Association between vitamin D concentration and levels of sex hormones in an elderly Polish population with different genotypes of VDR polymorphisms (rs10735810, rs1544410, rs7975232, rs731236).

BACKGROUND: Vitamin D co-regulates the synthesis of sex hormones in part by interaction with its nuclear receptor. The aim of this study was to determine whether there is an association of vitamin D concentration vs the level of sex hormones in elderly Polish individuals with different genotypes of the vitamin D receptor (VDR) gene. MATERIALS AND METHODS: Rs10735810, rs1544410, rs7975232, and rs731236 polymorphisms of VDR, the serum sex hormone level, free estrogen index (FEI) and free androgen index (FAI) as well as vitamin D, were evaluated in 766 persons (362 women and 404 men) selected from 5695 Polish population, aged 65-90years from the PolSenior survey. RESULTS: We observed that women with GG (rs731236), TT (rs7975232), BB (rs1544410) and FF (rs10735810) genotypes were characterized by a significant correlation between vitamin D vs testosterone concentration and FAI value. We found a significant correlation between testosterone level and FAI vs vitamin D concentration in men with heterozygote AG in the rs731236 polymorphism and in the GG (rs7975232), the BB (rs1544410), and the Ff (rs10735810) genotypes. CONCLUSION: In elderly selected Polish population with different genotypes of VDR polymorphisms, a statistically significant relationship between vitamin D concentration vs testosterone level was observed.

Interrelation between genotypes of the vitamin D receptor gene and serum sex hormone concentrations in the Polish elderly population: the PolSenior study.

AIM: Vitamin D co-regulates the synthesis of sex hormones. Therefore, the aim of this study was to determine whether the presence of certain genotypes of the vitamin D receptor gene (VDR) is associated with the serum levels of sex hormones in the elderly Polish population. MATERIALS AND METHODS: The rs10735810, rs1544410, rs7975232, and rs731236 polymorphisms of VDR, the serum levels of testosterone and estradiol, as well as free estrogen index (FEI) and free androgen index (FAI) were evaluated in 360 women and 400 men aged 65-90years selected from 5695 respondents of the PolSenior survey. RESULTS: Only the rs1544410 VDR polymorphism was associated with the serum levels of sex hormones. The prevalence of rs1544410 genotypes was 38% BB, 46% Bb, and 16% bb in women and 41% BB, 44% Bb, and 15% bb in men. In women the frequency of the B allele was p=0.61 and b allele q=0.39, while in men it was p=0.63 and q=0.37, respectively. We found significant differences in the serum testosterone level (p<0.0004) and FAI (p<0.0015) between the rs1544410 genotypes in women but not in men. Higher mean testosterone level and higher mean FAI were observed in women with a rare bb genotype in comparison to a common BB genotype. CONCLUSION: We hypothesize that in women the increase in VDR expression associated with a rare genotype of the rs1544410 polymorphism of this gene may be associated with an increase in testosterone and FAI levels.

Hypothalamic-pituitary-adrenal axis activity, personality traits, and BCL1 and N363S polymorphisms of the glucocorticoid receptor gene in metabolically obese normal-weight women.

We sought associations among metabolic profiles, copeptin levels, emotional control, personality traits, and hypothalamic-pituitary-adrenal axis activity in metabolically obese normal-weight young women (MONW). We assessed body composition, including fat-free mass; body fat (BF) and android and gynoid fat depots; fasting blood glucose, insulin, copeptin, cortisol (baseline and after dexamethasone), adrenocorticotropin (ACTH), triglycerides, total cholesterol, low- (LDL) and high-density (HDL) lipoproteins; and the BCL1 and N363S polymorphisms of the glucocorticoid receptor gene in 59 MONW and 71 healthy women aged 20-40 years. We also evaluated personality traits using the NEO-Five Factor Inventory and the subjective extent of emotional suppression by the Courtauld Emotional Control Scale. Compared to the controls, MONW had significantly higher insulin, cholesterol, LDL, triglycerides, and waist circumference, but lower HDL. MONW also had increased BF (>30 % of weight) and unfavorable regional fat distribution with excess android fat. The android/BF ratio was 8.29 % (MONW) versus 7.89 % (controls) (p = 0.005), while the gynoid/BF ratio was 31.99 versus 34.1 %, respectively (p = 0.008). Despite similar ACTH levels in both groups, MONW had higher cortisol levels both at the baseline (p < 0.001) and in the dexamethasone suppression test (p = 0.003). Copeptin levels and the distribution of glucocorticoid receptor polymorphisms were similar in both groups. There were also no significant differences in psychological features between MONW and controls. In conclusion, the MONW phenotype was associated with hypothalamic-pituitary-adrenal axis dysregulation, unfavorable metabolic profiles, and fat accumulation, but normal distribution of glucocorticoid receptor gene polymorphisms and copeptin levels, and no significant differences in psychological features between MONW and controls.

The associations between cardiometabolic risk factors and visceral fat measured by a new dual-energy X-ray absorptiometry-derived method in lean healthy Caucasian women.

Excess visceral adipose tissue (VAT) is associated with a cluster of metabolic abnormalities. A new dual-energy X-ray absorptiometry (DXA)-based VAT measurement approach, CoreScan™, computes VAT mass and volume within the android region of a total body DXA scan. However, there have been no reference values developed for this method. The objective of this study was to determine the normal reference ranges for DXA-derived VAT in young, healthy, premenopausal women. We also sought associations between VAT, blood lipids, glucose, insulin and insulin resistance. In 120 randomly selected, normal weight, Caucasian women aged 20-40 years, we measured body fat (BF), VAT and lean mass by DXA. We also assessed blood pressure, waist and hip circumference, waist-to-hip ratio, body mass index, fasting glucose, insulin, triglycerides (TG), and high- (HDL) and low-density lipoproteins. Insulin resistance was evaluated by the homeostasis model assessment (HOMA). VAT mass accounted for 0.37 ± 0.3 % of weight and 1.11 ± 0.72 % of BF. Mean VAT mass and volume were 235.9 ± 183 g (95 % CI 202.7-269.1) and 250.3 ± 194.5 cm(3) (95 % CI 215.1-285.4), respectively. Anthropometric indices moderately correlated with VAT. VAT significantly correlated with HDL (R = -0.193; P = 0.03), glucose (R = 0.252; P = 0.005) and HOMA (R = 0.184; P = 0.049). In this study, we provide normal values of VAT mass and volume measured by DXA and determined for healthy, normal weight, Caucasian women aged 20-40 years. Even in such strictly selected population VAT correlated positively with insulin resistance and inversely with HDL.

Adiponectin, visfatin and regional fat depots in normal weight obese premenopausal women.

BACKGROUND: Normal weight obesity (NWO) is defined as percentage body fat (%BF) above 30% or %BF in the upper tertile in normal weight subjects. Using these criteria, we assessed lipid profiles, glucose metabolism parameters, blood pressure and regional fat in 91 premenopausal women with NWO and 54 age-matched healthy controls. METHODS: We measured total cholesterol, high-density lipoproteins (HDL), low-density lipoproteins (LDL), triglycerides (TG), glucose, insulin, visfatin and adiponectin.%BF, abdominal fat (Android) and hip fat (Gynoid) were measured by dual-energy X-ray absorptiometry. Insulin resistance was evaluated by homoeostasis model assessment (HOMA-IR). RESULTS: Women with NWO had higher diastolic blood pressure (DBP) (P = 0·003), LDL (P = 0·048), TG (P = 0·004) Android (P = 0·008) and Gynoid (P = 0·007) levels, but lower HDL (P = 0·009) than healthy controls. The NWO women had one (P = 0·041), two (P = 0·007) or three (P = 0·002) metabolic syndrome components more frequently than the controls. Across %BF tertiles, the number of metabolic syndrome components significantly increased (R = 0·21; P = 0·02), as did Gynoid (R = 0·83; P < 0·001) and Android (R = 0·81; P < 0·001) levels. Android (but not Gynoid) level was linearly associated with DBP (R = 0·194; P = 0·019), HDL (R = -0·295; P = 0·0004) and TG (R = 0·183; P = 0·031). Visfatin and adiponectin levels were comparable in both groups. Visfatin was inversely correlated with cholesterol, LDL and HOMA-IR. Adiponectin was inversely correlated with the Android/Gynoid and Android/Total fat ratios. CONCLUSIONS: Compared with healthy controls, women with NWO had higher DBP, TG, LDL, and regional fat and lower HDL. These findings seem to be associated more with excess Android fat than excess %BF.

The reference values of sex hormones and SHBG serum levels in subjects over 65 years old - The PolSenior Study.

INTRODUCTION: Over the last decade, average life expectancy has continuously increased. There has been no data on normal sex hormone (SH) levels in a Polish elderly population. In this study, we assessed SH in the PolSenior cohort to determine normal reference ranges in relation to gender, age, and cardiovascular disease risk factors (CVDRFs). MATERIAL AND METHODS: The study was performed with 4,352 participants (2,168 men and 2,088 women), aged from 55 to over 90 years, stratified in five-year age groups. Pre-elderly subjects (55-59 years of age) served as the reference group. We assessed total testosterone (TT), estradiol (TE2) and DHEA-S (by RIA) SHBG and FSH (by IRMA) and calculated free androgen and free estrogen indices (FAI and FEI). Percentage body fat (%BF) was measured by bioelectric impedance analysis. The CVDRFs assessment included blood pressure and biochemical (blood glucose, high-density lipoproteins, triglycerides) and anthropometric (waist circumference) components of the metabolic syndrome. RESULTS: TT was low in 19.9%, normal in 78.2%, and high in 1.8% of men. TE2 was low in 94.6% of women. Age and CVDRFs significantly influenced values of SHBG, FSH, TT, FAI, FEI, and DHEA-S in men, while in women values of FSH, TT and TE2 did not change. BMI and %BF affected SH regardless of the age groups and CVDRFs. CONCLUSIONS: Our findings suggest that the reference ranges stratified by the five-year age bands seem more accurate than those given for the overall population over 60 years of age. The clinical relevance of these reference ranges increases when they are considered in relation to CVDRFs, BMI and %BF.

Vitamin D receptor gene polymorphism and cardiovascular risk variables in elderly Polish subjects.

The aim of this work was to evaluate whether the FokI and BsmI polymorphisms of the VDR gene are associated with anthropometric and biochemical features of cardiovascular disease (CVD) in a Caucasian population aged over 65, participants of the Polish PolSenior study. We performed the study on randomly selected subjects: 427 women and 454 men aged over 65. Measurements of anthropometric parameters were carried out and biochemical parameters were estimated using commercial kits. VDR polymorphisms (rs10735810, rs1544410) were genotyped by PCR and FRLP. The prevalence of BsmI genotypes was 50% Bb, 23% bb, 27% BB in women and 48% Bb, 20% bb, 32% BB in men. The prevalence of FokI was 48% Ff, 22% ff, 30% FF in women and 50% Ff, 18% ff, 32% FF in men. The women bearing the rare allele b differ in homeostatic model assessment (HOMA) (p < 0.049) from women bearing common allele B, and the men differ in insulin level (p < 0.047) and HOMA (p < 0.017). There were no significant differences in anthropometric or biochemical parameters between genotypes in FokI in female and male groups. The common allele B is connected with biochemical risk factors of CVD in older Caucasian men and women.

Thyroid dysfunction and thyroid autoimmunity in a large unselected population of elderly subjects in Poland - the 'PolSenior' multicentre crossover study.

INTRODUCTION: Data on the thyroid function of a randomly chosen elderly population was collected during a multicentre study performed in Poland (PolSenior) in 2007-2010. MATERIAL AND METHODS: The population of 4,190 participants under study was divided into six age subgroups of > 65 to > 90 years of age and a younger group aged between 55 and 59 years. Assessment of thyroid function was based on hormonal measurements. RESULTS: Concentrations of both TSH and fT(4) were significantly higher in females than in males. No differences in TSH and fT(4) concentrations between different age groups were found. Thyroid dysfunction was revealed in more than 10% of participants, hypothyroidism in 7.95%, and hyperthyroidism in 2.95%. Both types of dysfunction were more prevalent in women, and in more than 80% both dysfunctions were subclinical. In 1,542 participants, concentrations of TPOAb were measured. Increased TPOAb was revealed in 19% of the cohort and the prevalence of thyroid autoimmunity was higher in women and also more often found in participants with hypothyroidism. CONCLUSIONS: Cross sectional survey revealed thyroid dysfunctions in over 10% of non selected elderly population. No age related differences were found in TSH concentrations, TPOAb positivity and prevalence of thyroid dysfunctions.

Evaluation of the prevalence of metabolic obesity and normal weight among the Polish population.

INTRODUCTION: In the 1980s, the idea evolved that some individuals with normal weight (Metabolically Obese, Normal-Weight), who probably have increased abdominal fat, have metabolic disturbances related to obesity. This observation initiated the concept of the metabolically obese but normal-weight syndrome (MONW). Since then, there have been only a few studies in non-obese subjects. MONW men and women should be regarded as at high risk for cardiovascular disease. MATERIAL AND METHOD: A group of 854 randomly chosen non-obese men and women, 20-40 years of age, was selected from three different areas of Poland - Szczecin, Krakow and Wroclaw. All subjects were interviewed and underwent physical examination, anthropometric measurements (waist circumference, hip circumference, BMI and WHR) as well as densitometry (total body DPX, total fat, android/gynoid deposit). Serum level of fasting glucose and insulin, indices of insulin sensibility (QUICKI) and insulin resistance (HOMA, FIRI), total cholesterol, triglycerides and HDL-C were measured using commercially available kits. LDL-C level was calculated using Friedewald's formula. RESULTS: The total amassed fatty tissue and its android deposit was found to be significantly greater in MONW men and women. MONW women were found to exhibit increased levels of triglycerides and LDL-C but lower levels of HDL-C. In women with excess abdominal fat (EAF), fasting glucose and insulin levels, HOMA and FIRI were considerably higher, while QUICKI was lower. Triglyceride and LDL-C levels were also higher while HDL-C levels were lower. In men with EAF, increased levels of total cholesterol and LDL-C were confirmed. CONCLUSIONS: The occurrence of MONW is contingent upon the diagnosis criterion and increases when the criterion represents the value of HOMA - 21.76% in women and 31.42% in men. The frequency of MONW occurrence is lower when the criterion for abdominal fat content limit is used, amounting to 15.78% in women and 7.83% in men.

The Polish version of the Quality of Life Assessment of Growth Hormone Deficiency in Adults (QoL-AGHDA) - four-stage translation and validation.

INTRODUCTION: The Quality of Life Assessment of Growth Hormone Deficiency in Adults (QoL-AGHDA) was developed simultaneously in five languages (English, Swedish, German, Italian and Spanish) to measure quality of life (QoL) in adult patients with Growth Hormone (GH) deficiency. The aim of the project was to produce a validated Polish version of the QoL-AGHDA that was conceptually equivalent to the UK-English version. MATERIAL AND METHODS: Translation and validation procedure consisted of 4 stages. Stage 1: A bilingual translation panel [7 participants, fluent in both English and Polish (Polish as their first language) with university education] translated the questionnaire. Stage 2: A lay translation panel (6 participants of an average to lower than average educational level, speaking only the target language) reviewed the wording of the draft version produced by bilingual panel to improve clarity and immediacy. Stage 3: The translated questionnaire was then field-tested with 15 adults with GH deficiency. Stage 4: Finally, the amended version underwent psychometric evaluation to check its reliability and validity (it was administered to 85 GH-deficient adults on two occasions, two weeks apart). RESULTS: The Polish QoL-AGHDA version was successfully adapted and it is characterized by a high degree of reliability and validity. The test-retest reliability coefficient for the Polish QoL-AGHDA was 0.92. The Cronbach's Alpha coefficient for the Polish QoL-AGHDA was 0.91 (N = 70) at Time 1 and 0.94 (N = 79) at Time 2. Correlation between QoL-AGHDA and Nottingham Health Profile items confirmed high convergent and divergent validity. CONCLUSIONS: The Polish QoL-AGHDA is a reliable and valid measure of QoL suitable for use in clinical studies and routine clinical practice.

[Does type 2 diabetes predispose to osteoporotic bone fractures?]. / Czy cukrzyca typu 2 predysponuje do osteoporotycznych zlaman kosci?

Chronic complications of diabetes are associated mainly with changes in major and small arterial vessels as well as in peripheral and autonomic fibers of the nervous system. For years it has been suggested that DM2 does not predispose to osteoporosis because bone mineral density (BMD) in DM2 patients is commonly normal or even increased. However, results of recent large cross-sectional studies have indicated that patients with DM2 have significantly increased risk of bone fractures, predominantly hip fractures (by 70%). Results of these studies suggest that the increased risk of fractures in DM2 is independent of BMD. In this group of patients is frequently associated the loss of vision caused by diabetic eye disease, peripheral neuropathy, arterial hypertension, orthostatic hypotonia (caused by autonomic neuropathy or/and by concomitant antihypertensive treatment), and ischemic disease of the brain, heart and lower extremities--conditions that predispose to falls. There are no specific methods of prophylaxis and treatment of osteoporosis associated with diabetes; therefore they should be based on widely accepted principles as in non-diabetic populations. It seems that in DM2 patients the most purposeful strategy could be the popularization of healthy attitudes aiming the elimination of unfavorable dietetic and environmental factors, such as low physical activity, smoking, and low vitamin D intake, as well as education against falls.

[Endocrine tumors of the stomach and duodenum (including gastrinoma) - management guidelines (recommended by the Polish Network of Neuroendocrine Tumors)]. / Guzy endokrynne zoladka i dwunastnicy z uwzglednieniem gastrinoma ( zasady postepowania rekomendowane przez Polska Siec Guzów Neuroendokrynnych).

The neuroendocrine tumors of the stomach and duodenum constitute only minority of neoplasms in this localisation. However due to their clinical behaviour and/or hormonal syndromes they pose diagnostic and therapeutic challenge. They display distinct phenotypes, regarding their pathogenesis, pathology and clinical course. Herein we present Polish guidelines for biochemical, pathological and localisation diagnosis, and discuss therapeutic approaches, considering endoscopic and surgical treatment, pharmacological and radionuclide therapy.

Consensus statement of the Polish Society for Endocrinology: presurgical somatostatin analogs therapy in acromegaly.

Consensus statement of the Polish Society for Endocrinology, regarding presurgical somatostatin analogs in acromegaly has been presented. It is suggested to administer depot somatostatin analog (Octreotide LAR at the dose 20 mg and then 30 mg or equivalent doses of Lanreotide Autogel 90/120 mg every 4 weeks) in order to normalize or suppress to a maximal extent GH and IGF-1 concentrations. The period of therapy in case of microadenoma would be at least 3 months (targets: biochemical improvement, reduced risk of disease's complications, perioperative risk reduction, inhibition of tumor growth). The period of therapy in case of macroadenoma would be at least 6 months, until maximal possible reduction of GH and IGF-1 concentrations (targets: tumor shrinkage, biochemical improvement, reduced risk of disease's complications, perioperative risk reduction). Using an uniform approach in a group, as numerous as possible, of treated patients would allow objective evaluation of long-term efficacy of the treatment.

[Consensus of the Polish Society of Endocrinology. Presurgical somatostatin analogs therapy in acromegaly]. / Konsensus Polskiego Towarzystwa Endokrynologicznego. Przygotowanie analogami somatostatyny do leczenia operacyjnego akromegalii.

Consensus statement of the Polish Society of Endocrinology, regarding presurgical somatostatin analogs in acromegaly has been presented. It is suggested to administer depot somatostatin analog (Octreotide LAR at the dose 20 mg and then 30 mg or equivalent doses of Lanreotide Autogel 90/120 mg every 4 weeks) in order to normalize or suppress to a maximal extent GH and IGF-1 concentrations. The period of therapy in case of microadenoma would be at least 3 months (targets: biochemical improvement, reduced risk of disease's complications, perioperative risk reduction, inhibition of tumor growth). The period of therapy in case of macroadenoma would be at least 6 months, until maximal possible reduction of GH and IGF-1 concentrations (targets: tumor shrinkage, biochemical improvement, reduced risk of disease's complications, perioperative risk reduction). Using an uniform approach in a group, as numerous as possible, of treated patients would allow objective evaluation of long-term efficacy of the treatment.

Bone mineral density and hip structural analysis in type 1 diabetic men.

OBJECTIVE: The risk of non-vertebral fractures is increased in men with type 1 diabetes (DM1) but studies have shown only moderately decreased or normal bone mineral density (BMD) in these patients. No previous studies have evaluated hip strength and geometry indices in DM1 patients. This study was therefore designed to characterize associations between BMD, dual X-ray absorptiometry (DXA)-based hip strength indices, metabolic control, and DM1chronic complications. DESIGN AND METHODS: The study was performed on 36 males aged 43.6 +/- 5.1 years with long-lasting DM1 and 36 healthy males matched for age, weight, and height. BMD in lumbar spine, total hip, upper and lower part of the femoral neck, hip axis length, cross-sectional area and moment of inertia (CSMI), and glycated hemoglobin (HbA1c) were measured. RESULTS: DM1 men had decreased spine BMD (P < 0.05) and normal total hip BMD in comparison with controls. Hip geometry and strength indices were comparable in both groups. However, M1 men had decreased CSMI and upper femur BMD but these differences did not reach statistical significance (P = 0.06). BMD changes and hip strength parameters did not correlate with HbA1c. CONCLUSIONS: Middle-aged DM1 men have decreased lumbar spine BMD, normal hip BMD and normal hip strength indices. These changes are not influenced by metabolic control and presence of chronic microvascular complications.

[The effect of one year of recombinant human growth hormone (rhGH) therapy on left ventricle structure and function in adults with severe growth hormone deficiency]. / Wplyw rocznego, substytucyjnego leczenia ludzkim rekombinowanym hormonem wzrostu (rhGH) na budowe i czynnosc lewej komory serca u doroslych z duzym niedoborem hormonu wzrostu.

UNLABELLED: The aim of the study was to analyze the functional and structural changes in the echocardiographic parameters of the left ventricle (LV) in adult patients (pts) with growth hormone deficiency (GHD) without any treatment in childhood before and after one year long somatropin treatment. MATERIAL AND METHODS: Twelve GHD pts (mean age 42 +/- 10 years; M/F: 6/6) before (group GHD-1) and after one year rhGH therapy (group GHD-2) were compared. The s.c. rhGH treatment with somatropin (Genotropin, Pharmacia) at a dose 0.125 U/kg/week up to 0.25 U/kg/week has been continued for 1 year. Both groups were examined with echocardiography Twelve GHD pts (mean age 42 +/- 10 years; M/F: 6/6): with indiopatic GHD (n = 10, age from 29 to 46 years; M/F: 6/4) and with Sheehan syndrome (n = 2, age from 46 to 61 years; M/F: 0/2) before (group GHD-1) and after one year rhGH therapy (group GHD-2) were compared. The s.c. rhGH treatment with somatropin (Genotropin, Pharmacia) at a dose 0.125 U/kg/week up to 0.25 U/kg/week (till 50 percentyl of blood IGF-1 concentration for age and sex norm ) has been continued for 1 year. Both groups were examined with echocardiography. RESULTS: On echocardiography, in the group GHD-1 pts compared to GHD-2 pts, had lower LVM and LVMI were lower (adequately (138.4 +/- 39.8 vs. 153.1 +/- 49.5, p < 0.036), lower and LVMI (87.3 +/- 19.7 vs. 96 +/- 23.7, p < 0.05). There was no Therapy had no significant therapy effect on systolic LV function. The diastolic function of LV did not differ between both GHD-1 and GHD-2 groups (E/A: 1.4 +/- 0.2 vs. 1.3 +/- 0.3 ; E: 79 +/- 17; A: 59 +/- 16 vs. 58 +/- 10, ns), but DT increased significantly from 132 +/- 21 vs. 147 +/- 30, p < 0.05). There was only significant correlation between LV systolic dimension after one year and IGF plasma basal concentration (r = 0.7, p < 0.01). CONCLUSIONS: One year medical therapy with rhGH (somatropin) is associated with a significant positive effect on LVM and LVMI but no significant effect on systolic LV function, as assessed by echocardiography in adults with GHD. Significant decrease of DT after therapy may suggest an influence of GH therapy on diastolic LV function. The level of IGF did correlate with LV systolic diameter after therapy.

Body composition and concentrations of leptin, neuropeptide Y, beta-endorphin, growth hormone, insulin-like growth factor-I and insulin at menarche in girls with constitutional delay of puberty.

AIM: Constitutional delay of puberty (CDP), a rare condition among girls, manifests as retarded sexual maturity past the 13th year of life. The clinical and endocrinological aspects of this interesting problem appear to have escaped attention in the literature. The purpose of the present study was to compare body composition and concentrations of leptin, neuropeptide Y (NPY), beta-endorphin, growth hormone (GH), insulin growth factor-I (IGF-I) and insulin at menarche in CDP girls and girls with normal pubertal development (NP). MATERIALS AND METHODS: We enrolled 11 girls with CDP and 40 girls with NP. All participants were studied at or within 3 months of menarche. Age, height and weight were recorded. Body composition was established with a body composition analyzer. Radioimmunoassays were performed to measure concentrations of NPY, beta-endorphin, leptin, GH, IGF-I and insulin. RESULTS: The mean age at menarche in the CDP and NP groups was 16.1 and 12.5 years, respectively (p = 0.0001). CDP girls at menarche were taller (1.64 vs. 1.57 m; p = 0.012). The difference between groups in body weight (57.5 vs. 50.4 kg; p = 0.1), body mass index (BMI), fat mass, fat percentage (BF%) and lean mass was not significant, and nor was the difference in leptin, GH and insulin levels. However, CDP girls demonstrated significantly higher NPY concentrations (199.4+/-105.1 vs. 56.9+/-26.3 pg/ml; p = 0.001). NPY correlated with BF% (r = 0.60) in this group. IGF-I concentrations were significantly lower in CDP girls (524.8+/-50.6 ng/ml) than in NP girls (744.5+/-56.1 ng/ml; p = 0.024). CONCLUSION: Girls with CDP differed from NP girls only in age at menarche and height; they did not differ significantly with respect to BMI and body composition parameters. Higher concentrations of NPY in CDP girls may be responsible for CDP and reduced levels of IGF-I. Correlation of NPY with BF% suggests an involvement of this neuropeptide in the process of fat accumulation associated with CDP.

Body composition, dehydroepiandrosterone sulfate and leptin concentrations in girls approaching menarche.

UNLABELLED: There is strong evidence that the initiation of adrenarche and gonadarche during puberty in girls depends on body mass in general and body fat in particular. The aim of this study was to analyze changes in body composition, i.e. body fat (BF), fat percentage (BF%), and lean tissue mass (LM) in girls during pre-menarcheal stages of development, including the earliest stage lacking clinical manifestations of changes in primary, secondary, and tertiary sexual characteristics. Puberty was assessed according to clinical and ultrasonographic staging of sex features developed by us. Concentrations of leptin and DHEA-S were compared and related to changes in body composition. SUBJECTS AND METHODS: The study was carried out on 65 healthy girls aged 8 years and older who were followed every 3 months over a 5-year period. Age, height, weight, and BMI were recorded. Body composition (BF, BF%, LM) was determined with an infrared method. Tertiary sexual features were staged according to Tanner. Vaginal secretion was assessed according to Peter et al. Transabdominal ultrasound of the uterus and ovaries was performed with the bladder unvoided. Groups were formed according to developmental stage: E0A = pre-estrogenization (no ultrasonographic or clinical evidence of estrogenization); E0B pre-estrogenization with 'luminosity' of mucus in cervical canal; E1 = onset of estrogenization; E = full estrogenization; M = menarche +/- 3 months. Concentrations of DHEA-S and leptin were determined by radioimmunoassay. RESULTS: BF in prepubertal girls averaged 16%. At menarche, BF was 23.9%. Body weight at menarche was 50.6 kg and the LM/BF ratio was 3.0. High leptin concentrations were found in E0B and M groups. Leptin concentrations were lowest during full estrogenization (E). Positive correlations of leptin with BF and LM were found in girls during developmental stages preceding menarche. Mean concentration of DHEA-S started at 1,091.6 microg/l during E0A stage, dropped significantly on passing to E0B (p <0.05), and increased by menarche. DHEA-S levels were found to correlate with BF, LM, and leptin in E0A, E0B, and E1 groups. Correlation coefficients were highest (DHEA-S/BF r = 0.61; DHEA-S/LM r = 0.54; DHEA-S/LEP r = 0.57) in the E0A group, i.e. about 5 months before the appearance of 'luminosity' of cervical mucus, considered to be the first ultrasonographic sign of puberty. Apparently, leptin stimulates somatic maturation during this stage of gonadarche which terminates with menarche. The action of DHEA-S is exerted during the early stages of female puberty.

[The influence of hyperthyroidism and glucocorticosteroid treatment on bone metabolism in patients with Graves' disease and ophthalmopathy]. / Wplyw nadczynnosci tarczycy oraz glikokortykoterapii na metabolizm tkanki kostnej u pacjentów z choroba Gravesa-Basedowa i oftalmopatia.

UNLABELLED: The aim of the study was to assess influence of hyperthyroidism and glucocorticosteroid treatment on changes of bone turnover markers in patients with Graves' disease and thyroid ophthalmopathy (TO). MATERIAL AND METHODS: Three groups of patients were included in the study. Group I was composed of 26 euthyroid Graves' disease patients with TO suitable for steroid treatment. Group II included 14 hyperthyroid Graves' patients without TO treated medically with anti-thyroid drugs. Group III (control group) included 20 healthy volunteers. Levels of the bone formation marker, i.e. bone-specific alkaline phosphatase (BALP) and the bone resorption marker, i.e. deoxypyridinoline (DPD) were measured in the group I before steroid treatment administration, after 3 methylprednisolone i.v. pulses and after completing the oral prednisone treatment. In the group II levels of BALP and DPD were assessed twice: before treatment of hyperthyroidism and after 6 months since euthyroid state had been achieved. In the group III levels of BALP and DPD were measured once in the basal conditions. RESULTS: Mean initial levels of BALP in groups I and II did not differ significantly and were increased when compared to healthy volunteers. In the group I a transient significant decrease in BALP levels after 3 i.v. pulses of methylprednisolone was observed, followed by a significant increase in BALP after completing the oral prednisone therapy. The achievement of euthyroid state in Graves' patients (II) did not influence significantly BALP values. In the group I initial DPD levels were significantly lower than those in group II and higher than those in the control group (III). During steroid treatment of TO (group I) no dynamic changes of DPD levels were observed. The achievement of euthyroid state in group II was accompanied by a significant decrease in DPD levels, which were however than those in the control group. CONCLUSIONS: 1. In hyperthyroid state is associated with the profound stimulation of bone resorption, and to a lesser extent of bone formation. 2. The achievement of euthyroid state causes a rapid inhibition of bone resorption and maintains a compensatory stimulation of bone formation. 3. Glucocorticosteroid treatment with methylprednisolone i.v. pulses and orally administered prednisone do not influence significantly the processes of bone formation and bone resorption.