Climacteric symptoms are related to thyroid status in euthyroid menopausal women.

BACKGROUND: Climacteric symptoms are a variety of disturbing complaints occurring during menopausal transition, many of which may be influenced by hormonal abnormalities other than related to sex steroids. AIM OF THE STUDY: In this study, we investigated the association between the intensity of climacteric symptoms measured with the Kupperman index and a thyroid status. MATERIAL AND METHODS: We evaluated by measuring serum thyrotropin (TSH), and free thyroxine (fT4) 202 euthyroid women admitted to the Department of Gynecological Endocrinology, Poznan University of Medical Sciences because of climacteric symptoms. Patients were both in perimenopause (n = 74) and postmenopause (n = 128), with no history of thyroid disorders. RESULTS: Results presented as the mean value and standard deviation were as follows: age 54.2 ± 4.9 years, BMI 26.8 ± 4.6 kg/m2, Kupperman index 26 ± 13.1 points, TSH 2.4 ± 2.6 mU/l, fT4 1.2 ± 0.37 ng/dl. We observed a negative correlation between fT4 and the time since the last menses (R = - 0.38; p = 0.02) as well as between serum TSH concentration and sweating (R = - 0.18; p = 0.03), general weakness (R = - 0.17; p = 0.03), and palpitation (R = - 0.18; p = 0.02) and a positive correlation between fT4 and nervousness (R = 0.34; p = 0.007) and palpitations (R = 0.25; p = 0.04). In the perimenopausal subgroup, there was a positive correlation between fT4 and general weakness (R = 0.42; p = 0.03), palpitations (R = 0.50; p = 0.009), and paresthesia (R = 0.46; p = 0.01). In the postmenopausal subgroup, there was a negative correlation between TSH and sweating (R = - 0.21; p = 0.03). CONCLUSIONS: Menopausal symptoms are related to thyroid status in euthyroid menopausal women.

Salivary alpha-amylase, secretory IgA and free cortisol as neurobiological components of the stress response in the acute phase of anorexia nervosa.

Objectives One novel hypothesis of the pathogenesis of anorexia nervosa (AN) is the possible role of mental stress in hyperactivity of the autonomic nervous system (ANS) and of the hypothalamic-pituitary-adrenal (HPA) axis. Two components of stress response - salivary alpha-amylase (sAA) and free cortisol - have been proposed. They can be determined in saliva, which closely reflects their concentrations in plasma. The purpose of this study was to measure salivary free cortisol, sAA and their correlation to secretory IgA (sIgA) of patients with AN in comparison to the average population. Methods A controlled clinical trial was designed for a matched group of 47 AN patients and 54 healthy individuals. After clinical examination, unstimulated salivary samples were taken during the acute stage of AN (BMI < 15 kg/m(2)) in the first week of hospitalisation. An enzyme-linked immunosorbent assay (ELISA) suitable for measuring sAA, sIgA and free cortisol were used. Results Anorexic patients exhibited disturbances in sAA secretion, and significantly increased cortisol and sIgA levels with a distinct correlation between these two parameters. Conclusions The behaviour of cortisol, sAA and sIgA levels can be assessed as an effect of stress reaction among AN patients with hyperactivity of the HPA axis and ANS dysregulation. The effect of stress response can be assessed reliably in saliva.

The genetic background of climacteric symptoms in women during menopause.

The subject of the study is the evaluation of the correlation between the polymorphism of candidate genes in the etiology of depression and the occurrence of the symptoms of the climacteric syndrome in women during menopause. The group subjected to the study comprised of 203 women aged between 42-65 years: 71 of them still menstruated (premenopausal group) and 132 at least one year after the last period (postmenopausal group), admitted to the Department of Gynecological Endocrinology at the University of Medical Sciences in Poznan with symptoms of the climacteric syndrome All the examined women were evaluated according to the degree of severity of the climacteric syndrome symptoms using the Kupperman index and the concentration of FSH, LH hormones, 17ß-estradiol, PRL, total testosterone, and DHEAS in peripheral blood serum. Among the candidate genes in the aetiology of depression the following were selected for the research: the serotonergic system receptor genes: 5HTR2A, 5HTR1B, 5HTR2C, TPH 1, TPH2, and MAO-A; the genes of noradrenergic and dopaminergic systems (COMT, NET), the genes of the GABAergic (GABRBl) system, a gene of the estrogen receptor (ESR1), and the genes of the enzymes crucial in the methyl cycle (MTHRF, MTR, and MTHFD1). With regards to the correlation between the examined polymorphisms and the occurrence of the symptoms of the climacteric syndrome, the associations analysis indicated a connection between GABRBl.TaqI polymorphism and the occurrence of vertigo in premenopausal women (0.0198; after correction: 0.0497 CC to CA). The correlation was also found regarding the examined polymorphisms and the concentration of the examined hormones in blood serum: TPH1.MaeI polymorphism and the LH concentration in the postmenopausal group (0.004; after correction: 0.014 CC to CA), NET.Eco1471 polymorphism, and the 17ß-estradiol concentration in the postmenopausal group (0.0208; after correction: 0.048 GG to GA) and HTR2AMspI polymorphism and PRL concentration in all examined women (0.03; after correction: 0.038 TT to CT).

Depressive symptoms' pattern in postmenopausal women.

The study was conducted to elucidate the problem of depressive symptoms' pattern in climacteric women. The study included 128 postmenopausal women aged 47-65 years admitted to the Department of Gynecological Endocrinology, Poznan University of Medical Science because of climacteric symptoms. The authors assessed the intensity of climacteric symptoms with the Kupperman index and the severit of depressive symptoms with the Hamilton depression scale. They measured BMI of all studied women. The average score of the Hami ton scale in the studied group was 11 points (SD ± 7 points). No depressive symptoms were found in 40 (31.2%) of the study participants. A slight increase in the severity of the depression symptoms was found in 64 (50%) and 23 (29.9%) displayed depressive symptoms at moderate severity, while one (1.3%) study participant was diagnosed with very severe depressive symptoms. Depressive symptoms observe most often were: somatic symptoms of anxiety and fear experienced in 90 (70.2%), light and interrupted sleep reported in 88 (68.6%), an general symptoms in 88 (68.6%) of the study participants.

Depressive symptoms and hormonal profile in climacteric women.

OBJECTIVES: The aims of the study were: evaluation of depressive symptoms in climacteric women, comparison of depressive symptoms between peri- and post-menopausal women, and assessment of a possible relationship between the presence of depressive symptoms and the hormonal profile of the studied women. MATERIALS AND METHODS: The study included 45 peri-menopausal and 95 post-menopausal women admitted to the Department of Gynecological Endocrinology, Poznafi University of Medical Sciences, because of climacteric symptoms. The following parameters were evaluated in all studied women: intensity of climacteric symptoms (Kupperman Index), intensity of depressive symptoms (Hamilton depression scale), serum concentrations of hypothalamic-pituitary-gonadal axis hormones (FSH, LH, 17ß-estradiol), prolactin (PRL) and androgens [total testosterone, dehydroepiandrosterone sulfate (DHEAS)]. FSH, LH, 17ß-estradiol, PRL, and total testosterone were evaluated by the immunoenzymatic methods and DHEAS was measured by the radioimmunological method. RESULTS: Psychic and somatic manifestations of anxiety and fear, shallow sleep, and general somatic symptoms were the most frequent depressive symptoms in both studied groups. Both investigated groups differed in relation to the incidence and intensity of symptoms from the genital system (observed more often in post-menopausal women) and hypochondria (noted more frequently in peri-menopausal women). Numerous relationships between the incidence and intensity of certain symptoms and serum concentrations of the investigated hormones were found in both groups. The correlations were different in peri- and post-menopausal subjects.

Serum prolactin concentration and severity of depression symptoms in climacteric women.

OBJECTIVE: The study was conducted to elucidate the problem of prolactin (PRL) serum concentration in menopausal women and its possible relations with climacteric and depressive symptoms. MATERIALS AND METHODS: The study included 202 women aged 40-65 years admitted to the Department of Gynecological Endocrinology, Poznan University of Medical Sciences, because of climacteric symptoms. The authors assessed the intensity of climacteric and depressive symptoms with the Kupperman index and the Hamilton depression scale, measured BMI index, serum PRL, FSH, LH, 17ß-estradiol, total testosterone, and dehydroepiandrosterone sulfate (DHEAS) levels in all studied women. RESULTS: They found a correlation between serum PRL concentration and result of M. Hamilton depression scale (R = 0.21; p = 0.005) and a between serum PRL concentration and serum 17ß-estradiol concentration (R = 0.21; p = 0.003). CONCLUSION: The authors concluded that serum PRL concentration is related to severity of depressive symptoms in menopausal women.

The c.1460C>T polymorphism of MAO-A is associated with the risk of depression in postmenopausal women.

OBJECTIVE: The aim of the study was an evaluation of possible relationships between polymorphisms of serotoninergic system genes and the risk of depression in postmenopausal women. METHODS: We studied 332 women admitted to our department because of climacteric symptoms. The study group included 113 women with a diagnosis of depressive disorder according to the Hamilton rating scale for depression; the controls consisted of 219 women without depression. Serum 17ß-estradiol concentrations were evaluated using radioimmunoassay, while polymorphisms in serotoninergic system genes: serotonin receptors 2A (HTR2A), 1B (HTR1B), and 2C (HTR2C); tryptophan hydroxylase 1 (TPH1) and 2 (TPH2), and monoamine oxidase A (MAO-A) were evaluated using polymerase chain reaction-restriction. RESULTS: We found that the 1460T allele of MAO-A c.1460C>T (SNP 1137070) appeared with a significantly higher frequency in depressed female patients than in the control group (P = 0.011) and the combined c.1460CT + TT genotypes were associated with a higher risk of depression (P = 0.0198). Patients with the 1460TT genotype had a significantly higher 17ß-estradiol concentration than patients with the 1460CT genotype (P = 0.0065) and 1460CC genotype (P = 0.0018). CONCLUSIONS: We concluded that depression in postmenopausal women is closely related to the genetic contribution of MAO-A.

Temperament and character inventory and pharmacotherapeutic outcome in bulimia nervosa.

OBJECTIVE: To assess the relationship between the personality dimensions measured by the temperament and character inventory (TCI) and pharmacotherapeutic outcome in bulimia nervosa (BN). METHODS: Thirty female BN patients aged 19.5+/-2.9 years were enrolled to receive 12 weeks' treatment with fluoxetine or buspirone and assessed using the Polish version of the TCI. The personality dimensions of the patients with good and poor treatment responses were compared. RESULTS: The subjects with a good outcome had a higher self-directedness and lower harm avoidance score; this difference was more pronounced in the fluoxetine-treated subjects. At multiple regression analysis, only self-directedness predicted a good outcome. DISCUSSION: The results indicate that self-directedness is associated with a good pharmacotherapeutic outcome in BN. This seems to confirm the results of previous studies of the pharmacotherapy of depression and cognitive-behavioural therapy (CBT) in BN.

[Genetic factors in the etiology of anorexia nervosa]. / Czynniki genetyczne w etiologii jadlowstretu psychicznego.

Anorexia nervosa (AN) is a disease of complex ethiopatogenesis. Population genetics studies suggest a significant role of genetic factors in the morbidity risk. Family and twin studies allow for the estimation of the heritability--the influence of genetic factors on the specific phenotype--of the anorexia nervosa in 50-80%. Due to the low prevalence of the disease, the adoption studies have not been performed. The rapid development of the molecular biology methods gives possibility for the searching of the specific genes increasing the risk of anorexia nervosa. Linkage studies are based on scanning the whole genome for loci associated with susceptibility to a certain disease. In the preliminary studies, no linkage was found between anorexia nervosa and the markers on the chromosomes 1-5, 13 and X. In the association studies, relationship between vulnerability to AN and polymorphism in 5-HT2a receptor and uncoupling proteins gene were reported. These results need further confirmation.

[Genetic studies in autistic disorders]. / Badania genetyczne w autyzmie dzieciecym.

Since autism was first described by Leo Kanner the view on its etiology and pathogenesis has been changing. Recently there are more data on genetic and neurobiological background of autism. At the beginning it was noticed that autism appeared more frequently among boys, in population studies it was found that autism appeared more frequently among siblings, mostly among monozygotic twins. Many disorders like Tourett syndrome and tuberous sclerosis were reported in connection with autism. Recently research is focused mostly on chromosome abnormalities: chromosome 15 (locus 15q11-13), chromosome 7 (locus 7q), chromosome 16 (locus 16p) and gens of particular receptors (GABRB3, UBE3A/E6-AP, 5-HTT). These abnormalities may also be one of the causes of autism.