The prevalence of cholelithiasis, its close pathogenetic connection with metabolic syndrome, high frequency of surgical intervention, significant economic losses put forward this comorbid pathology in a number of leading problems of modern clinical medicine. The factors associated with the metabolic syndrome not only increase the risk of developing cholelithiasis, but also form the basis of non-drug and drug therapy. Metabolic syndrome often determines the occurrence of three common and potentially life-threatening complications of cholelithiasis: acute cholecystitis, acute cholangitis and biliary pancreatitis. Therefore, the solution of this problem is associated with the need for early detection of additional risk factors for cholelithiasis, optimization of the early diagnostic and prognostic model of existing multi-organ pathology with the aim of reducing the progression of the disease and its complications. The data obtained in recent years on the human genome with metabolic syndrome and cholelithiasis make it possible to predict the development of comorbid pathology and to fully ensure the effectiveness of primary prevention.

Autoimmune hypoglycemia is a condition caused by the interaction of endogenous antibodies to insulin or the insulin receptor. Awareness of autoimmune hypoglycemia is important, since the syndrome can cause severe neuroglycopenic symptoms, and should be considered in differential diagnosis of hypoglycemic syndromes. Timely establishment of the correct diagnosis will help to avoid unnecessary surgical interventions in patients who can be successfully treated with conservative support.

Current studies show that metabolic and behavioral disorders represent severe health problems. Several questions arise about the molecular relationship of metabolic and behavioral disorders. This review will discuss the relationship of lipid metabolism and fructose consumption accompanied by an increase in weight as well as associated disorders: hypertension, insulin-resistance, oxidative stress and depression. Adipose tissue is considered as an endocrine tissue with intense secretory activities (metabolic and inflammatory). These adipokines are responsible for an alteration of several physiological functions. In this review we will try to understand how lipogenesis that causes dyslipidemia can influence insulin resistance, hypertension, oxidative stress, depression and the relationship between these various disorders.

Sarcopenia is one of the syndromes that significantly affects the health and life of the patient. Sarcopenia is a polyetiological syndrome with a complex, insufficiently studied pathogenesis, in which endocrine factors play a leading role. Comorbidity of elderly patients creates difficulties in differential diagnosis of existing pathology. The combination of sarcopenia with various endocrine pathologies, such as obesity, osteoporosis, hypothyroidism, hypoparathyroidism, vitamin D deficiency leads to a more severe course of disease and a worse prognosis for the quality and life expectancy of the patient. In this case, in some situations, the patient's condition can be improved by assessing pathogenetic causes and their elimination. Thus, the endocrinologist should pay more attention to the sarcopenia syndrome and its correction, as well as for its prevention at the earliest stages.

Background: Bone tissue is a non-classical endocrine organ, which produces at least two hormones: fibroblast growth factor 23 (FGF-23) and decarboxylated osteocalcin (OC). In addition to this, recent studies demonstrate that specific proteins involved in the paracrine regulation of bone remodelling can be measured in peripheral serum samples and may serve as additional biomarkers of bone metabolism.

Aims: to evaluate the serum levels of biomarkers related to endocrine and paracrine function of bone tissue in patients with Cushing’s disease (CD) and acromegaly.

Materials and methods: The study was conducted according to the cross-sectional case-control type. Fasting serum samples were taken between 8–10 a.m. from patients with CD, acromegaly and age-, sex- and BMI-matched healthy volunteers and stored at -40° C. Commercially available kits for enzyme-linked immunosorbent assay (ELISA) were used to determine the serum levels of FGF-23, co-factor (co-receptor) Klotho, cathepsin K, sclerostin, P1NP. Insulin-like growth factor-1 (IGF-1) was measured by the immunochemiluminescence assay, late-night (11 p.m.) salivary cortisol (LNSC) was evaluated using the electrochemiluminescence method. Non-parametric tests (the Kruskal-Wallis test and the Mann-Whitney test) were used to assess the differences between the groups of patients.

Results: The study includes 78 patients, (37.6 years old, 95% CI 34.75–40.46): 29 patients with CD (group 1), 22 – with acromegaly (group 2), and 27 healthy individuals (group 3), matched by sex, age and BMI (p = 0.432, 0.373 and 0.725 between groups, respectively). LNSC in patients with CD and IGF-1 in patients with acromegaly were significantly higher compared to the control group (p = 0.004 and p <0.001, respectively). In patients with acromegaly, a statistically significant increase in FGF-23 (1.13 (0.78;1.49) vs 0.78 (0.54;1.09)) and phosphorus (1.38 (1.24;1.52) vs 1.16 (1.12;1.29)) (p = 0.01 and p <0.001, respectively) was observed along with increased levels of bone remodelling markers. In patients with CD, bone formation markers were suppressed, but differences in the levels of other biomarkers could not be identified.

Conclusions: Acromegaly leads to hyperphosphatemia and increase in FGF-23, which is most likely due to the development of resistance to FGF-23, and the intensification of bone remodelling. With CD, another bone hormone, osteocalcin, is suppressed along with the suppression of P1NP.

Background: According to WHO forecasts, childhood obesity can soon become equally dangerous to public health as malnutrition and infectious diseases. Elimination of modifiable risk factors is important for the disease and disease-associated complications prevention. At the same time it is shown that the risk factors can vary widely not only from country to country but also from area to area within one country.

Aim: To establish risk factors associated with obesity in adolescents in rural areas of Buryatia, Russia.

Materials and methods: The cross-sectional study included 11–17 year old adolescents with normal weight (BMI 25–75 percentile) and obesity (BMI ≥ 95 percentile). We assessed anthropometric measures of adolescents and their parents, sociodemographic characteristics, early-life exposures, eating and lifestyle patterns.

Results: The study included 128 adolescents with normal weight and 72 adolescents with obesity. Both groups were comparable by sex, age and ethnicity. Factors, associated with obesity in rural adolescents, were: parents’ obesity (odds ratio (OR) 3.63 (95% confidence interval (CI) 1.92–6.87); the mother’s body mass index (OR 1.17 (95% CI 1.1–1.25)); duration of breast-feeding less than 4 months (OR 2.42 (95% CI 1.14–5.13)); disturbed dietary pattern (OR 2.54 (95% CI 1.1–5.88)). Factors showing protective effect were total breast-feeding duration (OR 0.94 (95% CI 0.89–0.99)) and mother’s employment as a skilled worker (OR 0.51 (95% CI 0.27–0.96)).

Conclusions: Characteristics of family (obesity in parents, mother’s BMI), breast-feeding less than 4 months and the disturbed dietary pattern are the risk factors associated with obesity in adolescents living in rural areas of Buryatia which are worth considering when local obesity prevention programs are being developed.

In this lecture, we discuss in detail the endocrinopathies associated with the use of immune-checkpoint inhibitors in oncology. The cases, terms and features of clinical manifestations of endocrine-related immune reactions are discussed, and practical recommendations for the treatment of patients are proposed.

Рrevalence of endogenous hypercortisilism is about 5–6 cases per 1 million people. ACTH-dependent hypercortico- sis in the general structure is about 80%. Among this cohort of patients in 70–75% the cause of hypersecretion of ACTH is corticotrophinoma, about 10% are diagnosed with hyperplasia of corticotrophs, in the remaining 15–20% – neuroendocrine tumors of different locations, producing ACTH and / or corticoliberin. With ectopic ACTH syndrome the development of clinical manifestations is faster than with corticotropinoma, which determines the nature of the clinical picture. Difficulties in identifying the primary focus hypersecretion of ACTH may be due to its small size, absence or nonspecificity of the clinical picture from the primary focus, early metastasis in the case of malignant tumors. Besides, clinical manifestations of hyper- cortisolism can be considered and as independent nosological units, which creates certain difficulties at the stages of early diagnosis and timely treatment of ectopic ACTH syndrome.

Hyperprolactinemia is one of the most common endocrine diseases in the practice of different specialists. Interdisciplinary approach and unified principles of patient management are extremely relevant for this pathology due to the variety of clinical forms. The article demonstrates typical clinical manifestations of hyperprolactinemic syndrome on the example of three patients and shows the different approach to management and treatment.

Background: the violations of eating behavior began to be actively studied since the mid-20th century. In recent years, researchers from different countries have found new evidence of the role of eating behavior, the patient's eating habits in the development of obesity. Since the scope of the study of eating behavior and its disorders began to develop actively relatively recently, many aspects of this problem have not yet been studied.

Aim: was to study the psychological features, body composition and parameters of actual nutrition of women with eating behavior disorders.

Methods. We used the Dutch questionnaire DEBQ to analyze the types of eating behavior. To assess the severity of eating disorders inherent in eating disorders, the technique "Scale of Eating Behavior Assessment" was used. The actual mental state of the subjects was studied using a clinical and psychological test – a questionnaire of the severity of psychopathological symptoms (SCL-90-R). The component composition of the body was assessed using the apparatus for bioimpedanceometry ABC-01 "Medass". The evaluation of the actual nutrition by the method of frequency analysis was carried out with the help of the computer program "Analysis of the state of human nutrition".

Results. In all groups of women with eating disorders, higher values on the scales of desire for thinness, bulimia and dissatisfaction with the body, somatization, obsessional-compulsiveness, interpersonal sensitivity, depressiveness, anxiety were found. As the eating disorders worsened, the consumption of mono-and disaccharides and added sugar increased, which was accompanied by an increase of the body fat, both in absolute and relative units.

Conclusions. In women with eating disorders violations of personal and psychological characteristics, nutrition patterns were detected, which were accompanied by an increase in body fat.