Introduction. The study of pathogenetic factors of obesity is an urgent task of modern medicine. The formation of obesity is characterized by changes in the activity of individual mechanisms of innate immunity. At the same time, the values of laboratory indicators that characterize them are often within the current boundaries of the reference values of laboratory indicators of the immunity of a healthy person. This complicates the pathogenetic assessment of the mechanisms of nonspecific immunological reactivity in obesity and determines the need for further study of the characteristics of nonspecific immune defense factors in this pathology.Aim. To identify the features of changes in cellular and humoral factors of nonspecific immunological reactivity in obesity.Materials and methods. A single-center cross-sectional, one-time controlled study was conducted with the participation of 118 people, of which 87 people were obese patients (BMI 37.2 [34.1; 42.05] kg/m2), 31 people had normal body weight (BMI 21.9 [ 20.2; 23.5] kg/m2) and were included in the control group. All patients underwent a study of lipid profile (total cholesterol, high-density lipoproteins, low-density lipoproteins, very low-density lipoproteins, triglycerides), carbohydrate metabolism (glucose, insulin, glycated hemoglobin), C-reactive protein, indicators of cellular and humoral factors of nonspecific immunity (leukogram, cytokine profile, C3-C4 complement components).Results. An increase in the total number of leukocytes was revealed, due to neutrophil granulocytes against the background of the development of a disproportion between the percentage and absolute value of the number of lymphocytes and monocytes, the concentration of C3 and C4 complement components, C-reactive protein, as well as an increase in the level of IL-6, which confirms the presence of low-grade chronic inflammation in obese patients. Statistically significant correlations of immunological parameters with anthropometric data, indicators of carbohydrate and lipid metabolism were revealed.Conclusion. The results of the study indicate that obesity causes activation of certain cellular and humoral mechanisms of nonspecific immune defense involved in the formation of the inflammatory process. Confirmation of the presence of a latent inflammatory process in obesity is an increase in the level of leukocytes and their individual cellular forms, C-reactive protein, C3 and C4 complement components, IL-6. A feature of the changes is the presence of fluctuations in the values of the studied indicators within the current boundaries of the reference values of laboratory indicators, which makes it difficult to timely diagnose chronic inflammation in obesity

The goal of modern insulin therapy used in the treatment of diabetes mellitus is to mimic physiologic insulin secretion by pancreatic beta cells. The new ultrafast-acting insulin analog aspart (UFAiAsp) demonstrates a faster onset and shorter duration of action compared to the ultra-short-acting insulin analog aspart (USAIasp), which substantiates the possibility of insulin administration immediately before meals, which helps to improve glycemic control by regulating postprandial glucose levels, improving patients' quality of life. We conducted a literature search for the period from 2012 to 2023 in the electronic databases PubMed, Elibrary.ru, and Cophrane library of scientific information on the efficacy and safety of ultrafast-acting insulin aspart in comparison with USAIasp. With the use of UFAiAsp, a reduced risk of late postprandial hypoglycemia due to increased absorption rate and earlier termination of the sugar-lowering effect was observed. The problem of using ultrafast-acting insulin aspart in our country, which is solved by the admission of biosimilar drugs (biosimilars) to the market, is considered. It was shown that the domestically produced biosimilar UFAiAsp (RinFast® Nick) registered in the Russian Federation is recognized as interchangeable with the original UFAiAsp (Fiasp®) in terms of bio- and therapeutic equivalence, immune safety, good tolerability, and also meets the specification norms when used for continuous subcutaneous infusion in terms of physicochemical parameters. Dosing accuracy and absence of occlusions in the systems over 72 hours with the new biosimilar in pumps have been proven. Consequently, UFAiAsp can be recommended for all patients, including children, who require the prandial component of insulin therapy.

BACKGROUND:The prevalence of obesity is rising dramatically worldwide. Recently, there is increasing evidence linking obesity with the functional state of the intestinal microbiota. The understanding of this relationship may provide new approaches to the treatment of obesity by manipulating the qualitative and quantitative parameters of intestinal bacterial-fungal associations. AIM:To study the features of the qualitative and quantitative composition of the colon microbiota and to evaluate associations with anamnestic, anthropometric and biochemical parameters in young obese patients. MATERIALS AND METHODS:A single-center, cross-sectional, single-stage, controlled study was conducted with the participation of 118 young people, of whom 87 were obese, and 31 people with normal body weight formed the control group. All participants underwent a biochemical blood test (total cholesterol, high-density lipoproteins, low-density lipoproteins, very low-density lipoproteins, triglycerides, uric acid, glucose, glycated hemoglobin, C-reactive protein), as well as an assessment of the state of the colon microbiota using polymerase chain reaction in real time using a set of Colonoflor-16 (premium) reagents. The Microsoft Excel 2010 and IBM SPSS Statistics 26.0 application software package was used for statistical calculations. The results were evaluated as statistically significant at a level of p<0.05. RESULTS:Analyzing the result of Colonoflor-16 premium, the discrepancy between the obtained data of the control group and the reference values of the analysis was revealed. There was a clear tendency to decrease the content of Lactobacillus spp and Bifidobacterium spp in the obesity group. In addition, in comparison with the control group (10.3%), in the obesity group Fusobacterium nucleatum significantly prevailed (37.6%) (p=0.005), with a significant decrease in the bacteria Faecalibacterium prausnitzii (p=0.030), and an increase in the bacteria Prevotella spp (p=0.029). A lot of associations of representatives of the colon microbiota with the most important anamnestic, anthropometric and biochemical parameters were revealed in young obese patients. CONCLUSION:There is a redistribution of microbiota phylotypes characterized by a decrease in apathogenic microorganisms and the appearance and increase of opportunistic and pathogenic microorganisms, which generally indicates the formation of the pro-inflammatory potential of dominants and associates in young obese patients. The presence of statistically significant correlations strongly indicates of existence of close and diverse relationships between the quantitative and qualitative parameters of the microbiota and the metabolic parameters of patients.

Thiazolidinediones (TDD) are a group of hypoglycemic drugs used for the treatment of type 2 diabetes mellitus (DM). TDD are synthetic ligands of PPAR-γ-receptors activated by the proliferator peroxisome. When TDD is combined with PPAR-γ-receptors, transcription of genes regulating carbohydrate and lipid metabolism is triggered. TDD has protective properties against pancreatic β-cells, as it reduces glucose and lipotoxicity. These drugs reduce insulin resistance, have a positive effect on fat metabolism. This effect makes it possible to use one of the representatives of the class in the treatment of non-alcoholic fatty liver disease (NAFLD), which is confirmed by clinical recommendations from different countries. Type 2 diabetes and NAFLD are diseases closely related to each other by common pathogenetic patterns. When combined, patients have a high risk of developing non-alcoholic steatohepatitis, cirrhosis of the liver and hepatocellular carcinoma, as well as worsening of the course of diabetes mellitus. For many years, drugs of the thiazolidinedione class remained in the shadows due to the negative experience of using specific representatives – hepatotoxic troglitazone and increasing the risk of cardiovascular complications of rosiglitazone. The representative of the pioglitazone class, which has many proven positive effects on the cardiovascular system, lipid metabolism and the course of NAFLD, remained forgotten. It is necessary to find out whether hepatotoxicity is actually a class-effect of TDD or a particular effect of specific drugs. A literary search for information for the period from 1982 to 2023 was carried out in PubMed electronic databases, Elibrary.ru. This article will consider: the historical development of the TDD class, research in the field of the effects of pioglitazone on the liver.

BACKGROUND: Vitamin D deficiency in secondary hyperparathyroidism (SHPT) against the background of chronic kidney disease (CKD) in patients with diabetes mellitus (DM) is one of the key factors in the deterioration of renal function. AIM. To assess the indicators of calcium-phosphorus metabolism in individuals with SHPT against the background of CKD, diabetes and without it to optimize treatment approaches. MATERIALS AND METHODS. A retrospective analysis of 416 medical records with diagnoses CKD3-C5 and SHPT was carried out, of which 112 had a history of diabetes, which were examined and treated in the nephrology department of the in the period from 01. 01. 2018 to 31. 12. 2022. Demographic and anthropometric data were studied, laboratory (total and ionized calcium, total protein, albumin, phosphorus, creatinine, parathyroid hormone, 25(OH)D, alkaline phosphatase) and instrumental (ECHO-CG, ultrasound of the abdominal organs and retroperitoneal space) research methods. RESULTS. Diabetes is the leading cause of CKD among all nosological forms. The level of 25(OH)D in patients without diabetes varied from 9.04 to 152 nmol/l, with diabetes from 8.3 to 77 nmol/l. The average level of 25(OH)D in patients without diabetes (41.7 ± 26.1 nmol/l) was significantly higher than in patients with type 1 diabetes (20.3 ± 14.9 nmol/l) and type 2 diabetes (27.6 ± 19.2 nmol/l) (p = 0.005 and p = 0.003, respectively). 25(OH)D deficiency and insufficiency were more often recorded in patients with diabetes compared with patients without carbohydrate disorders (89 % and 10 % versus 69 % and 19 % respectively), while the optimal level was more common in patients without diabetes (12 % and 1 %, respectively).

Hypercalcemia is a laboratory-confirmed syndrome with an increase in blood calcium levels above 2.55 mmol/l. A number of authors claim that the most common causes of hypercalcemia are malignant neoplasms, primary hyperparathyroidism (PHPT), vitamin D intoxication, and chronic kidney disease. One of the rarest causes to consider in patients with newly diagnosed hypercalcemia is familial hypocalciuric hypercalcemia syndrome (FHH). FHH is a genetic autosomal dominant disorder characterized by decreased urinary calcium levels and increased blood calcium levels in combination with normal or above-reference PTH levels. The presented case demonstrates the need to perform a differential diagnosis of hypercalcemia syndrome, the importance of calculating the ratio of renal calcium clearance to creatinine clearance, which is currently the most accessible method and allows one to avoid unjustified parathyroidectomy.

On September 29, 2023, a meeting of the interdisciplinary expert council “Cognitive health of a comorbid patient” was held in Vladikavkaz. To reduce the social and economic burden of cognitive impairment, which is increasingly being detected in comorbid patients in the Russian Federation, it is necessary to introduce socially significant initiatives for the timely diagnosis and prevention of these diseases, as well as update modern approaches to treatment, taking into account their multifactorial pathogenesis and the risk of complications. Based on the results of scientific reports and discussions held during the expert council, experts made decisions on a further plan within the framework of socially significant initiatives for the prevention of obesity.

Introduction. Congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency (21OHD) is one of the most common autosomal recessive disorders, affecting 1:9000-1:15000 live births. During the last twenty years in most countries prenatal DEXtreatment has been used to prevent genital virilisation and androgen excess outcome on sex brain differentiation of XX-foetus with 21-hydroxylase deficiency. Fetal DEX-treatment for the prevention of prenatal virilization of genitalia in girls affected by classic congenital adrenal hyperplasia (CAH) has been used in many medical centers worldwide since the mid-1980s. The treatment is effective in reducing virilization, but the potential long-term outcome has only been investigated in a minority of treated cases.Aim. To study possible long-term effects of prenatal glucocorticoid treatment on children cognition and physical development.Materials and methods. The prospective research of intellectual development patterns of 288 children from mothers prenatally treated with dexamethasone, and of 107 children (the observational group) from mothers, not treated with dexamethasone, with high biochemical markers of adrenal hyperandrogenism.Results. Significant differences of frequency of overweight and obesity (p = 0.04); of intellectual quotients (p = 0.0004) in schoolaged children have been revealed in the treatment group vs observational group. The level of general intelligence of school-aged children whose mothers have been treated with dexamethasone in I and II trimesters of pregnancy is considerably lower than that of children from the observational group (p = 0.004; p = 0.0005, respectively). The tendency of correlation between IQ quotients of school-aged children and the initiation date of prenatal dexamethasone treatment has been established (r = 0.27; p = 0.004).Сonclusion. Prenatal DEX-treatment at an early gestation can result in significant adverse effects on intellectual abilities and physical development of children furtheron.

Introduction. The global economic and social burden of obesity requires a clear understanding of the causes and underlying factors contributing to its development which will allow to develop and implement effectively the potential therapeutic pathways to direct influence on the pathology. Recently, in the pathogenesis of obesity, great attention is paid to the state and diversity of the intestinal microbiota, its main interaction with men is performed through short-chain fatty acids (SCFAs) – biologically active substances being formed during the anaerobic fermentation of indigestible carbohydrates.Aim. To assess the metabolic activity of the colon microbiota, in terms of quantity and proportion of short-chain fatty acid levels in young obese patients taking into account the degree of obesity in comparison with healthy individuals.Materials and methods. 87 obese patients and 31 subjects with the normal body weight were included in the study. All study participants met the inclusion criteria and signed the informed consent. In addition to filling out a questionnaire specially designed for the goals and objectives of this study, anthropometric measurements were carried out and the level of SCFAs in feces was determined with the help of gas-liquid chromatography usingChromos GC-1000 equipment in the independent INVITRO laboratory.Results. Young obese patients have a higher concentration of SCFAs and SCFA isoforms in feces compared to healthy individuals, while it is statistically significantly higher in the group of patients with BMI more than 40 kg/m2. The proportion of acetate was statistically significantly higher in the normal weight group, while the proportion of propionate was higher in the obese group. No statistical differences were found regarding the proportion of butyrate. In addition, the associations of SCFAs with anthropometric parameters were identified.Conclusion. The results of the study confirm the possible role of SCFA in in pathogenesis of obesity.

Objective. To study the features of the colon microbiota, as well as the associations of microbial representatives with anthropometric, anamnestic and biochemical parameters in young patients with metabolic syndrome. Materials and methods. 118 young people took part in a single-center, one stage, controlled study. 87 of them were diagnosed with obesity, and 31 people with normal body weight formed the control group (“C”). 87 obese patients were divided into 2 groups: “MS-” which consisted of 43 people (49.4%), and “MS+” including 44 people (50.6%) with metabolic syndrome. When stratifying the groups, the NCEP ATP III criteria were used. Blood for biochemical test was taken from all the participants, and the condition of the colon microbiota was assessed using polymerase chain reaction («Colonoflor-16 (premium)»). The Microsoft Excel 2010 and IBM SPSS Statistics 26.0 application software package were used for statistical calculations. The results were evaluated as statistically significant at a level of p0.05. Results. In the MS+ group Fusobacterium nucleatum (Fusobacteriaceae family) was detected statistically significantly more often than in individuals from group “C” (40.5%). Differences in the bacterial composition of the intestinal microbiota between two groups of obese people were revealed: in the “MS+” group there was a significant decrease in bacteria of the genus Bifidobacterium (Bifidobacteriaceae family), Prevotella (Prevotellaceae family) and Faecalibacterium prausnitzii (Ruminococcaceae family) (p0.05). In addition, correlation patterns between the species and generic composition of the microbiota on the one hand and age, BMI, waist circumference, hip circumference, breastfeeding duration, indicators of carbohydrate (glucose, insulin, HOMA-IR index) and lipid (total cholesterol, triglycerides, low-density lipoproteins, very low-density lipoproteins, high-density lipoproteins) metabolism, CRP on the other hand have been established. Conclusions. The colon microbiota in obese patients is characterized by proinflammatory changes. For the metabolically unhealthy phenotype of obesity these changes are most characteristic. It is clear that further research is needed to determine the mechanisms underlying the influence of bacterial-fungal associations on metabolism in obese individuals, as these mechanisms are likely to play a key role in the development of metabolic diseases.

The territory of the Tyumen region is an endemic region with insufficient iodine content in the environment, in which, since the early 1990s, active preventive measures have been taken to increase the use of iodized salt (IS) in households, catering and the food industry. The purpose of the research was to assess the consumption of iodine with IS used in the organized nutrition of children in the Tyumen region. Material and methods. The assessment of iodine intake was carried out in preschool institutions and schools randomly selected the city of Tyumen and rural areas (village of Isetskoye). Modeling of iodine consumption in organized groups was carried out for children aged 1-3, 3-7, 7-11 and 12 years and older in urban and rural areas, respectively, using a standard menu and a technological map of dishes. Iodine intake was estimated based on the content of 40 μg of iodine in 1 g of salt and its 30% loss during cooking. Model 1 assumed the mandatory use of IS in the preparation of all salt-containing meals for preschoolers and schoolchildren. Model 2, in addition to the mandatory use of IS in school and preschool meals accounted the consumption of iodine with bakery products (BP) produced with IS. Results. The modeling showed that the average intake of iodine with meals (model 1) in preschool institutions in Tyumen was 89±16 μg/day for children aged 1-3 years. When BP with IS were included in the menu (model 2), iodine intake increased to 101±14 μg/day. In children aged 4-7 years iodine intake was 115±18 and 126±18 μg/day, respectively. In rural areas, iodine intake was lower: in children aged 1-3 years, under model 1, iodine intake was 66±3 μg/day, under model 2 - 76±4 μg/day. In children aged 4-7 years, these figures were 83±3 and 92±4 μg/day, respectively. Iodine consumption in a school in Tyumen under model 1 in children 7-11 years old was 24±5 μg/day, and in children 12 years and older - 27±6 μg/day. When BP with IS were included in the menu (model 2), iodine intake increased to 32±5 μg/day in children 7-11 years old and to 39±6 μg/day in children 12 years of age and older. In rural areas, when using model 1, iodine intake in children aged 7-11 years was 37±15 μg/day, in children aged 12 and over 40±21 μg/day. When BP with IS were included in the menu (model 2), iodine intake increased to 44±15 μg/day in children aged 7-11 years and to 50±21 μg/day in children 12 years of age and older. Conclusion. The use of IS in the preparation of salt-containing meals in preschool educational institutions of the Tyumen region fully covered the iodine requirements of preschool children, which confirms the effectiveness of the chosen strategy for the prevention of iodine deficiency and can be considered as an important part of the concept of universal salt iodization. The use of IS in preparation of school breakfast meals provides 23.5-36.9% of the recommended nutrient intake for iodine in rural schools and 15.4-26.4% of the recommended nutrient intake in urban schools, which can be a significant contribution to the total intake of this micronutrient.

Hyperprolactinemia is a persistent excess of the blood serum prolactin. The syndrome contains various symptoms, the most characteristic is a violation of the reproductive system. There are multiple endogenous and exogenous causes of hyperprolactinemia. The main treatment method is dopamine agonist therapy, in case of prolactinoma existence, surgical and radiation methods can be applied. About 15% of patients are resistant to dopamine agonist therapy, which determines creation of individual management tactics. The article presents a draft of clinical guidelines for the diagnosis and treatment of hyperprolactinemia, which provides a modern examination algorithm, discusses the basic principles of diagnostics and treatment approaches.

In the prescriptions of an endocrinologist to patients with diabetes mellitus, glucagon-like peptide agonists, belonging to the group that affects the incretin system of the body, have recently been increasingly appearing. In addition to the pronounced hypoglycemic effect and high safety, these drugs also have many pleiotropic properties due to the presence of glucagon-like peptide receptors in the vascular endothelium, kidneys, heart and nervous tissue. The purpose of this work is to describe the most studied neuroprotective effects of this class of drugs. As materials in the course of the work, studies of domestic and foreign colleagues published in the period from 2008 to 2022 were used. Our work has shown that the neuroprotective effect of GLP-1 is associated with the activation of the corresponding receptor systems in the central nervous system, which leads to increased cellular survival in ischemic conditions by reducing reactive oxygen species, stimulating beta-oxidation by mitochondria, and reducing pro-inflammatory cytokines. In addition, the analysis of the literature also established the positive role of GLP-1 in neurodegenerative diseases – drugs reduce the amount of unnormal proteins (alphasynuclein, microtubular T-peptide, etc.), reduce the activity of non-enzymatic glycation of proteins in hyperglycemia, as well as reduce insulin resistance. The effects described above were analyzed during preclinical trials of GLP-1, and also demonstrated their validity in human models during some clinical trials. However, the data obtained is not yet sufficient to form clear indications for this class of drugs in neurology, so the topic requires further study and large clinical trials.

ЦЕЛЬ: оценить результаты мониторинга йододефицитных заболеваний (ЙДЗ) в Тюменской области за 25-летний период реализации региональной программы профилактики. МАТЕРИАЛЫ И МЕТОДЫ: проведен анализ медико-биологического и социально-гигиенического мо- ниторинга в популяции новорожденных, школьников 8–10 лет, в группе беременных женщин и взрослой популяции в Тюменской области за период 1994-2020 гг. Все исследования проведены в соответствии с рекомендациями ВОЗ, ЮНИСЕФ, Международного совета по контролю за йододефицитными заболеваниями (2007). РЕЗУЛЬТАТЫ: на фоне реализации региональной программы профилактики ЙДЗ в популяции де- тей препубертатного возраста (ДПВ) медианная концентрация йода в моче (мКЙМ) значимо возросла с 71,4 мкг/л до 125 мкг/л в 2002 г., и остается в целевом диапазоне весь наблюдаемый период, достигая 153,6 мкг/л в 2019 г. Частота зоба в группе ДПВ за период 1994 – 2019 гг. значимо снизилась от тяжелой (87%) до легкой степени тяжести зобной эндемии, достигнув 8% среди детей 8-10 лет. В популяции беременных женщин мКЙМ возросла с 92,8 мкг/л (1999 г) до 159,05 мкг/л (2019 г.). На фоне нормализации йодного потребления значимо снизилась частота зоба с 17,8% в 1999 г. до 0,8% в 2009 г. и 0,38% в 2019 г. По данным анализа результатов скрининга на врожденный гипотиреоз в 1995 г. в Тюменской области доля неонатальной гипертиреотропинемии выше 5 мМЕ/л составляла 44,7%. В процессе реализации региональной программы профилактики отмечается статистически значимое снижение доли нТТГ выше 5 мМЕ/л с 19,2% в 2002 г. до 3,07% в 2020 г. (р< 0,001). Результаты гигиенического мониторинга в Тюменской области на протяжении всех лет существования программы профилактики ЙДЗ свидетельствуют об увеличении доли домохозяйств, использующих ЙС с 49% в 2005 г. до 74,3% в 2019 г., и в то же время указывает на недостижение целевого показателя выше 90%. Анализ данных статистической формы № 63МЗ и СР РФ «Сведения о заболеваниях, связанных с микро- нутриентной недостаточностью» демонстрируют снижение заболеваемости диффузным (эндемическим) зобом как в популяции детей, так и среди взрослых. Первичная заболеваемость диффузным зобом у детей до 14 лет снизилась с 0,19 до 0,071 на 1000 детей соответствующего возраста, такая же картина у взрослого населения (старше 18 лет) – снижение с 1,16 до 0,27 на 1000 населения. ВЫВОДЫ: таким образом, результаты мониторинга ЙДЗ в Тюменской области за 25-летний период демонстрируют ликвидацию тяжелой зобной эндемии в регионе, однако недостаточное использование йодированной соли в домохозяйствах, сохраняющаяся частота зоба у школьников выше 5%, недостижение целевого уровня доли неонатальной гипертиреотропинемии свидетельствуют о недостаточной эффектив- ности добровольной модели профилактики, сложившейся в отсутствии закона о всеобщем йодировании соли и необходимости принятия последнего

Today there is a worldwide trend of population aging, in addition, the proportion of older people with obesity is increasing. In order to adequately manage these patients in the outpatient setting, it is critical to understand the dynamic relationship between body weight, chronic disease prevalence, development of functional disability, life expectancy, and health care costs. While the obesity epidemic has affected people of all age groups, empirical knowledge about the management of obese older people remains largely scarce. Currently, there is no single therapeutic approach to this problem. Weight loss should be treated with caution in people over 60 years of age. The risk of sarcopenia, malnutrition, bone loss, increased risk of falls and injury must be considered, which can lead to an increase in the number of people with disabilities and the associated costs of medical and social care. The analytical review focuses on the relationship between two of the greatest epidemiological trends: aging and obesity. This paper highlights the features of the pathophysiology of obesity in the elderly, the phenomenon of the «obesity paradox». Also from the perspective of evidence-based medicine approaches to the treatment of obesity in the elderly, including surgical interventions aimed at reducing body weight, are analyzed.

ЦЕЛЬ: оценить потребление йода с йодированной солью (ЙС), используемой в организованном питании детей дошкольного возраста в Тюменской области. МАТЕРИАЛЫ И МЕТОДЫ: оценка потребления йода проводилась в детских дошкольных учреждениях, выбранных случайным методом в г. Тюмени и сельской местности (с. Исетское). Моделирование потребления йода в организованных коллективах было выполнено для 4-х групп детей в возрасте 1-3 и 4 -7 лет в городе и сельской местности, соответственно, с использованием типового меню и технологической карты блюд, где был указан вес одной порции блюда и содержание в ней соли. Расчеты были выполнены с использованием Модуля 2 «Руководства по оценке использования йодированной соли в пищевых продуктах промышленного производства», разработанного «Глобальной сетью по йоду». При моделировании потребления йода детьми было использовано 2 сценария потребления йода. При сценарий 1 потребление йода оценивалось из расчета содержания 40 мкг йода в 1 г соли и его 30% потери при приготовлении блюд. При сценарии 2 для расчета использовали более реалистичное содержание йода (35 мкг на 1 г соли) и его 30% потери при кулинарной обработке. РЕЗУЛЬТАТЫ: в Тюменской области с 2009 года в соответствии с постановлением главного государственного санитарного врача по Тюменской области №2 от 19.05.2009 г «О дополнительных мерах по профилактике заболеваний, обусловленных дефицитом микронутриентов в структуре питания населения Тюменской области» и СанПиН 2.3/2.4.3590-20 «Санитарно-эпидемиологические требования к организации общественного питания населения» для приготовления блюд в организованном питании детей, в том числе в дошкольных учреждениях, в обязательном порядке используется ЙС. Проведенное моделирование показало, что среднесуточное потребление йода детьми в дошкольных учреждениях города Тюмени при сценарии 1 составило 100,8 мкг у детей 1-3 лет и 126,0 мкг у детей 4-7 лет. В сельской местности потребление йода было ниже: 75,6 мкг у детей 1-3 лет и 92,4 мкг у детей 4-7 лет. При использовании сценария 2 среднесуточное потребление йода в г. Тюмени составило 88,2 мкг у детей 1–3 лет и 110,3 мкг у детей 3–7 лет, а в сельской местности потребление йода составляло 66,2 мкг у детей 1–3 лет, и 80,9 мкг у детей 4-7 лет. При обоих сценариях использование ЙС в организованном питании полностью покрывало суточную потребность в йоде у детей, а различия между городской и сельской местностью, вероятно, связаны с тем, что в городских детских садах реализуется 5-разовое питание детей, а в сельской местности - 4-разовое. ВЫВОДЫ: использование ЙС в питании детей в дошкольных образовательных учреждениях обеспечивало адекватную обеспеченность йодом, что подтверждает эффективность выбранной модели профилактики.

Diabetes mellitus is a chronic metabolic disease with a rapidly increasing prevalence. Glycemic control in diabetes mellitus remains the key to improving the effectiveness of therapy, reducing the risk of hypoglycemia, preventing microvascular complications, and reducing the long-term risk of macrovascular complications. However, regular glycemic control is only a part of this process, since an equally important step is the timely and correct interpretation of the data obtained, as well as the decision on further therapeutic tactics. Technological advances are providing tools to help diabetic patients reach their glycemic targets and facilitate ongoing monitoring of blood glucose levels. Currently, there is the possibility of remote monitoring of glycemia, transmission of data to medical professionals and caregivers: blood glucose meters with wireless glucose reporting, continuous glucose monitors, flash glucose monitors, and non-invasive glucose monitoring systems. Large scientific studies have proven the effectiveness and prospects of telemedicine technologies in the treatment of diabetes. Today, the digitalization of healthcare is actively developing from telemedicine and remote interaction with patients to new digital approaches to diagnostics and information exchange. Thus, in the Russian Federation, within the framework of the digital transformation strategy of the Healthcare industry until 2024 and for the planned period until 2030, the Personal Medical Assistants project is being implemented, aimed at creating technologies for dynamic remote monitoring of patients using platforms of centralized diagnostic services based on a unified state information system in the field of healthcare.