ACTA ENDOCRINOLOGICA (BUC)

Background. The purpose of this study was to explore the influencing factors of serum uric acid (SUA) level and related gene polymorphisms in the healthy population. Methods. A total of 346 healthy individuals screened from different areas in Shenyang City and 195 patients with high SUA levels were included. Results. The levels of TC (total cholesterol), HDL-C (high-density lipoprotein cholesterol), LDL-C (lowdensity lipoprotein cholesterol), TG (triglycerides), GLU (blood glucose) ALT (alanine aminotransferase), TBA (total bile acid), TBIL (total bilirubin), CR (creatinine) and CYSC (Cystatin C) were statistically different between the healthy and hyperuricemia population (P<0.05). However, there was no statistical difference in the UA level between the two groups (P>0.05). After adjusting for UA, TC, HDL-C, LDL-C, GLU, TBIL and CYSC, the additive and recessive models of rs2231142 were statistically significant in females (P<0.05). For males, haplotypes of A-C-A-A-G-G, A-CG- C-G-G and A-T-G-A-A-G had significant difference between the healthy and hyperuricemia population (P<0.05). For females, the haplotypes of A-C-G-C-G-G and A-T-A-CA- T had significant differences (P<0.05). Conclusion. The distributions of SLC2A9 (solute carrier family 2 and facilitated glucose transporter member 9), ABCG2 (ATP-binding cassette G2), GCKR (glucokinase regulatory protein), KCNQ1, IGFIR (Insulin-like growth factor-I receptor) and VEGFR (Vascular Endothelial Growth Factor Receptor) were balanced in the population in Shenyang City. The haplotypes of A-C-A-A-G-G, A-CG- C-G-G and A-T-G-A-A-G were the influencing factors of high SUA in the population in Shenyang City.

Context. Inhibin B could be a good marker in predicting spermatogenetic activities and in discriminating men with spermatogenesis impairment, especially azoospermia and it would be considered as a current clinical tool in the future. Objective. This study aimed to investigate the clinical value of serum Inhibin B and AMH levels in subfertile men particularly in those with non-obstructive azoospermia (NOA). We conducted a prospective study to assess the role of inhibin B in the evaluation of male factor infertility. Patients and Methods. Thirty fertile men and three groups of infertile patients (n=91): normozoospermia (n = 40), oligozoospermia (n = 19) and NOA (n = 32), from Faculty of Medicine (Sfax, Tunisia) were investigated. Serum levels were measured by ELISA and by ELFA (FSH). Results. Inhibin B and AMH levels were significantly lower in NOA patients than in normozoospermic ones (72.6±76.8 pg/mL vs. 242.4± 124.7 pg/mL; p<0.001 and 3.7±2.9 ng/mL vs. 5.3±2.3 ng/mL; p<0.001). Only Inhibin B levels were significantly lower in NOA than in oligozoospermic (72.6±76.8 pg/mL vs. 141.3± 81.9 pg/mL;p<0.001) and were negatively correlated with FSH concentrations (r = -0.56, p = 0.001). But both Inhibin B and AMH were positively correlated with sperm count (r = 0.44, p < 0.0001and r = 0.26, p = 0.03 respectively). Conclusions. We conclude that our results support the literature data showing that serum Inhibin B level is strongly correlated with sperm count and suggesting that it could be a good marker in discriminating men with spermatogenesis impairment, especially NOA.

Systemic Lupus Erythematosus (SLE) is a chronic autoimmune polymorphous disease that primarily affects women of reproductive age. This gender disparity has suggested the importance of investigating the role of reproductive hormones in the pathogenesis of the disease. Estradiol, the most potent form of estrogen, plays a key role in shaping the immune system including the production of lymphocytes, the peripheral differentiation of regulatory T cells (T-regs), antibody production, and the complement and interferon systems, and has been studied in the pathogenesis of systemic lupus erythematosus (SLE). It operates by binding to estrogen receptors (ERs) α and β, initiating cellular responses including alterations in gene expression. Regulatory T cells are instrumental in preserving immunological self-tolerance and moderating immune responses. Estradiol’s serum levels correlate with the expansion of CD4+CD25+ and FoxP3+ in healthy females. However, this response is reduced in lupus patients. Estradiol also interacts with microRNAs (miRNAs) in gene regulation. Hsa-miR-10b-5p, a miRNA targeting SRSF1, is overexpressed in SLE patients and its levels increase with exposure to estrogens. Other miRNAs also show correlation with plasma Estradiol levels. The precise role of Estradiol in the pathogenesis of SLE remains complex and multifaceted and is a topic for further research.

Context. Nonalcoholic fatty liver disease is common in type 2 diabetes mellitus patients, being difficult to diagnose. Objective. To find a correlation between elastographic parameters and lab results, for facilitating the diagnosis of nonalcoholic fatty liver disease. Design. This is a cross sectional study, conducted at the Departments of Diabetes, Nutrition and Metabolic Diseases, and Gastroenterology and Hepatology, of the Clinical Emergency Hospital “Pius Brinzeu” Timisoara. Subjects and Methods. We included 190 type 2 diabetes mellitus patients, collected data regarding medical history, clinical and biological features and applied the Alcohol Use Disorders Identification Test. We excluded patients with other causes of liver disease. Liver steatosis and fibrosis were evaluated through transient elastography, yielding two parameters: liver stiffness as an indicator of liver fibrosis stage, expressed in kPa, and liver steatosis stage, assessed by controlled attenuation parameter, expressed in dB/m. Data were analyzed using SPSS 15. Results. The analyzed group comprised 113 patients. Elastographic measurements showed that 93.8% of the patients had steatosis (controlled attenuation parameter ≥232.5 dB/m) and 70.8% severe steatosis (controlled attenuation parameter ≥290 dB/m). Severe steatosis was more common in women (75.7%) than in men (68.1%) (p<0.0001). From the patients with steatosis, 47.2% had liver stiffness values suggestive for fibrosis and 19.8% for cirrhosis. Most patients with steatosis and severe fibrosis were obese (66.7%). Triglycerides/HDLc ratio >4 correlated with hepatic steatosis (p=0.04), being more common in patients with severe fibrosis/cirrhosis (58.3%) than in those with absent or mild fibrosis (36.2%). Conclusions. Our study found a clear correlation between type 2 diabetes mellitus and the presence of liver steatosis. It correlates with body mass index, waist circumference (in men) and triglycerides/HDLc ratio. Controlled attenuation parameter is a useful noninvasive method for detection and quantification of liver steatosis.

Background. Prevention of complications is widely considered as the main aim of diabetes control. And diabetes education is the cornerstone for type 2 diabetes (T2D) management. However, traditional lecture-based diabetes patient education activities have small and shortlasting efficacy. Therefore, technology-based initiatives for diabetes patient education are urgently required. Objective. To evaluate Guessing, a popular game, as tool in increasing complication awareness of patients with newly diagnosed T2D during diabetes care. Patients and Methods. In a cohort study, 103 patients were split into Guessing Game group and control group. The opinions of patients and educators in Guessing Game group were surveyed. Patient performance was evaluated by test scores and the attendance to diabetes complication screening clinic. Results. A majority of patients and all educators believed that Guessing Game enhanced complication awareness. Educatees achieved higher total scores and test scores in “Fill in the Gaps” (one of 2 types of test item), more actively attended complication screening clinic, after using Guessing Game as an education tool. Conclusion. Guessing Game is an attractive and effective educational intervention to increase complication awareness of T2D patients.

The aim of the study was to evaluate the prevalence of hyperhomocysteinemia in hypothyroid patients and the effect of folic acid supplementation when serum homocysteine\r\n(Hcy) was over risk level.\r\nPatients and methods. Patients with moderate (Group1) and severe hypothyroidism (Group 2) were evaluated before any therapy and after 6 months of combined folic acid and\r\nlevothyroxine substitution, versus control subjects. Hcy, folic acid, thyroid hormones and lipids were measured for all subjects. Thyroglobulin and antithyroglobulin antibodies were measured only for Group 2.\r\nResults. Only 17 % of the cases had basal Hcy at non risk level (<10 mmol/L). Both groups had higher Hcy levels than control (p <0.0001). In Group 1 basal folic acid was lower\r\nthan in control and group 2 (p<0.001). No correlation was found between high levels of Hcy (> 12 mmol/L ) and positive thyroglobulin. After 3 months of combined therapy, significant decrease of Hcy (p<0.0001) was observed compared with the basal level. Normalization of\r\nHcy appears during next 3 months even with reducing the folic acid supplementation.\r\nConclusion. Our results report moderate hyperhomocysteinemia in hypothyroid patients. This may exacerbate the cardiovascular risk traditionally attributed to lipid changes. Six months of combined therapy (L-thyroxine and folic acid) corrected hyperhomocysteinemia excluding the additional risk.

Context. The environmental occurrence of metformin has been frequently world-widely reported. Despite the diabetes susceptibility in the Chinese population, the studies on occurrence of metformin as environment disruptor in China are insufficient. Objective. To determine the occurrence trends and possible environmental pollution sources of metformin as an emerging micropollutant. Methods. High-performance liquid chromatographyelectrospray ionization-tandem mass spectrometry system was used to detect the metformin levels in water samples collected from the Xi’an city Moat, China once a year from 2017 to 2021. Correlations among the metformin levels in moat water, in surrounding hospital wastewater, and hospital metformin consumption data were assessed using Pearson, Spearman and Kendall’s tau-b correlation coefficients. Results. Occurrence of metformin was found in Xi’an city Moat water with levels in the range of 304- 793 ng/L. Significant correlations were found between the metformin levels in city moat water and the total (or outpatient) metformin utilization data of the hospital. Conclusion. Data suggested the potential environmental issues posed by metformin in Xi’an city in China. The metformin consumption volume in the surrounding hospitals, especially at the outpatient services, could be used to predict the metformin concentrations in the moat water.