ACTA ENDOCRINOLOGICA (BUC)

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.

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.

Context. Scarce data on dietary habits in Eastern European countries is available and reports investigated individual food items and not dietary patterns in these populations Objective. To identify dietary patterns and to explore their association with obesity in a sample from Romanian population. Design. Cross-sectional. Subjects and Methods. This was an analysis of data collected from 1398 adult participants in ORO study. Data on lifestyle, eating habits and food frequency consumption were collected. Results. By principal component analysis we identified 3 dietary patterns explaining 31.4% of the diet variation: High meat/High fat pattern, Western pattern and Prudent pattern. High meat/High fat pattern was associated with male gender, lower educational level, living in a rural, smoking and a higher probability for the presence of obesity (OR 1.2 [95%CI: 1.1-1.4]). Western pattern was associated with younger age, a higher level of physical activity and smoking. Prudent pattern was associated with older age, female gender, a higher level of physical activity, not smoking status and a lower probability for the presence of obesity (OR 0.8 [95%CI: 0.7-0.9]). Conclusions. This study provides for the first-time information on the association between dietary patterns in adults from an Eastern European country and the presence of obesity.

Background. There are many systemic illnesses that constitute risk factors for cerebral vein thrombosis (CVT).The association between cerebral venous sinus thrombosis and polycystic ovary syndrome (PCOS) has been rarely reported in the literature. This report\r\ndescribes a case of cerebral venous sinus thrombosis following intake of contraceptive pill (cyproterone acetate 2mg + etinil-estradiol 35 micrograms), for dysfunctional uterine bleeding secondary polycystic ovary syndrome in young women.\r\nCase report. We reported a 22-year-old women presented with severe headache associated with vomiting sudden onset; she had been taking contraceptive pills for the previous ten days. CVT was diagnosed with CT scan, MRI and MR venography. Laboratory investigations showed no evidence of inherited thrombophilia. The patient was treated with classic heparine, followed by acenocumarol with good clinical outcome.\r\nConclusions. This case illustrates that patients with polycystic ovary syndrome may develop thrombosis, if the patient is treated with combined contraceptives, even for short period of time. The role of PCOS as independent prothrombotic factor and the risk associated with oral contraceptive as first line treatement in PCOS need to be further investigated.

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. 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.

experience regarding the first 24 patients diagnosed with refractory secondary and/ or tertiary hyperparathyroidism (HPT) who underwent subtotal parathyroidectomy (sPTx) in our clinic between 2010 and 2012. Methods. Data were retrospectively retrieved from a prospectively maintained database. We included patients diagnosed with refractory secondary and/or tertiary HPT who underwent sPTx; we excluded patients who underwent total parathyroidectomy (tPTx) and patients followed-up for less than six months. Results. We analyzed 24 patients,16 women (66.7%) and 8 men (33.3%) who were evaluated in a prospective manner in a short (1-6 months)/ medium (6-18 months) term follow up. Preoperative intact parathyroid hormone level (iPTH) was characterized by a median of 2131 pg/ mL (range: 1141-10000); in the first month after surgery the median iPTH level was 28 pg/mL (range: 3-1263). We found a statistically significant difference (p<0.01: Student test) in calcium level between preoperative values and values in the first month after surgery. Postoperative serum phosphorus (nv: 2.7-4.5 mg/dL) normalized in 19 patients (79.16%) and serum alkaline phosphatase values decreased significantly in the interval 2-6 months postoperative versus preoperative levels (p-0.002). We tried to establish a correlation between preoperative alkaline phosphatase (Alk Phos) and postoperative calcium level in the first month postoperatively. The overall clinical response to sPtx was good and we did not encounter postoperative mortality in our series. Conclusion. We believe that subtotal parathyroidectomy is feasible, safe and effective for patients with refractory secondary and tertiary hyperparathyroidism.

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Context. Obesity is a complex and heterogeneous disorder with multiple phenotypes described. Although metabolomic biomarkers of obesity have been extensively studied, biomarkers of obesity phenotypes and differences between these phenotypes and normal-weight (NW) persons have been less investigated. Objective. The objective of this cross-sectional analysis was to investigate serum amino acids (AA) as markers of metabolic alterations in obesity phenotypes and NW. Design. Cross-sectional Subjects and Methods. By targeted metabolomics we analyzed serum samples of 70 women using ultrahighperformance liquid chromatography/mass spectrometry. Participants were divided into 3 groups: NW, metabolically healthy obesity (MHO) and metabolically unhealthy obesity (MUHO). Results. Five AAs were significantly different between study groups: cysteine, methionine, asparagine, glutamine, and lysine (p-value <0.05 and variable importance in the projection >1). Cysteine increased linearly with metabolic unwellness from NW to MUHO. Lysine and glutamine were significantly higher, and asparagine was significantly lower in NW and MHO than in MUHO. Conclusions. By trend and group analysis we identified specific changes in serum AAs along with the progression of metabolically unwellness.