ACTA ENDOCRINOLOGICA (BUC)

Objective. To find out the relationship of thyroid hormone profile of females with outcomes after intra cytoplasmic sperm injection (ICSI). Method. It was a cross sectional study conducted in Islamabad Clinic Serving Infertile Couple from June 2013 till August 2015. T3 (triiodo thyronine), T4 (thyroxine) and TSH (thyroid stimulating hormone) of 168 consented females was estimated after they underwent the first step of treatment protocol (ovarian down regulation) for ICSI. Pregnant group had ß hCG result more than 25 IU/mL while the rest were included in the non-pregnant group. Both groups were compared by using independent sample t-test. Pearson correlation coefficient was used to associate T3 and T4 with other pregnancy variables with their significance. Results. Non pregnant women had significantly higher mean values for T3 and T4 as compared to pregnant women (p <0.05, p<0.01). Difference in mean TSH value between non-pregnant and pregnant women was not significant p=0.08. It was found that T4 gave significant negative association with grading of embryo-I, blastocysts formed, thickness of endometrium and number of gestational sacs. Conclusion. Disturbance in thyroid profile with raised T4 levels leads to alteration in endometrial thickness and quality of embryos required for implantation and hence conception.

Introduction. The pituitary gland serves as the center of the endocrine system. Stem cells are typically found in a specialized microenvironment of the tissue, called the niche, which regulates their maintenance, self-renewal, fate determination, and reaction to external influences. The aim of this study is to elucidate the role of stem cells in the initiation, invasion, and progression of pituitary adenomas. Materials and methods. All specimens were collected between January 2007 and April 2015. Radiological classification (invasiveness) for all cases was performed according to the Wilson-Hardy classification system. Immunohistochemical staining was performed to all specimens for CD133, Oct4, Sox2 and nestin. Results. The study included 48 patients. Of 48 patients, 17 (35.4%) were male and 31 (64.6%) were female. Mean age is 47.10±14.14 (17–86 yrs.). According to the Wilson-Hardy classification system, 27 (56.3%) were noninvasive adenomas. There was no statistical significance between the expression of pituitary stem cell markers (CD133, OCT4, SOX2, nestin) and invasiveness. Conclusion. All stem cell markers are stained extensively in pituitary adenomas, except for SOX2 which was stained weakly. However, there is no effect of stem cells on invasiveness of pituitary adenomas because we cannot find a difference of the staining level between invasive and non-invasive adenomas. Nestin was stained extensively in functional adenomas, especially for GH, PRL, and gonadotropin secreting adenomas. SOX2 was stained extensively for ACTH-secreting adenomas.

Background. The aim of this study was to observe the differences in serum 25-hydroxyvitamin D(3) levels in nondiabetic healthy control subject and type 2 diabetic patients, and to investigate the differences in serum 25-hydroxyvitamin D(3) levels in type 2 diabetic patients with normo-, micro- and macroalbuminuria. P atients and Methods. Total 140 nondiabetic healthy controls and 384 type 2 diabetic patients (156 normoalbuminuric, 152 microalbuminuric and 76 macroalbuminuric) were included in the study. 25-hydroxyvitamin D(3) levels were measured in sera with the method of electrochemiluminescence using modular immunoassay analyzer. Results. Vitamin D deficiency was detected in 70.85% and 22.9% of type 2 diabetic patients and nondiabetic healthy controls, respectively. Serum 25-hydroxyvitamin D(3) levels were significantly lower in type 2 diabetic patients compared to nondiabetic healthy controls (16.4 ± 9.5 ng/mL vs. 28.2 ± 11.6 ng/mL, p=0.0001). Serum 25-hydroxyvitamin D(3) levels were lower in albuminuric and nonalbuminuric diabetic patients (14.3 ± 7.9 ng/mL vs. 19.6±10.9 ng/mL, respectively, p=0.013). Serum 25-hydroxyvitamin D(3) levels were 19.6 ± 10.9 ng/mL in normoalbuminuric, 14.9 ± 8.8 ng/mL in microalbuminuric and 12.9 ± 5.8 ng/mL in macroalbuminuric diabetic patients. While lower serum 25-hydroxyvitamin D(3) levels were detected both in microalbuminuric (p=0.028) and macroalbuminuric diabetic patients (p=0.014) compared to normoalbuminuric diabetic patients, 25-hydroxyvitamin D(3) levels did not change significantly between microalbuminuric and macroalbuminuric diabetic patients (p=0.67). Serum 25-hydroxyvitamin D(3) levels correlated negatively with urinary albumin excretion (r=-0.24, p=0.016) in patients with diabetes mellitus. Conclusion. Findings of the present study demonstrated reduced serum 25-hydroxyvitamin D(3) levels which were significantly related with albuminuria in type 2 diabetic patients.

Introduction. Prostate specific antigen (PSA) progression is considered to be the earliest evidence of persistent or recurrent disease after primary therapy with curative intent in prostate cancer. The purpose of the study was to evaluate the predictive value of PSA progression under anti-androgen treatment in patients with advanced disease treated by bilateral orchidectomy alone or associated with antiandrogens.\r\nPatients and methods. We studied 87 patients diagnosed with prostate cancer between January 1998 and October 2005 with PSA values over 20 ng/ml. Prostate cancer was confirmed by transrectal ultrasound guided prostate biopsy. In all patients, prostatectomy was not performed, but bilateral orchidectomy. Flutamide 750 mg three times daily was associated from the beginning with surgical castration in patients with bone metastases (n=11). In the other patients, Flutamide 750 mg three times daily was started if a progression of the disease was noted, 29 out of 76 cases. The follow-up protocol included physical examination and digital rectal examination, acid and alkaline phosphatases and seric PSA every 3 months in the first two years and then every 6 months.\r\nResults. Patients were divided after orchidectomy and after 6 months of flutamide therapy in four groups: Group 1 (n= 46 cases) with PSA response, i. e. decrease at less than 1 ng/ml, Group 2 (n= 22 cases) with PSA decrease to 1 - 4 ng/ml, Group 3 (n= 11 cases) PSA response between 4 and 10 ng/ml and Group 4 (n= 8 cases), with PSA serum levels over 10 ng/ml PSA serum levels increased progression occurred in 12, 10, 8 and 8 patients of the four groups, respectively, and disease clinical progression was observed in 7, 7, 6 and 7 patients, respectively. Mean intervals of PSA progression in the four groups were 52, 36, 32 and 11 months, respectively. An important complication rate was observed, represented by acute urinary retention, unilateral ureterohydronephrosis, obstructive anuria, pulmonary and bone metastases, chronic renal failure and hematuria by bladder invasion.\r\nConclusions. Our study confirmed the data from the literature that serum PSA level could be used as an surveillance marker in patients with advanced prostate cancer submitted to orchidectomy with or without anti-androgen receptor therapy and also has an important prognostic value.

Context. Exercise and anabolic steroids are anticipated to promote fat mass reduction and so to decrease the number of comorbidities related to excessive weight. Objective. The aim of this study was to verify the influence of aerobic exercise and the use of steroids on the accumulation of adipose tissue and on the biochemical limitations of Wistar rats nourished by a hypercaloric diet. Methods. Forty, young male Wistar rats were split into four groups: obese control (n=10), obese under treatment (n=10), obese under aerobic exercise (n=10) and obese under aerobic exercise and treatment (n=10). All animals were fed with a hypercaloric diet and animals under treatment received intramuscular testosterone. Body (weight and visceral fat) and blood (lipidogram, glucose, and liver enzymes) parameters were assessed. Results. The group treated with aerobic exercise and testosterone revealed a reduction in body weight and visceral, perirenal, retroperitoneal and epididymal fats, accompanied by the blood levels of glucose, lactate, LDLcholesterol, HDL-cholesterol, and lactate dehydrogenase; following high-intensity physical activity. Conclusion. The results support the theory that the combination of steroids and physical activity reduces the side-effects of androgenic-anabolic hormones and conveys benefits to some constraints

Context. Ghrelin, in both its acylated and desacylated forms, and leptin can modulate fetal energy balance and development. Objective. The aim of our study is to assess desacylated ghrelin (DAG) and leptin values and influence on intrauterine and postnatal growth in infants with intrauterine growth restriction. Design, subjects and methods. We performed a prospective study on 39 infants recruited over five months, 20 appropriate - for - gestational - age (AGA) infants and 19 small-for-gestational-age (SGA) infants, in which we measured DAG and leptin in the umbilical cord blood and we compared their respective values between the two groups, along with auxological parameters at birth and at 10 months of postnatal age. Results. Our results show that both DAG and leptin have lower values in SGA infants and correlate with most of the anthropometrical parameters at birth. Both hormones correlate with weight at 10 months in SGA infants, but this correlation lacks in AGA infants. Whereas DAG in the cord blood can be considered a predictor for weight at 10 months (β=0.207, p=0.001), the same cannot be stated about leptin (β=0.078, p=0.195). Conclusion. DAG and leptin are involved in both intrauterine and postnatal development, but the extent of their role is still to be determined.

Background. The potential measures of preventing environmental pollutants-induced reproductive toxicity in mammals require adequate investigations. \r\nAim. The protective role of vitamin C against gasoline vapors?induced reproductive toxicity was assessed in male rats. \r\nAnimals and Methods. Vitamin C (200mg/kg body weight) was daily administered orally to albino Wistar rats concomitantly exposed to 17.8cm3h-1m-3 of Premium Motor Spirit (PMS) blend unleaded gasoline vapors(UGV) for 6 hr/day, 5days/week for 10 weeks. \r\nResults and Discussion. No significant changes (P &#8805; 0.05) in the serum FSH and LH levels were observed to be associated with exposure to UGV. However, the results showed that UGV caused a significant decrease (P &#8804; 0.05) in serum testosterone level and distortions in the architectural structure of the testicular tissues in male rats, compared to the control. This suggests that the gonads may be the target tissue of interaction for UGV reproductive toxicity in male rats. Also, treatment of the exposed rats with vitamin C was observed to produce a significant increase in the level of serum testosterone to a mean value within the range obtained for the control. Moreover, the distorted architectural structure of the testicular tissues observed to be associated with exposure to UGV was significantly prevented by the administration of vitamin C. \r\nConclusion. These observations indicated that vitamin C can be effective in the protection of UGV-induced reproductive toxicity in male rats.

Context. The androgen/androgen receptor interaction plays a critical role in the development of the male genital system, and investigations around these receptors can expand our knowledge about mechanisms of some male abnormalities such as hypospadias. Objective. In the present study, the expression of androgen receptor (AR), fibroblast growth factor-10 (FGF10), and fibroblast growth factor receptor-2 (FGFR2) genes were investigated in prepuce tissue of healthy and hypospadic children. Design. It was a case-control study with follow-up about up to eight months after operation. Subjects and Methods. Patients’ tissue samples (n=20) and controls tissue samples (n=20) were collected after surgery and circumcision. After RNA extraction and cDNA synthesis, the Real time PCR was performed to evaluate and compare the levels of gene expressions. Both groups were checked until eight months after surgery. Results. The results showed that FGFR2 gene expression had significantly decreased in prepuce tissue of patients compared with healthy children (p-value <0.05). Patients and healthy children follow up showed that 20% of hypospadic patients who needed reoperation had AR gene upregulation along with FGF10 and FGFR2 downregulation. Conclusions. Taken together, interestingly, FGF10/ FGFR2 signaling has an important role in external genital system development and wound healing process.

Context. Diabetes mellitus is a well known risk factor for COVID-19 patients. However, There is limited data to investigate the association between prediabetes and COVID-19. Objective. We aimed to evaluate the effect of prediabetes and mechanical ventilation on the course of COVID-19 and determine whether patients who recover from COVID-19 infection show changes in cardiac function and laboratory findings during follow-up. Patients and Methods. This study included 87 adult patients who were diagnosed with COVID-19 according to the WHO definition and were admitted for inpatient treatment between April 2021 and August 2021. They were classified into 3 groups, normoglycemia (n=40), prediabetes (n=25), and diabetes (n=22), and then divided into groups according to need for mechanical ventilation. Statistical analyses were performed to compare laboratory, echocardiographic findings and COVID-19 outcomes among the groups. Results. The need of mechanical ventilation was significantly higher in both diabetes and prediabetes groups than the normoglycemic group. Patients with diabetes and prediabetes had significantly higher LV E/Em (p=0.003, p=0.045) and RV MPI (p=0.032, p=0.021) and significantly shorter PAT (p=0.001, p=0.036) and significantly longer RV IVRT (p=0.021, p=0.017), respectively, compared to the normoglycemia group. Patients who required mechanical ventilation had significantly higher CRP (p=0.043), troponin (p<0.001), ferritin (p<0.001), HBA1C (P<0.001), glucose (p=0.019), monocytes (p<0.001), and monocytes-HDL ratio (MHR) (p<0.001) and significantly lower levels of HDL-C (p<0.001). Glucose, HDL-C, troponin, MPV, NLR, PLR level and RV and E/Em were found independently associated with the RVMPI Conclusion. Prediabetes was associated with more impaired LV and RV diastolic functions compared to normoglycemic patients, comparable to those seen in diabetes. Our observations suggest that prediabetes should be considered as diabetes in the risk stratification of patients with COVID-19.

Objective. We analyzed the correlation between glycemic variability and psychological problems such as depression, anxiety disorder, and low self-esteem in pregnant and non-pregnant (excluding gestational diabetes) patients with diabetes. Besides its originality, this study might contribute to better / earlier diagnosis of these psychological conditions, with a special interest in pregnant diabetic women. Better management and cost reduction of care could be a consequence. Methods. We compared diabetic pregnant and non-pregnant women from the perspective of the glycemic variability (for a period of 15 days prior inclusion in the study) and their results on the standardized questionnaires: Beck depression inventory, Hamilton anxiety scale – HRSA, Rosenberg self-esteem test. Results and Conclusions. A statistically significant correlation was identified in both groups between the glycemic oscillation and depression, anxiety, and low selfesteem. Diabetic pregnant women had a higher statistical significance for the correlation between the glycemic oscillation and depression, as well as between the glycemic oscillation and anxiety than non-pregnant diabetic patients. The present data justify further research. Our results could be developed into a preliminary intervention protocol, using the daily glycemic values measurements, collected by patients.