Leptin and Andropause

To determine whether circulating leptin levels change in andropausal Egyptian men. Subjects and Forty elderly nondiabetic nonobese Egyptian men [aged 65 to 75 years] [group I] were included. Subjects were non obese with BMI <25 kg/m2. Twenty healthy adult men served as controls [group II]. Estimation of fasting serum level of leptin, DHEAS and free testosterone were done using ELISA technique. Mean fasting serum leptin was significantly higher in elderly and ropause men when compared to adult men [P<0.001]. Mean fasting serum free testosterone and DHEAS ware significantly lower in group I when compared to group II [t = 18.15, P < 0.001, and t = 25 - 16, P < 0.001, respectively]. Significant negative correlation was found between serum free testosterone and serum leptin in group I [r=-0.692, P < 0.001]. Our data confirmed increased serum leptin concentration in andropausal elderly Egyptian men. An inverse correlation between serum leptin and testosterone was illustrated. Testosterone replacement therapy may be of benefit in suppressing hyperleptinemia in elderly men with subsequent break of hypogonadal-obesity cycle and prevention of development of CHAOS Complex. Further studies examining the effect of other hormonal changes during aging on serum leptin are recommended

Estimation of plasma leptin and plasma insulin concentration in heart failure patients

This work aimed at estimating the plasma leptin and plasma insulin levels in patients with chronic congestive heart failure. This work was carried out on 20 patients with chronic congestive heart failure [group I], in addition to 10 healthy control [group II]. All patients and controls were subjected to full history taking, full clinical examination, echocardiography, estimation of fasting blood glucose, fasting plasma leptin and fasting plasma insulin level. Patients with chronic congestive heart failure were found to be hyperinsulinaemic and hyperleptinaemic when compared to controls [P< 0.001 and P<0.002 respectively], fasting plasma leptin correlated positively with fasting plasma insulin in patients with chronic congestive heart failure [r=0.78, P<0.001]. Patients with chronic congestive heart failure are hyperleptinaemic.

Impact of selective fetal reduction on maternal thyroid function in cases of multi-fetal pregnancy after assisted reproductive techniques

The aim of this work has been to evaluate the maternal thyroid function in multifetal pregnancy before and after fetal reduction and to evaluate changes in serum level of beta-hCG hormone. Two groups were evaluated. Group I: included 15 cases of multifetal pregnancies [12 triplets and 3 quadruplets]. 13 Cases were pregnant after gonadotropin ovulation induction and the remaining 2 quadruplet cases were [PROST]. Group II: included 10 cases, 5 cases singleton pregnancy [Group II a] and 5 cases twin pregnancies [Group II b]. These pregnancies resulted from gonadotropin ovulation induction in 7 cases and [ICSI] in 3 cases. Fetal reduction for group I patients was done at 7th -8th week gestation but no fetal reduction was done for group II. Estimation of serum FT4, TSH, and beta hCG was done in both groups at 7th -8th week gestation 1st sample and at 11th -12th week gestation 2nd sample. Before fetal reduction mean serum FT4 in multifetal pregnancy was significantly greater when compared with singleton and twin pregnancy [t=3.4, 3.8 respectively]. After fetal reduction mean serum FT4 decreased but remained significantly higher than both singleton and twin pregnancy [t= 3.9 and 4.1 respectively]. Mean serum TSH in muttrfetal pregnancy before fetal reduction was significantly lower when compared with singleton pregnancy and twin pregnancy P<0.05 for both, while after fetal reduction mean serum TSH increased but remained significantly lower than singleton and twin pregnancy [t= 4.211 and 6.579 respectively]. Negative correlation was found between mean serum FT4 and serum TSH before fetal reduction [r=0.63, P=0.001]. Before fetal reduction mean serum hCG in multifetal pregnancy was significantly higher than both singleton and twin pregnancy P<0.05 for both, and after fetal reduction it decreased but was still significantly higher than singleton and twin pregnancy P<0.05 for both. Before fetal reduction a positive correlation was found between serum FT4 and hCG [r=0.72, P=0.003]. There is alteration in thyroid physiology in multifetal pregnancies due to hCG but it remains to be determined if a fetal factor exists and if so, what is its nature. So, we recommend a larger scale prospective study with long duration follow up with evaluation of more factors that are expected to have an impact on maternal thyroid function during pregnancy