INSULIN LIKE GROWTH FACTOR 1 POSSIBLE DEPENDENCE IN PATIENTS WITH METABOLIC SYNDROME OF NODULAR PATHOLOGY OF THE THYROID GLAND.

Metabolic syndrome and nodular pathology of the thyroid gland is a widespread problem nowadays. Recently there has been a notable coincidence between metabolic syndrome and nodular pathology of thyroid gland. Hence, it is interesting to reveal the connection between these two diseases. It is possible that insulin-like growth factor system (IGF), namely IGF 1 is connecting link between metabolic syndrome and nodular pathology of thyroid gland, because IGF1 stimulates growth and proliferation of cells in the body. We have investigated18-82 years of age 71 patients. group 1 n27- subjects with thyroid nodular disease, and metabolic syndrome, group 2 n31- subjects with thyroid nodular disease and without metabolic syndrome. group 3 n13 - subjects with metabolic syndrome and no thyroid pathology. In all groups were assessed thyroid structural data, defined parameters of carbohydrate metabolism, thyroid function and blood concentration of IGF1. In patients with hyperinsulinemia IGF 1 was noted in normal or reduced concentration. In I group IGF1 was normal in 70,4% (n=19), decreased in 29,6% (n=8), In II group was normal in 77,4 % (n=24), decreased in 22,6% (n=7) and in III group was normal in 76,9% (n=10), decreased in 23,1% (n=3). Increase of IGF 1 in patients with thyroid nodular disease patients was not noted. Statistically significant connection between IGF1 and thyroid nodules was not revealed. For the further investigation of this connection we plan to measure IGF1 in the thyroid histological samples in the future studies.

Fasting insulin and HOMA-index changes in patients treated with valproic acid.

Our study was carried out to ascertain the role of valproic acid for inducing metabolic disorders like hyperinsulinemia, insulin resistance and metabolic syndrome. Seventy-nine subjects were enrolled into the study. They were divided in 3 groups: 26 patients with epilepsy on VPA monotherapy and 28 patients with epilepsy on CBZ monotherapy and 25 healthy controls. Blood samples for fasting insulin, glucose, C-peptide, TG and HDL were collected. We compared insulin, C-peptide, C-peptide/insulin ratio, HOMA-IR, BMI, central obesity and metabolic syndrome in patients treated with VPA, patients treated with CBZ and in healthy controls. VPA treatment was associated with insulin resistance (30.8%) in opposite to CBZ treatment (7.1%). Metabolic syndrome existed in 34,6%, 14,3% and 12% among VPA, CBZ and control groups, respectively. There was no difference in C peptide/insulin ratio between study groups. Interestingly lean VPA treated patients showed high frequency of insulin resistance and metabolic syndrome compared to lean CBZ treated patients and controls. Therefore we suppose that obesity should not be an obligatory factor for VPA induced metabolic disturbances. VPA treatment is associated with insulin resistance and metabolic syndrome. This metabolic disorders were not connected with diminished hepatic insulin extraction. Although VPA treated patients showed central obesity predominance, we suggest that VPA can induce such metabolic and endocrine changes without obesity.

[Relation of serum uric acid levels with basic metabolic parameters in patients with metabolic syndrome during insulin-sensitizing therapy].

The aim of our investigation was to study the peculiarities of serum uric acid (UA) levels in patients with metabolic syndrome (MS) during 6 month therapy with metformin (MF), Rosiglitazone (RG) and their combination. 30 patients with MS (10 males, 20 females, mean age - 35,5+/-9,7 years) have been investigated by all parameters of MS and serum UA levels. Investigated group was divided into 3 subgroups of 10 patients: group 1 - patients on RG; group 2 - patients on MF; group 3 - patients on RG + 850-1000 mg of MF. Results of investigation showed that UA serum levels did not decrease significantly. However, the frequency of hyperuricemia decreased significantly. PPG, basal C-peptide, and HOMA-% IR also decreased significantly. Despite percentage reduction of BMI in group 3 (7,6%), decrease of UA and HOMA-IR was significantly higher in group 1 (18,2% and 37.0%, respectively). Correlation analysis showed that decrease of UA significantly correlated with BMI and HOMA-IR in the whole group (r=0.5674, p=0.001; r=0.5437, p=0.002; respectively); in group 1 - with HOMA-IR (r=0.5753, p=0.016); in group 3 - with BMI (r=0.7821, p<0.001). Obtained results showed that UA levels and hyperuricemia cases significantly decreased during insulin sensitizing therapy.