Morphological characteristics of abdominal adipose tissue in normal-weight and obese women of different metabolic profiles.

BACKGROUND AND AIMS: Morphological changes in adipose tissue reflect functional disorders that correlate with cardiometabolic complications of obesity. The metabolic risks vary among the obese individuals. Furthermore, normal-weight individuals are not necessarily metabolically healthy. Therefore, the aim of this study was to analyze morphological characteristics of the abdominal adipose tissue in normal-weight and obese individuals in regards to metabolic risks. METHODS AND RESULTS: The study group consisted of 30 overweight or obese and 20 normal-weight women undergoing elective surgery. Women of each group were divided into metabolically healthy and metabolically obese, based on the homeostasis model assessment of insulin resistance (HOMA-IR), triglyceride, total-, LDL- and HDL-cholesterol levels. The size and numerical density of adipocytes, as well as volume density of blood vessels in subcutaneous and visceral adipose tissue were compared among subgroups. The results showed hypertrophy of adipocytes of visceral adipose tissue in metabolically obese normal-weight women. At the same time, metabolically healthy obese women had smaller adipocytes in both depots in comparison with "at risk" obese women. The lowest volume density of blood vessels correlated with the largest diameter of adipocytes in "at risk" obese women indicating hypoxic changes in visceral adipose tissue. The observed differences of the adipose tissue morphology did not correlate with considerable phenotypic differences within either the normal-weight or obese women group. CONCLUSION: Changes in adipocyte size, cellular and vascular density of adipose tissue in relation with metabolic disorders, regardless of nutritional level, suggest limited capacity of fat deposition and adipose tissue response to hypoxia.

[Prolactin secretion in hyperthyroid individuals]. / Stanje prolaktinske sekrecije kod hypertireoidnih osoba.

Several endocrine and metabolic changes occur in hyperthyroidism, among which also changes in prolactin secretion are present. Causes are numerous. However, a decreased content of prolactin in secretory granules of the lactotrophic cells in the adeno-hypophysis gland, e.i. a decreased prolactin pool, should be especially emphasized. Prolactin secretion of the adeno-hypophysis gland was examined in 30 hyperthyroid patients. Normoprolacinaemia was diagnosed in basal conditions, but prolactin response was not so great during stimulation tests (test with thyrotropic hormone and eglonylic test) and suppression tests (L-DOPA and bromo-cryptic test). This finding suggests the existence of a decreased prolactin pool in hyperthyroidism.

[Hypophyseal pseudomacroadenoma in primary hypothyroidism--2 case reports]. / Pseudomakroadenomi hipofize u primarnom hipotireoidizmu--povodom dva slucaja.

Primary hypothyroidism is often accompanied with hyperprolactinemia and if the untreated disease persists longer hypophyseal adenoma consisting of thyreotropic cells might develop. On the other hand, although rarely, simultaneous occurrence of primary hypothyroidism and hypophyseal prolactin adenoma might be encountered. If substitutional therapy, after the establishment of euthyroid status, does not eliminate clinical signs of hyperprolactinemia and normalize prolactin levels, a decision can be made in favor of hyperprolactinemia within primary hypothyroidism. In that case possible tumor changes in the hypophysis will show regressive tendency towards final disappearance. However if clinical signs and hyperprolactinemia persist after the establishment of euthyroid status, especially if accompanied with compressive signs this should be regarded as a coincidence of primary hypothyroidism and hypophyseal prolactin tumor. We report two female patients with primary hypothyroidism and hypophyseal pseudomacroadenoma.

[Case report of pheochromocytoma with an atypical localization]. / Slucaj feohromocitoma s atipicnom lokalizacijom.

One of the endocrine causes of arterial hypertension is pheochromocytoma, usually located in the adrenal gland medulla. Extra-adrenal tumor locations are seldom encountered, and this can considerably complicate the diagnostic procedure. If a distinct clinical manifestation exists, supported by the finding of elevated catecholamine values, it is essential to persistently and carefully search for the place of their increased production. Such an attitude is completely justified in regard to the knowledge that this endocrinologically conditioned hypertension can be permanently and successfully solved with a surgical procedure. A case of pheochromocytoma has been presented with an atypical mediastinal location, prolonged and complicated diagnostic procedure, which has been successfully solved by surgery.