INTERNATIONAL JOURNAL OF ENDOCRINOLOGY (Ukraine) 2021-10-20T10:53:14+03:00 Pankiv Volodymyr Open Journal Systems <div align="center"> <table id="table1" style="border-collapse: collapse;" border="0" width="100%"> <tbody> <tr> <td colspan="2" align="center" valign="top"><span style="color: #6b818e; font-family: Verdana, Arial, Helvetica, sans-serif; font-size: 10pt; font-style: normal; font-variant: normal; font-weight: bold; letter-spacing: normal; line-height: 18px; orphans: auto; text-align: start; text-indent: 0px; text-transform: none; white-space: normal; widows: 1; word-spacing: 0px; -webkit-text-stroke-width: 0px; display: inline !important; float: none;">The International Journal of Endocrinology (Ukraine) - Mìžnarodnij endokrinologìčnij žurnal is the professional scientific and practical specialized peer-reviewed journal for endocrinologists, immunologists, nephrologists, gynecologists and doctors of other specialties, dedicated to the problems of endocrine disorders.</span></td> </tr> <tr> <td colspan="2" align="center" valign="top"><hr noshade="noshade" size="1" /></td> </tr> <tr> <td valign="top" width="25%"><img src="" /></td> <td valign="top" width="75%"><span style="font-size: 10pt; font-family: Verdana;"><strong>The founder:</strong> Bukovinian State medical University, Zaslavsky O.Yu.<br /><strong>Publisher:</strong> Zaslavsky O.Yu.<br /><strong>Language of edition:</strong> Ukrainian, English.</span> <p align="justify"><span style="font-size: 10pt; font-family: Verdana;"><strong>Registration Certificate:</strong> КВ № 19313-9113ПР. Issued by the Ministry of Justice of Ukraine 06.09.2012.</span></p> <p align="justify"><span style="font-size: 10pt; font-family: Verdana;">The journal is included in the new List of scientific publications of the Higher attestation Commission, which can publish results of dissertations on competition of scientific degrees of doctor and candidate of Sciences. Order of the MES from 11.07.2019 № 975.</span></p> <p><span style="font-size: 10pt; font-family: Verdana;"><strong>Publication frequency:</strong> 8 times per year.<br /></span><span style="font-size: 10pt; font-family: Verdana;"><strong>Founded: </strong>September 2005</span></p> <p><span style="font-size: 10pt; font-family: Verdana;"><strong>ISSN</strong> 2224-0721 (print)<br /><strong>ISSN</strong> 2307-1427 (online)</span></p> <p><strong><span style="font-size: 10pt; font-family: Verdana;">DOI: 10.22141/2224-0721</span></strong></p> <p><span style="font-size: 10pt; font-family: Verdana;"><strong> <a href=""> <span style="text-decoration: none;"></span></a></strong><strong><br /><a href=""> <span style="text-decoration: none;"></span></a></strong></span></p> </td> </tr> <tr> <td colspan="2" align="center" valign="top"><hr /></td> </tr> </tbody> </table> </div> <table id="table2" style="border-collapse: collapse;" border="0" width="100%"> <tbody> <tr> <td align="left" valign="top" width="98%"><strong>The journal in its publication activity is guided by the recommendations of the following editorial associations:</strong><br /><a href="" target="_blank" rel="noopener"> <img src="" alt="" width="100" height="37" /></a> <a href="" target="_blank" rel="noopener"> <img src="" alt="" width="100" height="37" /></a> <a href="" target="_blank" rel="noopener"><img src="" alt="" width="100" height="37" /></a> <a href="" target="_blank" rel="noopener"> <img src="" alt="" width="100" height="37" /></a></td> </tr> <tr> <td align="left" valign="top" width="98%"><hr /></td> </tr> <tr> <td align="left" valign="top" width="98%"><strong>We endorse the following declarations:</strong></td> </tr> <tr> <td align="left" valign="top" width="98%"><a href="" target="_blank" rel="noopener"> <img src="" alt="" width="100" height="37" /></a> <a href="" target="_blank" rel="noopener"> <img src="" alt="" width="100" height="37" /></a></td> </tr> <tr> <td align="left" valign="top" width="98%"><hr /></td> </tr> </tbody> </table> Diabetic ketoacidosis precipitated by COVID-19 in patient with newly diagnosed diabetes mellitus 2021-10-04T16:05:11+03:00 E. Xhardo P. Kapisyzi A. Rada <p><strong>Background.</strong> Coronavirus disease 2019 (COVID-19) is a viral infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Diabetes mellitus (DM) have been reported frequently in patients with the new corona virus disease — 2019, COVID-19. It has been associated with progressive course and worse outcome. There is scarce data on diabetic ketoacidosis (DKA) in COVID-19 infection. There has been several cases reported on COVID-19 infection precipitating a new diagnosis of type 2 DM (T2DM). However, there is a lack of evidence regarding type 1 DM (T1DM). We report a case of DKA precipitated by COVID-19 in a patient with newly diagnosed T1DM. Recently, case reports and small cross-sectional studies described diabetic patients who develop DKA when infected with COVID-19. The incidence of DKA has been found to be high in patients with T1DM and T2DM admitted to hospital with COVID-19. <strong>Case presentation.</strong> We present a 29 year-old, previously healthy man with 5 days history of fever, fatigue, vomiting, polydipsia and polyuria. His lab results showed high blood glucose, high anion gap metabolic acidosis and ketonuria diagnostic of DKA. He also tested positive for COVID-19 and his Chest CT was consistent with bilateral COVID 19 pneumonia (ground-glass opacity, consolidation, and crazy-paving pattern). He was successfully managed with intravenous fluids and insulin as per DKA protocol. He required intravenous antibiotics, steroids and oxygenotherapy for COVID-19 pneumonia. He was discharged after 14 days in stable condition. <strong>Conclusions.</strong> COVID-19 infection can be complicated by DKA and development of DM in previously non-diabetic individuals. It is possible that SARS-CoV-2 may aggravate pancreatic beta cell function and precipitate DKA. Very few cases have been reported in the literature on COVID-19 infection precipitating DKA in a newly diagnosed patient of type 1 diabetes mellitus.</p> 2021-10-20T00:00:00+03:00 Copyright (c) 2021 Diagnosis and treatment of primary hyperparathyroidism (20 years of own experience and literature review) 2021-10-04T15:57:05+03:00 Yu.I. Karachentsev M.E. Sazonov V.V. Khaziev V.N. Dubovik O.A. Goncharova I.V. Gopkalova <p><strong>Background.</strong> Currently, primary hyperparathyroidism (pHPT) is the third most common endocrine disease after thyroid gland pathology and diabetes mellitus. Untimely diagnosis leads to a severe course of the disease with the development of disabling deformations — osteoporotic fractures, recurrent stone formation in the urinary tract, gastrointestinal bleeding, etc., as well as to an increased risk of premature death. The purpose of the study is to assess the dynamics of detection of thyroid disease (thyroid) for the period 2000–2019. <strong>Materials and methods.</strong> Since 2000, based on the surgical department of the clinic of the State Institution “V. Danilevsky Institute for Endocrine Pathology Problems of the National Academy of Medical Sciences of Ukraine”, 205 surgeries have been carried out for pHPT (in 188 women and 17 men: 91.7 and 8.3 %). <strong>Results.</strong> Since 2008, there has been a steady increase in the number of cases. The incidence of pHPT in women increases with age and becomes significantly higher at the age of 50–69 years. At the same time, the gap between women and men is widening, the reason for which needs to be studied. The proportional ratio of the number of patients with asymptomatic and clinically pronounced course persists for 20 years and is approximately 2 : 1. In countries where blood calcium screening has been introduced, the proportion of asymptomatic forms reaches 80 %. The obtained data confirm the fact of untimely diagnosis of pHPT in Ukraine, which requires the introduction of large-scale population screening in the form of a questionnaire survey and study of serum calcium. <strong>Conclusions.</strong> A positive contribution to the timely detection of pHPT can be made by activating the work of postgraduate (continuous) education institutions in this direction, primarily the departments of endocrinology based on endocrinological clinics with surgical departments.</p> 2021-10-20T00:00:00+03:00 Copyright (c) 2021 Fibroblast growth factor 23 and Klotho protein: assessment of the role in the development of secondary hyperparathyroidism in patients with various stages of chronic kidney disease 2021-10-04T15:58:07+03:00 N.V. Karlovich T.V. Mokhort <p><strong>Background.</strong> Secondary hyperparathyroidism (SHPT) is universal complication of chronic kidney disease (CKD), the likelihood of which increases as renal function decreases. Currently, SHPT is considered in the context of mineral and bone disorders associated with CKD. Mineral and bone disorders associated with CKD include, in addition to SHPT, disorders of calcium-phosphorus metabolism, bone pathology and metastatic calcification, which determine poor outcomes of the disease. The purpose of the study was to evaluate the serum concentrations of fibroblast growth factor (FGF) 23 and Klotho protein in patients with various stages of CKD and their relationship with SHPT, vitamin D levels, and calcium-phosphorus metabolism in patients with varying degrees of decreased renal function. <strong>Materials and methods.</strong> Serum concentrations of FGF 23, Klotho protein, parathyroid hormone (PTH), 25(OH)D, calcium and phosphorus were evaluated in 229 patients with various stages of chronic kidney disease and in 40 people without signs of CKD. <strong>Results.</strong> It has been shown that individuals with CKD are characterized by overproduction of humoral phosphatonin FGF 23 and Klotho deficiency, which increase as renal failure worsens. A significant relationship was established between FGF 23 and the levels of PTH and blood phosphorus; Klotho protein — with the patient’s age and serum vitamin D. An early marker of disorders in the FGF 23-Klotho system is a decrease in the Klotho protein concentration, which occurs in the early stages of CKD and is aggravated with the progression of renal failure. A statistically significant overproduction of FGF 23 associated with secondary hyperparathyroidism was registered in patients with glomerular filtration rate less than 35 ml/min/1.73 m2. <strong>Conclusions.</strong> An early marker of disorders in the FGF 23-Klotho system is a decrease in the concentration of the Klotho protein, which occurs in the early stages of CKD and is aggravated with the progression of renal fai-<br />lure. The relationship between Klotho deficiency and the formation of SHPT has not been found. As kidney function decreases, excess production of PTH and FGF 23 appears and increases, hyperphosphatemia progresses. This proves the pathogenetic relationship between the formation of SHPT and the overproduction of humoral phosphatonin FGF 23, since it is this glomerular filtration rate that determines the growth of PTH above the upper limit of the general population reference interval.</p> 2021-10-20T00:00:00+03:00 Copyright (c) 2021 Assessment of factors influencing consultations after bariatric surgery 2021-10-04T15:59:24+03:00 Marisol Barradas-Lagunes Paola Bravo-De Avila Raquel Colorado-Subizar Maripi De Uriarte-Llorente Rosario Gamboa-Huerta Rey Jesus Romero <p><strong>Background.</strong> Bariatric surgery programs are recognized as the best alternative for patients with severe obesity. Many studies conclude that bariatric surgery programs that include these pre- and postoperative consultations (PPC) by the multidisciplinary team have better overall outcome. The purpose of the present study was to evaluate factors that affect PPC during a bariatric surgery program in Mexico and assess the possible impact on the patients’ post-operative course. <strong>Materials and methods.</strong> In accordance with the the International Federation for the Surgery of Obesity and Metabolic Disorders guidelines, all patients included were between 18 and 65 age when bariatric surgery was performed. Preoperative assessment of patient eligibility for bariatric surgery included consultation with the main surgeon, a dietician, an internist, and a psychologist. If non-eligible cases were detected, these issues were addressed and fully treated before surgery was considered. <strong>Results.</strong> A total of 110 patients were included in this study. Eighty-one (74 %) patients were women and 29 (26 %) were men. We observed that women had significantly more consultation attendance than men (54.3 % versus 24.1 %, p = 0.005). Patients with higher initial BMI had significantly more consultation attendance than those with lower BMI (42.9 kg/m2 versus 38.6 kg/m2, p = 0.007). When consultation attendance was evaluated according to occupation, teaching workers had significantly (p = 0.003) <br />more consultation attendance (71.4 %) while the students group had less consultation attendance (0). Patients who had higher percentage of excess of weight loss (EWL) had significantly more general, medical, nutritional and psychological consultation attendance than those with lower percentage of EWL (p = 0.04, p = 0.032, <br />p = 0.039 and p &lt; 0.001).<strong> Conclusions.</strong> Consultation attendance with the multidisciplinary team is associated with better outcomes after bariatric surgery. “Nonattending” patients are at least partly responsible for any suboptimal results observed. Although this is certainly a factor for some patients, many other non-dependent reasons, such as cultural, social, economic or motivational reasons can also affect the loss of consultations in other patients.</p> 2021-10-20T00:00:00+03:00 Copyright (c) 2021 Effects of vitamin D in thyroid autoimmune pathologies: literature review and own data 2021-10-04T16:00:43+03:00 Yu.V. Buldygina L.K. Sokolova V.M. Pushkarev S.L. Shlyakhtych M.D. Tronko <p><strong>Background.</strong> Vitamin D (VD) is a versatile steroid hormone that regulates the activity of several thousand genes. Over the past decades, numerous diseases associated with VD deficiency have been reported, including cancer and autoimmune thyroid disorders. Researches revealed that VD can influence the development and course of these diseases. The VD participation in modulation of the hypothalamus-pituitary-thyroid gland axis, both at the level of the pituitary gland and at that of the thyroid, has been shown. The effect of VD on autoimmune diseases, including thyroid autoimmune diseases, is widely studied. Most of the <br />existing data support the relationship between VD deficiency and a greater tendency to develop and higher antibody titers associated with Hashimoto’s thyroiditis, Graves’ disease (GD) and postpartum thyroiditis. An important fact is that epidemiological studies have demonstrated a high prevalence of VD deficiency or insufficiency throughout the world. VD insufficiency is a potent dietary trigger that results in severe, chronic diseases. The question arises how reliable is the relationship between VD and autoimmune thyroid diseases (AITD). Although the results of the studies performed are somewhat contradictory, the vast majority of data indicates a link between VD deficiency and an increased risk of developing the disease, high antibody titers, and difficulties in treatment. Genetic polymorphisms associated with VD function and metabolism also have some influence on the risk of ATD. With regard to the precise nature of the relationship between VD and AITD, it is believed that VD plays a small but significant role in the AITD pathogenesis. After the AITD development, its consequence may be an increase in VD deficiency. It is the need to determine the effect of VD supplementation in the prevention and treatment of AITD and its optimal level directly for clinical practice. It is necessary for clinical practice to determine the effect of VD supplements in the prevention and treatment of AITD and its optimal level. A study, the purpose of which was to study the content of VD, namely 25(OH)D in 176 patients with GD complicated by autoimmune ophthalmopathy (AO) and to identify a correlation relationship with antithyroid antibodies (TPO, TSHR-Ab) was carried out at the State Institution “V.P. Komissarenko Institute of Endocrinology and Metabolism of the National Academy of Medical Sciences of Ukraine”.<strong> Materials and methods.</strong> The levels of 25(OH)D, TSH, TSHR-Ab, TPO were determined by enzyme immunoassay using standard kits from Siemens firm. During the study, 176 patients were divided into two groups, depending on the presence of AO: the first group consisted of patients with GD without AO (62 people), the second group included patients with GD and AO (114 people). <strong>Results.</strong> In GD, 91.78 % of patients (161 people) have an insufficient level of 25(OH)D content: a suboptimal level was recorded in 42 patients (23.86 %), and a deficit — in 119 patients (67.61 %). A significant negative correlation relationship was revealed between TSHR-Ab and 25(OH)D in the group of patients with GD and AO — with a lower level of 25(OH)D, the higher values of TSHR-Ab correlate. Compensation of the 25(OH)D deficiency leads to a significant (P &lt; 0.05) decrease in the levels of TSHR-Ab and TPO in patients with GD. Besides, there is a large body of literature available lin-king vitamin D to thyroid autoimmunity as a result of cross-sectional studies and observations. <strong>Conclusions.</strong> Thus, there is still an urgent need for large multicenter studies to evaluate the effect of vitamin D supplementation on meaningful long-term clinical endpoints in AITD.</p> 2021-10-20T00:00:00+03:00 Copyright (c) 2021 Effects of COVID-19 and diabetes mellitus on apolipoprotein A1 level in the blood plasma of patients 2021-10-04T16:02:05+03:00 V.V. Pushkarev L.K. Sokolova S.A. Cherviakova Yu.B. Belchina M.V. Bigun O.I. Kovzun V.M. Pushkarev M.D. Tronko <p><strong>Background.</strong> Increased level of high-density lipoprotein (HDL) cholesterol and apolipoprotein A1 (ApoA1) in plasma is associated with a reduced risk of developing cardiovascular diseases. In addition to its potential cardioprotective function, HDL and ApoA1, the main HDL apolipoprotein, also have antidiabetic properties. The aim of the study was to determine the level of ApoA1 in the blood of patients (n = 81) with diabetes mellitus and COVID-19. <strong>Materials and methods.</strong> ApoA1 was determined by enzyme-linked immunosorbent assay kits (Elabscience, USA). The measurements were performed at an optical density of 450 nm. <strong>Results.</strong> ApoA1 level in the blood of patients with diabetes and especially with COVID-19 was significantly lower than in healthy people. The study of the dependence of plasma ApoA1 content on the level of Hb1Ac, the gender and the type of diabetes showed that in blood of patients with type 2 diabetes the amount of ApoA1 is lower than in those with type 1 diabetes, and with an increase in the level of Hb1Ac the amount of ApoA1 decreases. There was also significant gender difference. With an increase in the body mass index, the content of ApoA1 in blood plasma decreases below normal — 0.9 g/L, and at body mass index &lt; 25 kg/m2, the amount of ApoA1 is significantly higher than the average lipoprotein level in diabetic patients. In individuals with newly diagnosed diabetes, the level of ApoA1 is significantly higher, and in patients with more than 10 years of illness, it is below average and below normal. Biguanide treatment, either in combination with other drugs (mainly insulin) or as monothe-<br />rapy, does not significantly affect the level of ApoA1 compared to the entire group average. In patients treated with sulfonylurea, the level of ApoA1 is significantly lower than the average level for the group and the norm. <br />A significant positive effect on the amount of ApoA1 in plasma was observed in people treated with a combination of drugs with sodium-glucose cotransporter type 2 inhibitors, insulin and especially dipeptidyl peptidase-4 inhibitors. However, insulin monotherapy did not significantly affect the ApoA1 content. Possible mechanisms of ApoA1 decrease in COVID-19 and diabetes are discussed.<strong> Conclusions.</strong> Thus, the level of ApoA1 may be one of the promising markers of severe COVID-19.</p> 2021-10-20T00:00:00+03:00 Copyright (c) 2021 Myo-inositol supplementation in women of reproductive age with subclinical hypothyroidism and obesity on the background of vitamin D deficiency 2021-10-04T16:09:03+03:00 N.V. Pasyechko V.M. Kulchinska S.V. Kadubets <p><strong>Background.</strong> In recent years, thyroid diseases occupy the top places in the structure of the endocrine pathology. There exists a tight functional relationship between the thyroid and reproductive systems, which leads to a high probability of the development of combined disorders in one of these links of homeostasis. The problem of reproductive health disorders is of particular concern around the world and is relevant to the study of the impact of thyroid diseases on both fertility and pregnancy, especially in conditions of comorbidity. The purpose of the study was to investigate the effect of myo-inositol on the reproductive function of women with subclinical hypothyroidism on the background of autoimmune thyroiditis and obesity. <strong>Materials and methods.</strong> The study included 98 patients aged 18–40 years with subclinical hypothyroidism, overweight, or obesity on the background of autoimmune thyroiditis. They were randomly subdivided into two groups. Patients of the first group (n = 49) before the basic treatment received myo-inositol at a dose of 2000 mg/day and cholecalciferol at a dose of 2000 IU/day. Patients of the second group (n = 49) before the basic treatment received only cholecalciferol at a dose of 2000 IU/day. <strong>Results.</strong> Vitamin D deficiency was observed in 90.81 % of women with subclinical hypothyroidism, and vitamin D insufficiency in 9.19 %. A negative correlation was found between the level of 25(OH)D and the level of TPO-Ab (r = –0.189; p &lt; 0.05). There was a weak negative correlation between the level of 25(OH)D and the level of the HOMA-IR (r = –0.168; p &lt; 0.05). The administration of myo-inositol together with vitamin D led to a significant increase in the content of 25(OH)D, as well as to a decrease in the titer of TPO-Ab. <strong>Conclusions.</strong> The positive effect of myo-inositol drugs together with vitamin D on the functional state of the thyroid gland, on the level of TPO-Ab and HOMA-IR in women of reproductive age with subclinical hypothyroidism and obesity has been established.</p> 2021-10-20T00:00:00+03:00 Copyright (c) 2021 The effect of iodine deficiency on the course of recurrent respiratory infection in children living in the iodine deficient region 2021-10-04T16:10:20+03:00 T.V. Sorokman O.V. Makarova <p><strong>Background. </strong>The consequence of iodine deficiency is a decrease in the secretion of thyroid hormones, which adversely affects the immune system with the development of somatic and predisposition to frequent respiratory diseases. The purpose was to investigate the iodine supply of the body of children with recurrent respiratory infections (RRI) by studying the organification and inorganic fractions of iodine in the serum and excretion of iodine in the urine. <strong>Materials and methods.</strong> The study was conducted by simple sampling, taking into account the characteristics of the clinic course of respiratory disease. Clinical and laboratory and instrumental examination was performed in 60 children aged 3 to 11 years with a diagnosis of RRI. The concentration of iodine in urine, the level of inorganic and organification iodine in the blood were studied. <strong>Results.</strong> The clinical picture presented with the symptoms of intoxication, fever, and catarrhal symptoms typical of RRI. In children with severe RRI experienced a clear decrease in the iodine level to 57.34 μg/l (p &lt; 0.05) and a decline in the blood content of total iodine and iodine organification by 31.12 and 39.11 % (p &lt; 0.001), respectively. The concentration of inorganic iodine was significantly higher (p &lt; 0.001). Such results indicate a “wrong” subcellular distribution of iodine into fractions in the inflammatory process caused by RRI. The children with detected iodine deficiency demonstrated a more severe course of RRI. There was a moderately negative relationship between the levels of organification and inorganic iodine (r = –0.515; p &lt; 0.05) and a direct relationship between the blood concentrations of total and organification iodine (r = 0.899; p &lt; 0.05). <strong>Conclusions.</strong> The course of RRI in patients with iodine deficiency is characterized by an increase in the level of inorganic iodine, a decrease in organification iodine and total iodine, the deepening of these changes correlates with the severity of the respiratory disease.</p> 2021-10-20T00:00:00+03:00 Copyright (c) 2021 Erectile dysfunction in men with diabetes (literature review) Part 1 2021-10-04T16:06:28+03:00 E.V. Luchytskyy V.Ye. Luchytskiy <p>The first part of the review article highlights modern views on the prevalence, etiology and features of the pathogenesis of erectile dysfunction (ED) in men with diabetes mellitus. Google Scholar and PubMed databases were used to search for literature sources. The role of comorbid diseases in the development of ED in men with diabetes mellitus has been shown. The generalized data on the main clinical manifestations of erectile dysfunction, methods of its diagnosis and treatment are given. A number of epidemiological studies over the past 20 years have found that erectile dysfunction in men with diabetes may be an early marker of cardiovascular complications. Thus, in the algorithm for ED diagnosis in patients with diabetes it is necessary to conduct a thorough examination of the cardiovascular system. Numerous literature sources indicate an important role in the correction of androgen deficiency in men with type 2 diabetes, in order to enhance the effectiveness of phosphodiesterase type 5 inhibitors. Erectile dysfunction involves a change in any of the components of an erectile response. ED can negatively affect a man’s quality of life because most patients experience symptoms of depression and anxiety related to their sexual capabilities. These symptoms also affect a partner’s sexual experience and the couple’s quality of life. Clinical features of ED have many key features in the anamnesis, including some physical signs during examination depending on a type of diabetes. With age, comorbid conditions play an increasing role in the development of ED. Diabetes mellitus, cardiovascular diseases, obesity can lead to the development of ED before accelerated deterioration of erectile function and disorders at the molecular level of the mechanisms underlying erection. Patients with diabetes and ED have higher scores on the depression rating scale, and poorer overall health and quality of life. Early detection of ED in individuals with diabetes can improve the overall health and quality of life of patients. Patients with diabetes with poor glycemic control and older age are more likely to develop severe ED, which further exacerbates an already compromised health and quality of life. According to the National Health and Nutrition Examination Survey (2001–2002), diabetes mellitus is a modified risk factor independently associated with the development of ED (odds ratio (OR) 2.69), obesity (OR 1.60), smoking (OR 1.74) and hypertension (OR 1.56). Erectile dysfunction is a common complication of diabetes, and diabetes is a risk factor for ED; men with diabetes are three times more likely to have ED.</p> 2021-10-20T00:00:00+03:00 Copyright (c) 2021 Vitamin D dosage 2021-10-04T16:07:51+03:00 O.V. Kaminsky <p>Despite its historical name, vitamin D is not a vitamin at all but a hormone that, when activated, is a metabolically active steroid fat-soluble hormone that acts on cellular receptors. Vitamin D hormone is synthesized endogenously and then metabolized in the body, provi-<br />ding that there are the necessary precursors and some factors — the effects of ultraviolet light on the skin. At the same time, vitamins themselves are nutrients, co-factors of biochemical reactions that are not synthesized in the body and cannot interact with receptors, consumed with food, so the hormone D is not a vitamin. Disputes about its use and dosage continue throughout the study period of vitamin D hormone. Most reputable experts in Europe and the USA support the need to replenish and maintain a normal level of vitamin D, believing it to be completely safe and useful. In 2011, the US Endocrine Society issued clinical practice guidelines for vitamin D, indicating that the desired serum concentration of <br />25(OH)D is &gt; 75 nmol/l (&gt; 30 ng/ml) to achieve the maximum effect of this vitamin on calcium metabolism, bone, and muscle metabolism. According to them, for a consistent increase in serum 25(OH)D above 75 nmol/l (30 ng/ml), adults may require at least 1,500-2,000 IU/day of additional vitamin D, at least 1,000 IU/day in children and adolescents. The most common form of thyroid dysfunction is secondary hyperparathyroidism, which develops due to vitamin D defect/deficiency (80–90 %). Non-optimal serum concentrations of 25(OH)D <br />lead to secondary hyperparathyroidism, potentially leading to decreased bone mineralization and, ultimately, to an increased risk of osteopenia, osteoporosis and fractures, cardiac arrhythmia, and increased blood pressure. Vitamin D is most commonly used at a star-<br />ting dose of 5,000 IU daily for 2–3 months, then transferring patients to maintenance doses of 2,000–4,000 IU/day daily that are consi-dered safe. However, it should be noted that some patients will need constant administration of 5,000 IU of vitamin D per day for a long time (years) to maintain the target optimal level of 25(OH)D in the blood, especially in patients with normocalcemic forms of secondary hyperparathyroidism.</p> 2021-10-20T00:00:00+03:00 Copyright (c) 2021 Subclinical hypothyroidism: do you always need hormone replacement therapy? A modern view of the problem 2021-10-04T16:03:28+03:00 N.O. Kravchun I.P. Dunaeva <p>Subclinical hypothyroidism is the initial stage of development of hypothyroidism, in which there are no clear clinical symptoms and there is a slow decline in thyroid function. It is known that subclinical hypothyroidism occurs in the population much more often than overt one, its prevalence depends on gender, age of patients and it is much more often diagnosed in elderly women. The literature review considers the effectiveness of the combined herbal preparation to improve the quality of life in hypothyroidism — Endomar, which contains 50 % of Potentilla alba, 25 % of Skutellaria baicalensis and 25 % of Rhodiola rosea. All three components of Endomar are synergistic in hypothyroidism. This multicomponent herbal product has a wide range of therapeutic properties and can be recommended for subclinical forms of thyroid hypofunction. Potentilla alba has been used in medical practice since ancient times. Biologically active components of Potentilla alba extract are flavonoids that regulate the permeability and elasticity of blood vessel walls, thereby neutralizing free radi-cals, phenolcarboxylic acids having antimutagenic and diuretic properties, saponin glycosides, which have a cardiotonic, neurotropic effect, hypocholesterolemic, adaptogenic, sedative action. Rhodiola rosea, an extract of the roots and rhizomes of this plant, is an adaptogen that increases the body’s resistance to stress, exhaustion, fatigue. Rhodiola rosea includes the following active substances: phenols and their derivatives aurol, salidroside; flavonoids: kaempferol, rhodiolin, rhodionin, rhodiosine, trace elements. Endomar includes Skutellaria baicalensis, which has unique properties. This plant contains flavonoid baicalin, which has a neuroprotective and neotropic effect, flavonoids scutellarin and vagonin that maintain normal vascular tone. In general, all components have an antioxidant, antispasmodic, antiinflammatory effect, they are also adaptogens and include trace elements such as magnesium, zinc, selenium.</p> 2021-10-20T00:00:00+03:00 Copyright (c) 2021 Appeal of Editor-in-Chief 2021-10-04T15:52:31+03:00 V.I. Pankiv <p>No abstract</p> 2021-10-20T00:00:00+03:00 Copyright (c) 2021