The relationship between selected biochemical parameters, clinical factors and bone mineral density in postmenopausal women with osteoporosis

Bone loss in women occurs mainly due to postmenopausal estrogen deficiency and impaired balance between bone resorption by osteoclasts and bone formation by osteoblasts. Objective: The aim of this study was to determine the relationship between selected biochemical parameters, bone turnover markers, clinical parameters and bone mineral density (BMD) in postmenopausal women with osteoporosis. Material and methods: The study group consisted of 85 women treated at the Menopause and Osteoporosis Clinic of the Obstetrics and Gynecological Hospital in Poznań. The average age of the women was 59.9±5.20 years. Quantitative assessment of bone mass at the lumbar spine and proximal femoral epiphysis was performed using DEXA technique. The study included women with BMD expressed as T-score ≤ (-2.5) SD. A multifactorial regression analysis was used to determine the correlation between selected biochemical parameters, clinical factors and BMD. Results: As far as biochemical parameters were concerned, the concentration of estradiol correlated with BMD. The assessed bone turnover markers did not show a correlation with BMD. The following clinical parameters correlated with BMD: age, body mass index - BMI, family history of fractures, bisphosphonates treatment, transdermal hormone replacement therapy use, and intensity of physical activity. Conclusion: It is important to identify risk factors for osteoporosis in women, especially when planning prevention of bone loss in postmenopausal women

Glucocorticoids action in etiology of hypertension

Glikokortykosteroidy (GKS), z których kluczową rolę pełni kortyzol (F), odgrywają wiele istotnych funkcji metabolicznych, przede wszystkim w regulacji stężenia glukozy czy wpływie na przemiany białek i tłuszczy. Zwiększona sekrecja F lub jego nieprawidłowy metabolizm lub zwiększona wrażliwość tkanek na działanie GKS może prowadzić do powstawania zaburzeń metabolicznych i wielu chorób, między innymi nadciśnienia tętniczego. Kluczowym enzymem w metabolizmie F jest dehydrogenaza 11β-hydroksysteroidowa, która katalizuje wzajemne przekształcenie aktywnego biologicznie F i nieczynnego kortyzonu. Izoforma 2 tego enzymu odpowiada za ochronę receptora mineralokortykosteroidowego przed działaniem F. W przypadku defektu jej aktywności, między innymi w zespole pozornego nadmiaru mineralokortykosteroidów, dochodzi do pobudzenia MR przez F, zwiększenia objętości płynów w łożysku naczyniowym i w konsekwencji do nadciśnienia tętniczego. Innym potencjalnym mechanizmem hipertensyjnego działania GKS jest wpływ na syntezę tlenku azotu (NO). Obniżenie stężenia NO, głównego czynnika rozszerzającego naczynia krwionośne, zachodzi między innymi na drodze hamowania ekspresji izoformy 2 i 3 syntazy tlenku azotu, niekorzystnego wpływu na dostępność niezbędnego kofaktora oraz poprzez zmniejszenie poziomu substratu do syntezy NO. W pracy przedstawiono aktualne dane z piśmiennictwa dotyczące udziału GKS w patogenezie nadciśnienia tętniczego.Glucocorticoids (GKS), among which cortisol (F) is the most important factor, have various metabolic functions. They regulate glucose levels and influence proteins and lipids metabolism. Higher secretion of F, its changed metabolism or higher sensitivity of cells or tissues to F might be a source of metabolic disorders and many diseases, inter alia arterial hypertension. The key enzyme in F metabolism is 11b-hydroxysteroid dehydrogenase, which catalyzes the interconversion of F and inactive cortisone. The isoform 2 of that enzyme (11β-HSD2) is responsible for mineralocorticoid receptor’s protection from F. Disturbances in activity of 11β-HSD2, for example in apparent mineralocorticoid excess, lead to mineralocorticoid receptor activation by F, water retention and finally to hypertension. The influence of GKS on nitric oxide (NO) synthesis is another possible mechanism of hypertensive action of GKS. Decrease of NO levels may be an effect of inhibition of expression of nitric oxide synthase isoform 2 and 3, lack of enzyme co-factor or the substrate for NO synthesis. The paper summarises data considering GKS influence on pathomechanism of arterial hypertension. Arterial Hypertension 2010, vol. 14, no 3, pages 208-21

Effect of morphological and functional changes in the secundines on biometric parameters of newborns from dichorionic twin pregnancies

Objectives: The aim of the study was to determine if, and to what extent, structural and functional changes of the secundines influence biometric parameters of neonates from dichorionic twin pregnancies.Material and methods: The study included neonates from dichorionic, diamniotic twin pregnancies, along with their secundines. Based on histopathological examination of the secundines, the mass and dimensions of the placenta, length and condition of the umbilical cord, chorionicity, focal lesions, and microscopic placental abnormalities were determined for 445 pairs of twins. Morphological development of examined twins was characterized on the basis of their six somatic traits, while birth status of the newborns was assessed based on their Apgar scores. Statistical analysis included Student t-tests, Snedecor’s F-tests, post-hoc tests, non-parametric chi-squared Pearson’s tests, and determination of Spearman coefficientsof rank correlation.Results: The lowest values of analyzed somatic traits were observed in twins who had placentas with velamentous or marginal cord insertion. Inflammatory lesions in the placenta and placental abruption turned out to have the greatest impact of all analyzed abnormalities of the secundines. Inflammatory lesions in the placenta were associated with lower values of biometric parameters and a greater likelihood of preterm birth. Neonates with a history of placental abruption were characterized by significantly lower birth weight and smaller chest circumference.Conclusions: Morphological changes in the secundines have a limited impact on biometric parameters of neonates from dichorionic twin pregnancies. In turn, functional changes exert a significant effect and more often contribute to impaired fetal development

Differences in sex hormone levels in the menstrual cycle due to tobacco smoking — myth or reality?

Introduction: Tobacco smoke contains, among others, polycyclic aromatic hydrocarbons (PAHs), heterocyclic analogues, aromatic amines, N-nitrosamines, volatile hydrocarbons, aldehydes, phenols, miscellaneous organic compounds, metals, and inorganic compounds. Tobacco smoking can harm women’s reproductive system and may reduce fertility. The objective of the study was to explore the effect of tobacco smoke on the menstrual cycle due to smoking and second-hand smoke-exposure. Material and methods: The study was performed on 153 women of reproductive age, who received care at the Gynaecological-Obstetric Clinical Hospital of the Poznan University of Medical Sciences. They were divided into three treatment groups: non-smokers, secondhand smokers, and smokers. Comprehensive assessment of all hormone levels: follicle-stimulating hormone (FSH), luteinizing hormone (LH), 17β-oestradiol (E2), and progesterone (P), in the various phases of the menstrual cycle and with concomitant determinations of serum cotinine concentrations was performed. The menstrual cycle was observed with ultrasonography. Results: Cigarette smoking may be an important factor in disrupting reproduction: 1. The increase in the oestradiol E2 level was accompanied by significantly lowered serum cotinine concentrations in tobacco smokers; 2. In smoking patients, the serum level of LH significantly increased on the first days of the menstrual cycle; 3. The higher levels of P (in the 14th and 21st days) were assumed to be the result of a longer menstrual cycle. Conclusions: Active and passive smoking may be an important contributor to reproductive health issues and deserves greater focus in health education programs directed towards women of reproductive age

Peripartum prolactin and cortisol level changes. A prospective pilot study

Although the role of prolactin and cortisol in the human lactation process seems to be undisputed, the changes in postpartum serum concentrations in mothers make data interpretation difficult. To determine the factors that possibly influence these hormones, we examined a group of patients who were admitted to the Gynecology-Obstetrics Clinical Hospital in Poznan for labor induction and/or in the active phase of the first labor period. The serum levels of cortisol and prolactin were assessed in these full-term pregnant women during admission to labor, in the third stage of labor, and on the second day postpartum. The prolactin and cortisol levels were also measured in the umbilical cord for the assessment of newborn babies. The results showed a significant relationship between maternal age and the level of prolactin measured before childbirth and fluctuations in cortisol level with respect to labor duration. In addition, we observed a strong correlation between the level of prolactin assessed before childbirth and the pH and base excess of the umbilical cord artery. Most importantly, a correlation was noted between breastfeeding within two hours after the labor and the level of cortisol measured after childbirth, which is worth mentioning to emphasize the significance of early maternal–neonatal skin-to-skin contact