The Hormonal Background of Hair Loss in Non-Scarring Alopecias.

Hair loss is a common clinical condition connected with serious psychological distress and reduced quality of life. Hormones play an essential role in the regulation of the hair growth cycle. This review focuses on the hormonal background of hair loss, including pathophysiology, underlying endocrine disorders, and possible treatment options for alopecia. In particular, the role of androgens, including dihydrotestosterone (DHT), testosterone (T), androstenedione (A4), dehydroepiandrosterone (DHEA), and its sulfate (DHEAS), has been studied in the context of androgenetic alopecia. Androgen excess may cause miniaturization of hair follicles (HFs) in the scalp. Moreover, hair loss may occur in the case of estrogen deficiency, appearing naturally during menopause. Also, thyroid hormones and thyroid dysfunctions are linked with the most common types of alopecia, including telogen effluvium (TE), alopecia areata (AA), and androgenetic alopecia. Particular emphasis is placed on the role of the hypothalamic-pituitary-adrenal axis hormones (corticotropin-releasing hormone, adrenocorticotropic hormone (ACTH), cortisol) in stress-induced alopecia. This article also briefly discusses hormonal therapies, including 5-alpha-reductase inhibitors (finasteride, dutasteride), spironolactone, bicalutamide, estrogens, and others.

Non-compliance with medical recommendations results in delayed hospitalization and poorer prognosis in patients with cerebral ischemic stroke in Poland: Non-compliance effects on post-ischemic stroke prognosis.

OBJECTIVES: This study aimed to reveal and analyze the causes of delays in reaching the hospital of patients with cerebral ischemic stroke and to assess their clinical picture. MATERIAL AND METHODS: The study group included 161 patients with stroke, who reported to the hospital beyond the thrombolytic treatment therapeutic window. The control group consisted of 85 patients recruited consecutively with stroke who received thrombolytic treatment per eligibility criteria. Laboratory and medical imaging tests essential for neurological condition assessment were conducted in the study group. Control group research was based on retrospective analysis of medical records. RESULTS: The rate of deaths during hospitalization was lower in the control group (4.7%) compared to the study group (14.9%). In the study group, more patients (16.8%) admitted to non-compliance with medical recommendations than in the control group (5.9%). There were no statistically significant differences in nicotinism and alcohol dependence syndrome frequency between both groups. CONCLUSIONS: Based on each group inclusion criteria, a lower mortality rate in the control group indicates a crucial role of the therapeutic window in cerebral stroke treatment. Analysis of reasons for delay points out that efficient prophylaxis is the education of patients with stroke risk factors and their families.

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.

Effect of sleep duration on blood pressure in women over 55 years of age - Poznan Cohort study.

INTRODUCTION: Hypertension is considered to be the most common pathology of the circulatory system and the most common cause of death or cardiovascular diseases' development. There are many commonly known risk factors of this condition, such as overweight, obesity, a high-fat diet, family history of ischemic heart disease, lipid disorders, and atherosclerosis. In order to reduce the effect of high blood pressure, patients should modify their lifestyle, including sleeping patterns. We wanted to investigate if, in a group of women over 55 years of age compared to the general population from Poznan cohort, sleep duration is related to hypertension. MATERIALS AND METHODS: All subjects were divided into three research groups depending on the time of sleep. The first group included people who have been sleeping less than 6 hours a day. The second group included people who have been sleeping from 6 to 9 hours a day. The third group was characterized by people with sleep time over 9 hours a day. Due to their age, participants were divided into two groups, below and over 55 years of age. RESULTS: There is a weak positive correlation between long sleep duration (>9h) and a higher prevalence of unregulated blood pressure (r = 0.3, p = 0.017) in the group of women over 55 years of age. CONCLUSION: Unregulated increased blood pressure may occur more frequently in postmenopausal women whose sleep duration exceeds 9 hours a day.

An Update to the WISP-1/CCN4 Role in Obesity, Insulin Resistance and Diabetes.

Insulin resistance refers to the diminished response of peripheral tissues to insulin and is considered the major risk factor for type 2 diabetes. Although many possible mechanisms have been reported to develop insulin resistance, the exact underlying processes remain unclear. In recent years, the role of adipose tissue as a highly active metabolic and endocrine organ, producing proteins called adipokines and their multidirectional activities has gained interest. The physiological effects of adipokines include energy homeostasis and insulin sensitivity regulation. In addition, an excess of adipose tissue is followed by proinflammatory state which results in dysregulation of secreted cytokines contributing to insulin resistance. Wingless-type (Wnt) inducible signalling pathway protein-1 (WISP-1), also known as CCN4, has recently been described as a novel adipokine, whose circulating levels are elevated in obese and insulin resistant individuals. Growing evidence suggests that WISP-1 may participate in the impaired glucose homeostasis. In this review, we characterize WISP-1 and summarize the latest reports on the role of WISP-1 in obesity, insulin resistance and type 2 diabetes.

Arterial Stiffness Parameters Correlate with Estimated Cardiovascular Risk in Humans: A Clinical Study.

Arterial stiffness is said to be a novel predictor of cardiovascular events. This study investigated the correlation between arterial stiffness parameters and the estimated cardiovascular disease risk (RISK) in a Polish cohort of patients divided by age, sex, and body-mass index (BMI). The cross-sectional study enrolled 295 patients who met the inclusion criteria. Subjects were divided into three age groups, four weight groups, and by gender. The stiffness of the vessels was assessed by the measurement of the stiffness index (SI) and reflection index (RI). An individual 10-year RISK was calculated for each patient using the Heart Risk Calculator algorithm by the American Heart Association. A correlation between the SI and estimated RISK was observed (rS 0.42, p < 0.05). The strongest relationship was presented for women, the age group 40-54, and individuals with normal weight. The correlation between RI and calculated RISK was observed (rS 0.19, p < 0.05), the highest correlation was noticed for people aged 40-54 and obese. In conclusion, both SI and RI are correlated with estimated cardiovascular risk, however SI seems to be more useful than RI to predict the individual risk of future cardiovascular events. Both of these can be measured using non-invasive techniques, which demonstrates their potential utility in clinical practice.

Impaired Glucose Metabolism in Bipolar Patients: The Role of Psychiatrists in Its Detection and Management.

Bipolar patients have a higher risk of type 2 diabetes and obesity, which are associated with cardiovascular diseases as the leading cause of death in this group. Additionally, there is growing evidence that impaired glucose metabolism in bipolar patients is associated with rapid cycling, poor response to mood stabilizers and chronic course of illness. The aim of the study was to assess the prevalence of type 2 diabetes and other types of impaired glucose metabolism in bipolar patients along with an evaluation of the Fasting Triglycerides and Glucose Index (TyG) as a method of the insulin sensitivity assessment. The analysis of fasting glycemia, insulinemia and lipid profile in euthymic bipolar patients was performed, and the Homeostasis model assessment for insulin resistance (HOMA-IR) and TyG were computed. Type 2 diabetes was observed in 9% and insulin resistance with HOMA-IR in 48% of patients. The TyG and HOMA-IR indices were correlated (p < 0.0001), the TyG index value of 4.7 had the highest sensitivity and specificity for insulin resistance detection. The usefulness of TyG in the recognition of insulin resistance in bipolar patients was suggested. The significant role of psychiatrists in the detection and management of impaired glucose metabolism in bipolar patients was presented.

New lower cutoff for serum high sensitive C-reactive protein in obese women indicates the risk of metabolic syndrome.

Objective, materials and methods: The aim of this cross-sectional study with a consecutive enrolment was to analyse the role of high sensitive C-reactive protein (hs-CRP) measurement in similarly obese patients with and without the metabolic syndrome (MS). Results: In total, 589 obese patients were screened, of whom 138 aged 50-75 years were enrolled. The others were rejected due to strict criteria of enrolment, so that the group was highly homogenous in numerous clinical aspects. The study group consisted of 96 patients (49 females and 47 males) with MS; 42 patients (20 females and 22 males) had isolated obesity without MS and served as a control group. hs-CRP levels were significantly higher in patients with MS (p = .0012). To find out the CRP cutoff between MS and non-MS obesity, we performed ROC curve analyses: hs-CRP lower than 1.96 mg/l was the best predictor of simple obesity without MS (sensitivity = 66.7%; specificity = 66.7%; AUC = 0.7; p = .0002). In a separate analysis, hs-CRP level lower than 1.96 mg/dl remained statistically significant as a predictor of isolated central obesity only for females. Conclusions: Already a relatively low level of hs-CRP around 2.0 mg/dl is observed in the MS, whereas patients with simple obesity without the accompanying features of MS would have hs-CRP lower than this value.

The influence of meal frequency on lipid profile in the Polish population.

OBJECTIVES: Despite numerous investigations, the influence of meal frequency on the lipid profile has not been clearly determined. The aim of the study was to investigate whether meal frequency corresponds with the lipid profile. MATERIAL AND METHODS: The cross-sectional study enrolled 495 patients of University Hospital of Lord's Transfiguration who met inclusion criteria for study treated in 2015-2017. The subjects were divided according to meal frequency into a group consuming three or fewer meals a day and a group consuming four or more meals daily. To investigate whether there is a significant difference in cholesterol fractions and triglycerides concentrations between the mentioned groups the Mann Whitney U test was performed. RESULTS: The group included 495 patients (66.1% women, mean age 49.9 (SD=14.7) years). The median meal frequency was 4 per day. The frequency of consumed meals a day was significantly higher for women (median 4 meals per day) than for men (3 meals per day; p<0.0001). A significant difference in serum triglycerides concentrations between the mentioned groups was observed (p<0.0001). Similarly, the difference between HDL cholesterol concentrations was presented. (p<0.01). No significant difference in the serum concentrations of total cholesterol and LDL cholesterol between the group consuming 3 or fewer meals and the group consuming 4 or more meals daily was seen (p>0.05). CONCLUSION: We conclude that meal frequency equaling or higher than four meals daily is associated with lower fasting triglycerides and higher HDL cholesterol concentrations than consuming no more than three meals daily.

Pasireotide - Mechanism of Action and Clinical Applications.

BACKGROUND: Pasireotide (SOM230) is a multi-receptor ligand somatostatin analogue (SSA) developed as the successor of the first-generation SSAs. Currently, pasireotide is recommended for the treatment of patients with Cushing's disease in whom surgery was unsuccessful, and patients with acromegaly who either remain uncontrolled after surgical therapy or in whom tumor resection is not possible. METHODS AND RESULTS: Phase II and III clinical trials have shown pasireotide efficacy in these diseases, with a similar rate of adverse events when compared with first-line SSA, although higher incidence of hyperglycemia has been observed. CONCLUSION: Pasireotide therapy provides biochemical control, tumor volume reduction, and improves the quality of life in patients with those disorders. Furthermore, pasireotide might be considered as second-line therapy in patients with metastatic neuroendocrine tumors, and it also might be effective in other neoplasms with a high expression of somatostatin receptors. In addition, therapy with this novel agent has been effective in prevention of postoperative complications after pancreatectomy. However, considering the diversified responsiveness to this drug in vivo, future studies should identify factors predicting better clinical response to pasireotide.

Anti-thyroidal peroxidase antibodies are associated with thyrotropin levels in hypothyroid patients and in euthyroid individuals.

OBJECTIVE: The study was designed to evaluate the relationship between thyroid antibodies and gland dysfunction, with the aim of finding a clinically useful threshold value of thyreoperoxidase antibodies, which could prove to be predictive for thyroid failure. MATERIAL AND METHODS: The study was conducted on 99 women, ages ranging from 18-91 years (mean age: 45.5 ±17.0), were treated as outpatients in the Department of Endocrinology, Metabolism and Internal Medicine. Analysis of serum samples for TSH concentration and anti-TPO titers was conducted. RESULTS: The most common disorder was hypothyroidism. Anti-TPO titers above reference range values were observed in 35 patients (35.4%): 21 (60%) were hypothyroid and 11 (31.4 %) were euthyroid. The anti-TPO and TSH serum levels correlated both in patients with high thyroid antibody titers, and in the anti-TPO negative groups. To find the threshold value of anti- TPO that would help predict hypothyroidism, receiver operating curves were used. With this approach, TPO antibody titers over 17 IU/ml indicated hypothyroidism with a 90% sensitivity and 75% sensibility. CONCLUSIONS: It can be postulated that the cutoff values of anti-TPO in the general population should be decreased in order to improve autoimmune thyroid disorder screening. Obviously, using that margin may lead initially to the detection of some false positive subjects. However, with lower cut-off values, more patients can be enrolled into thyroid follow-up groups. In this way, many people could avoid complications of undiagnosed, insidious thyroid failure.

Permanent atrial fibrillation in heart failure patients as another condition with increased reverse triiodothyronine concentration.

OBJECTIVE: To fully investigate the thyroid hormonal function in patients with the most common arrhythmia - atrial fibrillation. MATERIALS AND METHODS: 120 patients (aged 55-85 yrs) with symptoms of congestive heart failure exacerbation and no other concomitant disorders (inclusion criteria: normal cardiac troponin T at admission and 12 hours after, normal renal, hepatic and respiratory function; exclusion criteria: inflammatory state, history of myocardial infarction). Depending on the presence of permanent atrial fibrillation (PAF), patients were divided into two groups: PAF (34 females, 26 males) and regular sinus heart rhythm (43 females, 17 males), the groups did not differ in terms of heart rate, blood pressure, presence of overt/subclinical thyroid dysfunction, and medical therapy used. In all subjects thyroid stimulating hormone, free thyroxine, free triiodothyronine, reverse triiodothyronine were measured; echocardiography was performed. RESULTS: PAF group showed higher FT4 and rT3 (1.41 vs. 1.27 ng/dl, p=0.0007; 0.61 vs. 0.32 ng/ml, p<0.0001, respectively). With ROC curve analysis the biochemical thyroid related factor of the highest prognostic value for PAF occurrence (with the highest sensitivity and specificity: 77% and 72%, respectively) was rT3 with the cut-off of above 0.3 ng/ml. Also, a positive correlation between rT3 levels and left ventricular posterior wall diameter was observed (Spearman's correlation coefficient 0.33, p=0.0093). CONCLUSIONS: PAF is another condition where an increase in rT3 is observed. rT3 concentration above 0.3 ng/ml may be a novel biochemical sign associated with the presence of PAF in patients with chronic heart failure.

Depression with atypical features in various kinds of affective disorders. / Depresja z cechami atypowymi w róznych rodzajach zaburzen afektywnych.

OBJECTIVES: Assessment of atypical symptoms in various types of depressive disorders, using the author's questionnaire for symptoms of atypical depression. METHODS: The study involved 70 patients with a diagnosis of depressive episode in the course of recurrent depression, 54 patients with a diagnosis of depressive episode in bipolar disorder (BD) and 58 patients with a diagnosis of dysthymia. To assess the severity of atypical symptoms, the special questionnaire has been elaborated. In each diagnostic group, half of patients had normal body weight, and half were overweight or obese (BMI > 25). RESULTS: Patients with various types of depression did not differ significantly in terms of clinical and demographic factors. Symptoms of atypical depression such as increased appetite, weight gain and leaden paralysis were more common in women. Patients with bipolar depression had significantly increased symptoms such as hypersomnia (compared with dysthymia), and leaden paralysis (vs. recurrent depression and dysthymia). In overweight and obese patients, the severity of atypical symptoms correlated with body mass index and intensity of depression score on the 17-items Hamilton Depression Rating Scale. In this group, all symptoms of atypical depression were significantly more intense in patients with depression in the course of bipolar disorder. CONCLUSIONS: The results indicate higher prevalence of symptoms of atypical depression in bipolar disorder compared with recurrent depression and dysthymia. They also suggest the interdependency between the symptoms of atypical depression, bipolar disorder and obesity.

Hypothyroidism Affects Olfactory Evoked Potentials.

Background. Objective electrophysiological methods for investigations of the organ of smell consist in recordings of olfactory cortex responses to specific, time restricted odor stimuli. In hypothyroidism have impaired sense of smell. Material and Methods. Two groups: control of 31 healthy subjects and study group of 21 with hypothyroidism. The inclusion criterion for the study group was the TSH range from 3.54 to 110 µIU/mL. Aim. Assessment of the latency time of evoked responses from the olfactory nerve N1 and the trigeminal nerve N5 using two smells of mint and anise in hypothyroidism. Results. The smell perception in subjective olfactory tests was normal in 85% of the hypothyroid group. Differences were noticed in the objective tests. The detailed intergroup analysis of latency times of recorded cortical responses PN5 and PN1 performed by means between the groups of patients with overt clinical hypothyroidism versus subclinical hypothyroidism demonstrated a significant difference (p < 0.05) whereas no such differences were found between the control group versus subclinical hypothyroidism group (p > 0.05). Conclusion. We can conclude that registration of cortex potentials at irritation of olfactory and trigeminal nerves offers possibilities for using this method as an objective indicator of hypothyroidism severity and prognostic process factor.

Atypical features in depression: Association with obesity and bipolar disorder.

OBJECTIVES: Depression with atypical features amounts to a significant proportion of depressed patients. Studies have shown its association with bipolarity and, recently, with obesity. In this study, we investigated atypical features of depression in relation to overweight/obesity in three diagnostic categories: unipolar depression, bipolar depression and dysthymia. METHODS: Out of 512 depressed patients screened, we recruited 182 research subjects, consisting of 91 pairs, matched by age, gender and diagnosis, in which one member of the pair was within the normal weight range (BMI≤25) and the other was either overweight or obese (BMI>25). There were 35 pairs with unipolar depression, 27 with bipolar depression and 29 with dysthymia. Symptoms of atypical depression, such as increased appetite, hypersomnia, leaden paralysis, longstanding pattern of interpersonal rejection sensitivity, and, a significant weight gain in the past 3 months, were assessed. RESULTS: All the symptoms of atypical depression were significantly more pronounced in those depressed patients with a BMI>25, compared with depressed subjects with a normal weight. Except for hypersomnia, these symptoms scored significantly higher in women compared to men. Among the diagnostic categories, symptoms of atypical depression were significantly higher in patients with bipolar disorder compared with both major depressive disorder and dysthymia. LIMITATIONS: The preponderance of women, the assessment of atypical depression by adaptation of the DSM criteria, entirely Polish population, specificity of selection criteria. CONCLUSIONS: The results demonstrated a higher intensity of atypical depression's symptoms in overweight/obese depressed patients. They also confirm the association between obesity and bipolarity.

The role of adipocytokines in the pathogenesis of knee joint osteoarthritis.

Osteoarthritis (OA) is one of the most common causes of musculoskeletal disability in the world. Traditionally, it has been thought that obesity contributes to the development and progression of OA by increased mechanical load of the joint structures. Nevertheless, studies have shown that adipose tissue-derived cytokines (adipocytokines) are a possible link between obesity and OA. Furthermore, according to recent findings, not only articular cartilage may be the main target of these cytokines but also the synovial membrane, subchondral bone and infrapatellar fat pad may be encompassed in the process of degradation. This review presents the most recent reports on the contribution of adipocytokines to the knee joint cartilage degradation, osteophyte formation, infrapatellar fat pad alterations and synovitis.

The role of serum C-reactive protein measured by high-sensitive method in thyroid disease.

The aim of this study was the evaluation of serum C-reactive protein (CRP) concentration as a marker of the inflammatory state in many different thyroid diseases and its dependence on the stage and duration of disease. We conducted a retrospective analysis of 444 randomly selected patients with different kinds of thyroid disease (106 men and 338 women, ranging 18-72 years of age; mean 56.2 ± 5.0 years; median 52 years). Group 1 (G1) comprised 250 patients with hyperthyroidism. Group 2 (G2) consisted of 72 euthyroid patients. Group 3 (G3) consisted of 122 patients with hypothyroidism. Free T4, free T3, and thyrotropin (TSH) levels were measured using the electrochemiluminescent method. Human serum thyroglobulin autoantibodies (Tg-Abs), thyroperoxidase autoantibodies (TPO-Abs), and autoantibodies against the thyrotropin receptor (TSHR-Abs) levels were measured by radioimmunoassay. The high-sensitive CRP (Hs-CRP) level (reference range <3 mg/L) was determined with a highly sensitive latex-based immunoassay. The mean value of Hs-CRP in G1 was 3.6 ± 2.8 mg/L, in G2 2.5 ± 1.5 mg/L and in G3 5.9 ± 5.8 mg/L. Hs-CRP (in mg/L) medians, interquartile and the total ranges in G1 were 3.0 (2.0 [0.1-21.0] 4.0); in G2: 2.3 [1.8 (0.2-9.2) 3.2]; and in G3: 4.3 [2.2 (0.3-31.5) 7.8]. We found statistically significant differences (Kruskal-Wallis test) in serum Hs-CRP values between G1 and G2 (P = 0.007), G1 and G3 (P = 0.001), G2 and G3 (P < 0.001). In G1, statistically significant correlation was confirmed between Hs-CRP and Tg-Abs (r = -0.22, P = 0.0016), CRP and TPO-Abs (r = -0.26, P < 0.001), and also between Hs-CRP and TSHR-Abs (r = -0.18, P = 0.02). In the remaining cases, differences between Hs-CRP and TSH levels (r = -0.09, P = 0.16) were not statistically significant. In G2, no statistically significant correlation was observed: Hs-CRP and Tg-Abs (r = -0.18, P = 0.13), Hs-CRP and TPO-Abs (r = -0.17, P = 0.15), Hs-CRP and TSH (r = 0.01, P = 0.91), Hs-CRP and TSHR-Abs (r = -0.19, P = 0.17). In G3, a statistically significant correlation was confirmed between Hs-CRP and Tg-Abs (r = 0.22, P = 0.012), Hs-CRP and TSH (r = -0.28, P = 0.001). No statistically significant correlation was observed between Hs-CRP and TPO-Abs (r = 0.20, P = 0.06) and between Hs-CRP and TSHR-Abs (r = -0.23, P = 0.11). Hs-CRP is increased in various types of hypothyroidism. This is particularly relevant in postpartum thyroiditis and in patients after radioiodine treatment. The impact of this situation on human health requires further research, however, one might assume that some types of thyroid disease may lead to systemic inflammatory reactions that are reflected in elevated CRP levels.

Serum homocysteine levels are decreased in levothyroxine-treated women with autoimmune thyroiditis.

BACKGROUND: Hyperhomocysteinemia is a well-known cardiovascular risk factor and its elevation is established in overt hypothyroidism. Since some authors suggest that chronic autoimmune thyroiditis per se may be considered as a novel risk factor of atherosclerosis independent of thyroid function, the analysis of classical cardiovascular risk factors might be helpful in evaluation the causative relationship. Data concerning the impact of thyroid autoimmunity in euthyroid state on homocysteine (Hcy) level is lacking. The aim of this study was to evaluate Hcy level in context of anti-thyroperoxidase antibodies (TPOAbs) in euthyroidism. METHODS: It is a case-control study. 31 euthyroid women treated with levothyroxine (L-T4) due to Hashimoto thyroiditis (HT) and 26 females in euthyroidism without L-T4 replacement therapy were enrolled in the study. All women with HT had positive TPOAbs. Forty healthy females negative for TPOAbs comparable for age and body mass index (BMI) participated in the study as controls. Exclusion criteria were a history of any acute or chronic disease, use of any medications (including oral contraceptives and vitamin supplements), smoking, alcoholism. RESULTS: TPOAbs titers were higher in both groups of HT patients versus the healthy controls. Hcy levels were found to be significantly lower in treated HT patients (Me 11 µmol; IQR 4.2 µmol) as compared with healthy controls (Me 13.35 µmol; IQR 6.34 µmol; p = 0.0179). In contrast, no significant difference was found between non treated HT and control group in Hcy level. The study groups and the controls did not differ in age and BMI. Furthermore, levels of TSH, FT4, TC, LDL, HDL and TAG did not differ between the study group and the control group. CONCLUSION: The main finding of the study is a decrease in Hcy level in treated HT as compared with healthy controls. Based on our observations one can also assume that correct L-T4 replacement was associated here with a decrease of Hcy. Furthermore, it seems that non treated HT in euthyroidism is not associated with Hcy increase, in contrast to overt hypothyroidism. This may be just another argument against the concepts about the role of "euthyroid HT" in the development of atherosclerosis.

The prevalence of thyroid nodular disease in patients with increased titers of anti-thyroidal peroxidase antibodies.

OBJECTIVES: The aim of our study was to evaluate the possible association between autoimmunity and thyroid nodular disease (TND). DESIGN AND SETTING: We conducted a study on 58 patients who were treated in outpatient setting at the Department of Endocrinology, Metabolism and Internal Medicine. Serum samples were analyzed for TSH concentration and anti-TPO antibodies titers. Thyroid ultrasonography was performed in each subject in order to evaluate volume of the gland, and the number and size of nodules. RESULTS: TND occurred in 70% of anti-TPO positive subjects and in 57.9% of anti-TPO negative subjects, but statistical analysis did not demonstrate a significant concordance between the presence of anti-TPO antibodies and prevalence of TND (p>0.05). We showed that the mean (0.82 vs 0.75; p=0.49), minimal (0.2 vs 0.3; p=0.89) and maximal (2.7 vs 2.4; p=0.49) diameters of a nodule were similar in both groups. Solely in anti-TPO positive patients, anti-TPO titers positively correlated with the number of nodules (p=0.04). CONCLUSION: Our results favor the role of autoimmunity in TND development although associations between thyroid nodules and thyroid autoimmunity are complicated and may be the subject of much controversy. Increased anti-TPO may influence the number of nodules rather than the presence of TND itself.