The Level of Intima-Media Thickness in Patients with Metabolic Syndrome in Poland Depending on the Prevalence of Type 2 Diabetes.

BACKGROUND: Metabolic syndrome (MetS), increasingly diagnosed among the Polish population, is a combination of factors that are associated with an increased risk of atherosclerosis and cardiovascular diseases. Intima-media thickness (IMT) of the common carotid artery has been suggested as, simply, a non-invasive and reproducible marker of the early stages of the atherosclerotic process. The carotid IMT can also be a strong predictor of future cerebral and cardiovascular events. The aim of our study was to evaluate atherosclerotic lesions in carotid vessels in patients with MetS depending on the presence of DMt2 and to assess which demographic factors affect the level of IMT. The study involved 335 subjects diagnosed with MetS, including 211 females (65%) and 124 males (37%) aged 37-82. The diagnosis of MetS was made on the basis of the International Diabetes Federation (IDF) criteria. The patients were divided into two subgroups: with DMt2 and without DMt2. The value of IMT depended on gender, education, and smoking status. We noticed that patients with DMt2 had the highest measurement of IMT compared with other groups (1.01 vs. 0.98). Additionally, a statistically significant difference between the subgroup with DMt2 and those without DMt2 was found (1.01 vs. 0.92; p < 0.005). Ultrasound assessment of the carotid IMT should be used more often in the diagnosis and monitoring of high cardiovascular risk and early progression of atherosclerosis, especially in patients with MetS with current DMt2.

Assessment of Metabolic Parameters in Female Triathletes with Hashimoto's Thyroiditis in Poland.

Background: Hypothyroidism is a complex disorder characterized by an increase in body weight. About 15-30% of hypothyroid patients are reported to be overweight. The triathlon is an endurance combination sport that comprises a sequential swim, cycle, and run. Triathletes must withstand high training loads with various combinations of intensity and volume. Adequate body structure, the ratio of fat and muscle tissue, and adequate hydration play a huge role. The aim of our study was to show the potential differences in metabolic parameters assessed by medical Body Composition Analyzer before the initiation of treatment with L-thyroxine and after 3 and 6 months of treatment in females who practiced triathlon and who were newly diagnosed with Hashimoto's thyroiditis. Methods: The study group included 32 females practicing triathlon. They were recruited for 10 months from March to December 2021. Analysis of anthropometric measurements was performed using a seca device mBCA 515 medical Body Composition Analyzer. Results: We observed significant differences in FM and VAT before and after L-thyroxine treatment. We also noticed lower BMI levels after treatment, along with significant differences in thyroid function tests (TSH and fT4) carried out during the recruitment period and after 3 and 6 months of treatment. Conclusion: Due to their higher daily energy consumption, further research is needed into the treatment of Hashimoto's thyroiditis in athletes who practice triathlon. Frequent bioelectrical impedance analysis of body composition during treatment can be very helpful.

The role of vitamin D in women with Hashimoto's thyroiditis.

INTRODUCTION: Autoimmune thyroid diseases (AITD), including Hashimoto's thyroiditis (HT), are the most common organ specific autoimmune disorders. Vitamin D (vit-D) is a steroid molecule, mainly produced in the skin, which regulates the expression of many genes. The vitamin D receptor (VDR) is found in most tissues and cells in the body. Many studies suggests that vit-D deficiency, which is common worldwide, could also play an important role in autoimmune diseases, including HT. The aim of our study was to show the potential differences in vit-D levels between healthy women and individuals with hypothyroidism and HT. Additionally, we assessed the correlation between vit-D concentration and the level of TSH and anti-thyroid antibodies in females diagnosed with HT. MATERIAL AND METHODS: The study group included 370 subjects. The group was divided into 3 subgroups: (125 - healthy individuals, 111 - hypothyreosis, 134 - HT). Anthropometric measurements including height and weight were obtained in all participants. Body mass index (BMI) was calculated as body weight (in kilograms) divided by the square of body height (in metres). The measurement of the thyroid gland was performed using an ultrasound scan with a 10-MHz linear probe by one endocrinologist (Vivid S60N). RESULTS: We noticed that a lower level of vit-D was connected with a higher level of TSH in each subgroup. There was also strong, negative correlation between TSH and vit-D levels in all the study groups. Moreover, there was a weak, negative correlation between antithyroid peroxidase antibody (anti-TPO) and antithyroglobulin antibody (anti-TG) and vit-D levels in females with HT regardless of vit-D status: < 20 ng/mL, 20-30 ng/mL, and > 30 ng/mL. CONCLUSIONS: To our knowledge, the current study is the first in Poland to compare vit-D status in healthy patients and patients with hypothyroidism, taking into account the level of antibodies (anti-TPO and anti-TG). The results of our study suggest that vit-D supplementation in patients with hypothyroidism, especially in the course of AITD, although determining its optimal, safe dose requires further research.

The Low Energy Availability in Females Questionnaire (LEAF-Q) as a Useful Tool to Identify Female Triathletes at Risk for Menstrual Disorders Related to Low Energy Availability.

BACKGROUND: Nutrition in sport is a priority; it is the basis for maintaining optimal health and a prerequisite for the high performance necessary for competitions. The aim of this study was to assess low energy availability and its possible consequences among female triathletes by using the Low Energy Availability in Females Questionnaire (LEAF-Q). METHODS: The study involved 30 female triathetes. The LEAF-Q was used in the study. An analysis of the body composition was carried out with the seca device mBCA 515 medical Body Composition Analyzer. RESULTS: Of the 30 female triathletes studied, 23.3% had a monthly cycle disorder, defined as an amenorrhea state for more than 90 days. No differences were found in injury rates or training days lost to injury due to menstrual disturbances. Menstruation changes were significantly greater due to increases in exercise intensity, frequency, and duration in the group experiencing menstrual disturbances (85.7 [95% CIs: 42.1-99.6] vs. 8.7 [95% CIs: 1.1-28.0]). The menstrual disorder group had a greater incidence of their periods stopping for more than 3 months than the group without menstrual disturbances. CONCLUSIONS: The female triathletes did not show abnormalities in body weight or composition, and these were not related to the incidence of menstrual disturbances. However, 20% of the triathletes either had, at the time of the study, or had had in the past monthly cycle disorders that could indicate an immediate risk of low energy availability. The LEAF-Q identified 10% of the triathletes as at risk (score > 8) of low energy availability and the physiological and performance consequences related to relative energy deficiency in sports (RED-S).

Aberrations in carbohydrate metabolism in patients with diagnosed acromegaly - observational study.

INTRODUCTION: Acromegaly is characterized by excessive secretion of growth hormone (GH). The incidence rate of acromegaly is 40 to 70 persons per one million people. Carbohydrate disorders often accompany the above pathology. The aim of this study was to examine the influence of high levels of somatotropin on aberrations in glycaemia in patients with acromegaly, and then a 5-year observation. MATERIAL AND METHODS: The study group consisted of 86 patients (48 females and 38 males) with acromegaly diagnosed on the basis of clinical features, elevated insulin-like growth factor 1 (IGF-1) levels, and/or no inhibition of GH ≤ 1 ug/L secretion during 2 hours after an oral glucose load. RESULTS: In the study group type 2 diabetes mellitus (T2DM) was diagnosed in 21 patients (24.4%). There were also 14 cases (16.3%) of the diagnosis of impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) combined. The mean age of participants with concomitant T2DM was 52.1 years, while the mean age of those without carbohydrate metabolism disturbances was 46.1 years. During a 5-year observation, we noticed an increase level of glycated haemoglobin (HbA1c) and new cases of pre-diabetes and T2DM. CONCLUSION: In patients with acromegaly the incidence rate of T2DM is 3-4 times higher than in the rest of the population, and it increases with age, especially after the patient reaches 55 years old.

An Assessment of the Early Symptoms of Energy Deficiency as a Female Athlete Triad Risk among the Polish National Kayaking Team Using LEAF-Q.

Background: Kayaking is a high intensity sport that demands high levels of aerobic and anaerobic capacity as well as a great deal of strength and endurance. The aim of this study was an assessment of the frequency of occurrence of early low energy availability symptoms using the Low Energy Availability in Females Questionnaire for women belonging to the Polish national kayaking team. Additionally, quantitative measurements of body composition and levels of calcium were performed. Methods: The study involved 33 women who were competitors in the Polish national kayaking team. Results: An analysis of the results in terms of disorders in the monthly cycle in the tested kayakers found that only five competitors, approximately 15% of the entire group, had this type of problem. Between the participants who had disorders of the menstrual cycle and those whose cycle was normal, there was only a statistically significant difference at the level of p < 0.001 in relation to the age of the kayakers. Conclusions: The Low Energy Availability in Females Questionnaire proved to be a useful screening tool, which allowed for the early detection of Female Athlete Triad symptoms in several young female kayakers from the Polish national team.

Metabolic syndrome in women - correlation between BMI and waist circumference.

INTRODUCTION: Metabolic syndrome (MetS), which includes abdominal obesity, hypertension, hypertriglyceridaemia, low high-density lipoprotein cholesterol and elevated fasting plasma glucose, is now well understood. The prevalence of MetS is increasing all over the world. Central obesity is the main and the most common component of MetS. The most simple, practical, and frequently used tool for assessing body weight is body mass index. The aim of our study was to show the correlation between waist circumference (WC) and BMI in women with MetS depending on its components. MATERIAL AND METHODS: It was a study of 36-month duration (2016-2019) conducted in University Hospital No. 1 in Bydgoszcz, Poland. The study included 696 women with diagnosed MetS according to the 2009 International Diabetes Federation criteria. RESULTS: In the study group, WC was found to be significantly correlated with BMI according to the arterial hypertension, T2DM, IFG, lower HDL-C, and higher TG level. CONCLUSION: We should consider changing the WC guidelines for Europeans, but for this we need more prospective studies.

Verbal Fluency in Metabolic Syndrome.

Metabolic syndrome (MetS) or otherwise insulin resistance (IR) is described as a cluster of several commonly occurring disorders, including abdominal obesity; lipids disorders, such as hypertriglyceridemia; and low levels of high-density-lipoprotein cholesterol (HDL-C), hypertension (≥130/85 mmHg), and carbohydrates disorders, such as impaired fasting glucose or diabetes mellitus type 2. Type 2 diabetes (T2DM) constitutes insulin resistance, which is a strong risk factor for strokes. Patients with MetS are often prone to cognitive decline. Metabolic risk factors, hypertension, and diabetes, amongst them, have been hypothesized to play a great role in the pathogenesis of Alzheimer's disease (AD) and the development of vascular dementia. For neuropsychological diagnostic and theoretical purposes verbal fluency is defined as a cognitive function that facilitates information retrieval from memory. It engages executive control and other cognitive processes, such as selective attention, selective inhibition, mental set shifting, internal response generation, and self-monitoring, as well as imagination and psychomotor skills. A total of 90 subjects, divided into 2 groups, patients with MetS (45) and healthy controls (45), were assessed. A significant difference in performance was found between the patients and controls, both in the phonetic (p < 0.01) and semantic fluency trials (p < 0.001). The MetS patients produced less words in the letter K and animal categories. The analysis of descriptive statistics shows that the group of patients with metabolic syndrome generated fewer words in both the phonetic and semantic categories. Our study shows that there is an association between metabolic factors and the verbal fluency performance of MetS patients. This is true, especially for phonetic verbal fluency, which is traditionally connected with the frontal cortex. Lower switching signifies possible executive dysfunctions amongst people with MetS. Subjects with this condition generated more diverse words and created less standard associations. This further implies the existence of dysexecutive syndrome and the need for diagnosing patients in this direction and involving this group of people in therapy. The proper correction of MetS components may improve cognitive function.

Hyperprolactinemia and insulin resistance.

Hyperprolactinaemia is the most common dysfunction of the hypothalamic-pituitary axis and occurs more commonly in women. The prevalence of hyperprolactinaemia ranges from 0.4% in the general adult population to as high as 9-17% in women with reproductive diseases. It is accompanied by the phenomenon of insulin resistance (IR), which is also a significant clinical problem nowadays. The prevalence of IR is increasing, particularly in developing countries and in younger populations, with estimates of prevalence ranging from 20 to 40% in different populations. The aim of our review is to summarize recent data on the possible association between IR and hyperprolactinaemia. This review is based on an electronic search of the literature in the PubMed database published from 2000 to 2022 using combinations of the following keywords: IR, hyperprolactinemia or IR and hyperprolactinemia. The references included in previously published review articles were also checked, and any relevant papers were also included. Numerous scientific studies have shown a relationship between IR and hyperprolactinaemia. Increased plasma prolactin (PRL) levels are often associated with an increase in tissue resistance to insulin. There are many scientific theories explaining the probable mechanisms of this phenomenon. One is the finding that glucose and PRL act synergistically in inducing the transcription of insulin genes. It is also suggested that PRL may act as a regulator of insulin sensitivity and metabolic homeostasis in adipose tissue. The topic of the mutual correlation of hyperprolactinaemia and IR is important, and it certainly requires further research and observation.

Insulin resistance in metabolic syndrome depending on the occurrence of its components.

INTRODUCTION: Metabolic syndrome (MetS) is described as a cluster of several commonly occurring disorders including abdominal obesity, hypertension (HT) (≥ 130/85 mm Hg), carbohydrate disorders: impaired fasting glucose or type 2 diabetes mellitus and lipids disorders such as hypertriglyceridaemia (TG), and low levels of high-density-lipoprotein cholesterol (HDL-C). Insulin resistance (IR) is defined as a glucose homoeostasis disorder involving a decreased sensitivity of muscles, adipose tissue, liver, and other body tissues to insulin, despite its normal or increased concentration in blood. MATERIAL AND METHODS: The study group included 424 subjects with MetS (260 females, 164 males). All patients were recruited for 24 months from the Internal Ward of the District Hospital in Wabrzezno, Poland and the Department of Endocrinology and Diabetology Collegium Medicum in Bydgoszcz, Poland. The diagnosis of the MetS was made on the basis of International Diabetes Federation (IDF) criteria. MetS diagnosis was established when three or more criteria were met. To evaluate and measure IR, a hyperinsulinaemic-euglycaemic clamp was performed in each patient. IR was also determined through HOMA-IR. RESULTS: All patients of the study group were diagnosed with obesity, 73.5% with high fasting glucose levels, 66.9% with HT, 48.3% with lower level of HDL-C, and 38.2% with TG. It did not have an influence on the IR results. The study group was divided into 6 subgroups according to the constellation of 3 particular components of MetS (O + DM2T + ↑TG; O + HT + DM2T; O + DM2T + ↓HDL-C; O + HT + IFG; O + HT + ↑TG and O + HT + ↓HDL-C). IR of different degree was diagnosed in all patients of the study group. The results of our study showed that the highest IR was observed in patients with central obesity accompanied by DM2T and ↑TG. Also in subgroups with DM2T and HT or DM2T and ↓HDL-C, a high index of IR was noticed. CONCLUSIONS: The occurrence of IR in patients with MetS is obvious. However, despite the fact that they are high or very high cardiovascular risk patients, they are not a homogeneous group. Such patients differ from each other depending on the presence and constellation of particular disorders that make up the diagnosis of the MetS. Patients with MetS are a heterogeneous group differing in degree of IR and the risk of CVD.

Evaluation of lipid profiles in patients with metabolic syndrome according to cardiovascular risk calculated on the basis of the SCORE chart.

INTRODUCTION: Metabolic syndrome predicts the development of CVD. Lipid abnormalities probably have an important influence on the increase of cardiovascular death risk. The SCORE chart includes only total cholesterol level, which may be inadequate. The aim of our study was to evaluate the lipid profile in patients with metabolic syndrome according to the cardiovascular risk calculated on the basis of the SCORE chart. MATERIAL AND METHODS: The study participants comprised 974 patients with metabolic syndrome. The 10-year death risk of cardiovascular disease was calculated on the basis of SCORE chart in all patients. The study group was divided in three subgroups depending on the risk level calculated by SCORE scale. RESULTS: There was a significantly higher level of LDL-C fraction in the subgroup of very high CV risk in comparison to the group of medium and high CV risk. The level of non-HDL-C was also significantly higher in the group with SCORE ≥ 10 compared to the remaining subgroups of medium and high CV risk. CONCLUSIONS: Increased CV risk in this group of patients may be associated not only with higher TC level, but also the other lipid fractions. The assessment of the CV risk on the basis of the SCORE chart, which includes only TC level, may be inadequate. A modification of the SCORE chart for the European population should be considered (inclusion of LDL-C level, or in selected cases non-HDL-C level instead of TC level). (Endokrynol Pol 2016; 67 (3): 265-270).

Admission glucose and left ventricular systolic function in non-diabetic patients with acute myocardial infarction.

Carbohydrate metabolism disorder in patients hospitalized due to acute ST-segment elevation myocardial infarction (STEMI) is associated with poor outcome. The association is even stronger in non-diabetic patients compared to the diabetics. Poor outcome of patients with elevated parameters of carbohydrate metabolism may be associated with negative impact of these disorders on left ventricular (LV) function. The aim of the study was to determine the impact of admission glycemia on LV systolic function in acute phase and 6 months after myocardial infarction in STEMI patients treated with primary angioplasty, without carbohydrate disorders. The study group consisted of 52 patients (9 female, 43 male) aged 35-74 years, admitted to the Department of Cardiology and Internal Medicine, Collegium Medicum in Bydgoszcz, due to the first STEMI treated with primary coronary angioplasty with stent implantation, without diabetes in anamnesis and carbohydrate metabolism disorders diagnosed during hospitalization. Echocardiography was performed in all patients in acute phase and 6 months after MI. Plasma glucose were measured at hospital admission. In the subgroup with glycemia ≥7.1 mmol/l, in comparison to patients with glycemia <7.1 mmol/l, significantly lower ejection fraction (EF) was observed in acute phase of MI (44.4 ± 5.4 vs. 47.8 ± 6.3 %, p = 0.04) and trend to lower EF 6 months after MI [47.2 ± 6.5 vs. 50.3 ± 6.3 %, p = 0.08 (ns)]. Higher admission glycemia in patients with STEMI and without carbohydrate metabolism disturbances, may be a marker of poorer prognosis resulting from lower LV ejection fraction in the acute phase and in the long-term follow-up.

The effect of hypothyroidism occurring in patients with metabolic syndrome.

INTRODUCTION: Metabolic syndrome involves abdominal obesity, arterial hypertension, type 2 diabetes and lipid disorders manifested as atherogenic dyslipidaemia. Abnormal thyroid function affects the severity of MetS components, since regulating metabolism is one of the most important functions of thyroid hormones. In this study, we present the influence of hypothyroidism on lipid and carbohydrate disorders in patients with MetS. MATERIAL AND METHODS: The described study was a prospective, two-centre screening study of 24-month duration. The study participants were 441 patients (350 women, 91 men, aged 28-82) with metabolic syndrome diagnosed according to the 2005 IDF. RESULTS: By comparing the study and the control group, statistically significant differences were observed in the mean triglyceride levels (respectively 161,5 vs. 134,8 mg/dL, p = 0.047), mean fasting glycaemia (respectively 111,8 vs. 126,1 mg/dL, p = 0.044) and TG/HDL ratio (4,74 vs. 3,71, p = 0.043). Hypothyroidism shows a positive correlation with the TG levels and TG/HDL-C ratio and a negative correlation with the mean fasting glycaemia in people with MetS. A significantly higher TG/HDL-C ratio and lower mean insulin sensitivity ratio observed in men with hypothyroidism, indicated higher insulin resistance in men. CONCLUSIONS: In view of the above, it may be hypothesized that in patients with both MetS and hypothyroidism, especially of male gender, the risk of death of cardiovascular causes is greater due to the severity of MetS components. Moreover, we suggest that in patients recently diagnosed with MetS, active detection of hypothyroidism should be performed by determining the TSH levels, while patients diagnosed with hypothyroidism (apart from replacement therapy) should be monitored for the possible occurrence of MetS in the future.

Correlation between Body Mass Index and Waist Circumference in Patients with Metabolic Syndrome.

Metabolic syndrome is defined as a group of coexisting metabolic risk factors, such as central obesity, lipid disorders, carbohydrate disorders, and arterial hypertension. According to the 2005 IDF criteria, subsequently revised in 2009, abdominal obesity is identified as the waist circumference of ≥80 cm in women and ≥94 cm in men. It is responsible for the development of insulin resistance. The aim of our study was to demonstrate a correlation between waist circumference (WC) and body mass index (BMI) in patients with metabolic syndrome in relation with hypertension, lipid disorders, and carbohydrate disorders. A cross-sectional two-site study was conducted in the Kuyavian-Pomeranian Voivodeship for 24 months. The study group consisted of 839 patients with diagnosed metabolic syndrome: 345 men (41.1%) and 494 women (58.9%) aged 32-80. In the study group, WC was found to be significantly correlated with BMI (R = 0.78, P < 0.01). The presence of overweight in men (BMI 25, 84 kg/m(2)) and even normal body weight in women (BMI 21,62 kg/m(2)) corresponds to an increased volume of visceral tissue in the abdomen. Introduction of primary prophylaxis in those people to limit the development of diabetes mellitus type 2 and cardiovascular diseases should be considered.

Insulin resistance and thyroid disorders.

Insulin resistance is defined as a glucose homeostasis disorder involving a decreased sensitivity of muscles, adipose tissue, liver and other body tissues to insulin, despite its normal or increased concentration in blood. Insulin resistance may be asymptomatic or occur presenting a variety of disorders, such as: glucose tolerance impairment, type 2 diabetes, as well as hypercholesterolaemia, hypertriglyceridaemia, obesity, and arterial hypertension. Insulin acts via specific receptors present on the surface of most cells of the body. The greatest number of these receptors is found on adipocytes, hepatocytes and striated muscle cells. There are three mechanisms of insulin resistance: pre-receptor, receptor and post-receptor. Multiple methods of assessing insulin resistance are based on the concurrent measurements of glucose and insulin levels in blood serum. The glucose and insulin measurements are conducted in baseline conditions or after intravenous administration of a specific quantity of glucose or insulin. The methods of assessing insulin resistance are divided into direct and indirect. The current 'gold standard' in the assessment of insulin sensitivity is the determination of tissue glucose utilisation using the metabolic clamp technique. The presence of disorders of carbohydrate metabolism has been demonstrated in thyroid disease involving either overt hyperthyroidism or overt hypothyroidism. The severity of the disease is proportional to the severity of these disorders. The possible influence of subclinical forms of both hyperthyroidism and hypothyroidism on carbohydrate disorders is still under discussion. Thyroid hormones have a significant effect on glucose metabolism and the development of insulin resistance. In hyperthyroidism, impaired glucose tolerance may be the result of mainly hepatic insulin resistance, whereas in hypothyroidism the available data suggests that the insulin resistance of peripheral tissues prevails.

Congenital vascular malformations in scintigraphic evaluation.

BACKGROUND: Congenital vascular malformations are tumour-like, non-neoplastic lesions caused by disorders of vascular tissue morphogenesis. They are characterised by a normal cell replacement cycle throughout all growth phases and do not undergo spontaneous involution. Here we present a scintigraphic image of familial congenital vascular malformations in two sisters. MATERIAL/METHODS: A 17-years-old young woman with a history of multiple hospitalisations for foci of vascular anomalies appearing progressively in the upper and lower right limbs, chest wall and spleen. A Parkes Weber syndrome was diagnosed based on the clinical picture. Due to the occurrence of new foci of malformations, a whole-body scintigraphic examination was performed. A 12-years-old girl reported a lump in the right lower limb present for approximately 2 years, which was clinically identified as a vascular lesion in the area of calcaneus and talus. Phleboscintigraphy visualized normal radiomarker outflow from the feet via the deep venous system, also observed in the superficial venous system once the tourniquets were released. In static and whole-body examinations vascular malformations were visualised in the area of the medial cuneiform, navicular and talus bones of the left foot, as well as in the projection of right calcaneus and above the right talocrural joint. CONCLUSIONS: People with undiagnosed disorders related to the presence of vascular malformations should undergo periodic follow-up to identify lesions that may be the cause of potentially serious complications and to assess the results of treatment. Presented scintigraphic methods may be used for both diagnosing and monitoring of disease progression.

Hashimoto's thyroiditis and carbohydrate metabolism disorders in patients hospitalised in the Department of Endocrinology and Diabetology of Ludwik Rydygier Collegium Medicum in Bydgoszcz between 2001 and 2010.

INTRODUCTION: Chronic lymphocytic thyroiditis, also known as Hashimoto's thyroiditis, is the most frequent type of thyroiditis. An average of 2% of the population have the disease. It occurs in all age groups, also in children. The main cause of the disease are autoimmune disorders, which results in incresed risk of suffering from type 1 diabetes. Fourthermore, during the course of Hashimoto's thyroiditis, hypothyroidism may cause carbohydrate metabolism disorders. Aim of our study was estimate disturbances of glycaemia in patients with recognized Hashimoto's thyroiditis, hospitalized in Endokrinology and Diabetology Depatment of Collegium Medicum University of Nicolaus Copernicus in Bydgoszcz in years 2001-2010. MATERIAL AND METHODS: We examined 54 patients with the diagnosis of Hashimoto thyroiditis based on clinical picture and examination(autoantibodies anti-TPO and anti-Tg). RESULTS: In the tested group with Hashimoto's thyroiditis, diabetes has been confirmed in 27.8% of the patients; impaired fasting glycaemia (IFG) or impaired glucose tolerance (IGT) occurred in 16.6%, whereas a normoglycaemia has been confirmed in 55.6% of the pacients. An average age of the patients with Hashimoto's thyroiditis and diabetes at the same time, was 53 years. The patients in which we confirmed the impaired fasting glycaemia or impaired glucose tolerance were on average 49.9 years old. An average age of the patients without any carbohydrate methabolism disorders was on average 43.1 years. CONCLUSIONS: Carbohydrate metabolism disorders in the form of type 1 diabetes connected with an autoimmune process, as well as type 2 diabetes connected with the increase of the insulin resistance, occured in average of half of the patients with Hashimoto's thyroiditis.

Aberrations in carbohydrate metabolism in patients with diagnosed acromegaly, hospitalized in the Endocrinology and Diabetology Department of Collegium Medicum University of Nicolaus Copernicus in Bydgoszcz in the years 2001-2009.

INTRODUCTION: The incidence rate of acromegaly is 50 to70 persons per one million people. It occurs twice as often in women than in men, especially in middle age. In the course of the disease, insulin resistance develops, which is connected with the hypersecretion of somatotropin. Type 2 diabetes mellitus occurs more frequently in patients with acromegaly than in the rest of the population. It is diagnosed in 13-56% of acromegaly sufferers; impaired glucose tolerance occurs in 16-46% of examined patients with acromegaly. The aim of this study is to estimate disturbances of glycaemia in patients with diagnosed acromegaly, hospitalized in the Endocrinology and Diabetology Department of Collegium Medicum University of Nicolaus Copernicus in Bydgoszcz in the years 2001-2009. MATERIAL AND METHODS: The participants were a group of 70 patients with acromegaly diagnosed on the basis of clinical symptoms, high levels of somatotropin, and MRI imaging of the pituitary gland. RESULTS: Type 2 diabetes was diagnosed in 19 patients (27%); there were 11 cases (15%) of diagnosis of impaired fasting glycaemia (IFG) and imapired glucose tolerance (IGT) combined. Normoglycaemia was recognized in 57% of participants (40 patients). The average age of participants with concomitant type 2 diabetes was 56.1 years, whereas the average age of those without carbohydrate metabolism disturbances was 47.1 years. CONCLUSIONS: In patients with acromegaly, the incidence rate of type 2 diabetes is 3-4-times higher than in the rest of the population and increases with age, especially after the age of 60.

Single photon emission computed tomography in pulmonary embolism - estimation of selected, scintigraphic regions of interests.

BACKGROUND: Pulmonary embolism is considered dangerous form of thrombo-embolic venous disease contracted by 25000 people annually with around 30% deaths. Accurate diagnosis of the disease and treatment could reduce mortality rate by several per cent. Discernment of ailment is obstructed by variety of clinical picture. Suspicion of pulmonary embolism is verified by diagnostic patterns, among which SPECT is used as well. Aim of this study was to prove perfusion scintigraphy with use of SPECT evaluated together with radiological examinations of chest could be efficient method of pulmonary embolism diagnosis. MATERIAL/METHODS: SPECT of lungs was performed in 92 patients, examinations were compared to X-ray scans of chest and in 13 cases to computer tomography. Regions of interest in symmetric zones of chest were also traced in order to evaluate differences radiotracer accumulation. RESULTS: Pulmonary embolism was diagnosed by means of SPECT in 59 patients (64.1%). Radiological examinations allowed to exclude other causes of decreased pulmonary perfusion. CONCLUSIONS: Difference over 10% in radiotracer accumulation in symmetric zones among patients with pulmonary embolism was stated in 42 patients, 5-10% - in 15,under 5% - in 2. Drawing symmetric regions of interest all over lungs indicates essential points of decreased perfusion whereas difference in radiotracer accumulation is greater than 10%.

A single photon emission computed tomography of the chest with the use of receptor radiotracer (Tc-99m-Depreotide) in sarcoidosis.

BACKGROUND: Sarcoidosis is a systemic and multiorgan disease with unknown etiopathogenesis. Granulomas that do not undergo necrosis and caseous degeneration are distinctive for this disease. Mostly it is connected with young adults, more frequently females than males, and changes are mainly situated in the lymph nodes of the pulmonary hilus and pulmonary parenchyma. Somatotropin release inhibiting hormone receptors could be located in epithelioid and giant cells that create sarcoidal tubercles and lymph nodes. Aim of the study was to determine the usefulness of a single photon emission tomography (SPECT) for an evaluation of the range of sarcoidal changes in the chest after using a receptor tracer. An assumption was made that scintigraphy with the use of Tc-99m-Depreotide could help with location of extrapulmonary sarcoidosis focuses. MATERIAL/METHODS: Authors present five patients with clinically recognized and histopathologically confirmed sarcoidosis. Patients were given Tc-99m-Depreotide and underwent SPECT of chest. The results were compared with X-rays of these patients chests and with the accumulation of radiotracer in 2 other patients with carcinoid syndrome without visible pathological changes in examination. Patients got an intravenous injection of 500 MBq (14mCi) Tc-99m-Depreotide. SPECT of chest together with a "whole body" examination, was performed after 2 hours and 24 hours. RESULTS: Higher radiotracer accumulation was observed in all patients in the area of some chest lymph nodes, in pulmonary tissue in 3 patients and in other groups of lymph nodes in 2 patients. CONCLUSIONS: Emission Tomography of the chest with the use of receptor radiotracer (Tc-99m-Depreotide) can be a crucial complement of sarcoidosis diagnostics in an evaluation of the extent of lung changes together with an estimation of chest lymph nodes abnormalities.