ACTA ENDOCRINOLOGICA (BUC)

Context. Persistent inflammation and impaired neovascularization are important contributors to the development of diabetic retinopathy (DR). Gene polymorphisms of adiponectin (APN) were demonstrated to have an important role on the plasma level and activity of adiponectin. APN has anti-inflammatory, anti-diabetic and anti-atherogenic properties. Toll-Like Receptor 4 (TLR4) is a critical mediator of innate immunity. Polymorphisms in TLR-4 gene were shown to be associated with impaired inflammatory response in diabetes. Objective. The aim of the study was to analyze the association of +276G>T variant of APN gene and Asp299Gly and Thr399Ile of TLR-4 gene variants in relationship with T2DM and DR in an Eastern European population group. Design. The distribution of the mutant alleles in 198 T2DM patients with DR and 200 non-T2DM controls was examined. Genomic DNA from T2DM patients and healthy controls genotyped through the use of PCR-RFPL assay. Results. Genotype and allele frequencies of the Asp299Gly and Thr399Ile polymorphisms differed between T2DM patients and non diabetic subjects (P<0.001). Moreover, the presence of the minor alleles of these polymorphisms were significantly identified as protective factors against T2DM, under a dominant model of Fisher’s exact test (χ2=4.988, phi=0.745, OR=0.767, 95% CI=0.602-0.867, P<0.001; respectively χ2=5.254, phi=0.820, OR=0.487, 95% CI=0.211- 0.648, P<0.001). Genotype analysis for the adiponectin 276G>T gene polymorphism yielded no significant association with T2DM, but revealed a borderline significance for the association with DR (χ2=5.632, phi=0.423, OR =1.101, 95% CI=0.887-1.203, P=0.009). Conclusions. We found an association between the TLR4 Asp299Gly and Thr399Ile polymorphisms and protection for DR. The APN genetic polymorphism is not associated with T2DM.

Endemic goiter occurred in different degrees throughout 2/3 of Romania, mainly in the Carpathian area. The prophylaxis of iodine deficiency disorders (IDD) using salt iodization was introduced in 1956 with potassium iodate, KIO3, 15-25 mg/1kg salt, but only in 23 districts. In 2002 a new legislation introduced the mandatory use of the iodized salt in a higher concentration in households of all 41 districts and also in the baking industry. The study aims to evaluate the effects of iodine legislation changes upon the urinary iodine excretion (UIC) in schoolchildren (study group A) and pregnant women (study group B). Urine samples were collected from 3737 schoolchildren aged 6-14 years of 14 districts and from 1283 pregnant women of 11 districts in the years 2004-2005. In two areas - Bistrita Nasaud and Bucharest - the number of schoolchildren was larger, i.e. 465 and 1617 respectively. UIC was determined in spot urine samples by Sandell Kolthoff?s method. The results show in schoolchildren an increase of the median UIC in 9 out of 14 districts up to 90 ? 61.1 ?g/L (range 12.5-300 ?g/L). Six of these districts are in the Carpathian area. However, in pregnant women in 2004, UIC still showed low levels of 55 ? 48.78 ?g/L (range 12.5-280 ?g/L) in all 11 studied districts and in Bucharest, close to the UIC obtained in the year 2001. In conclusion, this study revealed an increase of median values of UIC in schoolchildren after universal salt iodization program. The persistence of iodine deficiency in pregnant women in the studied districts is an emergency problem that has to be solved as soon as possible. This fact involves the necessity of a large monitoring program in the next years, in all districts in urban and rural areas and in all known pockets of endemia.

Background. Recent studies suggested that MPTP could cause gastrointestinal motility deficits additionally to its nonconclusive and controverted effects on the CNS (behavior and brain oxidative stress) in rats. A possible interaction between MPTP typical impairments and magnesium modulatory potential was previously suggested, as magnesium role was described in neuroprotection, gastrointestinal function, and oxidative stress. Aim. To investigate the possible modulatory effect of several magnesium intake formulations (via drinking water) in MPTP neurotoxicity and functional gastrointestinal impairment induction. Materials and Methods. Adult male Wistar rats were subjected to 3-week magnesium intake-controlled diets (magnesium depleted food and magnesium enriched drinking water) previously to acute subcutaneous MPTP treatment (30 mg/ kg body weight). Gastrointestinal motility (one hour stool collection test), and behavioral patterns (Y maze task, elevated plus maze test, open field test, forced swim test) were evaluated. Followingly, brain and bowel samples were collected, and oxidative stress was evaluated (glutathione peroxidase activity, malondial-dehyde concentrations). Results. MPTP could lead to magnesium intakedependent constipation-like gastrointestinal motility impairments, anxiety- and depressive-like affective behavior changes, and mild pain tolerance defects. Also, we found similar brain and intestinal patterns in magnesium-dependent oxidative stress. Conclusion. While the MPTP effects in normal magnesium intake could be regarded as not fully relevant in rat models and limited to the current experimental conditions, the abnormalities observed in the affective behavior, gastrointestinal status, pain tolerance, peripheric and central oxidative status could be indicative of the extent of the systemic effects of MPTP that are not restricted to the CNS level, but also to gastro-intestinal system.

Context. Four major modifiable behavioral risk factors are considered responsible for the current burden of the non-communicable diseases: tobacco use, physical inactivity, unhealthy diet and excessive alcohol consumption. Limited data on the lifestyle habits in Romanian population is currently available. Objective. To assess the eating patterns and physical activity habits and other lifestyle components in various age groups in the population included in the ORO study. Design. ORO was a cross-sectional, epidemiologic, multicenter non-interventional study conducted from January 2014 until August 2014 in 8 study centers spread in the main historical regions of Romania Results. Eating 3 meals/day every day was more frequently reported in the 60-79 years and ≥ 80 years age groups (53.0% and 51.7%) than in the 18-39 years and 40- 59 years age groups (26.8% and 35.8%), p <0.001. The frequency of eating breakfast every day increased with age from 43.5% in the youngest age group to 79.3% in the oldest one (p <0.001). Intense and moderate leisure-time physical activity was more frequent among participants in the 18- 39 years age group. Leisure time physical activities were associated with younger age groups, male sex, rural area, higher educational level and non-smoking status. Regular breakfast and regular consumption of 3 meals/day was associated with older age group, male sex and non-smoking status. Conclusions. Our analysis showed a high frequency of unhealthy lifestyle habits among the younger age groups as compared to the older ones, with the highest frequency of these unhealthy behavior reported in the 18-39 years age group.

Context. The socio-economic and medical burden of obesity represents a continuous challenge for both developing and developed countries. For Romania, the available data on the eating patterns, behavior and other components of lifestyle are scarce. Objective. The objective of this study was to assess the prevalence of overweight and obesity in the Romanian general population and to identify lifestyle patterns characteristic for the Romanian population in terms of eating patterns and physical activity. Design. Cross-sectional, epidemiologic, multicenter non-interventional study Subjects and Methods. Between January 2014 and August 2014 were enrolled 2128 adults by 8 investigators spread in the main historical regions of Romania. The following data: demographic, anthropometric, employment status, education, family history, personal medical history, information on the lifestyle and eating habits. Results. The final population included in the analysis presented here consisted of 2103 participants with no missing information on height and weight. The prevalence of overweight and obesity was 31.1% and 21.3%, respectively. The prevalence of obesity was 9.9% in the 18-39 years age group, 30.1% in the 40-59 years age group, 41.6% in the 60- 79 years age group and 24.1% in the ≥80 years age group (p <0.001). Irregular meals together with eating while watching TV were the most frequent unhealthy eating habits of the participants. Conclusions. We found a high prevalence of overweight and obesity among the participants enrolled. Our study has important implications for increasing the knowledge on the prevalence of overweight and obesity in Romania and associated lifestyle habits.

Oxytocin is a complex molecule involved in a variety of biological processes at both the central and the peripheral level. Although its role was initially associated almost exclusively with birth and breastfeeding, recent studies are suggesting that in fact oxytocin could be involved in many other physiological and pathological processes. In this way, lately there is a growing interest towards a possible involvement of oxytocin in many etiopathogenic and psychopathological processes, as for example in the affective disorders, where the roles of oxytocin are not yet clearly understood. In this paper we shortly describe the main aspects regarding the relevance of oxytocin administration or its mechanisms in the affective disorders, as well as its relations with the hypothalamic-pituitary-adrenal axis and cortisol secretion. It seems that although the researches on the importance of oxytocin in the affective disorders are rather at the beginning, an increasing number of evidence is supporting the involvement of oxytocin in the pathogenic processes of these psychiatric disorders. Still, the studies covering this topic are still in their early days, and the results that are trying to understand if there is a major role of oxytocin in affective disorders are not consistent enough to draw definitive conclusions and establish with certainty where the place of oxytocin in the affective disorders pathology is

Aim. To evaluate the malignancy rates of Atypia of undetermined significance /follicular lesion of undetermined significance (AUS/FLUS) cases in the light of clinical and sonographic features. Material and Methods. The percentage of AUS/ FLUS cases, second fine needle aspiration cytology (FNAC) results, cyto-histopathological correlations and risk of malignancy were analyzed. Results. 113 out of 1461 thyroid FNAC samples (7.7%) were diagnosed as AUS/FLUS and included in the study. Seventy three out of 113 cases (64.6 %) underwent repeat biopsies or surgery. From 45 cases repeat biopsies were taken and 28 had thyroidectomy or lobectomy. There was a significant relation between nodule size and underwent surgery or repeat FNAC (p=0.036). Malignancy rate was 24.6% for cases which had any managements. The malignancy rates were higher in AUS/FLUS cases with cytological atypia (28.8%). After surgery the most common malignancy was papillary thyroid carcinoma, followed by follicular carcinoma. Conclusion. The risk of malignancy of AUS/ FLUS cases is quite high because of the heterogeneity of the group. The sub-classification of this category according to cytological or/and architecture atypia may be more useful in predicting malignancy risk. Further larger studies with ancillary techniques including molecular analysis may be more useful in determining the malignancy risk and appropriate management of this heterogeneous category.

Context. Scarce data on dietary habits in Eastern European countries is available and reports investigated individual food items and not dietary patterns in these populations Objective. To identify dietary patterns and to explore their association with obesity in a sample from Romanian population. Design. Cross-sectional. Subjects and Methods. This was an analysis of data collected from 1398 adult participants in ORO study. Data on lifestyle, eating habits and food frequency consumption were collected. Results. By principal component analysis we identified 3 dietary patterns explaining 31.4% of the diet variation: High meat/High fat pattern, Western pattern and Prudent pattern. High meat/High fat pattern was associated with male gender, lower educational level, living in a rural, smoking and a higher probability for the presence of obesity (OR 1.2 [95%CI: 1.1-1.4]). Western pattern was associated with younger age, a higher level of physical activity and smoking. Prudent pattern was associated with older age, female gender, a higher level of physical activity, not smoking status and a lower probability for the presence of obesity (OR 0.8 [95%CI: 0.7-0.9]). Conclusions. This study provides for the first-time information on the association between dietary patterns in adults from an Eastern European country and the presence of obesity.

We present the case-report of a 56 years-old woman with hypothyroidism due to autoimmune thyroiditis. The family history was positive for biopsy proven celiac disease (CD) in her daughter. The patient declared gluten-containing diet and was completely asymptomatic regarding gastrointestinal tract. The serological screening for CD reflected an activity of the disease by the presence of antiendomysial antibodies (EMA). Consequently, an upper gastrointestinal endoscopy was performed and biopsy specimens were obtained. The standard histopathological examination was unremarkable for a defined CD. However, the results of immunohistological techniques showed intestinal IgA deposits compatible with early developing CD. In patients with family history of CD, even without any suggestive symptoms, high index of suspicion regarding CD should be kept even more in those associating other autoimmune disease.

Background. The occurrence of mixed dementia defined as the association of Alzheimer’s disease with vascular dementia is increasing due to the global aging of the human population. Since thyroid hormones play a role in cognition and alterations of the thyroid axis occur with aging it is reasonable to assume that thyroid function and cognitive decline in mixed dementia are linked. Objective. To investigate whether there is a link between TSH, oxidative stress, cognitive decline and depression in female patients with mixed dementia. Methods. Fourty female patients with mixed dementia and 10 healthy controls were included in the study. MMSE, depression score (Cornel Scale of depression), TSH, MDA, glutathione were determined. Serum TSH levels correlated with the cognitive decline measured by MMSE (r=0.55 p=0.0002) and with de depression score (r=0.34 p=0.0314). Furthermore an increase in the oxidative stress marker MDA (p=0.0004) and in the antioxidant defense marker Glutathione (p=0.0013) was observed in patients with mixed dementia. In addition the levels of Glutathione correlated with cognitive decline (r=-0.4997 p=0.001) and with the levels of TSH (r=-0.4997 p=0.001). Conclusion. Our results suggest that thyroid function, oxidative stress and mixed dementia are corelated. However, a possible cause and effect relationship is not yet proved.