We determined the levels of TSH, free T4 (fT4), immunoregulatory proteins (alpha-2-macroglobulin (α2-MG), lactoferrin (LF), alpha-1-antitripsin (α1-AT) , and cytokines (TNF-alpha, IL-6, IFN-gamma)) in the blood of 50 women presenting with diffuse toxic goiter (DTG) and 35 women with autoimmune thyroiditis (AIT) before and 4-6 months after the treatment. Thirty healthy women served as controls. Hypothyroidism in the outcome of AIT was associated with hypercytokinemia and the enhanced levels of a2-MG and LF, but not a1-AT. The treatment had no effect on these parameters but normalized the TSH and T4 levels. Manifest DTG was associated with the increased IFN-gamma, IL-6, α2-MG, LF, and α1-AT levels . The treatment during 4-6 months resulted in the reduction of the IL-6 and α2-MG levels whereas the hormonal status of the patients became normal. The persistence of certain disturbances suggested that dysfunction of the immune system was not totally corrected despite the normalization of the hormonal status and could be interpreted as the risk factor of a relapse of thyroid pathology.

Background. Immunoregulatory proteins (alpha-2-macroglobulin, lactoferrin) actively participate in inflammatory and autoimmune processes, affect synthesis and transport of hormones and cytokines, and control cell proliferation and apoptosis. However, the role of these proteins in the pathogenesis of Graves disease (GD) is poorly understood. Objective the study objective was to determine blood levels of alpha-2-macroglobulin (2-MG), lactoferrin (LF), and cytokines (TNF-, IL-6, IL-8, and IFN-) in GD. Material and methods. We determined blood levels of TSH, free T4, TSH receptor antibodies, TNF-, IL-6, IL-8, IFN-, and LF by ELISA as well as 2-MG by quantitative rocket immunoelectrophoresis in 50 patients with decompensated and compensated (4―6 months and 1.5―2 years after treatment onset) GD and 25 healthy females (control group). Results. GD clinically manifested by body weight l in 84% of patients, sinus tachycardia in almost all patients, paroxysmal atrial fibrillation in 18% of cases, endocrine ophthalmopathy in 12% of patients, and neurological changes. In decompensated GD, there was a statistically significant increase in levels of IFN-, IL-6, and 2-MG and an especially significant increase in levels of IL-8 and LF. At 4―6 months after treatment onset, clinical manifestations were stopped in all patients, levels of IL-6 and 2-MG decreased, but the concentrations of TSH receptor antibodies (TSHR-Abs), IL-8, IFN-, and LF remained elevated. At 1.5―2 years, levels of the studied proteins and cytokines did not differ from those in the control group. Conclusion. An increase in blood levels of IL-8, LF, IL-6, and 2-MG in incident or recurrent GD and a decrease in the levels during treatment confirm involvement of immunoregulatory proteins in pathogenesis of the disease.

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The indigenous population of Mountainous Altai and the slavic population of Kuzbas Region with a thyroid gland pathology is surveyed. Prognostic algorithms of an estimation of peripheric action of hormones of a thyroid gland are made. Algorithms of inspection of patients with a diffusive struma can be recommended for practical use. For monitoring of an autoimmune pathology of a thyroid gland the estimation of a quantitative parity of a thyritropic hormone, an α2-macroglobulins and IL-6 in blood serum has prognostic value.

The analysis of results of examination of 2569 visitors of health center was carried out. The study of nutrition status of242 women with different body mass revealed surplus of intake of fats, carbohydrates, caloricity of day diet in persons with obesity and tendency of its increasing as far as body mass increases. On the basis of characteristics of structure of diet the program «School of rational diet» is developed. The comparison of laboratory, diagnostic and resource possibilities of health center with algorithm of treatment of patients with surplus body mass and obesity established large possibilities of health center not only in diagnostic (examination of diet and metabolic status) but in complex treatment of patients with different body mass. These possibilities include behavioral (development of motivation to change life-style), non-medicinal (diet therapy) and medicinal therapy. At the expense of group and individual prevention counseling in «School of rational diet» the implementation of such an approach promoted decreasing of body mass during a month (on 2.18±1.28 kg) in 64.4% of listeners of «School of rational diet».