Adipose tissue: colors, depots and functions

Obesity is a chronic disease characterized by excessive accumulation of adipose tissue. The prevalence of obesity and associated diseases has prompted researchers to expand the study of the biology of adipose tissue. New technologies have significantly expanded the understanding of adipogenesis mechanisms, various aspects of lipid and glucose metabolism, as well as the paracrine and endocrine functions of adipose tissue. Adipose tissue is a complex, heterogeneous endocrine organ. The existence of several shades of adipocytes demonstrates their morphological and functional heterogeneity. The main function of white adipose tissue is to store energy. Brown and white adipocytes perform a predominantly thermogenic function. Bone marrow (yellow) adipose tissue regulates the processes of bone remodeling and hematopoiesis. Pink adipocytes are formed during pregnancy and satisfy the energy needs of the offspring. The study of the biology of adipose tissue is crucial to understanding the pathophysiology of obesity and determining its molecular relationships with type 2 diabetes as well as cardiovascular and oncological diseases. The review presents current literature data on the origin, adipogenesis, and functional properties of adipose tissue depending on its cellular composition and localization. It outlines the nature of changes in adipose tissue in obesity and the clinical significance and therapeutic potential of various adipose tissue depots

The importance of melatonin in the regulation of metabolism, eating behavior, sleep, and the prospects for the use of melatonin drugs for obesity treatment

Melatonin is a special hormone that act as an internal synchronizer of circadian rhythms, the organism physiology and behavior to the environmental day and night and seasons of the year. The present urban society and the industrial production processes as organized should be considered, as both depend on the presence of indoor lights during the night and include the profuse use of electronic devices whose screens are rich in blue wavelength light. Light during the night delays the beginning of the secretory episode of melatonin and blunts its peak, causing chronic hypomelatoninemia. Hypomelatonemia, that causes deprivation of sleep and eating behavior disorders, along with low physical activity, can be the reason of the obesity, «non-infectious epidemic of the 21st century». According to this, the use of melatonin drugs for obesity treatment can be effective. Further prospective, controlled, randomized trials in this area are required to confirm this hypothesis

Functional brain MRI in the setting of drug correction of obesity

AIMS. Study of the dynamics of brain activity using functional MRI (fMRI) in obese patients treated with sibutramine (Reduxine®).MATERIALS AND METHODS. The study enrolled patients with a body mass index (BMI) ≥30 kg/m2 . All participants underwent initial brain fMRI mapping. The obesity cohort was treated with sibutramine at a dose of 10 or 15 mg per day for 3 months. After treatment patients with obesity underwent a second fMRI mapping to assess changes against the initial mapping.RESULTS. The study included: 30 patients (86,7% women) with mean age of 31 [27.25; 36] years, mean body weight (BW)  - 106 [95.75; 121.75] kg, mean BMI 37.4 [33.55; 41.9] kg/m2 , mean waist circumference (WC) - 109 [100; 114.75] cm. The most marked activation volume (via fMRI) was observed in patients with obesity (before treatment) in the visual cortex (occipital lobes). After 3 months of treatment with sibutramine, 80% of patients lose ≥5% of BW. Mean BW decrease was -7.2 [-13.46; -5.37] kg, BMI decrease — -7.2 [-13.49; -5.34] кг/м2 , WC decrease — -6.9 [-11.88; -4.03] см, p <0,05. According to fMRI data, a  decrease in brain activation in the projection of the occipital lobes (35%), left insula (44%), and increase inactivation by 70% in the area of the left DMPF.CONCLUSION. A dynamic study of brain activity using fMRI in obese patients showed that during treatment with sibutramine, a decrease in body weight is accompanied by a decrease in activation in the projection of the occipital lobes and the left insular lobe of the brain, and an increase in activation in the area of the left DMPFC. These data may indicate a decrease in the emotional perception of high-calorie food, a decrease in motivation to eat it, and an increase in cognitive control. In general, the noted dynamics of the functional activity of the brain in obese patients against the background of obesity therapy can be regarded as a change in previously formed patterns of eating behavior

Clinical guidelines ‘Hyperprolactinemia’ (draft)

Hyperprolactinemia is a persistent excess of the blood serum prolactin. The syndrome contains various symptoms, the most characteristic is a violation of the reproductive system. There are multiple endogenous and exogenous causes of hyperprolactinemia. The main treatment method is dopamine agonist therapy, in case of prolactinoma existence, surgical and radiation methods can be applied. About 15% of patients are resistant to dopamine agonist therapy, which determines creation of individual management tactics. The article presents a draft of clinical guidelines for the diagnosis and treatment of hyperprolactinemia, which provides a modern examination algorithm, discusses the basic principles of diagnostics and treatment approaches

INTERDISCIPLINARY CLINICAL PRACTICE GUIDELINES "MANAGEMENT OF OBESITY AND ITS COMORBIDITIES"

Clinical guidelines have long been one of the working tools of the modern doctor, helping him quickly navigate the most effective proven methods of treatment and prevention of various diseases, and also to adapt these methods to the specific tasks of their patients and to achieve maximum personalization of treatment. Clinical  practice guidelines are drawn up by professional non-profit associations and are approved by the Scientific Council of the Ministry of Health of the Russian Federation, while often one recommendation is prepared by two or even three associations. The peculiarity of the recommendations offered to your attention is that not only endocrinologists, but also therapists, cardiologists, gynecologists, gastroenterologists, and experts of many other specialties are involved in the prevention and treatment of obesity. The Multidisciplinary Working Group presents this a project in a multidisciplinary journal to bring together the efforts of several professional associations that associated with the need to pay attention not only to obesity itself but also to comorbid conditions. We are looking forward to constructive criticism and a comprehensive discussion of the problem on the pages of our journal

Origin, diagnostics and treatment of androgen-dependent skin lesions

Hirsutism, acne, seborrhea and alopecia in women, according to general opinion, are directly attributed to androgenic metabolic disorders. However, androgen-dependent skin lesions represent a heterogeneous group of diseases and include symptoms of various origin associated with various diseases and conditions, not always consisting in the excess production or action of male hormones in the female body. Whatever the cause of androgen-dependent dermopathy, presence of an obvious cosmetic defect causes trauma to the patient. That is why androgen-dependent dermopathy is a relevant issue. The other facet of its relevance lies in the fact that androgen-dependent symptoms may become the first sign of a serious illness, so they need to be considered by all specialists, not only dermatologists. In fact, the problem of androgen-dependent dermopathy is interdisciplinary and a matter of interest for dermatologists, gynecologists, endocrinologists, psychiatrists and general practitioners

Effects of metformin on body weight in patients with type 2 diabetes mellitus,receiving insulin analogue treatment

Aims. To study the dynamics of body weight, waist circumference, blood lipid and insulin demand in patients with type 2 diabetes mellitus (T2DM) during first year of combined treatment with metformin and insulin analogues, compared with insulin analogue monotherapy. Materials and Methods. We examined 78 patients with T2DM on newly initiated insulin therapy, including 54 females and 24 males. Median age was 56 [51.0; 64.0] years, median disease duration ? 9 [6.8;14.0] years. Participants were subdivided in two groups. First group was comprised of 48 subjects (33 females and 15 males), who received monotherapy with insulin analogues (glargine, de- temir, biphasic Aspart 30 and Humalog Mix 25 or rapid-acting lispro and aspart). Second group included 30 patients (18 females and12 males), who were treated with combined therapy (insulin analogues plus metformin). We measured HbA1c, plasma lipid composition, BMI, waist circumference and insulin demand initially and after one year of follow-up. Results. We showed that combined therapy vs. insulin monotherapy allows better glycemic compensation while reducing insulin demand and lowering risks for weight gain. Conclusions. Combined insulin analogue plus metformin treatment delivers better metabolic control in patients with T2DM and is as- sociated with lower risks for body weight gain and increase in insulin demand against monotherapy with insulin analogues

Waveguide Modes in the AKR Source. Planetary Radio Emissions| PLANETARY RADIO EMISSIONS VII 7|

The Auroral Kilometric Radiation (AKR) was investigated on measurements in the POLRAD experiment on the INTERBALL-2 satellite. It was revealed ”lowfrequency” radiation with specific features in a spectrum on a polar edge of the auroral region. We have obtained that a series of narrow-band splashes are observed at frequencies between 35 and 70 kHz with the period modulation some tens seconds and bow-shaped envelope. Possible interpretation of emission generation with a specific spectrum is discussed. We suppose that increase of intensity at small frequencies is interpreted as crossing by the satellite of the source region and observation of waveguide modes within it