ACTA ENDOCRINOLOGICA (BUC)

Context. Clinical research suggests that vitamin D deficiency correlates with mental illnesses. Objective. The aim was to prove that the patients from the psychiatric health care service in Serbia had higher vitamin D deficiency than patients from general practice. Design. The study had a cross-sectional design. Methods. The study included 47 patients aged 19 – 76 of both sexes with different mental disorders. We performed sample size calculation on available data for vitamin D deficiency in patients in health care facilities compared with the general population. The concentrations of vitamin D in serums were measured by HPLC (high performance/pressure liquid chromatography). Results. The mean value of vitamin D (standard deviation) in the whole group of study subjects was 16.27(10.62) ng/mL; 68.1% of the patients had a deficiency of vitamin D (25(OH)D<20 ng/mL). The difference is statistically significant from expected proportion of people with vitamin D deficiency in general practice (p=0.040). Serum concentrations of 25(OH)D were significantly correlated with serum concentrations of phosphorus (ϱ=0.336, p=0.024) and sodium (ϱ=0.304, p=0.038). Conclusions. The patients of psychiatry health care had significantly higher frequency of vitamin D deficiency than expected. There is a significant association between serum levels of vitamin D, and phosphate and sodium.

Unilateral breast edema is an uncommon semiologic finding. Lots of etiologies could occur: acute mastitis, acute inflammatory breast cancer, after radiotherapy for breast cancer, lymphatic metastasis and malignant lymphoma. Rarely congestive heart failure could lead to breast edema, since the phenomenon is usually bilateral. In contrast unilateral breast edema from cardiologic etiology is exceptional. We report a case of an 86 year-old woman suffering from congestive heart failure who presented with unilateral breast edema and an imaging appearance of inflammatory breast carcinoma on mammography. The clinical and mammography appearance is described, the differential diagnosis discussed. After the cardiologic treatment, the unilateral breast edema disappeared, and the patient recovered.

Context. Adiponectin is an abundant adipokine, which has antiinflammatory, anti-atherosclerotic and vasoprotective actions, and potential antiresorptive effects on bone metabolism. It seems to be directly involved in the improvement and control of energy homeostasis, protecting bone health and predicting osteoporotic fracture risk. Objective. To examine the relationship between adiponectin level and bone mineral density (BMD) in postmenopausal women with metabolic syndrome (MetS) and low BMD, and to estimate the prognostic significance of adiponectin in osteoporosis. Design. Clinical-laboratory cross-sectional study including 120 middle-aged and elder women (average 69.18±7.56 years). Subjects and Methods. The anthropometric parameters were measured for all examinees. Lumbar spine and hip BMD, as well as body fat percentage, were measured using a Hologic DEXA scanner. In all subjects serum adiponectin concentration was measured by ELISA method. Results. The level of adiponectin was significantly positively correlated with BMD-total, BMD of the lumbar spine and BMD of the femoral neck (r=0.618, r=0.521, r=0.567; p<0.01). Levels of adiponectin and BMD are significantly lower in post-menopausal women with MetS and osteoporosis compared to patients with osteopenia (856.87±453.43 vs. 1287.32±405.21 pg/mL, p<0.01; BMD, p<0.05), and the highest values in healthy examinees. A cutoff value of adiponectin level for osteoporosis/osteopenia was 1076.22/1392.74 pg/mL. Conclusions. Post-menopausal women with MetS have significantly lower adiponectin level and low BMD compared to healthy examinees. Adiponectin may be an early, significant and independent predictor of developing osteoporosis in women with MetS, especially in postmenopausal period.

Adipose tissue is a major store of energy for the human body. Polycystic ovary syndrome (PCOS) patients are more prone to abnormal production of some regulatory proteins secreted from the adipose tissue. This study aims to investigate serum levels of adiponectin and their correlation with metabolic and endocrine indices in PCOS. Patients and methods. This study was conducted on 61 women with PCOS and 17 healthy women whose age and body mass index (BMI) were matched. Adiponectin serum levels were assessed and correlated with parameters of metabolic and hormonal disturbances. Results. In PCOS women, serum levels of insulin, HOMA-IR, testosterone, LH, and LH/FSH were significantly higher, while SHBG was lower than in healthy women. Lower adiponectin was observed in both PCOS groups compared to the control group. Serum levels of adiponectin correlated inversely with BMI (r=- 0.56; p<0.001),WC(r = -0.452;p<0.001), insulin levels (r= - 0.409; p<0.001), HOMA-IR (r= -0.368; p<0.001), and free androgen index (FAI) (r= - 0.53; p<0.001). A positive correlation was found between adiponectin and LH (r= 0.35; p<0.001), LH/FSH ratio (r= 0.33; p<0.001) and SHGB (r= 0.51; p<0.001). Serum adiponectin levels are decreased in women with PCOS compared to the control group. The decrease in adiponectin concentration indicates its potential role in metabolic disorders in the pathogenesis of PCOS, as well as in the development and progression of insulin resistance in PCOS patients.