ACTA ENDOCRINOLOGICA (BUC)

Context. In patients with suspected primary aldosteronism (PA), the aldosteroneto- renin ratio (ARR) is the most frequently recommended screening test. Further evaluation is based on hormonal changes during volume expansion. Both analyses are critically dependent on an accurate estimation\r\nof renin concentration. Direct active renin (DAR) is a novel laboratory technique used for plasma renin assessment.\r\nObjective. The objective of this study was to evaluate DAR for use in PA diagnostic work-ups.\r\nSubjects and Methods. The study enrolled 69 healthy volunteers. Blood sampling was conducted before and after an\r\nincrease in oral salt intake. Furthermore, a subset of 32 individuals underwent a saline infusion suppression test. DAR and serum aldosterone were measured in all blood samples. To calculate the ARR, serum aldosterone and DAR were expressed in ng/L.\r\nResults. ARR values [median (range); 97.5 percentile] associated with normal and elevated oral salt intake were 8.4 (0.6-37.7); 26.3, and 6.8 (1.1-37.7); 19.6, respectively. DAR and serum aldosterone concentrations\r\n[median (range); 97.5 percentile] after saline infusion suppression were 2.9 (2.7-10.7); 7.2 ng/L and 30 (30-72); 54 pmol/L, respectively.\r\nConclusions. The observed values may be useful in excluding a diagnosis of PA.

Context. Gestational diabetes mellitus (GDM) is one of the most common complications during pregnancy. It is also a growing problem worldwide and is associated with many maternal and fetal complications during and after pregnancy. Objective. This study aimed to investigate the neonatal and maternal complications of gestational diabetes in the Iranian population of pregnant women. Design. This prospective cohort study was carried out on the health assessment data of pregnant women in the age range of 18-45 years who were referred to health centers affiliated with Mashhad University of Medical Sciences, Mashhad, Iran, from March 2019 to September 2020. Subjects and Methods. Overall, 2,500 pregnant women with GDM and 7,700 healthy pregnant women were enrolled in the GDM and healthy groups, respectively. Individuals’ data were recorded in an electronic health record system (SINA System) and were later collected and analyzed. Results. Significant between-group differences were observed in terms of cesarean delivery risk, hypertension, fetal macrosomia, preeclampsia, preterm birth, fetal birth weight, and neonatal icterus in GDM and non-GDM groups. However, no significant differences were found in terms of stillbirth, and low birth weight between the two groups. Based on the logistic regression model, GDM significantly increased the risk of cesarean delivery, fetal macrosomia, and neonatal icterus. Conclusions. The fetal macrosomia leading to the cesarean delivery, and neonatal icterus were determined as the significant complications of GDM in the Iranian population. These results can provide valuable insight into healthcare planning.

Background. Secreting different adipocytokines, adipose tissue plays an important role in health and disease. Upon omega-3 consumption, changes in the secretion of adipose tissue and its effects on glycemic profile are a controversial subject at the present time. Objectives. We evaluated the effects of eicosapentaenoic acid (EPA) alone and in combination with vitamin E on adiponectin and serum glycemic indices in type II Diabetes patients. Design. This double-blind clinical trial divided all patients randomly into four balanced permuted blocks of EPA, Vitamin E, EPA and vitamin E and placebo (Corn oil). Subjects and Methods. 127 patients with type II diabetes living in Kashan in 2008, 35-50 years old, and 25≤BMI ≤30 were enrolled. ELISA, Glucose Oxidase, spectrophotometry, and Radioimmunoassay methods were used for measurement of serum adiponectin, Fasting Blood Glucose (FBG), HbA1C, and Insulin, respectively. Results. Serum adiponectin increased significantly after EPA consumption in EPA and EPA+E groups. Moreover, FBG, HbA1c, serum insulin and Homeostasis Model HOMA-IR decreased significantly after EPA consumption in the two previously mentioned groups. Conclusions. This study showed that EPA supplementation affects the secretion of adipose tissue, improves the FBS as well as HbA1c values and significantly decreases fasting serum insulin and insulin resistance.

Objectives. The present paper aims to investigate the effects of both progesterone and progestin treatment mainly related to the occurrence of breast cancer in women. Materials and methods. Extensive systematic bibliographic review of Greek and International articles was conducted through the electronic databases Pubmed, Cinahl, Uptodate, and Google Scholar for the identification of articles related to progesterone, progestins and breast cancer treatment. Results. Hormone therapy with the use of estrogen alone presents a small increased risk or does not present at all an increased risk of breast cancer. With ORs in some studies below 1.0 in current users for 3 plus years and safe option until 7 years, while in other studies the risk was increased with the ORs 1.29. However, the use of estrogen in combination with progestogens, depending on the type of progestogens, shows an increased risk of breast cancer, with the ORs to vary between 1.14- 2.38 from 3 to 5 years and is inversely proportional to the time of its use. This risk varies depending on the combination of the preparations. Other factors that are associated with breast cancer risk when receiving hormone therapy are the years that hormone therapy is taken, directly proportional to the risk. At higher risk are older women, women with low body mass index in menopause (BMI <25kg/m2) and women with increased mammographic breast density. Continued use of hormone therapy is associated with an increased risk for breast cancer compared to sequential. The risk became visible sooner to women who used in the past hormone therapy and were using it again. Starting hormone therapy in the immediate postmenopausal period also increased the risk for breast cancer. Hormone therapy was associated with tumors with positive estrogen and progesterone receptors, and also the lobular histological type was associated with its use. Tibolone use was associated with an increased risk.

Testosterone influences cancer development. This in vitro experiment was exerted to determine the association of testosterone with human colorectal cancer(HT29), glioblastoma (A172) and human embryonic kidney(HEK293) cells proliferation. HT-29, A172 and HEK293 cell lines were cultured in standard growth medium, then randomly divided into control group (not exposed to testosterone) and groups exposed to 1, 10, 100 and 1000 μg/mL of testosterone. Cell viability was quantified by MTT assay. Statistical analysis was performed using ANOVA. Viability of HEK293 cells significantly increased in groups exposed to 1 μg/mL and decreased in groups exposed to 100 and 1000 μg/mL of testosterone compared to control group (P<0.05, P<0.05 and P<0.001, respectively). Viability of HT29 cells significantly increased in groups exposed to 10 and 100 μg/mL of testosterone and significantly decreased when exposed to 1000 μg/mL of testosterone compared to control group (P<0.05, P<0.001 and P<0.001, respectively). Viability of A172 cells significantly decreased in groups exposed to 100 and 1000 μg/mL of testosterone compared to control group (P<0.001). In conclusion, different doses of testosterone have enhancing or suppressive effects on HEK293, HT29 and A172 cells proliferation; according to which, considering clinical use of testosterone therapy for cancer treatment is a highly controversial issue.

Context. Heat Shock Protein 60 (HSP60) is a chaperone protein which is involved in proteins transfer and re-folding of proteins. Objective. Importance of HSP60 in sperm capacitation and facility of sperm-oocyte membrane binding was confirmed, therefore in this study the effect of HSP60 on the rate of in vitro fertilization and the cleavage rate in mouse embryo was investigated. Design. Ten male mice and twenty five female mice were involved to collect sperms and oocytes required for this study. Subjects and Methods. Sperms were collected from the epididymis of male mouse and oocytes were collected from the oviduct of female mouse following ovarian hyperstimulation. Then, capacitated sperms and oocytes were placed together in fertilization medium in four groups in the presence of different concentrations of HSP60 (10, 50 and 100 ng/mL) and in the absence of HSP60. After calculation of the fertilization rate, zygotes were transformed into the other medium for development and the cleavage rate was monitored to blastocyst stage. Results. There was not a significant difference in the rate of fertilization between 10 ng/mL HSP60 group and the control group. The rate of fertilization and two-cell embryo development decreased significantly (P≤0.05) in 100 ng/mL HSP60 compared to other experimental and control groups. Further, the rate of two-cell embryo development increased significantly (P≤0.05) in 10 ng/mL HSP60 compared to other experimental and control groups. Conclusions. The present study demonstrated that HSP60 in low dose had a positive effect on two-cell embryo development, however it did not have any significant effect on the fertilization rate. Conversely, HSP60 had adverse effects on the fertilization and cleavage rates at higher doses.

Objective. To evaluate circulating FFAs in relation to glucose and insulin metabolism and to different fat compartments in men with and without diabetes. Patients and Methods. Thirtythree men with uncomplicated type 2 diabetes mellitus (T2DM) and 28 controls underwent an oral fat load and were studied at baseline and for 5 hours postprandially for serum FFAs, glucose and insulin. Abdominal fat distribution and gluteal fat accumulation were evaluated by anthropometrics and axial MRI images. Insulin resistance and sensitivity were estimated by HOMA and Matsuda index respectively. Results. Fasting and postprandial FFAs were higher in diabetics (p=0.007) despite similar fat accumulation and distribution between groups. Postprandial FFAs correlated positively with postprandial glucose, and fasting and postprandial insulin levels (p< 0.05) in controls, and with fasting and postprandial insulin levels (p< 0.05 and p < 0.01 respectively) in diabetics. Postprandial FFAs were positively correlated to HOMA (p<0.01) and negatively to Matsuda index (p<0.05), and positively to total visceral and retroperitoneal fat,the strongest association observed at L2- L3 (p<0.05 and p<0.001 respectively) in diabetics. Conclusions. Diabetics have higher serum FFAs, despite similar levels of adiposity and fat distribution. Interestingly, postprandial FFAs correlate strongly and positively with total visceral fat, underlying the importance of visceral fat in metabolic abnormalities in diabetes.

Acute pancreatitis is a common and potentially fatal gastrointestinal disease. We report a case of acute pancreatitis induced by iodine-131 therapy for hyperthyroidism. Iodine 131 is distributed through the blood, so it can accumulate and damage normal tissues in other parts of the body that are involved in thyroid hormone metabolis.

Objective. We aimed to investigate the prevalence of obesity and visceral obesity (VO) within children living on the small Greek island of Tinos and their associated factors. Methods. Three hundred and fifty two healthy children and pre-adolescents (54% boys) attending the primary schools of Tinos island were evaluated, aged (mean±SD) 8.53±1.72 years (range 6-11), from which 286 (81.25%) were of Greek origin and 65 (18.46%) foreign immigrants. Body weight, height and waist circumference (WC) were measured, plus BMI and WC percentiles were calculated. Children with WC > 90th percentile were categorized as having VO. Results. Among our patients, 235 (66.76%) were of normal weight, 88 (25%) overweight and 29 (8.2%) obese. Obese children, as opposed to their normal weight counterparts, were more likely to be of younger age (p=0.009). VO was found in 65 (18.47%) children, with a higher prevalence among the obese than overweight ones (96.43% vs. 42%, p<0.001). There was no difference in the prevalence of VO between children and pre-adolescents. However, foreign immigrants had lower frequency of overweight and obese children (p=0.026) and less viscerally obese children (9.09% vs. 20.63%, p=0.018) than the Greek participants. Conclusions. The prevalence of childhood obesity in rural Tinos was 8.24%, which was lower than the reported national prevalence of obesity in Greece, whilst almost all of the obese and 42% of the overweight children presented VO. The low prevalence of childhood obesity and VO on this small island could possibly be attributed to a more healthy diet and natural way of life.

Previous studies have correlated the expression of PAR proteins with breast cancer invasiveness. The scope of this study was to evaluate the expression of PAR-1 in human breast cancer specimens and investigate possible correlations with tumor size, grade and lymph node status, as well as covariations with estrogen and progesterone receptors, c-erbB-2 protein and lysosomal protease Cathepsin D. Formalin-fixed paraffin-embedded sections of 75 mastectomy specimens deriving from patients with primary breast carcinomas were implemented. Expression of PAR-1 was detected employing immunohistochemical assays utilizing a goat polyclonal PAR-1 antibody. The granular pattern of cytoplasmic immunoreaction was considered indicative for the protein?s expression. Statistical assessment was performed using SPSS 13.0 statistical package, Pearson?s correlation, &#967;2 and Fisher?s exact test. Expression of PAR-1 protein had a statistically significant correlation (p<0.001) with tumor grade, while in invasive tumors a similar relationship (p<0.001) was documented between PAR-1 expression and presence of positive axillary lymph nodes. However, PAR-1 expression did not exhibit a significant correlation with tumor size or with the expression of ER, PR, c-erbB-2, or Cathepsin D molecules. PAR-1 possesses a role in tumor invasion and contributes to the metastatic potential of certain types of breast carcinomas. The disassociation between expression of PAR-1 and that of the ER, PR, c-erbB-2, or Cathepsin D might imply participation in alternative pathways of malignant transformation and tumor progression.