63 research outputs found
Influence of hormonal therapy on growth rate and bone age progression in patients with Turner syndrome
Celem pracy była ocena skuteczności leczenia hormonalnego u pacjentek z zespołem Turnera (TS) poprzez analizę tempa wzrastania i progresji wieku kostnego w trakcie stosowania hormonu wzrostu (GH), oxandrolonu (Ox) i estrogenów (E). 62 pacjentki z TS w zależności od rodzaju zastosowanej terapii podzielono na pięć grup: grupę GH (n=11); GH+Ox (n=18); GH+Ox+E (n=7); Ox+E (n=6) oraz grupę 0, którą stanowiły pacjentki nie leczone. Wzrost pacjentek wyrażano w wartościach standaryzowanych obliczonych według siatek dla TS (hSDST), a wiek kostny (BA) oceniano metodą Greulich-Pyle. Wyniki: Średnie wartości ∆hSDST uzyskane w poszczególnych grupach w pierwszym i drugim roku terapii różniły się znamiennie, co wynikało z istotnie wyższych wartości ∆hSDST w grupie GH+Ox. Na podstawie analizy regresji pomiędzy przyrostem wieku metrykalnego w trakcie terapii (∆CA) a przyrostem wieku kostnego w tym czasie (∆BA) uzyskano w poszczególnych grupach współczynniki kierunkowe α równania ∆BA=α x ∆CA, które różniły się istotnie, co wynikło ze znamiennie wyższych ich wartości w grupie GH niż w grupie 0 i GH+Ox. Tylko w grupie GH+Ox stwierdzono ujemną korelację pomiędzy początkowych CA a ∆BA. Wnioski: Wszystkie formy terapii przyczyniły się do poprawy tempa wzrastania u naszych pacjentek, jednak największy przyrost wzrostu przy najmniejszej progresji wieku kostnego obserwowano w grupie GH+Ox.The efficacy of growth promoting hormonal therapy is assessed on the basis of growth rate as well as bone age progression until the patients reach their final height. The aim of our study was to investigate which hormonal therapy influences in most appropriate way height velocity and bone age progression in patients with Turner syndrome (TS) and to establish the optimal age to initiate treatment. Patients were divided into five groups according to the type of hormonal therapy:1) 11 patients treated with growth hormone (GH); 2) 18 patients treated with GH and oxandrolone (Ox); 3) 7 patients treated with GH, Ox and estrogens (E); 4) 6 patients treated with OX and E; and the control group (Group 0) of 62 untreated patients. The patients height was expressed in hSDS calculated on the basis of growth chart for patients with TS (hSDST). Bone age (BA) was assessed according to Greulich-Pyle method. Results: The mean values of ∆hSDST in the first and second year of therapy in individual groups were significantly different. The difference resulted from significantly higher value of ∆hSDST in group treated with GH+Ox. Analysis of regression between ∆CA and ∆BA revealed regression coefficients α of equation ∆BA= α x ∆CA: in group 0: 0.817; group GH: 1.233; group GH+Ox: 0.861; group GH+Ox+E: 0.997; group Ox+E: 1.141. There was significant difference between regression coefficients in studied groups. It resulted from significantly higher value of α in group treated with GH than in a group 0 and treated with GH+Ox. Only group treated with GH+Ox showed a significant negative correlation between baseline CA and ∆BA during the therapy. We can conclude that all regimens of hormonal therapy improved height in our patients but the highest increase of height during the therapy and the smallest progression of the bone age in the same time were observed in patients treated with GH+Ox
Body weight and adipose tissue distribution in adolescents with mild and moderate asthma
WSTĘP. Ograniczenie aktywności fizycznej oraz konieczność stosowania
przewlekłej steroidoterapii u pacjentów z astmą oskrzelową
może być przyczyną nadmiernego przyrostu masy ciała.
Celem pracy była ocena masy ciała i rozmieszczenia tkanki tłuszczowej
u młodzieży z astmą oskrzelową leczonej przewlekle steroidoterapią
wziewną i/lub doustną.
MATERIAŁ I METODY. W badaniu wzięło udział 143 pacjentów
(71 dziewcząt i 72 chłopców) w wieku 15,1-19,5 lat. Średni czas
leczenia steroidami wynosił 10 ± 3,7 lat. Grupę kontrolną stanowiło
zdrowe rodzeństwo: 89 sióstr i 77 braci. U wszystkich badanych
obliczono wskaźnik masy ciała (BMI, body mass index) oraz współczynnik
talia–biodra (WHR, waist to hip ratio). Nadwagę i otyłość
określano na podstawie wartości powyżej 90. i 97. percentyla na
siatkach odpowiednich dla płci i wieku. WYNIKI. Nadwagę i otyłość stwierdzono u 17 chorych na astmę
i u 19 zdrowych. Różnica ta nie była istotna statystycznie. U obu
płci średnia wartość BMI i WHR nie różniła się istotnie u pacjentów
leczonych wziewnie od pacjentów leczonych drogą wziewną i doustną
(odpowiednio: p = 0,064 i p = 0,31).
WNIOSKI. Metoda przewlekłej steroidoterapii u młodzieży z astmą
oskrzelową o lekkim i umiarkowanym przebiegu nie ma istotnego
wpływu na ich masę ciała i na sposób rozmieszczenia tkanki
tłuszczowej.INTRODUCTION. Adolescents with asthma may be at risk for obesity
or overweight due to decreased physical activity and chronic
glucocorticoid treatment.
The aim of the study was to evaluate body weight and adipose
tissue distribution in patients with mild and moderate asthma treated
only with inhaled or inhaled and oral steroid.
MATERIAL AND METHODS. Anthropometric measurements were
performed in a group of 143 patients (71 girls, 72 boys) with asthma
in the age 15.1-19.5 years treated with steroids for a mean
time of 10 ± 3.7 SD years. Healthy siblings - 89 sisters and
77 brothers served as a control group. In all of them body mass index
(BMI) and waist-to-hip ratio (WHR) were calculated. Overweight and obesity were assessed according to 90 and 97 BMI percentile
on the charts appropriate for age and gender.
RESULTS. Seventeen asthmatic children and nineteen healthy
controls were overweight or obese. The difference between groups
was not statistically significant. The BMI and WHR values were
not significantly different between the groups of asthmatic children - regardless of gender and the way of steroids application (p
= 0.064 and 0.31).
CONCLUSION. Chronic oral and inhaled glucocorticoid therapy in
children with mild and moderate bronchial asthma does not influence
their body mass and fat distribution
Hyperandrogenism in adolescent girls with type 1 diabetes mellitus treated with intensive and continuous subcutaneous insulin therapy
Wstęp: U kobiet z cukrzycą typu 1 (T1DM) stwierdza się zwiększoną częstość występowania klinicznych i biochemicznych objawów
hiperandrogenizmu. Celem pracy była ocena profilu hormonalnego oraz częstości występowania hiperandrogenizmu u dojrzewających
dziewcząt z T1DM.
Materiał i metody: Do badania włączono 47 dziewcząt z T1DM oraz 19 zdrowych i 21 dziewcząt z zespołem policystycznych jajników
(PCOS). U wszystkich dziewcząt dokonano oceny klinicznej i ultrasonograficznej oraz przeprowadzono badania hormonalne przed i po
stymulacji analogiem GnRH.
Wyniki: U dziewcząt z T1DM pierwsza miesiączka występowała istotnie później aniżeli u zdrowych dziewcząt [13,1 (12,0–14,0) v. 12,0
(11,0–12,0) lat, p = 0,02]. Dziewięć (19,2%) z nich spełniało kryteria rozpoznania PCOS (T1DM+PCOS). U dziewcząt z cukrzycą, u których
zdiagnozowano PCOS, stwierdzono istotnie niższą średnią HbA1c od początku zachorowania na T1DM aniżeli u dziewcząt z T1DM bez
PCOS [6,7 (6,6–7,2) v. 7,3 (6,4–7,8)%, p = 0,049]. Hirsutyzm, objętość jajników oraz profil hormonalny nie różniły się pomiędzy grupami.
HbA1c oznaczona w momencie badań oraz średnia HbA1c z ostatniego roku korelowały negatywnie ze stężeniem SHBG (r = –0,5,
p = 0,006; r = –0,04, p = 0,02). Dziewczęta T1DM+PCOS miały istotnie niższy indeks wolnych androgenów [3,0 (2,6–4,3) v. 8,6 (6,5–10,8),
p = 0,04] i objętość jajnika aniżeli dziewczęta z PCOS nie chorujące na cukrzycę [4,6 (2,7–5,2) v. 7,4 (4,3–10,0) ml, p = 0,007].
Wnioski: Kliniczne objawy PCOS u dojrzewających dziewcząt z T1DM są łagodniejsze aniżeli u dojrzewających dziewcząt nie chorujących
na cukrzycę. Może być to spowodowane protekcyjną rolą SHBG i mniejszą ilością wolnych androgenów. (Endokrynol Pol 2013; 64 (2): 121–128)Introduction: Women with type 1 diabetes mellitus (T1DM) experience high prevalence of hyperandrogenic disorders. The aim of this
study was to evaluate hormonal profile with respect to hyperandrogenic disorders in adolescents with T1DM.
Material and methods: Forty seven adolescent girls with T1DM were evaluated and compared to 19 healthy and 21 non-diabetic girls
with polycystic ovary syndrome (PCOS). In all subjects, basal and GnRH analogue stimulated androgens, gonadotropins and SHBG were
measured and ultrasonography of ovaries was performed.
Results: Girls with T1DM experienced first menses significantly later than healthy controls [13.1 (12.0–14.0) v. 12.0 (11.0–12.0) years,
p = 0.02]. Nine (19.2%) of them fulfilled PCOS criteria (T1DM+PCOS). They had significantly mean HbA1c from the diagnosis of T1DM
than T1DM girls with no PCOS [6.7 (6.6–7.2) v. 7.3(6.4–7.8)%, p = 0.049]. Hormonal profile, hirsutism score and ovarian volume did not
differ significantly between the two groups. HbA1c at the study point and mean HbA1c for the last 12 months correlated negatively with
SHBG level (r = –0.5, p = 0.006; r = –0.04, p = 0.02). T1DM+PCOS girls had significantly lower FAI [3.0 (2.6–4.3) v. 8.6 (6.5–10.8), p = 0.04]
and ovarian volume than non-diabetic PCOS girls [4.6 (2.7–5.2) v. 7.4 (4.3–10.0) mL, p = 0.007].
Conclusions: Clinical symptoms of PCOS in adolescent girls with T1DM are milder than in non-diabetic peers, probably due to the protective
role of higher SHBG resulting in lower free androgen level. (Endokrynol Pol 2013; 64 (2): 121–128
Social abilities and gender roles in adolescent girls with polycystic ovary syndrome — a pilot study
Wstęp: Kliniczne i hormonalne objawy zespołu policystycznych jajników (PCOS), które często ujawniają się już w okresie dojrzewania, mogą znacząco wpływać na rozwój emocjonalny i psychiczny stan zdrowia młodych dziewcząt. Celem pracy była ocena kompetencji społecznych oraz ról płciowych u nastoletnich dziewcząt z PCOS w porównaniu do zdrowych rówieśniczek, oraz określenie zależności pomiędzy profilem psychologicznym a klinicznymi i hormonalnymi składowymi PCOS.Materiał i metody: U 28 nastoletnich dziewcząt z PCOS oraz u 12 zdrowych, regularnie miesiączkujących dziewcząt dokonano oceny klinicznej i hormonalnej oraz przeprowadzono kwestionariusz kompetencji społecznych (KKS) i inwentarz do oceny płci psychologicznej (IPP).Wyniki: Nie stwierdzono istotnych statystycznie różnic we wszystkich częściach KKS ocenianych w liczbach bezwzględnych oraz skalistenowej pomiędzy grupą badaną a kontrolną. Również różnice pomiędzy badanymi grupami w IPP, zarówno w skali kobiecości, jak i w skali męskości, nie były istotne statystycznie. W grupie badanej stężenie DHEAS korelowało pozytywnie z kompetencjami warunkującymi efektywność zachowań w sytuacji ekspozycji społecznej (r = 0,4; p = 0,03). Stwierdzono również istotną korelację negatywną pomiędzy stężeniem testosteronu a KKS (r = –0,5; p = 0,01), jak również kompetencjami warunkującymi efektywność zachowań w sytuacjach intymnych (r = –0,5; p = 0,02).Wnioski: Zależności pomiędzy KKS i IPP a BMI z-score i hirsutyzmem nie były statystycznie istotne. Pomimo obecności klinicznychi hormonalnych składowych PCOS, które mogą wpływać na kondycję socjopsychologiczną, u nastoletnich dziewcząt z PCOS, kompetencje społeczne oraz role płciowe wydają się być niezaburzone.Introduction: Clinical and hormonal features of polycystic ovary syndrome (PCOS), which may be present already in adolescence, cansignificantly influence the psychological development and wellbeing of a young woman.The aim of this pilot study was to determine social competence and gender roles in adolescent girls with PCOS compared to healthy peers, and to evaluate the relationship between psychological profile and clinical and hormonal components of PCOS.Material and methods: In 28 adolescent girls with PCOS, and 12 healthy regularly menstruating girls, clinical evaluation and hormonal profile were assessed and social competence inventory (SCI) and psychological gender inventory (PGI) tests were performed.Results: There were no significant differences in all parts of SCI in absolute numbers or in sten scores between the study and the control group. Also in PGI, in both the feminine and masculine gender schemes, the differences between the groups were statistically insignificant. In the study group, DHEAS concentration correlated positively with self presentation score (r = 0.4, p = 0.03). There was also a significant negative correlation between testosterone level and SCI score (r = –0.5, p = 0.01) as well as assertiveness score (r = –0.5, p = 0.02). Nosignificant correlations between SCI or PGI with BMI z-score or hirsutism score were found.Conclusions: Despite the existence of clinical and biochemical features that can influence sociopsychological condition, in adolescent girls with PCOS, social abilities and sex-typical behaviours do not seem to be disturbed
Depression, anxiety and self-esteem in adolescent girls with polycystic ovary syndrome
Objectives: Objective of the study was to evaluate the depression, anxiety and perceived stress level in adolescent girls with diagnosed polycystic ovary syndrome (PCOS), as well as to assess their body and self-esteem and its impact on emotional status.
Material and methods: In 27 adolescent girls with confirmed diagnosis of PCOS (study group) as well as 27 healthy, regularly menstruating, age and BMI matched girls (control group) Hospital Anxiety and Depression Scale (HADS), Perceived Stress Scale-10 (PSS-10), Rosenberg Self-Esteem Scale (RSES) and Body-Esteem Scale (BES) containing three subscales (sexual attractiveness, weight concern, physical condition) were performed.
Results: There were no significant differences between PCOS group and control group in depression and PSS-10 scores, but the anxiety score was significantly higher in control than in PCOS group (9.6 ± 3.0 vs 7.3 ± 3.9, p = 0.02). Moreover, in BES subscales’ scores there were no significant differences between the groups, whereas RSES score was significantly higher in PCOS group (25.0 ± 7.1 vs 28.3 ± 4.6, p = 0.04). In PCOS group anxiety score was related to PSS-10 score (r = 0.56, p = 0.005). Moreover, we found that obesity was negatively related to anxiety (rƴ = –0.4, p = 0.04), depression (rƴ = –0.48, p = 0.02), PSS-10 (rƴ = –0.59, p = 0.004) and physical condition scores (rƴ = –0.44, p = 0.04). In girls with PCOS the more severe depression the worse weight control (rƴ = –0.56, p = 0.04).
Conclusions: We conclude that in adolescent girls PCOS is not related to anxiety and depressive symptoms as well as poor self-esteem
Complications of obesity in children and adolescents
W ciągu ostatnich kilkudziesięciu lat częstość otyłości dziecięcej
gwałtownie wzrosła. Szacuje się, że na świecie aktualnie około
110 milionów dzieci ma nadwagę lub otyłość. Epidemia otyłości
dziecięcej stała się jednym z poważniejszych wyzwań dla współczesnego
społeczeństwa, przede wszystkim z powodu jej klinicznych
i społecznych konsekwencji. Czasy, kiedy otyłe dziecko postrzegano
jako zdrowe, są już historią. Celem niniejszej pracy było
wskazanie najczęstszych powikłań otyłości u dzieci i młodzieży.
Skoncentrowano się na ich dwóch kategoriach. Do pierwszej zaliczono
powikłania występujące już w okresie dzieciństwa, takie jak
zaburzenia psychologiczne, powikłania ze strony układu krążenia,
zaburzenia metaboliczne i powikłania ze strony układu oddechowego.
Do drugiej włączono powikłania występujące u dorosłych,
u których otyłość trwa od wczesnego dzieciństwa lub od okresu
dojrzewania. Zwrócono uwagę na zwiększone ryzyko chorób układu
sercowo-naczyniowego, przedwczesne zgony, zmniejszenie
płodności oraz konsekwencje socjalno-ekonomiczne.During the past decades the prevalence of childhood obesity increased
worldwide. About 110 million children are now classified
as overweight or obese. The recent epidemic of childhood obesity is one of the most serious problems of modern society mainly
because of the clinical and public health consequences. Historically
a fat child meant a healthy child. The aim of the present
review was to demonstrate the consequences of obesity
in children and adolescents. We focused on two major categories
- co-morbidities of obesity in childhood such as psychological
burden, increased cardiovascular risk factors, metabolic
disturbances and sleep apnea and consequences for the
adult who was obese as a child or adolescent. In the latter
increased cardiovascular risk factors, premature mortality, decreased
fertility and negative socioeconomic effects were discussed
Depression, anxiety and self-esteem in adolescent girls with polycystic ovary syndrome
Objectives: Objective of the study was to evaluate the depression, anxiety and perceived stress level in adolescent girls with diagnosed polycystic ovary syndrome (PCOS), as well as to assess their body and self-esteem and its impact on emotional status.Material and methods: In 27 adolescent girls with confirmed diagnosis of PCOS (study group) as well as 27 healthy, regularly menstruating, age and BMI matched girls (control group) Hospital Anxiety and Depression Scale (HADS), Perceived Stress Scale-10 (PSS-10), Rosenberg Self-Esteem Scale (RSES) and Body-Esteem Scale (BES) containing three subscales (sexual attractiveness, weight concern, physical condition) were performed.Results: There were no significant differences between PCOS group and control group in depression and PSS-10 scores, but the anxiety score was significantly higher in control than in PCOS group (9.6 ± 3.0 vs 7.3 ± 3.9, p = 0.02). Moreover, in BES subscales’ scores there were no significant differences between the groups, whereas RSES score was significantly higher in PCOS group (25.0 ± 7.1 vs 28.3 ± 4.6, p = 0.04). In PCOS group anxiety score was related to PSS-10 score (r = 0.56, p = 0.005). Moreover, we found that obesity was negatively related to anxiety (rƴ = –0.4, p = 0.04), depression (rƴ = –0.48, p = 0.02), PSS-10 (rƴ = –0.59, p = 0.004) and physical condition scores (rƴ = –0.44, p = 0.04). In girls with PCOS the more severe depression the worse weight control (rƴ = –0.56, p = 0.04).Conclusions: We conclude that in adolescent girls PCOS is not related to anxiety and depressive symptoms as well as poor self-esteem
Lipid Profile in Adolescent Girls with Type 1 Diabetes Mellitus and Hyperandrogenemia
Study Objectives. The study aim was to evaluate whether hyperandrogenemia in adolescent girls with type 1 diabetes mellitus (T1DM) may adversely influence lipid profile. Design and Participants. Lipid levels in 16 diabetic girls with biochemical hyperandrogenemia (T1DM-H) aged 16.3 ± 1.2 years were compared to 38 diabetic girls with normal androgen levels (T1DM-N) aged 15.8 ± 1.2 years. 15 healthy girls served as controls (CG). In all patients, anthropometric measurements were done, and androgens and SHBG were assessed. Results. In T1DM-H, total cholesterol (TC) and low density cholesterol (LDL-ch) were significantly higher than in CG (196.1 ± 41.2 versus 162.7 ± 31.7 mg/dL, p=0.01; 117.3 ± 33.1 versus 91.3 ± 27.8 mg/dL, p=0.01, resp.). Their LDL-ch, non-high density cholesterol (non-HDL-ch) concentrations, and LDL/HDL ratio were also significantly higher than in T1DM-N (117.3 ± 33.1 versus 97.7 ± 26.7 mg/dL, p=0.03; 137.3 ± 42.9 versus 113.3 ± 40.4 mg/dL, p=0.04; 2.8 ± 3.7 versus 1.6 ± 0.5, p=0.04, resp.). In stepwise multiple linear regression, free androgen index (FAI) and waist-to-hip ratio (WHR) were associated with TC (R2=0.4, p<0.0006), non-HDL-ch (R2=0.4, p<0.0003), and LDL-ch (R2=0.4, p<0.0008). Triglycerides and LDL/HDL ratio were (R2=0.7, p<0.0001, R2=0.6, p<0.0003 resp.) related to testosterone, FAI, WHR, and mean HbA1c. Conclusion. Lipid profile in diabetic adolescent girls is adversely influenced by the androgens level, particularly in the group with higher WHR and poorer glycemic control
EVALUATION OF THE CORTISOL CONCENTRATIONS IN PATIENTS WITH SCHIZOPHRENIA
Introduction: The hypothalamus-pituitary-adrenal axis (HPAA) plays a pivotal role in response to a range of external and
internal factors often described as a “stress”. Growing evidence in a literature, suggest various dysregulations of HPAA, in course
of numerous mental disorders. Patients with schizophrenia and bipolar disorder seem to have elevated basal cortisol secretion, what
might be caused by the diminution of glucocorticoid receptors’ amount. It was of the interest if the cortisol concentrations in patients
with diagnosed schizophrenia who underwent treatment, differs from healthy individuals.
Materials and methods: Two groups of participants were included into the study. First group (study) consisted of 10 patients
with diagnosed schizophrenia and control group which included 38 healthy individuals. Study was divided into two stages, first one
(pilot) included only control group, and utilized cortisol concentrations measurement from saliva, blood and 24h urine sample.
Second part (main study) involved both groups although focused on a salivary cortisol concentrations.
Results: A mean salivary cortisol concentration in patients with schizophrenia who underwent treatment was significantly lower
in comparison with healthy individuals.
Conclusions: Obtained results indicate that patients who underwent a treatment, and does not present notable clinical signs of
schizophrenia may have moderately lowered levels of salivary cortisol. This may be a reflection of relenting psychotic symptoms as
well as a direct effect of atypical antipsychotic drugs on a HPA axis activity
Are Psychosocial Consequences of Obesity and Hyperandrogenism Present in Adolescent Girls with Polycystic Ovary Syndrome?
The objective of this study was to evaluate whether body weight status and clinical hyperandrogenism may influence social competencies and psychological gender features in adolescent girls. Design and Participants. In 104 adolescent girls, psychological gender inventory (PGI) and social competencies questionnaire (SCQ) (assessing social abilities in three aspects: intimacy (I), social exposure (SE), and assertiveness (AS)) were performed. Subjects were divided into four subgroups: G1—24 nonobese girls without hyperandrogenism, G2—18 obese girls without hyperandrogenism, G3—30 nonobese hyperandrogenic girls, and G4—32 obese girls with hyperandrogenism. Results. There were no significant differences in all parts of SCQ and PGI between the study and control groups. The feminine woman type dominated in all groups; in G3 and G4, masculine woman type appeared more often than in G1 and G2 (13.3% and 12.5% versus 4.0% and 0.0%, resp.). In G4, positive relationship between BMI z-score and SCQ (, ) was found. In G1, the relationship was opposite (, ). Hirsutism correlated negatively with SCQ (, ), I (, ), and AS (, ) only in G1; in other groups, this relationship was insignificant. In G4, higher testosterone level was associated with lower SCQ (, ) and AS (, ). In G2, testosterone concentration correlated positively with SCQ (, ), SE (, ), and AS (, ). Conclusion. In adolescent girls, neither body weight nor clinical features of hyperandrogenism seem to be the source of evaluated disorders in psychological functioning
- …