INTERNATIONAL JOURNAL OF ENDOCRINOLOGY (Ukraine) http://iej.zaslavsky.com.ua/ <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="http://iej.zaslavsky.com.ua/public/journals/347/pageHeaderTitleImage_uk_UA.jpg" /></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="http://www.mif-ua.com/"> <span style="text-decoration: none;">http://www.mif-ua.com/</span></a></strong><strong><br /><a href="http://www.bsmu.edu.ua/en/"> <span style="text-decoration: none;">http://www.bsmu.edu.ua/</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="http://www.wame.org/" target="_blank" rel="noopener"> <img src="http://www.mif-ua.com/media/uploads/index/wame.jpg" alt="" width="100" height="37" /></a> <a href="https://publicationethics.org/" target="_blank" rel="noopener"> <img src="http://www.mif-ua.com/media/uploads/index/cope.jpg" alt="" width="100" height="37" /></a> <a href="http://www.icmje.org/journals-following-the-icmje-recommendations/" target="_blank" rel="noopener"><img src="http://www.mif-ua.com/media/uploads/index/icmje.jpg" alt="" width="100" height="37" /></a> <a href="https://www.councilscienceeditors.org/resource-library/editorial-policies/white-paper-on-publication-ethics/" target="_blank" rel="noopener"> <img src="http://www.mif-ua.com/media/uploads/index/cse.jpg" 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="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5209927/pdf/CroatMedJ_57_0527.pdf" target="_blank" rel="noopener"> <img src="http://www.mif-ua.com/media/uploads/index/sarajevo.jpg" alt="" width="100" height="37" /></a> <a href="https://sfdora.org/" target="_blank" rel="noopener"> <img src="http://www.mif-ua.com/media/uploads/index/dora.jpg" alt="" width="100" height="37" /></a></td> </tr> <tr> <td align="left" valign="top" width="98%"><hr /></td> </tr> </tbody> </table> Zaslavsky O.Yu. en-US INTERNATIONAL JOURNAL OF ENDOCRINOLOGY (Ukraine) 2224-0721 <p>Our edition uses the copyright terms of <strong>Creative Commons</strong> for open access journals.</p><p>Authors, who are published in this journal, agree with the following terms:</p><ol><li>The authors retain rights for authorship of their article and grant to the edition the right of first publication of the article on a <span><a href="http://creativecommons.org/licenses/by/4.0/"><strong>Creative Commons Attribution 4.0 International License</strong></a></span>, which allows others to freely distribute the published article, with the obligatory reference to the authors of original works and original publication in this journal.</li><li>Directing the article for the publication to the editorial board (publisher), the author agrees with transmitting of rights for the protection and using the article, including parts of the article, which are protected by the copyrights, such as the author’s photo, pictures, charts, tables, etc., including the reproduction in the media and the Internet; for distributing; for the translation of the manuscript in all languages; for export and import of the publications copies of the writers’ article to spread, bringing to the general information.</li><li>The rights mentioned above authors transfer to the edition (publisher) for the unlimited period of validity and on the territory of all countries of the world.</li><li>The authors guarantee that they have exclusive rights for using of the article, which they have sent to the edition (publisher). The edition (the publisher) is not responsible for the violation of given guarantees by the authors to the third parties.</li><li>The authors have the right to conclude separate supplement agreements that relate to non-exclusive distribution of their article in the form in which it had been published in the journal (for example, to upload the work to the online storage of the journal or publish it as part of a monograph), provided that the reference to the first publication of the work in this journal is included.</li><li>The policy of the journal permits and encourages the publication of the article in the Internet (in institutional repository or on a personal website) by the authors, because it contributes to productive scientific discussion and a positive effect on efficiency and dynamics of the citation of the article.</li></ol> Appeal of Editor-in-Chief http://iej.zaslavsky.com.ua/article/view/232646 <p>No abstract</p> V.I. Pankiv Copyright (c) 2021 http://creativecommons.org/licenses/by/4.0 2021-06-24 2021-06-24 17 3 197 199 10.22141/2224-0721.17.3.2021.232646 Glycemic control and awareness of foot care in diabetic foot syndrome http://iej.zaslavsky.com.ua/article/view/232647 <p><em><strong>Background.</strong> </em>The chronic complications of diabetes mellitus (DM) result from a wide variety of effects of disease. The correlation between blood sugar level and chronic complications has been demonstrated in various studies. Patient education, risk factor management, and other preventative measures are critical elements in reducing the incidence of diabetes complications such as Diabetic Foot Syndrome (DFS). We purposed to evaluate knowledge and attitudes towards foot care amongst patients with diabetes mellitus; in addition, we investigated the correlation between glycemic control and DFS. <em><strong>Materials and methods.</strong></em> This was a descriptive cross-sectional evaluation of patients who were diagnosed with diabetes mellitus seeking outpatient medical care with data being collected through patient surveys, clinical evaluation, specialty consultation, and biochemical analysis of glycated haemoglobin (HbA1c) serum levels. The population of the study was composed of 90 patients diagnosed with DM. <em><strong>Results.</strong></em> A total of 90 patients, 42 (46.7 %) females and 48 (53.3 %) males were included in the study. The rate of participants who reported completing daily self-evaluations for wounds, cracks, and discoloration on the feet was significantly higher (68.9 %) than those who reported not evaluating on a daily basis (31.1 %). Almost half of the participants were diagnosed with DFS (n = 43; 47.7 %) with the HbA1c levels of patients with DFS being significantly higher compared to the HbA1c levels of patients without DFS (p &lt; 0.05). <em><strong>Conclusions.</strong></em> As a high incidence of DFS was found with a positive and statistically significant correlation between the HbA1c level and DFS presence, our study highlights the importance of close monitoring, education, and treatment given the risk of serious complications of DM such as DFS in setting of poorly controlled DM.</p> Ayten Guner Atayoglu Ali Timucin Atayoglu Rahime Ozgur Hammad Khan Copyright (c) 2021 http://creativecommons.org/licenses/by/4.0 2021-06-24 2021-06-24 17 3 200 208 10.22141/2224-0721.17.3.2021.232647 Evaluation of the prognostic significance of leptin, adiponectin and resistin in the development of diabetic retinopathy in type 2 diabetes mellitus patients http://iej.zaslavsky.com.ua/article/view/232649 <p><em><strong>Background.</strong> </em>There is evidence of the participation of adipose tissue hormones leptin, adiponectin and resistin in the formation of metabolic disorders in the retina, retinal neovascularization, and diabetic microangiopathy. The development of methods for the mathematical evaluation of the prognosis of diabetic retinopathy (DR) formation with the participation of adipokines is a relevant problem in modern diabetology. Aim. Elaboration of a mathematical model for assessing the prognostic significance of serum leptin, adiponectin and resistin to study the likelihood of deve­loping and progressing DR in patients with type 2 diabetes mellitus (DM). <em><strong>Materials and methods.</strong> </em>An open observational single-center one-stage selective study was conducted among patients with type 2 DM and DR. The blood serum concentration of leptin, adiponectin and resistin, HbA1с, lipid metabolism findings were determined, the results of an instrumental examination of the fundus were analyzed. The diagnostic predictive value of serum leptin, adiponectin and resistin was assessed using discriminant analysis. Statistical analyses were conducted using Statistica 9.0 (StatSoft, Tulsa, OK, USA) software. The differences were considered statistically signifi­cant at p &lt; 0.05. A model with linear combinations of the serum leptin, adiponectin and resistin, triglyceride (TG), HbA1с, type of antihyperglycemic therapy (oral anti-hyperglycemic medication or insulin therapy) were developed, and, subsequently, formulas for classification-relevant discriminant functions were derived. <em><strong>Results.</strong></em> Fifty-nine patients (107 eyes) with type 2 DM and DR (men and women; mean age, 58.20 ± 0.18 years; mean diabetes duration, 9.19 ± 0.46 years; mean HbA1с 9.10 ± 0.17 %) were assigned to the basic group and underwent the study. They were divided into three DR groups based on the stage of DR. When performing the ran­king of patients for discriminant analysis, the stage 2 DR group was aggregated with the stage 3 DR group for convenience to form the stage 2 + 3 DR group based on the pathognomonic sign (portents of proliferation or actual proliferation). Anti-diabetic therapy (ADT) included metformin, either alone (type 1 ADT) or in combination with oral anti-hyperglycemic medication (metformin + OAHGM, type 2 ADT) or insulin therapy (metformin + IT, type 3 ADT). Inclusion criteria were informed consent, age above 18 years, pre­sence of T2DM and DR. Exclusion criteria were endocrine or body system disorders leading to obesity (Cushing’s syndrome, hypothyroidism, hypogonadism, polycystic ovarian syndrome, or other endocrine disorders, including hereditary disorders, and hypothalamic obesity), type 1 DM, acute infectious disorders, history of or current cancer, decompensation of comorbidities, mental disorders, treatment with neuroleptics or antidepressants, proteinuria, clinically significant maculopathy, glaucoma or cataract. The study followed the ethical standards stated in the Declaration of Helsinki and was approved by the Local Ethics Committee. The formulas for classification-relevant discriminant functions were derived based on the results of physical examination, imaging and laboratory tests, and subsequent assessment of clinical signs of DM (HbA1с), DR stage and serum leptin, adiponectin, resistin, TG concentrations and taking into account the type of antihyperglycemic therapy. The classification functions (CF) computed based on the variables found from the above developed models provided the basis for predicting the development of DR. The formulas for CF from model are as follows: CF1 = 0.29 • TG + 1.55 • HbA1С + 1.81 • ADT_Type + 0.04 • Leptin + 0,34 • Adiponectin + 0,91 • Resistin – 13,82. CF2= 0.05 • TG + 1.36 • HbA1С + 3.01 • ADT_Type + 0.08 • Leptin + 0,35 • Adiponectin + 1,01 • Resistin – 15.95. A step-by-step approach to a diagnostic decision should be used. First, blood samples are tested for serum leptin, adiponectin and resistin, TG, blood HbA1c, and the patient is assigned a code for ADT Type (metformin only, 1; metformin + OAHGM, 2; or metformin + IT, 3). Second, CF1 and CF2 values are calculated based on clinical and laboratory data. Finally, the two values are compared to determine which is greater. The predictive decision is made by selecting the classification function with the greater value. Thus, if CF1 &gt; CF2, the process can be stabilized at this stage given adequate glycemic control (through compensation of carbohydrate metabolism) and body mass control as well as patient compliance. If CF1 &lt; CF2, the pathological process may progress to the next stage or even within stage 3, and there is an urgent need to reduce BMI, and to correct the ADT and the blood lipid profile. <em><strong>Conclusions.</strong></em> The informative value and statistical significance of the model were 71.4 % and p = 0.040, respectively. Using the formulas, one can determine the probability of progression of DR.</p> M.L. Kyryliuk Copyright (c) 2021 http://creativecommons.org/licenses/by/4.0 2021-06-24 2021-06-24 17 3 209 213 10.22141/2224-0721.17.3.2021.232649 Are metabolic syndrome and its components a risk factor for gallbladder polyps? http://iej.zaslavsky.com.ua/article/view/232650 <p><em><strong>Background.</strong> </em>Gallbladder polyps are usually benign lesions originating from the mucosa and are usually detected incidentally during radiological examinations or after cholecystectomy. Gallbladder polyps are common and may have malignant risk. In this study, it was investigated whether metabolic syndrome (MS) is a risk factor for gallbladder polyps. This study aimed to determine the prevalence of MS and its components in patients with gallbladder polyps. <em><strong>Materials and methods.</strong> </em>We conducted a retrospective, cross-sectional study. We investigated the age, gender and past medical history of 90 adults (45 with polyps, 45 without polyps). Body height and weight, body mass index, waist circumference and laboratory data were obtained from the hospital data processing system. National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III) and International Diabetes Foundation (IDF) MS diagnostic criterion were used for the diagnosis of MS. <em><strong>Results.</strong></em> 51.1 % (n = 46) of the subjects participating in the study were female and 48.8 % (n = 44) were male. The mean age was 58.79 ± 15.70 years. MS was found in 56.7 % (n = 51) of the cases according to the criteria of NCEP-ATP III and, in 64.4 % (n = 58) of the cases according to the IDF criteria. In patients with a gallbladder polyp, MS was detected in 55.55 % according to the criteria of NCEP-ATP III and in 66.66 % according to the IDF criteria. The rates of MS were not similar in the gallbladder polyp group and control group (p &gt; 0.01). Abdominal obesity was found to be a risk factor for the development of gallbladder polyp (odds ratio: 14.23, 95% CI: 1.751–15.722; p &lt; 0.01). Although it was not statistically significant, low HDL and hypertension were detected approximately 2 times higher in patients with gallbladder polyps than in the control group.<em><strong> Conclusions.</strong></em> While MS is not associated with the development of gallbladder polyp, obesity is seen as a sole risk factor.</p> Emine Duygu Boz Refik Demirtunç Mehmet Sözen Copyright (c) 2021 http://creativecommons.org/licenses/by/4.0 2021-06-24 2021-06-24 17 3 214 218 10.22141/2224-0721.17.3.2021.232650 Predicting the risk of severe menopausal syndrome in perimenopausal women with hypothyroidism http://iej.zaslavsky.com.ua/article/view/232651 <p><em><strong>Background.</strong> </em>Every year the number of menopausal women increases. At this age, the prevalence of hypothyroidism (HT) reaches its peak. The problem of menopausal syndrome (MS) is relevant for patients with HT, concomitant endocrine disorders create a background for combination with dyshormonal factors. The purpose of the study: to propose an approach to predicting the risk of severe MS in perimenopausal women with HT according to the developed algorithm and mathematical model. <em><strong>Materials and methods.</strong></em> To predict the development of MS, 146 perimenopausal women with autoimmune HT were surveyed. ­Using multiple regression analysis, a prognostic model of the risk of severe MS was created. <em><strong>Results.</strong></em> Logistic regression analysis revealed the following most significant multicollinear risk factors for MS: smoking, alcohol consumption, adverse environmental conditions, physical activity, history of stress and anxiety, thyroid disease. A correlation matrix with calculation of regression coefficients and coefficient of determination was constructed, a mathematical model was created to determine the risk factor for the progression of MS. The predicted value of the risk factor for severe MS with a high degree of probability was determined in 72 (49.32 %) women, with an average probability — in 58 (39.73 %), and with a low probability — in 16 women (10.95 %) with HT. The correspondence of the predicted results with the theoretically expected ones in the high-risk group was recorded in 104.37 %, in the average-risk — in 94.73 %, and in the low-risk — in 89.65 % of cases. <em><strong>Conclusions.</strong></em> The developed algorithm and mathematical model for predicting severe MS on the background of HT are highly informative and allow determining in advance the group of women at high risk of severe MS for the timely implementation of appropriate preventive measures.</p> N.V. Pasechko O.O. Chukur A.O. Bob A.S. Sverstiuk Copyright (c) 2021 http://creativecommons.org/licenses/by/4.0 2021-06-24 2021-06-24 17 3 219 225 10.22141/2224-0721.17.3.2021.232651 Serum WNT-induced secreted protein 1 level as a potential biomarker for thyroid nodules http://iej.zaslavsky.com.ua/article/view/232652 <p><em><strong>Background.</strong> </em>Thyroid nodule (TN) is a common thyroid disease worldwide, and it has increased significantly last decades. Most TNs are usually incidental findings of asymptomatic, benign lesions discovered by imaging modalities performed for reasons unrelated to thyroid diseases. The purpose of this study was to investigate the value of serum WNT-induced secreted protein 1 (WISP1) level as a supporting biomarker to perform differential diagnosis of benign and non-benign thyroid nodules. <em><strong>Materials and methods.</strong></em> The study was completed with the 89 patients undergone fine needle aspiration biopsy and 43 controls. The patients were composed of 96 (72.7 %) females and 36 (27.3 %) males. And they were divided into 2 group according to the Bethesda cytological evaluation as Benign (Bethesda 2) and Non-Benign (Bethesda 3–6) groups. Their serum WISP1 levels were measured by an ELISA method. <em><strong>Results.</strong> </em>There were 58 (43.9 %) patients in Benign (Bethesda 2) and 31 (23.5 %) in non-Benign (Bethesda 3–6) groups. In the contrary nodule size was bigger in the Non-benign group than that benign group (p = 0.006). The serum WISP1 level in the Benign (Bethesda 2) group was significantly higher than that in the and Non-Benign (Bethesda 3–6) group, and controls (p &lt; 0). The difference between benign and non-benign group accordingly to their echogenicitiy was significant (p &lt; 0.05). In benign group there was 76.9 % mixed echoic nodules, 76.7 % isoechoic nodules 68.4 % isohypoechoic nodules and 35.7 % hypoechoic nodules. In the non-benign group, the highest hypoechoic echo (64.3 %), the least mixed echo (23.1 %), while in the benign group, the most mixed echo (76.9 %), the least hypoechoic echo (35.7 %) was present. There was no relation between WISP1 levels and echogenicity with Kruskal-Wallis H test. <em><strong>Conclusions.</strong></em> According to the preliminary results of current study, addition of serum WISP1 measurement to the differential diagnostic work-up of thyroid nodules patients may provide supportive information. In thyroid nodules patients with Benign (Bethesda 2) category of cytological evaluation, a higher level of serum WISP1 may support cytological diagnosis.</p> Gulhan Duman Baris Sariakcali Copyright (c) 2021 http://creativecommons.org/licenses/by/4.0 2021-06-24 2021-06-24 17 3 226 233 10.22141/2224-0721.17.3.2021.232652 Antithyroid autoantibodies in extrathyroid autoimmune diseases http://iej.zaslavsky.com.ua/article/view/232653 <p>This review summarizes data on the incidence of autoimmune diseases and examines the prevalence of antithyroid antibodies in extrathyroid autoimmune diseases. In the world, about 5–7 % of the population suffers from one or another type of autoimmune diseases. Among the six most common autoimmune diseases, thyroid and associated diseases predominate. The high prevalence of autoimmune thyroid diseases raises questions about the potential role of antithyroid antibodies in the course of extrathyroid autoimmune diseases. It is believed that autoimmune di­seases are the result of interactions between triggers, autoantigens, genetic predisposition, impaired tolerance of autoantigens and mechanisms of apoptosis. Among the currently known antithyroid autoantibodies, antibodies to thyroglobulin (TgAb), thyroid peroxi­dase (TPO), as well as bispecific autoantibodies to thyroglobulin and thyroid peroxidase are of particular importance. Categories of functionally significant autoantibodies that mimic hormone function and provoke the development of autoimmune pathology as a result of binding to the receptor and subsequent stimulation of thyrocytes include antibodies to thyroid-stimulating hormone receptor (rTSH-Ab). Circulating antibodies against thyroid antigens are not limited to autoimmune diseases of the thyroid gland, but are also found in other autoimmune diseases, most often in rheumatoid arthritis, type 1 diabetes mellitus and celiac disease. The association with other immune pathologies further confirms that TPO antibodies were also detected in 15 % of patients with asthma, in 10–29 % of those with idiopathic purpura and vitiligo. The prevalence of TPO antibodies is slightly higher than TgAb, and rTSH-Ab are rarely registered in non-thyroid immunological diseases.</p> T.V. Sorokman M.G. Gingulyak O.V. Makarova Copyright (c) 2021 http://creativecommons.org/licenses/by/4.0 2021-06-24 2021-06-24 17 3 234 240 10.22141/2224-0721.17.3.2021.232653 Adrenal adenomas: what to do with them? Review 2 http://iej.zaslavsky.com.ua/article/view/232655 <p>Adrenal incidentalomas (AI) are a collective, working category that contains a wide range of different forms of patho­logy of these glands. They differ in the original tissue structures from which they originate, in clinical and hormonal characte­ristics, in diagnostic and tactical approaches. Such a wide range of emergencies, which are hidden under the guise of accidentally detected AI, puts before the clinician the task of identifying them (establishing a clinical and, if possible, morphological diagnosis) with the definition of tactical approaches. Based on the analysis of these data, as well as numerous publications, their working classification is proposed. When deciding on surgical treatment, the surgeon must have a clinical diagnosis — what nosological form of adrenal pathology is to be operated on. Interventions with the diagnosis AI are unacceptable and are a gross error. The optimal operation for most such tumors is laparoscopic adrenalectomy with the tumor. Open operations are indicated for malignant tumors of significant size, especially with signs of invasion into surrounding structures. Given that most AI are benign formations, it is equally important to determine further tactics for them — the mode and duration of observation, the order and scope of control clinical and hormonal and imaging studies, the principles of evaluation of the results. Several guidelines indicate that in the presence of hormonally inactive adenomas, without signs of malignancy, less than 3–4 cm in size, no further observation is indicated. It is noted that in such tumors the tendency to growth, malignancy, emergence of hormonal activity is extremely seldom observed. In other cases, especially with the slightest doubt of the initial results, follow-up examinations are recommended after 3, 6, 12 months and then after 1–2 years, the maxi­mum period is set to five years. These parameters are the subject of discussion in various clinics.</p> S. Rybakov Copyright (c) 2021 http://creativecommons.org/licenses/by/4.0 2021-06-24 2021-06-24 17 3 241 249 10.22141/2224-0721.17.3.2021.232655 Diabetes mellitus, platelet function and acetylsalicylic acid http://iej.zaslavsky.com.ua/article/view/232660 <p>Diabetes mellitus is an independent risk factor for cardiovascular disease (CVD). Accelerated development of atherosclerosis in patients with diabetes is a consequence of endothelial dysfunction, low-grade inflammation, oxidative stress, dyslipidemia, and platelet dysfunction. The results of studies have shown that among diabetic patients there is a high percentage of no effect when using both acetylsalicylic acid (ASA) and clopidogrel. It is necessary to distinguish between patients with a weak response and people with no effect — resistant to aspirin. The frequency of the so-called aspirin resistance, according to modern research, is different and depends on the methods used to study platelet function. In diabetic patients, it ranges from 5 to 45 % when taking ASA and from 4 to 30 % when taking clopidogrel. Recent studies show an even higher proportion of such individuals among people with diabetes. The appropriateness of lifelong ASA for secondary prevention in people diagnosed with CVD is indisputable (level of evidence A). At the same time, approaches to primary prevention vary in different countries. It is emphasized that the primary prevention with ASA in modern conditions maintains a favorable balance of benefits/risks. The new guidelines state that the calculated 10-year risk of cardiovascular events should not be considered when deciding whether to prescribe ASA to patients without CVD. Instead, all risk factors present in each patient should be considered, including burdensome family history, inability to achieve lipid and glycemic levels, and coronary calcification. The conclusion that ASA has evidence-based efficacy in secondary prophylaxis in patients with CVD has been confirmed. Regarding the primary prevention of cardiovascular events, including healthy individuals, the appropriateness, duration of administration, and choice of ASA should be determined taking into account the 10-year development of serious events, the presence of comorbidities, and the risk of bleeding.</p> G.F. Gendeleka A.N. Gendeleka Copyright (c) 2021 http://creativecommons.org/licenses/by/4.0 2021-06-24 2021-06-24 17 3 250 257 10.22141/2224-0721.17.3.2021.232660 R-enantiomer of α-lipoic acid. Opportunities and prospects for clinical use http://iej.zaslavsky.com.ua/article/view/232661 <p>The paper presents an analysis of current literature data on the use of the R-enantiomer of α-lipoic acid as an antihypertensive treatment in patients with hypertension and metabolic syndrome. An analysis of the literature was carried out on its use as an antiinflammatory agent in inflammatory diseases. Currently, a very important aspect of researches is the possibility of using R-α-lipoic acid as a micronutrient and therapeutic agent for the treatment of diabetic polyneuropathy and neurodegenerative di­seases, especially Alzheimer’s disease, carbohydrate metabolism disorders and metabolic syndrome. Lipoic acid has now become an important ingredient in multivitamin formulas, anti-aging supplements. R-α-lipoic acid is a metabolic antioxidant, its molecule contains a dithiolane ring in oxidized form, this ring has the ability to cleave with formation of dihydrolipoic acid. And since α-lipoic acid, a physiological form of thioctic acid, is a strong antioxidant that relieves the symptoms of diabetic neuropathy, the literature review analyzed data from various authors on the antioxidant effects of the R-enantiomer of α-lipoic acid and found that it had strong antioxidant effects, and its dose of 300 mg is bioequivalent to 600 mg of racemic α-lipoic acid. As presented in a sufficient number of analyzed sources, the biological role of lipoic acid is quite diverse. It is important to determine the exact causal relationship between lipoic acid and its immediate cellular targets. Lipoic acid can have a number of important and diverse physiological effects on the stimulation of neurohormonal function and, thus, indirectly affect multiple cellular signaling pathways in peripheral tissues.</p> N.A. Kravchun I.P. Dunaieva P.P. Kravchun Copyright (c) 2021 http://creativecommons.org/licenses/by/4.0 2021-06-24 2021-06-24 17 3 258 270 10.22141/2224-0721.17.3.2021.232661