Searchable abstracts of presentations at key conferences in endocrinology ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

ОБОСНОВАНИЕ. Беременность — состояние, при котором происходят важные структурные и физиологические изменения щитовидной железы. В связи с этим экспертами Американской и Европейской тиреоидологических ассоциаций рекомендована разработка специфических референсных интервалов тиреоидных гормонов у беременных женщин с учетом природных и социально географических особенностей исследуемого региона.ЦЕЛЬ. Предложить референсные интервалы для тиреотропного гормона (ТТГ) у беременных женщин, проживающих в условиях легкого дефицита йода (в центральных регионах РФ).МАТЕРИАЛЫ И МЕТОДЫ. В наблюдательное многоцентровое поперечное сплошное исследование были включены 2008 здоровых беременных женщин на разных сроках беременности, проживающих в трех сопоставимых по степени тяжести дефицита йода регионах РФ (Москва, Иваново, Смоленск). У всех беременных женщин определяли уровни ТТГ, антител к тиреоидной пероксидазе, антител к тиреоглобулину в сыворотке крови, экскреции йода с мочой в утренней порции мочи (церий-арсенитным методом). Женщины, имеющие повышенный титр антител к тиреопероксидазе и/или антител к тиреоглобулину по результатам обследования, исключались из исследования (245 женщин). Исследование проводилось с августа 2018 по декабрь 2020 гг., конечным результатом исследования явилась оценка верхнего и нижнего уровней ТТГ и ее сопоставление с йодной обеспеченностью беременных женщин. Результаты оценивались с помощью расчета 2,5 и 97,5 процентилей. Статистически значимыми предполагались различия при р<0,05.РЕЗУЛЬТАТЫ. Нами подтверждено наличие йодного дефицита на исследуемых территориях. Медианная концентрация йода в моче составила в Москве 106 мкг/л, в Иваново — 119 мкг/л, в Смоленске — 134 мкг/л. Пациенткам при первичной постановке на учет в женской консультации был рекомендован прием физиологических доз калия йодида 150–200 мкг в сутки. Женщины были разделены на 2 группы в соответствии с уровнем йодурии. В группе с оптимальным уровнем йодурии уровень ТТГ составил в I триместре 0,006–3,36, во II триместре — 0,20–3,74, в III триместре — 0,33–3,68 мМЕ/л. В группе с легким йодным дефицитом: в I триместре — 0,11–3,00, во II триместре — 0,22–3,78, в III триместре — 0,07–3,04 мМЕ/л. При статистическом анализе данных было выявлено, что при сопоставлении уровней ТТГ по триместрам в зависимости от места проживания статистической разницы не выявлено (p=0,239).ЗАКЛЮЧЕНИЕ. По результатам нашего исследования получены данные о том, что уровень ТТГ у здоровых беременных женщин, проживающих в центральных регионах РФ, сопоставимых по степени тяжести природного йодного дефицита, не превышает 3,8 мМЕ/л во всех триместрах.

Iodine deficiency disorders is a sweeping term that includes structural and functional impairment of the thyroid gland. These clinical guidelines include algorithms for the diagnosis and treatment of euthyroid goiter and nodular/ multinodular goiter in adults and children. In addition, these clinical guidelines contain information on methods for an adequate epidemiological assessment of iodine deficiency disorders using such markers as the percentage of goiter in schoolchildren, the median urinary iodine concentration, the level of neonatal TSH, the median thyroglobulin in children and adults. As well from these clinical guidelines, you can get to know the main methods and groups of epidemiological studies of iodine deficiency disorders.

Riedel's thyroiditis is a rare disease characterized by chronic fibrosis. Clinical performance of this disease is dense stony goiter, which can poorly be displaced during palpation. The overgrowth of the goiter can lead to the development of compression syndrome. To diagnose we need to made fine needle biopsy and made the final diagnose according to its results or according to the morphological description of the postoperative material. An important step in the diagnosis of Riedel's thyroiditis is the determination of serum IgG and IgG4 to exclude an IgG4-associated disease. Treatment of this disease includes drug therapy, which is based on glucocorticosteroids administration or surgical treatment when develops compression syndrome. This article presents a clinical case of a patient with Riedel's thyroiditis; the main complaints were associated with the growth of goiter and the development of compression syndrome. In this regard, patient underwent surgery on the thyroid gland, and after this we get final diagnose. Due to feeling unwell, drug therapy with glucocorticosteroids was prescribed, against the background of which we noted a positive trend.

Background: Throughout all territory of Russian Federation has been confirmed absence of iodine deficiency of varying severity. Chronic iodine deficiency leads to irreversible defects in the intellectual and physical development of children, thyroid gland diseases, including such severe manifestations as functional autonomy and iodine-induced thyrotoxicosis and reproductive disorders. Aims: To assess the awareness of Russians about the effect of iodine deficiency on health and the need to use iodized salt in food. Materials and methods: During November 2019 we conducted an anonymous online survey about iodine deficiency and methods of its prevention. The participants of this survey were 9309 Russians of different age categories. Weasked each respondent six questions regarding their knowledge about the importance of iodine for the body and its supply sources. This study is one-staged, uncontrolled, full-designed, and conducted using Google Forms (Google LLC, 2019). As a result, we summarized data on the awareness of Russians about iodine deficiency disorders and methods for its prevention. Results: 60.4% of respondents is using iodized salt, while the number of respondents who consider prevention with iodized salt to be unhealthy (or have lack knowledge of its effects) is related to the number of respondents who do not use iodized salt. We get that in Volga region only 50% of population is using iodized salt (the lowest level), while 62.83% of the European South inhabitants is using iodized salt. In the rest of Russian Federation, this indicator varies from 52 to 57%. There is a low awareness of the population about prevention of iodine deficiency disorders and as a result myth about the dangers of universal salt iodization are widespread in Russian Federation. Conclusions: Awareness of Russians about prevention of iodine deficiency disorders still remains at a low level, and it is directly affecting the success of ongoing prevention programs.

BACKGROUND : It has been proven that vitamin D plays an important role in pregnancy. Deficiency of this element may be associated with the risk of developing gestational diabetes mellitus, preeclampsia, placentar insufficiency, low birth weight and premature birth. AIMS : To conduct an epidemiological analysis of vitamin D supply in women at different stages of pregnancy, living in Russia. MATERIALS AND METHODS : We included 1198 pregnant women living in 3 regions of Russia in the observational, multicenter, cross-sectional, continuous study. All pregnant women were tested for serum 25(OH)D levels. We collected biomaterial from August 2018 to December 2019. The end point of the study was the indicator of vitamin D supply in pregnant women and its level depending on the trimester of pregnancy and region of Russia. Statistical analysis included counting and grouping according to vitamin D levels, and calculating the median vitamin D concentration in each region. RESULTS : We confirmed vitamin D deficiency in all regions. The optimum level of this element is present in less than 7% of women. Insufficiency of this element is present in 20,62% of all women. The largest percentage of them is in a deficit of this element — 46,66%. We found that the lowest rates are in Smolensk, where the median was 12,75 ng/ml. In addition, we found changes in vitamin D concentration: with an increase in gestational age revealed a decrease in its level. CONCLUSIONS : In our study, we confirmed the presence of a 25(OH)D deficiency in most of the examined pregnant women, which is consistent with international epidemiological data. We should remember about these both at the stage of pre-gravid preparation and at the stage of pregnancy itself in order to achieve the optimal level of vitamin D.

Searchable abstracts of presentations at key conferences in endocrinology ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

A large number of socially significant diseases is accompanied with oxidative stress and carry with tissue damage. Free radicals play a crucial role in the development of these diseases. Similar processes occur under the influence of ionizing radiation and bacterial infections. Recently, was indicated the significant role of oxidative stress in the development of autoimmune thyroiditis. It is assumed that the synthesis of thyroid hormones depends on the concentration of H2O2, which, due to its high toxicity, must be in strict accordance with the activity of antioxidant systems. Many biochemically negative processes occur on the apical membrane of the thyrocyte, which allows limiting the effect of free radicals and avoid cell destruction. However, in pathological conditions, enzymatic systems are disturbed and their components become abnormally activated in the cytoplasm, and it is leads to functional and morphological disorders. A deeper understanding of oxidative stress and its role in the development of autoimmune thyroiditis can contribute to the identification of new methods for its assessment, the expansion of therapeutic ranges for this disease. This review discusses oxidative stress, which is the accumulation of active damaging agents (free radicals, prooxidants, reactive oxygen species) that initiate cell damage and lead to the development of various pathological conditions.

Background: In the Russian Federation, newborn screening comprises thyroid stimulating hormone determination to exclude primary congenital hypothyroidism. Screening is carried out throughout Russia. Neonatal TSH can be used to assess iodine deficiency and monitor iodine prevention programs.Objective: To assess and compare official statistical data on congenital hypothyroidism, the prevalence of hypothyroidism and iodine deficiency syndrome in children, as well as urinary iodine in the Russian regions.Materials and methods: The level of neonatal TSH was determined in 97.69% of children born in the Russian Federation in 2017. This article represents the results on the prevalence of hypothyroidism in the regions with various iodine availability. The correlation analysis was used to assess the relationship of CH incidence in newborns and iodine availability.Results: The calculated correlation coefficient, which was 0.2, reflects a weak relationship between the degree of iodine deficiency in the region and the number of newborns diagnosed with congenital hypothyroidism.Conclusions: In the Russian Federation, a law on universal salt iodization does not exist, and many regions are still in conditions of moderate or severe iodine deficiency. To assess the iodine status in these particular regions, we could use the results of newborn TSH screening

Searchable abstracts of presentations at key conferences in endocrinology ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

In most cases, estimation of tests of the functional state of the thyroid gland does not cause difficulties. Often, according to results of hormonal research, we can conclude that there is a manifest (subclinical) hypothyroidism or a manifest (subclinical) hyperthyroidism. In these situations, difficulties in diagnosing and prescribing treatment to the patient usually do not arise. However, in clinical practice, can be a situation when the results of laboratory researches either do not correspond to clinical picture or do not correspond to the normal functioning of the pituitary-thyroid axis by the principle of log negative relationship. In such situations, quite often inadequate results can be explained by laboratory errors, effect of drugs or existence of genetic disease. Also, recently more and more questions arise in the diagnosis of the syndrome of euthyroid pathology. The correct algorithm of action in this situation will play a key role in diagnosing and identification of further tactics of patient management. In this study will be considered factors that lead to changes in laboratory researches and structured approach to assess functional state of the thyroid gland, which has big importance in clinical practice.

Searchable abstracts of presentations at key conferences in endocrinology ISSN 1470-3947 (print) | ISSN 1479-6848 (online)