ACTA ENDOCRINOLOGICA (BUC)

Background. Erectile dysfunction(ED) in men is a frequent under-reported complication of diabetes mellitus, which is becoming significant health problem worldwide. Aims. The study aims to determine the prevalence and risk factors for development of ED in North Indian patients with type 2 diabetes mellitus. Methods. We used international index of erectile function (IIEF-5) for the assessment of ED in 796 patients with type 2 diabetes mellitus. We recorded the age, duration of diabetes, glycemic status, body mass index, diabetes medications, microvascular and macrovascular complications. Results. The mean age of patients in the study was 49.38 ± 9.52 years. The prevalence of ED in patients with type 2 diabetes mellitus was 79.4%. Logistic regression analysis revealed that age, body mass index, glycemic control, insulin therapy, retinopathy and nephropathy was not significantly associated with erectile dysfunction in patients with type 2 diabetes mellitus. Duration of diabetes (OR = 1.054, 95% CI 1.007 to 1.102, P=0.023) and vibration perception threshold (OR = 1.071, 95% CI 1.042 to 1.102, P=0.000) were identified as key risk factors for development of ED. Conclusion. Duration of diabetes and peripheral neuropathy emerged as significant risk factors for development of severe erectile dysfunction.

Context. Betel nut is consumed by millions of people for stress reduction and increased capacity to work. One of its components is arecoline which is useful for Alzheimer and schizophrenia; it also influences endocrine and gonadal functions. Objective. Objective is to examine whether arecoline can influence pineal-testicular function in metabolic stress. Design. Rats were deprived of food or water or treated them with arecoline, each separately for 5 days. Subjects. Pineal and testis with sex accessories were studied. Methods. Ultrastructural (pineal, testis, Leydig cells and prostate), hormonal (melatonin and testosterone) and other parameters (fructose and sialic acid) were examined. Pineal indoleamines were quantitated by fluorometric method; testosterone by ELISA, and carbohydrate fractions by spectrophotometric methods. Results. Inanition/ water deprivation caused pineal stimulation ultrastructurally (with enlarged synaptic ribbons) and elevation of melatonin level, but reproductive dysfunction by ultrastructural degeneration of Leydig cells and prostate with fall of testosterone, fructose and sialic acid concentrations. Arecoline treatment showed reversed changes to those of metabolic stress, but arecoline treatment in metabolic stress showed same results as in metabolic stress. Conclusion. The findings suggest that arecoline cannot alter the action of metabolic stress on pineal-testicular activity in rats.

Renal osteodystrophy and low bone mass are frequently found in patients with end-stage renal disease (ESRD). Our aim was to identify the independent predictors of age - and sex-adjusted bone mineral density (BMD), measured at different traditional sites, in patients with ESRD treated by hemodialysis (HD) or peritoneal dialysis (PD). Patients and Methods. We consecutively assessed 23 patients with ESRD (17 on HD and 6 on PD). Patients treated with 1,25 dihydroxyvitamin D, vitamin D derivates (paricalcitol) or calcimimetics were excluded. Serum parathormone and 25OH vitamin D were measured in all patients. In HD patients all biochemical measurements were done in the day between dialysis sesions. BMD was assessed at following sites: femoral neck, total proximal femur, 1/3 radius, ultradistal (UD) radius and total radius. Radial BMD was assessed in the forearm without arteriovenous fistula. BMD Z-score provided by the manufacturer was used. Results. In patiens undergoing PD the femoral neck BMD Z-score was significantly higher than in HD patients (difference -0.77 DS, 95% CI for difference -1.48 to -0.06). PTH correlated significantly with BMD Z-score at the 1/3 (r=-0.664, p<0.001) and total (r=-0.583, p=0.002) radius levels. Total proximal femur and UD radius BMD Z-scores did not correlate with any of the proposed variables. Years of dialysis, 25OH vitamin D and body mass index did not correlate with BMD Z-score at any site. Conclusion. In patients with ESRD PTH correlates strongly with BMD Z-score at cortical sites. PD seems to be less harmful to BMD than HD.

-

Aim of the study. The objective of the present study was to determine the dose dependent effects of lisinopril, a ACE\r\ninhibitor on cardiovascular complications in streptozotocin induced diabetic rats.\r\nMaterials and methods. Two days old neonatal pups (7?10 g) were used and they were made diabetic by intra-peritoneally (i.p.) injection of 90 mg/kg STZ in citrate buffer solution. Lisinopril was given orally at two different doses of 0.5 mg/kg/day and 3 mg/kg/day, p.o for 8 weeks. After 8 weeks\r\ntreatment biochemical parameters from blood serum and hemodynamic parameters were analyzed.\r\nResults. The significant differences of glucose, insulin, cholesterol, triglyceride, creatinine kinase (CK-MB), lactate dehydrogenase (LDH), CRP level, left ventricular collagen content, cardiac hypertrophy index, left ventricular hypertrophy index in 3 mg/kg/day Lisinopril\r\ntreated group compared to diabetic group were found. It showed a significant decrease in blood pressure compared to diabetic group.\r\nConclusion. Lisinopril has beneficial effects on diabetes and its associated cardiovascular complications.

Context. Schizophrenia is a chronic disease most frequently necessitating lifelong antipsychotic treatment. Selecting which antipsychotic is to be prescribed in an individual schizophrenia patient represents an important clinical decision that need to take into account efficacy and side effects. Objective. Evaluating weight gain related with one year antipsychotic treatment in antipsychotic naive firstepisode schizophrenia patients. Design. This study is an analysis of weight gain associated with typical or atypical antipsychotics used in European First Episode Schizophrenia Trial (EUFEST) study. Subjects and Methods. 113 first episode naïve antipsychotic schizophrenia patients included in EUFEST - Romanian cohort, who were randomized to one of the 5 treatment arms. Weight was obtained at baseline, 3, 6, 9 and 12 months for the 5 antipsychotics (typical-Haloperidol; atypical-Olanzapine, Amisulpride, Ziprasidone, Quetiapine). Results. There are no statistically significant differences between groups treated with typical or atypical antipsychotics or between any individual antipsychotics concerning weight gain during the study. Weight gain was the highest in the first 3 months (57.49%) for all the studied neuroleptics. At the end of the study, the less increase was observed with ziprasidone (3.87 kg) and the highest with olanzapine (9.83 kg). Conclusion. Increase in weight has taken place for each individual neuroleptic, but also as a group (all neuroleptics) in the first three months (57.49%). Therefore, we should address the issue of weight gain with great care, especially in first period of antipsychotic administration, in order to fast deploy intervention tailored to maintain pretreatment weight.

Objective. to investigate the factors associated with postprandial glucose excursions in\r\npatients with type 2 diabetes.\r\nResearch Design and Methods. A complete medical history and physical examination\r\nwere assessed in 118 consecutive patients with type 2 diabetes attending the Diabetes\r\nOutpatient Clinic, Cluj-Napoca. Blood samples were collected in fasting state, and HbA1c\r\nand lipid profile were assessed. A six points blood glucose profile measured by patients at\r\nhome was performed. To determine variables associated with higher postprandial glycemic\r\nlevels, factor analysis followed by linear regression model was performed.\r\nResults. The study group had a median age of 59.2 years, 43.4% were females. The\r\nmedian duration of diabetes was 5 years. By factor analysis we have extracted 4 factors that\r\nexplained 75.6% of the variance of postprandial glycemia: factor 1 with positive loadings of\r\ntotal cholesterol and LDL cholesterol, factor 2 with positive loadings of body mass index\r\nand waist circumference, factor 3 with positive loadings of diabetes duration and age, factor\r\n4 with positive loadings of triglycerides and glycosylated hemoglobin (HbA1c). After\r\nadjustment for the sex and treatment, only factor 2 and factor 4 remained significantly associated\r\nwith postprandial glycemic values (p=0.003 and p<0.001), indicating that the postprandial\r\nglycemia is best predicted by a multiple regression that included body mass index, waist\r\ncircumference, tryglicerides and HbA1c as independent variables (r=0.54, p<0.001).\r\nConclusion. The results of our study shows that low body mass index and waist\r\ncircumference, high triglycerides and HbA1c levels are independently associated with\r\npostprandial glucose excursions.

Background. Organophosphate exposure induces many endocrine effects. Aim. In this study we observed the effects of acute stress induced by cholinesterase inhibition on the main hormonal axes. Materials and Methods. We included thirteen weanling Wistar rats that were subjected to organophosphate exposure. They were first tested for baseline levels of butyrylcholinesterase, cortisol, free triiodothyronine, thyroxine, thyroid-stimulating hormone and prolactin. Secondly, chlorpyrifos was administered. Next samples were taken to determine the level of all the above-mentioned parameters. Results. Butyrylcholinesterase was significantly decreased after exposure (p<0.001). Cortisol levels were significantly higher after clorpyrifos administration (358.75±43 vs. 241.2±35 nmoL/L)(p<0.01). Although prolactin had a growing trend (450.25±24.65 vs. 423±43.4 uI/mL), the results were not statistically significant. Both free triiodothyronine and thyroxine were significantly higher after exposure. Surprisingly, thyroid-stimulating hormone level almost doubled after exposure with high statistical significance (p<0.001), suggesting a central stimulation of thyroid axis. Butyrylcholinesterase level was proportional with thyroid-stimulating hormone level (p=0.02) and thyroxine level was inversely correlated to the cortisol level (p=0.01). Acute cholinesterase inhibition may induce high levels of cortisol, free triiodothyronine, thyroxine and thyroid-stimulating hormone. From our knowledge this is the first study dedicated to the assessment of acute changes of hormonal status in weanling animals after low-dose organophosphate exposure. Conclusion. Acute cholinesterase inhibition may cause acute phase hormonal disturbances specific to shocked patients.

Purpose. Vitamin D insufficiency and age related cataract (ARC) are public health problems. We evaluated serum vitamin D levels in ARC patients. Method. A prospective hospital-based crosssectional study was designed to measure the vitamin D status of patients with ARC. Patients have grouped either presence of any type of posterior subcapsular cataract (PSC) (group 1) or ARC without the PSC component (Group 2). After full ophthalmologic consideration, patients over 40 years of age with no history of ocular trauma, multivitamin supplement ingestion, chronic renal failure, thyroidectomy, parathyroidectomy, skin cancer, and cigarette smoking were included in the study. Results. Totally, 79 subjects of which 26 (32.9%) subjects in group 1 and 53 (67.1%) subjects in group 2 were included in the study. Group 1 had mean vitamin D levels of 17.31±13.30 ng/mL. Vitamin D levels in Group 2 were 13.34±7.87 ng/mL. Group 1 did not show vitamin D insufficiency (P = 0.31; one-sample t-test). However, Group 2 showed a statistically significantly lower vitamin D level compared to the insufficiency level of 20ng/mL (P= 0.00; one-sample t-test). Conclusion. Vitamin D may have an important function in lens metabolism. Vitamin D deficiency and cataract development need further extensive researches.

Background. Valepotriate is an active ingredient of valerian (Valeriana officinalis) with strong antioxidant activity that is effective for numerous cardiovascular diseases. Objective. The aim of this study was to investigate the effect of an active ingredient of V. officinalis extract on ischemia-reperfusion-induced cardiac injuries in male rats. Methods. Thirty-two male rats were subjected to ischemia for 40 minutes and reperfusion for five days. The rats were divided into 4 groups of 8 each; group 1 (control) was given normal saline, and groups 2-4 were gavaged with 0.2, 0.1, 0.05 mg/kg of valepotriate extract, respectively, and received extract (0.2 mg/kg ip) two weeks before ischemia induction. Results. Dichloromethane V. officinalis (valepotriate) extract exerted a protective effect against ischemia-reperfusion-induced injuries. So that infarct size and number of ventricular arrhythmia and ventricular escape beats decreased compared to the control group. Moreover, ST segment amplitude, QTC interval, and heart rate decreased in the injured hearts and serum levels of antioxidant enzymes glutathione peroxidase, catalase, and superoxide dismutase increased. Biochemical markers malondialdehyde and lactate dehydrogenase also decreased on day 5 after the onset of reperfusion. Conclusion. V. officinalis extract may have a protective effect against myocardial ischemia-reperfusion by producing antioxidant effects.