциту легкого ступеня на всій території України. Спостерігався високий ступінь кореляції між КЙС і ДЕЙС, як для всієї бази даних, так і для кожного регіону України, що підтверджує адекватність визначення КЙС для оцінки ДЕЙС в епідеміологічних дослідженнях. Необхідність оцінки ефективності йодної профілактики вимагає в подальших дослідженнях поряд з йодною забезпеченістю визначати вміст йоду в солі, що споживає населення.

У статті підбиті основні підсумки роботи співробітників відділу епідеміології ендокринних захворювань (далі — відділ) ДУ «Інститут ендокринології та обміну речовин ім. В.П. Комісаренка НАМН України» (далі — Інститут) за період із 1985 року по теперішній час. Відділ було створено на базі науково-організаційного відділу Інституту. Вже в 1985 році співробітники відділу були залучені до дослідження розповсюдженості ендокринних захворювань та за допомогою створеної нами комп’ютерної програми «Армен» встановили показники розповсюдженості ендокринних захворювань. Дані про розповсюдженість та захворюваність населення на цукровий діабет (ЦД) у різних регіонах України опубліковані в престижному закордонному журналі. Протягом 1986-2001 років за підтримки Всесвітньої організації охорони здоров’я (ВООЗ) досліджено йодний статус населення в 45 населених пунктах України та показано наявність йододефіциту серед населення по всій території України, що послугувало основою для видання наказів Міністерства охорони здоров’я України (МОЗ України) про запобігання йодозалежних захворювань. Національні дослідження у 2002 році та виконання «Державної програми профілактики йодної недостатності в населення на 2002-2005 роки» сприяли суттєвому поліпшенню йодного забезпечення населення. Споживання йодованої солі населенням збільшилось майже у 20 разів і як наслідок суттєво знизилася захворюваність населення на тиреоїдну патологію. Показано, що серед постраждалих після аварії на Чорнобильській АЕС (ЧАЕС) когорт населення, також спостерігався різний ступінь йодної недостатності, що впливало на поглинання радіойоду щитоподібною залозою (ЩЗ) під час аварії. Співробітники відділу були ініціаторами та учасниками розробки Державної програми «Цукровий діабет». За їх безпосередньою участю було створено Державний реєстр хворих на ЦД та виконано епідеміологічний аналіз баз даних. В останні 5 років виявлено порушення елементного забезпечення у вагітних та у хворих із тиреоїдною патологією. Створені препарати біодобавки мікро- та макроелементів для компенсації елементної недостатності.

PurposeThe effect of renin-angiotensin-aldosterone system (RAAS) inhibitors in combination with COVID-19 and diabetes mellitus (DM) remains unknown. We assessed the risk of death in COVID-19 inpatients based on the presence or absence of DM, arterial hypertension (AH) and the use of RAAS inhibitors or other antihypertensives.MethodsThe results of treatment of all adult PCR-confirmed COVID-19 inpatients (n = 1097, women 63.9%) from 02/12/2020 to 07/01/2022 are presented. The presence of DM at the time of admission and the category of antihypertensive drugs during hospital stay were noted. Leaving the hospital due to recovery or death was considered as a treatment outcome. Multivariable logistic regression analysis was used to assess the risk of death. Patients with COVID-19 without AH were considered the reference group.ResultsDM was known in 150 of 1,097 patients with COVID-19 (13.7%). Mortality among DM inpatients was higher: 20.0% vs. 12.4% respectively (p=0.014). Male gender, age, fasting plasma glucose (FPG) and antihypertensives were independently associated with the risk of dying in patients without DM. In DM group such independent association was confirmed for FPG and treatment of AH. We found a reduction in the risk of death for COVID-19 inpatients without DM, who received RAAS inhibitors compared with the corresponding risk of normotensive inpatients, who did not receive antihypertensives: OR 0.22 (95% CI 0.07–0.72) adjusted for age, gender and FPG.ConclusionThis result raises a question about the study of RAAS inhibitors effect in patients with Covid-19 without AH.

Summary Background Diabetes prevalence is increasing in most places in the world, but prevalence is affected by both risk of developing diabetes and survival of those with diabetes. Diabetes incidence is a better metric to understand the trends in population risk of diabetes. Using a multicountry analysis, we aimed to ascertain whether the incidence of clinically diagnosed diabetes has changed over time. Methods In this multicountry data analysis, we assembled aggregated data describing trends in diagnosed total or type 2 diabetes incidence from 24 population-based data sources in 21 countries or jurisdictions. Data were from administrative sources, health insurance records, registries, and a health survey. We modelled incidence rates with Poisson regression, using age and calendar time (1995–2018) as variables, describing the effects with restricted cubic splines with six knots for age and calendar time. Findings Our data included about 22 million diabetes diagnoses from 5 billion person-years of follow-up. Data were from 19 high-income and two middle-income countries or jurisdictions. 23 data sources had data from 2010 onwards, among which 19 had a downward or stable trend, with an annual estimated change in incidence ranging from −1·1% to −10·8%. Among the four data sources with an increasing trend from 2010 onwards, the annual estimated change ranged from 0·9% to 5·6%. The findings were robust to sensitivity analyses excluding data sources in which the data quality was lower and were consistent in analyses stratified by different diabetes definitions. Interpretation The incidence of diagnosed diabetes is stabilising or declining in many high-income countries. The reasons for the declines in the incidence of diagnosed diabetes warrant further investigation with appropriate data sources. Funding US Centers for Disease Control and Prevention, Diabetes Australia Research Program, and Victoria State Government Operational Infrastructure Support Program.

Exposure to ionizing radiation could affect the brain and eyes leading to cognitive and vision impairment, behavior disorders and performance decrement during professional irradiation at medical radiology, includinginterventional radiological procedures, long-term space flights, and radiation accidents.The objective was to analyze the current experimental, epidemiological, and clinical data on the radiation cerebro-ophthalmic effects.In our analytical review peer-reviewed publications via the bibliographic and scientometric bases PubMed / MEDLINE, Scopus, Web of Science, and selected papers from the library catalog of NRCRM - theleading institution in the field of studying the medical effects of ionizing radiation - were used.The probable radiation-induced cerebro-ophthalmic effects in human adults comprise radiation cataracts,radiation glaucoma, radiation-induced optic neuropathy, retinopathies, angiopathies as well as specific neurocognitive deficit in the various neuropsychiatric pathology including cerebrovascular pathology and neurodegenerativediseases. Specific attention is paid to the likely stochastic nature of many of those effects. Those prenatally and inchildhood exposed are a particular target group with a higher risk for possible radiation effects and neurodegenerative diseases.The experimental, clinical, epidemiological, anatomical and pathophysiological rationale for visualsystem and central nervous system (CNS) radiosensitivity is given. The necessity for further international studieswith adequate dosimetric support and the follow-up medical and biophysical monitoring of high radiation riskcohorts is justified. The first part of the study currently being published presents the results of the study of theeffects of irradiation in the participants of emergency works at the Chornobyl Nuclear Power Plant (ChNPP).Peredumova. Ionizuiuche vyprominiuvannia mozhe vplyvaty na golovnyĭ mozok ta organ zoru, vyklykaiuchy kognityvni ta zorovi rozlady, porushennia povedinky ta znyzhennia pratsezdatnosti pry profesiĭnomu oprominenni vmedychniĭ radiologiï, zokrema, pry interventsiĭnykh radiologichnykh protsedurakh, tryvalykh kosmichnykh pol'otakh imozhlyvykh radiatsiĭnykh avariiakh.Meta. Metoiu danogo tsyklu robit ie analiz suchasnykh eksperymental'nykh, epidemiologichnykh i klinichnykh danykh stosovno radiatsiĭnykh tserebrooftal'mologichnykh efektiv.Materyaly ta metody. U nashomu analitychnomu ogliadi buly vykorystani retsenzovani publikatsiï z bibliografichnykh i naukometrychnykh baz PubMed/MEDLINE, Scopus, Web of Science, z biblioteky NNTsRM – providnoï ustanovy vgaluzi vyvchennia medychnykh efektiv vplyvu ionizuiuchogo vyprominiuvannia.Rezul'taty. Ĭmovirni tserebrooftal'mologichni efekty u doroslykh osib vkliuchaiut' radiatsiĭnu kataraktu, promenevu glaukomu, radioindukovanu zorovu nevropatiiu, retynopatiï, angiopatiï ta spetsyfichnyĭ neĭrokognityvnyĭdefitsyt pry riznomanitniĭ neĭropsykhiatrychniĭ patologiï, vkliuchaiuchy tserebrovaskuliarnu patologiiu i neĭrodegeneratyvni zakhvoriuvannia. Osoblyva uvaga prydiliaiet'sia ĭmovirnomu stokhastychnomu kharakteru bagat'okh takykhefektiv. Osoby, iaki zaznaly vplyvu ionizuiuchogo vyprominiuvannia vnutrishn'outrobno ta v dytiachomu vitsi, ie osoblyvoiu tsil'ovoiu grupoiu, iaka maie bil'sh vysokyĭ ryzyk mozhlyvykh radiatsiĭnykh efektiv i neĭrodegeneratyvnykhzakhvoriuvan'.Vysnovky. Navedeno eksperymental'ne, klinichne, epidemiologichne, anatomichne ta patofiziologichne obґruntuvannia radiochutlyvosti zorovogo analizatora i tsentral'noï nervovoï systemy. Obgruntovana neobkhidnist' podal'shykh doslidzhen' z adekvatnym dozymetrychnym suprovodom ta tryvalym medychnym i biofizychnym monitoryngom kogort vysokogo radiatsiĭnogo ryzyku, zokrema, dlia otsinky mozhlyvykh mekhanizmiv rozvytku patologichnykhzmin. U pershiĭ chastyni doslidzhennia vykladeni rezul'taty vyvchennia naslidkiv oprominennia uchasnykiv avariĭnykhrobit na ChAES.

PURPOSE: Intrauterine undernutrition is associated with increased risk of type 2 diabetes. Children born premature or small for gestational age were reported to have abnormal retinal vascularization. However, whether intrauterine famine act as a trigger for diabetes complications, including retinopathy, is unknown. The aim of the current study was to evaluate long-term effects of perinatal famine on the risk of proliferative diabetic retinopathy (PDR).METHODS: We studied the risk for PDR among type 2 diabetes patients exposed to perinatal famine in two independent cohorts: the Ukrainian National Diabetes Registry (UNDR) and the Hong Kong Diabetes Registry (HKDR). We analysed individuals born during the Great Famine (the Holodomor, 1932-1933) and the WWII (1941-1945) famine in 101 095 (3601 had PDR) UNDR participants. Among 3021 (251 had PDR) HKDR participants, we studied type 2 diabetes patients exposed to perinatal famine during the WWII Japanese invasion in 1942-1945.RESULTS: During the Holodomor and WWII, perinatal famine was associated with a 1.76-fold (p = 0.019) and 3.02-fold (p = 0.001) increased risk of severe PDR in the UNDR. The risk for PDR was 1.66-fold elevated among individuals born in 1942 in the HKDR (p < 0.05). The associations between perinatal famine and PDR remained statistically significant after corrections for HbA1c in available 18 507 UNDR (padditive interaction < 0.001) and in 3021 HKDR type 2 diabetes patients (p < 0.05).CONCLUSION: In conclusion, type 2 diabetes patients, exposed to perinatal famine, have increased risk of PDR compared to those without perinatal famine exposure. Further studies are needed to understand the underlying mechanisms and to extend this finding to other diabetes complications. (Less)

The present study evaluated influence of boiled sausages consumption fortified with β-CD-I2 on the urinary iodine excretion (UIE) level of volunteers. Median urinary UIE level was increased from 58.02 (24.0–175.4) μg/L to 110.6 (20.5–231.6) μg/L during 10 days. Thyroid stimulating hormone (TSH) and free thyroxine (FT4) levels were determined by radio immunoassay analysis. As it was expected, intake of sausages fortified with β-CD-I2 resulted in rise of FT4 level from 1.1 (0.95–1.25) to 1.23 (1.07–1.63) ng/dL, whereas TSH level decreased from 1.53 (0.47–3.37) mIU/L to 1.1 (0.51–3.17) mIU/L. A dynamic gastrointestinal model in vitro was used in order to determine possibility of 3,5-diiodotyrosine (DIT) formation during consumption of the fortified sausages. The DIT concentration was determined by HPLC–MS method and was found to be 0.38 ng/mL in sausage dialyzate. These findings indicate that β-CD-I2 introduction as an iodine carrier in boiled sausages may help to improve iodine status and to control organic iodine species concentration.

Diabetes-related conditions such as chronic hyperglycemia and related oxidative stress and inflammation were repeatedly associated with accelerated telomere shortening in epidemiological studies, although some findings are inconsistent. In present study, we aimed to assess the impact of disturbances in glucose metabolism on association between age and leukocyte telomere length (LTL) in the Ukrainian population. The study was conducted on the 119 adult subjects aged between 43 and 87 years residing in the Kyiv region, Ukraine. LTL was determined by a quantitative PCR-based method. LTL was negatively correlated with the measure of abdominal obesity such as waist-hip ratio, as well as with both fasting plasma glucose (FPG) and two-hour post-load glucose (2hPG) levels. Consistently with previous studies, a significant negative association between LTL and age was observed in individuals with normal (5.6 mmol/L) FPG levels. Unexpectedly, however, no association was found in subjects with impaired glucose metabolism assessed by abnormal FPG or/and 2hPG levels. No association between LTL and age was observed in a logistic regression model; the association between LTL and age became significant after adjusting for FPG level. In the FPG-adjusted model, 1.6-time lower odds to have long telomere length were indicated for each 10 years increase in age. We hypothesize that the attenuation of association between LTL and age in hyperglycemic persons can likely be attributed to the interaction of multidirectional processes determining this relationship.

The present study investigated the status of calcium and magnesium as well as essential trace elements including iodine, selenium, copper, iron, and zinc in adults residing in the Zhytomyr region of Ukraine. In addition, the relative risk of goiter occurrence was evaluated. In this comparative study, 40 adults without goiter (control group) and 16 adults with diagnosed nodular goiter (NG) were examined. Inductively coupled plasma optical emission spectrometry (ICP-OES) was used for the measurements of Mg, Ca, Se, Zn, Cu, and Fe in serum of patients with NG and control group. Patients with nodular goiter had lower serum values of Ca, Mg, Se, Cu, Fe, and Zn than those in the control group. The presence of mild iodine deficiency was evident in both groups with the median urinary iodine excretion (UIE) 80.5 μg/L in the control group and 64.5 μg/L in goiter group. There was a positive association between goiter presence and low concentration of Ca in serum (odds ratio (OR) = 2.29 (1.26-3.55), p < 0.05) in the NG group. High relative risk of goiter was observed at low concentrations of magnesium (OR = 3.33 (1.39-7.62), p < 0.05) and selenium (OR = 1.63, (1.16-1.78), p < 0.05) in comparison with OR values in the control group. Low concentrations of Ca, Mg, Zn, and Se in serum combined with reduced UIE resulted in the highest risk of goiter (OR = 12.5, (2.15-79.42), p < 0.01). This study proved that Thyroglobulin concentration in serum is the reliable indicator of nodular goiter. We also suggest that a combination of low concentrations of Ca, Mg, Zn, Cu, and Se in blood serum, and reduced iodine concentration in urine resulted in the highest risk of nodular goiter development.

Type 2 diabetes mellitus is characterized by shorter leukocyte telomere length, but the relationship between leukocyte telomere length and type 2 diabetes mellitus development is rather questioned. Fasting and post-load glycaemia associated with different types of insulin resistance and their relation with leukocyte telomere length remains unknown. We compared leukocyte telomere length and fasting or post-load glucose levels in persons who do not receive glucose lowering treatment. For 82 randomly selected rural residents of Ukraine, aged 45+, not previously diagnosed with type 2 diabetes mellitus, the WHO oral glucose tolerance test and anthropometric measurements were performed. Leukocyte telomere length was measured by standardized method of quantitative monochrome multiplex polymerase chain reaction in real time. Spearman’s or Pearson’s rank correlation was used for correlation analysis between fasting plasma glucose or 2-h post-load plasma glucose levels and leukocyte telomere length. Logistical regression models were used to evaluate risks of finding short or long telomeres associated with fasting plasma glucose or 2-h post-load plasma glucose levels. No association of fasting plasma glucose and leukocyte telomere length was revealed, whereas 2-h post-load plasma glucose levels demonstrated a negative correlation ( P Impact statement • Contradictory epidemiologic data have been obtained about the link between the leucocyte telomere length (LTL) and diabetes. Type 2 diabetes (T2D) is likely to be pathophysiologically heterogeneous, but comparison of the association of LTL separately with fasting plasma glucose (FPG) and 2-h post-load plasma glucose (2hPG) levels has not been done before. Thus, the study of LTL changes associated with different types of hyperglycaemia, that largely determine the heterogenity of T2D is important. • In a population-based study of rural Ukrainians, we were the first to demonstrate that the increase of 2hPG (but not FPG) level increases the chances of revealing short telomeres. • The obtained data can help to clarify the relationship between the LTL shortening and different conditions of the insulin resistance (mainly liver resistance in high FPG and mostly muscle and adipose tissue resistance in high 2hPG).

Dirofilariosis is a cosmopolitan vector-borne transmitted disease whose causal agents in Europe are D. immitis and D. repens. Hosts are mainly domestic and wild canines and felines. While there is a great amount of data on dirofilariosis in pets (dogs and cats), information on the extension of this parasitosis in wild reservoirs is scarce. In the present study, we analyzed the carcasses of 451 carnivores that were legally shot during the hunting periods of 2006-2011 in 4 different geo-climatic areas of Krasnodar Krai, Southwestern Russian Federation. Two hundred and thirty-five foxes, 60 jackals, 90 raccoon dogs and 66 badgers were examined for the presence of D. immitis and D. repens. Worms were identified by morphological and morphometric characteristics, anatomical location and their identities being confirmed by PCR. One hundred and seven animals were parasitized by Dirofilaria spp. (23.7%). D. immitis was found in foxes, jackals and raccoon dogs with a global prevalence of 23.4%. D. repens was observed in jackals and badgers with a global prevalence of 10.3%. Mixed infections were observed only in 4 jackals. The highest prevalence was observed in raccoon dogs (31.1%), but no significant differences exist among the 4 species. Comparing the results obtained in each geo-climatic area, there is a higher prevalence in animals from the bay marshes (35.4%). These prevalences are, in general, higher than those reported in other countries from Central Europe and Balkans. Two new wild hosts in Europe, raccoon dog for D. immitis and badger for D. repens, were reported in Krasnodar Krai. Future research can contribute to establish the real risk of dirofilariosis in wild reservoirs for man and their pets in this region.

Planar organic heterostructures were prepared using poly-N- epoxypropylcarbazole films and poly[2-methoxy-5-(2’-ethylhexyloxy)-1,4-phenylenevinylene] by the method of successive deposition adding 2,3,9,10,16,17,23,24-zinc octabutylphthalocyanine. Photoelectric, photodielectric and photovoltaic properties of the heterostructures were studied.

Exposure to ionizing radiation (IR) could affect the human brain and eyes leading to both cognitive and visual impairments. The aim of this paper was to review and analyze the current literature, and to comment on the ensuing findings in the light of our personal contributions in this field. The review was carried out according to the PRISMA guidelines by searching PubMed, Scopus, Embase, PsycINFO and Google Scholar English papers published from January 2000 to January 2020. The results showed that prenatally or childhood-exposed individuals are a particular target group with a higher risk for possible radiation effects and neurodegenerative diseases. In adulthood and medical/interventional radiologists, the most frequent IR-induced ophthalmic effects include cataracts, glaucoma, optic neuropathy, retinopathy and angiopathy, sometimes associated with specific neurocognitive deficits. According to available information that eye alterations may induce or may be associated with brain dysfunctions and vice versa, we propose to label this relationship “eye-brain axis”, as well as to deepen the diagnosis of eye pathologies as early and easily obtainable markers of possible low dose IR-induced brain damage.

Purpose A few interventional studies to date have specifically assessed the association between dairy products and/or sugar consumption and the risk of type 2 diabetes mellitus (T2D) incidence. The aim of this study was to assess the effectiveness of diet modification in people with impaired glucose regulation (IGR) as defined by a glucose tolerance test (GTT). Methods A quasi-experimental study design was used for this study. A total of 318 randomly selected 18-year-old or older participants from the rural area of the Kyiv region of Ukraine who had not been registered as T2D patients before underwent GTT between June 2013 and June 2017. For those who had been diagnosed with IGR, World Health Organization (WHO)/International Diabetes Federation criteria were used. Of 318 participants screened for T2D, 123 (74% of them females) were diagnosed with IGR. They were aged 18 to 79 years old with a median (QI – QIII) age of 62 (52–68) years. They were repeatedly tested during the study and completed a questionnaire on average 2.8 (1.1) years (standard deviation [SD]), after they had received their lifestyle-based T2D prevention recommendations. In addition to basic recommendations, they were advised to consume approximately 200 g of low-fat dairy products and less than 25 g of sugar daily. Cases of screen-detected diabetes mellitus (SDDM) were diagnosed and reported as an outcome variable if a fast capillary blood glucose level reached 6.1 mmol/L and above. To define the association between implementation of recommendations and the risk of SDDM, the Cox proportional-hazards regression analysis was used. Results During the study observation period, 56 (45.5%) of 123 IGR-positive participants were recognized as SDDM cases. Those individuals with IGR (n = 111) who confirmed their adherence to preventive recommendations had a significantly lower risk of identifying SDDM, age- and gender-adjusted hazard ratio (HR) 0.26 (95% CІ; 0.09–0.72). This effect appears to be related to the recommendation to reduce the daily intake of sugar to less than 25 g (n = 99), corresponding to age- and gender-adjusted HR 0.44 (95% CІ; 0.2–0.99). We cannot prove that increasing consumption of dairy products, vegetables, and fruit or increased physical activity had similar effectiveness. Conclusions After 2.8 years of follow-up, the individuals who are IGR-positive and who confirmed their adherence to lifestyle-based preventive recommendations had a significantly lower risk of identifying SDDM. This effect appears to be related to recommendations to reduce the daily intake of sugar to less than 25 g.

The biochemical processes occurring in sand filters loads of tertiary treatment of urban wastewater are investigated. The significance of those processes in reducing the overall biochemical and chemical oxygen demand in water purified by filters was established. The studies were conducted in natural conditions of the wastewater treatment plant in Krasnoyarsk using the installation for filters’ technological modeling. Equations for calculating and adjusting filtering parameters, taking into account biochemical processes, were obtained.

For the purpose of improving retrospective internal thyroid dose estimations for children and adolescents following the Chernobyl accident, age- and gender-dependent thyroid masses have been estimated for the children of Kiev and Zhytomyr oblasts, which are two of the most contaminated regions of Northern Ukraine. For children ages 6-16 y, the thyroid masses were based on the measurements by ultrasound of the thyroid volumes of about 60,000 children performed by the Sasakawa Memorial Health Foundation in the 1990s. For children aged 0 to 36 mo, because thyroid mass values for Ukrainian children were not found in the literature, autopsies were performed for the specific purpose of this paper. Thyroid mass values for children aged 3-5 and 17-18 y were either interpolated or extrapolated from the measured data sets. The results for children aged 6-16 y indicate that the thyroid masses of rural children are, on average, slightly higher (by about 8%) than the thyroid masses of urban children. The geometric means of the thyroid masses were estimated as 5.2 g, 9.0 g, and 15.8 g for boys and 5.2 g, 9.4 g, and 16.0 g for girls aged 5, 10, and 15 y, respectively. Those values are greater than the reference values that ICRP recommends for iodine-sufficient populations, thus reflecting the fact that the northern part of Ukraine is iodine-deficient.

In this study, we compared the rate of insulin requirement among adults with type 1 diabetes (T1D) in 24 Ukrainian regions. The glutamic acid decaroxylase 65 antibody (GADA), insulin antibody (IA), and plasma c-peptide levels were investigated. The data included the prevalent cases of T1D in Ukraine at the end of 2006. Only persons aged over 14 years at the time of inclusion into the Ukrainian register and diagnosed with diabetes before 30 years of age were included in this study (n=26796). A total of 86 T1D patients (42 males; 44 females) with a mean age of 27.5 years (0.86) and a mean diabetes duration of 10.3 (0.72) years (SE), were randomly selected from four regional diabetes registers. The GADA, IA, and the plasma c-peptide levels were also determined. The logistic regression model was used, and the odds ratio (OR) and 95% confidence interval (CI) were calculated. Furthermore, the differences in the T1D prevalence among the 24 Ukrainian regions were obtained (p0.001). In the "minimal" regional cluster (MIC), the prevalence rate was 6 (5-6), and in the "maximal" (MAC) regional cluster, it was -9 (8-9) per 10000 adults. For patients with a disease duration (DD) of up to 15 years (n=13677), the daily insulin dose (DID) was observed to increase linearly with DD (R=0.899, p0.001). The median insulin doses were standardized according to DD, and the values were lowest in the MIC and highest in the MAC populations: 45.89 (45.28-47.19) and 56.59 (53.33-57.88) U/24 h, respectively (p0.01). Furthermore, the level of HbA1c in the MAC of T1D patients was observed to be higher than that in the MIC (9.52+/-2.24%, n=240, and 8.57+/-3.29%, n=111, respectively; p0.01). In addition, the GADA levels and persistence in the MAC patients (n=38) were higher than that in the MIC patients (n=48): 14.1+/-4.6 and 3.2+/-1.2 U/ml, respectively, mean+/-SE; p=0.028; OR=9.66 (3.31-28.17), p0.001. Adjusting for age, gender, and duration of diabetes affected the results only slightly. Furthermore, the IA and c-peptide levels and their persistence were not observed to be associated with TD1 prevalence.

The gender differences in stroke risk among diabetic patients with different treatments have not been studied previously. We aim to determine if there is a gender difference in nonfatal stroke risk in diabetic patients receiving different types of glucose-lowering treatments.In December 2005, data of type 2 diabetic patients were extracted from a nationwide population-based diabetes registry covering 11 Ukrainian regions. Male/female odds ratios (OR) for nonfatal stroke were calculated in three treatment groups: diet only 7,273/15,901, oral glucose-lowering drugs 15,109/33,913, and insulin 5,529/12,462 male/female. Male/female ORs of stroke were estimated using a logistic regression model.The age-adjusted ORs of stroke were higher among diabetic men compared with diabetic women with oral glucose-lowering drug treatment (OR 1.37, 95% CI 1.22-1.54) and diet treatment only (OR 1.53, 95% CI 1.35-1.73). No differences were found among patients who used insulin (OR 0.97, 95% CI 0.84-1.11). Further adjustment for duration of type 2 diabetes, body mass index (BMI), systolic blood pressure, total cholesterol, and smoking affected the results only slightly.The gender risks of nonfatal stroke in patients with type 2 diabetes appear to differ considerably depending on treatment types.

To compare the joint effects of different types of glucose-lowering treatment (oral drugs, insulin, and both) and duration of diabetes on total and cardiovascular mortality among diabetic patients.Study cohorts included 30,534 Ukrainian males and 58,909 females with type 2 diabetes. During the mean follow-up of 2.7 years, 7804 deaths were recorded.The multivariate-adjusted hazard ratios (HRs) for total mortality among diabetic patients, who used oral glucose-lowering drug (OGLD) only, insulin only, both insulin and OGLD, were 1.00, 2.34, and 2.22 in men, and 1.00, 2.12, and 2.20 in women, respectively. The multivariate-adjusted HRs for total mortality across categories of duration of diabetes (5, 5-9, 10-14, 15-19, and/=20 years) were 1.00, 1.17, 1.32, 1.43, and 1.57 (p(trend)0.001) in men, and 1.00, 1.13, 1.34, 1.74, and 1.68 (p(trend)0.001) in women, respectively. Diabetic patients who used insulin and reported longer duration of diabetes had the highest risk of total mortality.Type 2 diabetic patients treated with insulin show a greater risk of death than those treated with OGLD only. Increasing duration of diabetes is associated with an increased death risk. The combination of insulin treatment and longer duration of diabetes identifies a particular high death risk.

Aims/hypothesis Numerous epidemiological studies have shown differences in seasonality of birth patterns between the general population and the group who develop type 1 diabetes mellitus. This finding indicates that environmental factors operating during pre- and/or postnatal development could be aetiologically important. We examined whether the pattern of month of birth for type 1 diabetes patients in Ukraine differs from that for total live births. Methods Data consist of prevalent cases of type 1 diabetes in Ukraine by the end of 2003. Cases are restricted to persons born after 1 January 1960, diagnosed with type 1 diabetes before the age of 30 years (n=20,117). People born during the same time in the general population (n=29,105,560) were the reference standard. Seasonal patterns were estimated using logistic regression with harmonic terms. Results We found a strongly significant seasonal pattern of type 1 diabetes incidence rates (p

Type 1 diabetes mellitus is a chronic disease characterized by autoimmune degradation of insulinproducing β-cells. Seasonality of birth of children with type 1 diabetes has been shown in a number of epidemiological studies. It could testify that autoimmune process began during fetal and postnatal development. No such studies were carried out in the former Soviet Union countries. The aim of the present study is to compare the seasonal birth month pattern in patients with type 1 diabetes (10780 men and 9337 women) born in 1960–2003 to that in the total population of Ukraine (14 995768 men and 14 109792 women) born during the same period. Significant differences were found between these two populations: χ 2 = 103.97, p < 0.0001 and 135.17, p < 0.0001 in men and women, respectively. The results of cosinor analysis showed similar sinusoidal birth patterns of patients with type 1 diabetes in all subgroups, irrespective of the age of clinical disease manifestation: 0–9, 10–19, or 20–29 years. In all cases, the highest and lowest predispositions to type 1 diabetes were inherent in the people born in spring and autumn, respectively. In all groups, the highest incidence rate was in persons born in spring and early summer and the lowest ones, in those born in autumn and early winter. We propose that seasonality of birth of patients with type 1 diabetes in the two above populations could be due to long-term programming of glucose-insulin metabolism caused by the effect of certain seasonal factors during early ontogenesis.

Urinary iodine concentrations were measured in 11,926 subjects who are participants in the Ukrainian-American Cohort Study of Thyroid Cancer and Other Thyroid Diseases Following the Chornobyl Accident. Measurements were made in two time periods corresponding to the first and second thyroid screening cycles (1998-2000, 2001-2003). These time periods fall before and after initiation of a government program to increase iodine sufficiency. Median urinary iodine concentrations did increase in the later time period compared to the earlier [47.5 microg/L, 95% confidence interval (CI) 46.5-48.9 microg/L versus 41.7 microg/L, 95% CI 40.4-42.5 microg/L], but levels remained in the mild-to-moderate iodine deficiency range as defined by the World Health Organization (WHO), indicating the need for further efforts at iodination. In both time periods, urinary iodine levels were found to vary by place of residence and were lower in rural compared to urban areas. Iodine status needs to be considered when evaluating risk of thyroid cancer and other thyroid diseases.

The major fallout of radionuclides from the nuclear power station accident at Chernobyl on 26 April, 1986, occurred in regions of Ukraine and Belarus that are believed to be moderately deficient in dietary iodine. On 17 November, 2000, in conjunction with the Ukraine-Belarus-USA study of developing thyroid disease in a cohort of individuals exposed as children, a workshop was held to review what is known about iodine nutrition in the region, how this might influence the risk of thyroid tumor formation from radioiodine, and whether and how iodine nutrition should be monitored in this long-term project. This report is a summary of the workshop proceedings. Although no precise information about iodine intake in 1986 was found, the prevalence of mild goiter in the region's children suggested iodine deficiency and urinary iodine measurements begun in 1990 indicated that mild to moderate deficiency existed. Increased thyroid iodine uptake and increased thyroid size in 1986 resulting from iodine deficiency would have had counteracting influence on the thyroid radiation dose and knowledge of these parameters is required for dose reconstruction. More problematic is the possible role of iodine deficiency in the years following the accident. Theoretically, the resulting increase in thyroid cellular activity might increase the risk of tumorigenesis but experimental or clinical evidence supporting this hypothesis is meager or absent. Despite this limitation it was considered important to monitor iodine nutrition in the cohort subjects in relation to their place of residence and over time. Methods to accomplish this were discussed.

Keywords Birthcohorts.Early-lifeconditions.Month-of-birthpattern.Type2diabetesTo the Editor: Epidemiological studies have repeatedlyshown a link between poor fetal growth and increased riskof developing type 2 diabetes [1]. Month of birth is a goodinstrument for the assessment of effects of early growth onadult health independent of life-course factors. This is truebecause in decades past there were important seasonaldifferences in nutrition, especially in developing countriessuch as Ukraine. These differences in access to high-qualityfood supply can potentially influence intrauterine growth,depending on the month of gestation [2]. Other possibletriggering factors for developing type 2 diabetes, such asproduction of vitamin D [3] and outdoor temperature [4],also tend to change seasonally.Seasonal pattern of birth in type 1 diabetic children andadolescents was repeatedly described around the world,including our recent study in Ukraine [5]. In contrast, theseasonality of birth in type 2 diabetic patients waspreviously reported only in a few small-sample studies,e.g. in 155 African-American type 2 diabetic adolescent [6]and 282 adult patients in the Netherlands [7]. To studywhether abnormal seasonality of birth exists in middle- toold-aged type 2 diabetic patients in Ukraine, we comparedthe month-of-birth patterns in type 2 diabetic patients in threelarge Ukrainian regions with those in general populations.Information on date of birth, sex and year of diagnosiswas extracted from the nationwide primary-care-basedUkrainian diabetes mellitus register created in 2000 in theInstitute of Endocrinology, Kiev, Ukraine. The definition oftype 2 diabetes was based on onset after 39 years of age,irrespective of the type of treatment.Cases were identified from the three regional diabetesregisters with high completeness of ascertainment: Cherni-giv (100%), Kherson (99.7%) and Rivne (86.2%). Theseregisters cover 7.4% of the total Ukraine population. Afemale excess was evident in all three registers. Cases wereall people alive with diagnosis of type 2 diabetes as of1 January 2008, and who were diagnosed at age 40 or later.Only people born before 1 January 1960 were included;thus all cases included were at least 48. In total, 17,510male and 34,704 female type 2 diabetic patients werefinally included in the study. Reference populations werebased on the Ukraine census 2001 depersonalised data.These populations included people who had been bornduring the same period and were residents of the sameregions: Chernigiv, 247,253 men and 369,357 women;Kherson, 208,944 men and 291,802 women; Rivne,189,887 men and 260,674 women.

Analysis of the prevalence of insulin-dependent diabetes mellitus (IDDM) and non-insulin-dependent diabetes mellitus (NIDDM) in various climato-geographic and administrative regions of the Ukraine was performed. The prevalence of diabetes mellitus (DM) complications in the west and north zones of the Ukraine was studied. The role of prophylactic measures in decreasing the number of complications was elucidated. The statistical reports from the specialized endocrinologic institutions of the Ukraine were analysed in the Laboratory of Epidemiology of Endocrine diseases of Institute and results from 3450 and 673 diabetic patients in the west and north zone of the Ukraine were used, respectively. In various administrative regions of the Ukraine the prevalence of IDDM significantly varied from 1740 to 3813 patients per 1 million population. Significant differences in the prevalence of NIDDM were found. Generally in the west zone of the Ukraine the prevalence of DM was less than that of average in the Ukraine. Angiopathy of the lower extremities, neuropathy and retinopathy were registered in 92, 24 and 21% of diabetes cases in the west zone, respectively. Prophylactic measures directed at a decrease in patient weight, the normalization of metabolism, arterial pressure and the elimination of pernicious habits promoted a decrease in the number of complications.

A relationship between childhood starvation and type 2 diabetes mellitus (T2D) in adulthood was previously indicated. Ukraine suffered a series of artificial famines between 1921 and 1947. Famines of 1932 to 1933 and 1946 were most severe among them. Long-term health consequences of these famines remain insufficiently investigated. Type 2 diabetes mellitus screening was conducted between June 2013 and December 2014. A total of 198 rural residents of Kyiv region more than 44 years of age, not registered as patients with T2D, were randomly selected. In all, 159 persons answered the question about starvation of parental family, including 73 born before 1947. Among them, 62 persons answered positive. Anthropometric measurements and glucose tolerance tests were performed. A logistic regression model was used to evaluate results. Type 2 diabetes mellitus was detected in 7 of 62 persons (11.3%), who starved during childhood vs 6 of 11 (54.5%) who did not ( P = .002), age-adjusted and sex-adjusted odds ratio (OR) (95% confidence interval): 0.063 (0.007-0.557). Analysis of the anthropometric data revealed a negative connection between adulthood height and neck circumference (cm, continued variables) and childhood starvation: age-adjusted and sex-adjusted ORs 0.86 (0.76-0.97) and 0.73 (0.54-0.97), respectively. Individuals who starved during famines of 1932 to 1933 and 1946 in Ukraine had a decreased T2D prevalence several decades after the famine episodes.

To compare mortality risks among type 2 diabetes (T2D) patients being treated with glibenclamide, gliclazide, or glimepiride.Retrospective observational cohort studies of primary care-based diabetes register were carried out. Risk of total and cardiovascular (CVD) mortality was evaluated in cohort of T2D patients that were treated with either glibenclamide (n=50,341), glimepiride (n=2479) or gliclazide (n=11,368). Cox regression was used for multifactor evaluation. A cross-sectional evaluation of oral anti-diabetic drug (OAD) structure for 2005 and 2007 was also performed, as well as age at the time of death was compared in the timeframe between 2002 and 2007.Total mortality was lower for gliclazide and glimepiride, vs. glibenclamide cohort: HRs 0.33 (95% CI 0.26-0.41), p0.001 and 0.605 (95% CI 0.413-0.886), p0.01 respectively. CVD mortality risk reduction vs. glibenclamide was significant only in gliclazide cohort: 0.29 (95% CI 0.21-0.38), p0.001. Glibenclamide prescriptions had changed from 64.0% (95% CI 63.5-64.5) to 59.5% (95% CI 9.7-10.4). Age at the time of death for OAD-treated patients increased by 6.27 (95% CI 3.67-8.87)yrs, p0.001.Glibenclamide treatment of T2D is associated with greater risk of all-cause mortality, vs. gliclazide or glimepiride treatment, and CVD mortality, vs. gliclazide treatment.

Layered piezoelectric resonators exhibit a complex spectrum of eigenfrequencies, which can be understood better if the associated vibration patterns are examined. For a closer insight into such a system, planoconvex AT‐cut quartz crystals with a thick layer of copper on one side are investigated experimentally. Since presently no comprehensive three‐dimensional theory of layered resonators is available, the experimental results can be compared only with one‐dimensional descriptions of layered resonators or with theoretical models for unloaded contoured quartz crystals. The anharmonic spectrum of the crystals is used to find a formula by which the eigenfrequency of the corresponding infinite plate can be determined from measured frequencies of planoconvex crystals. If this correction is applied to experimental frequency spectra of composite quartz‐film resonators, excellent agreement with the one‐dimensional model is found. As theoretically predicted, also even harmonic overtones of heavily loaded crystals...

Several prospective studies have evaluated the association between body mass index (BMI) and cardiovascular mortality among patients with type 2 diabetes; however, the results are controversial.To investigate the association of different BMI distributions with total and cardiovascular mortality among diabetic patients.A total of 30 534 Ukrainian men and 58 909 women with type 2 diabetes from the nationwide population-based diabetes register were included in this study.During a mean follow-up of 2.7 years, 7804 deaths were recorded, of which 3320 were due to cardiovascular disease. After adjustment for age, smoking and alcohol drinking, the hazard ratios across the five BMI categories (23, 23-24.9, 25-29.9 (reference group), 30-34.9 andor=35 kg/m2) among diabetic men were 1.57 (95% CI 1.42 to 1.74), 1.16 (1.05 to 1.28), 1.0, 1.01 (0.91 to 1.12) and 1.24 (1.02 to 1.50) for total mortality, and 1.67 (95% CI 1.42 to 1.95), 1.30 (1.12 to 1.51), 1.0, 1.13 (0.96 to 1.34) and 1.54 (1.16 to 2.05) for cardiovascular mortality, respectively. The respective hazard ratios among diabetic women were 1.34 (95% CI 1.22 to 1.47), 1.00 (0.91 to 1.10), 1.0, 1.04 (0.97 to 1.12) and 1.27 (1.14 to 1.41) for total mortality, and 1.36 (95% CI 1.18 to 1.57), 1.06 (0.92 to 1.21), 1.0, 1.12 (1.01 to 1.25) and 1.35 (1.15 to 1.59) for cardiovascular mortality. Additional adjustment for systolic blood pressure, total cholesterol, history of cardiovascular disease, diabetes treatments and duration of diabetes affected the results only slightly.This study indicated a U-shaped association between BMI and total and cardiovascular mortality among diabetic men and women.

Q-switched laser behavior of the new IRE RAS developed Yb-Er phosphate glass LGS-KhCh2 was studied using FTIR and water-cooled chamber with lamp pumping. Laser rod near 3 mm in diameter and 80 mm long was investigated. Laser output of 5-10 mJ was achieved at 1535 nm at 20 Hz repetition rate. For the first time, to our best knowledge, the CW operation of the erbium glass laser under lamp pumping is demonstrated.