[The effect of one year of recombinant human growth hormone (rhGH) therapy on left ventricle structure and function in adults with severe growth hormone deficiency]. / Wplyw rocznego, substytucyjnego leczenia ludzkim rekombinowanym hormonem wzrostu (rhGH) na budowe i czynnosc lewej komory serca u doroslych z duzym niedoborem hormonu wzrostu.

UNLABELLED: The aim of the study was to analyze the functional and structural changes in the echocardiographic parameters of the left ventricle (LV) in adult patients (pts) with growth hormone deficiency (GHD) without any treatment in childhood before and after one year long somatropin treatment. MATERIAL AND METHODS: Twelve GHD pts (mean age 42 +/- 10 years; M/F: 6/6) before (group GHD-1) and after one year rhGH therapy (group GHD-2) were compared. The s.c. rhGH treatment with somatropin (Genotropin, Pharmacia) at a dose 0.125 U/kg/week up to 0.25 U/kg/week has been continued for 1 year. Both groups were examined with echocardiography Twelve GHD pts (mean age 42 +/- 10 years; M/F: 6/6): with indiopatic GHD (n = 10, age from 29 to 46 years; M/F: 6/4) and with Sheehan syndrome (n = 2, age from 46 to 61 years; M/F: 0/2) before (group GHD-1) and after one year rhGH therapy (group GHD-2) were compared. The s.c. rhGH treatment with somatropin (Genotropin, Pharmacia) at a dose 0.125 U/kg/week up to 0.25 U/kg/week (till 50 percentyl of blood IGF-1 concentration for age and sex norm ) has been continued for 1 year. Both groups were examined with echocardiography. RESULTS: On echocardiography, in the group GHD-1 pts compared to GHD-2 pts, had lower LVM and LVMI were lower (adequately (138.4 +/- 39.8 vs. 153.1 +/- 49.5, p < 0.036), lower and LVMI (87.3 +/- 19.7 vs. 96 +/- 23.7, p < 0.05). There was no Therapy had no significant therapy effect on systolic LV function. The diastolic function of LV did not differ between both GHD-1 and GHD-2 groups (E/A: 1.4 +/- 0.2 vs. 1.3 +/- 0.3 ; E: 79 +/- 17; A: 59 +/- 16 vs. 58 +/- 10, ns), but DT increased significantly from 132 +/- 21 vs. 147 +/- 30, p < 0.05). There was only significant correlation between LV systolic dimension after one year and IGF plasma basal concentration (r = 0.7, p < 0.01). CONCLUSIONS: One year medical therapy with rhGH (somatropin) is associated with a significant positive effect on LVM and LVMI but no significant effect on systolic LV function, as assessed by echocardiography in adults with GHD. Significant decrease of DT after therapy may suggest an influence of GH therapy on diastolic LV function. The level of IGF did correlate with LV systolic diameter after therapy.

Lack of association between the Pro12Ala polymorphism in PPAR-gamma2 gene and body weight changes, insulin resistance and chronic diabetic complications in obese patients with type 2 diabetes.

BACKGROUND: It is generally accepted that the Pro12Ala polymorphism in peroxisome proliferator-activated receptor-gamma2 (PPAR-gamma2) is associated with an increased risk of type 2 diabetes. However, studies on an association between the polymorphism and obesity have yielded inconsistent findings. Also, a role of PPAR-gamma receptors in development of chronic diabetic complications cannot be excluded. The aim of this study was to investigate an association between Pro12Ala polymorphism and body weight changes, insulin resistance, insulin secretion and incidence of diabetic complications in obese patients with long-lasting type 2 diabetes. METHODS: In 216 obese patients with at least a 10-year history of type 2 diabetes, a detailed medical history was taken and a physical examination with assessment of diabetic complications was performed as well as evaluation of insulin resistance (homeostatic model assessment-HOMA), insulin secretion and other biochemical parameters. PCR-RFLP was used to assess Pro12Ala polymorphism. Two subgroups of patients were compared: homozygotic Pro/Pro and Ala allele carriers (Ala/Ala + Ala/Pro). RESULTS: No differences between the analyzed groups in body weight changes, insulin resistance and insulin secretion were found, but Ala allele was significantly more frequent in males than in females. There was no difference in incidence and progression of diabetic complications with only a trend towards higher incidence of diabetic retinopathy in patients with Ala allele. CONCLUSIONS: There is no association between Pro12Ala PPAR-gamma2 polymorphism and body mass changes observed during a course of type 2 diabetes, differences in peripheral insulin resistance and incidence and progression of diabetic complications in obese patients with long-lasting type 2 diabetes.

[Serum leptin and adiponectin concentrations in patients infected with human immunodeficiency virus type 1 (HIV-1) on antiretroviral therapy]. / Stezenia leptyny i adiponektyny w surowicy chorych zakazonych ludzkim wirusem niedoboru odpornosci typu 1 (HIV-1) leczonych antyretrowirusowo.

UNLABELLED: The lipodystrophy syndrome with dyslipidaemia and insulin resistance is side-effect of combined antiretroviral therapy (CART). AIM OF THE STUDY: to describe the influence of CART on leptin and adiponectin concentration in connection with lipids levels in HIV-infected patients on antiretroviral therapy. BMI, serum leptin, adiponectin, triglycerides, total cholesterol, HDL- and LDL-cholesterol concentrations were measured in 56 HIV(+) patients before and on CART; average of treatment duration 38.4 +/-13.2 months. Significant increase of BMI (p=0.0268) of (22.6 +/- 3.3 before and 23.5 +/- 3.4 kg/m2 on therapy, respectively) and all analyzed lipids were found. Mean adiponectin concentration in treated patients was significantly (7.256 +/- 3.551 microg/ml) lower than mean value before treatment (8.395 +/- 3.568 microg/ml; p=0.0011). Mean values of leptin concentrations did not differ significantly (before therapy 3.721 +/- 0.347 log10; on therapy 3.1737 +/- 0.353 log10). Significant positive correlation between BMI and leptin concentrations was found before, as well as during CART (r=0.5333; p<0.0001), but negative correlation between adiponectin and leptin concentrations (r=-0.2677; p=0.042). Leptin and adiponectin concentrations did not revealed significant correlation with lipids levels before therapy. The decrease of adiponectin concentration on CART correlated negatively with total (r=-0.2912; p=0.0310) and LDL-cholesterol (r=-0.310; p=0.0225). CART lasting longer than 2 years resulted in the decrease of adiponectin concentration, with lack of influence on leptin concentration in analyzed group. The increase of total cholesterol and LDL-cholesterol in correlation with the decrease of adiponectin concentration confirms that CART induces metabolic disturbances related to higher risk of atherosclerosis and its sequel.

[The effect of primary lack of estrogens and the influence of the age at the beginning of estrogen therapy on bone mineral density in patients with Turner's syndrome]. / Wplyw pierwotnego niedoboru estrogenów na gestosc mineralna kosci u pacjentek z zespolem Turnera w zaleznosci od wieku zapoczatkowania leczenia estrogenami.

Lumbar spine bone mineral density (BMD) values were measured in women with Turner's syndrome (TS) and the influence of primary ovarian failure as well as the age at the start of estroprogestins (EP) therapy were considered. EP treatment with 2mg of estradiol (E2) and BMD monitoring were started in 72 and finally continued for 5 years in 34 patients with TS, aged 12-38 years, previously not treated with growth hormone or anabolic steroids. The mean total BMD gain (deltaBMD) was 20% and the most significant increase was observed after the first (7.5%) and the second (6.6%) year of the therapy. Before the start and during EP treatment E2 levels were evaluated: they increased from 9.2pg/ml to the values observed in the controls (C) but positive correlation with BMD was not observed. Analysis of TS patients in age brackets (<15 years, 15-20 years, 21-25 years, >25 years) showed that only in the group that started EP treatment before the age of 15 every year significant deltaBMD was observed. The group that started EP therapy after the age of 20 didn't achieve significant deltaBMD. Patients wit TS had significantly higher levels of bone metabolism markers (Ntx and BALP) than the controls and in both groups negative correlation with age was found. On the basis of the results the conclusion was made that in hypoestrogenic women, not exclusively TS, the age when estrogen therapy is started may determine the effects in relation to bone mass. The administered E2 doses may also be important.

[The influence of hyperthyroidism and glucocorticosteroid treatment on bone metabolism in patients with Graves' disease and ophthalmopathy]. / Wplyw nadczynnosci tarczycy oraz glikokortykoterapii na metabolizm tkanki kostnej u pacjentów z choroba Gravesa-Basedowa i oftalmopatia.

UNLABELLED: The aim of the study was to assess influence of hyperthyroidism and glucocorticosteroid treatment on changes of bone turnover markers in patients with Graves' disease and thyroid ophthalmopathy (TO). MATERIAL AND METHODS: Three groups of patients were included in the study. Group I was composed of 26 euthyroid Graves' disease patients with TO suitable for steroid treatment. Group II included 14 hyperthyroid Graves' patients without TO treated medically with anti-thyroid drugs. Group III (control group) included 20 healthy volunteers. Levels of the bone formation marker, i.e. bone-specific alkaline phosphatase (BALP) and the bone resorption marker, i.e. deoxypyridinoline (DPD) were measured in the group I before steroid treatment administration, after 3 methylprednisolone i.v. pulses and after completing the oral prednisone treatment. In the group II levels of BALP and DPD were assessed twice: before treatment of hyperthyroidism and after 6 months since euthyroid state had been achieved. In the group III levels of BALP and DPD were measured once in the basal conditions. RESULTS: Mean initial levels of BALP in groups I and II did not differ significantly and were increased when compared to healthy volunteers. In the group I a transient significant decrease in BALP levels after 3 i.v. pulses of methylprednisolone was observed, followed by a significant increase in BALP after completing the oral prednisone therapy. The achievement of euthyroid state in Graves' patients (II) did not influence significantly BALP values. In the group I initial DPD levels were significantly lower than those in group II and higher than those in the control group (III). During steroid treatment of TO (group I) no dynamic changes of DPD levels were observed. The achievement of euthyroid state in group II was accompanied by a significant decrease in DPD levels, which were however than those in the control group. CONCLUSIONS: 1. In hyperthyroid state is associated with the profound stimulation of bone resorption, and to a lesser extent of bone formation. 2. The achievement of euthyroid state causes a rapid inhibition of bone resorption and maintains a compensatory stimulation of bone formation. 3. Glucocorticosteroid treatment with methylprednisolone i.v. pulses and orally administered prednisone do not influence significantly the processes of bone formation and bone resorption.

[I/D polymorphism of angiotensin I converting enzyme gene and insulin resistance and some parameters of metabolic syndrome in patients with type 2 diabetes]. / Polimorfizm I/D genu enzymu konwertuj cego angiotensyne I a insulinoopornosc i niektóre elementy zespolu metabolicznego u chorych z cukrzyca typu 2.

Insulinresistance is a component of the metabolic syndrome and important pathogenetic factor of type 2 diabetes mellitus. There are evidences that activation of the renin-angiotensin system (RAS) can decrease insulin sensitivity of tissues. As I/D polymorphism of angiotensin converting enzyme (ACE) gene can influence the activity of RAS, it may also influence insulin resistance. Aim. To assess the relationship between the I/D polymorphism of ACE gene and degree of insulin resistance and intensity of metabolic syndrome in type 2 diabetic patients. Study group and methods. Examined group: 108 type 2 diabetic patients (38 women and 70 men), with mean duration of disease 9.07 +/- 6.68 years, mean age 59.98 +/- 9.10 years. Assessed parameters: body mass index (BMI), waist/hip ratio (WHR), arterial blood pressure. Laboratory tests: concentration of the glycosylated hemoglobin (HbA 1c), glucose, insulin, total cholesterol, HDL and LDL cholesterol, triglycerides, creatinine, uric acid. Insulin resistance was calculated by the HOMA rate. Criterion of insulin resistance was rate > or = 2.5. The diagnosis and assessment of intensity of metabolic syndrome was performed according to criteria of National Education Cholesterol Adult Treatment Program the Panel III. I/D ACE gene polymorphism was evaluated by polymerase chain reaction (PCR). Results. Groups with 11, ID and DD genotype were not different in age, BMI, WHR, duration of diabetes, the prevalence and duration of arterial hypertension, degree of metabolic control and insulinresistance assessed by HOMA rate and intensity of metabolic syndrome. DD genotype carriers had significant higher systolic and diastolic blood pressure (147.8 +/- 19.8 mmHg vs 138.2 +/- 16.5 mmHg, p = 0,02; 89.2 +/- 9.6 mmHg vs 81.7 +/- 8.6, p = 0,003, respectively) than II patients. Conclusion. In type 2 diabetic patients the I/D genotype of ACE gene is not associated with the increased insulin resistance assessed by HOMA rate and intensity of metabolic syndrome.

[Type 1 diabetes as a mask of a neuroendocrine tumour of pancreas]. / Cukrzyca typu 1 jako maska neuroendokrynnego guza trzustki.

Neuroendocrine tumours of pancreas originating from pancreatic islet cells are uncommon neoplasms with clinical manifestation depending on a type of hormone secreted. Diabetes as a clinical sign of such a tumour has been reported many times and is not an uncommon finding but it is generally mild and makes only a part ofa whole pattern of symptoms. We report on a case of a malignant neuroendocrine pancreatic tumour in 19 years old patient, where diabetes, with a clinical course typical for type 1 diabetes, was the first and the main symptom of the disease.

[The endocrine mask of a developing process of schizophrenia--case study]. / Maska endokrynna rozwoju procesu schizofrenicznego--studium przypadku.

In this research psychic and somatic symptoms related to disturbances of hypothalamus-hypophysis-peripheral regulation which may occur in the schizophrenic process were analysed. Authors discussed the problem of relations between hypothalamus neuroregulation and pathogenesis of endocrine disturbances which suggest the organic cause of obesity, hirsutism and secondary amenorrhea among women diagnosed with paranoid schizophrenia. Actual antipsychotic pharmacological treatment, including some side-effects: the metabolic (obesity) and the endocrine (hyperprolactinemia) ones were considered. The authors conclude that endocrine disorders which are connected with hypothalamus disfunction (sleeping, eating and reproductive functions) may reach the psychotic symptoms and treating them influences at the same time some endocrine changes. The estimation of PRL release in a test of stimulation with metoclopramide can be a sensitive (though not specific) test of dopaminergic activity in tuberous--infundibulum pathway and may be used to control the treatment.

[Magnetic resonance imaging and soluble forms of adhesion molecules: sICAM and sVCAM in assessing the activity of thyroid orbitopathy]. / Magnetyczny rezonans jadrowy oraz stezenia rozpuszczalnych form molekul adhezyjnych: sICAM-1 i sVCAM-1 w ocenie aktywnosci orbitopatii tarczycowej.

The aim of this study is to compare two different diagnostic methods (magnetic resonance imaging (MRI) and soluble forms of adhesion molecules: ICAM-1 and VCAM-1 measurement) in assessment of the activity of thyroid orbitopathy (TO) in patients with Graves' disease. 21 patients with infiltrative TO were treated with modified method by Bartalena et al. MRI scans and the measurement of soluble forms of ICAM-1 and VCAM-1 were performed before treatment, after methylprednisolone pulses along with radiotherapy of the retroorbital spaces and after the end of prednisone treatment. MRI scans did not reveal active stage of the disease in 4/21 patients with infiltrative TO, despite elevated levels of sICAM-1 and sVCAM-1. Patients both with active stage of the disease and with the results of MRJ scans revealing fibrotic changes in muscles responded well to therapy parallel with a significant decrease in levels of sICAM-1 and sVCAM-1. Levels of sVCAM-1 increased slightly under prednisone treatment despite improvement of clinical picture of TO, a significant decrease in sICAM-1 levels and in the number of muscles with active inflammatory process on MRI scans. In conclusion, serum levels of ICAM-1 seem to be more sensitive marker than MRI in assessment of the activity of TO. Concentrations of sVCAM-1 do not correspond with the clinical picture of the disease and the results of MRJ during treatment of TO.

[Concentrations of soluble vascular cell adhesion molecule-1 (sVCAM-1) in patients witt Graves' disease and thyroid associated orbitopathy]. / Stezenia rozpuszczalnej formy naczyniowej czasteczki adhezyjnej-1 (sVCAM-1) w chorobie Graves-Basedowa i orbitopatii tarczycowej.

The aim of this study is to evaluate serum concentrations of sVCAM-1 in patients with Graves' disease (GD) and thyroid associated orbitopathy (TAO). We measured serum sVCAM-1 levels in initially hyperthyroid GD patients without TAO, in patients with progressive and stable orbitopathy in euthyroid stage of GD and healthy controls. The highest serum concentrations of sVCAM-1 were observed in patients with hyperthyroid GD. In patients with euthyroid GD and progressive TAO, sVCAM-1 levels were slightly decreased than those in the group of patients with hyperthyroid GD and markedly elevated in comparison to the group of patients with stable TAO. In patients with hyperthyroid GD, sVCAM-1 concentrations dropped significantly after they had become euthyroid , but were still higher than those observed in group of patients with stable TAO and healthy people. Serum levels of sVCAM-1 in early stage of the progressive TAO (<6 m-ths) were higher than those in late stage of the disease (>6 m-ths), despite lower orbitopathy index (OI) found in early stage of the orbitopathy (<6 m-ths). In conclusion, both hyperhyroidism and TAO may contribute to elevated levels of sVCAM-1. A significant decrease in sVCAM-1 levels in initially hyperthyroid GD patients is associated with euthyroid stage of the disease. Concentrations of sVCAM-1 seem to correlate with the activity, not severity of progressive TAO.

[Lanreotide in the treatment of thyroid orbitopathy]. / Lanreotyd w leczeniu orbitopatii tarczycowej.

UNLABELLED: The aim of the present study was to evaluate the efficiency of somatostatin analogue--lanreotide in the treatment of Graves ophthalmopathy. We examined the group of 6 women with thyroid eye disease in class 2 and 3 according to NO SPECS classification. Ophthalmopathy index and clinical activity score were above 3. Lanreotide was given in a dose of 30 mg i.m. every 2 weeks over a period of 3 months. The therapeutic effect was evaluated twice: 2 weeks after the end of lanreotide treatment (initial assessment) and after 2 years (final assessment). On initial assessment a decrease in ophthalmopathy index more than 2 points in each eye was observed. On follow up after 2 years we did not observe the worsening of thyroid eye disease. IN CONCLUSION: lanreotide is an effective drug in reduction of soft tissue inflammatory changes in patients with active Graves ophthalmopathy. Absence of recurrence of the disease in final assessment indicates the persistent effect of lanreotide treatment.

[Effectiveness of treatment for thyroid orbitopathy in patients hospitalized at the Endocrinology Department of Pomeranian Medical University]. / Ocena skutecznosci leczenia orbitopatii tarczycowej w materiale Kliniki Endokrynologii PAM w Szczecinie.

UNLABELLED: The aim of the present study is the assessment of efficacy of systemic corticosteroid treatment combined with orbital radiotherapy in patients with thyroid ophthalmopathy. MATERIAL: 101 patients hospitalized in the Endocrinology Department of the Pomeranian Medical University in the years 1999-2002. METHODS: During first stage of treatment 3 to 6-7 intravenous pulses of methylprednisolone (SoluMedrol Pharmacia & Upjohn) in a dose of 1.0 g/day in consecutive 3 days were administered in combination with radiotherapy of the retroorbital spaces. Ten daily doses of 200 cGy using X-ray to each retroorbital space were given between the 2-nd to 4-th SoluMedrol pulse. Prednisone (Encorton Polfa) at an initial dose of 60 mg/day was used during the second stage of therapy. RESULTS: Donaldson's ophthalmopathy index scored for each eye separately decreased significantly after both stages of treatment (right eye: 6.35 (before treatment); 2.25 (after first stage), 1.2 (after second stage), p<0.05; left eye: 6.1 (before treatment); 2.1 (after first stage); 1.15 (after second stage), p<0.05). The clinical picture of Graves ophthalmopahty after the end of therapy in most of patients was significantly improved. Persistent diplopia was found in 16/101 patients. Two of them were referred for surgical correction of abnormal eyeball fixation, the rest were using prismatic glasses. Until now, no recurrence of thyroid eye disease in treated patients was observed. CONCLUSIONS: Combined therapy is an effective method of treatment of Graves' ophtahlmopathy in terms of both rapid regression of inflammatory changes in orbital soft tissues and in prevention of recurrence of the disease.

[Complications during systemic corticosteroid therapy combined with orbital radiotherapy in patients with graves orbitopathy]. / Powiklania skojarzonego leczenia orbitopatii tarczycowej glikokortykosteroidami i napromienianiem tkanek pozagalkowych.

OBJECTIVE: An assessment of complications during systemic corticosteroid therapy combined with orbital radiotherapy in patients with thyroid eye disease. MATERIAL: 101 patients including 86 women and 15 men hospitalized in the Endocrinology Department of Pomeranian Medical Academy in 1999-2002. METHODS: During the first stage of therapy, methylprednisolone in a daily dose of 1.0 g was administered intravenously for the following 3 days. The number of methylprednisolone pulses ranged from 3 up to 6-7. Orbital radiotherapy was usually performed between 2 and 4 pulse. Ten daily doses of 200 cGy were given in 2 weeks. After the series of methylprednisone and orbital radiotherapy had been finished, patients were treated with prednisone (Encorton, Polfa) given orally with an initial dose of 60 mg/day. RESULTS: During the first stage of therapy carbohydrate metabolism disturbances were observed in 27 patients. Cardio-vascular complications were noted in 8 patients. Four patients complained of digestive tract dysfunction. Acute psychosis was diagnosed in 3 patients. Twelve patients developed infectious diseases. During prednisone administration, 1 case of bacterial pneumonia, 1 purulent meningitis and 1 schizophrenia onset were observed. In prolonged ophthalmologic follow-up 3/101 patients with cataract needed surgical treatment.

[Evaluation of the effectiveness of extensive, ambulatory, non-pharmacological obesity treatment program]. / Ocena skutecznosci kompleksowego, ambulatoryjnego, niefarmakologicznego programu leczenia otylosci.

UNLABELLED: The aim of the study was an attempt to answer following questions: 1. Is extensive, non-pharmacological obesity treatment programme effective and is reduced body weight likely to be maintained in the long term? 2. What is the influence of the programme on some components of metabolic syndrome? 3. What is the effect of the programme on levels of leptin and insulin as indexes of weight reduction effectiveness? An informed consent to participate in the treatment was given by 37 women (GB) aged 19-47 yrs. (mean 36 +/- 7.7); with BMI 36 +/- 4.9 kg/m2. Control group (GK) was composed of 16 women aged 21-40 yrs. A 3-month extensive, ambulatory, non-pharmacological obesity treatment programme was offered to study subjects. Anthropometric, biochemical and hormonal assessment was performed before treatment (0), after 3 months--at the end of treatment (3), and after one year (R). After 3 months a reduction of body weight was observed in 34 persons (92%) whereas in 1 person (2.7%) body weight was stable and in 2 (5.4%) body weight increased. Body weight reduction was accompanied by beneficial changes in metabolic parameters. After one-year follow-up reduced body weight was maintained in 33 persons (89%), however, insulin and leptin levels and HOMA index increased significantly when compared to those observed during active treatment and were comparable with initial values. In the control group a significant increase in BMI, insulin and leptin levels and HOMA index was observed after one-year follow-up. CONCLUSIONS: 1. The extensive, non-pharmacological obesity treatment programme is effective because enables the reduction of body weight by 10% and patients are likely to maintain reduced body weight for one year. 2. The programme brings out metabolic benefits and enables to maintain them after its discontinuance. 3. The rebound increase in leptin and insulin levels after 9 months since active treatment has been discontinued may be an unfavourable prognostic factor in terms of maintenance of reduced body weight and indicates that the programme should be repeated in some patients groups.

[Assessment of soluble E selectin levels in patients with Graves' disease and thyroid orbitopathy]. / Analiza stezen rozpuszczalnej postaci E selektyny-1 (sELAM-1) u pacjentów z orbitopatia tarczycowa w przebiegu choroby Graves-Basedowa.

The aim of this study is to evaluate serum concentrations of sELAM-1 in patients with Graves' orbitopathy (GO). We studied levels of soluble form of E selectin -1 in patients with euthyroid progressive GO (group I) and euthyroid stable GO (group II), hyperthyroid Graves' disease (GD) without GO (group III) and in healthy controls (group IV). sELAM-1 levels were measured by ELISA method. The highest serum levels of sELAM-1 were found in group III. Mean sELAM-1 concentrations in patients with progressive and stable GO were slightly lower than those in group III patients. The sELAM-1 serum concentrations in group I and II were comparable, nearly the same despite the different clinical picture of the disease in both groups. Mean serum concentrations of sELAM-1 decreased significantly during treatment of progressive GO, parallel to the improvement of the eye changes. In conclusion, sELAM-1 concentrations do not reflect the degree of GO activity. A significant decrease in sELAM-1 concentrations are associated with the efficient outcome of treatment. Increased sELAM-1 levels seem to result form both GO and GD.

[Plasma leptin levels in relation to body composition and body fat distribution in patients with Cushing's syndrome]. / Stezenie leptyny w osoczu w odniesieniu do skladu tkanek ciala i rozmieszczenia tkanki tluszczowej u pacjentów z zespolem Cushinga.

It is known that body composition, especially body fat content, determines plasma leptin (LEP) levels. Clinical observation confirms that glucocorticoids (GS) have a considerable impact on body composition and body fat distribution which leads to visceral fat accumulation and a decrease in muscle mass in limbs. On the other hand, in experimental models GS stimulate ob mRNA expression in adipose tissue and LEP secretion into bloodstream. The aim of the study was to evaluate changes in body composition and fat and fat-free mass distribution in the conditions of endogenous hypercortisolism as well as to determine whether changes in body composition parameters may influence plasma LEP levels in patients with Cushing's syndrome (CUS). The study group was composed of 14 patients (12 F, 2 M) with ACTH-dependent and ACTH-independent CUS (BMI 29,5 +/- 1,0 kg/m2, aged 41,6 +/- 2,9 yrs.). The control group (KON) included 14 overweight/obese subjects (12 F, 2 M; WHR>0.8) matched for age, height, weight, and BMI with CUS group. Basal plasma LEP levels were measured by RIA kit. Total fat mass (BFM), fat-free mass (FFM), their regional depots (arms, legs, trunk) as well as bone mineral content (BMC) were determined by DEXA method (Lunar Co., USA). Values of BFM and %BF were comparable in both groups whereas the amount of FFM was lower in CUS group than in controls. Patients with CUS had less BF in limbs than controls whereas the difference in the amount of trunk BF in favour of CUS reached a borderline significance. Moreover, subjects with CUS exhibited decreased amount of FFM both in arms and legs when compared to controls, which may be explained by limb muscle and connective tissue wasting observed clinically. However, the amount of trunk FFM did not differ between both groups. Eventually, subjects with CUS had lower BMC values than controls. Absolute plasma LEP levels were 2-fold higher in CUS group than those in KON group (34,03 +/- 4,45 vs. 17,04 +/- 1,88, ng/ml; p=0.006), however, in both groups they were highly correlated with BFM and %BF. Multiple linear regression analysis revealed that in CUS group 64% of the variation of plasma LEP levels is explained by trunk BF and in KON group 92% of the variation of LEP levels is dependent of arms BF (+, 18%) and legs BF (+, 69%) and arms FFM (-, 5%). In conclusion, endogenous hypercortisolismus leads to the augmentation of truncal (visceral) fat accumulation as well as to a marked decrease in fat-free mass in limbs and in bone mineral content. In Cushing's syndrome, irrespectively of its cause (pituitary gland, adrenal glands), plasma LEP levels are elevated in relation to body fat content. Truncal (visceral) fat may have a relatively stronger influence on plasma LEP in Cushing's syndrome than in subjects with normal cortisolaemia, however, changes in body composition and tissue distribution do not fully account for the presence of markedly elevated LEP levels in this syndrome.

[Usefulness of soluble ICAM-1 measurements for the evaluation of the disease activity and efficiency of therapy in patients with infiltrative Graves' ophthalmopathy]. / Przydatnosc oznaczen rozpuszczalnej formy czasteczki adhezyjnej ICAM-1 do oceny aktywnosci choroby i efektów leczenia obrzekowo-naciekowej postaci oftalmopatii tarczycowej w przebiegu choroby Gravesa i basedowa.

The authors studied serum levels of soluble intercellular adhesion molecule-1 (ICAM-1) in patients with progressive Graves' ophthalmopathy (GO), stable GO, hyperthyroid Graves' disease (GD) without GO and in healthy controls. The highest serum concentrations of sICAM-1 were observed in patients with progressive GO. In patients with stable GO and GD mean serum levels of sICAM-1 were elevated to a lesser degree. Mean serum concentrations of sICAM-1 decreased significantly during treatment of patients with the progressive GO parallel to the improvement of the eye changes. In patients with hyperthyroid GD serum levels of sICAM-1 decreased significantly after they had become euthyroid. Mean sICAM-1 level in the euthyroid GD was markedly decreased in comparison to the group of patients with progressive GO and slightly elevated when compared to stable GO. In conclusion, serum levels of sICAM-1 seems to be a good parameter of disease activity in progressive infiltrative GO. The decrease in sICAM-1 concentrations in patients with the progressive GO closely corresponds to the improvement of the clinical picture of the progressive GO.