Elena Grineva

Almazov Federal Heart, Blood and Endocrinology Centre · Endocrinology institute

Background . Currently, the “gold standard” of differential diagnosis of Cushing’s disease is inferior petrosal sinus sampling and measurement of the adenocorticotropic hormone (ACTH) level. The studied literature data indicate a wide variability in the sensitivity and specificity of inferior petrosal sinus sampling in the range of 85–100 and 67–10...

In this study, we described a case that illustrates the clinical significance of the hook-effect, a laboratory phenomenon when the measured hormone level is falsely lowered due to the binding of signaling antibodies with high analyte concentration. In a patient with a newly diagnosed 2.7 x 1.7 x 2.1 cm pituitary macroadenoma, laboratory testing rev...

Over the past 10 years of studying the complications of type 2 diabetes mellitus (DM) and ways to deal with them, significant progress has been made in one of the most important areas of treatment — the prevention of cardiovascular and renal complications. Thus, when using inhibitors of type 2 sodium-glucose cotransporter, a significant reduction i...

Background. Primary hyperparathyroidism (PHPT) is an endocrine disorder characterized by autonomous production of parathyroid hormone (PTH). Currently, parathyroidectomy (PTX) is considered the main method of PHPT treatment. Its outcome is largely depended on precise preoperative localization of the parathyroid adenoma. Traditional visualization te...

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, surgica...

Background. Polycystic ovary syndrome (PCOS) is the most common endocrine disorder affecting 10-15% of women of reproductive age. PCOS is often associated with metabolic disorders, type 2 diabetes, cardiovascular disease, and other complications. In recent years, angiogenesis has been widely discussed as an important factor in the pathogenesis of P...

Background. Topical diagnosis of primary hyperparathyroidism (PHPT) remains an urgent problem due to the high incidence of persistence and recurrence after surgical treatment. At the preoperative stage, a search for the parathyroid hormone hyperproduction source is performed using instrumental methods: ultrasound, scintigraphy of the parathyroid gl...

Prolactinoma and associated hyperprolactinemia is one of the main causes of infertility. The disease can develop within the framework of multiple endocrine neoplasia type 1 (MEN 1), and the management of such patients may differ from the treatment of sporadic forms. The article presents a clinical case of a patient with prolactinoma that developed...

Objective. To analyze the results of a laboratory examination for chromogranin A in the blood performed in the laboratory at Almazov National Medical Research Centre in patients with confirmed diagnosis of pheochromocytoma/paraganglioma (PPGL) and in patients with unconfirmed neuroendocrine tumor based on the results of a comprehensive examination...

Introduction. In the cases of neurosurgery failure in acromegaly treatment, drug therapy with somatostatin analogues (SSA) octreotide or lanreotide is indicated. The effectiveness of SSA is limited by the presence of resistance, there is an opinion that in some cases it can be overcome by replacing one drug with another. Aim. Own experience analysi...

Objectives: Thyroid autoimmunity is common in pregnant women and associated with thyroid dysfunction and adverse obstetric outcomes. Most studies focus on thyroid peroxidase autoantibodies (TPOAbs) assessed by negative-positive dichotomy and rarely take into account thyroglobulin autoantibodies (TgAbs). This study aimed at determining the associat...

Objective: to measure the serum TSH level in hospitalized patients with moderate-to-severe COVID-19. Material and methods : this was a retrospective study at Almazov National Medical Research Centre enrolled 133 hospitalized COVID-19 patients without known thyroid disorders. Clinical data, biochemical parameters (TSH, 25(OH)D, C-reactive protein, L...

A dangerous viral disease COVID-19, caused by a new RNA coronavirus SARS-COV-2, has been actively spreading in the world since December 2019. The main manifestations of this disease are bilateral pneumonia, often accompanied by the development of acute respiratory syndrome and respiratory failure. Patients with diabetes mellitus (DM) are at high ri...

Introduction . Transsphenoidal adenomectomy (TSA) is the method of choice in the treatment of Cushing’s disease (CD), but remission of hypercorticism cannot be achieved in all patients. The search for predictors of CD remission after TSA remains to be an important challenge in the endocrinology today. Aim . To study the preoperative and postoperati...

Treatment of thyrotoxicosis caused by Graves’ disease or multinodular toxic goiter, is not difficult, in most cases, since the prescription of thionamides allows to normalize the level of thyroid hormones quickly and safety. But in a number of cases this therapy might be associated with serious side effects (agranulocytosis, toxic hepatitis, choles...

Background: The association between vitamin D deficiency and the severity of COVID-19 is currently being actively discussed around the world. Aim: The aim of this study was to assess the prevalence of vitamin D insufficiency and deficiency and compare it with the incidence rates of SARS-CoV-2 in eight Federal Districts of the Russian Federation....

Background : Sodium glucose co-transporter type 2 inhibitors (iSGLT2) are antihyperglycemic drugs approved for the treatment of type 2 diabetes mellitus (T2DM). Clinical trials with these drugs have shown evidence of an increased risk of fractures and an effect on phosphorus, vitamin D and parathyroid hormone (PTH) levels. Aim : The aim of this stu...

The OBJECTIVE of the study was to analyze the experience of performing thyroidectomy (TE) in patients with amiodarone-induced thyrotoxicosis (AmIT) at our centre. METHODS AND MATERIALS . The study included 12 patients with AmIT who underwent TE. Medical records were analyzed to assess the features of the AmIT and indications for TE. We also studied...

Objective. The aim of our study was to investigate the distribution of the PHPT clinical manifestations and biochemical features in patients who underwent parathyroidectomy. Materials and methods. Medical records of 449 patients from three Medical Centers (Saint-Petersburg, Russia), hospitalized during a period from 2011 to 2018, were reviewed. His...

Aim: To investigate the value of 24 hours post-surgery measurement of growth hormone (GH) level for prognosis of surgical outcomes in acromegaly. Materials and methods: A prospective cohort study included 45 patients with newly diagnosed acromegaly. The degree of parasellar extension was measured on the preoperative sellar magnetic resonance ima...

The infectious disease COVID-19, induced by virus SARS-CoV-2, is associated with high morbidity and mortality. Considering the COVID-19 pandemic since the beginning of 2020, the recognition of its risk and prognostic factors with the identification of the most vulnerable groups of population is highly relevant. The relationship between the severity...

During the COVID-19 pandemic, the efforts of many researchers around the world are aimed at finding preventive and prophylactic measures as well as therapeutic agents against SARS-CoV-2. Recent studies have showed that vitamin D deficiency could be one of many factors associated with the development and severity of acute respiratory infections, and...

Considering high prevalence of prediabetes, exceeding the incidence of type 2 diabetes mellitus, clear algorithms for identifying and managing patients with this pathology is the most important task for doctors of various specialties — therapeutists, cardiologists, general practitioners. The preventive measures are more efficient when started at th...

The aim of the study. To assess the role of early postoperative examination in the prognosis of cd remission 1 year after TSS.Patients and methods. 101 Patients (12 men, 89 women, mean age 41,2 years (15-72) with confirmed cd were included. Midnight and morning serum cortisol and plasma ACTH, late night salivary cortisol, 24-h urinary free cortisol...

Polycystic ovary syndrome (PCOS) is a common endocrine disease in women of reproductive age. In addition to hyperandrogenism, impaired ovulation and fertility, PCOS is associated with an increased detection of cardiovascular risk factors such as obesity, insulin resistance, impaired glucose tolerance, type 2 diabetes mellitus, arterial hypertension...

For a long time, surgical removal of somatotropinoma using the transsphenoidal approach has been the first stage of treatment in most acromegaly patients. For the past decades, the efficacy criteria for surgical treatment of acromegaly have significantly changed, which requires appropriate correction. Purpose: We aimed to evaluate the results of...

objective. Recent studies showed that statin therapy in patients with cardiovascular diseases (CVD) could increase serum 25(OH)D level. However, data remain unclear. the aim of the study was to assess serum 25(OH)D level in patients with abdominal obesity and dyslipidemia before and after atorvastatin therapy. design and methods. We included 66 wom...

Differentiation between amiodarone-induced thyrotoxicosis type 1 (AmIT1) and type 2 (AmIT2) is a diagnostic challenge. The current diagnostic tests are often unable to differentiate these two types of thyrotoxic syndrome. Several studies had shown that the serum T4 level and T3/T4 ratio are significantly different in patients with destructive thyro...

Aim. To study the role of prognostic oral high-dose dexamethasone suppression test (HDDST) and pituitary MRI in the prognosis of Cushing’s disease (CD). remission after transsphenoidal endoscopic surgery (TSS). Material and methods. 59 patients with Cushing’s disease (9 men, 50 women, mean age 40 years (15-72) underwent TSS were included. Before th...

Background. Subclinical hypothyroidism during pregnancy and gestational diabetes mellitus (GDM) is known to be associated with maternal and child morbidity. The concept of subclinical dysfunction of the thyroid gland in pregnant women depends on the population-specific and trimester-specific reference values so fixed universal cutoff concentrations...

Diabetic nephropathy (DN) is a serious complication of diabetes mellitus (DM), which increases morbidity and mortality. Accumulated evidence, mostly experimental ones that DPP-4 inhibitors have non-glycemic tissue effects including renal protection. Clinical data confirming these effects are insufficient. This makes it relevant to study the influen...

Objective. Primary aldosteronism (PA) is a common reason of secondary arterial hypertension (HTN) and is associated with an increased risk of cardiovascular complications, chronic kidney disease and mortality. The aim of this study was to compare the prevalence of cardiovascular complications in patients with PA and HTN and show the peculiarities o...

Background. Gestational diabetes mellitus (GDM) is a common complication of pregnancy. It can cause significant problems for the mother and offspring, such as caesarean delivery, birth trauma and the development of type 2 diabetes mellitus (T2DM) in the future. The identification and correction of modifiable risk factors for GDM will provide a poss...

This review includes the results of the original prospective studies and meta-analyses focusing on the relationship between Vitamin D deficiency and arterial hypertension (HTN). We discuss potential mechanisms of HTN development in Vitamin D deficiency subjects and the associations between high blood pressure and VDR gene polymorphisms. The Vitamin...

Introduction and purpose. A number of landmark trials have demonstrated clear benefits of metformin therapy in the prevention of macrovascular outcomes. Nevertheless, there is a lack of robust evidence to suggest whether metformin therapy will have similar beneficial outcomes in one of the most serious type 2 diabetes-related renal microvascular co...

Российская Федерация в силу географического расположения и экономических особенностей имеет все предпосылки для развития недостатка и дефицита витамина D. Цель исследования. Оценить уровень 25(OH)D) крови у жителей Северо-Западного региона РФ для изучения распространенности дефицита витамина D и его вклада в здоровье. Материал и методы. В исследова...

Russia is a country with geographic and economic preconditions for development of vitamin D deficiency. We analyzed serum 25(OH)D level in residents from North-West region (59–61° North latitude) of Russia to study the prevalence of vitamin D insufficiency and deficiency and its associations with gender, age, obesity and diet. The study population...

Background: Obstructive sleep disordered breathing or obstructive sleep apnea (OSA) is the most common respiratory impairment in acromegaly. OSA is bound up with heightened cardiovascular mortality. Aim: Тo study frequency, features, and structure of sleep disordered breathing in patients with newly diagnosed acromegaly and to elucidate the factors...

Objective: To assess prevalence of metabolically healthy individuals among patients with abdominal obesity (AO) and to determine phenotype and potential genetic traits associated with a benign metabolic status. Methods: 503 AO patients without cardiovascular diseases were examined. Waist circumference (WC), BMI, blood pressure, plasma glucose an...

To investigate the incidence of sleep-related breathing disorders (SRBDs) in patients with active acromegaly (AM), to specify risk factors influencing apnea/hypopnea index (AHI), and to reveal the specific features of obstructive sleep apnea (OSA) in patients with AM versus those with OSA without AM. Fifty patients with active AM were examined and...

Objective: The objective of our study was to assess the dynamics of vascular wall stiffness and central aortic pressure in patients with an active form of acromegaly after adenomectomy. Design and method: We examined 52 patients with active acromegaly, and 14 patients (4 men, 10 women; average age - 50,7 +/- 10,6 years) underwent transnasal adenome...

Background: Recent studies have demonstrated antioxidant and anti-inflammatory properties of metformin and vildagliptin, that could result in some positive effects on kidney function in diabetes. Indeed, in our previous study vildagliptin attenuated routine renal dysfunction markers in insulinopenic diabetic rats, however metformin didn’t improve i...

Aim. To investigate the incidence of sleep-related breathing disorders (SRBDs) in patients with active acromegaly (AM), to specify risk factors influencing apnea/hypopnea index (AHI), and to reveal the specific features of obstructive sleep apnea (OSA) in patients with AM versus those with OSA without AM. Subjects and methods. Fifty patients with a...

High prevalence and insufficient efficacy of medical treatment in type 2 diabetes mellitus (T2DM) poses a major challenge for medical care. Generally, only 30% of patients reach therapeutic goals, while remission occurs only in the minority of patients. In the obese (BMI>35 kg/m2), bariatric surgery provides an alternative to pharmacological treatm...

Optimizing treatments for type 2 diabetes mellitus (T2DM) remains an urgent issue. In addition to T2DM treatment strategies, such as glycaemic goals (glucose and glycated haemoglobin - HbA1c) among different patient populations, the influence of glycaemic variability(GV) on the prognosis of patients with T2DM is also important. According to recent...

Objective. To evaluate the importance of determining fasting glycemia at the first prenatal visit for timely diagnostics of gesta- tional diabetes mellitus (GDM). Material and methods. The study included 577 pregnant women examined with the use of the oral glucose tolerance test (OGTT) during weeks 24-28 of pregnancy. The results of the test were c...

Objective: The aim of this study was to identify early markers of gestational diabetes mellitus (GDM) and to reveal the most significant of them. Design: A total of 548 pregnant women were screened for GDM between weeks 24 and 28 of gestation, as defined by International Association of Diabetes In Pregnancy Study Groups (IADPSG) criteria, in a r...

Human cardiac β 1-AR perform a crucial role in mediating the cardiostimulating effects of norepinephrine. Gly389Arg and Ser49Gly polymorphisms of β 1-adrenoreceptors ( β 1-AR) can influence the cardiovascular prognosis. However, the possible effect of Gly389Arg and Ser49Gly polymorphisms on heart function in thyrotoxicosis has not been studied. We...

Introduction: Pregnancy is characterized by a progressive insulin resistance (IR). Some, but not all, previously published studies suggest that adipokines are related to insulin resistance in pregnant women and subsequent development of gestational diabetes (GDM). The aim of this study was to investigate the relation between adiponectin, leptin, it...

Background: Presently, a great deal of attention is being paid to investigation of pleiotropic effects of oral antidiabetic drugs. Several recent animal studies have suggested that vildagliptin and metformin could play some positive role in preventing the evolvement of diabetic nephropathy. Aim: This pilot study, concerned with high-fat fed heminep...

Introduction: Some, but not all, previously published studies suggest that low vitamin D status maybe associated with increased risk of gestational diabetes (GDM). We examined the association of plasma plasma 25-hydroxyvitamin D (25(OH)D) concentration with GDM risk and neonatal macrosomia. Methods: 143 women were recruited before 15 weeks of gesta...

Objective. To determine the prevalence of primary aldosteronism (PA) through routine practice — among patients visiting a specialized antihypertensive center due to uncontrolled hypertension or with adrenal incidentalomas. Design and methods. We included 314 patents with uncontrolled hypertension and 195 patients with incidentalomas. Aldosterone-re...

Adrenal incidentaloma is an unsuspected and asymptomatic mass, usually detected by an imaging study performed for other purposes. The widespread use of diagnostic ultrasound, computed tomography, magnetic resonance imaging has resulted in the frequent incidental discovery of asymptomatic adrenal mass. Adrenal incidentalomas represent a public healt...

The patients with obesity are known to suffer 25-hydroxy vitamin D (25(OH)D) deficiency, but the relationship between these two conditions remains unclear. The blood 25(ON)D levels in practically healthy women were compared with the amount and distribution patterns of the fatty tissue and with the content of plasma adipocytokines. The absence or de...

Objective. To compare the incidence of gestational diabetes mellitus (GDM), risk factors of its development when using the old (WHO, 1999) and the new Russian criteria (2012) and to assess the correspondence between fasting glycaemia and 75-g oral glucose tolerance test (OGTT), under the new criteria. Design and methods. A total of 354 pregnant wom...

It was suggested that glucose metabolism and body fat content depend on serum levels of 25-hydroxyvitamin D [25(OH)D]. We studied 320 healthy women at late reproductive age of 40 to 52 years old (mean age 46.1±4.5) from St. Petersburg (North-West region of Russia). 25(ОН)D levels were from 19.4 to 134.0 nMol/L (mean 52.9±22.7). Vitamin D deficiency...

Objective . We present the results of the study assessing the frequency and character of hypertension in thyrotoxicosis, and its impact on left ventricular remodeling and cardiovascular prognosis. Results and conclusions . Our data demonstrated that hypertension, and predominantly systolic hypertension, is highly prevalent in thyrotoxicosis and aff...

Clinical symptoms vary in thyrotoxicosis, and severity of these depends on many factors. Over the last years, impact of genetic factors upon the development and clinical significance of thyrotoxic symptoms became evident. It is known that a production of T3 in various tissues is limited by deiodinase 2 (D2). Recent studies revealed that certain sin...

Background. Several previous studies suggest that the drug in the biguanide class — metformin, in addition to the well-known hypoglycemic action can exert a significant cardioprotective effect. Molecular mechanisms of cardioprotection mediated by metformin are practically unknown. Objective. To examine the role of AMP-activated protein kinase (AMPK...

Objective. To determine the relationship between blood pressure measured during the first trimester of pregnancy and the risk of the development of gestational diabetes mellitus. Design and methods. A total of 209 pregnant women were screened for gestational diabetes mellitus between weeks 24 and 28 of gestation, as defined by WHO criteria. Blood p...

A total of 40 women presenting with polycystic ovary syndrome (PCOS) and excessive body weight/obesity were randomly allocated to 3 groups. The patients in group 1 were advised to change the life style (including consumption of a low-calory diet and regular physical exercises), those making up group 2 had to change the life style and take metformin...

The protein tyrosine phosphatase nonreceptor 22 gene (PTPN22) is an important negative regulator of signal transduction through the T-cell receptors (TCR). Recently a single-nucleotide polymorphism (SNP) 1858 C/T within this gene was shown to be a risk factor for several autoimmune diseases, such as rheumatoid arthritis (RA), Graves' Disease (GD),...

In recent years, evidence has been accumulated that metformin, an antidiabetic drug in the biguanide class, in addition to its well-recognized glucose-lowering effect, can also reduce cardiovascular mortality in the patients with type 2 diabetes mellitus (T2DM). Besides, there are a few experimental studies on the possibility of the direct anti-isc...

The high prevalence of vitamin D defi ciency worldwide and the associated increased risk for different pathologies require re-evaluation of this problem and its signifi cance. The wide spectrum of the diseases associated with vitamin D defi ciency explains the high scientifi c interest and increasing number of clinical trials in this area, and the...

It is well known that during last 10 years there is a significant growth in the number of patients with diabetes mellitus type 2. Early stages of glucose metabolism impairment such as glucose intolerance should be paid more attention. Diet and life style modification as well as acarbose (Glucobay) intake can result in glycemia normalization and pre...

Objective. Type 1 Diabetes (T1D) is a multigeniс autoimmune disease. The study addresses the polymorphism association between PTPN22, TAF5L genes and T1D. Design and methods. 154 nuclear families, each having affected children with T1D and non-diabetic siblings were recruited. The control group included 200 healthy individuals. Single nucleotide po...

Patients with thyreotoxicosis have variable clinical manifestations and various degree of cardiomyopathy which severity depends on many factors. Last years the genetic factors predicting development and clinical features of thyrotoxic symptoms and thyreotoxic cardiomyopathy became more evident. It is known, that production of T3 in various tissues...

Changes suspicious for malignancy were detected in 127 patients who, according to scintigraphic examination of the thyroid, had "cold" nodules. As a consequence, all the patients were operated on and fine-needle aspiration findings were compared with the histological results. Thyroid cancer was identified in 18.9%. No differences in age between cas...

To study efficacy of thyroxine (TX) and potassium iodide (PI) in the treatment of benign nodular thyroid lesions (BNTL). 118 patients with BNTL (colloid or colloid hypercellular as shown by thin needle aspiration biopsy, 'cold" or "warm" by scyntigraphy findings) were randomized into two groups: 59 patients were given thyroxin and the other 59 pati...

A comparative study of the thyrocyte nucleolar organizer region (NOR) activity was performed on silver - stained thyroid gland aspiration biopsies from controls, 39 patients with Graves' disease (GD), 15 other patients with Hashimoto thyroiditis (HT), and 71 patients with nodules which underwent surgery. Thyrocyte nucleoli from unchanged thyroid gl...