ACTA ENDOCRINOLOGICA (BUC)

There are no new national growth references for the Romanian population and the current recommendations for short stature evaluation is the use of the Swiss growth charts developed based on a longitudinal study. The aim of the present paper is to present the new synthetic growth references for Romanian children. Material and methods. We used local Romanian data from 9 studies with information on height and weight obtained between 1999 and 2016. Based on their plausibility and methodology six studies were selected for generating the National Synthetic Growth References for Romanian Children based on the specific methodology described previously. The selected studies included 8407 subjects measured in schools/kindergartens. Age is reported in years covering a range from 3-18 years. Height and weight were measured at a precision of 0.1 cm and 0.1 kg. All children were measured at normal temperature, in light clothes, without footwear. Results. We present the charts and tables with the common centiles for height, weight and body mass index for boys and girls. Conclusion. We suggest synthetic growth references based upon recent growth data from 6 different Romanian regions as new National Growth Charts for Romanian children.

Objectives. The objective of this retrospective study was to evaluate weight gain at 3 months following insulin therapy initiation and to determine if it is due to fat or fat free tissue. Methods. Fifty-eight patients with T2DM and initiation of insulin therapy were evaluated. Body composition was assessed with InBody720 device (Biospace, Korea) before and 3 months after the initiation of insulin therapy. Results. The insulin therapy was initiated with basal insulin in 84.48% of the cases. The initial dose of insulin was 22.76±12.89 units/day and increased at 3 months to 30.81±18.49 units/day (p<0.001). The initial HbA1c was 9.86±2.02% and decreased to 7.58±1.19% (p<0.001). The body weight increased from 87.01±17.37 kg to 88.04±16.64 kg (p=0.026). The fat body mass and the percent of fat decreased with no statistical significance; the intracellular and extracellular body water increased significantly (intracellular: 26.30±5.96 vs. 27.26±6.16; extracellular: 16.61±3.63 vs. 17.03±3.84; p<0.001). Conclusion. During the first 3 months after initiation of insulin therapy a modest weight gain due to increase in the body water after restoration of the metabolic balance was observed.

Context. The variety of tumor-seeking radiopharmaceuticals, which are currently in clinical use, may have a potential role as imaging agents for adrenal gland tumors, due to physiological characteristics of this organ. Objective. The purpose of this study was to evaluate the diagnostic potential of 99mTc-HYNIC-TOC, 99mTc(V)- DMSA, and 99mTc-MIBI in the assessment of adrenal tumors, by correlating with imaging findings and histopathologic results. Design. The research is designed as a crosssectional prospective study. Patients and method. The study included 50 patients with adrenal tumors (19 hormone-secreting and 31 nonfunctioning) and 23 controls without adrenal involvement. In all patients, single-photon emission computed tomography (SPECT) was performed, using qualitative and semiquantitative analysis. The tumor to nontumor tracer uptake was conducted by using a region-ofinterest technique. Adrenal to background (A/B) ratio was calculated in all cases. Results. 99mTc-HYNIC-TOC scintigraphy showed a high statistical significance between A/B ratios, while other two tracers resulted in a lower sensitivity, specificity and accuracy. Futhermore, 99mTc-HYNIC-TOC could have a high diagnostic yield to detect adrenal tumors (the receiveroperating- characteristic curve analysis, A/B ratio cut-off value of 8.40). Conclusion. A semiquantitative SPECT analysis showed that 99mTc-HYNIC-TOC is a highly sensitive tumorseeking agent for the accurate localization of adrenal tumors.

Context. Identification of CV risk factors from T2DM diagnosis allows optimization of treatment to prevent CV complications and death. Objective. The primary objective of the study was to describe the CV risk factors in patients with T2DM at the time of diagnosis and/or therapeutic specific measures taken. Design. This was a non-interventional, multicenter, retrospective chart review of newly diagnosed patients with T2DM in 49 study centers in Romania. Subjects and Methods. Adults with a diagnosis of T2DM between January - December 2014. Statistical analysis used appropriate descriptive methods. Results. 1218 patients were included, mean age (SD) at diagnosis was 59.16 (10.87) years. Half of the patients (54%) presented obesity and 47.7% of patients had arterial hypertension. Overall, 76.2% of subjects had LDLcholesterol ≥ 100 mg/dL, and 59.1% had triglycerides ≥ 150 mg/dL. The mean glycemia was 198.8 mg/dL (78.3) and 50.2% of patients had HbA1c ≥7%. Sedentary lifestyle in 73.8% of the cases, and 91.3% unhealthy eating habits reported. In addition to diet, 82.2% of patients received antidiabetes treatment, 62.6% lipid-lowering, and 66.6% antihypertensive medication. Conclusion. This retrospective study showed a high prevalence of CV risk factors and/or established CV disease at the time of T2DM diagnosis in Romania.

Background. Malignant melanoma is the most aggressive form of skin cancer with a rapidly increasing incidence rate. In contrast to other tumors, the role of sex steroid hormones\r\nin the initiation and progression of melanoma remains unclear.\r\nObjective. To assess the interaction between the content and composition of gangliosides and sex steroid hormones 17&#946;-\r\nestradiol (E2) and testosterone (T) in malignant melanoma.\r\nPatients and methods. The analysis included 45 melanoma patients (age 28-86; 14 men, 15 non -pregnant women in mid\r\nfollicular phase and 16 postmenopausal women) and 46 healthy controls. Serum levels of gangliosides (GM1-3, GD1a,b,2,3, GT1b, GQ1b), estradiol, testosterone measured in serum by chromatographic and immunochemiluminescence methods were correlated with sex and age.\r\nResults. Steroid hormones levels showed no differences between groups (p>0.05), while total gangliosides in normal\r\nserum were significantly lower than total ganglioside concentrations determined in melanoma samples (18.63 ? 3.17 mg/dL versus 74.82 ? 34.56 mg/dL) (p<0.05). There were no differences related to sex or age within groups regarding total gangliosides levels. Gangliosides pattern in\r\nmelanoma patients compared to control showed lower GM3, higher GD3, lower GM3/GD3 ratio, increased GD2 levels, and\r\nno significant variation of GM1, GM2, GD1a, GT1b gangliosides. There is a positive correlation between estradiol levels and total gangliosides concentration both in non-pregnant premenopausal and postmenopausal melanoma patients. GM3 is negatively correlated with estradiol levels in melanoma group, GT1b and O-Acetyl GD3 concentrations are positively correlated with estradiol levels in women with melanoma. Testosterone levels showed no significant\r\ncorrelation with the content and pattern of gangliosides in melanoma patients.\r\nConclusions. The correlations between content and composition of gangliosides and estradiol in melanoma suggest a possible role of these molecules in melanoma behavior.

Background. The aim of the present study was to measure the effects of raloxifene on bone metabolism and strength in orchiectomized male rats. Materials/Methods. Forty-three 4-month-old Wistar albino male rats were used and divided into 3 groups as orchiectomy (ORCX; n=23), sham (n=15), and control (n=5). Raloxifene (10 mg/kg/day) and methylcellulose (0.5 mL/day, as a vehicle treatment) treatments were initiated 2 months after ORCX for 2 months, then the rats were sacrificed. The left femur and fourth lumbar vertebrae (LV4) were measured to assess the effects of the orchiectomy and the raloxifene treatment and maintenance regimens. Bone strength was assessed using a compression test for the vertebrae and a three-point bending test for the femurs (N/mm). Results. Raloxifene increased femoral and vertebral bone strength in osteoporotic rats, but this increase was not statistically significant. Bone strength was found to be 267.44±18.03 in the femurs of the ORCXraloxifene group and 246.32±49.37 in the femurs of the ORCX-C group (p>0.05). Vertebral bone strength was 147.78±09.51 in the ORCX-raloxifene group and 114.61±05.93 in ORCX-C group (p=0.488). Raloxifene also increased the femoral and vertebral bone density compared with the control group, but the change was not significant. While raloxifene significantly decreased the serum osteocalcin levels (p=0.007), it did not decrease the carboxyterminal cross-linking telopeptide of bone collagen (CTX) levels significantly (p=0.066). Conclusions. Raloxifene caused a statistically significant decrease in serum osteocalcin levels and a non-significant reduction in NTX levels in orchiectomized rats.

Context. Literature shows that patients taking antipsychotic medication risk developing metabolic complications. Objective. The study aims to compare the presence of the metabolic syndrome (MS) and its components in outpatients treated with long acting injectable (LAI) olanzapine and risperidone. Design. A double-center study was performed on outpatients with psychosis, which were divided into two samples: one treated with olanzapine and another with risperidone. Subjects and Methods. The following data were analyzed: age, gender, severity of psychiatric symptoms, blood pressure, waist circumference, fasting blood glucose, lipid profile, tobacco use, medication, and time intervals related to psychosis duration (pre-LAI and LAI treatment). Results. The study included 77 patients with schizophrenia and schizoaffective disorder. MS was present in 45 (58.4%) patients. Subjects with MS and abdominal obesity had higher durations of psychosis and of LAI treatment. Patients with hypertension had a higher pre- LAI treatment interval. Risperidone was associated with higher rates of hypertension and higher values of abdominal circumference than olanzapine. Conclusions. The presence of MS is related to the duration of the psychosis and the time spent on LAI treatment with no differences between olanzapine and risperidone. Hypertension may be a consequence of age, disorder induced stress, or of treatment with risperidone.

Study Objective. To elucidate the association between POF and inhibin alpha (inhibin &#945;) G769A gene mutation and BMP15 variants in patients with POF.\r\nDesign. Prospective analytic study.\r\nSetting: University hospital.\r\nPatients. Forty subjects were included, twenty patients with premature ovarian failure, of them 12 presented with primary amenorrhea and 8 with secondary amenorrhea, and twenty control subjects. Genetic analysis for inhibin &#945; gene was\r\ndone by Polymerase Chain Reaction-Restriction Fragment Length Polymorphism analysis (PCR- RFLP) and Bone Morphogenetic protein 15 (BMP15) by PCR- sequencing analysis. \r\nMeasurements and Results. Regarding the inhibin &#945; G769A gene\r\nmutation, heterozygous form was found in 3 patients of the primary amenorrhea group, while none of the secondary amenorrhea group or the control group displayed this mutation. A statistically significant prevalence of the G769A mutation among Egyptian women with POF presenting with\r\nprimary amenorrhea was found. Mutational analysis of BMP15 gene performed by sequencing analysis showed no mutation\r\namong the patient or control group.\r\nConclusion. In this study we concluded that inhibin &#945; G769A gene mutation is more frequent among cases of POF presenting with primary amenorrhea and its presence conferred higher risk to development of POF. Variations of BMP15 gene were not encountered in the subjects of this study.

Introduction. Recent studies suggest that nutritional status can modify the association\r\nbetween high iPTH and mortality, especially in diabetics and older hemodialysis patients (HDP).\r\nAim. To assess the impact of mineral metabolism parameters in the survival of HDP\r\nin our area and to evidence the factors that influence iPTH levels in our HDP, which are\r\nyounger and have less frequently diabetic nephropathy as the cause of chronic renal failure\r\nthan in most published studies.\r\nPatients and Methods. A prospective cohort study of 126 HDP was recorded for\r\ndemographic, clinical and laboratory data, and after 24 months, the general mortality. Patients\r\nwere divided in two groups, survivors and non-survivors, and each of groups classified according\r\nto the time on hemodialysis (THD). The groups of non-survivors and survivors with THD more\r\nthan 10 year-period were compared to the groups with less than 10 year vintage, regarding the\r\nalbumin levels, iPTH levels, phosphate-calcium metabolism markers, age and sex.\r\nResults. We observed the better survival only for calcium phosphate product less than 55\r\nmg?/dL? (p=0,02). The iPTH level seems to be conditioned by albumin levels. For THD<10\r\nyears, iPTH levels are greater in survivors (p=0.01); in this subgroup we observed higher levels\r\nof serum albumin (p<0.001), the patients were younger (p<0.001), and had 5-fold lower\r\nfrequency of diabetes. For THD>10 years, iPTH levels are greater in non-survivor patients\r\n(p=0.02), as well as calcium, phosphorus and calcium phosphorus product.\r\nConclusions. Calcium-Phosphorus product is a better indicator for survival in HDP in our\r\narea than immunoreactive PTH levels. Immunoreactive PTH as prognostic factor might be\r\nbetter evaluated in association with calcium phosphorus metabolism parameters and albumin\r\nlevels too, even in younger and lower percent-diabetic HDP groups.

Background. Although diseases such as diabetes, hypertension, obstructive sleep apnea and hyperlipidemia are clearly documented as obesity associated diseases, it is not wellknown whether obesity causes renal pathologies. The aim of the present study was to evaluate the effect of weight loss following laparoscopic sleeve gastrectomy on clinical, renal parameters and urinary Neutrophil gelatinase-associated lipocalin (NGAL) levels in diabetic and non-diabetic obese patients. Methods. Nineteen morbidly obese patients (10 diabetic and 9 non diabetic) who underwent laparoscopic sleeve gastrectomy were evaluated clinically (anthropometric measurements) and biochemically before surgery and at 6 months from surgery. Results. Significant decreases in weight, BMI, FPG, PPG and HbA1c levels were observed in the diabetic group when the baseline and 6th month parameters of the patients were compared. There was also a significant decrease in SBP and DBP. At 6th month following laparoscopic sleeve gastrectomy, renal parameters such as creatinine, mAlb/creatinine, NGAL/ creatinine did not differ in the diabetic group. In the nondiabetic group, serum creatinine levels were significantly decreased, but other renal parameters such as mAlb/creatinine and NGAL/ creatinine were not significantly different. Conclusions. Our findings revealed significant decreases in weight, body mass index and glycemic parameters after sleeve gastrectomy in diabetic and non-diabetic patients, while no significant alteration was noted in renal functions, urinary NGAL and microalbumin levels.