ACTA ENDOCRINOLOGICA (BUC)

Context. Chronic stress is characterized by increased release of catecholamines, glucocorticoids and other neurohumoral factors, predisposing individuals to obesity, insulin resistance and vascular disease, pathologies considered priority health problems. Study of alterations induced by stress on metabolism in association with food intake modulatory hormones (insulin, leptin and ghrelin) is mandatory. Objective. This research studied temporal course during 60 days of chronic unpredictable mild stress (CUMS) on glucose and lipids metabolism, and on the neuroendocrine system that regulates appetite-satiety balance. Materials and Methods. Wistar rats were exposed to CUMS for 20, 40 and 60 days. Corticosterone stayed high during 60 days of CUMS; after 40 days, body weight, cholesterol and triglycerides decreased and glucose intolerance was evident at day 60; insulin and ghrelin increased at 20 and 40 days, respectively; leptin decreased after day 20. Data suggest that 60 days of CUMS progressively disturb metabolism of carbohydrates and lipids as well as food intake regulatory hormones, affecting the metabolism, and can lead to the development of chronic degenerative diseases, such as cardiovascular disease, metabolic syndrome and type 2 diabetes.

Context. Oxytocin has been investigated as a potential medication for psychiatric disorders. Objective and design. This study prospectively investigates correlations between oxytocin and other neuropeptides plasma levels in patients with autism spectrum disorders (ASD) according to severity and treatment, as compared to controls. Subjects and methods. Thirty-one children (6 neurotypical as control) participated in this study. The patients were classified into mildly and severely-affected, according to Autism Diagnostic Observation Schedule (ADOS) scores. Oxytocin, orexin A and B, α-MSH, β-endorphins, neurotensin and substance P were investigated using a quantitative multiplex assay or a competitive-ELISA method. Results. Plasma oxytocin levels differed between the groups (F (2, 24) =6.48, p=0.006, η2=0.35, observed power=86%): patients with the mild ASD had higher values of plasma oxytocin than those with the severe form (average difference=74.56±20.74pg/mL, p=0.004). Conclusions. These results show a negative correlation between plasma levels of oxytocin and the severity of ASD and support the involvement of oxytocinergic mechanisms in ASD.

Hypothalamic kisspeptin signaling has been recently observed to correlate with seasonal breeding in free ranging male rhesus monkeys. Recent evidence also suggests that excitatory and inhibitory amino acid neurotransmitters contribute in regulation of kisspeptin neurons. Objective. The present study was focused on analyzing the interplay of Kiss1 neurons with afferent excitatory and inhibitory signals in the brain of male rhesus monkeys during the breeding and non breeding seasons. We hypothesized that: kisspeptin stimulation may occur due to the increase in N-methyl-D,L-aspartate (NMDA) dependant excitatory inputs and decrease in inhibitory γ-aminobutyric acid (GABA) based cues during the breeding season Materials and Methods. Messenger ribonucleic acid (mRNA) was extracted from the medio basal hypothalamus (MBH) of five free ranging adult male rhesus monkeys (Macaca mulatta) during the breeding season (n=3; October; plasma testosterone levels: 26.15±2.64 nmol/L; testicular volume: 69.00 ± 0.57 ml); and the non-breeding season (n=2; July; plasma testosterone levels: 4.09±1.64 nmol/L; testicular volume: 12.88±0.31 ml). Real time polymerase chain reaction (RT-PCR) was used to quantify the levels of Kiss1, Kiss1r, NR1 and glutamic acid decarboxylase (GAD67) mRNA, relative to glyceraldehyde-3-phosphate dehydrogenase (GAPDH). Results. Significantly high (p<0.05) expression of Kiss1, Kiss1r and NR1 mRNA and low (p<0.05) expression of GAD67 mRNA in the hypothalamus were found to be in synchrony with the breeding season. Conclusion. Based on correlative gene expression changes in the adult male monkey hypothalamus we suggest that in higher primates increased kisspeptin signaling during breeding season may be entrained by an increase in NMDA excitatory inputs; while decreased kisspeptin signaling during the non-breeding season may be driven by an increase in GABA based inhibitory cues.

The determination of cardiac peptides at rest and during exercise stress testing (ET) represents a useful tool for the diagnosis of heart failure patients, but their usefulness in isolated LV diastolic dysfunction was less studied until now.\r\nAim. The aim of this study is to compare the effect of ET upon cardiac peptides in patients with left ventricular systolic and diastolic dysfunction.\r\nMethods. There were studied 101 heart failure patients, 58 with systolic LV dysfunction (LVEF 37.8%) and 43 patients with isolated LV diastolic dysfunction, mainly with hypertension (31 cases). All patients were submitted to a symptom-limited ET on cycloergometer, blood samples being obtained before ET and at peak effort. The plasmatic levels of N terminal pro brain-type natriuretic peptide (NT-proBNP) were determined using ELISA method (n.v. <250 fmol/ml). The systolic and diastolic LV functions were determined by echo-Doppler, according to ESC guidelines.\r\nResults. The results showed that the rest NT-proBNP values were increased in patients with LV systolic dysfunction (640?220 fmol/ml) in comparison with diastolic dysfunction (419 ?120 fmol/ml), p<0.01. At peak effort NT-proBNP increased to 790?242 fmol/ml (23%) in patients with systolic dysfunction (p<0.04) and to 490.2?179 fmol/ml (17%) in patients with diastolic dysfunction (p= NS). There was a close relationship between rest and exercise NT-proBNP values in both systolic (r=0.99, p< 0.05) and diastolic (r=0.72) LV dysfunction. \r\nIn conclusion, in heart failure patients with both systolic and diastolic LV dysfunction, NT-proBNP is increased at rest and during exercise, the increase being significant for patients with LV systolic dysfunction, probably in relationship with more important hemodynamic abnormalities.

Introduction. Primary hyperparathyroidism is diagnosed earlier and more frequently with the introduction of routine serum calcium measurements. In literature, it is shown that mortality and morbidity decrease after parathyroidectomy. In our study, we aimed to determine the effect of parathyroidectomy on oxidative stress. Materials and Methods. The results of 41 patients who underwent parathyroidectomy for primary hyperparathyroidism between March 2018 and end of December 2018 were evaluated prospectively. Total antioxidant capacity (TAC), superoxide dismutase (SOD), thiobarbituric acid reactive substances (TBARS), 8-hydroxy- 2’-deoxyguanosine (8-OHdG), malondialdehyde (MDA), parathyroid hormone, calcium and albumin were measured before and after parathyroidectomy. Results. The mean age of the patients in the study was 45 ± 13.1 years (age range: 18-76 years). The female/ male ratio was 32/9. Postoperative values of 8OHdG, MDA and SOD 1 were significantly lower than preoperative values (p <0.05). There was no significant difference between preoperative and postoperative TAC and TBARS values. Conclusion. Oxidative stress decreased in patients with primary hyperparathyroidism after parathyroidectomy. Randomized prospective studies are needed to show the relationship between biochemical and clinical parameters in order to see the clinical reflection of the study.

Context. Aromatase is a key enzyme in local estrogen production by androgen conversion, especially in women post-menopause. There have been controversies concerning aromatase localization in breast carcinomas and its association with current histopathological variables. Material and Methods. Using polyclonal antibody immunohistochemistry we assessed (by intensity and percentage scores) the immunolocalization of aromatase in 70 tissue samples, and described particularities within the molecular subtypes of breast cancer. Results. Aromatase was found in all tissue compartments: tumor (95.7%), stroma (58.6%) and adipose tissue (94.3%). Aromatase expression in tumor cells correlated inversely with tumor grading (p=-0.361, p=0.027), and positively with estrogen receptor status (ER, p=0.143, p<0.001). Dividing the study group by intrinsic subtypes, a strongly inversely association between tumor aromatase and grading (p=-0.486, p<0.001), and between stromal aromatase and Ki67-index (p=-0.448, p=0.048) was observed in luminal A breast cancer. Tumor aromatase and ER percentage scores had stronger correlations in luminal B HER2 negative (p=0.632, p=0.002), and positive (p=0.324, p=0.026) tumors. In contrast, in triple negative tumors, a positive association stromal aromatase and Ki67 index (p=- 0.359, p=0.007) was observed. Conclusion. Local aromatase was linked to better tumor differentiation and proliferation in luminal breast subtypes, and not in triple negative cases, suggesting a potential prognostic role of aromatase in breast carcinomas.

Introduction. The recall rate in congenital hypothyroidism (CH) newborn screening programs depends on several factors such as primary screening strategy, sample collection guidelines, and cut-off. A recall rate of 0.05% is recommended but recall rates of 0.01-13% are reported worldwide. Objective. The aim of the study was to assess the recall rate in association with the age of the newborn at sample collection and with a lower cut-off. Design. This was a retrospective correlational study concerning TSH results in CH screening program. Subjects and methods. All newborns from a tertiary center in Targu Mures, Romania between 2013-2018 were included. Four groups were created and a correlation test between TSH median value and age in days was performed. The recall rate was calculated using three cut-off levels for 8182 TSH results performed in 2018. Results. 90% of the DBS were collected in days 3-5 after birth and 1/79 live births from this group had TSH above the lower cut-off used (10 mUI/L). 2% of the samples were collected in less than 48 hours after birth and 1/21 live birth from this group had TSH > 10 mUI/L. The recall rate in our center in 2018 was 0.08%, higher than the recommended rate of 0.05%. With the cut-off value recommended by the Health Ministry a 0.03% recall rate was obtained. Conclusions. Sample collection in less than 48 hours increases the recall rate in CH screening with TSH primary testing strategy. A lower cut-off raises the recall rate with a higher rate of false-positive cases (94.12%) but with 100% negative predictive value.

12 adult male and 12 female Wistar albino rats were used to measure the levels of the serum follicle stimulating hormone (FSH), the luteinizing hormone (LH), the estradiol (E2) and the progesterone in female rats, as well as the FSH, the LH and the testosterone in male rats, following 8-hour daily inhalation exposure to gasoline vapours for 6 weeks, to assess the effect of the vapours on the reproductive integrity of experimental animals. The results showed that the levels of serum FSH and LH obtained for female rats in the test group (3.48?0.03 and 19.97?1.20mIU/ml, respectively) were insignificantly lower (p>0.05), compared respectively to the levels obtained for female rats in the control group (3.62?0.12 and 20.06?0.23mlU/ml, respectively), whereas the levels of serum estradiol and progesterone obtained for female rats in the test group (25.02?2.32pg/ml and 0.18?0.02mg/ml, respectively) were significantly lower (p<0.05), compared respectively to the levels obtained for female rats in the control group (39.84?3.64pg/ml and\r\n0.33?0.02mg/ml, respectively). On the other hand, the levels of serum FSH and LH obtained for male rats in the test group (2.87?0.21 and 3.09?0.32mIU/ml, respectively) were insignificantly higher (p>0.05), compared to the levels obtained for male rats in the control group (2.75?0.14 and 2.93?0.12mIU/ml, respectively).At the same time, the level of serum testosterone in the male test rats (7.82?2.17ng/dl) was significantly higher (p<0.05), compared to the level in the male control rats 4.66?1.85ng/gl. The results of this study showed that the adverse effect of inhalation exposure to gasoline fumes on the reproductive integrity in rats is sex-dependent, with the females being more vulnerable.

Aim. We investigated the relationship between irisin concentrations and glycemic control, body composition and anthropometric measures in children with type 1 diabetes mellitus. Methods. The study involved 40 subjects with T1DM prospectively. Glycemic control was evaluated. Body composition was analyzed with a bioimpedance analyzer (BIA). Serum irisin concentrations were measured using an ELISA kit. Results. Irisin levels were found higher in BMI <17 kg/m2 group (p=0.002) compared to BMI >17 kg/m2. Irisin level was negatively correlated with weight, height, BMI, fat free mass, skeletelal muscle mass, basal metabolic rate (r= -0.40, p= 0.011; r=-0.32, p=0.046; r=-0.366, p= 0.022; r=-0.423, p= 0.007; r=-0.430, p=0.006; r=-0.416, p=0.009, respectively); there was a strong correlation between LDL-C and irisin levels (r=0.367, p=0.02). In multivariate linear regression analyses model, irisin concentrations were correlated with weight (ß-coefficient= - 0.391, p= 0.015). LDL-C is associated, but not correlated significantly with irisin levels, (ß-coefficient =0.272, p=0.084). Conclusion. As a result, weight and LDL-C were the predictors of circulating irisin. To our knowledge, this study is the first examining association between irisin levels and body composition comprehensively, in children with type 1 diabetes mellitus.

Objective. In this study we investigated the effect of dorsomedial hypothalamus (DMH) neuropeptide Y (NPY) knock-down on hepatic insulin sensitivity in high-fat (HF) diet-fed rats. Methods. Forty-eight Sprague-Dawley rats were randomly assigned to receive bilateral DMH injections of adeno-associated virus AAVshNPY or AAVshCTL and then accessed to regular chow. Five weeks after viral injection, half rats in each group were given access to the HF diet. At 16 weeks, rat livers were collected. Insulin receptor substrate-1 (IRS-1) and phosphoinositide 3-kinase (PI3K) mRNA expression was measured by qRT-PCR. Blood glucose levels were measured by the oxidase method, serum insulin, triglyceride, and TC levels were measured by Elisa. Pathological changes in the liver were assessed by hematoxylin-eosin (HE) staining. AKT, p-AKT, and GSK-3 levels were measured by western blotting. Results. Compared with AAVshCTL-injected rats, AAVshNPY-injected rats showed a significant decrease in blood glucose concentrations; serum insulin, triglyceride, and TC; HOMA-IR; and IRS-1 and PI3K mRNA levels (P<0.05). ISI, GSK-3, and p-AKT levels were significantly increased (P<0.05). HE staining showed that AAVshNPYinjected rats fed the HF diet had mild fatty degeneration. Conclusion. These results suggest that DMH NPY knock-down improves hepatic insulin sensitivity in HF diet-fed rats by activating the hepatic PI3K/AKT insulin signalling pathway.