Galanin-like peptide and its correlation with androgen levels in patients with polycystic ovary syndrome

Introduction: We aimed to investigate serum galanin-like peptide (GALP) levels and their correlation with hormonal and metabolic parameters in patients with polycystic ovary syndrome (PCOS). Material and methods: The study included 48 women (age range, 18–44 years) with a diagnosis of PCOS, and a control group that included 40 healthy females (age range, 18–46 years). Waist circumference, body mass index (BMI), and Ferriman-Gallwey score were evaluated and plasma glucose, lipid profile, oestradiol, progesterone, total testosterone, prolactin, insulin, dehydroepiandrosterone sulphate (DHEA-S), follicle-stimulating hormone (FSH), luteinizing hormone (LH), thyroid-stimulating hormone (TSH), 25-hydroxyvitamin D (25(OH)D), fibrinogen, d-dimer, C-reactive protein (CRP), and GALP levels were measured in all study subjects. Results: Waist circumference (p = 0.044) and Ferriman-Gallwey score (p = 0.002) were significantly higher in patients with PCOS compared to the control group. Among the metabolic and hormonal parameters studied, only total testosterone was significantly higher in patients with PCOS (p = 0.002). Also, the serum 25(OH)D level was significantly lower in the PCOS group (p = 0.001). CRP, fibrinogen, and D-dimer levels were all similar between the 2 groups. Serum GALP level was significantly higher in PCOS patients (p = 0.001). GALP was negatively correlated with 25(OH)D (r = –0.401, p = 0.002) and positively correlated with total testosterone values (r = 0.265, p = 0.024). Multiple regression analysis revealed that both total testosterone and 25(OH)D significantly contributed to GALP levels. Conclusions: Our study is the first in the literature to evaluate serum GALP levels in patients with PCOS. Increased GALP levels in PCOS and its association with total testosterone levels might show that GALP can act as an intermediary in increased GnRH-mediated LH release, which is one of the underlying pathogenetic mechanism of PCOS

Serum neudesin levels in patients with polycystic ovary syndrome

Objectives: We aimed to investigate serum neudesin levels that has neural, metabolic functions in patients with polycystic ovary syndrome (PCOS). Material and methods: The study included 180 women (age range, 18–44 years) with a diagnosis of PCOS and a control group that included 100 healthy females (age range, 18–46 years). Body mass index (BMI), waist circumference, Ferriman-Gallwey score, was evaluated and plasma glucose, lipid profile, estradiol, progesterone, total testosterone, prolactin, insulin, dehydroepiandrosterone sulfate (DHEA-S), FSH, LH, free T3, free T4, thyroid stymulating hormone (TSH), anti-thyroperoxidase (anti-TPO) antibody and neudesin levels were evaluated in all participants. Results: BMI and waist circumference were similar between two groups. Ferriman-Gallwey score was significantly higher in the patient group. Fasting blood glucose, HbA1C, lipid parameters except triglyceride levels, free T3, free T4, TSH, anti-TPO were similar between the two groups. Triglyceride, insulin and HOMA values were significantly higher in PCOS patients. While follicle-stimulating hormone (FSH), estradiol, progesterone, prolactin and DHEAS levels were similar, LH was significantly higher in patients with PCOS. Serum neudesin level was significantly lower in PCOS patients with respect to controls (p = 0.015). Neudesin was positively correlated with insulin (r = 0.224, p = 0.037), and progesterone (r = 0.716, p = 0.001). Multiple regression analysis revealed that neudesin correlated with only progesterone (beta = 0.308, p = 0.001). Conclusions: Due to the association of decreased levels of neudesin with PCOS and correlation of neudesin with progesterone, neudesin may be related with one of patophysiologic pathways of PCOS. Still, it is not certain that decreased neudesin is involved in the pathogenesis of PCOS or is the result of the disorder

Does Glucagon-Like Peptide-1 Have a Role in the Etiopathogenesis of Gestational Diabetes?

Purpose: The aim of this study was to evaluate glucagon-like peptide-1 (GLP-1) levels, lipid parameters, thyroid-stimulating hormone (TSH), c peptide and glycated hemoglobin (A1C) values in pregnant women at high-risk for gestational diabetes mellitus (GDM)

Interference in ACTH immunoassay negatively impacts the management of subclinical hypercortisolism

WOS: 000399738100012PubMed ID: 28247312Purpose Low plasma corticotropin is considered a useful parameter for the diagnosis of subclinical hypercortisolism in patients with an adrenal incidentaloma. However, immunoassays are vulnerable to interference from endogenous antibodies. In this study, subjects who underwent Hypothalamus-pituitary-adrenal axis evaluation for the assessment of subclinical hypercortisolism were evaluated. The objective of the study was to ascertain whether antibody interference in corticotropin immunoassay affected the diagnostic work-up and clinical decisions. Methods The 437 consecutive patients with incidentally discovered adrenal adenomas were included in this single centre study. Patients who had a combination of a nonsuppressed corticotropin concentration (> 4.4 pmol/L) and a non-suppressed cortisol concentration after 1 mg overnight dexamethasone suppression test (> 50 nmol/L) were selected. Eight eligible subjects without specific features of Cushing's syndrome were identified and recruited for interference studies and follow-up. Nine controls including one patient with unilateral adrenalectomy and one patient with Cushing's disease were recruited as well. Measurements Eligible subjects and controls were subjected to hormonal tests and investigations for suspected interference. Interference studies included measurement of corticotropin on a different analytical platform, serial dilutions, polyethylene glycol precipitation and heterophilic antibody analysis. Patients were followed with clinical and laboratory parameters for a median duration of 30 (12-90) months. Results Antibody interference was identified in four patients. Rheumatoid factor was responsible for the interference in one patient. Clinical management of the patients was affected by the erroneous results. Interference tests were negative in control subjects. Conclusion Erroneous results associated with analytical interference negatively impacted on clinical decision making in this patient group. This should be considered particularly in conditions such as subclinical hypercortisolism which decisions depend on laboratory investigations mainly. Analytical interference could explain the high variability observed both in field measurements from patients who were expected to have lower corticotropin concentrations and in subclinical hypercortisolism prevalence reported by different studies. Many problems can be resolved by ensuring good communication between clinical and laboratory staff

Impact of Accompanying Comorbidities on Survival in Patients with Stage IIIB- IV Non-Small-Cell Lung Cancer

The aim of the study was to investigate the impact of accompanying comorbidities on survival in non-small-cell lung carcinoma (NSCLC) patients. A total of 221 patients with stage IIIB- IV NSLC between May 1998 and April 2009 were included. Survival data was analyzed according to age (those younger than 65 and those 65 and older) and Charlson Comorbidity Index (CCI) scores. Eighty-six (39%) patients were aged 65 and older, and the remaining 135 (61%) were younger than 65. In the 65 and over group the median survival of patients was 44 months for CCI Group 0, 16 months for CCI Group 1, 10 months for CCI Group 2, and 10 months for CCI Group 3. For the younger group, the median survival time was 19 months for CCI Group 0, 18 months for CCI Group 1, 11 months for CCI Group 2, and 11 months for CCI Group 3. There were no statistically significant differences in the comorbidity factors regarding survival in the two groups of patients. In conclusion, the frequency of comorbidity factors increased in stage IIIB and IV NSCLC patients as age increased. Although survival in patients with higher CCI scores was shorter, the CCI was not associated with survival for patients having local advanced and metastatic disease; no significant difference was found statistically for these patients. Therefore, these patients need to be managed more thoroughly

Prevalence of endocrine disorders in 304 premenopausal women referred with oligomenorrhoea

Introduction: We aimed to evaluate 304 premenopausal women admitted to our clinic for oligomenorrhoea, and to screen for Cushing’s syndrome (CS) in this population. Material and methods: The study included 304 premenopausal women referred to our clinic for oligomenorrhoea. Anthropometric measurements and Ferriman-Gallwey score were evaluated, and thyroid hormone, follicle-stimulating hormone (FSH), luteinizing hormone (LH), total testosterone, prolactin, dehydroepiandrosterone sulphate (DHEA-S), and 17-hydroxyprogesterone (17-OHP) levels were measured in all patients. If basal 17-OHP was > 2 ng/mL, we evaluated adrenocorticotropic hormone (ACTH)-stimulated 17-OHP levels. CS was screened by 1 mg-dexamethasone suppression test, and if the cortisol value was > 1.8 μg/dL, we performed additional confirmatory tests, and if necessary, pituitary magnetic resonance imaging (MRI) and inferior petrosal sinus sampling (IPSS) were performed. Results: The most common cause of oligomenorrhoea was polycystic ovary syndrome (PCOS) that was detected in 81.57% of cases, followed by hyperprolactinemia at 7.23% and hypothalamic anovulation at 5.26%. The prevalence of premature ovarian failure (POF) was 1.6%, and non-classical congenital adrenal hyperplasia (NCAH) was 1.97%. CS was detected in 7 (2.30%) patients. All the patients with CS were found to have Cushing’s disease (CD). Although 3 patients with CD had classical signs and symptoms, 4 had none. Patients with CD had similar total testosterone values to those in the PCOS and NCAH groups, but they had significantly higher DHEA-S compared to both groups (CD vs. PCOS, p = 0.001 and CD vs. NCAH, p = 0.030). Conclusions: We found higher prevalence of CS in patients with oligomenorrhoea even in the absence of clinical signs. Therefore, we suggest routine screening for CS during the evaluation of patients with oligomenorrhoea and/or PCOS. The likelihood of CS is greater in patients with high androgen, especially DHEA-S levels

Diffuse gastrointestinal involvement of mantle cell lymphoma

The gastrointestinal tract is the predominant site of appearance of extranodal non-Hodgkin lymphomas. The most frequent endoscopic finding of mantle cell lymphoma is multiple lymphomatous polyposis, which is a very rare entity. Multiple lymphomatous polyposis is characterized by multiple polypoid lesions involving long segments of the gastrointestinal tract and it accounts for 2% of primary gastrointestinal tract lymphomas. A 68-year-old patient was admitted to our clinic with intermittent diarrhea, weight loss, hematochezia and fatigue. Multiple lymphomatous polyposis was detected on the endoscopic evaluations. Gastrointestinal mantle cell lymphoma was confirmed with histopathological and immunohistochemical studies on biopsy specimens from colon, small intestine and stomach. The patient was successfully treated by combination chemotherapy

Wpływ gastrektomii rękawkowej na poziom irisiny w surowicy pacjentów z chorobliwą otyłością

  Introduction: Irisin, a recently identified myokine, is associated with increased energy expenditure and has a potential role in obesity. Therefore, we investigated circulating irisin levels in morbidly obese patients undergoing sleeve gastrectomy (SG). Material and methods: Thirty morbidly obese patients undergoing SG and 30 healthy subjects were included. All participants were evaluated at baseline and again at three months post-SG. Body weight and height, the lipid profile, and plasma glucose, HbA1c, insulin, and irisin levels were measured at each visit. Results: The two groups had similar mean age and sex distribution. Serum irisin was significantly lower in the morbidly obese subjects compared with the controls (p = 0.003) and negatively correlated with BMI, body weight, insulin levels, and HOMA-IR (p = 0.006, p = 0.011, p = 0.046, p = 0.048, respectively). When the morbidly obese patients were re-evaluated three months post-SG, their weight and BMI had significantly decreased (both p = 0.001). Similarly, the insulin, HbA1c, HDL-cholesterol, and HOMA-IR values significantly decreased (p = 0.001, p = 0.028, p = 0.006, and p = 0.001, respectively). However, irisin levels remained unchanged (p = 0,267). Conclusion: Although the irisin levels were significantly lower in the morbidly obese subjects, they did not change after SG-induced weight loss. (Endokrynol Pol 2016; 67 (5): 481–486)    Wstęp: Irisina jest niedawno poznaną miokiną, która jest związana ze wzmożonym zużyciem energii i która odgrywa potencjalna rolę w rozwoju otyłości. Dlatego też autorzy pracy badali stężenie krążącej irisiny u pacjentów chorobliwie otyłych poddawanych rękawkowej gastrektomii (SG). Materiał i metody: Do badana włączono trzydziestu chorobliwie otyłych pacjentów poddanych SG oraz 30 zdrowych ochotników. U wszystkich badanych pacjentów dokonano oceny wyjściowej oraz ponownie po 3 miesiącach po wykonaniu SG. Podczas każdej wizyty mierzono: masę ciała i wzrost, profil lipidowy, stężenie glukozy w osoczu, poziom HbA1c, insuliny raz irisiny. Wyniki: W obu grupach stwierdzono zbliżony rozkład średniej wieku i płci. Stężenie irisiny w surowicy było istotnie niższe u pacjentów z chorobliwą otyłością w porównaniu z grupą kontrolną (p = 0,003) i negatywnie korelowało z BMI, masą ciała, stężeniem insuliny i HOMA-IR (odpowiednio: p = 0,006, p = 0,011, p = 0,046, p = 0,048). W momencie wykonywania oceny u chorobliwie otyłych pacjentów po 3 miesiącach od SG ich masa ciała i BMI uległy istotnej redukcji (dla obu parametrów p = 0,001). Również stężenie insuliny HbA1c , cholesterolu frakcji HDL i HOMA-IR uległy istotnemu obniżeniu (odpowiednio: p = 0,001, = 0,028, p = 0,006 i p = 0,001). Niemniej stężenie irisiny nie uległy zmianie (p = 0,267). Wnioski: Mimo że stężenie irisiny było istotnie niższe u pacjentów z chorobliwą otyłością nie uległo ono zmianie przy spadku masy ciała indukowanym SG. (Endokrynol Pol 2016; 67 (5): 481–486)

The Role of Trace Elements in the Malignant-Benign Differentation of Pleural Effusions

WOS: 000376566800018Aim: It has been speculated that trace elements may play a role in some type of cancers. The aim of the present study was to examine the diagnostic utility of trace elements in pleural fluid with pleural effusions. Material and Method: This study consisted of 38 patients diagnosed with malignant and benign pleural effusions. Chrome, nickel, selenium, copper, lead and zinc concentrations in samples were determined by inductively coupled plasma optical emission spectrometry. Results: No significant difference was found between malignant and benign effusions with respect to Cr, Cu, Ni, Pb, Se and Zn concentrations in samples. Discussion: Trace elements have function as the component of many enzymes and the catalyst of some chemical reactions. There have been studies demonstrating the association of the deficiency or surplus of trace elements (TEs) with various type of cancers. In our study, the role of TEs measured in the pleural effusions in the differential diagnosis in the effusion etiology could not be demonstrated

Serum irisin and apelin levels and markers of atherosclerosis in patients with subclinical hypothyroidism

ABSTRACT Objective: In this study, we aimed to evaluate serum irisin and apelin levels in patients with subclinical hypothyroidism (SCH) when they were subclinical hypothyroid and become euthyroid after levothyroxine therapy and association of these adipokines with markers of atherosclerosis such as serum homocysteine levels and carotid intima-media thickness (IMT). Subjects and methods: The study included 160 patients with newly diagnosed subclinical hypothyroidism due to Hashimoto's thyroiditis and 86 euthyroid healty subjects. Serum glucose and lipid profile, insulin, HOMA, TSH, free T3, free T4, anti-thyroperoxidase and anti-thyroglobulin antibodies, homocysteine, apelin and irisin levels were measured in all study subjects. Thyroid and carotid ultrasound examinations were performed. The subclinical hypothyroid group was reevaluated after 12-weeks of levothyroxine therapy when they became euthyroid. Results: Clinical characteristics of the patient and control group were similar. Glucose, insulin and HOMA levels, lipid parameters and free T3 were similar between the two groups.. Serum homocystein was higher and apelin was lower in patients with SCH, but irisin levels were similar between the two groups. While thyroid volume was lower, carotid IMT was significantly greater in patients with SCH (pCarotidIMT:0,01). After 12-weeks of levothyroxine therapy, all the studied parameters remained unchanged except, serum freeT4, TSH, homocystein and apelin. While homocystein decreased (p: 0,001), apelin increased significantly (p = 0,049). In multivariate analysis, low apelin levels significantly contributed to carotid IMT (p = 0,041). Conclusions: Apelin-APJ system may play a role in vascular and cardiac dysfunction in patients with SCH and treatment of this condition may improve the risk of cardiovascular disease