Abstract:The research goal is to study the function of kidneys and serum concentration of immunoregulatory cytokines (IL-1ß, IL-6, IL-8, IL-10) in conditions of thyroid hormone deficit. Methods -The character and severity of renal dysfunction were investigated in patients with primary hypothyroidism. The clinical examination included study of serum concentration of creatinine, urea level, potassium and natrium in blood serum, blood and urine analyses, total cholesterol, high and low density lipoproteins, daily microalbuminuria, the performing of Zimnitsky test, urinary excretion of chemokines MCP-1, RANTES, rate calculation of glomerular filtration, thyroid hormone state. ResultsThe renal function in clinical hypothyroidism without concomitant kidney disturbances was characterized by normal parameters of the concentrational kidney function, reduction of glomerular filtration rate, increased of serum creatinine, urea excretion level of chemokine MCP-1 and level of cytokines IL-6, IL-8 in patients with autoimmune hypothyroidism were revealed. Conclusion -It was revealed that autoimmune hypothyroidism effected balance disturbance of cytokine-producing activity of Th1 and Th2 type therefore developing autoimmune state and disease progression.

«Научный диалог: Вопросы медицины» -27 -Фролова А.В., Орлова М.М., Родионова Т.И. Значение цитокинового ответа в развитии поражения сердечно-сосудистой системы при диффузном токсическом зобе ФГБОУ ВО «Саратовский ГМУ им. В.И. Разумовского» (Россия, Саратов) doi:10.18411/spc-15-11-2017-09 idsp: 000001:spc-15-11-2017-09 Аннотация Целью исследования является оценка возможности влияния иммунологических изменений на формирование сердечно-сосудистых осложнений тиреотоксикоза путем определения уровня антител к рецептору тиретропного гормона (АТ-рТТГ), интерлейкинов 6,8,10 (ИЛ-6,8,10) и фактора некроза опухоли-альфа (ФНО -α) у пациентов с диффузным токсическим зобом (ДТЗ) и хронической сердечной недостаточностью (ХСН) и без нее. При обследовании 68 пациентов с ДТЗ, ХСН диагностирована у 38 больных (55,9%), при этом 1 стадия -у 12 пациентов (31,6%), 2А стадия -у 19 (50%) больных, 2Б стадия -у 7 (18,4%) больных. Для проведения анализа пациенты разделены на 3 группы: 1 -без признаков ХСН, 2-с ХСН 1 стадии (так как клинические признаки, характерные для 1 стадии ХСН могут быть также симптомами тиреотоксикоза, данные больные выделены в отдельную группу), 3 -с ХСН 2А и 2Б стадии. Во всех 3 группах отмечено достоверное повышение уровней исследуемых цитокинов и АТ-рТТГ по сравнению с группой контроля. Развитие ХСН у пациентов с ДТЗ ассоциировано с повышением концентрации ИЛ-6, ИЛ-8 и ИЛ-10, также установлено, что прямой корреляции между уровнем АТ-рТТГ и ФНО-α с развитием поражения сердечно-сосудистой системы не выявлено.Ключевые слова: диффузный токсический зоб, хроническая сердечная недостаточность, антитела к рецептору тиреотропного гормона, цитокины. AbstractThe aim of the study is to assess the ability to influence immunological changes on the formation of cardiovascular complications of hyperthyroidism by determining the level of thyrotropin-receptor antibodies (TRAb), 6,8,8,10) and tumor necrosis factor-alpha (TNF -α) in patients with Graves' disease (GD) and chronic heart failure (CHF) and without it. 68 patients were investigated with GD, CHF diagnosed in 38 patients (55.9%), stage 1-in 12 patients (31.6%), stage 2A -in 19 (50%) patients, stage 2B -in 7 (18,4%) patients. For the analysis, patients were divided into 3 groups: 1 -with no signs of heart failure, 2 with CHF 1 stage (because the clinical signs characteristic of heart failure stage 1 can also be symptoms of hyperthyroidism, these patients were in separate group), 3 -CHF 2A and step 2B. In all three patients groups showed a significant increase in the levels of cytokines and TRAb compared with the control group. The development of CHF in patients with Graves' disease is associated with increasing of IL-6, IL-8 and IL-10 concentration. Direct correlation between the level of TRAb, TNF -α and development of the cardiovascular complications in patients with GD have not been identified.

The aim of the study is to assess the ability to influence immunological changes on the formation of cardiovascular complications of hyperthyroidism by determining the level of thyrotropin-receptor antibodies (TRAb), 6,8,10 interleukins (IL-6,8,10) and tumor necrosis factor-alpha (TNF-) in patients with Graves’ disease (Gd) and chronic heart failure (CHF) and without it. 68 patients were investigated with Gd, CHF diagnosed in 38 patients (55.9%), stage 1- in 12 patients (31.6%), stage 2A - in 19 (50%) patients, stage 2B - in 7 (18,4%) patients. For the analysis, patients were divided into 3 groups: 1 - with no signs of heart failure, 2 with CHF 1 stage (because the clinical signs characteristic of heart failure stage 1 can also be symptoms of hyperthyroidism, these patients were in separate group), 3 - CHF 2A and step 2B. In all three patients groups showed a significant increase in the levels of cytokines and TRAb compared with the control group. The development of CHF in patients with Graves’ disease is associated with increasing of IL-6, IL-8 and IL-10 concentration. direct correlation between the level of TRAb, TNF- and development of the cardiovascular complications in patients with Gd have not been identified.

Aim. To compare efficiency of two regimes of basal therapy with human insulin analogs glargin (Lantus) once daily and detemir (Levemir) twicedaily based on their hypoglycemic action (HbA1c

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