Primary hyperaldosteronism (PHA) is a clinical syndrome that develops as a result of excess production of aldosterone by adrenal glomerular zone, where aldosterone secretion is completely or partially autonomous in relation to the renin-angiotensin system. This factor leads to the development low renin arterial hypertension (AH). Primary idiopathic hyperaldosteronism is one of the forms of PHA. The prevalence of this form is variously estimated from 20 to 55% of patients with PHA. Morphological substrate primary idiopathic hyperaldosteronism is a bilateral micro- or macronodular adrenal hyperplasia. This article summarizes the contemporary view of the pathogenesis, clinical presentation, diagnosis and treatment of idiopathic hyperaldosteronism.

The article presents the results of clinical studies on the efficacy and safety of androgen therapy for metabolic syndrome and obesity in men with hypogonadism. The study is focused on the use of testosterone undecanoate for reduction of body fat and the severity of other components of the metabolic syndrome, improvement of sexual function without causing severe side effects. In a number of patients treated we observed suppression of spermatogenesis, which prevents the use of the drug in the reproductive rehabilitation.

Continuous glucose monitoring - an important diagnostic, teaching and treatment tool for patients with diabetes mellitus, which is increasingly becoming a part of routine clinical practice in endocrinology. This article presents an overview of modern techniques, their advantages and disadvantages, evidence basis and place in everyday clinical practice. The article discusses the key factors affecting the efficiency, indications, contraindications, conditions of use of the continuous glucose monitoring systems in patients with diabetes mellitus, gives an algorithm for the application of this technique in clinical practice.

The article presents the results of evaluation of vitamin D3, osteoprotegerin, carbohydrate and fat metabolic parameters in women with type 2 diabetes and obesity. The study subjects showed an increase of osteoprotegerin, decrease of vitamin D3, insulin resistance and compensatory hyperinsulinemia.

The study evaluated the effectiveness of screening tests performed on the basis of functioning centers of Health, to identify individuals with cardiometabolic risk factors. Materials and methods: A total of 2007 men (mean age 50,80±16,54 years) were evaluated. The results of physical and psychological tests, express-analysis of functional state of heart via ECG, express-analysis of cholesterol and glucose blood levels, vascular screening, and concentration of carbon monoxide, carboxyhemoglobin and human body composition by bioimpedance were estimated. Results: During the screening we revealed 62.33% men with BMI≥25 kg/m2. BMI≥25 kg/m2 was associated with an increase in the average levels of cholesterol, fasting blood glucose, blood pressure, as well as signs of myocardial electrical instability and autonomic dysfunction. Progressive increase in BMI≥25 kg/m2 was associated with the presence of combined cardiometabolic risk factors and the presence of unhealthy lifestyle behaviors. All patients with a BMI≥25 kg/m2 received individual recommendations about a mode of work, physical activity and diet, and were also invited for group training in «Weight reduction school»

A link between obesity, overweight and reproductive performance in male volunteers 18 to 40 years (n=261), living in the city of Novosibirsk was investigated. Hormone levels (follicle-stimulating hormone (FSH), luteinizing hormone (LH), testosterone (T), oestradiol (E2), inhibin B) and main indicators of semen quality (concentration, percentage of motile and morphologically normal sperm) were evaluated in each patient. Following groups were retrospectively formed: the control (group 1, a BMI of 18.5 to 24.9 kg/m2, n=50), overweight men (group 2, a BMI of 25.0 to 29.9 kg/m2, n=28), obese men (group 3, a BMI greater than 30.0 kg/m2, n=5). The exclusion criteria from the analysis were as follows: andrological disease (prostatitis, epididymal cyst, varicocele, sexually transmitted infection), transferred surgery of andrological diseases. A reduction in the testosterone serum concentration was found along the groups in the direction 1->2->3 respectively, 23.3->15.7->11.8 nmol/L (р1,2=0.006; р1,3=0.0001). Semen volume was statistically reduced in obese men compared with normal weight men (p1,3=0.019). There were no significant differences in age, FSH, LH, E2, Inhibin B levels, concentration, motility, percentage of morphologically normal sperm between groups. The findings show the distinct hypoandrogenia in young men with overweight and obesity. A testosterone deficiency is increased with increasing BMI and the testosterone concentration descends to less than 12 nmol/L in the obesity group, which corresponds to hypogonadism.

Objective. To study the influence of the drug Reduxine in obese patients on the distribution of adipose tissue measured by MRI. Methods. In an open, prospective, non-randomized study duration of 20 weeks included 31 obese patients aged 20 to 65 years. During the study, the anthropometric parameters and the dynamics of the area of adipose tissue by means of MR imaging. Results. Weight loss in patients averaged 9.0 kg. Clinically significant weight loss reached 23 people (79%). Median reduction in waist circumference was 10 cm. Dynamic assessment of adipose tissue by MRI was performed in 17 patients. Reduxine treatment induced statistically significant decrease of both visceral and subcutaneous fat. Conclusions. According to the results of MRI, the reduction in waist circumference in patients receiving Reduxine occurred by reducing the number of both subcutaneous and visceral fat in the abdominal area.

Multiple endocrine neoplasia syndrome type 1 (MEN1, Wermer syndrome) – group o а heterogeneous inherited deseases, caused by hyperlasia or neoplasia of several endocrine glands. The phenotype of MEN1 is broad, and over 20 different combinations of endocrine and non-endocrine metabolic manifestations have been described. This case demonstrates multiple formations of endocrine organs, starting non-classical with macroprolactonoma resistant to dopamine agonists therapy, other endocrine disorders developed gradually eventually: hyperparathyreoidism and hypoglycemia caused by pancreas lesions, produced proinsulin in high levels.