Introduction . Gallstone disease (GSD) and type 2 diabetes mellitus (T2DM) are common diseases, but few studies evaluate the clinical course, risk factors, quality of life (QоL), and genetic markers in their comorbidity. Aim . To identify possible associations of gastrointestinal symptoms and blood glucose (BG), HbA1c, insulin resistance indices (IR) – TyG, LAP, quality of life, physical activity (PA) and rs11887534 nucleotide sequence variants (NSV) of the ABCG8 gene in women with gallstone disease (GSD) combined with type 2 diabetes mellitus (T2DM). Materials and methods . In an open, single-stage, single-center, observational, cross-sectional, uncontrolled case series study, 137 patients (women) with GSD were examined: group 1 consisted of 71 patients with GSD and T2DM, Group 2 – 66 patients with GSD without T2DM. The patients were comparable in age and BMI (p > 0.05). All patients receive clinical and biochemical examination: abdominal pain syndrome, dyspeptic symptoms, venous blood – GC, HbA1C; TyG, LAP indices; quality of life according to the SF-36 questionnaires and the specialized for GSD “Gallstone Impact Checklist” (GIC), PA – according to the “Short Questionnaire”, the NSV rs11887534 of the ABCG8 gene was studied using PCR. Results . In patients of group 1, the frequency of abdominal pain syndrome and dyspeptic symptoms, BG indicators are higher than in patients of group 2. In group 1, we did not find an association of gastrointestinal symptoms with BG or HbA1c. In group 1, the TyG (5.09 [4.94; 5.28] and 102.00 [67.21; 130.68]) and LAP indices were higher than in group 2 (4.72 [4.52; 4.93] and 64.60 [36.16; 99.60]), respectively, p < 0.05. In group 1, the TyG and LAP indices were not associated with gastrointestinal symptoms. In group 1, the quality of life according to the SF-36 and GIC questionnaires was worse than in group 2 (p < 0.05); all scales of both questionnaires (except for the PH scale) demonstrated an inverse correlation between the quality of life and the presence and intensity of gastrointestinal symptoms. Patients in group 1 more often noted the absence of PA than in group 2 (71.8% and 40.9%, p < 0.001), less often – intense PA (12.7% and 34.8% in group 2, p < 0.05). In group 1, we did not find any relationships between the levels of PA and the presence of gastrointestinal symptoms. Among patients in group 1, the C allele (14.91%) and the CG genotype (29.82%) rs11887534 ABCG8 were less common than in group 2 (6.34 and 12.68%, p < 0.05). In group 1, we did not find any correlations of the rs11887534 VNP with gastrointestinal symptoms, BG, PA, or quality of life. Conclusions . Among patients of group 1, an inverse correlation was demonstrated between the presence and intensity of gastrointestinal symptoms and quality of life on SF-36 and GIC. Among patients of group 1, we did not find an association of gastrointestinal symptoms with BG, HbA1c, TyG, LAP indices, PA levels or with VNP rs11887534.

The sensory and motor functions of the stomach, including gastric emptying and accommodation, leading to dyspepsia (D), significantly affect energy expenditure, and obesity is characterized by an energy imbalance. However, the data on the association of obesity and FD are heterogeneous. Aim: to assess the prevalence of obesity and D, its types, and to identify a possible association of D with obesity in a population sample (PS) aged 35–54 years. Material and methods. During 2023–2025, a random representative sample of 35–54-year-olds from one of the districts of the city is being surveyed on the basis of NIITPM. Novosibirsk. As part of the gastroenterological fragment, the PS examination of 192 persons (92 men and 100 women) included: gender, age, BMI, filling in the mFSSG D scale (a total score of 6 points corresponded to D). The results are presented as Me [Q25; Q75]. Results. The average age in PS in people with/without D, in men and women did not differ. The prevalence of D in PS (n = 192) was 26.04 % (n = 50), in women – 64.00 %, in men – 36.00 % (p < 0.05). The prevalence of two types of FD: epigastric pain syndrome (EPS) is 24.00 %, and postprandial distress syndrome (PРDS) is 76.00 % (p < 0.05). The prevalence of obesity in the PS of people without D was 24.82%, with D – 32.00 % (p > 0.05). The BMI in individuals with PРDS – 27.54 [23.78; 32.96] kg/m2 exceeded the BMI in individuals with EPS – 23.56 [22.19; 27.02] kg/m2 (p < 0.05). Obesity is associated with the presence of PРDS (rSpearmen = +0.48, p < 0.05). In PS, no association was found between the presence of D and obesity, but among people over 53 years of age with obesity, D was observed 11.2 times more often than in people with normal body mass (p = 0.037). Conclusions. In PS in Novosibirsk, 35–54 years old, D is characterized by a high prevalence, and in women it is 1.78 times higher than in men; PPDS dominates in the D patients. The prevalence of obesity in PS in people with and without D did not differ, however, an association of obesity with D was found in people over 53 years and in people with PPDS.

Aim: to analyze the role of nucleotide sequence variants (NSVs) of ABCG5 and ABCG8 genes in gallstone disease (GSD) and gallbladder cancer (GBC). Key points. ABCG5 and ABCG8 are key sterol efflux transporters that regulate hepatic secretion and intestinal absorption of cholesterol. ABCG5/G8 is the human LITH9 gallstone gene. One of the major genetic risk factors for GSD rs11887534 (D19H) ABCG8 , as a ‘gain-of-function’ NSV, increases the activity of this transporter by 3.2 times, which leads to supersaturation of bile with cholesterol and an increased risk of GSD. On average, rs11887534 increases the risk of GSD in children by 4 times, in adults — by 2 times, which has been proven in population, genome-wide studies and meta-analyses worldwide. The presence of the H allele D19H (rs11887534) is associated with a two-fold risk of recurrence of GSD after cholecystectomy. The results of the studies of the associations of GSD with other NSVs of ABCG8 (T400K, A632V, M429V, C54Y) and ABCG5 (E604Q, R50C) genes are contradictory. In population studies, rs11887534 was associated with a 4-fold increase in the risk of GBC, and the risk is more prominent (4.9 times) in patients with GBC and gallstones. We found no studies of the NSVs of the ABCG5 and ABCG8 genes in biliary pathology in Russia. Conclusion. Most studies confirm the role of the rs11887534 ABCG8 gene as a predictor of GSD and GBC; however, replicating studies of NSVs of ABCG5 and ABCG8 genes in biliary pathology in Russia are needed.

Aim of the study was to characterize the intestinal microbiota and its metabolites in hyperlipidemia and analyze the associations between the intestinal microbiota and some biological (prebiotics and probiotics) and lipid-lowering (statins, fibrates) drugs in the treatment of hyperlipidemia. In hyperlipidemia, the number of bacteria producing toxic metabolites such as lipopolysaccharide and trimethylamine-N-oxide (TMAO) is increased (Bacillota (former Firmicutes), Pseudomonadota (former Proteobacteria), Desulfovibrionaceae) and the number of intestinal producers of beneficial short-chain fatty acids and bile salt hydrolase is decreased (Bacteroidota (former Bacteroidetes), Verrucomicrobia, Bifidobacterium, Lactobacillus, Streptococcus, Eubacterium). Prebiotics can improve lipid metabolism, but the mechanisms of such effect remain unknown. Probiotics (the best studied are Lactobacillus and Bifidobacterium) can remove cholesterol from circulation (by adsorbing and assimilating it on cell membranes), reduce intestinal absorption of cholesterol (by stimulating de novo bile acid synthesis), and modulate cholesterol synthesis (by inhibiting HMG-CoA reductase and reducing the expression of the ATP-associated cassette transporter type A1 gene family). Lactobacillus, in addition to improving the intestinal microbial profile and lipid metabolism, reduces body weight, blood pressure, inflammation, and insulin resistance. Statins and the intestinal microbiota demonstrate mutual influence: a better response to statin treatment is associated with a higher diversity of microbiota, statins are also able to restore the microbiota altered due to pathology to a healthier state (reduce the number of potential pathogens, such as Parabacteroides merdae, and increase the number of beneficial bacteria – Bifidobacterium longum, Bifidobacterium bifidum, Anaerostipes hadrus, Faecalibacterium prausnitzii, Akkermansia muciniphila and the genus Oscillospira, and reduce plasma TMAO levels). Moreover, the effect of statins on the composition and function of the gut microbiota does not depend on a decrease in cholesterol level. The data on the effects of fibrates on the microbiota, studied in mice, are contradictory: in some studies, fenofibrate can reduce caused by a high-fat diet systemic inflammation and lipid metabolism disorders, while in others, on the contrary, it can increase obesity and inflammation. Conclusions. The gut microbiome opens up fundamentally new approaches to the treatment of cardiometabolic diseases in the era of precision medicine.

Mutations with a decrease in the expression and function of the of the ATP-binding cassette genes proteins ABCG5 and ABCG8, as the main sterol efflux transporters, lead to the accumulation of xenosterols in plasma associated with changes in the lipid profile, hyperglycemia and the risk of cardiovascular diseases (CVD) and type 2 diabetes mellitus (DM2). The review presents studies of the role of ABCG5/G8 polymorphisms in CVD and DM2. In several studies, including large–scale ones, the influence of ABCG5/G8 variants (rs4245791, rs41360247 rs4299376, rs11887534, rs7598542, rs78451356, etc.) on the risk of coronary heart disease (CHD) was proved, in others – when confirming the association of the risk of CHD with ABCG5 polymorphism, this status for ABCG8 was denied. Since sterol metabolism disorders observed in individuals with DM2 are probably associated with low insulin sensitivity, many authors confirmed the association of variants rs4299376, rs4148211, rs140231607 and rs6720173 of the ABCG5/G8 with the risk of DM2, but some authors did not find such a connection with DM2 for variants rs4299376, rs11887534 and rs4148217 of the ABCG8. A decrease in ABCG5/G8 mRNA expression was observed in DM2 in experimental animals and in humans; on the contrary, overexpression of ABCG5/G8 in db/db mice restored the sensitivity of the liver to insulin, which led to a decrease in fasting glucose, lipids and improved glucose tolerance. The inconsistency of data on the association of ABCG5/G8 gene polymorphism with the risk of CVD and DM2 may probably be due to inter-population differences, which necessitates further study of the contribution of ABCG5/G8 variants to the risk of these diseases.

A number of human and animal studies have demonstrated that the hyperglycemia-lowering effects of metformin may result from modulation of the gut microbiota population. Metformin changes the Firmicutes/Bacteroidetes ratio and enhances the growth of some bacteria, such as Akkermansia muciniphila, Escherichia spp. or Lactobacillus and reduce the levels of others such as Intestinibacter. Moreover, in the intestine, metformin not only improves glucose absorption, but also promotes the production of short-chain fatty acids (SCFAs), regulates the secretion of the glucose-lowering hormone glucagon-like peptide 1 (GLP‑1) and other intestinal peptides, inhibits the Farnesoid-X-receptor (FXR) and resorption of the bile acid pool, and may reduce intestinal permeability barrier by increasing the expression of mucin and tight junction proteins, modulates the immune response, has an anti-inflammatory effect, etc. Thus, research results indicate that the intestinal microbiota is involved not only in the hypoglycemic effect of metformin in diabetes mellitus type 2, but also in the implementation of its numerous pleiotropic effects.

Введение. Желчнокаменная болезнь (ЖКБ) является одной из наиболее важных проблем общественного здравоохранения. Ее распространенность составляет 10–20 % в развитых странах мира, в целом ежегодные медицинские расходы на лечение ЖКБ превысили 6 млрд долларов в 2004 г. [1, 2].

Аim: to present data of Russian and foreign studies about association between physical activity (PA) and gallstone disease (GSD).Key point. A low PA level is one of the four major risk factors for chronic non-infectiuos diseases. The frequency of low PA in men and women of the Russian Federation (according to the medical examination in 2016) is 19 %. The global prevalence of GSD is up to 20 % among adults. Many systematic reviews and meta-analyses have confirmed an inverse association between GSD and PA in the world, regardless of potential risk factors for GSD, with a clear dose-dependent effect — the relative risk (RR) of GSD was 0.87 (95 % CI 0.83–0.92) per 20 metabolic equivalents (MET) of PA per week. According to our results of an epidemiological survey in the framework of the WHO MONICA program in Novosibirsk (n = 870) among women aged 25–64 with low total PA (less than 800 MET/min/week), as well as with the first class of PA in leisure-time, GSD occurred much more often (class 1 — 33 %, classes 2–4 — 8.7–11.0 %, p < 0.01). PA favorably affects almost all mechanisms of gallstone formation: improves cholesterol metabolism in bile, increases serum HDL cholesterol, bile acid synthesis, stimulates the release of cholecystokinin, reduces mucin hypersecretion, increases the diversity and richness of the intestinal microbiota. Daily PA serves as a preventive measure for GSD: the risk of GSD is reduced by 66 % (95 % CI 0.18–0.86).Conclusion. EASL has recognized PA as a protective agent against gallstone formation.

Aim of the study was to explore the impact of apolipoprotein E (APOE) gene polymorphisms (GP) on gallstone disease (GSD) and type 2 diabetes mellitus (DM2) and its role in lipid metabolism. APOE4 allele carriers had the highest levels of plasma and bile cholesterol and the lowest levels of bile acids in bile than other alleles. In GSD a higher frequency of APOE4 carriers (2.6 times compared to control) was found. GSD risk was reduced by 12 % in APOE2 carriers compared to APOE3/3. Our 20-year research confirms the association of APOE GP and GSD. The frequency of ε4/ε4 genotype is higher in people aged 18–35 years with a family history of GSD (5.8 %) compared to population of Novosibirsk (1.8 %, p < 0.05). The bile was more lithogenic in APOE4 carriers with GSD: the bile cholesterol level is 8.0 ± 0.5 versus 6.9 ± 0.6 g/l in ε3/ε3 genotype. APOE4 carriers with a family history of GSD had cholate-cholesterol ratio of 6.4 ± 0.7 versus 12.9 ± 0.2 (p < 0.05) in the absence of APOE4. in women with hypertension, the presence of GSD was associated with a combination of low density cholesterol (LDL-C) > 3.5 mmol/l and the APOE4 carriage. DM2 is a recognized risk factor for GSD. The most common opinion is that the ε4 allele is an independent risk of DM2, some authors consider the allele APOE2. Moreover, DM2 patients with the ε3/ε4 genotype have an increase in total cholesterol, LDL-C and non-high-density lipoprotein cholesterol compared to ε3/ε3. Other studies have not found any associations between APOE GP and GSD or DM2. The inconsistency of the data can be explained by the heterogeneity of the included groups and methods of APOE genotyping, which requires further research.

Аim: to evaluate metabolic risk factors and their impact on quality of life in patients with pancreatic cancer (PC) and in patients with acute or exacerbated chronic pancreatitis.Materials and methods. Forty-five patients with PC (group 1) and 141 patients with acute pancreatitis or exacerbated chronic pancreatitis (group 2) in an observational multicenter clinical cross-sectional uncontrolled study were examined. Clinical, laboratory and instrumental examination of patients and assessment of risk factors (lipid profile, blood plasma glucose, obesity, arterial hypertension) were carried out in accordance with clinical recommendations. Patients completed the SF-36 questionnaire once to assess quality of life at hospital admission before treatment.Results. In group 1, indicators of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) in blood serum (3.7 ± 0.2; 2.2 ± 0.2 and 0.8 ± 0.1 mmol/L) were lower than in group 2 (5.1 ± 0.1; 3.1 ± 0.1 and 1.2 ± 0.1 mmol/L; p < 0.05). Arterial hypertension was more common in group 1 (55.6 %) than in group 2 (34.8 %; p = 0.013). The presence of arterial hypertension increases the chance of having PC by 2.7 times (p < 0.05). Body mass index parameters, including obesity, as well as parameters of triglycerides, and fasting plasma glucose, did not differ between the groups. Logistic regression analysis revealed a direct relationship with PC HDL hypocholesterolemia (Exp B = 4.976; p < 0.001) and arterial hypertension (Exp B = 2.742; p = 0.027) and an inverse relationship — with hypercholesterolemia (Exp B = 0.204; p = 0.002). The chance of having PC was not associated with age, fasting plasma glucose ³ 7.0 mmol/L, obesity. Quality of life indicators were higher in group 1 than in group 2 on four SF-36 scales: bodily pain (68.1 ± 5.1 and 36.8 ± 2.0; p < 0.001), general health (51.1 ± 2.5 and 38.0 ± 1.7 points; p < 0.001), social functioning (74.7 ± 3.0 and 64.5 ± 2.2 points; p = 0.007), role emotional functioning (28.2 ± 5.2 and 12.5 ± 3.1 points; p = 0.007) and in the general domain “physical component of health” (40.2 ± 1.0 and 33.6 ± 0.8 points; p < 0.001). In group 1 with HDL hypocholesterolemia compared with its absence, the indicators of role emotional functioning (22.2 ± 5.1 and 51.9 ± 13.7 points; p = 0.020) were lower, with arterial hypertension compared with its absence — role physical functioning (5.0 ± 4.0 and 25.5 ± 7.5 points; p = 0.036) and role emotional functioning (16.0 ± 5.1 and 43.3 ± 8.8 points; p = 0.007) were lower.Conclusions. In patients with PC arterial hypertension was more common and the levels of total cholesterol, LDL-C and HDL-C were lower than in patients with acute or exacerbated chronic pancreatitis. The chance of having PC is directly associated with HDL hypocholesterolemia, with arterial hypertension, inversely — with hypercholesterolemia, and is not associated with age, fasting plasma glucose ³ 7 mmol/L, or obesity. In patients with PC, quality of life indicators were higher on four SF-36 scales and on the general domain “physical component of health” than in the group with acute or exacerbated chronic pancreatitis. In patients with PC metabolic factors significantly worsened self-assessment of quality of life in terms of role functioning; in patients with acute or exacerbated chronic pancreatitis there was no such association.

Введение. желчнокаменная болезнь (ЖКБ) встречается у 10–20 % населения в экономически развитых странах. ЖКБ связана с несколькими кардиометаболическими факторами риска: ожирением, дислипидемиями, нездоровым питанием и малоподвижным образом жизни [1, 2]. Наличие ЖКБ значительно увеличивает риск сахарного диабета 2 типа (СД2), сердечно-сосудистых заболеваний, включая ИБС и артериальную гипертензию (АГ), что было доказано в нескольких эпидемиологических исследованиях [3–6]. СД приводит к увеличению индекса насыщения желчи и к гипомоторике желчного пузыря изза висцеральной невропатии, ожирения, гиперинсулинемии, резистентности к инсулину, что может способствовать образованию желчных камней [3]. Связь между АГ и ЖКБ основывается, в частности, на активизации эфферентных симпатических механизмов, ренин-ангиотензин-альдостероновой системы с нарушением моторики желудочно-кишечного тракта из-за импульсации от механорецепторов желчного пузыря при его растяжении, что приводит к повышению АД [5]. Однако при изучении связи ЖКБ и Аг показаны противоречивые результаты [3, 7]. Кроме того, мы не нашли исследований ассоциации АГ с ЖКБ в сочетании с СД2.

This article provides an overview of the metaanalyzes (PubMed, 19952019) of alcohol and non-alcoholic (coffee, tea, dairy products) beverage consumption in relation to risk of pancreatic cancer PC (PubMed, 19952019). Increased the PC risk was associated with high alcohol intake. The increased risk for heavy drinking did not explained by residual confounding by history of pancreatitis or tobacco smoking or diabetes. Light-moderate alcohol intake may reduced the PC risk, probably due to the fasting insulin levels decrement, which leads to the diminished the РС risk. The association between alcohol and the PC was stronger in men than in women. Some metaanalyzes demonstrated that a small amount of coffee may reduce PC risk, and a large amount to increase PC risk. Another meta-analyzes have not confirmed any association between the PC risk and coffee or tea consumption. One meta-analysis revealed a direct association of the PC risk with the dairy products consumption, but most research showed no such connection. Nutrition is considered to be associated with the PC risk, but the degree of risk due to structure of beverages consumption (dose, duration, alcohol, coffee, tea, dairy products pattern) is still not clear.

Исследованы размерно-весовые характеристики культивируемых двустворчатых моллюсков подвесного выращивания в зал. Посьета (зал. Петра Великого, Японское море) за 1970–2011 гг. Представлен анализ сезонной изменчивости веса и размера раковин приморского гребешка Mizuhopecten yessoensis (Jay, 1857), тихоокеанских мидии Mytilus trossulus (Gould, 1850) и устрицы Crassostrea gigas (Thunberg, 1793) в течение первых трех лет выращивания. Определены средние даты достижения личинками и спатом размеров 0.2, 5 и 20 мм. Проведено сравнение с продукционными показателями культивируемых моллюсков из других районов Японского моря.

AIM To identify and compare the frequency of alcohol consumption, tobacco smoking, levels of main macronutrients, vitamins and mineral elements consumption in patients with acute (AP) and chronic pancreatitis (CP) and pancreatic cancer (PC). MATERIALS AND METHODS At the observational clinical cross-sectional uncontrolled case-study 65 patients with AP or CP (group 1) and 45 patients with PC (group 2) were examined. A survey of patients was carried out: questionnaire on tobacco smoking, a frequency questionnaire on alcohol consumption, a questionnaire for assessing the frequency of food consumption. RESULTS The frequency of smoking (33.8, 20.0%; p0.05), alcohol consumption 1 times/week during the last year (21.5, 15.6%; p0.05) did not differ significantly between the two groups. The highest consumption rates of total, vegetable, animal protein, total carbohydrates, refined sugar, animal fat, cholesterol, MUFA, dietary fiber, vitamins (-carotene, vitamin B1, B2, C, PP), mineral elements (iron, potassium, calcium, magnesium, sodium, phosphorus) and the daily energy content of the diet were determined in PC than in the AP and CP group. Among patients of group 1, deficient intake of fat-soluble vitamin A (93.3, 54.8%; p=0.009) and vitamin E (80.0, 48.4%; p=0.041) was more common in the subgroup of patients with excretory pancreatic insufficiency than without it, and the chance of having hypercholesterolemia was associated with a deficient intake of vitamin E [Ex(B)=3.3, 95% CI 1.59.3; p=0.027]. CONCLUSION There were no differences in the frequency of smoking and alcohol consumption between patients with AP and CP and PC. The highest indices of the main macronutrients, daily energy content of the diet, micronutrients (except for vitamins A, E) were found in PC than in the group of patients with AP and CP. Among patients with AP and CP with excretory pancreatic insufficiency, a lower intake of fat-soluble vitamins was noted and associations of hypercholesterolemia with deficient intake of vitamin E were obtained.

Obesity is a major risk factor for developing gallstone disease (GSD). Previous studies have shown that obesity is associated with an elevated Firmicutes/Bacteroidetes ratio in the gut microbiota. These findings suggest that the development of GSD may be related to gut dysbiosis. This review presents and summarizes the recent findings of studies on the gut microbiota in patients with GSD. Most of the studies on the gut microbiota in patients with GSD have shown a significant increase in the phyla Firmicutes (Lactobacillaceae family, genera Clostridium, Ruminococcus, Veillonella, Blautia, Dorea, Anaerostipes, and Oscillospira), Actinobacteria (Bifidobacterium genus), Proteobacteria, Bacteroidetes (genera Bacteroides, Prevotella, and Fusobacterium) and a significant decrease in the phyla Bacteroidetes (family Muribaculaceae, and genera Bacteroides, Prevotella, Alistipes, Paludibacter, Barnesiella), Firmicutes (genera Faecalibacterium, Eubacterium, Lachnospira, and Roseburia), Actinobacteria (Bifidobacterium genus), and Proteobacteria (Desulfovibrio genus). The influence of GSD on microbial diversity is not clear. Some studies report that GSD reduces microbial diversity in the bile, whereas others suggest the increase in microbial diversity in the bile of patients with GSD. The phyla Proteobacteria (especially family Enterobacteriaceae) and Firmicutes (Enterococcus genus) are most commonly detected in the bile of patients with GSD. On the other hand, the composition of bile microbiota in patients with GSD shows considerable inter-individual variability. The impact of GSD on the Firmicutes/Bacteroidetes ratio is unclear and reports are contradictory. For this reason, it should be stated that the results of reviewed studies do not allow for drawing unequivocal conclusions regarding the relationship between GSD and the Firmicutes/Bacteroidetes ratio in the microbiota.

The last decade saw extensive studies of the human gut microbiome and its relationship to specific diseases, including gallstone disease (GSD). The information about the gut microbiome in GSD-afflicted Russian patients is scarce, despite the increasing GSD incidence worldwide. Although the gut microbiota was described in some GSD cohorts, little is known regarding the gut microbiome before and after cholecystectomy (CCE). By using Illumina MiSeq sequencing of 16S rRNA gene amplicons, we inventoried the fecal bacteriobiome composition and structure in GSD-afflicted females, seeking to reveal associations with age, BMI and some blood biochemistry. Overall, 11 bacterial phyla were identified, containing 916 operational taxonomic units (OTUs). The fecal bacteriobiome was dominated by Firmicutes (66% relative abundance), followed by Bacteroidetes (19%), Actinobacteria (8%) and Proteobacteria (4%) phyla. Most (97%) of the OTUs were minor or rare species with ≤1% relative abundance. Prevotella and Enterocossus were linked to blood bilirubin. Some taxa had differential pre- and post-CCE abundance, despite the very short time (1–3 days) elapsed after CCE. The detailed description of the bacteriobiome in pre-CCE female patients suggests bacterial foci for further research to elucidate the gut microbiota and GSD relationship and has potentially important biological and medical implications regarding gut bacteria involvement in the increased GSD incidence rate in females.

BACKGROUND: «The vicious circle» of associations of diabetes mellitus (DM) with pancreatic pathology, when pancreatic diseases can initiate DM, and type 2 DM — cause functional and organic pancreatic pathology, determines the search for possible associations. Some studies have established a relationship between TNF or TP53 polymorphisms with DM or with pancreatic diseases. AIMS: to determine and compare fasting plasma glucose and the frequency of hyperglycemia in patients with acute pancreatitis (APp), chronic pancreatitis (CPp), pancreatic cancer (PCp) depending on gender, etiology or stage of the disease, polymorphism -308G/A TNF gene in all patients, and polymorphism 72Arg/Pro gene TP53 in PCp.. MATERIALS AND METHODS: At the observational multicenter clinical cross-sectional uncontrolled case-study 44 APp, 97 CPp and 45 PCp were examined; the groups were comparable by sex/age. Informed consent form for participate in the study was obtained from all patients. The main outcome of the study: frequency of hyperglycemia in APp, CPp, PCp, considering the polymorphism TNF and TP53 genes. RESULTS: The lowest age-standardized fasting plasma glucose (FPG) was found in CPp (6,2±0,2 mmol/l) than in APp (6,7±0,2 mmol/l, p=0,041). In PCp (6,6±0,2 mmol/l), the average levels of FPG did not differ substantially when compared with APp (p=0,749) or CPp (p=0,092). In APp, the norm of GP was detected less frequently (31,8%) than in CPp (54,6%, χ2 =6,3, p=0,012), and the frequency of the norm of GP in PCp (48,9%) did not differ with that in APp or CPp. The frequency of FPG≥6,1<7,0 mmol/l did not differ in APp (20,5%), CPp (9,3%) or PCp (17,8%). The frequency of FGP≥7.0 mmol/l did not differ in APp CPp and PCp: 47,7, 36,1, 33,3%. Logistic regression analysis revealed a tendency for an increased chance of having stage 3–4 PC with FPG≥7,0 mmol/l (Exp (B)=3,205 95%CI 0,866–11,855, p=0,081) in PCp, but not in patients with pancreatic necrosis or “definite» СP.The frequencies of G/G (71,4, 74,7, 76,2%), G/A (26,2, 24,1, 23,8%) of TNF genotypes did not differ in APp, CPp or PCp, p>0,05. In PCp genotypes Arg/Arg, Arg/Pro, Pro/Pro polymorphism gene 72Arg/Pro TP53 in 2,4, 35,7, 61,9% of cases. No associations of GP≥7,0 mmol/l with TNF polymorphism in APp, CPp, PCp and with TP53 polymorphism in PCp were obtained. CONCLUSIONS: The frequency of FGP≥7,0 mmol/l did not differ for various pancreatic disease and was not associated with the risk of pancreatic necrosis and “defined” CP. The -308G/A polymorphism TNF gene did not differ in APp, CPp or PCp and was not associated with impaired carbohydrate metabolism. The 72Arg/Pro polymorphism TP53 gene in PCp was not associated with impaired carbohydrate metabolism.

Gallstone disease (GSD) has, for many years, remained a high-cost, socially significant public health problem. Over the past decade, a number of studies have been carried out-both in humans and in animal models-confirming the role of the microbiota in various sections of the gastrointestinal tract as a new link in the etiopathogenesis of GSD. The microbiome of bile correlates with the bacterial composition of saliva, and the microbiome of the biliary tract has a high similarity with the microbiota of the duodenum. Pathogenic microflora of the oral cavity, through mechanisms of immunomodulation, can affect the motility of the gallbladder and the expression of mucin genes (MUC1, Muc3, MUC4), and represent one of the promoters of stone formation in the gallbladder. The presence of H. pylori infection contributes to the formation of gallstones and affects the occurrence of complications of GSD, including acute and chronic cholecystitis, cholangitis, pancreatitis. Intestinal bacteria (Clostridium, Bifidobacterium, Peptostreptococcus, Bacteroides, Eubacterium, and Escherichia coli) participating in the oxidation and epimerization of bile acids can disrupt enterohepatic circulation and lead to the formation of gallstones. At the same time, cholecystectomy due to GSD leads to the further transformation of the composition of the microbiota in various parts of the gastrointestinal tract, increasing the risk of developing stomach cancer and colorectal cancer. Further research is required to determine the possibility of using the evaluation of the composition of the microbiota of the gastrointestinal and biliary tracts as an early diagnostic marker of various gastroenterological diseases.

BACKGROUND: In the XXI century, the frequency of pancreas diseases increased 2–3 times. The expectation that causes a pandemic lead to the development of a number of diseases. The results of studies on the relationship of overweight, obesity with the risk of developing pancreas diseases (acute pancreatitis (AP), chronic pancreatitis (CP) and pancreas cancer (PC)) are very heterogeneous (for AP and PC) and not numerous (for CP). AIMS: to identify the frequency of obesity in AP patients (APр), CP patients (СPр) and PC patients (PCр) and compare these parameters. MATERIALS AND METHODS: at the observational multicenter clinical cross-sectional uncontrolled case-study 44 APp, 97 CPp and 45 PCp were examined; the groups were comparable by sex/age. Informed consent form for participate in the study was obtained from all patients. The main outcome of the study: the frequency of obesity in APp, CPp; PCp. RESULTS: The frequency of obesity in APp (13,6%), CPp (24,7%) and PCp (20,0%) did not differ significantly. Among the examined patients, the lowest average BMI (24,2±0,7 kg/m 2 ) was observed in APp (p=0,049). BMI ≥22,5 kg/m 2 was found to be associated with AP (OR=0,398; 95%CI 0,195–0,812; p=0,011). An inverse relationship was shown between the BMI and “definite” CP (Exp (B)=0,772; 95%CI 0,632–0,942; p=0,011). In men with CP and in CPp alcoholic etiology, weight deficit was observed significantly more often than in women with CP and in CPp biliary etiology, respectively. Earlier (a year before the present survey), obesity was more common in PCp (55,6%) than in APp (13,6%, χ 2 =3,3; p=0,000) and CPp (25,8%, χ 2 =12,0; p=0,001). A history of obesity (in our study one year before PC detection) and PC (OR=4,435; 95% CI 2,180–9,025; p=0,000) direct relationship was shown. CONCLUSIONS: the frequency of obesity in APp, CPp and PCp was similar. The average BMI was higher in APp, than in CPp and PCp. BMI≥22,5 kg/m2 was a protective factor for AP. BMI was inversely associated with “defined” CP. A history of obesity was directly associated with PC.

BACKGROUND: In the XXI century, the frequency of pancreas diseases increased 23 times. The expectation that causes a pandemic lead to the development of a number of diseases. The results of studies on the relationship of overweight, obesity with the risk of developing pancreas diseases (acute pancreatitis (AP), chronic pancreatitis (CP) and pancreas cancer (PC)) are very heterogeneous (for AP and PC) and not numerous (for CP). AIMS: to identify the frequency of obesity in AP patients (APр), CP patients (СPр) and PC patients (PCр) and compare these parameters. MATERIALS AND METHODS: at the observational multicenter clinical cross-sectional uncontrolled case-study 44 APp, 97 CPp and 45 PCp were examined; the groups were comparable by sex/age. Informed consent form for participate in the study was obtained from all patients. The main outcome of the study: the frequency of obesity in APp, CPp; PCp. RESULTS: The frequency of obesity in APp (13,6%), CPp (24,7%) and PCp (20,0%) did not differ significantly. Among the examined patients, the lowest average BMI (24,20,7 kg/m2) was observed in APp (p=0,049). BMI 22,5 kg/m2 was found to be associated with AP (OR=0,398; 95%CI 0,1950,812; p=0,011). An inverse relationship was shown between the BMI and definite CP (Exp (B)=0,772; 95%CI 0,6320,942; p=0,011). In men with CP and in CPp alcoholic etiology, weight deficit was observed significantly more often than in women with CP and in CPp biliary etiology, respectively. Earlier (a year before the present survey), obesity was more common in PCp (55,6%) than in APp (13,6%, 2=3,3; p=0,000) and CPp (25,8%, 2=12,0; p=0,001). A history of obesity (in our study one year before PC detection) and PC (OR=4,435; 95% CI 2,1809,025; p=0,000) direct relationship was shown. CONCLUSIONS: the frequency of obesity in APp, CPp and PCp was similar. The average BMI was higher in APp, than in CPp and PCp. BMI22,5 kg/m2 was a protective factor for AP. BMI was inversely associated with defined CP. A history of obesity was directly associated with PC.