ACTA ENDOCRINOLOGICA (BUC)

Introduction: Obesity, a disease whose morphological background has as main problem the “dysfunctional” adipocyte, continues to raise scientific interest for the completion of the existing data and the verification of the hypothetic ones. Material and method: We determined insulinemia and glycemia within the oral glucose tolerance test (OGTT), and we analyzed the relation between the fat mass and cortisolemia in a group of 50 obese patients aged between 4 months –18 years. In 19 obese patients, between 5 ½ -17 ½ years old, we determined the basal leptin and resistin serum levels, comparatively to a control group of 19 normal weight children. In 14 obese and 10 normal weight controls, we determined the number of androgenic and estrogenic adipocyte receptors, which we correlated with the degree of obesity, the Tanner stage and respectively the testosterone, progesterone and estradiol serum levels. We studied the cellularity, morphohistochemical and ultrastructural features of the adipose tissue in 42 obese and 20 normal weight controls. Leptin and resistin were determined by ELISA. The measurement of the fat mass was done by bioelectric impedance. For the study of the adipose tissue we took 1g of tissue from the retro-trochanterian area. We identified the estrogenic (ER) and androgenic (AR) receptors by LSAB2 technique. We interpreted the data statistically by the linear regression analysis and variance test “t” for two unequal parameters using Microsoft Excel 2002. Results: A positive correlation was demonstrated between glycemias and insulinemias for the entire group (r=0.927, p=0.002), as well as between cortisolemia and fat mass excess (r=0.917; p=0.001). Serum leptin levels were significantly high in the obese (mean values: 81.07 ng/ml) comparatively to normal weight individuals (mean values: 4.17 ng/ml). Resistin serum levels did not show significant differences between the obese and normal weight individuals. We cannot talk about the existence of any correlation between resistin and leptin.

Objective. The aim of the study was to test whether a correlation exists between the Epworth Sleepiness Scale (ESS) and respiratory sleep parameters in patients with\r\ntype 2 diabetes.\r\nDesign. Subjects and Methods.The records of 83 consecutive patients (mean age 54.6? 9.8 years) with type 2 diabetes\r\nthat accepted to perform an in-hospital sleep study for screening of sleep apnea have been retrospectively evaluated.\r\nResults. There was a weak positive correlation between apnea/hypopnea index (AHI), oxygen desaturation index and ESS, and a weak negative correlation between ESS and mean O2 saturation. When data was separately analyzed in men and\r\nwomen, it could not be identified any correlation between sleep respiratory parameters and ESS in men. In women,\r\ncorrelation coefficients increased, proving a stronger relationship between ESS and AHI (r=0.65, p<0.001), mean O2 saturation (r=-0.52, p=0.005) and oxygen desaturation index (r=0.60, p=0.001). ESS had only a moderate level of accuracy in identifying patients with moderate and severe sleep\r\napnea (sensitivity 84.1%, specificity 74.1%, PPV 84.1%, NPV 74.1%). In women ESS showed a higher sensitivity than in men\r\n(92% vs. 80.6%), but a lower PPV (63% vs.78.1%) in predicting the presence of an AHI &#8805; 15.\r\nConclusions. In women with type 2 diabetes, it is possible to suspect the existence of SAS solely on the basis of the\r\nESS score. In male population, symptoms evaluated by questionnaires, such as the ESS, provide additional information which combined with clinical findings are helpful in selecting patients who are candidates for further detailed sleep studies.

Context. Hashimoto’s thyroiditis is the most common autoimmune disorder as cause of secondary hypothyroidism. The disease is associated with several metabolic disturbances and inflammatory disorders. Objectives. The aim of the current report was to evaluate several inflammatory and metabolic predictors of Hashimoto’s thyroiditis. Subjects and Methods. In the current study, forty patients with Hashimoto’s thyroiditis participated in the current study. They were aged between 20 to 50 years old. Anthropometric and nutritional measurements were assessed and biochemical factors including serum VEGF, IL-23, Nesfatin-1 and serum lipids were measured. Results. Waist circumference was higher among patients with lower serum TSH concentrations. Serum HDL and T4 concentrations were lower and serum IL-23 was higher among patients with higher TSH concentrations. BMI, WC and serum HDL were negative predictors of serum TSH while IL-23 was positively associated with TSH concentrations. Serum lipids including TC, TG and LDL were also negatively associated with T3 and T4 concentrations. Conclusions. According to our findings, VEGF and serum IL-23 were potent predictors of Hashimoto’s thyroiditis. However, further studies are warranted to better clarify these associations and underlying pathologic mechanisms.

Introduction. Papillary thyroid microcarcinoma has provoked discussion among the endocrinological community due to the extremely diverse therapeutic methods adopted in international guidelines. From the radical approach of total thyroidectomy with prophylactic central lymphatic dissection to "active monitoring" and opinions such as "papillary microcarcinoma is not carcinoma". Aim. To investigate the factors of invasiveness in papillary microcarcinoma. Material and methods. We included 184 patients with thyroid microcarcinoma, operated in the Department of General Surgery "Kaspela",Plovdiv, for a period of five years. Results. Intra-organ metastases or multifocal growth was identified in 38 of the patients. Positive for micro and macro metastases lymph nodes in the central lymphatic basin are found in 54. In 46 of them we identified metastases in the ipsilateral, and in 21 in the contralateral central neck nodes. The analysis of patients with lateral metastases found 7 unilaterally and 3 bilaterally. Skip metastases were registered in 4 of these 10 patients. Conclusions. The results of our study show that despite the favorable prognosis and non-aggressive behavior of papillary microcarcinoma, factors attesting to the invasive nature of the tumor occur in 44.5% or almost half of patients. This requires careful and individual approach constructing therapeutic strategy for the treatment of patients with papillary microcarcinoma

Objective. Insulinoma is one of the functional neuroendocrine tumors, which induce hypoglycemia caused by inadequate high secretion of insulin. In rats, two genes coding for insulin, insulin 1 (Ins1) and insulin 2 (Ins2) are found on chromosome 1. Some structural feature studies have shown that Ins1 was generated from a transcript of Ins2 and was inserted into the genome by an RNA-mediated duplication–transposition event. Methods. In this study, the author has investigated how the expression of insulin genes, Ins 1 and Ins2, are altered by Pdx-1 gene overexpression in the insulinoma cell line, Rin-5F. Results. Overexpression of the Pdx-1 gene increases Ins1 gene mRNA expression, not Ins2 gene mRNA expression, in the insulinoma cell line. Thus, levels of the rat insulin 1 and insulin 2 peptides may be changed under specific conditions. Conclusions. This is the first report that Ins1, but not Ins2, is significantly increased by Pdx-1 gene overexpression in the insulinoma cell line. This could indicate more research and analysis of insulinoma tumorigenesis and Pdx-1 gene expression.

Objective. We aimed to investigate the potential relationship between plasma alarin levels and type 2 diabetes mellitus (T2DM). Patients and Method. We included 154 participants, divided into four groups in a cross-sectional study design. The first group includes patients with T2DM without complications (n=30), the second group patients with T2DM with microvascular complications (T2DMnoC n=32), the third group patients with T2DM with macrovascular complications, T2DM-MV (n=32) and the last group is the healthy control group (n=60). Results. In our study 94 patients were diabetic; 47 females and 47 males. The control group consists of 60 people, 30 women and 30 men. It was found that these had a significant (p>0.05) variation in serum alarin levels among the T2DM (T2DM-noC=3.1±0.7 ng/mL T2DMmV=2.8±0.4 ng/mL, T2DM-MV= 3.6±0.4 ng/mL) versus control group (15.6±2.6). We failed to find a significant variation of serum alarin levels (p>0.05) between T2DM subgroups. Serum alarin levels were significantly higher among control patients (p<0.05). There was no difference between diabetic sub-groups. Conclusion. We concluded that serum alarin levels in patients with T2DM are lower than in normal people. Further studies are needed to investigate the possible prognostic value of alarin in clinical practice in T2DM.

Abstract Context. The inhibition of adipocyte differentiation has a significant role on the prevention of obesity and obesity-associated complications. Objective. In this study, we aimed to detect whether hyperoside is able to inhibit the conversion of pre-adiposits into mature adiposits. Design and Methods. 3T3-L1 pre-adipocytes were stimulated so as to differentiate into mature adipocytes. Hyperoside in non-cytotoxic concentrations (1, 2, 5, and 10 μM) were separately applied to differentiated 3T3-L1 cells. Oil red O staining was performed and triacylglycerol contents were measured. Furthermore, gene and protein expressions of transcription factors, adipogenic genes and adipokines were examined in order to investigate the effect of hyperoside on adipocyte differentiation. Results. Hyperoside in high concentrations significantly suppressed the adipogenic process by inhibiting the expression of transcription factors and adipogenic genes and reducing lipid accumulation in adipocytes (p<0.05). Low doses of hyperoside are able to inhibit adipogenesis, but higher doses are needed to reduce fat accumulation in mature adipocytes. In the case of maturing preadipocytes, 5 μ M of hyperoside exerts its antiadipogenic effect at the early stages of adipogenesis, whereas 10 μ M of hyperoside acts at the later stages (p<0.05). Conclusion. These results suggest that hyperoside has a beneficial effect on the prevention and treatment of obesity.

Earlier reports had shown a profound effect of the below sea level environment of the Jordan Valley (JV) on serum levels of sex hormones in humans including testosterone (T).\r\nThis effect was suggested to be due to the environmental factors of higher temperatures and higher barometric pressure of the JV compared to those factors in areas above sea level such as Irbid City (IC).\r\nMethods. Herein, two groups of eight male Sprague Dawley rats were selected from all litters obtained at our Animal Facility at the Jordan University of Science and\r\nTechnology. The two groups were subdivided between IC and the JV.\r\nResults. Adrenocortical cytochromes P-450 of the steroidogeneic pathways were higher in rats of both sexes growing in the JV compared to those maturing in IC.\r\nIntratesticular T levels were significantly higher in male rats growing in the JV than in those of the IC (638.262?18.2464 ng / mL compared to 434.108?22.3764 ng / mL).\r\nConclusion. The high blood levels of T in rats of the JV compared to those of IC are due not only to the high testicular production of T, but also to the higher activities of the adrenocortical cytochromes P-450 in rats growing at the JV.

Objective. Few studies are available on the temporal sequence and effect of ethnicity,\r\nsocioeconomic status and environment on pubertal changes leading to sexual maturation in\r\nboys; therefore, we describe normative values for developmental changes in physical and\r\nendocrine characteristics at onset and during progression of the pubertal process in a cohort\r\nof Pakistani boys.\r\nDesign. This cross-sectional study involved 234 healthy, 8-18 years old, school-based boys.\r\nMethods. Body weight, height, appearance of pubic hair patterns and testicular volume\r\n(TV) along with serum FSH, LH, testosterone and GH levels were measured.\r\nResults. Pubarche was first recorded at a mean age of 11.3 years [Tanner stage 2]. TV of\r\n3 ml and the first significant increase in mean serum FSH and LH levels were detected at 10\r\nyears of age. The mean percent increase in TV/year was maximal from 12-14 years, coinciding\r\nwith rising testosterone levels. The levels of gonadotropins increased more than 2-fold between\r\n12-14 years. Whereas, LH continued to increase in postpubertal boys and FSH levels plateaued\r\nat 15 years. GH concentrations were shown to be maximal at 12-13 years and declined\r\nthereafter to prepubertal values. However, BW and height were significantly correlated with\r\nage; yet no significant correlation was seen between body mass index (BMI) and age.\r\nConclusion. The present data among boys indicates an earlier transition to the Tanner stage\r\n2 and an increase in TV, resulting in a slightly more extended period of pubertal development, as\r\ncompared to European and American children pointing to ethnic, social and economic differences.