The Value of Urinary NGAL, KIM-1, and IL-18 Measurements in the Early Detection of Kidney Injury in Oncologic Patients Treated with Cisplatin-Based Chemotherapy.

Cisplatin is still a widely used anticancer drug characterized by significant nephrotoxicity. Acute kidney injury (AKI), diagnosed based on the Kidney Disease: Improving Global Outcomes (KDIGO) criteria, has limitations, including a delayed increase in creatinine. We determined the usefulness of neutrophil gelatinase-associated lipocalin (NGAL), kidney injury molecule-1 (KIM-1), and interleukin-18 (IL-18) in diagnosing AKI according to the KDIGO criteria in patients treated with cisplatin. We recruited 21 subjects starting cisplatin-based chemotherapy (Cisplatin-based group) and 11 treated with carboplatin-based chemotherapy or 5-fluorouracil regimens (non-cisplatin-based group). Blood and urine samples were collected during four subsequent cycles of chemotherapy (68 and 38 cycles, respectively). AKI occurred in four patients in the cisplatin-based group (5.9% of 68 cisplatin-based chemotherapy cycles). Among them, three urinary markers were increased by over 100% in two cases, two in one case and one in another. A doubling of at least one investigated parameter was observed more frequently during cisplatin-based chemotherapy (80.3% vs. 52.8%; OR = 3.65, 95% CI: 1.49-8.90; p < 0.01). The doubling of at least one new urinary AKI marker was more common in patients receiving cisplatin and frequently was not associated with overt AKI. Thus, a subclinical kidney injury detected by these markers occurs more frequently than deterioration in kidney function stated with creatinine changes.

Evaluation of adipokines concentrations in plasma, peritoneal, and endometrioma fluids in women operated on for ovarian endometriosis.

Introduction: Some studies indicate the role of selected adipokines in the development of endometriosis. However, a comprehensive assessment of plasma, peritoneal, and endometrioma fluids adipokines concentrations in women with ovarian endometriosis has not yet been performed. Therefore, this study aimed to analyze plasma, peritoneal, and endometrioma fluids selected adipokines concentrations in women operated on for ovarian endometriosis. Materials and methods: A cross-sectional cohort study involved 56 women operated on for ovarian endometriosis. Body mass, height, and waist circumference were measured, and BMI was calculated. Plasma, peritoneal, and endometrioma fluids adiponectin, leptin, omentin resistin, RBP4, and visfatin/NAMPT were determined by ELISA. Results: The highest plasma levels of adiponectin, leptin, omentin, and RBP4 than in the endometrioma and peritoneal fluids were found, while levels of resistin and visfatin/NAMPT were significantly higher in endometrioma fluid than in plasma and peritoneal fluid. In addition, levels of visfatin/NAMPT were significantly higher in peritoneal fluid than in plasma. There were also positive correlations between leptin, RBP4, and adiponectin levels in endometrioma and peritoneal fluids (ρ = 0.28; p < 0.05; ρ = 0.31; p < 0.05; ρ= 0.32; p < 0.05, respectively). There were no associations between adipokines levels in plasma, endometrioma, and peritoneal fluids and endometriosis stage. Conclusion: Our results show that visfatin/NAMPT and resistin may be locally secreted in endometrioma related to inflammation regardless of the stage of endometriosis.

SARS-CoV-2 infection as a potential risk factor for the development of cancer.

The COVID-19 pandemic has a significant impact on public health and the estimated number of excess deaths may be more than three times higher than documented in official statistics. Numerous studies have shown an increased risk of severe COVID-19 and death in patients with cancer. In addition, the role of SARS-CoV-2 as a potential risk factor for the development of cancer has been considered. Therefore, in this review, we summarise the available data on the potential effects of SARS-CoV-2 infection on oncogenesis, including but not limited to effects on host signal transduction pathways, immune surveillance, chronic inflammation, oxidative stress, cell cycle dysregulation, potential viral genome integration, epigenetic alterations and genetic mutations, oncolytic effects and reactivation of dormant cancer cells. We also investigated the potential long-term effects and impact of the antiviral therapy used in COVID-19 on cancer development and its progression.

Can type 1 diabetes be an unexpected complication of obesity?

Type 1 diabetes (T1D) is one of the most common chronic autoimmune diseases, characterized by absolute insulin deficiency caused via inflammatory destruction of the pancreatic ß-cell. Genetic, epigenetic, and environmental factors play a role in the development of diseases. Almost ⅕ of cases involve people under the age of 20. In recent years, the incidence of both T1D and obesity has been increasing, especially among children, adolescents, and young people. In addition, according to the latest study, the prevalence of overweight or obesity in people with T1D has increased significantly. The risk factors of weight gain included using exogenous insulin, intensifying insulin therapy, fear of hypoglycemia and related decrease in physical activity, and psychological factors, such as emotional eating and binge eating. It has also been suggested that T1D may be a complication of obesity. The relationship between body size in childhood, increase in body mass index values in late adolescence and the development of T1D in young adulthood is considered. Moreover, the coexistence of T1D and T2D is increasingly observed, this situation is called double or hybrid diabetes. This is associated with an increased risk of the earlier development of dyslipidemia, cardiovascular diseases, cancer, and consequently a shortening of life. Thus, the purpose of this review was to summarize the relationships between overweight or obesity and T1D.

Obesity in Adults: Position Statement of Polish Association for the Study on Obesity, Polish Association of Endocrinology, Polish Association of Cardiodiabetology, Polish Psychiatric Association, Section of Metabolic and Bariatric Surgery of the Association of Polish Surgeons, and the College of Family Physicians in Poland.

Obesity in adults and its complications are among the most important problems of public health. The search was conducted by using PubMed/MEDLINE, Cochrane Library, Science Direct, MEDLINE, and EBSCO databases from January 2010 to December 2022 for English language meta-analyses, systematic reviews, randomized clinical trials, and observational studies from all over the world. Six main topics were defined in the joint consensus statement of the Polish Association for the Study on Obesity, the Polish Association of Endocrinology, the Polish Association of Cardio-diabetology, the Polish Psychiatric Association, the Section of Metabolic and Bariatric Surgery of the Society of Polish Surgeons, and the College of Family Physicians in Poland: (1) the definition, causes and diagnosis of obesity; (2) treatment of obesity; (3) treatment of main complications of obesity; (4) bariatric surgery and its limitations; (5) the role of primary care in diagnostics and treatment of obesity and barriers; and (6) recommendations for general practitioners, regional authorities and the Ministry of Health. This statement outlines the role of an individual and the adequate approach to the treatment of obesity: overcoming obstacles in the treatment of obesity by primary health care. The approach to the treatment of obesity in patients with its most common complications is also discussed. Attention was drawn to the importance of interdisciplinary cooperation and considering the needs of patients in increasing the long-term effectiveness of obesity management.

Emotional Eating and Binge Eating Disorders and Night Eating Syndrome in Polycystic Ovary Syndrome-A Vicious Circle of Disease: A Systematic Review.

Obesity is an established risk factor for the development of polycystic ovary syndrome (PCOS), especially phenotype A. PCOS is an important cause of fertility disorders in a large group of women of reproductive age. For many years, effective methods of treating hormonal disorders associated with PCOS have been sought in order to restore ovulation with regular menstrual cycles. Numerous studies support obesity treatment as an effective therapeutic method for many women. A seemingly simple method of treatment may prove to be particularly difficult in this group of women. The reason for this may be the lack of recognition the primary cause of obesity development or the occurrence of a vicious circle of disease. Primary causes of developing obesity may be emotional eating (EE) and eating disorders (EDs), such as binge eating disorder (BED) and its extreme form, addictive eating, as well as night eating syndrome (NES). All of these are caused by impaired function of the reward system. Consequently, these disorders can develop or be exacerbated in women with obesity and PCOS as a result of depression and anxiety related to hirsutism and fertility disturbances. Therefore, for the effective treatment of obesity, it is very important to recognize and treat EE, BED, and NES, including the appropriate selection of pharmacotherapy and psychotherapy. Therefore, the aim of our manuscript is to analyze the available data on the relationships between EE, BED, NES, obesity, and PCOS and their impact on the treatment of obesity in women with PCOS.

Relationship between Mental Health and Emotional Eating during the COVID-19 Pandemic: A Systematic Review.

Obesity is one of the most dangerous epidemics of the 21st century. In 2019, the COVID-19 pandemic began and caused many deaths among patients with obesity with and without complications. Simultaneously, the lockdown related to the COVID-19 pandemic caused a host of emotional problems including anxiety, depression, and sleep disturbances. Many people began to cope with their emotions by increasing food (emotional eating) and alcohol consumption and in combination with decreased physical activity, promoted the development of overweight and obesity. Emotional eating, also known as stress eating, is defined as the propensity to eat in response to positive and negative emotions and not physical need. It should be noted that emotional eating may be the first step in the development of binge eating disorder and its extreme subtypes such as food addiction. Interestingly in some post-bariatric surgery patients, an increased frequency of addictive disorders has been observed, for example food addiction replaced by alcohol addiction called: "cross addiction" or "addiction transfer". This data indicates that obesity should be treated as a psychosomatic disease, in the development of which external factors causing the formation of negative emotions may play a significant role. Currently, one of these factors is the COVID-19 pandemic. This manuscript discusses the relationships between the COVID-19 pandemic and development of emotional eating as well as potential implications of the viral pandemic on the obesity pandemic, and the need to change the approach to the treatment of obesity in the future.

Pentraxin 3 Levels in Young Women with and without Polycystic Ovary Syndrome (PCOS) in relation to the Nutritional Status and Systemic Inflammation.

OBJECTIVE: The aim of the study was to assess PTX3 levels in PCOS and non-PCOS women in relation to nutritional status and circulating markers of inflammation. METHODS: The study enrolled 99 stable body mass PCOS women (17 normal weight, 21 overweight, and 61 obese) and 61 non-PCOS women (24 normal weight, 19 overweight, and 18 obese). Body composition was assessed by bioimpedance, and plasma levels of pentraxin 3 (PTX3), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and monocyte chemoattractant protein 1 (MCP-1) were measured. Homeostatic model assessment of insulin resistance (HOMA-IR) was made. RESULTS: Plasma PTX3, TNF-α, and IL-6 levels and HOMA-IR were higher in PCOS than in non-PCOS group (p < 0.001). There were positive correlations between log10 (PTX3) and log10 (BMI), waist circumference and fat percentage, as well as log10 (HOMA-IR) and free androgen index but negative between log10 (estradiol) levels in PCOS. While in the non-PCOS group, the correlations between log10 (PTX3) and log10 (BMI), waist circumference and fat percentage, as well as log10 (HOMA-IR) were negative. The positive correlations between PTX3 and MPC-1 and log10 (IL-6) were shown in the PCOS group only. In multivariate regression analyses, variability in PTX3 levels in the PCOS group was proportional to log10 (BMI), waist circumference, and fat percentage, but inversely proportional to log10 (estradiol) levels. While in the non-PCOS group, PTX3 levels were inversely proportional to all anthropometric parameters. CONCLUSIONS: Our results show that the decrease in PTX3 levels observed in obese is distorted in PCOS by microinflammation, and possibly, dysfunction of stroma adipose tissue and liver steatosis is reflected by enhanced insulin resistance.

Could KIM-1 and NGAL levels predict acute kidney injury after paracentesis? - preliminary study.

BACKGROUND: Kidney dysfunction is a common complication in patients with severe liver cirrhosis. There is a need for discovery and validation of novel biomarkers for earlier AKI detection. The aim of this study was to determine if tubular injury markers: NGAL and KIM-1 could be helpful in the early diagnosis of AKI in patients undergoing therapeutic paracentesis. METHODS: This preliminary study included 24 adult patients diagnosed with liver cirrhosis who had been hospitalized due to massive ascites requiring paracentesis. Pre- and post-paracentesis plasma samples were taken from each patient and biomarkers were measured. RESULTS: Before paracentesis, the levels of serum and urinary NGAL were similar between patients and controls; while urinary KIM-1 was markedly increased in liver cirrhotic patients (0.76 vs. 0.24 ng/ml; respectively). Although urinary NGAL levels in AKI patients were 5-time greater than in non-AKI subgroup, the difference did not reach statistical significance (13.2 vs 1.5 pg/mL, p = 0.06). Serum NGAL level, post-procedure, was 3 times greater in AKI subgroup. CONCLUSION: Kidney injury markers, especially serum NGAL, may be useful for the early detection of AKI. However, further research is required to determine if biomarkers of kidney injury may help identify patients with cirrhosis who would most likely benefit from early AKI prevention and treatment.

Circulating omentin-1 levels and inflammation in polycystic ovary syndrome.

OBJECTIVES: The aim of the study was to analyze interrelation between plasma omentin-1 levels and nutritional status and inflammation in PCOS. MATERIAL AND METHODS: A cross-sectional study involving 86 PCOS (47 obese) and 72 Non-PCOS women (41 obese) determined anthropometric parameters and body composition. Serum glucose, insulin and omentin-1, TNF-α, sTNFRs, IL-6 and sR-IL6 were measured in the fasting state. RESULTS: Plasma omentin-1 levels were significantly lower in the PCOS than in the Non-PCOS group and both corresponding normal weight and obese subgroups. In three analyzed least-angle regression (LARS) models the lower plasma omentin- 1 levels was associated with PCOS occurrence, higher circulating TNF-α and lower IL-6 levels. CONCLUSIONS: Suppressed omentin-1 levels in PCOS are characteristic for this disturbance and proinflammatory cytokines are factors modifying secretion of this adipokine.

Renal resistive index and long-term outcome in patients with coronary artery disease.

BACKGROUND: The study aimed to evaluate the application of intra-renal Doppler flow indices for the prediction of major adverse cardiac and cerebrovascular events (MACCE) during 24-month follow-up in patients with coronary artery disease (CAD) subject to coronary angiography (CA). METHODS: This prospective study comprised 111 consecutive patients with stable and unstable CAD (68.5% men; median age 65 years), referred for CA. Ultrasonographic parameters of intra-renal blood flow in arcuate/interlobular arteries, including renal resistive index (RRI) and pulsatility index (RPI), were acquired directly before and 1 h after the procedure. Endpoint of MACCE (cardiovascular death, myocardial infarction, myocardial revascularization or stroke) were recorded during 24-month follow-up. RESULTS: MACCE occurred in 14 patients (12.6%). Patients with MACCE had more diffuse CAD reflected by Syntax score (23.6 vs.14.4 pts., p = 0.02), higher platelet level (242.4 vs. 207.2 × 1000/µl, p = 0.01), higher rate of left main CAD (42.9% vs.5.2%, p < 0.001) and left ventricular ejection fraction < 50% (50% vs.23.7%,p = 0.045). Patients with MACCE had higher pre-procedural (0.68 ± 0.06 vs. 0.62 ± 0.06, p < 0.001) and post-procedural RRI (0.72 ± 0.06 vs.0.66 ± 0.06, p = 0.01), but comparable RPI (p = 0.63 and p = 0.36, respectively). Cox proportional hazards model revealed that pre-procedural RRI (OR = 1.11 per 0.01; p = 0.02) and left main CAD (OR = 5.75, p = 0.002) were the only independent predictors of MACCE occurrence. Receiver operator characteristic curve analysis revealed that preprocedural RRI > 0.645 accurately predicted the composite endpoint (AUC = 0.78, p = 0.001) and identified patients with impaired 24-month prognosis according to Kaplan-Meier curve (log-rank p < 0.001). CONCLUSIONS: Increased pre-procedural RRI, together with left main CAD, are associated with worse 24-month prognosis in patients with CAD referred for CA.

Plasma sclerostin levels are associated with nutritional status and insulin resistance but not hormonal disturbances in women with polycystic ovary syndrome.

OBJECTIVE: The aim of this study was to evaluate the circulating sclerostin levels with nutritional status, insulin resistance and hormonal disturbances in women with polycystic ovary syndrome (PCOS). PATIENTS AND METHODS: The cross-sectional study involved 98 PCOS inpatients (20 normal weight, 17 overweight and 61 obese) with stable body mass. Body composition was assessed by bioimpedance method in addition to anthropometric measurements (body mass and height). Serum/plasma concentrations of glucose, insulin (with the calculation of homeostatic model assessment insulin resistance-HOMA-IR), estradiol, total testosterone, sex hormone-binding globulin (SHBG) and sclerostin were measured. Free androgen index (FAI) and estradiol/testosterone index were calculated. RESULTS: Plasma sclerostin levels were significantly higher in obese [0.61 (interquartile range 0.53-0.77) ng/mL] than in overweight [0.53 (0.49-0.57) ng/mL] and normal weight [0.49 (0.42-0.54) ng/mL] groups. Plasma sclerostin levels were significantly higher in the subgroup with insulin resistance [0.65 (interquartile range 0.53-0.77) vs. 0.52 (0.46-0.58) ng/mL; p < 0.001], while similar concentrations were observed in subgroups with FAI below and above median. Plasma sclerostin levels variability were explained by BMI (r = 0.40), the percentage of body fat (r = 0.40) and HOMA-IR values (r = 0.34) in multivariable models. CONCLUSIONS: Circulating sclerostin levels in women with PCOS are related to nutritional status and insulin resistance, but not to sex hormone disturbances.

Circulating vaspin levels and nutritional status and insulin resistance in polycystic ovary syndrome.

OBJECTIVES: The study aimed to assess the associations between circulating vaspin levels and nutritional status (assessed on tha basis of BMI) as well as insulin resistance in PCOS. MATERIAL AND METHODS: Eighty-seven PCOS women, 48 obese and 39 normal weight, were enrolled in the cross-sectional study. Seventy-two Non-PCOS women, 41 obese and 31 normal weight, constituted a control group. Body mass, height and waist circumference as well as body composition by bioimpedance were measured. In the morning (16h after the last meal) we determined: serum glucose, insulin, androgens, gonadotropin (LH, FSH) and sex hormone-binding globulin (SHBG) as well as plasma vaspin levels. Standard HOMA-IR formula was used to assess insulin resistance (IR). RESULTS: Plasma vaspin levels were significantly lower in PCOS, both normal weight and obese, than in Non-PCOS groups. Vaspin levels were similar in normal weight and obese PCOS subgroups. There was no association between plasma vaspin levels and anthropometric parameters in PCOS group. While in Non-PCOS group a negative correlation between plasma vaspin levels and body mass (r = -0.26; p < 0.05) was found. We did not observe correlations between plasma vaspin levels and serum glucose and insulin concentrations as well as HOMA-IR values, however, in multivariable, stepwise backward regression waist circumference and HOMA-IR values explained 18.0% of plasma vaspin levels variability in the study subjects. CONCLUSIONS: PCOS occurrence is associated with decreased vaspin levels. The influence of nutritional status on vaspin level observed in Non-PCOS is abolished in PCOS women, possibly by more severe insulin resistance.

Letter to Editor. Treatment of overweight and obesity during and after a pandemic. Let's not wait for the development of complications - new guidelines for doctors. / List do Redakcji. Leczenie nadwagi i otylosci w czasie pandemii i po jej zakonczeniu. Nie czekajmy na rozwój powiklan ­ nowe wytyczne dla lekarzy.

no summary.

Estradiol/testosterone and estradiol/androstenedione indexes and nutritional status in PCOS women - A pilot study.

OBJECTIVE: The aim of the study was to analyze interrelations between estradiol/testosterone (E2/T) and estradiol/androstenedione (E2/A) indexes and nutritional status, insulin resistance in PCOS. STUDY DESIGN: A cross-sectional study involved 76 PCOS (41 obese) and 67 Non-PCOS (40 obese) women. Anthropometric parameters and body composition were assessed. In fasting state of serum glucose, androgens, estradiol, FSH, LH, SHBG and insulin were measured. E2/T and E2/A indexes and the homeostasis model assessment of insulin resistance (HOMA-IR) were calculated. RESULTS: The values of E2/T and E2/A indexes were significantly lower in the PCOS than Non-PCOS subjects, but did not differ significantly between the obese and normal weight groups. The lowest E2/T and E2/A values were observed in the normal weight PCOS group. Multivariable regression analyses revealed that the presence of PCOS was the major factor affecting both the log10 E2/T (ß = -0.16) and log10 E2/A (ß = -0.15) indexes. In addition, log10 E2/A index variability was explained by percentage of body fat (ß = 0.57). HOMA-IR was not among the explanatory factors in all above models. COMMENT: The E2/A index is more affected by nutritional status than E2/T index. The lower value of both indices in PCOS women with normal body mass suggest that aromatase activity in PCOS are related to nutritional status.

Circulating sclerostin levels in relation to nutritional status, sex hormones and selected bone turnover biochemical markers levels in peri- and postmenopausal women.

OBJECTIVES: Hormonal changes during the peri- and postmenopausal age, especially decreasing estradiol levels as the result of the expired ovarian function, are an established link of the pathogenesis of postmenopausal osteoporosis. The objective of the study was to examine the association between the circulating sclerostin levels and nutritional status, sex hormones and selected bone markers turnover levels in peri- and postmenopausal women. MATERIAL AND METHODS: The study enrolled 84 stable-body mass women (31 perimenopausal and 54 postmenopausal). Anthropometric measurements and serum estrone, testosterone, androstenedione, DHEA-S, osteocalcin, ß-CTx, 25-OHVitamin D and sclerostin levels were obtained. RESULTS: There were not any differences between body mass, BMI, body fat and waist circumference between the study groups. The serum androstenedione and DHEA-S levels were similar in both study groups. However, estrone and total testosterone levels were observed to be notably higher in the perimenopausal group, unlike in the postmenopausal group (124.1 pg/mL vs. 98.3 pg/mL, p < 0.01 and 0.3 pg/mL vs. 0.22 pg/mL, p < 0.01, respectively). Higher plasma osteocalcin and ß-CTx levels were shown in the postmenopausal rather than in the perimenopausal group (19.8 ng/mL vs. 16.8 ng/mL, p < 0.001 and 0.35 ng/mL vs. 0.29 ng/mL, p < 0.05, respectively). Plasma sclerostin and 25-OH-Vitamin D levels were similar. There was not any correlation between plasma sclerostin levels and the other studied parameters. In the multivariate regression analyses, sclerostin levels were proportional to the androstenedione ones (b = 0.06; p < 0.05) but inversely related to the log10(testosterone) levels (b = -0.18; p < 0.05). CONCLUSIONS: Circulating sclerostin levels are similar in peri- and postmenopausal women and are related to the androstenedione and testosterone levels regardless of the nutritional status.

Pentraxin 3 as a marker of endothelial dysfunction in young women with polycystic ovary syndrome (PCOS).

One of the consequences of polycystic ovary syndrome (PCOS) is an increased risk of early development of cardiovascular diseases. Pentraxin-3 (PTX-3) is a new potential marker of endothelial dysfunction. The aim of the study was to assess PTX3 and other markers of endothelial dysfunction in PCOS women. The study enrolled 99 stable body mass PCOS women (17 normal weight, 21 overweight and 61 obese). Anthropometric measurements and serum/plasma levels of glucose, insulin, lipids, estradiol, testosterone, sex hormone binding globulin, 17-OH progesterone, free androgen index, pentraxin-3 (PTX3), soluble intercellular (sICAM-1) and vascular cell adhesion molecule 1 (sVCAM-1), endothelin-1 and total nitric oxide metabolites (tNO) concentrations were assessed. Groups were divided into tercile-subgroups according to PTX3 serum levels. Serum PTX3 tercile-subgroups significantly differed in respect to tNO, endothelin-1 and sVCAM-1, but not sICAM-1. The levels of tNO, endothelin-1 and sVCAM-1 were significantly decreased in the subgroup with the lowest PTX3 levels compared to both middle (tNO and endothelin 1) and upper tercile subgroups (all of them). There were significant positive correlations between log10(PTX3) and log10(tNO) (r = 0.34, p < .001), log10(endothelin-1) (r = 0.41, p < .001) as well as sVCAM-1 levels (r = 0.22, p < .05). Circulating PTX-3 levels seem to be a marker of endothelial dysfunction in PCOS women.

Is polycystic ovarian syndrome and insulin resistance associated with abnormal uterine bleeding in adolescents?

OBJECTIVES: The aim of the study was to determine if adolescents with juvenile bleeding had polycystic ovarian syndrome (PCOS) and insulin resistance. MATERIAL AND METHODS: The study was conducted in a group of 43 females aged 12-18 years, diagnosed with juvenile menorrhagia, and 37 healthy female adolescents aged 12-18 years. The study was conducted during the early follicular phase of the menstrual cycle. Menstrual cycle disturbances, acne and hirsutism were recorded. Ultrasound scan determining the condition of the ovaries was conducted. Laboratory tests of the glucose level, cholesterol, LDL and HDL cholesterol and triglycerides fraction, DHEAS, FSH, LH, insulin, SHGB, total testosterone, androstenedione, and free testosterone have been established. RESULTS: The occurrence of regular menstrual cycles (30.23%, p = 0.006) was significantly lower in the juvenile bleeding group. Also, secondary amenorrhea was significantly more likely to be recognized in this group of females (p = 0.03). The concentration of FSH was considerably lower (p = 0.0002) in the group of adolescents with AUB. CONCLUSIONS: Adolescents with abnormal uterine bleeding (AUB) are often diagnosed with secondary amenorrhea, and PCOS. The group with a diagnosis of juvenile bleeding was also diagnosed with higher rates of insulin resistance.

CA125 as a Marker of Heart Failure in the Older Women: Population-Based Analysis.

(1) Background: Cancer antigen 125 (CA125) is a glycoprotein that is expressed by tissue derived from coelomic epithelium in the pleura, peritoneum, pericardium. It has been shown that CA125 concentrations are correlated with NT-proBNP in older with congestive heart failure (HF). We conducted a study on the association between concentrations of CA125 and NT-proBNP in a population-based cohort of older Polish women. (2) Methods: The current research is sub-study of a large, cross-sectional research project (PolSenior). The study group consisted of 1565 Caucasian women aged 65-102 years. To assess the relationship between CA125 and other variables a stepwise backward multivariate normal and skew-t regression analyses were performed. (3) Results: The median of CA125 concentration was 13.0 U/mL and values over the upper normal range limit (35 U/mL) were observed in 5.1% (n = 79) of the study cohort. The concentration of CA125 was positively related to age, hospitalization for HF and history of atrial fibrillation and chronic obstructive pulmonary disease, levels of NT-proBNP, IL-6, hs-CRP and triglycerides. We found, in multivariate analyses, that increased CA125 levels were independently associated with log10 (IL-6) (ß = 11.022), history of hospitalization for HF (ß = 4.619), log10 (NT-proBNP) (ß = 4.416) and age (ß = 3.93 for 10 years). (4) Conclusion: Despite the association between CA125 and NT-proBNP, the usefulness of CA125 for the detection of HF in older women is limited by factors such as inflammatory status and age.

Osteoprotegerin Assessment Improves Prediction of Mortality in Stroke Patients.

BACKGROUND: Elevated circulating osteoprotegerin (OPG) level is associated with an increased risk of hospitalization for ischemic stroke and coronary artery disease. The aim of the present study was to analyze whether OPG assessment may improve the prediction of mortality in patients with stroke. PATIENTS AND METHODS: Serum OPG, fetuin A, 25-OH-D3, intact parathyroid hormone levels were assessed in serum samples which were left over after routine tests in a hospital laboratory. This assessment was conducted in 240 consecutive patients with acute ischemic stroke, admitted within 24hours after the onset of symptoms to the Stroke Unit. Mortality data were obtained from the local registry office. RESULTS: The mean OPG serum level was 14.6 ± 6.0pmol/L (range: 3.7-43.4). There were no significant differences in the OPG values between men and women (13.9 ± 5.0 versus 15.1 ± 6.7 pmol/L; P = .12). Therefore, tertiles were calculated for the whole group. During the follow-up, 85 (35.4%) patients died and 92 (38.3%) died or had recurrent stroke. OPG level appeared a significant predictors of death and composite end-point (death/recurrent stroke), in addition to the well-established once (age, atrial fibrillation, diabetes RANKIN at admission and discharge, severity of stroke). In multivariable stepwise backward analyses, the OPG level persisted as a significant and independent predictor of death (hazard ratio [HR] = 1.084 (95% confidence intervals: 1.036-1.134)] and composite and point (HR = 1.082 [1.037-1.129]). CONCLUSIONS: OPG level may be considered as a predictor of mortality in stroke patients.