ACTA ENDOCRINOLOGICA (BUC)

Introduction. Obesity was considered to protect against osteoporosis. Recent studies indicate the opposite.\r\nThe study aimed to see if adipose tissue has a protective effect on bone mass and if adipocytokines can explain the\r\nrelationship between obesity and osteoporosis.\r\nSubjects and methods We designed a study enrolling 83\r\npostmenopausal women, aged over 60, without diagnosed or treated osteoporosis and no secondary osteoporosis. We formed 3 groups- group 1- osteoporosis and metabolic syndrome (MetSyn), group 2- osteoporosis, group 3- MetSyn.\r\nWe evaluated the hematological, biochemical profile, bone turnover markers and adipocytokines. DXA of the spine and\r\nthe hip (left) was performed on all the enrolled women. Insulin resistance was appreciated using HOMA index. Metsyn\r\nwas defined using the International Diabetes Federation?s criteria.Results were statistically analyzed using SPSS program, version 15.\r\nResults. All groups were vitamin D insufficient with lower vitamin D, osteocalcin and adiponectin levels in the\r\ngroups with MetSyn and higher leptin levels. BMI correlated positively with spine BMD, while leptin correlated positively with hip BMD, pointing out to the protective effect of obesity against osteoporosis due to leptin?s involvement.\r\nConclusion. Obesity seems to have a protective effect against osteoporosis, probably due to leptin.

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The aim of our prospective study is to determine the prevalence of autoimmune thyroiditis (AIT), sub clinical hypothyroidism and metabolic syndrome in patients with polycystic ovary syndrome (PCOS). Twenty-five patients with PCOS (according to Rotterdam ESHRE/ASRM criteria) aged between 20-35 years, hospitalised in the Institute of Endocrinology between January 2004 and December 2006 were selected to evaluate thyroid morphology, function and immunologic status, and were compared with a control group of 20 women without PCOS. All subjects were clinically examined (BMI, blood pressure, hirsutism) and evaluated for LH/FSH ratio, E2, P, PRL, free testosterone, TSH, TPOA, HOMA-IR, fasting glycaemia, lipid metabolism. Thyroid ultrasonography was performed with a multiple&#8211;frequency linear transducer in grey scale and colour Doppler mode. Ultrasound transvaginal examination of the ovary was also performed. Patients with PCOS had LH/FSH ratio > 2, free testosterone > 0.95 ? 0.2 mMol/L, 15 patients had TSH > 4.5 mUI/L (60 %. p < 0.001) and 7 (28 %) had high levels of TPOA. In the control group TSH and TPOA were normal. Thyroid ultrasound showed total thyroid volume of 16.54?1.80 cm3 in 60 % of patients with PCOS and 10.51 ? 1.20 cm3 in the control group. Hypoechogenic areas were present in 60 % of patients with PCOS and absent in the control group. 15 (60 %) of the patients with PCOS had insulin resistance (HOMA&#8211;IR > 3.3?1.2 mU x mMol/L), and 16 (16 %, p<0.001) had hyperlipoproteinemia. In the control group one case has hypercholesterolemia. In conclusion, this demonstrates that autoimmune thyroiditis is frequent in patients with PCOS and indicates a potential cardiovascular risk due to the association of sub clinical hypothyroidism, dislipidemia and insulin resistance and suggests that patients with PCOS should be screened for thyroid function and morphology.

We report on a 4-years old girl with mosaic Turner karyotype: 45X/46XX (10% the 45,X line, 90% 46,XX line) / karyotype performed by the classical method and direct FISH (centromeres X and Y on buccal smears). As turnerian manifestations she presented short stature (more than &#8211;2 SD), mental retardation and slightly webbed neck. The most clinical manifestations were suggestive for the Kabuki syndrome, i.e.: -peculiar facies: very long palpebral fissures, arching of the eyebrows, short nasal septum, cleft palate, open mouth; -ventricular septal defect, left renal agenesis, dislocated hip on the left side. We present shortly the Kabuki and Turner syndromes and discuss the relationship between them.

Endogenous Cushing’s syndrome is rare, with an incidence of 0.7–2.4 per a million people a year. Clinical presentation of Cushing syndrome can be pleomorphic, and establishing diagnosis can be difficult. Early recognition and rapid control of hypercortisolaemia are necessary to decrease morbidity and mortality in these patients. We report a series of 6 endogenous Cushing’s syndromes of different etiologies (4 Cushing’s disease and 2 adrenal Cushing’s syndrome) assessed in our endocrine department over a decade (2009-2019). In order to highlight the diversity of clinical forms, diagnostic tools and specific management of this condition we labelled each case suggestively: the typical Cushing’s disease, the Pseudo Cushing’s, the elusive Cushing’s disease, the mild autonomous cortisol hypersecretion, Cushing’s syndrome in pregnancy and Cushing’s disease with thromboembolism. We discussed their particularities which were revelatory for the diagnosis, such as dermatologic, cardiovascular, musculoskeletal, neuropsychiatric, or reproductive signs, reviewing literature for each manifestation. We also discuss the commonalities and differences in laboratory and imagistic findings. Therapeutic approach can also differ with respect to the particular condition of each patient and the multiple choices of therapy will be reviewed.

Morris Syndrome is a pathological condition which needs a special approach regarding both diagnosis and treatment\r\nbecause of its rarity. While the diagnosis is based on karyotype test, the treatment should follow the idea of harmless and cosmetic benefits as well as complete gonads removal. This paper is presenting the usefulness and advantages of minimally invasive surgery as a feasible treatment for such a disease. A retrospective study was performed for two patients with Morris Syndrome, admitted to\r\nthe ?CI Parhon? National Institute of Endocrinology, Bucharest, Romania, followed-up for 4 - 16 years, and operated to the Department of Surgery, Emergency\r\nHospital, Bucharest, Romania. Patients with primary amenorrhea have been clinically observed and three patients\r\nwith 46, XY karyotype have been identified as Morris Syndrome cases needing surgical removal of the intraperitoneal gonads because of the risk of malignant transformation. A minimally invasive surgical technique has\r\nbeen chosen for proper treatment: the anterior transperitoneal laparoscopic approach. The surgery was adapted to every case, in according with preoperative imagistic diagnosis of the intraperitoneal testes\r\n(localization, dimensions, adjacent organs involvement, surgical access). No postoperative complications were noticed and specimens' pathology confirmed the final\r\ndiagnosis. Cosmetic benefits were achieved for every young patient as well as rapid postoperative recovery (discharge after 48 hours). The authors concluded that Morris Syndrome patients could benefit from the laparoscopic surgery which is a feasible, safe and proper treatment for such cases.