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The study of the viability of the spermatogenic epithelium in case of toxic lesions and their correction in experiment is a key factor for understanding the possibilities of restoring reproductive function in conditions of increasing technogenic pollution. The purpose of the study was to evaluate the level of pathomorphological changes in the testes of Wistar rats and the intensity of steroidogenesis upon administration of Escherichia coli lipopolysaccharide (LPS) endotoxin and subsequent correction of intoxication by administration of oxidized dextran. Material and methods. Three groups of Wistar rats were formed, intraperitoneal administration: 2 ml of 0.9 % NaCl solution (n = 5, control); E. coli LPS at a dose of 50 μg/kg body weight (n = 5); E. coli LPS at the same dose, followed by the introduction of 2 ml of a 2 % solution of oxidized dextran (OD) (n = 5). The content of testosterone in the blood serum and pathomorphological changes in the testes were assessed. Results and discussion. The administration of LPS led to moderate hypotrophy of the spermatogenic epithelium due to a decrease in the numerical density of spermatocytes and spermatogonia (by 22.4 and 26.6 %, respectively); a decrease in the numerical density of Leydig cells by 14.5 % and testosterone levels by 2.3 times (in 80 % of animals, testosterone levels ranged from 4.3 to 2.0 nmol/l). The injection of OD after LPS caused an increase in seminiferous tubule diameter and the spermatogenic epithelium height (by 2,9 и 3,3 %, respectively), in numerical density of spermatocytes and spermatogonia (by 16.8 and 14.6 %, respectively) compared to LPS; increase in the ratio of the number of spermatocytes to spermatogonia (by 6.8 %) compared to the control. The numerical density of Leydig cells increased by 4 %, the testosterone level increased by 1.7 times (in 60 % of animals the testosterone level varied from 12.7 to 37.3 nmol/l) compared to LPS. Conclusions. A single administration of OD after acute exposure to E. coli LPS endotoxin initiated the onset of restoration of the histological structure of the spermatogenic epithelium of the seminiferous tubules.

The significant prevalence and severe medical and social consequences of comorbidity dictate the need to determine the etiopathogenetic risk factors that contribute to its formation. Purpose of the study: to study the associations of metabolic factors (arterial hypertension, obesity, hyperglycemia, dyslipidemia, hyperuricemia, increased serum concentration of C-reactive protein (CRP) with a high degree of comorbidity in patients with somatic pathology. Material and methods. An analytical retrospective study was carried out including data from the medical records of 5296 patients at a therapeutic clinic, men and women, aged from 18 to 92 years (56.4 ± 0.2 years). Comorbidity was taken into account in the presence of two or more nosologies in one patient, its degree was assessed by the number of nosologies in one patient. The following risk factors were assessed: arterial hypertension, obesity, hyperglycemia, dyslipidemia, hyperuricemia, increased concentration of CRP. The presence of non-alcoholic fatty liver disease (NAFLD) was also taken into account. The association of the considered factors with a high degree of comorbidity was assessed using logistic regression analysis. Results and discussion. The relations have been established between NAFLD, age over 52 years, female gender, as well as the considered metabolic factors with a high degree of comorbidity. NAFLD, age, obesity and hyperglycemia had the strongest associations with comorbidity. NAFLD increased the risk of developing a high degree of comorbidity by 5.6 times (odds ratio (OR) 5.59, 95 % confidence interval (CI) 4.40–7.11), age over 52 years – by 2.6 times (OR 2.60, 95 % CI 2.30–2.95); obesity – by 2.4 times (OR 2.37, 95 % CI 2.08–2.70), hyperglycemia – by 2.1 times (OR 2.05, 95 % CI 1.69–2. 49). Conclusions. The data obtained indicate the importance of NAFLD, as well as metabolic risk factors for CND, in increasing the likelihood of developing a high degree of comorbidity, which must be taken into account when developing programs for the prevention and treatment.

Aim of the study was to quantify postprandial glucose levels in response to isocaloric protein load at main meals in men with different types of fat distribution. Material and methods. The study enrolled men aged 25 to 65 years. Group 1 (n = 17) consisted of obese men with subcutaneous fat distribution (SFD) type while group 2 (n = 16) was represented by obese men with abdominal type of fat distribution (AFD). Group 3 (comparators) consisted of 10 men with normal body weight (NBW). Glycemic response to standard isocaloric protein load was assessed by the results of glucose levels within 3 hours starting 5 minutes after end of food consumption on different days and mealtime. Standard protein lunch was introduced during the second day while standard protein dinner and breakfast were performed at the third and fourth days respectively. Results. It was found that protein intake leads to neither pronounced postprandial glycemic fluctuations nor decrease in glucose levels by the end of the 3rd hour of the test. Accordingly, it also doesn’t provoke hunger, unlike carbohydrate intake does. In men with NBW a more pronounced increase in glucose level after protein meal was found, both relative to the baseline levels and comparing with men from SFD and AFD groups. In NBW group at lunchtime and especially in the evening a double-humped glycemic curve was noted. Glycemic variability in men with different types of fat distribution was characterized by the fact that glycemic increment was more pronounced in men with AFD than in men with SFD whose glycemic curve was almost flat after all meals. Conclusions. Protein intake in men with NBW and different types of fat distribution does not lead to significant changes in postprandial glucose levels. Glycemic fluctuations don’t exceed 1 mmol/L within a 3-hour period after consuming of isocaloric breakfast, lunch or dinner. Protein intake results in greater postprandial glucose levels in men with AFD than in SFD men.

In men from infertile couples the serum level of total testosterone (tT) has been shown to vary widely. Is it possible to expect that there is an association of tT content with spermogram disorders in men from infertile couples? Aim of the study was to investigate the patterns of changes in the spermiological status of men from infertile couples depending on tT level in blood serum. Material and methods. Design – observational, retrospective, one-stage study. The analysis of medical histories of 358 men with infertility in marriage was carried out. The sample was divided into comparison groups according to tT level: group 1 – less than 12.1, group 2 – from 12.1 to 20.9, group 3 – 21.0 nmol/l or more. Results. From group 1 to group 3, tT content increases more than twice, as well as concentration of indicators related to the level of T – sex hormone binding globulin (SHBG) and free testosterone (fT). There are no significant differences in luteinizing hormone (LH) and follicle stimulating hormone (FSH) level, although there is a tendency to its increase from group 1 to group 3. From group 1 of men with androgen deficiency to group 3, not only body weight and body mass index (BMI), but also waist circumference (WC) and hip circumference (HC), as well as the WC/HC index, characterizing the degree of abdominal obesity, decrease. The groups examined did not differ in the values of all studied ejaculate parameters. In group 1, a pronounced correlation between the content of tT and fT was found, in groups 2 and 3 – statistically significant inverse relationships between the level of Tob and the values of anthropometric indicators (body weight, BMI, WC and HC), as well as direct ones - with the concentration of SHBG, tT, LH and estradiol, in group 3 – with FSH levels. There were no correlations between tT content and spermogram indicators in any group of examined men. Conclusions. The results obtained suggest that only at high-normal level of testosterone in the blood it can have a stimulating effect on spermatogenesis. As a result of the accumulation of cases of androgenic deficiency in the population, the direct positive effect of serum testosterone on spermatogenesis is becomes insufficient for normal regulation, and the negative effect of testosterone deficiency on spermatogenesis, mediated through the accumulation of overweight and obesity comes to the fore.

Adaptogens are a category of herbal medicinal products that enhance the adaptive reserves of the body, resistance to extreme factors and survival under stress. Adaptogenic properties have been revealed in dozens of plants, in particular, preparations based on raw materials from the Lady’s Mantle (Alchemilla vulgaris L.), a perennial herbaceous plant from the family Rosaceae, have a wide range of biological activity, including antioxidant, antiinflammatory, neuroprotective, anticancer and other, which allows them to be used for prevention and supportive therapy in the treatment of many pathological processes. The results of the authors’ own research and a number of literature data substantiate the presence of adaptogenic properties in this plant. The review analyzes the information in the scientific literature on the chemical composition of compounds included in preparations based on A. vulgaris raw materials, the modern interpretation of the concept of “adaptogen” and criteria for evaluating the adaptogenic properties of plants, and discusses possible molecular and cellular mechanisms that ensure the presence of such properties in the Lady’s Mantle.

BACKGROUND: Actual nutrition and eating behavior features affect the formation of excess or underweight which in turn are risk factors for the development of chronic non-infectious diseases.AIM: To assess eating behavior features and consumption of basic nutrients in relation to metabolic disorders in underweight and obese young men of military age.MATERIALS AND METHODS: The study enrolled 86 young men aged 18 to 23 years that were referred by military enlistment office due to violations in body weight and examined in the hospital. Participants were divided into 2 groups depending on the value of the body mass index (BMI): group 1 (n=41) — underweight (Uw) young men; group 2 (n=45) — obese (Ob) young men. Anthropometric, hormonal and biochemical parameters of the body were measured; the type of eating disorder (ED) was evaluated using the Dutch DEBQ questionnaire, the presence and severity of anxiety and depressive disorders were assessed using the Hospital Anxiety and Depression Scale; assessment of the actual diet was performed using «Somatonic» computer soft.RESULTS: Absolute intake of all essential nutrients was higher in Ob young men; the relative consumption of protein and cholesterol was higher in Uw young men, whereas relative fats intake was higher in Ob group. EDs were statistically significantly more common in Ob young men. The values of all anthropometric indicators were higher in Ob group, while Uw young men predominantly demonstrated deficiency of the body fat component which did not affect key hormonal and metabolic indicators values. In Ob young men carbohydrate metabolism hormonal regulation disorders along with increased blood pressure were revealed.CONCLUSION: The ratio of proteins and fats intake should be taken into account in dietary regimens composition; Uw young men need to increase the proportion of fat and reduce protein intake, whereas Ob young men on the contrary need to reduce the proportion of fat and increase amount of proteins enhancing energy expenditure due to the specific dynamic food action.

Introduction. Lifestyle factors, including smoking, alcohol (AU) and drug use (DU), can affect male fertility. The aim of the study was to investigate the frequency and characteristics of smoking, AU and DU in men from infertile couples, to identify the most significant associations of disorders of spermatogenesis and social risk factors.Material and methods. At the 1st stage of the study, the case histories of 1198 men from infertile couples were analyzed to determine the frequency of smoking, AU and DU, at the 2nd stage, a more detailed questionnaire of 239 patients from the general sample was conducted for detailed characteristics of smoking and/or AU and/or DU, at the 3rd stage, a comprehensive analysis of ejaculate from men who consumed strong alcohol, but did not smoke or use DU (n = 46) was performed in comparison with men without bad habits taken into account (n = 60).Results. In the general sample, the frequency of AU was 73 %, smoking – 41 %, DU –17 % (mostly in anamnesis). 47.9 % of AU men consumed beer (1.5 (1–2.5) liters per week, 25.6 % – strong alcohol (250 (100–500) ml per week), 7.6 % – champagne/wine (500 (250–725) ml per week); 92.7 % of smokers used cigarettes, 7.3 % – electronic cigarettes (smoking experience was 15 (10–20) years, the number of cigarettes per day was 15 (10–20) pieces); more than 90 % of DU men have a history of non-injection DU. Men who consumed only strong alcohol, but did not smoke and did not use drugs, increased sperm DNA fragmentation compared to men without bad habits taken into account: 16.0 (13.5–19.6) and 12.8 (8.8–19.4) %, respectively, p = 0.018.Conclusions. Among men from infertile couples, a high frequency of AU was revealed with the predominant use of beer or strong alcohol, the use of the latter increases sperm DNA fragmentation; smoking is characterized by a long experience; active DU is rare. Given the specifics of the requirements for the state of reproductive health of men applying to reproductive medicine centers, it is important to have knowledge about the frequency and severity of smoking, AU and DU among them, as well as about the relationship of risk factors of infertility with the parameters of ejaculate.

The article presents a review of the main circadian mechanisms regulating carbohydrate metabolism and their role in maintenance of energy homeostasis; the molecular genetic structure of the circadian system is also discussed. The role of adipose tissue and other organs and systems in the maintenance of circadian rhythm of carbohydrate metabolism, both in health and in obesity and diabetes, is highlighted. Particular attention is paid to diurnal rhythms of endocrine factors responsible for metabolic patterns of hormones such as cortisol, growth hormone and melatonin. Gender differences in the circadian regulation of energy and carbohydrate metabolism are also discussed, as well as their changes in different age periods. Article provides detailed review of the mechanisms of glucose utilization, reactivity of the pancreatic islets and peripheral insulin sensitivity shifts at different time periods of the day in people with normal body weight, android and gynoid types of obesity, both in women and men. Protective factors of energy metabolism circadian regulation structure preventing the development of diabetes mellitus and cardiovascular disease in individuals with so-called “metabolically healthy” obesity type are discussed. Article provides a review of various pathways of circadian rhythm disturbances, mechanisms of their development, as well as exogenous and endogenous factors leading to carbohydrate metabolic circadian rhythm misalignment, such as shift work, untiming of natural and artificial lighting, jet lags, sleep disorders. Represented data contribute to a new look at the pathogenesis of obesity and carbohydrate metabolism disorders in various types of obesity in men and women, that provides basis for searching for new effective methods of prevention and treatment of these conditions, elaboration of evidence-based diets and physical activity recommendations, as well as approaches to their medical treatment.

Particular attention in the study of comorbid conditions is paid to viral diseases, in particular, those caused by the pandemic influenza virus type A subtype H1N1, as one of the most pathogenic and contagious. Investigation of the effect of this virus in the development of diabetes mellitus will make it possible to more effectively carry out preclinical studies to find the most effective methods of treating a viral infection against the background of a pre-existing somatic pathology. Purpose of the study was to evaluate the pancreatic toxicity effect of exposure to influenza A/H1N1-California virus in the development of streptozotocin diabetes in DBA/2 and BALB/c mice. Material and methods. Groups of mice DBA/2 (n = 36) and BALB/c (n = 58) were formed: infected with influenza A/H1N1-California virus (at different doses); with the introduction of a solution of streptozotocin at a dose of 150 mg / kg; with the combined use of agents. Life expectancy, blood glucose and insulin level, pathomorphological changes in the pancreas were assessed. Results and discussion. The death of animals was observed only in mice of the DBA/2 line: with the introduction of streptozotocin – 12.5 %, with intranasal infection with the virus (at a dose of 5.7 lg TCID50) – 80 %, with combined exposure – 78 %. A comparative study of mice of the DBA/2 and BALB/c lines showed the possibility of using mice of both lines to study the combined effect of influenza A/H1N1 virus and experimental diabetes, taking into account the dose of infection. Infection of BALB/c mice caused the formation of morphological changes only in the exocrine part of the pancreas. In mice of both lines, after the administration of streptozotocin, persistent hyperglycemia was formed, and pathomorphological changes in the pancreas were recorded mainly in the endocrine part. Similar changes in the pancreas, but more severe, involving the exocrine zone, were found during subsequent infection: in mice of the DBA/2 line in the form of a focal disorder of the acinar structure with degeneration of acinocytes and a compensatory regenerative reaction of cells in intact areas; in mice of the BALB/c line in the form of more significant damage to the ductal system than in DBA/2 with the formation of powerful periductal fibrosis and mononuclear infiltrates. Conclusions. A comparative study showed that DBA/2 mice had more pronounced changes in both the exocrine and endocrine apparatus of the pancreas when infected with influenza A/H1N1-California virus and experimental diabetes mellitus.

BACKGROUND: Obesity and androgen deficiency (AnD) are characterized by similar disturbances in metabolic parameters, the presence of signs of insulin resistance, metabolic syndrome, the risk of developing cardiovascular diseases (CVD) and vascular complications. These facts indicate the possibility of the presence of common mechanisms that determine the predisposition to the development of obesity and AnD, which may include genetic factors, in particular, the rs4646994 polymorphism of the ACE gene, which, according to recent data, is associated with the risk of developing CVD, hypertension, and obesity.AIM: To study the association of the carriage of polymorphic variants of the rs4646994 locus of the ACE gene with the features of anthropometric and androgenic status in men.MATERIALS AND METHODS: In the period from April 2020 to October 2021 there were observed male patients aged 18–75 years old, who were hospitalized in a therapeutic hospital because of comorbid somatic pathology (hypertension, coronary heart disease, dorsopathy, vegetative-vascular dystonia, gastroesophageal reflux disease, and others). Anthropometry, a study of the content of hormones of the reproductive system in the blood serum using enzyme-linked immunosorbent assay (ELISA), as well as a genetic study for the carriage of polymorphic variants of the rs4646994 locus of the ACE gene by the polymerase chain reaction (PCR) method, followed by electrophoresis of PCR products, were carried out. RESULTS: 82 patients took part in research. According to the results of genetic analysis, 17 people were assigned to the group of homozygotes for the wild type (I/I, G1), 41 people were assigned to the group of heterozygotes (I/D, G2), and 41 people were assigned to the group of homozygotes for the mutant allele (D/D, G3) 24 people. Body weight, chest circumference, waist and hips, body mass index in patients carrying the D allele of the rs4646994 polymorphism were statistically significantly higher than in I/I homozygotes. Differences in hormonal status also turned out to be statistically significant: patients from G1 compared with G2 and G3 had higher levels of total testosterone; from G1 compared to G3 — a higher level of free testosterone.CONCLUSION: An association of the carriage of the D allele of the rs4646994 polymorphic locus of the ACE gene with overweight and ADI was revealed.

Background. According to the literature data, long-term and poorly controlled hypertension (HTN) leads to target organs damage, and in some cases, to the development of associated diseases, the severity of which in men may be partly due to the characteristics of the androgenic status.The aim: to reveal the features of hormonal indicators of androgen status and their relationship with the anthropometric and metabolic characteristics of the therapeutic clinic male patients, depending on the severity of HTN.Materials and methods. 296 men aged 59,0 [54,0; 65,0] years with confirmed HTN were examined. All study participants in the morning on an empty stomach underwent anthropometry, determination of metabolic and androgenic status, and assessment of comorbid burden. Depending on the severity of hypertension, all patients were divided into two groups (G): G1 (n = 134) – patients with hypertension without a history of coronary artery disease or stroke; G2 (n = 162) – patients with hypertension with a history of ischemic heart disease (IHD) and/or stroke.Results. In male patients of G2 with severe HTN, a decrease in the levels of free testosterone (FT) and, to a greater extent, dehydroepiandrosterone sulfate (DHEA-S), as well as total cholesterol, high and low density lipoproteins, was revealed. The correlation analysis performed revealed statistically significant negative correlations between the levels of total testosterone (TT) and FT with body mass index, the value of the ratio of waist circumference to hips, only the level of FT – with the presence of IHD, chronic heart failure (CHF), disorders of carbohydrate metabolism and abdominal type of fat distribution, and the level of DHEA-S – with the presence of IHD and CHF.Conclusion. A decrease in FT and DHEA-S is associated with early progression of atherosclerosis and the risk of developing HTN-associated cardiovascular events, which can aggravate the course of HTN.

The purpose of the study was to investigate the association of carriage of rs9939609 polymorphism in the FTO gene with features of androgen status in men.Material and methods. The observational one-stage examination of 139 male patients aged 22 to 69 years, admitted to a therapeutic hospital in a planned manner has been carried out in the Clinic of the Federal Research Center for Fundamental and Translational Medicine in the period 2020–2021. All fasting men in the morning (8:00–8:30) were carried out of an anthropometric examination to determine physical development, sampling of venous blood from the cubital vein to assess the hormonal parameters of androgen status, and taking a sample of the buccal epithelium for molecular genetic research. Based on the carriage of the rs9939609 (T>A) polymorphism of the FTO gene, the following groups (G) of patients were distinguished: G1 – wild-type homozygotes (WT/WT), G2 – heterozygotes (WT/A), G3 – homozygotes for the mutant allele (A/A).Results and discussion. The statistically significant differences were found in the levels of total testosterone between G1 and G3 (11.6 vs 14.5 nmol/L, p = 0.010), as well as free testosterone in G1 compared to G2 (0.233 vs 0.287 nmol/L, p = 0.012) and G3 (0.233 vs 0.321 nmol/L, p = 0.002) when analyzing the clinical-anthropometric and hormonal features of the androgen status of the examined male patients in the selected groups. Assessment of the association revealed statistically significant positive correlations between the carriage of the mutant allele and the levels of total (r = 0.247; p = 0.013) and free (r = 0.296; p = 0.003) testosterone, and negative - with the frequency of androgen deficiency according to the free testosterone criteria (r = –0.240; p = 0.016).Conclusions. It has been shown that the carriage of the A/A genotype of rs9939609 polymorphism of the FTO gene is associated with an increase in the levels of total and free testosterone, that indicates a protective effect against the development of androgen deficiency in men. The obtained results suggest that this effect is due to the epigenetic effect of the FTO gene protein product on the expression of other genes involved in the synthesis of androgens in the gonads, but also in the adrenal cortex since no association of the carriage of the rs9939609 polymorphism of the FTO gene with the DHEA-C level was found.

Introduction. The obesity seems to grow into a real pandemic. As one of the consequences of obesity we observe a significant increase of infertility in married couples, including male infertility. As the situation with male fertility continues to deteriorate, we consider further investigation of etiology and pathogenesis of male infertility important. Aim of the study was to investigate age-related anthropometric characteristics and metabolic status in men from infertile couples. Material and methods. 426 men from infertile couples were divided into 5 groups according to age: 1) < 30 years old, 2) 30.0-34.9 years old, 3) 35.0-39,9 years old, 4) 40.0-44.9 years old, 5) ≥ 45 years old. We carried out anthropometric examination and biochemical blood analysis. Results. Within groups 2 to 4 we observed group-to- group consecutive increase in body weight, body mass index values, waist circumference and waist circumference to hip circumference values which are related to the increase of adipose tissue mass in the abdominal region. We also detected the increase of hyperglycemia occurrence. Higher values of the abovementioned anthropometric parameters were detected for the test subjects of the group 1 despite the younger age. We observed 60 and 40 % of upper and lower types of abdominal fat distribution respectively for the group 1 test subjects. Conclusions. Based on the anthropometric parameters we conclude that the infertility can be caused by negative influence of subcutaneous and visceral adipose tissue accumulation for the youngest test subjects (age < 30 years). For the older test subjects, infertility results of the cumulative effect of abdominal obesity and other medical and social factors. Group 4 test subjects (age 40-45) exhibit the most frequent abdominal obesity and associated with metabolic status disorders.

Introduction. According to Russian Association of Urology a number of infertile couples ranges from 8 to 17.2 % in various regions of Russia. One of the causes of which is the male factor. Raising the age of the father reduces the chance of conception, increases the risk of early termination of pregnancy and the risk of certain diseases of the child. In this regard the existing knowledge of age-related changes in ejaculate parameters needs to be de veloped. This is particularly true for men of infertile couples.The study objective – to investigate the age patterns of change in the spermological status of infertile men and identify the most age-related variations.Materials and methods. Research design – observation, retrospective, crossection. Analysis of the medical records of 517 Novosibirsk male residents from couples with infertility in marriage was made. The sampling is divided into 5 age groups: 1st group (n = 108) – men of ≤29.9 years old; 2nd group (n = 171) – 30.0–34.9 years old; 3rd group (n = 130) – 35.0–39.9 years old; 4th group (n = 68) – 40.0–44.9 years old; 5th group (n = 40) – ≥45.0 years old.Results. Median of male age in total sample – 34 years, frequency of persons over 40 years – 21 %. Overall sample shows a decline in reference values of proportion of morphologically normal forms – 3.0 (1.5–5.0) % and increase in sperm DNA fragmentation index (SDFI) – 16.0 (11.0–22.2) %. In groups from 1st to 5th there is an age-specific decrease in ejaculate volume (3.5 (2.5–4.8) ml; 3.3 (2.4–4.2) ml; 3.2 (2.4–4.5) ml; 3.0 (1.7–4.9) ml; 2.7 (1.9–3.5) ml, р1–5

Aim of the study was to explore the gender characteristics of the circadian rhythm of carbohydrate metabolism in men and women with normal body weight. Materials and methods. 15 men and 22 women aged 18 to 56 entered the study and underwent clinical, antropometric, biochemical and hormonal examination. Standard oral glucose tolerance test (OGTT) was also performed in the morning and in the evening. Results and discussion. During OGTT performed in morning time there were no differences in mean baseline blood glucose levels between men and women. However higher glucose levels at 120th minute of the test in men demonstrated relative deceleration of glucose utilization in the morning in this group. Higher glucose levels at 120th minute during OGTT in the evening both in men and women comparing with baseline results, and also higher glucose levels at 120th minute of the test in the evening comparing with morning test, indicate decreased glucose tolerance. Insulin to glucose ratio values in men at all timepoints during OGTT were comparable in the morning and in the evening, but in women they were found to be higher in the evening than in the morning. Conclusion. In evening time both in men and women with normal body weight reduced rate of glucose utilization in peripheral tissues reflects circadian rhythm of carbohydrate metabolism. Gender differences of the circadian rhythm of carbohydrate metabolism consist in reduced glucose tolerance in the morning in men comparing to women that is associated with higher waist to hip circumference ratio in men which in turn is related to cumulation of visceral adipose tissue. Presumably greater amount of visceral adipose tissue in men determines more pronounced manifestations of insulin resistance in the morning.

The purpose of the study was to investigate the effect of overweight, obesity and fat distribution type on the severity of comorbid somatic pathology in men. Material and methods. 216 men, aged from 22 to 78 years, who were patients of therapeutic clinic from 2018 to 2019 years, were observed. Height, body weight, waist (WC) and hip (HC) circumference were measured using standard anthropometric procedures, and then WC/HC and body mass index (BMI) were calculated. Clinical signs of aging were estimated by using the AMS questionnaire. The CIRS was scored from the medical records after hospitalization. Results and discussion. It was shown that overweight and obesity increase the burden of cardiovascular, endocrine and general comorbidity in men. Nevertheless, the burden of cardiovascular pathology did not differ between overweight and obesity men. The contribution of fat distribution type in separate BMI-groups is different. The upper fat distribution type in normal body weight increases the burden of vascular pathology, in overweight – vascular pathology and endocrine system, in obesity – cardiovascular pathology, and general comorbidity in men. Conclusion. Thus, the BMI ≥ 25 kg/m2 is associated with an increase burden of cardiovascular, endocrine and general comorbidity and upper fat distribution type increases the burden of vascular pathology in men.

According to world statistics, 15 % of married couples do not reach pregnancy within one year and seek medical help. At the same time, an important component of the complex problem of infertility, in addition to not getting pregnant, are also pregnancy losses. According to modern ideas, one of the reasons for termination of pregnancy is sperm DNA fragmentation (SDF). According to the European Association of Urology guidelines on male infertility, SDF reduces the chances of natural conception and increases the risk of pregnancy loss. In the European Society of Human Reproduction and Embryology guideline on the management of recurrent pregnancy loss, the definition of SDF is recommended in the algorithm for examining a couple after a single episode of miscarriage. The causes, mechanisms and approaches to correcting increased SDF are the subject of active research; according to PubMed, more than 2,500 papers have been published on this problem to date. Given the huge amount of factual material, the purpose of this review is to highlight the key points of etiology, pathogenesis and approaches to the correction of increased levels of SDF

The purpose of the study was to carry out comparative and quantitative assessment of surrogate markers of visceral obesity and their connection with the severity of clinical, biochemical and hormonal disorders in men with the metabolic syndrome and obesity. Material and methods. 136 men, aged from 23 to 68 years, who were patients of therapeutic clinic were observed. Clinical, anthropometric, biochemical and hormonal screening was taken. Transthoracic echocardiography was performed in all patients. Criteria of international experts’ consensus in the fields of cardiology and endocrinology (2009) were used to identify metabolic syndrome. Results and discussion. It was shown that among the all surrogate markers of visceral obesity (waist circumference; waist circumference measured in the lying position; waist circumference measured without the thickness of the subcutaneous tissue; the ratio of waist circumference to the circumference of the hips; sagittal abdominal diameter; thickness of epicardial adipose tissue) the largest number of statistically significant correlations with the clinical-biochemical, hormonal and adipokine characteristics of men was found for the waist circumference, measured in the lying position, and the waist circumference, measured without the thickness of the subcutaneous tissue. Intermediate position among the estimated markers was taken by a waist circumference measured in a standing position. Fewer number of correlation connections were revealed for thickness of the epicardial fat, sagittal abdominal diameter and the ratio of waist circumference to the circumference of the hips. Conclusion. The received results demonstrate objectivity of the selection of the surrogate markers of the severity of visceral obesity reviewed in the study, among which the waist circumference measured in the lying position had the greatest efficiency.

The aim of the investigation was to study the relationship of blood testosterone levels with the severity of anxiety signs, depression and urological pathology symptoms in men of mature age with normal weight, overweight and obesity. Material and methods: 188 men of 36.7 average age participated in the study. Anthropometric examination was carried out, the HADS questionnaire (Hospital Anxiety and Depression Scale, 1983) was used to assess the level of anxiety and depression; the severity of urinary disorders symptoms was evaluated with the scale of IPSS (International Prostate Symptom Score). To study the sexual dysfunction the international index of erectile dysfunction (ICEF-5) was applied. AMS Men's Age Symptoms (Aging Males Symptoms) questionnaire was used to identify clinical signs of androgen deficiency. The content of testosterone and cortisol in blood serum was determined by EIA. Results and discussion: The growth of androgen deficiency along with the increase in the urinary disorders symptoms, extended anxiety, depression and enhanced signs of erectile dysfunction have been revealed in men with overweight and obesity relating to the men with normal body weight. The androgen deficiency growth influences the aging processes acceleration. In turn, the presence of urological pathology in men can plays an important role in the obesity pathogenesis through the increase in anxiety and depression.

Objective: to research features of vegetative regulation and their relation to eating behavior in women with different types of obesity and type 2 diabetes. Methods. 106 women were examined; survey of women included anthropometric measurements, study and calculation of heart rate variability were performed with “VNS-micro” (Neurosoft, Russia); recording of food consumption in 24hs were assessed. The types of eating disorders (ED) were detected with DEBQ. Results and discussion. Adipose tissue topography (ATT) among women is associated with vegetative regulation, as well with ED. So, the spectrum of both high-frequency (HF) and low-frequency (LF) oscillations are increased in women with gynoid type of ATT. Conversely, android type of ATT is characterized by overall decline of LF and HF oscillations with residual dominance of the sympathetic part. An increase in the relative contribution to the total power of the very low-frequency (VLF) spectrum among women has been revealed. Emotional and compulsive eating behavior disorders were prevalent in women with gynoid type of ATT, external type of ED prevailed among women with android type of ATT. Women with android type of ATT and type 2 diabetes had minimal severity of eating behavior disorders. The increase in activity of the sympathetic and parasympathetic parts of the autonomic nervous system in women with gynoid type of ATT was combined with sympathoadrenal and vagoinsular reactions, which is confirmed by a positive correlation of emotional ED with HF and LF, and there was a negative correlation of restrictive ED with LF. A negative correlation of emotional ED with VLF among women with android type ATT was detected. There are no correlation of ED indices and activity of the autonomic nervous system among women with android type of ATT and type 2 diabetes. It can be associated with manifestations of diabetic vegetative neuropathy.

The study included 348 women with chronic cystitis who were divided into 3 age groups: Group 1 - 20 to 39 years old; Group 2 - 40 to 59 years old; Group 3 - elderly age (60 years and older). Bacterial flora was detected for the total sample in 35.3 % of patients without significant differences between age groups. The results indicate that infection is not the only cause affecting the development and persistence of chronic inflammation of the bladder. The incidences of leukoplakia of the bladder in age groups 1, 2 and 3 were 71 %, 50 % and 11 %, respectively. The survey results revealed increasing severity of symptoms such as pelvic pain and urination disorders with age. The evaluation of urination diaries revealed a decrease in the bladder effective volume with age and an increase in urination frequency in the daytime and at night. A significant increase in symptoms in the presence of leukoplakia was also revealed. High incidence of squamous metaplasia and leukoplakia and increased frequency of exacerbations of cystitis in young women may be associated with the catatoxic, highly reactive type of response of the transitional epithelium of the bladder. Increasing symptoms such as urinary disorders in older women with chronic cystitis may be caused by an adverse effect of systemic metabolic factors of the disease pathogenesis.

Purpose of the study was to evaluate the effectiveness of complex treatment of essential hypertension based on the definition of risk of development, frequency and severity of metabolic syndrome (MS) and its components before and after treatment in male patients of the therapeutic clinic.Materials and methods. The study included 123 patients hospitalized with a main diagnosis of hypertension. In addition to the main examination, anthropometric, instrumental and hormonal-biochemical examination was additionally carried out. A point assessment of deviation degree and additional components of MS from reference was defined. In accordance with the received sum of points each patient was assigned a specific stratification category in relation to MS: lack of risk of development, existence of low, moderate or high risk of development and also light, medium or heavy severity of MS. Repeated examination was carried out in 14 days from initiation of treatment. The effectiveness of treatment was estimated as significant improvement, improvement, without change, deterioration, or significant deterioration depending on change of sum of points.Results. Before the start of treatment, 22.8% of the examined patients had a moderate or high risk of developing MS, and 77.2% had MS of varying degrees of severity. After 14 days the number of patients with MS decreased by 14.6%, and the number of patients with risk of its development increased to 37.4%. In 14 days the number of patients with MS decreased by 14.6%, and the number of patients with risk of his development increased to 37.4%. Among all components of the MS, the greatest number of cases of improvement was noted for hypertension. Significant improvement from the carried-out therapy was revealed in 17.9%, improvement in 39.0%, lack of changes in 37.4% and deterioration in 5.7% of patients.Conclusion. The employment of the method of Point assessment of degree of risk development and severity of MS, as a cluster of risk factors for the development of cardiovascular diseases, in patients with essential hypertension allowed the estimation of efficiency of the carried-out therapy and the individualization of a treatment regimen.

Objective: the definition of association of levels of sex steroid hormones and ejaculate parameters with different types of fat distribution in infertile men with overweight and obesity. Materials and methods. A total of 119 somatically healthy Russian men who contacted Novosibirsk Center of Reproductive Medicine in 2012–2014 with the problem of infertility have been examined. Based on the results of anthropometric surveys all the men were divided into 3 groups. The 1st group included men with overweight, obesity, and upper type of fat distribution (the ratio of waist circumference (WC) to the hip circumference (HC) ≥ 0.95); the 2nd group – men with overweight, obesity and lower type of fat distribution (WC/HC < 0.95); the 3rd group – men with normal body weight. Questionnaires have been completed; determination in serum of concentrations of total testosterone, estradiol, sex hormones binding globulin (SHBG); free testosterone calculated. Special study of ejaculate included semen analysis, sperm morphology assessment by strict criteria of Kruger MAP test, NCA-test, analysis of DNA fragmentation of sperm. Results. In all 3 groups frequency of medical and social risk factors occurrence for infertility were analyzed: sexually transmitted infections, 88 chronic prostatitis, the systematic consumption of alcohol and smoking. It was revealed that these factors occurred with a high, but not significantly different frequency in men of 3 groups: the frequency of sexually transmitted infections in the 1st, 2nd and 3rd groups was 65.8; 61.0 and 63.2 %; systematic consumption of alcohol – 85.4; 78.1 and 63.2 %; systematic smoking – 36.6; 53.7 and 34.21 %; chronic prostatitis – 68.3; 56.1 and 50.0 % respectively. The average concentrations of sex steroid hormones and SHBG in the serum of men of all groups did not go beyond the reference range. Patients of the 1st and 2nd groups had significantly lower concentration of total testosterone in serum compared with the third group, moreover the indicated decline was more pronounced in men of the 1st group. The content of SHBG in serum was also significantly lower in the 1st and 2nd groups in relation to the 3rd group. Comparison of ejaculate indicators revealed significant differences in the 1st and 2nd groups of men, differing in the type of fat distribution, in terms of volume of ejaculate, share of progressively motile sperm and DNA fragmentation level. Differences are identified for some indicators of ejaculate between the 1st and 3rd groups, but the differences between the 2nd and 3rd groups on any indicator are not detected. Conclusion. The revealed differences indicate a negative effect on the ejaculate indicators, particularly of upper type of fat distribution, peculiar to the men of the 1st group. The obtained results justify the assumption that abdominal obesity with upper type fat distribution is an independent risk factor of male fertility reduction.

The results were received from the screening surveys of workers of the industrial enterprises of Myrnyi town among non native nationalities according to the report of the program of European regional Bureau WHO / CINDI. The purpose was to reveal risk factors of development of chronic noncommunicable diseases in 1991, 2000 and 2007 and for the characteristics of trends in prevalence of lipid disorders in a population. Among men during the period from 1991 to 2007 the concentration of blood total cholesterol, cholesterol of low density and high density lipoproteins (LDL-C and HDL-C) have decreased, the concentration of triglycerides increased and the index of atherogenesis increased too. Among women similar changes were found. Prevalence of lipid disorders among men and women were more than 70 %. During the specified years (1991–2007) the prevalence of hypertriglyceridemia and hyper-HDL-C increased. The greatest increasing of the parameters has been marked during the period from 1991 to 2000.