ACTA ENDOCRINOLOGICA (BUC)

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Background. Diabetes mellitus (DM) is considered as an important health confounder in our world, which necessitates its better management by new methods. In this study, we have evaluated the effects of oral Arnebia Euchroma (AE) extract on different stereological parameters of the pancreas as well as blood glucose in Streptozotocin (STZ)-induced diabetes in rats. Methods. We divided 48 Wistar rats into 4 groups: C1 including normal rats, C2 not-treated diabetic rats, E1 with diabetic rats receiving 100 mg/kg AE extract orally, and E2 including diabetic rats treated with 300 mg/kg AE extract. Stereological study was done and the levels of blood glucose were also estimated and compared between experimental and control groups. Results. There were significant differences in volumes of pancreatic islets, β cell populations, blood glucose levels in AE treated groups compared with nottreated diabetic group. Conclusion. Although AE did not completely prevent or heal the pancreatic damage, its oral administration showed promising effects on maintaining the population of beta cells, the main insulin secreting cells, after STZ-induced injury and also lowered blood glucose levels compared to the not-treated diabetic group.

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The objective of this study was to investigate the prevalence of hyperthyroidism in Isfahan, a centrally located city in Iran, fifteen years after universal salt iodization. In a cross-sectional study, 2523 Isfahani adult people (aged >20 years, 1275 men and 1248 women) were selected by multistage cluster sampling method. TSH was measured in all (n=2523) and urinary iodine concentration (UIC) in one fourth of participants. Those with low TSH <0.3 mIU/L were recalled and re-tested (n=115). Low TSH with normal FT4I and T3 at the second measurement was considered as subclinical and low TSH with high FT4I or T3 as overt hyperthyroidism. TPOAb, TgAb and UIC were measured in hyperthyroid patients and controls. The prevalence of hyperthyroidism was 1.8 % (n=46): overt-0.8% (n=21) and subclinical hyperthyroidism 1.0% (n=25). Hyperthyroidism was observed in 2.6% of women (n=32) and 1.1% of men (n=14) (OR= 2.4, CI 95%: 1.3-4.5, P=0.006). Iodine deficiency and excess were observed in 21.4% and 18.7% of all population, being 38% and 33% in hyperthyroid patients, respectively (P>0.05). Thyroid function had no statistically significant correlation with iodine intake status. Nobody had UIC more than 100 µg/dl. The prevalence of positive TPOAb and/ or TgAb was 54.5% and 29.2% in hyperthyroid and euthyroid people, respectively (OR= 2.9, CI 95%: 1.2-7, P=0.01). Conclusions:The rate of hyperthyroidism in our region was similar to iodine sufficient areas. Its development is not a direct effect of iodine intake. Antithyroid autoimmunity may have a role.

McCune Albright syndrome (MAS) is a rare disease due to a sporadic mutation in Gs protein inducing polyostotic fibrous\r\ndysplasia, pigmented skin patches and hyper functioning endocrinopathies. We aimed to report its association with a hot thyroid nodule and gigantism.\r\nCase report. A man aged 37, with a history of pigmented skin lesions and lameness was referred for acromegaly. He was giant (height = 1.94 m/ target stature = 1.68 m), and had ?caf? au lait? spots. Biological analyses argued for pituitary mixed secretion (random growth hormone = 22 ng/ mL, N<5; prolactin = 27 ng/mL, N<10). Brain CT scan showed a pituitary process of 11x10 mm. Thyroid radioiodine scan revealed a hot nodule. Bone x-ray demonstrated large osteolytic lesions in the right femur and pelvis. He was operated on for endocrine tumours. The thyroid nodule\r\nwas benign and immunohistochemistry pituitary was positive for GH, prolactin and &#945; subunit.\r\nConclusion. Somatolactotrop adenoma causing gigantism associated with MAS is exceptional. It should be known, diagnosed, and treated early to avoid bone deformations\r\nand malignant transformation of osseous lesions under GH and/or IGF1 excess. One should also know that radiotherapy for the pituitary process is contraindicated, because of higher risk of sarcomatous transformation.

Intracranial germ cell tumors (GCT) are rare brain tumors that typically arise in the pineal or suprasellar regions. Germinomas are highly radiosensitive among pediatric CNS tumors. Suprasellar GCTs most commonly present with hypothalamic/ pituitary dysfunctions. We report a case of an 18 year old boy with particularly long term evolution from the onset of symptoms to the positive diagnosis of suprasellar germinoma. At 9 years he was diagnosed with idiopathic central diabetes insipidus and started DDAVP therapy. In the subsequent years he presented delay in longitudinal growth and delayed pubertal development. At 16 years he was referred to our institute with relatively good general condition despite an extremely severe hypernatremia of 186 mEq/L, serum osmolality of 405 mOsm/kg and impaired thirst sensation. He developed sinus thrombosis as a consequence of hyperosmolality and presented intermittent rises of temperature, but no septic episodes. During a long term follow neuroimaging eventually revealed a thickening of the pituitary stalk, mimicking as an infiltrative lesion. Finally, two supracentimetric tumor nodules were shown on contrast enhanced MRI in the suprasellar region and at the floor of the left lateral ventricle. Stereotactic biopsy concluded a pure germinoma, and craniospinal irradiation was performed. At present he has an infracentimetric suprasellar tumor remnant, reperfused sinus veins, optochiasmatic syndrome sequelae. He benefits from L-Thyroxin and testosterone replacement, and maintains hydro-electrolytic balance on DDAVP and controlled oral fluid intake.

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Chronic heart failure (CHF) and obesity are two conditions frequently associated and which, despite all the advances made in their management in the recent years, their prevalence continues to rise. Obese patients present unique challenges in the diagnosis of CHF and also therapeutic particularities. The genetic differences may be a possible explanation for the fact that some people, irrespective of their lifestyle and common classical cardiovascular risk factors, are more susceptible to develop heart failure. Moreover, the adipose tissue, a huge endocrine organ which secretes adipokines, is also a well-established source of all renin-angiotensin-aldosterone system components, being strongly involved in the pathogenesis of CHF. That is why this review will explore the possible links between the RAS genetic polymorphisms and leptin secretion in obese HF patients, trying to bring a more precise understanding of this relationship, which will undoubtedly facilitate a more appropriate treatment of HF in obese patients. We also try to explain the possible incriminated mechanisms, and plausible biological explanations for the relationship between RAS genetic polymorphisms and adipokines secretion in obese heart failure patients.

Context. Many negative effects of stress regarding cognitive performances and gastrointestinal habits were previously reported in both animal models and human participants. Objective. We aimed to compare perceived stress levels with declared gastrointestinal habits changes in a small cohort of college students during academic acquisition and evaluation periods. Design. College students were recruited and divided into two groups: the control group evaluated during the acquisition period of the academic year and the stressed group evaluated during the examination period. Subject and Methods. The students’ psychological and gastrointestinal status was evaluated using a common stress questionnaire and a gastrointestinal habits survey. Results. Our results showed increased perceived stress in college students during stressful conditions, as compared to lesser demanding periods. Similarly, more than 40%of the participants declared that gastrointestinal habits changes occurred during stressful periods. We observed significant correlations between the perceived stress levels and gastrointestinal habits changes. Conclusion. This small-sized survey study showed that the occurrence of the stressful event in young adults recorded higher perceived stress scores and frequent functional gastrointestinal symptoms, as compared to the lower stressful periods. Also, we showed that functional gastrointestinal symptoms are rather common and could be regarded as a negative response to stress.

Systemic Lupus Erythematosus (SLE) is a chronic autoimmune polymorphous disease that primarily affects women of reproductive age. This gender disparity has suggested the importance of investigating the role of reproductive hormones in the pathogenesis of the disease. Estradiol, the most potent form of estrogen, plays a key role in shaping the immune system including the production of lymphocytes, the peripheral differentiation of regulatory T cells (T-regs), antibody production, and the complement and interferon systems, and has been studied in the pathogenesis of systemic lupus erythematosus (SLE). It operates by binding to estrogen receptors (ERs) α and β, initiating cellular responses including alterations in gene expression. Regulatory T cells are instrumental in preserving immunological self-tolerance and moderating immune responses. Estradiol’s serum levels correlate with the expansion of CD4+CD25+ and FoxP3+ in healthy females. However, this response is reduced in lupus patients. Estradiol also interacts with microRNAs (miRNAs) in gene regulation. Hsa-miR-10b-5p, a miRNA targeting SRSF1, is overexpressed in SLE patients and its levels increase with exposure to estrogens. Other miRNAs also show correlation with plasma Estradiol levels. The precise role of Estradiol in the pathogenesis of SLE remains complex and multifaceted and is a topic for further research.