“To study the mechanisms of formation of sexual maturation disorders in adolescents with diffuse nontoxic goiter, to determine risk factors of their beginning”
(research supervisor – Doctor of Medical Sciences, professor O.I. Plekhova, 2007−2009 yrs)
Fulfilment of the research work made it possible to establish certain correlations between sexual maturation rates in adolescents and the thyroid gland state (goiter) under conditions of a slight iodine deficiency.
Object of study: the character of sexual maturation and the state of the thyroid gland in 1485 children of different sex, aged 10-17; genetic risk factors, and immunohormonal mechanisms of forming sexual maturation disorders in adolescents with diffuse nontoxic goiter (DNG).
Objective: to gain deeper understanding of the conventional notions as regards risk factors and mechanisms of forming sexual maturation disorders in adolescents of either sex against the background of diffuse nontoxic goiter.
Methods: clinical, ultrasonic, genetic, radioimmunologic, immunofermental, biochemical, and statistical.
Theoretical and practical results. There have been determined the incidence and distribution of DNG among children, aged 10–17, under conditions of slight iodine deficit, and the dependence of the disease formation incidence on the level of sexual development delay (SDD) was reliably higher, while girls showed higher rates of menstrual function disorders. There were determined some differences in the mechanisms of SDD formation against the background of DNG under conditions of minimal thyroidal dysfunction, namely, a decrease in melatonin production, an increase in PRL concentration, mostly in girls, shifts in the ratio of LH/FSH, and an increase in the SSBH content in adolescents of either sex. Basing on regression and factor analysis there was established a direct influence of TTH and thyroid hormones on the principal regulatory links of sexual maturation. There were revealed some changes in immunoreactivity and in cytokine profile in adolescents with DNG, the character of which is dependent on the sex and on the course of sexual maturation. There were worked out some factor models of immunohormonal interactions. There were also defined informative genetic signs for prognostication analysis as regards formation of SDD against the background of DNG (hereditary load, A24, B35, and B7 antigens, W patterns on finger V, RH, Lu on finger III, RH, T-like curves on finger II, RH, Lu on finger III, LH, LR on the hypothenar of LH.
Novelty: there have been explained immunohormonal mechanisms and informative factors of disorders in sexual maturation process against the background of the thyroid gland pathology, and a novel technology for prognosticating the course of sexual maturation in patients with diffuse nontoxic goiter.
Effectiveness: the technology makes it possible to optimize SDD diagnosis and treatment in adolescents with DNG.
Fields of application: endocrinology and pediatrics.
