The influence of estradiole and tibolone administration on leptin levels in women with surgically induced menopause.

BACKGROUND: Several studies suggest that changes in estrogens and androgens during menopause play a role in the regulation of leptin production. Some authors present hypothesis that sex hormone replacement therapy can modulate leptin levels but up to date evidence shows that the influence of endogenous estrogens, androgens levels and sex hormone therapy on leptin concentration remains uncertain. AIM: To evaluate the influence of surgically induced menopause on serum leptin levels and the influence of different types of hormonal therapy on serum leptin concentrations. METHODS: 58 women with surgically induced menopause were divided into three groups. Women who did not receive any hormonal substitution (group 1), women who received Estradiol l mg per day (group 2) and women who received Tibolone 2,5 mg per day (group 3). The levels of leptin, estradiol, testosterone, testosterone, dehydroepiandrosterone sulfate, FSH, LH and progesterone were measured in all subjects on the 5th day and after 3 months following the surgical procedure. RESULTS: Mean serum leptin concentrations did not differ statistically in any of the studied groups in the beginning and in the end of the study. There was no correlations between serum leptin and estradiol, LH, FSH, progesterone, testosterone, free testosterone and DHEAS concentrations in any of groups before and after treatment. CONCLUSION: Changes in sex hormone concentrations caused by ovariectomy do not influence serum leptin concentrations. Also the short term administration of low dose estrogen therapy or tibolone in postmenopausal subjects does not change serum leptin levels.

Free plasma metanephrines as a screening test for pheochromocytoma in low-risk patients.

OBJECTIVES: Detection of free plasma metanephrines seems to be the most exact method for biochemical diagnosis of pheochromocytoma, but their diagnostic efficacy in the common low-risk clinical settings is debated. METHODS: A cross-sectional multicentre study including 1260 subjects assessed the diagnostic efficacy of free plasma metanephrine and normetanephrine in low-risk patients screened for resistant or markedly accelerated hypertension, paroxysmal hypertension, 'flushes' and, in a small proportion, for adrenal incidentaloma or genetic predisposition to pheochromocytoma. RESULTS: Pheochromocytoma was identified and verified by histology in 25 subjects (2%), with the diagnosis not confirmed by long-term follow-up or use of imaging techniques in the remaining 1235 individuals. The combined assay of free plasma metanephrines was a highly sensitive (100%) and specific (96.7%) measure, yielding a negative predictive value of 100%. CONCLUSION: The satisfactory diagnostic efficacy of free plasma metanephrines allows their use as a single screening test in cases of suspected pheochromocytoma in the population with a low pretest probability.

Use of glycogen phosphorylase BB measurement with POCT in the diagnosis of acute coronary syndromes. A comparison with the ELISA method.

BACKGROUND: Glycogen Phosphorylase BB (GPBB) is considered an early and specific marker of myocardial necrosis and ischemia. A POCT kit GPBB for diagnostic use has recently been approved. AIM: an evaluation of the correspondence of qualitative POCT GBPP measurements with ELISA test results. MATERIAL AND METHODOLOGY: 20 individuals with non-ST elevation myocardial infarction (non-STEMI) and 20 probands without acute coronary syndrome (ACS) were tested. GPBB (POCT, ELISA) in venous plasma (lithium-heparin) was assayed in all probands. RESULTS: individuals with non-STEMI had significantly higher GPBB ELISA values (32.3 vs. 6.1 microg/l; p < 0.01). GPBB sensitivity and specificity for non-STEMI presence 6 hours after chest pain generation were 100 %. No proband was classified in a different subgroup with POCT of GPBB (positive/negative). GPBB POCT correlate with a non- STEMI diagnosis (chi(2) 36.1; p <0.01). CONCLUSION: GPBB POCT measurement is comparable with ELISA test results. GPBB analysis could expand the diagnostic palette in the first hours after the onset of acute coronary syndrome.