THE IMPACT OF 12-MONTH GROWTH HORMONE REPLACEMENT THERAPY ON LIPID METABOLISM AND ADIPOSE TISSUE DISTRIBUTION IN GEORGIAN PATIENTS WITH ADULT GROWTH HORMONE DEFICIENCY.

Growth hormone deficiency (GHD) is one of the reasons of significant metabolic morbidities inchildren and adults. The aim of our study was to evaluate the impact of growth hormone (GH) replacement therapy on lipid profile and adipose tissue distribution in adults with GHD. Twenty hypopituitary adults, aged 40.75±2.2 years (mean ± SE, range 20.5-60), with adult onset GHD (aGHD) were enrolled in a randomized, double blind, placebo-controlled study. 10 patients received recombinant growth hormone injection once weekly for 12 months, and the rest 10 patients (as control group) received placebo. The patients were selected from the basis of National Institute of Endocrinology. After 12 months of treatment mean values of low density lipoprotein cholesterol (LDL-CH), total cholesterol (CH) and triglycerides (TG) were increased in GH treated patients, compared to the control group (median increase in LDL-CH, CH and TG were 0.1 mmol/l, 0.1 mmol/l and 0.3mmol/l, respectively). In contrast, the favorable effect was seen in high density lipoprotein cholesterol (HDL-CH) levels with the median increase of 0.2 mmol/l). Furthermore, there was an increase in adipose tissue distribution percentages, in GH treated patients (DXA: Legs +10.22%, Trunk: +7.43%, Android: +5.59%, Gynoid: +10.59%, Total body: +7.6%), compared to the control group, in which adipose tissue distribution was slightly improved or remained unchanged. Since the results of 12-month growth hormone treatment therapy did not show any improvements in lipid profile and adipose tissue distribution, the decision was made to prolong the study for the next 12 months.

[METABOLIC SECRETION IN REPRODUCTIVE AGE WOMEN WITH OBESITY].

For the last decade melatonin has attracted attention as a neuroregulator in pathogenesis of obesity and metabolic syndrome. The aim of our study is to evaluate the characteristics of metabolic secretion in obese women of reproductive age. The study was conducted on the total number of 120 women. Eighty women with obesity formed the case group, and forty healthy women - the control group. Carbohydrate metabolism, lipid profile and serum levels of melatonin were evaluated in all study subjects. According to the results, 61.3% of the total study population had insulin resistance and 60% had dyslipidemia. Melatonin hypersecretion, with the mean level of melatonin 129.4±124.9, was observed in the case group. The mean level of melatonin in the control group was 107.5±10.9, which was 17% less than in the case group. Melatonin secretion was in significant correlation with patients' age (P=0.022), family history of myocardial infarction (P=0.030), excess carbohydrate intake (P=0.051) and enlarged ovaries (P=0.050). Our results confirm the relationship between obesity, metabolic abnormalities (insulin resistance, dyslipidemia) and melatonin hypersecretion in women of reproductive age.

[Effect of leptin on bone mineral dencity in premenopausal and postmenopausal women].

Leptin raises considerable interest as a potential mediator of the protective effects of fat mass on bone tissue. The literature data support the hypothesis that leptin can act directly or indirectly on bone remodeling. However, such influence is not confirmed possibly because of the shifting balance between stimulatory direct action and suppressive indirect action of leptin on bones. The effects of oestrogen decline and deficiency during natural or artificially induced menopause and hormone replacement therapy on leptin production remains controversial. Various studies have shown differences in leptin values in pre-and postmenopausal women. Larger clinical studies are necessary to assess central and peripheral role of leptin in the overall maintenance of bone turnover.

[Characteristics of occlusal plane in patients with class iii malocclusion].

Occlusive plane of teeth is the line of teeth which connects upper and lower teeth. Direction and level of occlusive plane determines normal function of dento-skeletal system and is very important for facial aesthetics. The aim of our study was to determine position of occlusive plane in relation to alveolar bases of upper and lower jaws in patients with class III malocclusion, also to analyze characteristics of occlusive plane changes during the growth. After analysis of the results of our study, we can conclude that during the growth and development of facial skeleton occlusive plane of examined patients with class III malocclusion rotates counter-clockwise, due to decrease of vertical dimension (height) of dento-alveolar segment in lower molar area.