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Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_2885_Библиотеки_им_академика_М_И_Перельмана.pdf
E
EC50, 17
Ectopic hormone secretion, 14
Egg donation, 130
Eicosanoids, 165–166, 165f
eicosanoids, 164–166
Emergency hormonal contraception, 129
Endocrine axis, 8
Endocrine control of parturition, 115
Endocrine disorders, 10
causes, 11t–12t
features, 11t–12t
investigation of, 10–14
biological samples, 13
ectopic hormone secretion, 13–14
imaging, 13, 13t
Endocrine glands
autocrine regulation, 6, 6f
classical, 2
hormones, 3t
neural regulation, 2–3, 4f
neuroendocrine, 2–3, 4f
paracrine, 6, 6f
Endocrine hypertension, 60
Endocrine pancreas, 134, 134t
Endocrine regulation
hormone secretion patterns, 8–10, 8f
diurnal variation, 8
endocrine axis, 9, 9f
episodic secretion, 8
negative feedback, 9–10, 9f
set point regulation, 8–9
Endocrinology, 2
bone, 151–153
centenary, 2, 2f
endocrine tests, 12
hormones, 3t
multiple organ disorders
autoimmune polyglandular
endocrinopathy, 171
multiple endocrine neoplasia (MEN),
171, 171t
multiple organ disorders in, 171
next 100 years of, 172
pregnancy, 112–115, 114f
Environmental endocrine disruptors, 100
Epidermal growth factor receptor (EGF- R),
22
Erythropoietin, 164
F
Female reproductive system
endocrinology of pregnancy, 112–115, 114f
adrenocorticotropic hormone (ACTH),
113
binding proteins, 113
endocrine control of parturition, 115
foeto–placental unit, 112–113, 114f
hormone secretion by the placenta, 112
lactation, 115, 115f
modern pregnancy testing kit, 113b
Female reproductive system (Continued)
non- placental hormones, 113
old- fashioned pregnancy testing, 113b
placenta, 112
hormone- dependent cancer in women,
107
menstrual cycle, 107–110
ovaries. See Ovaries
puberty, 102
structure of, 102, 102f
Fertilisation, 112
Fertility
differentiation, 118
gender determination, 118
hormones
assisted conception, 129–130
contraception, 128–129
hormonal control, 128–129
hormone replacement therapy, 126–127
menarche, 120–122
puberty. See Puberty
reproductive hormones, 118
sexual differentiation
abnormalities of, 119–120, 119f
hormonal control of, 118–119
Fetal programming, 115
Fight or flight response, 54
Foetal adrenal gland, 55
Foetal zone, 55
Foeto–placental unit, 112–113, 114f
Follicle stimulating hormone (FSH), 41, 94,
104, 107, 120–121
Follicular cells, 78–79
Folliculostellate cells, 40–41
G
Gender benders, 100
Gender determination, 118
Germ cells, 91–92
Gestational diabetes, 145
Glucagon, 137–138
Glucagon- like peptide 1 (GLP1), 134
Glucocorticoids, 25, 47, 71–73, 72f, 158
pharmacological uses of, 73–74, 74t
steroid treatment card, 74, 74f
Glucose
blood, levels, 135
diabetes clinic, 142
diabetes mellitus, 138–145
disorders of, 138–145
endocrine pancreas, 134, 134t
gestational diabetes, 145
glucagon, 137–138
at home, 141–142
insulin secretion, 134
measurement, 141–142
metabolic syndrome, 145–147, 146f,
146b
oral glucose tolerance test, 138
pancreas, anatomy of, 133f, 134
poor glycaemic control, long- term
consequences of, 145
Glucose (Continued)
sources, 132, 133f
type 1 diabetes, 138–140, 146b
type 2 diabetes, 143
in urine, 132–133
Glucose- dependent insulinotropic peptide
(GIP), 134
Glycaemic control, 145
Glycoproteins, 17–18
Glycosuria, 10
Goitre, 77f, 77, 78f
Golgi apparatus, 5
Gonadotropin releasing hormone (GnRH), 8,
48, 94, 107–108
G- protein coupled receptor kinases (GPK),
20–21
G- protein coupled receptors (GPCRs),
18–19, 94
Graves disease, 84
Growth hormone (GH), 41, 43–44, 46–49, 158
Growth hormone binding protein
(GHBP), 46
Growth hormone receptor (GHR), 49
Growth hormone releasing hormone
(GHRH), 44, 45f
Guanosine diphosphate (GDP), 18
Gut hormones, 168–169, 169t
Gynaecomastia, 81, 123
H
Headaches, 35b
Histocompatibility (HLA), 141b
Homeostasis, 2
Hormone- dependent cancer in men, 98
Hormone replacement therapy (HRT),
126–127, 160
alternative therapies, 127–128
long- term HRT, 126–127
Hormones, 2–3
amino acids, 5, 5f
antagonism, 10
binding proteins, 6–7, 7t
catecholamines, 5–6, 6t
chemical structures, 5–6
circulate, 17
definition, 2
growth, 22
hypothalamic hormones, 37
hypothalamus, 31
measurement of, 13b
metabolism of, 6–8
miscellaneous
ageing, hormone replacement therapy
in, 166
age- related changes in, 166
appetite, hormonal control of, 169–171,
170f
autoimmune polyglandular
endocrinopathy, 171
blood pressure, 171–172, 172f–173f
cytokines, 164–166
eicosanoids, 164–166, 165f
INDEX
179
INDEX
Hormones (Continued)
endocrinology, multiple organ disorders
in, 171
erythropoietin, 164
gut hormones, 168–169, 169t
immune–endocrine interactions,
164–166
melatonin, 166–167, 167f
multiple endocrine neoplasia (MEN),
171
peptide hormones, 3–5, 4f
pituitary gland, anterior, 43–44, 46–49
posterior pituitary, 32
response elements, 25
secretion, 3–6, 4f, 8–10, 8f
diurnal variation, 8
endocrine axis, 9, 9f
episodic secretion, 8
negative feedback, 9–10, 9f
by placenta, 112
regulation of, 43–46, 43f, 44t
set point regulation, 8–9
serum calcium, 153, 158
steroids, 5, 5f
synergy, 10
synthesis, 3–6, 4f
thyroid hormones, 5, 5f
transport, 6–8
types of, 3–6
Human chorionic gonadotropin (hCG), 41,
112
Human leucocyte antigen (HLA),
138–139
Hypercalcaemia
disorders of, 158–159
treatment, 158, 159f
vitamin D, 159
Hyperglycaemia, 142
Hypergonadotropic hypogonadism, 99
Hyperosmolar non- ketotic coma, 145
Hyperprolactinaemia, 110, 123
Hyperthyroidism, 84
Hypocalcaemia, disorders of, 159–160
parathyroid hormone (PTH) deficiency,
160
vitamin D deficiency, 159
Hypocretins, 37
Hypoglycaemia, 145
Hypoglycaemic coma, 142
Hypophyseal portal system., 31
Hypopituitarism, 50
Hypothalamic diabetes insipidus, 35
Hypothalamic insipidus, 35
Hypothalamic tumour
investigation, 31b
signs, 35b
symptoms, 35b
Hypothalamo- pituitary- adrenal axis (HPA
axis), 40, 66
Hypothalamo–pituitary–testicular axis, 90
Hypothalamo–pituitary–thyroid axis, 81f
Hypothalamus
development of, 31–32
hormones, 31, 37
investigation, 31b
Hypothyroidism
signs, 87f
symptoms, 87f
treatment, 86–87
I
IGF binding protein (IGFBP), 46–47
Imbalanced sex steroids
case history, 103b
diagnosis, 106b
fertility, 112b
investigations, 109b
treatment, 111b
Immune–endocrine interactions
cytokines, 165
eicosanoids, 165–166, 165f
Inferior vena cava (IVC), 54f
Inguinal canal, 90
Inguinal hernia, 90
Inherent tyrosine kinase activity, 22
Insulin, 22
blood, 135
deficiency, 138–140
gestational diabetes, 145
glucose, 136, 137f
glucose- stimulated insulin secretion, 136f
ketoacidosis, 139–140, 139f
metabolic effects of, 136b
metabolic syndrome, 145–147
poor glycaemic control, long- term
consequences of, 145
receptor, 136–137, 137f
resistance, 137, 143
therapy, 141
type 1 diabetes mellitus. See Type 1
diabetes mellitus
Insulin- like growth factor- 1 (IGF- 1), 46–47
Insulin receptor substrate (IRS), 22, 137
Internal secretion, 2
Intracellular receptors, 24–25, 24f
Intrinsic guanylyl cyclase activity, 23f
Iodine, 79
deficiency hypothyroidism, 85–86
IVF treatment, 130
J
Janus- associated kinase- signal transducer
and activator of transcription (JAK-
STAT) pathway, 22, 48, 165
K
Ketoacidosis, 139–140, 139f
Klinefelter syndrome, 99, 119
L
Lactation, 115, 115f
Leydig cells, 91, 94, 98
Ligand
efficacy, 17
potency, 17
properties, 17
Lipid metabolism, 47
Lipophilic steroid, 5–6
Long- term contraception, 128–129, 129f
Long- term HRT, 126–127
Low- density lipoproteins (LDL), 65
Luteinising hormone (LH), 26, 41, 94, 104,
120–121
M
Male contraceptive pill, 129
Male reproductive system
anabolic androgenic steroids (AASs), 99–100
androgens, therapeutic uses of, 99, 100f
disorders of, 98–99, 98f
primary hypogonadism, 99
secondary hypogonadism, 99
hormone- dependent cancer in men, 98
sperm counts, declining, 100
structure, 90, 90f
testes. See Testes
testosterone. See Testosterone
Melatonin, 8, 166–167, 167f
Menarche, 120–122
Menopause
acute symptoms, 125b
climacteric, 123–124
definition, 123–124
premature ovarian failure, 124
symptoms of, 124–126
Menstrual cycle, 107–110, 108f
disorders of, 110–111
hirsutism, 111b
hypothalamic causes, 110
pituitary causes, 110
polycystic ovarian syndrome (PCOS),
110–111, 111f
premature ovarian failure, 110
follicular phase, 108–109
LH surge, 109
luteal phase, 109–110
menstrual phase, 108
ovaries. See Ovaries
ovulation, 109
proliferative phase, 108–109
Metabolic syndrome, 145–147, 146f, 146b
description, 147
diagnosis, 146–147, 146f
growing problem, 145–147
treatment, 147
Metformin, 147
Mifepristone, 16
Mineralocorticoid (MR), 25
Mineralocorticoid excess, 73
Mitogen- activated protein kinases (MAPK), 22
Modern pregnancy testing kit, 113b
Monoamine oxidase (MAO), 8, 56–57
Morning- after pill, 129
Multiple endocrine neoplasia (MEN), 171
Myxoedema, 86
180
N
Nephrogenic diabetes insipidus, 35–36
Nerve supply, 93
Neural regulation, 2
Neural system, 2
Neuroendocrine reflex, 32–33, 33f
Neuro- hormones, 2–3
Neuropeptide kisspeptin, 120
Neurophysin, 32
Neurotransmitter, 2–3, 55
Non- insulin- dependent (NIDDM),
132, 143
Non- placental hormones, 113
Non- steroidal anti- inflammatory drugs
(NSAIDs), 166
Norepinephrine, 56
Nuclear hormone receptors, 24
Nuclei, 28–29
O
Obesity, 145–146
Octreotide, 49
Oestrogens, 98, 124, 153
cellular actions of, 104
metabolism of, 104
physiological actions of, 104–105
transport, 104
Old- fashioned pregnancy testing, 113b
Oral contraceptive pill, 128
Oral glucose test, 45b–46b
Oral glucose tolerance test, 138
Orexin, 37
Orexin A, 37
Orphan receptors, 25
Osteoclasts, 152
Osteomalacia, 160
Osteoporosis, 127, 160
Ovaries
activin, 106
androgen secretion by, 106
corpus albicans, 102
dehydroepiandrosterone (DHEA), 106
follicles, 102
follicular development stages, 103f
gonadotropins, 102
histology of, 102, 102f
hormonal regulation of, 107
hormones, 102
oestrogens, 102
progesterone, 102
inhibin, 106
menopause, 102
peptide hormones, 106
primary oocyte, 102
relaxin, 107
Ovulation, simple induction of, 129–130
Oxytocin, 32–33
P
Paget disease, 161
Pancreas
anatomy of, 133f, 134
endocrine, 134, 134t
Panhypopituitarism, 50
Paracrine effect, 6
Parathyroid glands, 153
Parathyroid hormone (PTH), 153–155, 164
actions of, 154, 154f
parathyroid glands, 153
parathyroid hormone related peptide
(PTHrp), 154–155
secretion, 153–154, 154f
Parathyroid hormone related peptide
(PTHrp), 14, 154–155
PEGylation, 49
Pendrin, 78–79
Peptide hormones, 3–5, 4f
Peptides, 17–18
Peroxisome- proliferator activated protein
gamma (PPAR- gamma), 25–26, 144
Phaeochromocytoma, 55b
adrenal medulla, disorders of, 59
causes of, 59t
diagnosis, 57b
familial phaeochromocytoma, 59
treatment, 57b
Phenylethanolamine- N- methyltransferase
(PNMT), 56
Phosphatases, 20
Phosphate, 161
Phosphatidylinositol bisphosphate, 19
Phosphorylation, 20
Phyto- oestrogens, 105
Pituitary gland
hypothalamus, 31
development of, 31–32
impaired sexual function, 35b
pituitary gland, anterior. See Pituitary
gland, anterior
pituitary gland, posterior. See Pituitary
gland, posterior
Pituitary gland, anterior
acromegaly, 40b
actions of, 46–48
beta endorphin, 42
blood, 46
carbohydrate metabolism, 47
disorders
oversecretion, 48–49
undersecretion, 50, 50f
growth hormone, 43–44, 46–49
receptors, 46
growth hormone releasing hormone
(GHRH), 44, 45f
hormones of, 41–42, 41f–42f
hypopituitarism tests, 50–51
insufficient growth hormone secretion,
50–51
insulin- like growth factor- 1 (IGF- 1),
46–47
lipid metabolism, 47
metabolism, 47
prolactin, 43–44, 47–48
secretion regulation, 45
prolactinoma, 49–50
Pituitary gland, anterior (Continued)
protein metabolism, 47
regulation of hormone secretion, 43–46,
43f, 44t
stress hormones, 46b
structure of, 40f, 40–41, 40t, 41f–42f
Pituitary gland, posterior
hormones of, 32
neuroendocrine reflex, 32–33, 33f
oxytocin, 32–33
vasopressin, 32, 33f
Placenta, 112
Plasma calcium, 157. See also Serum
calcium
Plasma osmolality, 34b
Pocket- sized glucose monitors, 141–142
Polydipsia, 36
Polyuria, 36
Pregnancy
adrenocorticotropic hormone (ACTH), 113
binding proteins, 113
endocrine control of parturition, 115
foeto–placental unit, 112–113, 114f
hormone secretion by the placenta, 112
lactation, 115, 115f
modern pregnancy testing kit, 113b
non- placental hormones, 113
old- fashioned pregnancy testing, 113b
placenta, 112
Premature ovarian failure, 124
Pre- proinsulin, 134
PreproPTH, 153
Primary hyperparathyroidism, 150b
case history, 150b
explanation, 158b
investigations, 152b
test results, 155b
Primary hypogonadism, 99
Progesterone
actions of, 106
definition, 105–106
metabolism of, 104
transport, 104
Progesterone (PR), 25
Prolactin (Prl), 41, 43–44, 47–48
Prolactinoma, 49–50
Pro- opiomelanocortin (POMC), 41
Prostacyclin, 166
Protein kinase A (PKA), 20, 20f
Protein metabolism, 47
Psychogenic polydipsia, 36
Puberty, 96, 120–122
boys, 121, 121f
delayed puberty. See Delayed puberty
disorders, 122–123
gynaecomastia, 123
girls, 121–122, 121f
R
Radiological imaging, 13
Reactive hypoglycaemia
case history, 167b
diagnosis, 169b–170b
INDEX
181
INDEX
Reactive hypoglycaemia (Continued)
investigation, 168b
pathophysiology, 169b–170b
Receptor activator of NF- KB ligand
(RANKL), 152
Receptors
agonists, 16
androgens, 25f
antagonists, 16
beta arrestin, 20–21
binding properties, 16–17, 16f
cell- membrane receptors, 17–18
characteristics of, 16–17
class II receptors, 25–26, 25f
class I receptors, 25, 25f
cytokine receptors, 22
desensitisation, 20–21
disorders of, 26
dissociation constant (KD), 17, 17f
dose–response effects, 16, 16f
downregulation, 20–21
GPKs, 20–21
G- protein coupled receptors, 18–19
growth hormone, 22
guanosine diphosphate (GDP), 18
heat shock protein (HSP), 25f
insulin, 22
intracellular receptors, 24–25, 24f
ligand properties, 17
phosphatases, 20
protein kinases, 20–22
second messenger systems, 18–20
transcription, hormonal regulation of,
22–26
types of, 17–21
ubiquitination, 21
Renal threshold, 132–133
Replacement therapy, 35
Reproductive hormones, 118
Reproductive system
female. See Female reproductive system
male. See Male reproductive system
Retinoic acid X receptor (RXR), 25–26, 82
Rhythm method, 128
Rickets, 160
S
Secondary hypogonadism, 99
Secondary thyroid failure, 10
Second messenger systems, 19–20
calcium signalling, 19–20, 20f
cyclic adenosine monophosphate (cAMP),
19, 19f–20f
phosphatidylinositol bisphosphate, 19, 20f
Selective oestrogen receptor modulators
(SERMs), 107b
Sella turcica, 31
Seminiferous tubules, 91–92, 92f
Sertoli cells, 91–92, 95
Serum calcium
calcitonin, 161
hormones, 153, 158
Serum calcium (Continued)
primary hyperparathyroidism, 150b
serum phosphate regulation, 161
sources of, 150, 150f
Serum growth hormone, 45b–46b
Serum phosphate regulation, 161
Sex hormone binding globulin (SHBG), 95,
104, 106
Sex steroids, 153
Sexual dysfunction, 127
Sinusoids, 54–55
Sodium- glucose linked transporter 2
(SGLT2), 144
Sodium- glucose linked transporter (SGLT1),
132
Spermatogenesis, 90, 92f, 93, 95
Spermatogonia, 91–92
Sperm counts, declining, 100
Sperm motility, 100
Splanchnic nerves, 55
Steroid biosynthesis, 63–65, 65t
ACTH, 66–67, 67f
aldosterone, 67–68
congenital adrenal hyperplasia, 67b
cortisol, 66, 66f–67f
defects of, 64f, 65, 65t
dehydroepiandrosterone (DHEA), 68
renin–angiotensin system, 67–68
Steroid hormones transport, blood, 68–71
adrenal androgens, actions of, 70–71
adrenal steroids, actions of, 68
aldosterone, physiological actions of, 69
cortisol, physiological actions of, 68–69
glucocorticoids, 69b
Steroidogenesis, 63–65
Steroid- rich blood, 55
Steroids hormones, 5, 5f
Stress hormones, 46b
Sulphonylureas, 143–144
Suprachiasmatic nucleus (SCN), 8
Sympathetic ganglion, 55
Syndrome of inappropriate antidiuretic
hormone (SIADH), 36
Synergy, 10
Synthetic adrenocorticotropin, 12
T
T3, 79–81
Tachycardia, 85
Tertiary thyroid failure, 10
Testes
androgen production, 93, 93f
definition, 90
inguinal hernia, 90
made up of, 91
nerve supply, 93
route of descent, 90, 91f
seminiferous tubules, 91–92, 92f
sertoli cells, 91–92
spermatogenesis, 92f, 93
temperature, 90
testicular blood, 93
Testes (Continued)
testicular function, hormonal control of,
94–95
control of spermatogenesis, 95
control of testosterone secretion, 94
leydig cell function, 94
sertoli cell function, 95
vasectomy, 93
Testicular blood, 93
Testicular function, hormonal control of,
94–95
control of spermatogenesis, 95
control of testosterone secretion, 94
leydig cell function, 94
sertoli cell function, 95
Testosterone, 119
actions of, 95–98
androgens, 97t
cellular actions of, 95, 96f
physiological actions of, 96–97, 96f
oestrogens, 97, 97f
replacement therapy, 99
secretion, 94
transport of blood, 95
Testosterone binding globulin (TeBG), 95
Tetrahydrogestrinone (THG), 99
Tetra- iodothyronine (T4), 78–79
Thiazolidinediones (TZD), 144
Thirst, 36
Thromboxane, 166
Thyroglobulin, 78–79
Thyroid follicles, 78
Thyroid function test, 81
Thyroid gland, 2
anatomy of, 76f, 77
blood, 77–81
control of thyroid function, 81–82, 81f
depression, 86b
disorders of
hyperthyroidism, 84
thyrotoxicosis, 84–85
thyrotoxicosis treatment, 85
goitre, 77f, 77, 78f
hormones
cardiovascular effects, 83
cellular action of, 82, 82f, 83t
developmental effects, 83
effects of, 82–83
hypothyroidism treatment, 86–87
insufficiency in adults, 86–87
metabolic effects, 83
other effects of, 83
respiratory effects, 83
secretion, 83–85
hypothalamo–pituitary–thyroid axis, 81f
iodine, 79
structure, 78, 78f
synthesis of, 78–79, 80f
T3, 79–81
thyroid function test, 81
thyroid hyposecretion
autoimmune thyroid disease, 86
causes of, 85–86
congenital hypothyroidism, 86
182
thyroid hyposecretion (Continued)
iodine deficiency hypothyroidism,
85–86
thyroxine, 79–81
thyroxine binding globulin (TBG), 79–81
weight loss. See Weight loss
Thyroid hormone binding globulin (THBG),
113
Thyroid hormone receptors (TR), 82
Thyroid hyposecretion
autoimmune thyroid disease, 86
causes of, 85–86
congenital hypothyroidism, 86
iodine deficiency hypothyroidism, 85–86
Thyroid stimulating hormone (TSH), 3–4, 26,
41, 77, 81–82, 113
Thyrotoxicosis, 84–85
treatment, 85
Thyrotropin releasing hormone (TRH), 3–4, 45
Thyroxine, 8, 79–81
Thyroxine binding globulin (TBG), 79–81
Transforming growth factor- (TGF- ) peptide
family, 106
Tri- iodothyronine (T3), 78–79
Tubercular lung tissue, 36
Type 1 diabetes mellitus, 138–140, 146b
case history, 138b
complications of, 142
diabetic ketoacidosis, 142
hypoglycaemic coma, 142
diagnosis, 140b
diet, 140–141
explanation, 141b
glycaemic control, 142b
insulin therapy, 141
investigations, 141b
Type 2 diabetes mellitus
complications, 145
hyperosmolar non- ketotic coma, 145
hypoglycaemia, 145
HONK, 143b
management of, 143–144
non- insulin- dependent diabetes, 143
risk factors, 143t
U
Unexpected fracture
case history, 92b
diagnosis, 99b
examination, 98b
investigation, 99b
treatment, 99b
Urine, glucose in, 132–133
Urine testing, 13
V
Vanillylmandelic acid (VMA), 56–57
Vascular endothelium, 2
Vasectomy, 93, 128
Vasoactive intestinal polypeptide (VIP), 59
Vasopressin, 32, 33f
actions of, 34–35, 34t
blood pressure, 33
disorders of, 35–36
plasma osmolality, 31b, 33
posterior pituitary, 32, 33f
regulation of, 33–35
replacement therapy, 35
resistance, 35
secretion, 36
thirst, 36
V1 receptors, 34
V2 receptors, 34
Vitamin D, 25–26, 155–158, 156f
blood, 156
Vitamin D3
formation and structure of, 156f
sources and activation of, 156f
therapeutic uses of, 157–158
Vitamin D response elements (VDREs),
156–157
V1 receptors, 34
V2 receptors, 34
W
Water
balance, regulation, 36
intoxication, 36
resorption, vasopressin effect, 34
Weight loss
anatomy, 79b
case history, 76b
diagnosis, 82b
investigations, 81b
symptoms, 84b
treatment, 85b
Wermer syndrome, 171
Wolffian ducts, 118, 118f
X
X chromosome, 95–96, 110, 119
X- linked recessive condition, 95–96
Y
Y chromosome, 118
Yellow body, 102
Z
Zeitgebers, 167
Zinc fingers, 24
Zollinger–Ellison syndrome, 168
Zona fasciculata, 62, 62f
Zona glomerulosa, 62, 62f, 67–68
Zona reticularis, 62, 62f
INDEX
183
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