Thyroid nodules measuring 1cm and more revealed in 27% adult inhabitants of region. Malignant tumors were diag nosed in 2.9% of them. There was increase in the number of people with nodules in the territories exposed to radioactive fallout after Chernobyl accident in comparison to the territories without such pollution – 57.3%/42.4% as well as malignant tumors among them (5.2%/2.7%) Comparison of thyroid palpation and ultrasound in detection of thyroid nodules revealed that thyroid nodules of 10 mm were detected only in every 10th patient by means of pal pation: and nodules of 11–15 mm in every 4th patient, comparing to ultrasound data of the same patients’ group. Malignant tumors were detected on cytology in 2.9% of thyroid nodules less than 2 cm (30171 patients) and in 1.9% of thyroid nodules larger than 2 cm (15 656 patients). At the same time the frequency of regional lymph node metas tases was significantly higher in patients with thyroid nodules larger than 2 cm (34.8%), than in patients with nod ules less than 2 cm – 18.3%. Only one malignant tumor was detected among 358 patients with autonomously func tioning nodules. Risk groups with higher rate of malignancy were patients living in the areas with Chernobyl’s fall out, and patients in whom nodules with “suspicious” sonographic features were revealed (rough edges, capsule inva sion, microcalcifications). Patients with high risk of malignant transformation should be submitted to FNAB regard less of thyroid nodule size. Biopsy is unnecessary for the patients with autonomously functioning nodules detected by scintigraphy.

The purpose of this research was to assess iodine levels in the population of St. Petersburg, and to study ultrasound goiter criteria in children taking into account controversial data at our disposal. Iodine concentration was measured in samples of morning urine by cerium arsenite method in 883 children aged 610 in 30 clusters. The total of 138 children of the same age underwent ultrasound examination of the thyroid; all the children are residents of Krasnoselsky District of the city, which is free from goitrogenous substances. A retrospective analysis of screening results for innate hypothyroidism was performed on 106 066 blood samples collected in 2004 and 2012. The medi an ioduria was 67.8 mkg/l; the proportion of urine samples with iodine concentrations below 50 mcg/l was 31%. The frequency of TSH > 5mE/l in newborn babies was 11% and 3.8% (in 2004 and 2012, respectively). The occur rence of goiter, as defined in 1997 WHO regulations, was 4.4%; however, according to the 2001 and 2003 criteria, it exceeded 30% in (34% and 63% respectively). The research results show that St.Petersburg, despite its favourable geographical location and economical status, is a region with mild iodine insufficiency; when 2001 and 2003 goiter criteria are employed, the degree of iodine insufficiency becomes severe.

The aim of the research was to estimate the iodine deficiency and the effectiveness of IDD prevention in Central Siberia according the results of neonatal TSHscreening. Methods. Screening for congenital hypothyroidism used as an indicator of the degree of iodine deficiency and of its control. We analyzed the neonatal TSH values of 34980 infants born in 2008–2009. Results. According to the data of the congenital hypothyroidism screening the rate of TSH < 5 mU/1 was 11.8% in the Krasnoyarsk territory (23.9% in 2000) and corresponded to mild iodine deficiency. In different regions of the Krasnoyarsk territory the rate of TSH < 5 mU/1 in the newborn varied from 3.5% to 23.7%. The highest values were marked in the Taimyr, in Irbeysky, Suchobuzimsky, Eniseysky, Tuchtetsky, Novoselovsky regions, in Zheleznogorsk and Sosnovoborsk city (20.9–23.7%). In Khakasia the rate of TSH < 5 mU/1 was 12.2%. In the Republic of Tyva – 6.6% (38.6% in 1997; 11.5% in 2000). It corresponding to mild iodine deficie ncy. Conclusion. Our investigations show that in Central Siberia there is mild iodine deficiency demanding continuous adequate iodine prevention.

The aim of the study was to examine the levels of sex hormones in men with hyperthyroidism before and during treatment, and determining the feasibility of testosterone prescribing together with thyrostatic therapy, in men with androgen deficiency. The study involved 37 men with newly diagnosed diffuse toxic goiter and 16 healthy men, aged from 22 to 55 years. The testosterone (test.) fractions (overall and free), SHBG, LH, FSH, estradiol and prolactin were determined. All hormones were measured before treatment and after 3, and then 6 months of thyrostatic ther apy. The overall test. level in men with hyperthyroidism was the same as in healthy subjects. Absolute and relative content of free test. fraction was significantly lower, but the SHBG level was higher than in healthy age relative men. The diagnostics of androgen deficiency syndrome was based on free test. determination. All patients with Diffuse toxic goiter the tiamazol (Merkazolil) was appointed, while treatment with testosterone (Omnadren250) were offered to patients with low of free test. levels, but not all followed the recommendations. The groups were follow: patients without androgen deficiency ( n = 16), patients with androgen deficiency, taking only thyrostatic therapy ( n = 10), patients with androgen deficiency taken thyrostatic therapy simultaneously with testosterone therapy ( n = 11). The decreasing of free test. level was detected in 57% of examined men. In most cases (80%) of that patients the 6 months thyrostatic therapy did not lead to free test. normalization. The free test. level concentration was nor mal only in 2 examined not receiving testosterone men (20%) and in 9 (82%; χ 2 = 5.76; p = 0.017) among those who recieved both: thyrostatic and testosterone therapy. During treatment with Omnadren250 the relative content of free test. was significantly higher at 3 and 6 months of treatment. Using a questionnaire AMS confirmed the dynamics characteristics of androgen deficiency in men with hyperthyroidism during treatment. Thus, the recom mendation of prescribing testosterone simultaneously with the start of thyrostatic therapy are grounded in androgen deficiency men with hyperthyroidism.

Aim: to consider association of polymorphous alleles of class II HLA genes with Graves’ disease (GD) in Tuvinian population. Methods. HLAgenotyping was accomplished in 40 GD patients and 164 volunteers randomly selected in Tuvinian population (native Siberian population, Mongoloids). GD was diagnosed accordind to the clinical and laboratory criteria. HLAgenotyping for 14 DRB1 alleles, 8 DQA1 alleles and 13 DQB1 alleles was performed by polymerase chain reaction sequencespecific primers (DNATechnology, Russia). Statistical analysis was performed using the Excoffer, Schneider and Kuffer package. RR have been calculated using Woolf method. Results. We found the HLAmarkers of predisposition to GD in Tuvinians: HLA DQA1*0501( RR = 1.76; p < 0.05) and DQB1*0301 (RR = 1.44; p < 0.05). Analysis of the HLA haplotypes showed, that DRB1*13DQA1*0501 DQB1*0301 was associated with an increased risk of GD (RR = 3.53). The protective were DRB1*0302 (RR = 0.19) and haplotype DRB1*04DQA1*0301DQB1*0302 (RR = 0.02). Conclusions. This molecular genetic study has been shown that HLA DQA1*0501, DQB1*0301 and haplotype DRB1*13DQA1*0501DQB1*0301 associated with Graves’ disease in Tuvinian population.