Is vitamin D deficiency an independent risk factor for obesity and abdominal obesity in women?

Introduction: Vitamin D has been determined to have some effects on b cell function and insulin sensitivity, and it is known that type 2 diabetes mellitus and hyperparathyroidism can cause obesity. The aim of our study was to investigate if vitamin D deficiency without diabetes mellitus and metabolic syndrome is associated with obesity and abdominal obesity. Material and methods: The study included 276 healthy premenopausal women. To exclude other causes of obesity, postmenopausal women and subjects with diabetes mellitus and metabolic syndrome were excluded. Women were divided into two groups depending on their 25-hydroxyvitaminD3 [25(OH)D3] levels: subjects with vitamin D deficiency (Group 1) and subjects without vitamin D deficiency (Group 2). Body mass index (BMI), waist circumference (WC), and waist-to-hip ratio (WHR) were compared between the two groups. Results: BMI, WC, WHR, rates of obesity, and abdominal obesity according to WC and WHR of Group 2 were lower than those of Group 1 (p = 0.0005, p = 0.0001, p = 0.0045, p = 0.032, p = 0.002, p = 0.011, respectively). 25(OH)D3 levels negatively correlated with BMIs (r = &#8211;0.480, p < 0.0001), WCs (r = &#8211;0.480, p < 0.0001) and WHRs (r = &#8211;0.312, p < 0.05). There were no differences between serum parathormone, calcium and phosphorus levels of Group 1 and 2 (p = 0.239, p = 0.354, p = 0.95, respectively). Conclusion: Vitamin D deficiency without diabetes mellitus and hyperparathyroidism may be associated with obesity and abdominal obesity.Wstęp: Wykazano, że witamina D wpływa na czynność komórek &beta; i wrażliwość na insulinę. Wiadomo również, że cukrzyca typu 2 i nadczynność przytarczyc mogą powodować otyłość. Celem badania było ustalenie, czy niedobór witaminy D u osób bez cukrzycy i zespołu metabolicznego wiąże się z otyłością i otyłością brzuszną. Materiał i metody: Do badania włączono 276 zdrowych kobiet przed menopauzą. W celu wyeliminowania innych przyczyn otyłości z badania wykluczono kobiety po menopauzie, chore na cukrzycę i osoby, u których rozpoznano zespół metaboliczny. Uczestniczki badania podzielono na 2 grupy w zależności od stężenia witaminy 25-hydroksyD3 [25(OH)D3]: grupa 1 &#8212; osoby z niedoborem witaminy D, grupa 2 &#8212; osoby z prawidłowym stężeniem witaminy D. Porównano wskaźniki masy ciała (BMI, body mass index), obwody talii (WC, waist circumference) i współczynniki talia/biodra (WHR, waist-to-hip ratio) w obu grupach. Wyniki: Wartości BMI, WC, WHR, odsetek osób otyłych i częstość otyłości brzusznej, określone na podstawie WC i WHR, były mniejsze w grupie 2, niż w grupie 1, (odpowiednio p = 0,0005; p = 0,0001; p = 0,0045; p = 0,032; p = 0,002; p = 0,011). Stężenia 25(OH)D3 były ujemnie skorelowane z wartościami BMI (r = &#8211;0,480; p < 0,0001); WC (r = &#8211;0,480; p < 0,0001) i WHR (r = &#8211;0,312; p < 0,05). Nie stwierdzono różnic między grupami pod względem stężeń parathormonu, wapnia i fosforu w surowicy (odpowiednio p = 0,239; p = 0,354; p = 0,95). Wnioski: Niedobór witaminy D u osób bez cukrzycy i nadczynności przytarczyc może się wiązać z otyłością i otyłością brzuszną

Wpływ chorób autoimmunologicznych tarczycy na rozwój otyłości brzusznej i hiperlipidemii

Background: Thyroid autoimmunity has been suggested as a risk factor for atherosclerosis independent of thyroid function in several studies. The aim of this study was to investigate whether thyroid autoimmunity had any effect on hyperlipidaemia, obesity and abdominal obesity independent of thyroid function. Material and methods: 184 premenopausal female patients with Hashimoto&#8217;s thyroiditis (HT) and 150 healthy premenopausal female volunteers as control group (CG) were included in the study. According to thyroid function status, the patients were divided into three subgroups: overt hypothyroid patients (ohp), subclinical hypothyroid patients (shp) and euthyroid patients (ep). Body mass index (BMI), waist to hip ratios, waist circumference (WC), and serum lipid levels of all the participants were determined. These parameters of ep were compared with those of ohp, shp and CG. Relationships among thyroid stimulating hormone (TSH), thyroid autoantibodies and lipid levels were investigated. Results: There were no significant differences between serum total cholesterol and low density lipoprotein cholesterol (LDL-C) levels of ohp and ep with HT (P = 0.18, P = 0.07 respectively) and LDL-C levels of ep were higher than those of CG (P = 0.03, P = 0.042, respectively). Although TSH levels did not correlate with serum lipid levels, levels of anti-thyroid peroxidase antibody correlated with triglyceride levels and WCs (r = 0.158; P = 0.013, r = 0.128; P = 0.048 respectively) and negatively correlated with high density lipoprotein cholesterol (HDL-C) levels (r = &#8211;0.137; P = 0.031). Levels of anti-thyroglobulin antibody also correlated with triglyceride and nonHDL-C levels (r = 0.208; P = 0.007, r = 0.158; P = 0.043 respectively). Conclusion: Thyroid autoimmunity may have some effects on hyperlipidaemia and abdominal obesity independent of thyroid function. (Pol J Endocrinol 2011; 62 (5): 421&#8211;428)Wstęp: Wyniki badań wskazują, że choroby autoimmunologiczne tarczycy są czynnikiem ryzyka miażdżycy, bez względu na czynność tego narządu. Celem badania było ustalenie, czy obecność chorób autoimmunologicznch tarczycy niezależnie od jej funkcji wpływa na rozwój hiperlipidemii, otyłości i otyłości brzusznej. Materiał i metody: Do badania włączono 184 kobiet przed menopauzą z zapaleniem tarczycy typu Hashimoto (HT) i 150 zdrowych ochotniczek przed menopauzą, które stanowiły grupę kontrolną (CG). Chore podzielono na 3 podgrupy w zależności od stanu czynnościowego tarczycy: osoby z jawną niedoczynnością tarczycy (ohp), z bezobjawową niewydolnością tarczycy (shp) i osoby z eutyreozą (ep). U wszystkich uczestniczek badania określono wskaźnik masy ciała (BMI), wskaźnik talia/biodra, obwód talii i stężenia lipidów w surowicy. Powyższe parametry porównano między grupą ep i pozostałymi grupami (ohp, shp, CG). Zbadano zależności między stężeniem TSH, przeciwciał przeciwtarczycowych i stężeniami lipidów. Wyniki: Nie stwierdzono istotnych różnic między stężeniami cholesterolu całkowitego i cholesterolu frakcji LDL między grupami ohp i ep (odpowiednio p = 0,18 i p = 0,07). Stężenia cholesterolu frakcji LDL w grupie ep były wyższe niż w grupie CG (odpowiednio p = 0,03 i p = 0,042). Stężenia TSH nie korelowały ze stężeniami lipidów w surowicy, jednak stwierdzono prostą zależność między stężeniami przeciwciał przeciw peroksydazie tarczycowej i stężeniami triglicerydów oraz obwodem talii (odpowiednio r = 0,158; p = 0,013, r = 0,128; p = 0,048) i odwrotną zależność między cholesterolem frakcji HDL (r = &#8211;0,137; p = 0,031). Stężenia przeciwciał przeciw tyreoglobulinie korelowały ze stężeniami triglicerydów i cholesterolu nie-HDL (odpowiednio r = 0,208; p = 0,007, r = 0,158; p = 0,043). Wnioski: Choroby autoimmunologiczne tarczycy mogą wpływać na rozwój hiperlipidemii i otyłości brzusznej niezależnie od stanu czynnościowego tego narządu. (Endokrynol Pol 2011; 62 (5): 421&#8211;428

Application of alternative anthropometric measurements to predict metabolic syndrome

OBJECTIVE: The association between rarely used anthropometric measurements (e.g., mid-upper arm, forearm, and calf circumference) and metabolic syndrome has not been proven. The aim of this study was to assess whether mid-upper arm, forearm, calf, and waist circumferences, as well as waist/height ratio and waist-to-hip ratio, were associated with metabolic syndrome. METHODS: We enrolled 387 subjects (340 women, 47 men) who were admitted to the obesity outpatient department of Istanbul Medeniyet University Goztepe Training and Research Hospital between September 2010 and December 2010. The following measurements were recorded: waist circumference, hip circumference, waist/height ratio, waist-to-hip ratio, mid-upper arm circumference, forearm circumference, calf circumference, and body composition. Fasting blood samples were collected to measure plasma glucose, lipids, uric acid, insulin, and HbA1c. RESULTS: The odds ratios for visceral fat (measured via bioelectric impedance), hip circumference, forearm circumference, and waist circumference/hip circumference were 2.19 (95% CI, 1.30-3.71), 1.89 (95% CI, 1.07-3.35), 2.47 (95% CI, 1.24-4.95), and 2.11(95% CI, 1.26-3.53), respectively. The bioelectric impedance-measured body fat percentage correlated with waist circumference only in subjects without metabolic syndrome; the body fat percentage was negatively correlated with waist circumference/hip circumference in the metabolic syndrome group. All measurements except for forearm circumference were equally well correlated with the bioelectric impedance-measured body fat percentages in both groups. Hip circumference was moderately correlated with bioelectric impedance-measured visceral fat in subjects without metabolic syndrome. Muscle mass (measured via bioelectric impedance) was weakly correlated with waist and forearm circumference in subjects with metabolic syndrome and with calf circumference in subjects without metabolic syndrome. CONCLUSION: Waist circumference was not linked to metabolic syndrome in obese and overweight subjects; however, forearm circumference, an unconventional but simple and appropriate anthropometric index, was associated with metabolic syndrome and bioelectric impedance-measured visceral fat, hip circumference, and waist-to-hip ratio

Askin's Tumor in an Adult: Case Report and Findings on 18F-FDG PET/CT

Primitive neuroectodermal tumor (PNET) of the chest wall or Askin's tumor is a rare neoplasm of chest wall. It most often affects children and adolescents and is a very rare tumor in adults. In this case report, we present an Askin's tumor occurred in a 73-year-old male. The patient was admitted with a history of 3-month lower back pain and cough. In computed tomography, there was a lesion with dimensions of 70 × 40 × 65 mm in the superior segment of the lower lobe of the left lung. Positron emission tomography/computed tomography with 18F-flourodeoxyglucose revealed a pleural-based tumor in the left lung with a maximum standardized uptake value of 4.36. No distant or lymph node metastases were present. The patient had gone through surgery, and wedge resection of the superior segment of left lobe and partial resection of the ipsilateral ribs were performed. Pathology report with immunocytochemistry was consistent with PNET and the patient received chemotherapy after that

Case Report Papillary Thyroid Microcarcinoma with a Large Cystic Dilated Lymph Node Metastasis to the Neck Mimicking a Branchial Cleft Cyst: A Potential Pitfall

Lateral cervical cystic mass in a young adult very rarely could be a first sign of an occult thyroid papillary microcarcinoma metastasis. In this paper, we presented a 37-year-old male patient whose preoperative 6 cm left lateral cervical cystic mass was initially diagnosed as branchial cleft cyst, but then the postoperative histopathological examination of the mass was revealed as papillary thyroid carcinoma metastasis. Preoperative fine needle aspiration biopsy was relevant with a branchial cleft cyst. In the left thyroid lobe there were 3 solid nodules with 4, 6, and 12 mm dimensions, respectively. One of the nodules had malignant well-differentiated cells diagnosed after fine needle aspiration biopsy. After total thyroidectomy, histopathologic evaluation of biopsy material&apos;s showed papillary thyroid microcarcinomas. This case indicates that especially in a young adult lateral cervical cystic mass should be carefully considered preoperatively for the possibility of metastatic occult thyroid carcinoma, especially for papillary carcinoma in differential diagnosis, and evaluation of the thyroid gland should be taken into account

Pituitary infiltration by non-Hodgkin's lymphoma: a case report

<p>Abstract</p> <p>Introduction</p> <p>Pituitary adenomas represent the most frequently observed type of sellar masses; however, the presence of a rapidly growing sellar tumor, diabetes insipidus, ophthalmoplegia and headaches in an older patient strongly suggests metastasis to the pituitary. Since the anterior pituitary has a great reserve capacity, metastasis to the pituitary and pituitary involvement in lymphoma are usually asymptomatic. Whereas diabetes insipidus is the most frequent symptom, patients can present with headaches, ophthalmoplegia and bilateral hemianopsia.</p> <p>Case presentation</p> <p>A 70-year-old woman with no previous history of malignancy presented with headaches, right oculomotor nerve palsy and diabetes insipidus. As magnetic resonance imaging revealed a sellar mass involving the pituitary gland and infundibular stalk, which also extended into the right cavernous sinus and sphenoid sinus, the patient underwent an immediate transsphenoidal decompression surgery. Her prolactin was 102.4 ng/ml, whereas her gonadotropic hormone levels were low. A low level of urine osmolality after overnight water deprivation, along with normal plasma osmolality suggested diabetes insipidus. Histological examination revealed that the mass had been the infiltration of a high grade B-cell non-Hodgkin's lymphoma involving respiratory system epithelial cells. Paranasal sinus computed tomography scanning and magnetic resonance imaging of the thorax and abdomen were performed. Since magnetic resonance imaging did not reveal any abnormality, after paranasal sinus computed tomography was performed, we concluded that the primary lymphoma originated from the sphenoid sinus and infiltrated the pituitary. Chemotherapy and radiotherapy to the sellar area were planned, but the patient died and her family did not permit an autopsy.</p> <p>Conclusion</p> <p>Lymphoma infiltration to the pituitary is difficult to differentiate from pituitary adenoma, meningioma and other sellar lesions. To plan the treatment of lymphoma infiltration of the pituitary gland, it must be differentiated from other sellar lesions.</p

Response of Macroprolactinemia to Dopamine Agonists

Macroprolactinemia, defined as hyperprolactinemia with a predominance of the big big prolactin (macroprolactin) isoform, is considered idiopathic and poorly symptomatic. Although macroprolactinemia has been considered to be a cause of apparent resistance to antiprolactinemic drugs, prolactin (PRL) normalization with dopaminergic treatment cannot exclude macroprolactinemia. We report three cases with macroprolactinemia, whose PRL and macroprolactin levels were decreased and hyperprolactinemic symptoms were improved with dopamine agonists