Corticotropinomas and adrenocorticotropic hormone (ACTH)-secreting neuroendocrine tumors exhibit differential levels of some microRNAs (miRs) compared to normal tissue. Because miRs can be released from tissues into circulation, they offer promise as novel disease biomarkers. Objective: To evaluate whether miRs are differentially detected in plasma samples of patients with ACTH-dependent Cushing's syndrome (CS). Design: Case-control study. Methods: Morning fasting plasma samples were collected from 41 consecutive patients with confirmed ACTH-dependent CS and 11 healthy subjects and stored at −80 • C. Twenty-one miRs previously reported to be differentially expressed in ACTH-secreting tumors vs. healthy tissue samples were quantified in plasma by qPCR. Results: Among enrolled subjects, 28 were confirmed to have Cushing's disease (CD), 13 had ectopic ACTH secretion (EAS) and 11 were healthy controls. We found statistically significant differences in the circulating levels of miR-16-5p [45.04 (95% CI 28.77-61.31) in CD vs. 5.26 (2.65-7.87) in EAS, P < 0.001; q = 0.001], miR-145-5p [0.097 (0.027-0.167) in CD vs. undetectable levels in EAS, P = 0.008; q = 0.087] and differences in miR-7g-5p [1.842 (1.283-2.400) in CD vs. 0.847 (0.187-1.507) in EAS, P = 0.02; q = 0.14]. The area under the receiver-operator (ROC) curve was 0.879 (95% CI 0.770-0.987), p < 0.001, when using miR-16-5p to distinguish between CD and EAS. Circulating levels of miR-16-5p in the healthy control group differed from that of both the CD and EAS groups. Conclusions: Plasma miR levels differ in patients with CD and EAS. In particular, miR-16-5p, miR-145-5p and miR-7g-5p are promising biomarkers for further research to differentiate ACTH-dependent CS.
In this review, we discuss the main reasons for the vitamin D insufficiency in Russian Federation, as well as data on the prevalence of vitamin D deficiency among various population groups and regions, which confirm the widespread prevalence of vitamin D deficiency in the country. The discussed data suggest that the current vitamin D insufficiency in Russian population (reduced levels of 25(OH)D occurs in 50 - 94% of general population) is due to both a low level of its endogenous synthesis and insufficient intake from food : the territory of the country is located in a zone of low insolation, and at the same time, the main natural sources of vitamin D (sea fish of fatty varieties) and fortified with vitamin D products are very limited in the diet of the population. Taking measures to improve the status of vitamin D and maintaining the optimal serum levels of 25(OH)D in children and adults, adequate vitamin D intake will improve the condition of the musculoskeletal system, as well as reduce the risk of development and improve the control of some chronic diseases.
Background: The registry is the main source of information about patients with acromegaly for assessing the quality of medical care, treatment effectiveness, determining the compliance of real clinical practice with existing standards and patient management. Aims: To analyze epidemiological, demographic and clinical characteristics of acromegaly in the Russian Federation and the effectiveness of various treatment methods. Materials and methods: The object of the study was the database of Russian registry of patients with pituitary tumors with specific analysis of patients with acromegaly only. We analyzed the data of 4114 patients with acromegaly stored on the online system in February 2019. Results: Based on the data 32% of patients had complete clinical and laboratory remission of acromegaly; percentage of patients with no remission was 68%, among them 22.5% had significant improvements in clinical symptoms and a decrease in GH and IGF1 without IGF1 normalization. The average age of patients at the onset of the disease was 42.7 years and at diagnosis 45.8 years. Men to women ratio was 1:2.6. In patients with acromegaly hypopituitarism was registered in 14.7% of cases and among them hypothyroidism (66%) and hypogonadism (52%) were registered more often. Among other complications the leading were diabetes mellitus (15.7%) and acromegalic arthropathy (15%). The proportion of patients receiving neurosurgical treatment increased from 35.7% to 49.6% in 2012-2019; the percentage of patients undergoing radiation therapy decreased significantly from 17.7% in 2012 to 0.8% in 2019. Remission was achieved in 40.47% after neurosurgery and 28.95% after medical treatment as a first line therapy p0.01. The number of patients receiving medical treatment at the time of the study was 1209. Among them 51% of patients treated with long-acting lanreotide and 24% receiving long-acting octreotide achieved remission (p0.0001) Conclusions: The remission rate of acromegaly remains suboptimal despite increased surgical activity, which corresponds to global trends. Long-acting lanreotide was significantly superior versus long-acting octreotide in the rate of acromegaly remission, which does not correspond with clinical trials and can be explained by the usage of different generic forms of octreotide, regional differences in medical supply and difficulties in long-acting octreotide injection vs lanreotide.
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