ACTA ENDOCRINOLOGICA (BUC)

Objective. To study the correlation between neck circumference(NC) and umbilical artery blood flow in physiologic pregnancies. Methods. One hundred and one healthy pregnant woman in the third trimester were enrolled. Anthropometric measurements and ultrasonic testing were done. Results. The women with NC ≥34.7cm had a more elevated umbilical artery pulsatility index(PI) and systolic/diastolic ratio (S/D) than the women with NC <34.7cm (P<0.01). NC were positively correlated with PI(r=0.224,P=0.024) and S/D ratio(r=0.415,P=0.0001). In multivariate analysis, NC was independently associated with PI (β=0.026, P=0.016) and S/D ratio (β=0.132, P=0.0001). Conclusions. Obesity has an adverse impact on feto-placetal vessels, and NC was superior to body mass index.

Background. Sarcopenia is a syndrome, considered one of the main risk factors for morbidity and mortality among adults. Thyrotoxicosis may contribute to its development. Aim. To assess the physical well-being among women with thyrotoxicosis and to determine the risk of sarcopenia among them; 13 women over 40 years of age with thyrotoxicosis took part in this study. Materials and Methods. Grip strength was used to assess muscle strength. Appendicular skeletal muscle mass, adjusted for body size was used to asses muscle quantity. Physical performance was measured by gait speed test. We divided women in groups: group A - patients with newly diagnosed thyrotoxicosis and group B - patients who had started treatment. Results. The values of muscle strength, muscle mass and gait speed were lower in group A compared to group B. Three of the patients in group A were diagnosed with severe sarcopenia. Thus the frequency of sarcopenia was 50% in this group. None of the women in group B met the criteria for sarcopenia. Despite the small number of women in this study, we can conclude that untreated thyrotoxicosis is a risk factor for decreased muscle strength, quantity and physical performance and could cause secondary sarcopenia.

The recent discoveries on organelles autoregulation and their molecular mechanisms motivate a novel perspective on mitochondria involvement in cardiovascular dysfunctions related to diabetes mellitus and obesity. We present here an up-dated view on the latter topic along with a condensed perception on morphological details resultant from diabetes mellitus experimental models. This study is organized into sections covering the following topics: (i) mitochondrial stress/dysfunction, (ii) the “quality controller” role of mitochondria exerted by fusion, fission, and mitophagy events, (iii) the connection between mitochondria and metabolic diseases, and (iv) the perspectives of potential application of mitochondrial-targeted compounds in metabolic diseases. Critical analysis of the knowledge available so far on mitochondria-metabolic diseases relationship allows a two sides conclusion: a doubtful view, as the correlation between impaired mitochondrial function and insulin resistance is still unclear, even after 40 years since its first publication, and a hopeful view based on the novel traits of this organelle uncovered recently, such as plasticity, the “quality controller” role, the “retrograde signalling”, and the coordinate interaction with the nucleus, endoplasmic reticulum, Golgi apparatus and lysosomes. At the horizon, the essential issue of targeting mitochondria for the alleviation of diabetes/obesity complications remains to be resolved.

Background. Thyroid disorders are the most prevalent of all autoimmune diseases and identifying them clinically can be challenging. A retrospective study was taken up with the aim to determine the prevalence of anti thyroid antibodies (ATA) in both suspected thyroid as well as non-thyroid diseases.\r\nMaterials and methods. During a period of 18 months, 207 serum samples were screened for anti thyroid antibodies by Elisa method. Clinical data of 171 cases were available for review. These 171 cases were classified into two clinical subgroups: thyroid diseases (106 cases) and non-thyroid diseases (65 cases).\r\nStatistical Method. For data analysis Epi-info was used.\r\nResults. 60.82% cases were positive for anti thyroid antibodies. 53.22% (91/171) were positive for anti Thyroglobulin (TG) antibodies whereas 50.29% (86/171) were positive for anti Thyroid peroxidase (TPO) antibodies. For TG 34.50% were strongly positive and 18.71% were weakly positive and for TPO, there were 32.75% and 17.54%, respectively. ATA were positive in 79.25% of suspected thyroid diseases whereas they were positive in 30.77% of non-thyroid diseases. The relationship between the two antibodies was highly significant as it was observed that both thyroid antibodies were present in 68.87% (73/104) of positive cases whereas 29.81% (31/104) were positive for either TG or TPO antibodies alone.\r\nConclusion.ATA are good markers for the assessment of thyroid autoimmunity. Being negative for antibodies does not necessarily exclude thyroid autoimmunity in many instances; but when antibodies are positive, together with clinical presentations, they strongly indicate the autoimmune nature of the disease.

Aim: We have undertaken an attempt to compare the application efficacy of the proliferative activity markers in the differential diagnosis of thyroid H?rthle cell tumors using the PCNA and Ki-67 labeling and AgNOR visualization techniques.\r\nMaterials and methods: The present work is a retrospective analysis of proliferative potential in 40 H?rthle cell tumors, on paraffin blocks: 10 H?rthle cell carcinomas (HCC), 16 H?rthle cell adenomas (HCA) and 14 hyperplastic nodules with H?rthle cell metaplasia (HCM). The evaluation of the mean number of nucleolar organizer regions (NORs) per nucleus and the proliferative index (PI-the percentage of PCNA and Ki-67 positive cells) was performed using staining silver impregnation method and antibodies against PCNA (clone PC 10) and Ki-67 (clone MIB-1) in LSAB detection Kit and visualization with DAB (diaminobenzidine). U-Mann-Whitney test was used for statistical analysis. The difference was considered significant for p<0.05.\r\nResults: The values of PI-PCNA, PI-Ki-67 as well as the mean AgNOR counts in nuclei were: 25.5, 12.8, and 5.0 in HCC; 7.6, 4.9, and 3.1 in HCA and respectively 5.1, 4.0 and 2.3 in HCM. Statistically significant differences were found in all the proliferative\r\nactivity markers between malignant and benign tumors: HCM: HCC (p<0.0001) and HCC: HCA (p<0.001). Indifferently of the examined markers and the method of quantification of the reaction, we did not found significant differences between hyperplastic nodules with H?rthle cell metaplasia and oncocytic adenomas (p< 0.07).\r\nConclusions: PI-PCNA, PI Ki-67 and mean AgNOR/ nucleus, used as markers for the appreciation of proliferative activity of oncocytic thyroid tumors (classified as adenomas, carcinomas and hyperplastic nodules with H?rthle cells), reflect differences between the studied thyroid lesions. Our results indicate the utility of these parameters in the differentiation of the benign oncocytic tumors from the malignant ones.

Context. Chronic unpredictable mild stress (CUMS) has been widely shown to impact neurological disorders. Recently, growing evidence suggests that CUMS may also contribute to the development of metabolic conditions such as diabetes mellitus. Objective. This study aimed to investigate blood glucose levels and histopathological and immunohistochemical changes in the endocrine pancreas in an experimental rat model of CUMS, as well as the potential protective effects of vortioxetine (VOR) treatment. Subjects and methods. A total of 28 rats were divided into four groups. The CUMS group was exposed to random stressors once daily for six weeks. Rats in the VOR and CUMS+VOR groups received VOR treatment. The VOR and control groups were housed separately, without exposure to CUMS. At the end of the experiment, blood and pancreatic tissue samples were collected from all rats. Results. Blood glucose levels were elevated in the CUMS group compared to the other groups. Histopathological analysis revealed a reduction in insulin, amylin, and insulin receptor expression, along with a slight increase in glucagon expression and a small number of necrotic cells in the CUMS group. VOR treatment improved all these parameters. Conclusions. Our findings suggested that CUMS may contribute to endocrine pancreatic damage resembling diabetes mellitus, while VOR treatment may mitigate this effect.

Hyponatremia is a common abnormality found in patients admitted in an internal medicine department of an emergency hospital. Sometimes its cause is quite easy to find (in our clinic especially drug-induced due to thiazide or various antidepressant medication in geriatric population), but in other situations it proved to be a challenging diagnosis in what concerns etiology. It is not frequently found in young patients and if this situation occurs a tight diagnosis protocol is always recommended.

Nephrogenic diabetes insipidus (NDI) is the most common renal side effect seen with lithium therapy. Persisting cases after the cessation of the therapy may be seen when lithium therapy is continued for too long. Although desmopressin treatment is not one of the accepted treatment modalities for NDI, there are few reports using desmopressin treatment in unresponsive cases. Herein, we reported the fourth lithium-induced NDI case in the literature responsive to desmopressin therapy.

Context. Intermedin (IMD) is the member of calcitonin gene-related peptide family, and tightly associated with type 2 diabetes mellitus (T2DM). The change of plasma IMD levels in T2DM is still unknown. Objective. We aimed to investigate the plasma levels of IMD in patients with T2DM. Design. Fortyone patients with T2DM who were hospitalized in the endocrinology department of Civil Aviation General Hospital from January 2012 to June 2015 were enrolled, and 44 volunteers were selected as the control group. Subjects and Methods. Plasma level of IMD was detected by ELISA. Diagnostic value of IMD was analyzed by area under the receiver operating characteristic (ROC) curve (AUC). Results. The plasma level of IMD in T2DM group was higher than that in the healthy control group, whereas smoking or cardiovascular complications did no influence the IMD levels. IMD levels were correlated with BMI, DBP, triglyceride, uric acid, urea nitrogen, fasting and 2 hours postprandial blood glucose, and HbA1C. The greatest value of AUC for IMD was only 58.73%. Conclusions. Although plasma levels of IMD were increased in patients with T2DM, the very low diagnostic value of IMD for T2DM might not be used for the disease diagnosis.

Introduction: Leptin, which is known to regulate appetite and energy expenditures, may also contribute to mediate the effects of fat mass on the bone.\r\nObjective: The aim of this study was to analyse to what extent leptin and total body composition influence the maintenance of bone mass.\r\nSubjects and methods: We evaluated 34 women divided into two BMI-matched groups based on the ovarian function: 12 premenopausal women, aged 34.08?7.18 years and 22 postmenopausal women aged 61.31?4.51 years, respectively. Total body composition (total fat mass, trunk fat mass and lean mass) and bone mineral density were measured by means of dual-energy X-ray absorptiometry (DXA). Serum leptin concentrations were assessed by ELISA.\r\nResults: The bone mineral content was influenced by both the fat mass (women with normal menstrual cycles r=0.62, p=0.03; postmenopausal women r=0.625, p=0.002) and the trunk fat mass (r=0.597, p=0.004 premenopausal women; r=0.675, p=0.001 postmenopausal women), independently of the ovarian function. Only for the postmenopausal group we could identify a significant correlation between leptin levels and the total body bone mineral density (r=0.479, p=0.024) and the total body bone mineral content (r=0.605, p=0.003), respectively. The serum leptin levels were highly significantly correlated with the total fat mass and the trunk fat mass for both groups. No difference was obtained with regard to the serum leptin levels between pre- and postmenopausal women.\r\nConclusions: Our results suggest the role played by leptin and the fat mass in the maintenance of bone mass.