Turchina S. Immuno-hormonal mechanisms and risk factors in regard of an unfavorable course of a diffuse nontoxic goiter at puberty.

The object of study: diffuse nontoxic goiter (DNG) at puberty. The aim of research: prevention of the formation of thyroid insufficiency and disorders of the reproductive system formation in adolescents by deepening existing notions of risk factors and mechanisms of formation of unfavorable course of DNG in puberty. The methods of research: clinical, anthropometric, instrumental, immunological, immunoenzymatic, radioimmunoassay, biochemical, fluorometrical, statistical. The results of study, scientific novelty: The presents a new data on the effect of puberty on the DNG frequency in adolescents. Transformation of the diffuse goiter at the stages of puberty and the most informative factors concerning the prognosis of the DNG have been studied. A number of patients with symptoms of thyroid insufficiency and disorders in somatic and sexual development, especially in unfavorable course DNG, increase significantly at early puberty. The role of disturbances in the cellular and phagocytic links of the immune system, an imbalance of cytokines, a decrease in the level of vitamins and essential elements on the background of the excessive accumulation of toxic metals in the mechanisms of the disease unfavorable course have been established in the work. Some features regarding formation the of the sexual development delay in patients with the goiter have been established. A new concept of a differentiated approach to the examination and treatment of patients with DNG, based on defining an individual prognosis of the disease course, has been worked out. Degree of introduction: the obtained data can be used as theoretical augmentation for development of the practical steps directed on the prophylaxis the formation of DNG in a lung of iodine deficiency and prevention of disease progression in puberty. The sphere of application: endocrinology, paediatric.