ACTA ENDOCRINOLOGICA (BUC)

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Background. The literature contains several definitions of the metabolic syndrome, different from one another through the components included and the reference ranges considered normal. The aim of this study is to evaluate the prevalence of the metabolic syndrome and its components in a rural community from the North-East region of Romania. Methods. The study included 3248 persons from the rural environment. The data recorded regarded gender, age, anthropometric parameters (weight, waist circumference, body mass index), arterial blood pressure, and laboratory findings. The defining criteria for the metabolic syndrome used were IDF 2005 in comparison with the criteria NCEP-ATP III. Results. Over half of the studied population presents excess body weight, the prevalence of obesity (Body Mass Index - BMI≥30kg/m2) being 17.5% with a proportional relationship between age and BMI value (p<0.001), as well as between age and waist circumference value (p<0.001). The prevalence of the metabolic syndrome according to IDF criteria is 16.3% and 14.2% according to NCEP-ATP III criteria. Irrespective of the BMI value, there is an individual increase in the number of cardiovascular risk factors parallel to the increase of the WC. Conclusions. The metabolic syndrome is frequently encountered in the clinical practice and the use of the IDF definition criteria allows a wider identification of the patients with high cardiometabolic risk. This is the group of people that need to be targeted by the diagnostic and treatment of important cardiometabolic pathology.

for non-functioning pituitary macroadenomas (NFMAs) is still under debate. Aim. To appreciate the best timing for postoperative high voltage radiotherapy (hRT) in different type of NFMAs (classified using immunohistochemistry (IHC)). Subjects and Methods. Of 97 patients with a remnant (>1 cm) and IHC for anterior pituitary hormones, 41 patients (groups A & B) were submitted to hRT and followed up at least 5 years. RT was performed in 20/41 patients (Group A) within the first year after surgery, 21/41 patients (Group B) afterwards while in control group C, 56 patients were followed up without hRT. The progression of postoperative remnant was defined as a change of minimum of 25% of any diameter (transversal or vertical) by serial imaging studies. Results. The IHC of NFMAs revealed the following: 38 (39%) null cell, 29 (30%) gonadotropinomas, 12 (12%) silent plurihormonal, 11 (11%) silent corticotroph and 7 (7%) silent GH/PRL adenomas. Immunoreactive adenomas have relapse rate higher than null cell adenomas (ACTH> GH/ PRL> FSH/ LH> null cell) with a significant rate for silent ACTH 6/8 (75%). The null cell adenoma relapse rate was 6/23 (26%), p<0.009 in group without hRT. The relapse rate was significantly lower in group AB with hRT than in group without RT (p=0.025), at five years. Immediate hRT (applied within in first years) improved the control of the tumour growth in 90% (18/20) cases. In the group A, 10 % (2/20) patients relapsed than 24% (5/21) patients in group B and 39% (22/56) patients, Group C. Conclusion. An optimal time for radiotherapy is within the first year after the partial surgical removal of NFMAs, particularly if a large amount of residual tumour remains. Patients with silent corticotroph adenoma require special attention.