The International Journal of Romanian Society of Endocrinology / Registered in 1938

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  • Endocrine Care

    Shao HJ, Li J, He XQ, Liu N, Li YH, Yan JJ, Qu XL, Yuan XY

    Prevalence of Nontoxic Nodular Goiter After a Nearly Two-Decade Universal Salt Iodization in a Littoral Region of Shandong Province, China

    Acta Endo (Buc) 2016 12(1): 43-46 doi: 10.4183/aeb.2016.43

    Introduction. With the introduction of iodized salt, more and more people are exposed to iodine sufficiency in some regions. The purpose of this study was to investigate the prevalence of nontoxic nodular goiter (NTNG) in the littoral region with high iodine supply after a nearly twodecade universal salt iodization. Subjects and Methods. Eight hundred and thirtyfive participants (from 25~65 years; males 421 and females 414) were invited for the study from Huan-cui District of Weihai City, Shandong Province from January 2013 to September 2014. All participants were inspected and diagnosed by endocrinologists according to the thyroid function tests and the thyroid gland imaging. After the normal diet of three days, the urine samples of the participants were collected between 8:00AM and 9:00AM and the urinary iodine (UI) concentrations were analyzed using Urinary Iodide Test Kit. Results. The overall prevalence of NTNG in the region was 40.1%, and different prevalence occurred in the different age ranges (p<0.01). The prevalence of NTNG was 32.51%, 37.44%, 49.70%, 58.57 and 74.77% in the age group of ≤ 30, 31-40, 41-50, 51-60 and >60 years, respectively. Meanwhile, the prevalence of NTNG in women (42.08%) was higher than that in men (34.29%, p<0.05). The median of UI concentrations were 139.4μg/L and 101.5μg/L for the group with NTNG and without NTNG, respectively (p<0.01). However, there was no significant difference in UI concentrations among the groups with different age ranges (p>0.05), and statistical difference was not observed for UI concentrations between women and men (p>0.05). Intriguingly, higher UI concentrations were found in the group with larger thyroid size (p<0.01). Conclusion. The iodine excess can lead to the high occurrence of nodular goiter in the littoral region, and individual UI concentration detection is recommended for the iodine nutritional status analysis among normal people when Universal Salt Iodization (USI) continues to be implemented in the region.
  • Notes & Comments

    Grigorescu F, Attaoua R, Ait El Mkadem S, Beleza S, Bohdanowicz-Pawlak A, Bosch Comas A, Boulton A, Brismar K, Catrina SB, Coculescu M, Escobar-Morreale H, Fica S, Gheorghiu M, Gomis R, Hanzu F, Jobling M, Khusnutdinova E, Milewicz A, Nosicov V, Novialis A, Pasqua, Muller-Wieland D

    Haplogendis initiative - SICA

    Acta Endo (Buc) 2009 5(1): 143-148 doi: 10.4183/aeb.2009.143

    In response to increasing interest of the European Commission on large-scale\r\ngenotyping for complex diseases, including variability in ethnic minorities in\r\nEurope (HEALTH-2009-4.3.3-1), at the end of 2008 we composed the\r\nHAPLOGENDIS consortium with partners from Russia and European countries. A\r\nfirst program (SICA) was proposed in cooperation with Russian Federal Agency for\r\nScience and Innovation, focusing on comparative population genetics on diseases\r\naccompanied by insulin resistance. Beside the specificity in analyzing the human\r\ngenome with SNP (single nucleotide polymorphism) and defining haplotype\r\nstructure of genes, the program rises new hypotheses which directly link\r\ncolonization of Europe at the Neolithic period from Eastern Ukraine or Anatolia\r\nwith the development of agriculture and major dietary and life style changes that\r\nmay have an impact on the genome. Although there will be many occasions to\r\nreview both genetic and clinical detailed aspects, this short note will expose some\r\nunifying ideas that joint these partners.
  • General Endocrinology

    Qu P, Li Y, Hu X, Guo Y, Zhu Y, Li X , Zhao J

    The Effect of Adiponectin Via Regulating the Bone Microenvironment Oxidative Stress on Osteogenesis in Type 2 Diabetic Rats

    Acta Endo (Buc) 2021 17(2): 168-176 doi: 10.4183/aeb.2021.168

    Objective. To observe the effect of adiponectin on osteogenesis in type 2 diabetic rats. Methods. The 4th-week-old male SD rats were divided into normal control group (n=18) and diabetic model group (n = 42). Type 2 diabetes was induced by high-fat and high-sugar diet and intraperitoneal injection of a low dose of streptozotocin (STZ). The successfully-induced diabetic rats were divided into diabetic group (DM=18) and adiponectin intervention group (APN=18). APN group was injected with APN 10 μg/kg*d. The rats were separately sacrificed at the 4th, 8th and 12th week after the intervention. Bone microstructure and adipose tissue were observed via HE staining. Bone marrow was extracted from one side of the femur, and the supernatant was achieved by centrifugation. After BMD assessed by DXA, the other side of the femur was for further HE staining. Runx-2 expression in the bone marrow cells was detected by RT-PCR. BALP and AOPPs in bone marrow supernatant were assayed by ELISA. AGEs were detected by immunohistochemical staining. Results. With the feeding time over, blood glucose, AOPP, and AGEs were increased, and Runx-2 mRNA, BALP, BMD were decreased in diabetic rat group(P<0.05). Oxidative stress (OS) maker (AOPP) was decreased and osteogenesis makers (Runx2 mRNA, BALP) were increased after intervention with exogenous adiponectin (P<0.05). At the 8th and 12th week, the trabecular bone became thinner and broken, and the fat cell number increased in all 3 groups, especially in the DM group. The adiponectin intervention group showed that the trabecular bone structure was moderately restored. Conclusions. OS is obvious in bone microenvironment in diabetic rats. OS may have an inhibitory effect on regulation of osteogenic differentiation factor Runx2, causing down regulation of osteoblast differentiation and bone formation. Adiponectin may improve OS response and protect the bone structure.
  • Case Report

    Miryala I, Seaquist ER

    Use of cinacalcet during pregnancy in hypophosphatemic vitamin D resistant rickets with tertiary hyperparathyroidism

    Acta Endo (Buc) 2008 4(2): 189-194 doi: 10.4183/aeb.2008.189

    Cinacalcet is used to treat tertiary hyperparathyroidism in renal failure. However, its use in pregnancy and hereditary hypophosphatemic vitamin D resistant rickets (HVDRR) has not been reported. In this study we describe the use of cinacalcet in a case of HVDRR with tertiary hyperparathyroidism diagnosed during pregnancy, in a tertiary care hospital in an academic center. A 29 year old woman with HVDRR was found to have tertiary hyperparathyroidism at week 15 of her second pregnancy: serum calcium 11.4 mg/dL, intact parathyroid hormone 307 pg/mL. Reductions in potassium phosphate and calcitriol were unsuccessful in restoring normocalcemia. Cinacalcet was started to avoid parathyroidectomy and to reduce the risk of hypercalcemia to the mother and fetus. After 10 weeks of treatment, calcium normalized but placental abruption prompted delivery at week 27 of gestation. A healthy live male was born with weight of 964 g and serum calcium of 9.0 mg/dL. After delivery cinacalcet was stopped. Eight months later, calcium was 10.0 mg/dL and intact parathyroid hormone 426 pg/mL. This case demonstrates the successful use of cinacalcet during pregnancy to manage hypercalcemia in a patient with HVDRR and treatment related tertiary hyperparathyroidism.
  • Case Report

    Elenkova A, Robeva R, Gimenez-Roqueplo AP, Zacharieva S

    40-Year Follow-Up of a Patient with Multiple Paragangliomas and a SDHD Mutation

    Acta Endo (Buc) 2019 15(2): 254-260 doi: 10.4183/aeb.2019.254

    Context. Germline mutations in Succinate Dehydrogenase Complex Subunit D gene (SDHD) predispose to predominantly benign head and neck and/or thoracic-abdominal pelvic paragangliomas (PGLs). Objective. We present the case of a patient carrying a germline SDHD mutation responsible for multiple PGLs, who was followed for 40 years. He was initially diagnosed with a left cervical PGL at the age of 23 years, treated by surgery. Then, he recurred and developed a multifocal disease. The second-line therapeutic option was a threedimensional conformal radiotherapy performed in 2008. In 2013 the patient had clinical, hormonal, PET- and SPECTCT data revealing a disease progression. The treatment with the long-acting somatostatin analogue Octreotide Lar was carried out till the patient’s death caused by pulmonary embolism in December 2014. Results. Complex treatment led to a long clinical and biochemical remission and control of tumor growth. Conclusions. Despite their usually benign behavior, multicentric SDHD-related PGLs can require a multimodal approach involving surgery, radiotherapy and medical treatment for providing a long-term control of the disease and maintaining a good quality of life.
  • Case Report

    Borrayo G, Basurto L, González-Escudero E, Diaz A, Vázquez A, Sánchez L, Hernández-González GO, Barrera S , Degollado JA, Córdova N, Avelar F

    Tg/Hdl-C Ratio as Cardio-Metabolic Biomarker even in Normal Weight Women

    Acta Endo (Buc) 2018 14(2): 261-267 doi: 10.4183/aeb.2018.261

    Context. Despite that the Triglycerides/High Density Lipoprotein Cholesterol (TG/HDL-C) ratio has been associated with insulin resistance and cardiovascular disease, some outcomes differ between populations. Objective. The objective of this study was to evaluate the association between TG/HDL-C ratio and cardio-metabolic risk factors in both obese and normal weight women. Design. Cross sectional, from January to December of 2015. Subjects and Methods. Two hundred and fifty three women aged 40 to 60 years. Anthropometric and laboratory measurements were performed. Insulin resistance was measured by the homeostasis model assessment for insulin resistance (HOMA-IR). All participants underwent a Doppler ultrasound to measure intima-media thickness of carotid artery (cIMT). Results. TG/HDL-C ratio correlated with body mass index (r=0.194, p=0.01), and visceral adipose tissue (r=0.193, p=0.002). Additionally, TG/HDL-C correlated with glucose (r=0.367, p=0.001), insulin (r=0.354, p=0.001) and HOMA-IR (r=0.396 p=0.001). TG/HDL-C was associated with prediabetes, Odds Ratio (OR) was 1.83 (95%CI 1.07-3.13) and insulin resistance 3.27 (95%CI 1.78- 6.01), and this risk remains in normal weight women 4.7 (95%CI 1.2-17.81) for prediabetes and 4.38 (95%CI 1.42- 13.84) for insulin resistance. No significant risk for cIMT. Conclusion. A TG/HDL-C ratio ≥ 3.0 is a potential risk factor for prediabetes and insulin resistance in women 40-60 years, even in normal weight women.
  • Endocrine Care

    Lopez-Sandoval J, Sanchez-Enriquez, Rivera-Leon EA, Bastidas-Ramirez BE, Garcia-Garcia MR, Gonzalez-Hita ME

    Cardiovascular Risk Factors in Adolescents: Role of Insulin Resistance and Obesity

    Acta Endo (Buc) 2018 14(3): 330-337 doi: 10.4183/aeb.2018.330

    ntroduction. Childhood obesity is a public health problem characterized by early insulin resistance (IR), inflammation, and oxidative stress. The presence of an uninterrupted low-grade inflammatory state impairs metabolic and cardiovascular health. The population is particularly susceptible to develop metabolic disorders related to increased body fat. Methods. Eighty-three adolescents were recruited and grouped according to HOMA-IR and BMI in either with or without IR and obese or normal-weight respectively. Anthropometric, biochemical, immunological and hormonal variables were determined. Transverse Analytical Study. Results. Obesity, dyslipidemia, IL-6, and C-reactive protein were significantly higher in the IR group than in the non-IR group. Obese adolescents showed increased insulin levels, HOMA-IR, inflammatory markers, and triglycerides; while having lower HDL-C, and adiponectin when compared to normal-weight adolescents. As expected, obesity-related anthropometric markers positively correlated with IR and inflammatory markers while negatively correlated with adiponectin levels. Conclusions. Early IR, subclinical inflammation, dyslipidemia, and hypoadiponectinemia characterize obesity in adolescents. These factors may increase the risk of future coronary heart disease (CHD) and diabetes mellitus development (DM) in early adulthood.
  • Case Report

    Cho SR, Seaquist ER

    Amiodarone-induced thyrotoxicosis following treatment for amodarone-induced hypothyroidism

    Acta Endo (Buc) 2007 3(3): 359-367 doi: 10.4183/aeb.2007.359

    Amiodarone-induced thyroid dysfunction is common but the development of hyperthyroidism following treatment for amiodarone-induced hypothyroidism is very unusual. We recently saw an elderly man who developed severe thyrotoxicosis four years after diagnosis of and initiation of treatment for amiodarone-induced hypothyroidism. The thyrotoxicosis was treated first with methimazole and discontinuation of L-thyroxine replacement and then with methimazole and prednisone. After successful treatment and withdrawal of therapy, he subsequently re-developed hypothyroidism and required resumption of L-thyroxine replacement. This case highlights that amiodarone-induced hyperthyroidism can occur in patients who previously became hypothyroid on the drug.
  • Case Report

    Chadha C, Seaquist ER

    An unusual case of lymphocytic hypophysitis in a young man presenting with elevated serum IGF-1

    Acta Endo (Buc) 2009 5(3): 391-397 doi: 10.4183/aeb.2009.391

    Objective. To describe an unusual case of lymphocytic hypophysitis in a man,\r\npresenting with an elevated serum Insulin like growth factor-1(IGF-1) level.\r\nCase report. We report the case of a 27 year old male presenting with a 2 week history\r\nof severe headaches. Magnetic resonance imaging of the head showed an adenoma-like\r\npituitary. The physical examination was normal, laboratory tests revealed secondary\r\nhypothyroidism and hypogonadism along with an elevated IGF-1. Complete\r\ntranssphenoidal resection of the pituitary mass was done. Tissue analysis was diagnostic for\r\nlymphocytic hypophysitis. No evidence of a somatotroph adenoma was found. After surgery\r\nthe patient developed panhypopituitarism and diabetes insipidus.\r\nDiscussion. IGF-1 is a sensitive disease related marker in acromegaly and corresponds\r\nto disease activity. However, it should not be used as the sole marker for diagnosis of\r\ndisease. Inflammatory lesions of the pituitary gland, such as lymphocytic hypophysitis, can\r\nclinically and radiologically mimic tumors of the sellar region.\r\nConclusion. We report an index case of a young male who presented with elevated\r\nserum IGF-1 level in the setting of lymphocytic hypophysitis. This case illustrates the\r\ndilemma associated with reliance on the IGF-1 levels for diagnosis of acromegaly, since an\r\nelevated IGF-1 level in the presence of a pituitary mass may not always be a somatotroph\r\ntumor. We propose the differential diagnosis should also include autoimmune hypophysitis.
  • General Endocrinology

    Paniagua MV, Ruiz JG, Vazquez CR, Gomez BP

    Melatonin Application Alters the Male Wistar Rat's Fertility

    Acta Endo (Buc) 2011 7(4): 475-482 doi: 10.4183/aeb.2011.475

    Introduction. Antigonadotropic effect of melatonin in seasonally breeding rodents is due to the influence of this indol on the reproductive axis hypothalamicpituitary-gonads, although it is known that melatonin has a negative effect on the hormonal function of the reproductive axis, and is unknown whether it can affect the fertility of male Wistar rats.\r\nAim. The objective of this study was to investigate the effects of melatonin application on the fertility of the male Wistar rat.\r\nMaterials and Methods. Sixteen male Wistar rats were used. Rats were divided into two groups, Control and the group of animals treated with melatonin 1mg/kg (M) injected i.p. daily for two months. The evaluation of fertility was\r\ndetermined by the number of pregnant female rats. In addition, it was quantified the number of spermatozoa and Leydig cells in the seminiferous tubules. After removing\r\nthe treatment for two months, the experiments were repeated, to determine the possible recovery.\r\nResults. The results showed that rats treated with melatonin were able to impregnate only 25% of the mated female rats\r\n(p<0.05). In this group, the number of sperm decreased with a significance of p< 0.001 while the number of Leydig cells increased with respect to the control group with a significance of p< 0.001. After removing the treatment for two months, both the sperm and the Leydig cells were recovered at similar levels as the control group, while the fertility was not totally recovered in the group treated\r\nwith melatonin. These results suggest that the exogenous melatonin application (1mg/kg i.p) induces infertility.