ACTA ENDOCRINOLOGICA (BUC)

Background. Although cardiovascular risk is increased in patients with subclinical hypothyroidism (SCH), replacement therapy is not recommended in those with TSH levels\r\nbetween 5 and 10 mU/L.\r\nObjective. We aimed to evaluate the effects of levothyroxine (LT4) treatment on cardiovascular risk factors and carotid artery intima media thickness (CIMT) in patients with SCH who had TSH levels between 5 and 10 mU/L.\r\nSubjects and Methods. Sixty SCH patients with TSH levels between 5 and 10 mU/L were included in the study. Patients\r\nwere randomized into two groups as treatment (n=30) and control (n=30) groups. BMI, blood pressure, lipid profile, fibrinogen, homocysteine, hs-CRP and CIMT were measured in all patients at baseline and after six months. LT4 treatment was initiated and the dose was tapered according to TSH levels in treatment.\r\nResults. There was no significant difference between baseline and six month measurements in the control group. However, TSH, LDL-C, fibrinogen and mean CIMT measurements were decreased and HDL-C level was increased in the treatment group.\r\nConclusions. We suggest that LT4 therapy is necessary for the prevention of modifiable cardiovascular risk factors in\r\npatients with TSH levels between 5 and 10 mU/L.

Thyroid carcinomas associated with Graves? ophthalmopathy had been described in the literature, before. The rate of this coincidence is 1.1% - 7.1%. Papillary carcinoma is more common than thyroid cancer in Graves? disease. Herein, we present a 37-year-old male Graves? disease patient with thyroid papillary carcinoma.

Introduction. Vinegar is known with its positive impact on post-prandial dysmetabolism. The aim of this study was to\r\nelucidate the acute effects of high amount vinegar on blood glucose and lipid parameters.\r\nMaterial and Methods. Sixteen type 2 diabetic patients who had been treated with metformin only, were served a\r\nstandardized meal to which 50 g vinegar was added on the first day but not on the second day. Blood glucose, insulin and lipid levels were measured during fasting and at the second hour after intake of the meal.\r\nResults. Postprandial increase in the levels of venous blood glucose measurements was not different in the vinegar group when compared with the reference group (p=0.163). There was no significant difference on postprandial insulinemia (p=0.796). While investigating the effect of the vinegar on postprandial lipemia, no differences in triglyceride\r\nchanges was found between vinegar and reference group (p=0.816).\r\nConclusion. In this study in which we have tried to find an answer to the question about the effect of high amount grape\r\nvinegar on postprandial metabolism, no favorable or deleterious effect on postprandial changes of glycemia and\r\nlipemia was found.

Objective. The aim of this study was to compare the clinical effects of a triple oral antidiabetic combination versus basal insulin and metformin combination treatment in patients with poorly controlled type 2 diabetes.\r\nMethods. Eighty patients with type 2 diabetes, who were treated by metformin and sulphonylurea combination, and had\r\nHbA1c values between 7.5 and 10 % (58 and 86 mmol/L), were randomized into two groups. The first group was given triple oral antidiabetic therapy (pioglitazone, metformin, and sulphonylurea) and the second group was given metformin and a bedtime basal insulin (insulin detemir) combination for 12 weeks. Metabolic parameters were evaluated.\r\nResults. The mean fasting plasma glucose and HbA1c levels decreased in both groups. The decrease in HbA1c was slightly\r\nhigher in triple oral antidiabetic group (p=0.046). The patients in triple oral combination group gained 0.2 kg (p=0.881) and those in the metformin-insulin detemir combination group lost 1.7 kg (p=0.001) in 12 weeks (p=0.29 between groups). The frequency of hypoglycemia was higher in\r\ntriple oral antidiabetic group (11 vs. 2 episodes, respectively).\r\nConclusion. Both sulphonyureametformin-pioglitazone and insulin detemir-metformin therapies provided significant improvements in glycemic control. However, sulphonylurea,\r\npioglitazone and metformin combination led to more frequent hypoglycemic events, and weight management seemed in favor of insulin detemir-metformin combination.

A 40-year-old woman has been followed up for 19 years by the\r\nendocrinology clinic with the diagnoses of Addison disease and primary hypothyroidism. During the most recent\r\nvisit of the patient, she complained about fatigue and malaise with pretibial edema. In albumin analysis: 2.2 gr/dL and 5.8 g/day proteinuria were detected. In terms of\r\nnephrotic syndrome etiology, renal biopsy was performed and it was considered as minimal change disease. The dose of 7.5\r\nmg/day methyl prednisolone was potentiated to a dose of 1mg/kg/day. During her control, the proteinuria did not regress and 150 mg/day cyclophosphamide was added to the treatment. During the control, her proteinuria regressed from 5.8 r/day to 1.95 mg/day.