ПРО- ТА ПРОТИЗАПАЛЬНІ ІНТЕРЛЕЙКІНИ У ПАЦІЄНТІВ ...



МІНІСТЕРСТВО ОХОРОНИ ЗДОРОВ’Я УКРАЇНИ

ХАРКІВСЬКИЙ НАЦІОНАЛЬНИЙ МЕДИЧНИЙ УНІВЕРСИТЕТ

кафедрА внутрішньої медицини №1

Актуальні питання внутрішньої медицини:

здобутки та перспективи

тези доповідей науково-практичної конференції

студентів та лікарів-інтернів

25 листопада 2015 року

Харків

УДК: 616.1/.4-036.12-084-06

Наукові керівники проекту:

В’юн В.В., Бабак О.Я.

Редакційна колегія:

Андреєва А.О.,

Гопцій О.В.,

Железнякова Н.М.,

Зелена І.І.,

Молодан В.І.,

Просоленко К.О.

Відповідальні секретарі:

Башкірова Г.Д.,

Голено Т.М.,

Лапшина К.А.

THYROID DYSFUNCTION IN PATIENTS WITH DIABETES MELLITUS TYPE 1

Aakash Sajjar, N.M. Zhelezniakova

Kharkiv National Medical University

Department of internal medicine #1

Diabetes mellitus type 1 (DM 1) is often associated with other autoimmune diseases, with autoimmune thyroid disease as the most common one. It can be manifested as subclinical thyroid gland dysfunction, hypothyroidism,or as euthyiroid state with positive antithyroid antibodies and rarely as Hyperthyroidism (Graves-Basedow).

Aim: to determine the level of thyroid antibodies and the frequency of autoimmune thyroid disease in patients with diabetes mellitus type 1.

Materials and Methods: The study has included 38 DM 1 patients, 20 women and 18 men with an average duration of DM 12 ± 4.7 years.Clinical assessments included level of Thyroid stimulating hormone receptor antibodies (TRAb), antibodies to thyroid peroxidase (TPOab), thyroglobulin antibodies (TGab ) and hormones ( T3, T4, TSH) were calculated . As the findings were considered positive values TRab greater than 1.5 U, TPOab greater than 12 U and TGab greater than 34 U.

Results:Positive TPOab are found in 9 patients (23.7%), TGab in 7 (18.4%) and by 4 patients (10.5%) positivity was defined by both antibodies. Positive TRab were not established even in one patient. Total of 20 respondents (52.6) had positive antibody titers. Notable is the frequent thyroid antibody presence in females. Also 12 pts (31,5%) had increased level of TSH, 5 pts (13.2%) had hypotiroidsm and only one(2.7%) had hipertiroidsm. Four pts (10.5%) had suffer subclinical hypotiroidsm.

Conclusions: The results indicate a high frequency of occurrence of thyroid antibodies and autoimmune diseases in patients with DM 1. Therefore, it is recommended screening thyroid antibodies because regular screening for thyroid abnormalities in all diabetic patients will allow early diagnose of thyroid dysfunction, especially in patients with subclinical dysfunction.

FEATURES CARBOHYDRATE METABOLISM IN PATIENTS WITH NONALCOHOLIC FATTY LIVER DISEASE

AND METABOLIC SYNDROME

Abduldjalil S.M., Alhater R.M., Prosolenko K.

Kharkiv National Medical University

Department of internal medicine #1

Abnormalities of carbohydrate metabolism have important role in pathogenesis of nonalcoholic fatty liver disease (NAFLD) and metabolic syndrome (MS).

Aim: To examine the clinical and laboratory features of disorders of carbohydrate metabolism in patients with nonalcoholic steatosis (NS) and nonalcoholic steatohepatitis (NASH) and MS.

Materials and Methods: 68 patients aged 18 to 65 years with NAFLD and MS were examined. Patients were divided into two groups - the first with NS (n=38); second - with NASH (n=30). The control group consisted of 20 healthy volunteers. To assess control of carbohydrate metabolism studied daily glycemic profile with the definition of fasting glucose, before and 90 minutes after breakfast, lunch and dinner, also at 24 and 3 o’clock. For monitoring carbohydrate metabolism used the following indicators: ADFG - average daily fasting glucose; APG - average postprandial glycemia; ADAG - the average daily amplitude of glycemia. The level of glycosylated hemoglobin (HbA1s) using a set of "Diabetes Test".

Results: The highest level of ADFG and APG detected in patients with NASH: 7,03(0,14 and 9,90(0,32 mmol/l against 5,93(0,22 and 6,21(0,24 mmol/l respectively in I and II groups. In these patients was the largest ADAG: 2,52(0,22 mmol /l compared with 1,52(0,19 mmol /l in patients with NS. HbA1s values ​​were significantly higher in representatives of both groups, but more among patients with NASH - 8,66(0,39 and 6,72(0,5% respectively, to 84.5% and 42.9% higher than rates healthy individuals.

Conclusion: carbohydrate metabolism make a significant contribution to the development and progression NAFLD that must be considered when assigning differential treatment for the patients.

TNF-Α INTERRELATIONS WITH EXTERNAL RESPIRATORY FUNCTION OBSTRUCTIVE CHANGES IN HYPERTENSIVE PATIENTS WITH OBESITY

Abdyresulova Mahri, Sytnyk K.

Kharkiv National Medical University

Department of internal medicine #1

Objective: Recent evidence suggests close obesity and arterial hypertension association. Both pathological states are characterized by low-grade inflammation which result in adipokines dysfunction: increased activity of proinflammatory cytokines and decreased activity of anti-inflammatory cytokines. The aim of our research was study relationships between serum TNF-α concentrations and external breathing function disorders in hypertensive patients with obesity.

Design and Methods: 55 Patients with arterial hypertension (AH) were examined. Serum TNF-α levels by ELISA were detected. All patients underwent anthropometry, office BP measurement, and spirography. Patients were divided into 3 group depend on body mass and FEV1 means: 1 gr. – hypertensives with normal body mass; 2nd gr. – obesity-related hypertensives without bronchial obstruction (FEV1 >80%); 3rd gr. – obesity-related hypertensives with bronchial obstruction (FEV1 ................
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