Leptin and ghrelin concentrations and weight loss in Parkinson's disease.

OBJECTIVES: To investigate the role of leptin, ghrelin, GH and IGF-1 in energy balance disturbances in Parkinson's disease (PD). MATERIALS AND METHODS: Thirty-nine patients were included: 11 PD patients with unintentional weight loss, 16 PD patients without weight loss and 12 controls. UPDRS, MMSE, MADRS, appetite scale, BMI, adipose tissue content, plasma leptin and active ghrelin concentrations and serum GH, IGF-1, TSH, T3 and T4, concentrations were evaluated. RESULTS: A lower plasma leptin concentration and a higher serum IGF-1 concentration were found in PD patients with weight loss. BMI and the content of adipose tissue were positively correlated with leptin concentration in all PD patients. Paradoxically, the lower BMI was, the lower plasma active ghrelin concentration was in PD patients with the weight loss. CONCLUSION: These findings confirm that changes of plasma leptin concentration occur in PD patients with loss of weight.

[Possibility of using saliva for therapeutic monitoring of digoxin]. / Mozliwosc zastosowania sliny do terapii monitorowanej digoksyny.

Digoxin in salvia and blood serum of 24 patients obtained Bemecor was determined by the method of FPIA (IMx-ABBOT). Mixed saliva was collected by three different types of Salivette (Sarstedt) given in order: normal Salivette with cotton wool swab, Slivette with polyester wool and Salivette with citric acid as a stimulator. It was found, that the correletio between the digoxin concentrations in saliva and serum and saliva/serum rations depended on the type of Salivette. The highest correlation was obtained with the Salivette with polyester wool (r = 0.892), but low concentrations of this drug in serum were good reflected in all samples of saliva, independent on kind of Salivette.

An analgesic effect of synthetic human calcitonin in patients with primary osteoporosis.

Examinations were performed in 20 adult male and female patients (pts) suffering from acute back pain due to vertebral compression fracture secondary to osteoporosis proved by lateral X-rays of the dorso-lumbar spine (Th3-L5), and bone mineral density with the method of dual energy X-ray absorptiometry. The synthetic human calcitonin (SUC) (0.5 mg) was injected I.M. every day during 28 days. Analgesic effect was evaluated on 0, 3, 7, 14, 21 and 28th day by patient's assessment of functional capacity, and physician's assessment of pain and mobility. On the same days biochemical variables of Ca-P homeostasis were determined. Treatment with calcitonin resulted in a positive analgesic effect. The functional capacity and mobility of pts increased with diminution of pain. No significant alterations of Ca-P homeostasis was observed. Mild and transient side effects as nausea and tachycardia were negligible. SHC appears to have a significant analgesic effect in treatment of primary osteoporosis.

Calcium/phosphate/vitamin D homeostasis and bone mass in patients after gastrectomy, vagotomy, and cholecystectomy.

Sixty-two outpatients were assessed and divided into the following groups: 20 patients who had had partial gastrectomy (PG group), 22 patients who had had truncal vagotomy and pyloroplasty (TV group) or high selective vagotomy (HSV group), and 20 patients who had had cholecystectomy (CH group). The patients' age ranged from 35 to 64 years (mean 45 years), and the average postoperative period was 9 years. None of the patients evidenced clinical or biochemical symptoms of malnutrition or malabsorption or of diseases affecting vitamin D metabolism. The function of the kidneys and the liver was normal. An age-matched group of volunteers served as a control group. The calcium dietary intake was determined using a standardized questionnaire; and the levels of serum calcium (Cas), phosphate (Ps), alkaline phosphatase (AP), and 25-hydroxyvitamin D [25(OH)D] and the excretion of Ca in a sample of fasting urine corrected for concurrent creatine excretion (FuCa/cr) were assessed by means of standard laboratory techniques. The bone mineral density (BMD) of the lumbar spine (L2-4) and femoral neck (neck-L) was determined by means of dual energy x-ray absorptiometry (DXA). The daily Ca dietary intake was lower than recommended (RDA) in 80% of the patients, with most of them ingesting less than 300 mg daily. The mean values of Cas, Ps, AP, and FuCa/cr did not differ from those in the controls. Significantly reduced 25(OH)D levels were observed in the PG group (7.0 ng/ml) (p < 0.001) and CH group (12.5 ng/ml) (p < 0.01) compared with the values in the control group (20.0 ng/ml).(ABSTRACT TRUNCATED AT 250 WORDS)

Vitamin D deficiency in patients with chronic gastrointestinal disorders: response to UVB exposure.

UVB irradiation of the skin of patients with chronic gastrointestinal disorder (CGD) and decreased serum concentrations of 25-OHD (6.8 +/- 3.0 ng/ml, n = 15) result in a subsequent increase in circulating vitamin D and 25-hydroxyvitamin D (25-OHD) levels and is associated with a marked increase in calcuria (mean increase: 82 mg/d). Before UVB irradiation the mean total 1,25-(OH)2D concentration (48 +/- 12 pg/ml) and free 1,25-(OH)2D index (2.0 +/- 0.5) in CGD was not different from the values obtained in age-matched healthy controls (51 +/- 12 pg/ml and 2.0 +/- 0.8, respectively), but the mean PTH levels were significantly higher in CGD (135 +/- 62 pg/ml) than those in controls (45 +/- 19 pg/ml, p < 0.01). During and after UVB irradiation of CGD, mean 1,25-(OH)2D levels (129 +/- 32 pg/ml) as well as free 1,25-(OH)2D index (5.5 +/- 1.5) were on the rise with a maximum reached on the 14th day and were paralleled with a drop in PTH (72 +/- 24 pg/ml) concentration. These data indicate that UVB stimulated calciuria in CGD is due to increased synthesis of 1,25-(OH)2D and suppression of PTH.

Long-term consequences of surgical treatment of peptic ulcer.

Surgical treatment of peptic ulcer may lead to several late postoperative morphological and metabolic abnormalities. Forty two patients (16 females and 26 males) at mean age of 47 years after surgery for peptic ulcer (mean postoperative period of 9 years) were recruited in this study. Following methods have been used for evaluation of those patients: clinical and serum biochemical assessment, UGI tract endoscopy, histology of gastric or duodenal mucosa biopsies, test for H-pylori presence, Ca-P-Mg homeostasis and BMD using DXA-absorptiometry. No clinical and biochemical abnormalities were found. In 60% of examined pts gastritis or duodenitis with various degrees of the reflux were found endoscopicaly. In 64% of pts histology showed signs of mucosal inflammation. Recurrent ulcer was found in 3 pts. H-pylori was present in 16 pts (40%). The significant reduction of BMD, especially of the lumbar spine, in the pts after the PG resection in comparison to the pts with the vagotomy was found. Within several years after gastric operation the patient must be carefully evaluated and adequate supplementation of Ca and vitamin D is strongly recommended.

[Biochemical markers of bone remodelling and their usefulness in the diagnosis of osteoporosis]. / Biochemiczne markery przebudowy kosci i ich przydatnosc do diagnostyki osteoporozy.

In 65 subjects (42 women and 23 men) aged from 40 to 80 years, at risk for primary or secondary osteoporosis development without concomitant diseases affecting renal and hepatic function and vitamin D metabolism, alkaline phosphatase activity (F.A.s) and total calcium level (Cas) were determined in the blood serum, and also the excretion in the morning urine portion of hydroxyproline and calcium was measured in relation to creatinine excretion (FUHpr/kr; FUCa/kr). In each patient an X-ray was done of the thoracolumbar spine, and on its basis the X-ray vertebral index was calculated. The study has been undertaken in order to elucidate whether the above stated compounds regarded as biochemical markers of bone remodelling, and the X-ray vertebral index are useful in the diagnosis of osteoporosis. An increased F.A.s activity in the blood serum, and higher values of the X-ray vertebral index were found both in the group of patients with primary and secondary osteoporosis, in relation to normal values. It was found that FUHpr/kr and FUCa/kr were increased in patients with secondary osteoporosis in comparison to patients with primary osteoporosis. A statistically significant correlation was also noted between FUHpr/kr and FUCa/kr, and F.A.s in patients with primary and secondary osteoporosis. In both studied groups no relationship was found between the value of the X-ray vertebral index, and the levels of biochemical markers of bone remodelling.

[Biochemical indicators of the nutritional status of the body in various diseases of the digestive system]. / Wskazniki biochemiczne okreslajace stan odzywienia organizmu czlowieka w niektórych przewleklych chorobach ukladu trawienia.

In 45 patients with chronic digestive tract diseases (gastric and/or duodenal peptic ulcer, cholecystolithiasis, conditions after gastrectomy and cholecystectomy) the biochemical parameters serving as indicators of the nutritional status of the organism (Hb, Bc, Fe, Ca, alkaline phosphatase) were determined. In the group with postgastrectomy syndrome the serum calcium level was decreased. The other parameters were normal in all groups of patients.

Etiopathogenesis of UVB stimulated calciuria in chronic gastrointestinal patients with decreased supply of vit. D.

It was stated that in patients with chronic gastrointestinal disorders (CGD) and decreased supply of Vit. D (25/OH/D = 6.8 +/- 3.0 ng/ml) during UVB stimulated skin synthesis of Vit.D the increment of Vit.D and 25-hydroxycholecalciferol (25/OH/D) depends on the starting values of Vit.D and 25/OH/D and is accompanied by significant increment of calciuria (delta mean UCa). Before the irradiation with UVB, mean 1,25/OH/2D in age paired healthy controls (50.66 +/- 12.35 pg/ml) when compared with CGD (47.62 +/- 12.08 pg/ml) and F.1,25/OH/2D in controls (2.02 +/- 0.80) and CGD (2.03 +/- 0.46) did not differ when mean PTH in CGD (135.3 +/- 61.6 pg/ml) was significantly higher in CGD (44.6 +/- 18.54 pg/ml, p less than 0.01) than in control group. During and after UVB irradiation completion of CGD mean 1,25/OH/2D levels (129.0 +/- +31.9 pg/ml) as well as F. 1,25/OH/2D index (5.54 +/- +1.54) were rising with the maximum reached on the 14-th day which was paralleled with a subsequent drop in mean PTH (72.3 +/- 24.42 pg/ml) concentration. The data indicated that UVB stimulated calciuria in CGD patients was correlated with increased synthesis of 1,25/OH/2D and increased F. 1,25/OH/2D index which was accompanied with suppression of mean PTH.