Comparison of the pleiotropic effect of atorvastatin and rosuvastatin on postmenopausal changes in bone turnover: A randomized comparative study.

BACKGROUND: Statins are the first-line treatment for dyslipidemia, which is a major modifiable risk factor for atherosclerotic cardiovascular disease. Studies have shown that in addition to the beneficial lipid-lowering effect, statins also exhibit a number of pleiotropic effects that may find application in other diseases, including osteoporosis. This study aimed to assess the effect of statins on bone turnover, as measured by the concentration of bone turnover markers, and to compare the effect of atorvastatin as a lipophilic statin and rosuvastatin as a hydrophilic statin. METHODS: This study included 34 postmenopausal women aged < 65 years with newly diagnosed dyslipidemia requiring statin therapy. Patients were randomly assigned to receive a statin drug. Statins were initiated at standard doses of 5 to 10 mg of rosuvastatin and 20 mg of atorvastatin. The levels of C-terminal telopeptide of type I collagen as a bone resorption marker and N-terminal propeptide of procollagen type I as a marker of bone formation, lipid concentrations and other biochemical parameters were assessed at baseline and after 6 and twelve months of treatment. RESULTS: There were no statistically significant differences between the levels of bone turnover markers before and 6 months after statin implementation (P > .05) - for all patients or subgroups according to statin use. Analysis of the results showed that after 12 months, there was a statistically significant decrease in N-terminal propeptide of procollagen type I concentration in all subjects (P = .004). By statin subgroup, a statistically significant decrease in N-terminal propeptide of procollagen type I was observed only in patients receiving rosuvastatin (P = .012) and not in those receiving atorvastatin (P = .25). Moreover, changes in bone turnover markers did not correlate with changes in lipid concentrations. CONCLUSIONS: These results may indicate the superiority of atorvastatin over rosuvastatin in inhibiting adverse changes in bone turnover in postmenopausal women. Confirmed by studies involving a larger population, the observed differences might find particular applications in clinical practice, and the choice of atorvastatin over rosuvastatin for women could be considered in the early postmenopausal period to reduce the risk of osteoporosis and subsequent osteoporotic fractures.

The correlation between two potentially antagonistic human adipocytokines, WISP-1 and CTRP1, and their association with insulin resistance.

INTRODUCTION AND OBJECTIVE: Wnt-1 signaling pathway protein 1 (WISP-1) and complement-C1q TNF-related protein 1 (CTRP1) are adipokines with possible opposite effects in regulating insulin sensitivity. The study investigated the correlation between circulating WISP-1 and CTRP1 in non-diabetic patients. Correlations between adipokines concentrations and biochemical and anthropometric parameters were also studied. MATERIAL AND METHODS: The cross-sectional study enrolled 107 adult patients without diabetes. Patients with obesity accounted for 52.3% of the study group. Clinical, anthropometric, and laboratory data, including serum levels of WISP-1 and CTRP1, were obtained. RESULTS: The moderate positive correlation between serum WISP-1 and CTRP1 concentrations was observed (p<0.000001, r=0.49). The correlation was more substantial in non-obese patients than in the obese group (r=0.66 and r=0.36, respectively; p<0.01). Circulating CTRP1 correlated positively with fasting insulin, Homeostatic Model Assessment for Insulin Resistance (HOMA-IR), total cholesterol, HDL cholesterol, and LDL cholesterol (p<0.05). WISP-1 level correlated with total cholesterol and HDL cholesterol concentrations (p<0.05). There was no significant difference in WISP-1 and CTRP1 concentrations between the groups with and without insulin resistance. The concentrations of WISP-1 and CTRP1 were significantly higher in females than in males (p<0.05). CONCLUSIONS: WISP-1 and CTRP1 may represent interrelated factors that antagonistically affect insulin resistance.

Serum Asprosin Correlates with Indirect Insulin Resistance Indices.

BACKGROUND AND OBJECTIVES: Insulin resistance is a major contributor to the development of type 2 diabetes and can be assessed using indirect indicators calculated from non-invasive tests. Asprosin is a recently discovered adipokine with a postulated effect on glycemic regulation. This study aimed to investigate the correlation between serum asprosin levels and insulin resistance indices. The correlation between circulating asprosin and obesity indices was also investigated. MATERIALS AND METHODS: A total of 50 non-diabetic patients with obesity and 50 healthy volunteers were studied. Laboratory data, including circulating asprosin and anthropometric data, were collected. The following insulin resistance indices were calculated: triglyceride-glucose index (TyG), TyG-neck circumference (TyG-NC), TyG-neck circumference to height ratio (TyG-NHtR), TyG-waist circumference (TyG-WC), TyG-waist to height ratio (TyG-WHtR), TyG-body mass index (TyG-BMI), and the ratio between triglycerides and high-density cholesterol (TG/HDLc). The obtained data were analyzed separately for males and females. RESULTS: Asprosin concentrations were significantly higher in obese patients (p < 0.001). Asprosin concentrations positively correlated with body mass index (p < 0.001, r = 0.8 in females and r = 0.8 in males), waist circumference (p < 0.001, r = 0.73 in females and r = 0.81 in males), and all tested indices of insulin resistance. The strongest correlation was observed for TyG-BMI (p < 0.001, r = 0.78 in females and r = 0.81 in males). Circulating asprosin was higher in females (p < 0.001). CONCLUSIONS: Asprosin can be considered a marker of obesity and insulin resistance.

Peripheral T-Cell Lymphoma Possibly Due to Unrecognized Celiac Disease in an Elderly Patient: A Case Report.

Celiac disease (CD) is widely perceived as a childhood disorder. However, it has been demonstrated that 19-34% of new CD cases are diagnosed in patients over 60 years of age and lack the typical presentation. A 76-year-old female was admitted to the clinic due to a recurrent fever that had lasted over a year accompanied by progressive weakness, weight loss of about 10 kg, dehydration, and malnutrition. The patient had undergone resection of a fragment of the small intestine due to perforation and abscess 13 years previously (at which time no histopathological examinations were performed). During the current hospitalization, despite extensive laboratory, microbiological, and imaging tests, no specific diagnosis was made. Symptomatic treatment and empirical antibiotic therapy were conducted, but the patient died on the twenty-seventh day of hospitalization due to progressive respiratory failure. The autopsy revealed peripheral T-cell lymphoma in the mesentery of the small intestine, uterus, cecum, lung, and mediastinal lymph nodes. Based on the clinical picture, we believe that the lymphoma was induced by long-term, undiagnosed CD. Current knowledge allows us to see age-related differences in the manifestation of celiac disease and to be alert to the possible late-stage complications of the disease. The lack of awareness of how CD's symptoms vary with age may lead to misdiagnosis and serious consequences of delayed diagnosis, including death.