ACTA ENDOCRINOLOGICA (BUC)

Though increased BMI represents a risk factor for developing heart failure, in heart failure (HF) patients it paradoxically increases survival. This effect was not\r\nstudied in relationship with BNP and ACE mutations. Objective. To investigate the relationship between BNP fragment (8-29) plasmatic level, ACE I/D polymorphism and BMI in patients with chronic congestive heart failure. Methods. We studied 50 patients with HF, NYHA III and IV, mean age 64.96?13.24 years, 21 patients with BMI &#8805;30 kg/m2 vs 29 patients with BMI<30 kg/m2. BMI, ACE polymorphism,\r\nthe plasmatic levels of BNP fragment (8-29) were determined.\r\nResults. Mean plasmatic BNP fragment (8-29) level was\r\n1891.02?1008.06 pg/mL, mean BMI value 29.09?7.59 kg/m?, with a negative correlation between the two parameters (r=-\r\n0.46), stronger in women (r=-0.79 vs. r=-0.32 in men). Significant greater value of BNP fragment (8-29) was registered in nonobese patients (2130.77?866.58 pg/mL vs. 1547.765?1135.744pg/mL, p<0.05). The distribution of ACE mutation was: DD allele 36%, II allele 24%, and ID allele 40%. In all three groups, the patients with BMI &#8805;\r\n30kg/m2 presented lower values of BNP fragment (8-29) levels.\r\nConclusion. In HF patients, there was an inverse correlation between BNP value and BMI, obese patients having lower BNP fragment (8-29) values, no matter the ACE\r\npolymorphism.

Context. Clinical research suggests that vitamin D deficiency correlates with mental illnesses. Objective. The aim was to prove that the patients from the psychiatric health care service in Serbia had higher vitamin D deficiency than patients from general practice. Design. The study had a cross-sectional design. Methods. The study included 47 patients aged 19 – 76 of both sexes with different mental disorders. We performed sample size calculation on available data for vitamin D deficiency in patients in health care facilities compared with the general population. The concentrations of vitamin D in serums were measured by HPLC (high performance/pressure liquid chromatography). Results. The mean value of vitamin D (standard deviation) in the whole group of study subjects was 16.27(10.62) ng/mL; 68.1% of the patients had a deficiency of vitamin D (25(OH)D<20 ng/mL). The difference is statistically significant from expected proportion of people with vitamin D deficiency in general practice (p=0.040). Serum concentrations of 25(OH)D were significantly correlated with serum concentrations of phosphorus (ϱ=0.336, p=0.024) and sodium (ϱ=0.304, p=0.038). Conclusions. The patients of psychiatry health care had significantly higher frequency of vitamin D deficiency than expected. There is a significant association between serum levels of vitamin D, and phosphate and sodium.

Context. The relationship between life changes and glycemic control in children with type 1 diabetes during the pandemic period was examined. Objective. We aimed to investigate the effect of the pandemic period on 66 children (aged 5-18 years) with type 1 diabetes using scales evaluating family functionality, nutritional habits, adherence to treatment and depression status. Design. It is a cross-sectional clinical and laboratory study using certain scales for its descriptive features. Subjects and Methods. Demographic characteristics, anthropometric measurements, laboratory investigations were evaluated. Family functionality of the patients were evaluated with Smilkstein’s family APGAR scale, motivation and knowledge levels were evaluated with the 6-item Morisky medication adherence scale (MMAS-6), nutritional habits were evaluated with the Mediterranean diet quality index (KIDMED), and depression status was evaluated with the children depression inventory (CDI). Results. The mean HbA1c level increased significantly in the first year of the pandemic compared to the onset of the pandemic period (8.5% vs. 8.9%, p: 0.003). In the responses to these scales, children with diabetes have high family functionality (89.4%), high motivation (90.9%) and high knowledge level about adherence to treatment (97%). Furthermore, healthy eating habits (high KIDMED index scores 92.4%), and low degree of depression score (95.5%) have been observed. We detected a statistically significant positive correlation between HbA1c and CDI scores (r: 0.27; p: 0.02), and a negative correlation between HbA1c and MMAS-6 motivation score (r: -0.30; p: 0.01). Conclusions. In this study, the effect of motivation and mood changes on glycemic control was more clearly demonstrated.

Aim. To evaluate the expression of Galectin-3, Fibronectin-1, Cytokeratin-19 and HBME1 in benign and malignant thyroid nodules and to assess their diagnostic value. Methods. Immunohistochemical analysis was performed on 59 surgically removed thyroid nodules, including 34 carcinomas (12 papillary, 2 tall cell variants, 3 lymph node metastases from papillary carcinoma, 5 follicular variants of papillary carcinoma (FVPTC), 3 anaplastic, 5 follicular and 4 Hürthle cell carcinomas), as well as 25 benign lesions (10 follicular adenomas, 4 Hürthle cell adenomas, 11 nodular goiters with surrounding normal thyroid tissue).3 expression in all malignant lesions except for one case of FVPTC and one follicular carcinoma. Normal thyrocytes and the majority of the benign lesions were negative for all markers. Statistical analysis of each protein confirmed that Galectin-3 was the most sensitive (94%), followed by Cytokeratin-19 (88%). Fibronectin-1 and HBME1 proved to be less sensitive (56% and 68%, respectively), but more specific (92% specificity for each of them). Coexpression of two or more proteins was restricted to carcinomas, while their concurrent absence was highly specific for benign lesions. Comparing the immunopositivity in follicular carcinoma versus adenoma we achieved 80% sensitivity for Galectin-3 and 100% specificity for HBME1. For distinguishing the Hürthle cell lesions, Fibronectin-1 turned out to be more sensitive than Galectin-3 and Cytokeratin- 19. Conclusion. Our findings suggest that immunohistochemical panel consisting of Galectin-3, Cytokeratin-19, HBME1 and Fibronectin-1 might contribute to differential diagnosis between malignant and benign thyroid nodules, including those with follicular architecture.

Background. Phytoestrogens are a heterogenic chemical category in which are\r\nincluded: isoflavones (genistein, daitzein, glycitein, biochianin A, formononetin, equol),\r\nsome lignans from cereals, cumestrans, some components of volatile oils (anetol, scareol),\r\nsome steroid saponins (diosgenin) and some phytosterols (beta-sitosterol, stigmasterol).\r\nGenistein is the most discussed phytoestrogenic substance, because it is very well\r\nrepresented in the botanical sources - especially in Fabaceae (Leguminosae) species, and\r\nmainly in soybeans.\r\nAim. The actual study evaluates the quantity of genistein in soybeans\r\nMethods. We used three extraction techniques: extraction with hydrolysis, extraction\r\nwithout hydrolysis and, finally, extraction with hydrolysis and clean-up and HPLC\r\nidentification.\r\nResults The experimental results indicated the content of genistein /g soya using the\r\nextraction techniques described.\r\nConclusions. Our study shows that extraction without hydrolysis followed by HPLC\r\nchromatographic method detects the genistein from vegetal sources and offer a good\r\nmethod, proposed by us for the drug industry.

Objective. This study was to investigate RIP140 expression levels in the pancreas and islet β-cells in mice and rats and the role of RIP140 in cultured β-cells using the mouse pancreatic β-cell line MIN6. Methods. The MIN6 cell line stably overexpressing RIP140 was used. The effects of RIP140 on cell viability, cell cycle, apoptosis, insulin secretion, and its regulated genes were analyzed using flow cytometry, the MTT assay, Western blot analysis, reverse transcriptase (RT)-PCR, and enzyme-linked immunosorbent assay (ELISA). Results. Most of insulin-positive cells in islets expressed RIP140. In MIN6 cells, overexpression of RIP140 inhibited cell viability by reducing the number of cells in S phase and inhibiting proliferating cell nuclear antigen (PCNA) expression. We also found that overexpression of RIP140 inhibited Bcl-2 and mRNA expression of peroxisome proliferator-activated receptor-γ coactivator-1α (PGC-1α) and uncoupling protein 2 (UCP2) and increased levels of phosphorylated extracellular signalregulated protein kinases 1/2 (p-ERK1/2). However, apoptosis rate and levels of basal level of insulin secretion (BIS) and glucose-stimulated insulin (GSIS) were not significantly altered in MIN6 cells. Conclusions. RIP140 was expressed in the pancreas of mice and rats, particularly in β-cells, and participated in regulating β-cell function and proliferation.

Context. Acromegaly, a severe condition characterized by excessive and unmodulated secretion of growth hormone, leads to morphologic disturbances and multisystem complications. Objective. The purpose of this study was to evaluate the quality of life (QOL) in patients with acromegaly compared to matched obese patients. Design. This was an observational cross-sectional study. Subjects and methods. We enrolled 49 patients with acromegaly and 49 obese patients. AcroQoL (acromegaly QoL questionnaire) was applied to all patients and IGF-1 (type 1 insulin-like growth factor 1) was measured. Results. Patients with acromegaly had a worse QoL compared to patients with obesity (score= 77(53-86) vs. 96(90- 102), p˂0.001). In the group of patients with acromegaly, there was no difference in the QoL regarding the activity of the disease (active, controlled, or cured). Men had a higher AcroQoL score than women (score= 88(55-95) vs. 74(52.75- 82), p=0.02), but there was no difference between patients with microadenomas and the ones with macroadenomas (score= 82(66-88.5) vs. 73(55-83), p=0.136). The most frequent complications were cardiovascular complications (81.63%), articular complications (73.46%), dyslipidemia (65.30%) and digestive complications (63.26%). Conclusions. Despite complex treatment and hormonal control, the presence of complications reduces the quality of life in patients with acromegaly, even when compared with obese patients.

Context. Despite the available evidence showing the vital role of glycemic control in the management of type 2 diabetes, a significant proportion of patients are not achieving a good glycemic control. Objective. Here we present the results of the Diabetes Unmet Need with basal insulin Evaluation (DUNE) study for patients enrolled in Romanian centers with the aim to describe the proportion of participants who achieved individualized HbA1c targets at 12 weeks following basal insulin therapy initiation. Design. Prospective, observational study. Subjects and Methods. 355 consecutive adults with type 2 diabetes, who were newly initiated with basal insulin therapy (Newly initiated group) or had been treated for less than 12 months with basal insulin prior to study enrollment (Previously initiated group) were enrolled and followed for 12 weeks. Results. The individualized HbA1c target was achieved by 22.7% of the patients in the Newly initiated group and by 25.0% of the patients in the Previously initiated group. During the study period, in the Newly initiated group mean basal insulin dose increased from 16.2 U at baseline to 27.6 U at 12 weeks. In the Previously initiated group, the insulin dose increased from 27.4 U at baseline to 33.1 U at 12 weeks. In both groups, 9.7% and 12.8% of the patients reported at least 1 episode of symptomatic hypoglycemia. Conclusions. In real-world settings, despite insulin initiation a large number of patients fail to achieve their individualized glycemic targets. One of the reasons appeared to be linked to the insufficient basal insulin titration.

Context. Papillary thyroid carcinoma (PTC) is the most common type of thyroid cancer due to its high fibrotic content; it can affect the blood flow resistance. Objective. To introduce duplex Doppler ultrasonography (DDUS) parameters of papillary thyroid carcinoma (PTC) and their correlation with size. Design. The study was designed as a prospective study. Subjects and Methods. Thyroid nodules of the patients who were already scheduled for thyroid surgery either for malignant thyroid nodules or multinodular goiter were evaluated for DDUS parameters. Size, systolic to diastolic flow velocity (S/D) ratio, pulsatility index (PI), and resistive index (RI) of each nodule were recorded. Nodules were diagnosed as PTC or benign nodules based on histopathology. DDUS parameters were compared between PTCs versus benign nodules and micro PTCs (≤ 10 mm) versus large PTCs (> 10 mm). A correlation analysis was performed between the size and DDUS parameters. Results. 140 thyroid nodules (30 PTCs, 110 benign nodules) were obtained. The mean S/D ratio, PI, and RI values were significantly higher in PTC than in benign nodules (p values were 0.0001, 0.0003, and 0.0001 respectively). The optimal cut-off values of S/D (0.732), PI (0.732), and RI (0.738) had accuracy rates of 71%, 69%, and 69%, respectively. There was no statistically significant difference between micro PTC and large PTC with regards to DDUS parameters. The size and DDUS parameters of PTC showed no significant correlation. Conclusions. PTC has a high resistive flow pattern regardless of its size; however the clinical utility of DDUS to differentiate a PTC from benign nodule is limited.

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.