[Optimization of the treatment of moderate to severe and active thyroid orbitopathy considering the recommendations of the European Group on Graves' Orbitopathy (EUGOGO) [Optymalizacja leczenia umiarkowanej do ciezkiej i aktywnej orbitopatii tarczycowej z uwzglednieniem zalecen European Group on Graves' Orbitopathy (EUGOGO)]].

Graves' disease (GB), also known as Basedow's disease, is the most common cause of hyperthyroidism, and thyroid orbitopathy (TO) is its most common non-thyroid manifestation with an incidence of 42.2/million people/year. Based on the guidelines of the European Graves' Orbitopathy Group (EUGOGO), certain management standards presented in our publication should be used to optimize and improve the efficacy of TO treatment. Deciding on the optimal treatment for both hyperthyroidism and TO requires a cooperative team of specialists: endocrinologist, ophthalmologist, radiation therapist, and surgeon, as well as consideration of the risk of relapse and possible complications of the treatment method. The inflammatory activity and severity of TO should be diagnosed based on the investigator's own experience and according to standard diagnostic criteria. Assessment of the inflammatory activity of TO can be performed using the clinical activity score (CAS) and using imaging methods - mainly MRI. The severity of TO is assessed using a seven-grade NOSPECS classification and a three-grade EUGOGO scale. In moderate to severe and active TO, i.v. methylprednisolone pulses are the treatment of choice. It is important to maintain the standard and regimen of treatment. The recommended standard as first-line treatment in most patients with moderate to severe and active TO is the combined use of methylprednisolone i.v. (cumulative dose of 4.5 g over 12 weeks) with concurrent administration of mycophenolate sodium 0.72 g per day for 24 weeks. In more severe forms of moderate to severe and active TO, a higher cumulative dose of methylprednisolone i.v. is recommended as an alternative first-line treatment (7.5 g) as monotherapy starting with a dose of 0.75 g once a week for 6 weeks and 0.5 g for a further 6 weeks. EUGOGO guidelines recommend that in cases of no clinical response after 6 weeks of first-line treatment with i.v. methylprednisolone and mycophenolate, after 3-4 weeks, a second course of i.v. methylprednisolone monotherapy should be started with a higher cumulative dose of 7.5 g. Other second-line treatment options are orbital radiotherapy with or without oral or i.v. systemic glucocorticosteroid therapy, cyclosporine, or azathioprine in combination with p.o. glucocorticosteroid, methotrexate monotherapy, and a group of biologic drugs rituximab, tocilizumab, teprotumumab). Keeping in mind that TO is a sight-threatening disease, we expect, through the treatment applied, to maintain full visual acuity, pain relief, single vision in the useful part of the visual field, and a positive cosmetic effect.

THE MOST COMMON UROLOGICAL CONDITIONS IN POSTMENOPAUSAL WOMEN.

OBJECTIVE: The aim: To analyze the available literature on the most common daily urological problems in menopausal women and to evaluate the use of hormone replacement therapy for troublesome urological symptoms. PATIENTS AND METHODS: Materials and methods: Analysis of publications from PubMed databases on the most common disorders during menopause was performed and the most common urog¬ynaecological problems in postmenopausal women were selected according to literature data. Different available methods of treatment of these disorders were compared. Conclusions: During menopause, women struggle with many unpleasant symptoms from the genitourinary system. For most women, this is a very embarrassing topic and, although bothersome, underestimated. The urinary tract infections, urinary incontinence or kidney stones can lead to serious complications, if left untreated. We should strive to make women more aware of possible methods of prevention and treatment of the menopausal symptoms in the context of urological disorders.

IMPROVED PHYSICAL FUNCTION WITH COMPLEMENTARY USE OF A DIETARY SUPPLEMENT FOR MILD KNEE OSTEOARTHRITIS: A SUBGROUP ANALYSIS.

OBJECTIVE: The aim: In this study, we present a sub-analysis of physical functionality in sufferers of mild knee osteoarthritis (OA) following a clinical assessment of a novel nutraceutical supplement Tregocel® complementary to standard treatment. PATIENTS AND METHODS: Materials and methods: We evaluated the results of a multicenter, open-label, single-arm efficacy and safety evaluation of a polyherbal nutraceutical, performed in subjects with symptomatic, mild knee OA (n = 107, 59.7 ± 10.8 yrs, 68.2% female) over 36 weeks. Physical function was assessed using a standardized walking challenge (6-min walk test), combined with WOMAC indices and leg flexion measurements. Sub-analysis was performed using a linear mixed model that tracked changes in the walking challenge outcomes over time, adjusted for age, gender, and OA duration. RESULTS: Results: Walking distance was significantly improved with the duration of nutraceutical use, increasing by 0.72 m (95% CI: 0.56, 0.88) per week of product administration. Similarly, there were significant decreases in WOMAC indices per week for stiffness (-1.6, 95% CI: -1.8, 1.4), daily functioning (-13.5, 95% CI: 14.9, 11.9) and global outcome (-19.2, 95% CI -21.3 - -17.1). Furthermore, supine heel-to-high flexion distance was improved relative to the duration of nutraceutical use. CONCLUSION: Conclusions: The use of a polyherbal nutraceutical resulted in clinical improvements in several indices of physical functioning in mild knee OA suffers. Trial registration: NCT03636035.

EFFICACY OF HERBAL AND NATURALLY-DERIVED DIETARY SUPPLEMENTS FOR THE MANAGEMENT OF KNEE OSTEOARTHRITIS: A MINI-REVIEW.

Knee osteoarthritis (OA) accounts for approximately 85% of the burden of OA worldwide. Knee OA is a whole joint disorder involving structural alterations in the hyaline articular cartilage, subchondral bone, ligaments, capsule, synovium, and periarticular muscles. The complex knee OA pathogenesis includes mechanical, inflammatory, and metabolic factors, eventually leading to the synovial joint's structural destruction and failure. This review aims to present an overview of current knowledge on dietary supplements, such as glucosamine, chondroitin, methylsulfonylmethane, diacerein, avocado-soybean unsaponifiables, curcuminoids, as well as boswellic acids. Results originating from several small studies with natural products in managing knee OA are encouraging. However, additional well-designed placebo-controlled clinical trials are required.

Prospective, Multicenter Evaluation of a Polyherbal Supplement alongside Standard-of-Care Treatment for Mild Knee Osteoarthritis.

BACKGROUND: This study aimed to provide clinical information on general and joint performance from individuals taking Tregocel® (containing curcuminoid and extracts of the herbs Harpagophytum procumbens, Boswellia serrata, Apium graveolens, and Zingiber officinale) alongside a standard therapy of symptomatic mild knee osteoarthritis (OA). METHODS: This was a multicenter, open-label, prospective, single-arm study, in which Tregocel® was supplemented for 36 weeks. Participants with symptomatic mild knee OA requiring pharmacologic treatment for pain were enrolled. Physical performance (6-minute walk test, WOMAC-pain and functional domain, and heel-thigh distance flexion test), general performance (WOMAC questionnaire), and VAS (Visual Analogue Scale) assessment of knee pain, as well as anti-inflammatory and analgesic medication consumption, were assessed. RESULTS: Between January and April 2019, 107 participants were enrolled and analysed in per protocol population. Mean age was 59.7 (SD 10.8) years, and there were 68.2% women. Mean observation time was 291.1 (SD 7.7) days. Mean increase in 6MWT result observed at the end of the study was 26.0 (SD 30.4) m (p < 0.001). Median VAS score decreased from 60.0 (IQR 50-72) mm at the beginning of the study to 21.0 (IQR 14-30) mm after 36 weeks of product administration (p < 0.001). Regular knee OA medications were taken in 99.1% of subjects at baseline decreasing to 55.1% at the end of the Tregocel® supplementation. CONCLUSIONS: During Tregocel® supplementation, participants observed improved functional capacity confirmed in the distance in 6MWT and in the heel-thigh distance flexion test, decreased level of pain, and improved WOMAC scores for all domains.

LUNG NODULE 25 YEARS AFTER LOBECTOMY - RECURRENCE OF BRONCHIAL CARCINOID.

OBJECTIVE: Introduction: Bronchopulmonary (BP) carcinoids are low and intermediate grade tumors, seen in adults between fourth to sixth decade, where no clear association with tobacco smoking is established. Most often they are sporadic lesions (95%). Half of patients have no symptoms and the tumor is incidentally found on a chest x- ray. BP carcinoids have a good prognostic, however there is a risk of distant metastasis and the recurrences are frequent. Therefore a crucial role of vigilant follow- up, extending far beyond 5 years. PATIENTS AND METHODS: Case presentation: We report a case of 73 years old women, with history of recurrent pulmonary infections, and positive family history for lung cancer. Patient underwent left inferior lobectomy for BP carcinoid 25 years before and completed a 5 years long follow- up. On a thoracic computed tomography scan a nodule in the right lung was detected. Patient benefited from surgery and the pathological result was typical carcinoid with Ki67<1%. Follow- up CT scans showed stable images, with no signs of spread or recurrence. CONCLUSION: Conclusions: Although there is a low risk of distant spread in such tumors, the recurrences are frequent. Moreover, patients may exhibit a higher risk of development of second tumors and there is a risk of metachronous tumors. The post-operative follow-up should be prolonged.

Antibodies involved in the development of pernicious anemia and other autoimmune diseases.

INTRODUCTION: Pernicious anemia (PA) is an autoimmune hematopoietic disease. OBJECTIVES: The aim of the study was to determine autoantibodies involved in the pathogenesis of PA and the development of other autoimmune disorders such as connective tissue diseases and celiac disease. We also aimed to assess the potential usefulness of the specific diagnostic and screening tests in patients with PA. PATIENTS AND METHODS: The study group comprised 124 women and men with newly diagnosed PA and 41 healthy controls. Intrinsic factor (IF) antibodies, gastric parietal cell (GPC) antibodies, endomysium antibodies (EmAs), and antinuclear antibodies (ANAs) were determined in blood samples. RESULTS: IF or GPC antibodies were present in 61.3% of patients, GPC antibodies, in 46%, IF antibodies, in 30.6%, IF and GPC antibodies, in 15.3%. There was no difference in the occurrence of ANAs and EmAs between the PA and control groups. However, ANAs were found in 16.1% of patients with PA and in 4.9% of controls. The occurrence of EmAs in both groups was similar (3.2% vs 2.4%); however, it has been shown that patients with IF or GPC antibodies are more prone to be EmA positive (P = 0.009). CONCLUSIONS: Simultaneous determination of IF and GPC antibodies increases the chances of confirming the diagnosis of PA. Also, screening for connective tissue diseases and celiac disease may be considered in patients with PA, due to the presence of ANAs and EmAs in that population.

Selected adipose tissue hormones in the blood of patients with ischaemic cerebral stroke.

INTRODUCTION: Despite considerable progress in knowledge, ischaemic stroke is still a disease that causes serious clinical problems. A role in its pathogenesis can be attributed to i.a. adipose tissue hormones. The aim of this paper is to assess the blood levels of selected adipocytokines in patients during the acute phase of ischaemic stroke as compared to healthy persons, and an attempt to indicate a correlation between their blood concentrations and the level of stroke severity and its outcomes. MATERIAL AND METHODS: The study included 46 patients with fresh ischaemic stroke (27 females, 19 males, average age 67.6 years). All patients had a CT scan of the head, their neurological condition was assessed using a stroke severity scale, and their blood levels of resistin, chemerin, and visfatin were tested. The control group consisted of 32 patients (16 females, 16 males, average age 64.1 years) who had never suffered cerebrovascular diseases. RESULTS: Elevated levels of both resistin and chemerin were found in the group of patients with ischaemic stroke (9.17 ± 2.95 ng/mL vs. 6.55 ± 2.01 ng/mL for resistin and 265.0 ± 59.3 ng/mL vs. 191.0 ± 43.6 ng/mL for chemerin). It was also found that the blood concentration of chemerin was higher in females than in males with stroke. However, no difference was found in visfatin blood concentration between the group with ischaemic stroke and the control group (1.65 ± 1.09 ng/mL vs. 1.5 ± 1.39 ng/mL). CONCLUSIONS: Higher resistin and chemerin blood concentrations significantly increase the risk of ischaemic stroke. The level of stroke severity at the moment of its occurrence and during its course do not depend on the concentrations of adipocytokines under analysis.

[Obesity and osteoporosis-connections between adipose tissue and bone.]

The adipose and osseous tissue, although both derived from the connective tissues, perform different functions. In the common opinion, obesity might be a protective factor against bone loss and osteoporosis. The adipose tissue is a recognized major endocrine organ, producing a number of active biological substances, which affect the bone mass. Adipocyte and osteoblast are derived from the same mesenchymal stem cells. Therefore abnormal secretion of adipocytokines may play an important role not only in pathogenesis of the obesity, but also can influence the bone . It is supposed that obesity might have a protective effect on bone tissue in postmenopausal women, by increasing the load on the axial skeleton and because of its hormonal activity.

Assessment of selected adipocytokines in obese women with postmenopausal osteoporosis.

INTRODUCTION: Osteoporosis and obesity are considered civilisation diseases. Menopause is a time of increased bone resorption and increased mass of adipose tissue. Adipocytokines secreted by the adipose tissue are believed to be a potential factor in the pathogenesis of osteoporosis. MATERIAL AND METHODS: The aim of this research was to assess leptin, adiponectin, and resistin secretion in obese postmenopausal women with osteoporosis and determine whether obesity might be a factor mitigating the risk of osteoporosis. The study involved 80 postmenopausal women with osteoporosis divided into groups: I with BMI of 30.0 34.9, obese; and II with BMI of 18-24.9, normoweight. Leptin, adiponectin and resistin concentrations were assessed, and bone mineral density (BMD) was measured in the L1-L4 section of the spine using the DXA densitometric method. RESULTS: The results of the comparison of the two groups indicate a statistically significant dependence in groups regarding leptin secretion; the group of obese women demonstrated significantly higher concentrations. No differences between the groups were demonstrated for adiponectin or resistin secretion. CONCLUSIONS: Higher leptin concentration and a positive correlation with BMI was confirmed in obese postmenopausal women with osteoporosis. It was also demonstrated that BMD increases with growing BMI. No effect of obesity on the secretion of adiponectin or resistin in women with postmenopausal osteoporosis was found. From among the investigated adipocytokines, only leptin can be considered a bone tissue protective factor in postmenopausal women.

[Vitamin D - a geriatric point of view].

Elderly people more often suffer from vitamin D insufficiency. It is caused by insufficient supply with diet and scarce sun exposure, due to life style. This is a very common situation in Poland and worldwide. Vitamin D influences functioning of many various organs. Its deficiency may cause bone mineralization disorders, osteomalacia, osteoporosis, muscle weakening, which can result in higher risk of falls. Its influence on cardiovascular diseases, type 2 diabetes and cognitive functions is widely discussed. Supplementation is crucial in elderly population. It should be administrated all year, with adjustement of dose to age and weight. Initial blood concentration is not required. An appropriate sun exposure is recommended. Treatment of vitamin D deficiency should be intensive and last for several months. Although the doses are high, no adverse effects were observed.

[Assessment of the relationship between bmd and body mass index bmi in women with postmenopausal osteoporosis].

OBJECTIVE: Introduction: Osteoporosis is chronic metabolic disease of the bone-joint system and it is increase risk of bone fractures and mortality. The effect of postmenopausal hormonal changes can be the adipose tissue gain along. Osteoporosis and decreased BMD in women with menopause can be a result of the change of body mass. Previous studies have demonstrated protective effect of high values of BMI on the bone tissue, may be which protect against osteoporosis. The aim: The assessment of BMD in a connection with the body mass index BMI in women with postmenopausal osteoporosis. PATIENTS AND METHODS: Materials and methods: The researches have been conducted on 120 selected postmenopausal women who were diagnosed with osteoporosis after analysis of the risk factors and carrying out the bone densitometry test - DXA method. The patients were divided into three research groups each comprising with 40 persons, depending on the body mass index BMI.. The first group were postmenopausal women with osteoporosis and with the value of BMI 18-24.9,indicating normal range; second group were postmenopausal women with osteoporosis with the value of BMI 25-29.9,indicating overweight and the third group were postmenopausal women with osteoporosis with the value BMI 30-34.9, indicating obesity. RESULTS: Results: In the group of postmenopausal women with osteoporosis with a BMI value corresponding to obesity, the mean BMD was 0.82 g/cm2. In the overweight and normal body mass index group there were no statistically significant differences in the values obtained, which are 0.78 and 0.79 g/cm2, respectively. The correlation analysis showed a statistically significant positive relationship - the increase in BMI was accompanied by the increasing BMD in the entire study population. The T-score in the densitometric study in relation to BMD was the lowest in people with normal BMI and comparable in the overweight group, while the highest in obese women. CONCLUSION: Conclusions: Of the results of the research: postmenopausal women with osteoporosis confirmed the relationship that there are higher BMD values with increasis BMI values. From the other side owerweight and obesity may determine an intensification of osteoporosis in postmenopausal women.

[Periodontal diseases and risk of osteoporosis - case report].

Osteoporosis is a generalized skeletal disease characterized by an increased risk of fractures resulting from decreased bone mineral density. Risk factors for osteoporosis are genetic determinants and lifestyle related. Osteoporosis also affects the jawbone and mandible and tobacco smokers show a greater degree of periodontitis. The aim of the study is to present the case of a patient with chronic osteoarthritis having a significant influence on periodontal inflammation. The description concerns a male tabacco smoker, aged 50, with osteopenia and progressive atrophy of the alveolar process of the jaw and mandible. An interdisciplinary approach to the patient is necessary to properly assess the stage of periodontal disease with respect to the occurrence or absence of osteoporotic changes in the patient. KEY WORDS.

Transcriptional activity of TGFß1 and its receptors genes in thyroid gland.

INTRODUCTION: Determination of gene-candidates' profile expression responsible for fibrosis, immunosuppression, angiogenesis, and neoplasia processes in the pathogenesis of thyroid gland disease. MATERIAL AND METHODS: Sixty-three patients underwent thyroidectomy: 27 with non-toxic nodular goitre (NG), 22 with toxic nodular goitre (TNG), six with papillary cancer (PTC), and eight with Graves' disease (GD). In thyroid tissues, transcriptional activity of TGFbeta1 and its receptors TGFbetaRI, TGFbetaRII, and TGFbetaRIII genes were assessed using RT-qPCR (Reverse Transcriptase Quantitative Polymerase Chain Reaction). Molecular analysis was performed in tissues derived from GD and from the tumour centre (PTC, NG, TNG) and from peripheral parts of the removed lobe without histopathological lesions (tissue control). Control tissue for analysis performed in GD was an unchanged tissue derived from peripheral parts of the removed lobe of patients surgically treated for a single benign tumour. RESULTS/CONCLUSIONS: Strict regulation observed among transcriptional activity of TGFb1 and their receptor TGFbetaRI-III genes in control tissues is disturbed in all pathological tissues - it is completely disturbed in PTC and GD, and partially in NG and TNG. Additionally, higher transcriptional activity of TGFb1 gene in PTC in comparison with benign tissues (NG, GD) and lower expression of mRNA TGFbRII (than in TNG, GD) and mRNA TGFbetaRIII than in all studied benign tissues (NG, TNG, GD) suggests a pathogenetic importance of this cytokine and its receptors in PTC development. In GD tissue, higher transcriptional activity of TGFbetaRII and TGFbetaRIII genes as compared to other pathological tissues was observed, indicating a participation of the receptors in the pathomechanism of autoimmune thyroid disease (AITD). TGFbeta1 blood concentrations do not reflect pathological processes taking place in thyroid gland. (Endokrynol Pol 2016; 67 (4): 375-382).

Growth hormone/insulin-like growth factor-1 axis, calciotropic hormones and bone mineral density in young patients with chronic viral hepatitis.

INTRODUCTION: Chronic liver disease caused by HBV and HCV infections, due to its great prevalence and serious medical consequences, is at the present time a significant clinical problem. An impaired liver function can provoke severe disturbances in calcium and phosphorus homeostasis, and consequently in the bone metabolism resulting in hepatic osteodystrophy. The aim of this study was to determine whether there are significant differences in bone mineral density (BMD) and/or circadian levels of hormones connected with bone metabolism and bone turnover markers in patients with chronic viral hepatitis. MATERIAL AND METHODS: Circadian levels (AUC, area under the curve) of GH, IGF-I, IGFBP-3, osteocalcin (BGLAP), C-terminal telopeptide of type I collagen (ICTP), PTH, 25(OH)D, total calcium and total phosporus were measured in the blood of members of the study group (n = 80). BMD was assessed using the dual-energy X-ray absorptiometry method of the L2-L4 lumbar spine. Data was compared to that of healthy individuals (n = 40). RESULTS: BMD (1.05 g/cm3 vs. 1.20 g/cm3), total calcium concentration (2.20 mmol/L vs. 2.45 mmol/L), total phosphorus concentration (1.06 mmol/L vs. 1.33 mmol/L), IGF-I (AUC 3,982.32 ng/mL vs. 5,167.61 ng/mL), IGFBP-3 (AUC 725.09 ng/L vs. 944.35 ng/L), 25(OH)D (AUC 356.35 ng/mL vs. 767.53 ng/mL) and BGLAP (AUC 161.39 ng/L vs. 298 ng/L) were lower in the study group. GH (AUC 88.3 ng/mL vs. 48.04 ng/mL), iPTH (AUC 1,201.94 pg/mL vs. 711.73 pg/mL) and ICTP (AUC 104.30 µg/L vs. 54.49 µg/L) were higher in patients with hepatitis. Positive correlations were noted between bone mineral density and IGF-I, IGFBP-3, and BGLAP levels. CONCLUSIONS: Chronic viral hepatitis causes a decrease in bone mineral density. Impaired liver function disrupts homeostasis of the calcium- vitamin D-parathyroid hormone axis and provokes secondary hyperparathyroidism. Chronic viral hepatitis induces a decrease in the synthesis of IGF-I and IGFBP-3 and an increase in GH secretion. Hepatic osteodystrophy is probably caused by both changes in calciotropic hormones as well as in the somatotropin hormone axis.

Transforming growth factor ß1 (TGFß1) and vascular endothelial growth factor (VEGF) in the blood of healthy people and patients with Graves' orbitopathy--a new mechanism of glucocorticoids action?

INTRODUCTION: The first part of this paper is related to healthy people and presents concentrations of TGFß1 and VEGF in blood (with and without dividing data with respect to sex), their single measurement values (at 8 am), Mean Daily Concentrations (MDC), Area Under the Curves (AUC; total daily secretion), and circadian rhythm. The second part of the work is related to Graves' orbitopathy (GO). The aim of the study were: 1) to determine the physiological pattern of TGFß1 and VEGF secretion; 2) to compare the serum TGFß1 and VEGF circadian profile in newly diagnosed thyreotoxic patients with active GO and healthy controls (H); and 3) to estimate the influence of high-dose intravenous methylprednisolone pulse therapy (MP) on TGFb1 and VEGF blood levels in GO. MATERIAL AND METHODS: Twenty-two healthy (H) subjects and 16 hyperthyroid GO patients were treated with MP (6 g/14 days) and followed up by ophthalmological assessment. Blood was collected before and after 2 weeks MP-therapy. TGFß1 and VEGF levels were determined by the ELISA method. RESULTS: No difference was observed in the concentrations of TGFß1 and VEGF in the blood of healthy women and men - in further analysis, a combined healthy male and female cohort was used (H). While the absence of circadian rhythms in the concentrations of TGFß1 and VEGF allows the application of a single measurement approach, MDC and AUC measurements were found to be more precise. There were no differences in TGFß1 MDC/AUC between GO and H. VEGF MDC/AUC in GO were higher than in H. MP-therapy increased TGFb1 MDC/AUC, thus in GO after MP, the TGFß1 MDC/AUC were higher than in H. There were no differences in VEGF MDC/AUC during MP-therapy. MP-therapy was effective in 15/16 patients. CONCLUSIONS: 1. MP-therapy increases MDC and AUC of TGFß1. The effectiveness of MP-therapy in patients with active GO may be related to its influence on TGFß1 concentrations in blood. The results suggest the existence of a new mechanism of glucocorticoids action, consisting of an increase in the secretion of TGFß1.2. The elevated serum VEGF in thyreotoxic patients with active GO may reflect long-standing autoimmune processes in orbital and thyroid tissues and intensified angiogenesis in the thyroid gland.

[The assessment of glucose and lipid parameters in children with a positive family history of hypertension]. / Ocena parametrów przemiany weglowodanowej i lipidowej u dzieci z dodatnim wywiadem rodzinnym w klerunku nadcisnienia tetniczego.

UNLABELLED: Arterial hypertension in adults is often associated with excess body weight, and lipid or carbohydrate disorders. The incidence of hypertension in children is growing, although its connection with metabolic disorders and family history of hypertension has not been previously understood. THE AIM OF THE STUDY: To evaluate the relationship between a family history of hypertension and metabolic parameters (carbohydrate and lipid metabolism) and anthropometric measurements in children and adolescents. MATERIAL AND METHODS: The study group consists of 40 children (mean age 13.6 years +/-2.7 years) with a positive family history of hypertension, and a comparative group of 44 children with a negative family history of hypertension. Anthropometric measurements, blood pressure, plasma insulin, glucose, homeostasis model assessment insulin resistants (HOMA IR), and lipid profiles were determined in all children. RESULTS: Body weight, BMI, WHR, and measurements of skinfolds did not differ significantly between the groups. Systolic blood pressure was significantly higher in the study group (108 vs. 100 Me mmgHg, p = 0.031) Significant differences were observed in the levels of glucose (80 vs. Me. 67 mg/dl, p < 0.001), and insulin (8.89 vs. Me. 5.34 microIU / ml, p = 0.024). The HOMA index showed values significantly higher in the study group (1.68 vs. 0.80 Me p = 0.007). Children with a positive family history of hypertension were characterized by insignificantly higher values of total cholesterol, TG, LDL-cholesterol, and lower HDL-cholesterol. CONCLUSIONS: A positive family history of hypertension correlates with higher systolic blood pressure and changes in carbohydrate metabolism parameters in the direction of the development of insulin resistance in children.

Relationships between adiponectin, sex hormone binding globulin and insulin resistance in hyperthyroid Graves' disease women.

INTRODUCTION: Adiponectin and sex hormone binding globulin (SHBG) play a role in glucose metabolism. Hyperthyroidism has an impact on carbohydrate metabolism and could affect insulin resistance. The aim of this study was to assess the associations between insulin resistance, adiponectin and SHBG among hyperthyroid Graves` disease (GD) women. MATERIAL AND METHODS: The study was undertaken in 60 women with hyperthyroidism in the course of GD; 32 healthy women matched by BMI and age formed the control group. The concentrations of: free thyroxine (fT4), free triiodothyronine (fT3), thyroid-stimulating hormone (TSH), SHBG, insulin, adiponectin and glucose were measured, and the homeostasis model assessment (HOMA-I) was calculated. RESULTS: Compared to euthyroid subjects, hyperthyroid GD women had elevated glucose, fT4, fT3, adiponectin and SHBG concentrations, but there were no differences in HOMA-I. When we explored the relations between adiponectin as well as SHBG with glucose and HOMA-I, we observed that HOMA-I was associated with adiponectin and SHBG only in the control group, and in hyperthyroidism there were no such connections. We found positive associations between adiponectin, SHBG, fT4 and fT3 in the GD group. CONCLUSIONS: Elevated concentrations of adiponectin and SHBG were observed in hyperthyroidism but they were not related to insulin resistance.

Adiponectin, leptin, resistin and insulin blood concentrations in patients with ischaemic cerebral stroke.

INTRODUCTION: Stroke, due to its worldwide prevalence, is not only a medical challenge, but also a serious social problem. Recently, ongoing research has examined whether there are associations between adipose tissue hormones and the risk, mechanisms and course of stroke. The aim of our study was to determine whether there are significant differences in blood concentrations of insulin, adiponectin, leptin, resistin and in insulin resistance among patients in the acute phase of ischaemic stroke, compared to healthy subjects. In addition, we wanted to investigate if those biochemical values show a correlation with the neurological condition of our patients. MATERIAL AND METHODS: Adiponectin, leptin, resistin and insulin were measured in patients (n = 69) with first-ever ischaemic stroke (confirmed by CT), using specific electrochemoluminescence, radioimmunoassay and ELISA methods. Neurological evaluation was performed using Barthel ADL index on the day of admission and on the ninth day of hospitalisation. Insulin resistance value was obtained via the HOMA-IR calculator. Data was compared to that of healthy individuals (n = 26). RESULTS: Insulin concentration (51.08 v. 17.02 uU/mL) and HOMA-IR value (6.3 v. 2.2) were significantly higher in the study group. Leptin (14.98 v. 10.47 ng/mL) and resistin (28.92 v. 12.25 ng/mL) levels were elevated among the stroke survivors compared to controls, but no significant difference was noted in adiponectin. Negative correlations of adiponectin level and Barthel score were observed. CONCLUSIONS: Hyperinsulinaemia and insulin resistance are involved in the pathogenesis of ischaemic stroke. Hyperleptinaemia and hyperresistinaemia play a role in the mechanism of stroke. The severity of stroke is associated with adiponectin blood concentration.