ACTA ENDOCRINOLOGICA (BUC)

Background. Vascular calcifications (VCs) represent an important complication in dialysis patients. It is still a subject of debate whether VCs are associated with low or high intact parathormone (iPTH), or if it is not any relation.\r\nThe purpose of this study was to assess the predictive value of iPTH and other mineral markers for VCs development.\r\nMethods. The study evaluated peripheral VCs in haemodialysis (HD) and peritoneal dialysis (PD) patients using radiographies. We counted a semiquantitative score ranging from 0 to 8. Each category was divided into two groups according to VCs score. We assessed the relationship between the VCs score and mineral markers.\r\nResults. A VC score=2 was positively associated with male gender, serum Ca, P, CaxP, ALP and iPTH levels in HD patients. There was no correlation with age, HD vintage, received treatment. In PD patients, did CaxP have a higher significance with VC score>/2; were iPTH, CaxP and P of higher significance for a score=5.\r\nConclusions. Hyperparathyroidism can be considered a predictor for VCs development in dialysis patients. Other risk factors are increased serum Ca, P, CaxP and ALP levels. In PD patients, high iPTH could predict VCs only for severe calcifications, but the CaxP could even predict for less extended VCs.

Context. Studies of platelet function in diabetics are inconsistent, some studies reporting higher platelet reactivity, while others showed no change. Objective. We aimed to evaluate platelet indices and in vitro platelet aggregation in rats with long-lasting (28 weeks) diabetes mellitus. Design. Twelve controls and 14 diabetic rats were investigated. Diabetes was induced in 11-week-old rats using streptozotocin (60 mg/kg,i.p.). Platelet indices and in vitro adenosine diphosphate (ADP)-, protease-activated receptor 4 (PAR4) agonist-, and arachidonic acid (AA)-induced platelet aggregation were assessed at the age of 38 weeks. Results. Compared to controls, diabetic rats presented lower platelet count and plateletcrit (both p≤0.001), and higher mean platelet volume (p<0.01). ADP- (p=0.04) and AA-induced (p<0.01) platelet aggregation were lower in diabetic compared with control rats, whereas PAR4 agonistinduced platelet aggregation was similar between the two groups (p=1.00). Conclusions. This study demonstrates a paradox of high intrinsic platelet reactivity and low in vitro ADP- and AA-induced platelet aggregation in diabetic rats compared with non-diabetic controls. The relevance of in vitro platelet aggregation to the contribution of platelets to in vivo thromboembolic events in diabetic rats remains questionable.

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.

Introduction. In this study we aimed to evaluate urinary iodine excretion and the serum levels of thyroidstimulating hormone (TSH), free triiodothyronine (fT3), free thyroxine (fT4) and thyroglobulin (Tg) in pregnants and their newborn infants. Materials and Methods. This study was performed in Konya Faruk Sukan Children and Maternity Hospital, Konya Beyhekim State Hospital and Hospital of Selcuk University Medical Faculty. 180 pregnant women and their healthy infants born at 37-40 gestational weeks.Term infants included in this study were aged between 1-7 days, healthy. Midurination urine samples were taken into deiodinized plastic bottles and 2 mL of these samples were aliquoted to deiodinized eppendorf tubes. Results. Median urinary iodine concentration (UIC) was 95.5 μg/L for pregnant women and 245 μg/L for their infants. Frequency of iodine deficiency was observed as 63.3% (n=114) (<150 μg/L) and 24.4% (n=44) (<100 μg/L) in mothers and their infants, respectively. UIC of the infants whose mothers used iodized salt was significantly higher than the one whose mothers used rocksalt (p=0.030). Conclusions. It was stated in our study that UIC of pregnants was lower than the target limit (<150 μg/L), suggested by World Health Organisation (WHO) and iodine deficiency in pregnants is still a problem in our city located in the centre of Turkey. Iodine deficiency was observed in 24.4% of the infants and this prevalence suggests us that iodine deficiency is still an important health problem in infants.

Introduction. Salusins are multifunctional endogenous peptides shown in human and rat tissues. Serum salusin α level is decreased in coronary artery disease and lack of salusin α enhances coronary atherosclerosis. Hypothyroidism is a chronic inflammatory disease that has a high risk of developing cardiovascular disease. Here we aimed to search the relationship of overt hypothyroidism and subclinical hypothyroidism with salusin α and other inflammatory markers, also the effect of L-thyroxine treatment on these findings. Material and Methods. 32 patients with overt hypothyroidism taking L-thyroxine treatment, 18 patients with subclinical hypothyroidism without treatment and 25 healthy patients as control group were included in the study. Serum salusin α, TNF α, sCRP, glucose, insulin and lipid levels were tested for all groups and results were evaluated with SPSS statistical analysis method. Results. HDL, sCRP, salusin mean values were statistically significantly different in all 3 groups. HDL level was statistically significantly higher in control group compared to treatment group. sCRP level was higher and salusin level was lower in both treatment and non-treatment hypothyroidism groups compared to control group. When treatment and non-treatment hypothyroidism groups were compared, there was no statistically significant difference for salusin α, but HDL level was high and insulin level was low statistically significant in treatment group. Conclusions. Salusin α that is shown to be protective for coronary artery disease and hypertension, is found to be significantly low in hypothyroidism, thus it is a marker that increases the cardiovascular disease risk in this specific patient group.

Context. Hypothyroidism and iron deficiency are among the most common pathologies in population. Therefore, there are a lot of patients assuming both iron salt supplements and levothyroxine therapy. Objective. To evaluate the effect of iron salt intake on L-T4 absorption among different L-T4 formulations. Materials and methods. A PubMed/MEDLINE, Web of Science, and Scopus research was performed. Original studies and reviews written in English and published online up to 21 December 2022 were selected and reviewed. The final reference list was defined based on the relevance of each paper to the scope of this review. Results. The data show an impaired absorption of L-T4 in tablets formulation when taken concomitantly with iron salt supplements. These phenomena seem to be circumvented by new L-T4 formulations. Conclusion. Liquid L-T4 formulations can be ingested with iron salts, with no impairment of absorption. More studies are necessary to confirm these data for soft-gel capsules L-T4.

Background. Evaluation of features of puberal maturity on a representative specimen of adolescents from Mures county.\r\nMaterial and method. The collected data came from the Public Health Authority in 2008, from 2013 teenagers, with ages ranging between 11&#8211;18 years, according to the Physical development registration file, Tanner stages and demographic data.\r\nResults. Boys grew at a faster rate in both height and weight than girls. In the urban areas, there is a preponderence for children in Tanner stages I-IV, compared to Tanner stage V. In the rural area, girls from middle school cover stage I then stage V of development and boys prevail in stage III and decrease in stage V. The teenagers of Mures county between 15-18 of age, both boys and girls, have a higher frequency than the rest of the teenage population of the country in stage V development, and for ages between 11&#8211;14 there is a majority for stage I. Correlating the parent&#8217;s education level and the puberal maturation of teenagers, we concluded that elementary and medium education levels prevail for all Tanner stages involved, without significant differences between them. Late puberty is more frequently associated to the parent&#8217;s elementary education level (68.34%) and rural area, in both genders. In the rural area there is a higher preponderence of children with rank over 2, due to the tendency of families in the urban area to reduce the children&#8217; number in the past years. Out of the entire study group, 3.75% were disharmonious with obesity: 3.94% of boys and 3.56% of girls, with a slight predominance in younger girls. There is no significant correlation between obesity and birth weight (p=0.441) or between puberal maturity level and weight.\r\nConclusion. We must stress upon the importance of monitoring the aspects of physical, neuropsychic development and puberal maturity in children, considered influence factors of morbidity.

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.

Context. Subacute thyroiditis is an inflammatory thyroid disease, which is treated by nonsteroidal antiinflammatory drugs (NSAIDs) or steroids. Objective. Defining characteristics of patients with subacute thyroiditis at diagnosis and during follow-up. Investigating the efficacies of NSAID and different doses of steroids and their effects on rates of relapse, recurrence, development of hypothyroidism and on quality of life and sleep parameters. Design. A 3-year observational study in a tertiary referral center. Subjects and Methods. A total of 63 patients with subacute thyroiditis were included. Clinical outcomes of patients treated with NSAIDs and NSAID unresponsive patients treated with prednisolone with initial doses of 0.5 mg/kg/day and 15 mg/day were evaluated. Results. White blood cell count at diagnosis was an independent predictor of NSAID unresponsiveness. No relapse or recurrence was observed in patients receiving low dose of steroids. Long symptom duration until diagnosis and treatment with NSAIDs were associated with development of hypothyroidism. Subacute thyroiditis caused significant deterioration in quality of life and sleep of patients and low dose of steroid was as effective as higher doses in improving these parameters. Conclusions. For patients with no response to NSAID therapy, an initial low dose of prednisolone (15 mg/ day) is determined as a safe treatment method when dose reduction is performed with appropriate timing.

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.