Hormones and depression in the advanced age.

INTRODUCTION: In older people, depression and mental disability are more frequently present than in younger subjects. It is found that depressionis a risk factor for dementia, just as dementia is a risk factor for depression. In turn, both disturbances are known to be influenced by hormones. The present study aimed to see whether the hormonal changes in subjects over 75 years old correlate with the symptoms of depression measured using the Geriatric Depression Scale (GDS). MATERIAL AND METHODS: In a group of patients aged over 75 years, concentrations of follicle-stimulating hormone (FSH), luteinizing hormone (LH), oestradiol, testosterone, dehydroepiandrosterone sulphate (DHEAs), and cortisol were measured in serum with the use of chemiluminescence. The symptoms of depression were estimated by GDS, and the mental functions were assessed by the Mini-Mental State Examination (MMSE). The correlations between the obtained results were estimated by Spearman's test. RESULTS AND CONCLUSIONS: A significant correlation between GDS and MMSE scores was observed in the investigated patients. Some statistically significant correlations concerning cortisol and testosterone with GDS were observed in women, but not in men. On the other hand, no significant correlations between concentrations of FSH, LH, DHEAs, and oestradiol with GDS were noticed. Our data support the role of cortisol (possibly secreted during chronic stress) in the risk of depression. The gender difference in the mechanism of depression and stress in older age could be also hypothesized.

Immunohistochemical detection of prolactin in clinically non-functioning pituitary adenomas.

INTRODUCTION: Approximately one third of pituitary adenomas are manifested neither by specific symptoms of hormone overproduction nor by elevated blood levels of pituitary hormones. However, these tumours, diagnosed before surgical intervention as clinically non-functioning pituitary adenomas (CNFPAs) express in majority different pituitary hormones, as can be revealed by means of immunohistochemical examination. One of the pituitary hormones which may be expressed in CNFPAs is prolactin (PRL) but the clinical and pathological data on this condition are very scarce. MATERIAL AND METHODS: Sixty two pituitary adenomas, diagnosed before surgery as CNFPAs, were immunoassayed with antibodies against PRL, growth hormone (GH), luteinizing hormone (LH), follicle stimulating hormone (FSH), thyrotropin (TSH), alpha subunit (alpha-SU), corticotropin (ACTH) and dopamine receptor type 2. In a proportion of the patients the presurgical concentrations of insulin-like growth factor 1 (IGF-1) were estimated by means of enzyme-amplified chemiluminescence assay. RESULTS: Twenty-three (37.1%) of the examined CNFPAs presented the positive immunoreaction with anti-PRL antibody. Most cases concerned women. Only in two cases (one woman and one man), PRL was the unique hormone expressed in the tumour. In the remaining adenomas PRL immunopositivity was accompanied by GH expression - 17, LH or free bLH - 13, FSH - 2, free a subunit - 4 or by ACTH - 5 tumours. Seven (30.43%) of them were recurrent in comparison with 12.8% PRL-immunonegative recurrent CNFPAs. Dopamine receptors were positively immunostained in all the investigated PRL-immunopositive and all PRL-immunonegative adenomas. CONCLUSIONS: Our data confirm the observations that monohormonal silent prolactinomas are very rare but frequently silent PRL often co-expressed with GH or LH. Although in the whole population of patients with CNFPAs both sexes are equally represented, in the case of silent prolactinomas the female sex is prevalent. The observation of the higher rate of recurrent tumours within PRL-immunopositive adenomas versus PRL-immunonegative CNFPAs has to be confirmed on the larger material.

Are physical and mental abilities of older people related to gonadotropins and steroid hormones levels?

BACKGROUND: Aging is characterized by deep alterations of hormone secretion. In majority, hormone secretion, except gonadotropins, undergoes a pronounced decrease which is thought to contribute to the progression of aging. The recent data indicate that gonadotropin excess may also by itself influence the aging process. The aim of the present study was to investigate the relations between gonadotropins and steroid hormones with physical and mental abilities of older people. MATERIAL AND METHODS: In a group of patients aged over 75 years, concentrations of FSH, LH, estradiol, testosterone, DHEAs and cortisol were measured. The mental ability was estimated by MMSE and CDT and the physical ability by TUG and SPPB tests. RESULTS AND CONCLUSIONS: The positive correlation between SPPB scores and FSH and the negative correlations of SPPB with LH/FSH ratio were observed in men. The correlation of TUG scores and estradiol levels was also noted in men. The positive correlation between CDT scores and FSH in women and the negative correlation between CDT and LH/FSH ratio in men were found. The correlation between the results of CDT and cortisol levels in men was also observed. Thus, we did not confirm the simple deleterious effect of gonadotropins on cognitive abilities. FSH and LH seem exert different (antagonistic?) effects on cognitive functions, but this hypothesis needs further studies.

Elevated serum concentrations of IGF-1 and IGF-1R in patients with thyroid cancers.

BACKGROUND: The rising incidence of thyroid cancer observed in the last few decades requires an improvement in diagnostic tools and management techniques for patients with thyroid nodules. AIMS: The aim of this study was to assess serum concentrations of IGF-1 and IGF-1R in patients diagnosed with thyroid cancers. METHODS: 36 patients diagnosed with papillary thyroid cancer (PTC), 11 subjects with follicular thyroid cancer (FTC), 9 patients with anaplastic thyroid cancer (ATC) and 19 subjects with multinodular nontoxic goiter (MNG) were enrolled to the study. The control group (CG) consisted of 20 healthy volunteers. Blood samples were collected one day before surgery. Serum IGF-1 and IGF-1R concentrations were measured using specific ELISA methods. RESULTS: Significantly higher concentrations of IGF-1 were found in patients with PTC as compared with controls but not that obtained from subjects diagnosed with MNG. The concentration of IGF-1R was significantly elevated in subjects with PTC and ATC as compared with healthy volunteers. Similarly, patients diagnosed with PTC or ATC presented significantly higher serum concentration of IGF-1R in comparison to the MNG group. CONCLUSIONS: Our results show that the IGF-1 - IGF-1R axis plays a significant role in the development of PTC and ATC and imply that serum concentrations of both cytokines may be considered as additional markers for the differentiation of malignancies during the preoperative diagnosis of patients with thyroid gland tumors. These results indicate that IGF-1R serum concentrations allow us to differentiate between MNG and PTC or ATC. Moreover IGF-1R serum values appear to be better predictor of PTC and ATC than IGF-1 concentrations.

Gonadotropins and steroid hormones in older people: their mutual connections and relations to body mass indices.

INTRODUCTION: Aging in mammals, including man, is accompanied by deep changes in hormone secretion. In the majority of cases, hormone secretion (mostly of gonadal steroids and adrenocortical hormone dehydroepiandrosterone - DHEA) undergoes pronounced decrease. This decrease is thought to contribute to the progression of aging. In contrast, the secretion of gonadotropins is sharply increased in older adults, as a result of gonadal deficiency. Recent data indicate that gonadotropin excess may also, by itself, influence the aging process. The aim of the present study was to investigate the mutual relation between steroid hormones and gonadotropins and their effect on body mass indices in older people. MATERIAL AND METHODS: In a group of 100 patients (61 women and 39 men) aged over 75 years, blood serum concentrations of folliclestimulating hormone (FSH), luteinising hormone (LH), oestradiol (E2), testosterone, dehydroepiandrosterone sulphate (DHEAs), and cortisol were measured. All the patients were measured for the following: body weight (kg), body mass index (BMI) (kg/m²), and waist-to-height ratio (WtHR). The differences of the numerical data were evaluated by Student's t-test and the correlations between them by means of Pearson's test. RESULTS AND CONCLUSIONS: The most interesting finding of this study was to show that FSH and LH are negatively correlated with body mass and indices such as BMI and WtHR in older women. Because in older women the mediation of ovary is unlikely, we conclude that gonadotropins may influence the body mass by their direct extra-gonadal action.

Dysregulation in IGF-1R, FGFR4 and ßKlotho signaling in patients with medullary thyroid cancer.

BACKGROUND: Medullary thyroid cancer (MTC) is a relatively rare thyroid neoplasm derived from neuroendocrine C cells which secrete calcitonin. αKlotho (αKL) and ßKlotho (ßKL) are transmembrane proteins which modulate different signaling systems, such as endocrine FGFs and IGF1 pathways. Dysregulation of the FGF19/FGFR4/ßKL and IGF-1/IGF-1R/αKL signaling axes has been implicated in the pathogenesis of several cancers. However, their role in the pathogenesis of MTC has not been determined. METHODS: The aim of this study was to assess αKL, ßKL, FGF19, IGF-1, FGFR4, and IGF-1R concentrations in a group of 11 patients with medullary thyroid cancer (MTC). The control group consisted of 20 healthy volunteers. Serum concentrations of these factors were measured using specific ELISA methods. RESULTS: Significantly lower concentrations of ßKL and higher concentrations of FGFR4 and IGF-1R were found in patients with MTC as compared to controls. CONCLUSIONS: Our results indicate that a disrupted signaling pathway for ßKL, FGFR4 and IGF-1R may play a role in the development of medullary thyroid cancers. However, further studies are required to confirm these findings and to use this knowledge in clinical practice.

Blood serum concentrations of gonadotropins and α-subunit in patients with gonadotropinomas in relation to the immunoreactivity of pituitary adenoma.

INTRODUCTION: Although active gonadotropin-secreting pituitary adenomas are considered very rare, the vast majority of pituitary tumours diagnosed as "non-functioning" express gonadotropins or their free ß or α subunits. However, systemic investigations comparing the serum concentrations of follitropin (FSH), lutropin (LH), and α-subunit (αSU) before surgery with the immunoreactivity of the respective substances in the excised tumours are still lacking. MATERIAL AND METHODS: Immunostaining of FSH, LH, and αSU was compared in 43 surgically removed gonadotropin - expressing pitu-itary adenomas with serum concentrations of the above-mentioned substances before surgery in the same patients. RESULTS: The serum concentrations of FSH were elevated (> 11.6 mU/mL) in 8/12 (66.7%) cases of FSH-positive adenomas. By contrast, in FSH-negative tumours the elevation of FSH is absent. Moreover, only 1/25 (4%) patients with LH-positive adenoma had the elevated serum concentration of LH (51.5 mU/mL). The overproduction of LH was not observed in adenomas expressing free ß LH or in LH-negative tumours. In patients with αSU-positive adenomas elevated serum levels of αSU were observed in 3/15 (20%) cases. No αSU elevations were observed in patients with αSU-negative adenomas. The mean serum FSH, LH, and αSU concentrations were higher in patients with FSH, LH, and/or αSU immunopositive tumours in comparison with immunonegative. However, the differences are not statistically significant. CONCLUSIONS: Although "silent" gonadotropinomas constitute a frequent subtype of pituitary adenomas, the "active" subtype (i.e. manifesting by gonadotropin excess) are rare (approx. 4% of all pituitary adenomas). Gonadotropinomas are difficult to diagnose before surgery. The measurement of gonadotropins including αSU is needed but often not sufficient for presurgical diagnosis.

Estimation of vitamin D status in patients with secondary and primary hypothyroidism of different etiology.

BACKGROUND: Though vitamin D deficiency is a global problem with wide spectrum of severe public health consequences, inadequate vitamin D status still remains one of the most common and untreated medical conditions. Thyroid diseases, including hypothyroidism, also represent the most frequent endocrinopathies in general population. OBJECTIVES: To determine the vitamin D status in hypothyroid patients and to ascertain the status of thyroid hormone replacement. METHODS: The 25(OH)D concentrations (ECLIA) in 71 hypothyroid patients recruited in the Outpatient Clinic of Endocrinology or Department of Clinical Endocrinology were assessed. The examined group was composed of 59 subjects diagnosed with primary hypothyroidism of different etiology and 12 patients with secondary hypothyroidism. The control group included 16 healthy individuals. RESULTS: Mean serum 25(OH)D concentration in healthy volunteers was significantly lower than in hypothyroid subjects (13.09±1.63 vs. 19.92±1.37 ng/mL). Patients with a history of thyroidectomy presented with significantly higher mean 25(OH)D concentration than controls (23.25±2.75 vs. 13.09±1.63 ng/mL). Mean serum 25(OH)D concentration in effectively treated hypothyroidism was significantly higher than in controls (21.90±1.47 vs. 13.09±1.63 ng/mL) or undertreated hypothyroidism (21.90±1.47 vs. 13.52±3.39 ng/mL). Hypothyroid patients aged under 60 years presented with significantly lower mean 25(OH)D concentration than elders (16.46±1.54 vs. 24.39±1.18 ng/mL). The major 25(OH)D deficient (≤10 ng/mL) or deficient (≤20 ng/mL) hypothyroid patients were significantly younger than those with 25(OH)D concentrations exceeding 10 ng/mL or 20 ng/mL respectively. CONCLUSIONS: These findings confirm the necessity for vitamin D status improvement in the general population and more effective healthcare of hypothyroid patients.

Somatostatin Analogs and Tumor Localization Do Not Influence Vitamin D Concentration in Patients with Neuroendocrine Tumors.

Patients with neuroendocrine tumors (NETs), malignancies of rare but still rising incidence, may be a group at higher risk of vitamin D insufficiency. The gastrointestinal tumor prevalence and somatostatin analog (SSA) therapy may cause vitamin D malabsorption. The aim of this study was to evaluate the serum level of vitamin D in NET patients. A total of 36 NET patients were enrolled into the experimental group and 16 individuals were enrolled into the control group. All patients were further classified into subgroups according to primary tumor localization (gastropancreatic, lung, and other NETs) or therapy (with or without SSA treatment). The concentrations of total 25(OH)D were assayed with Electrochemiluminescence immunoassay (ECLIA). Serum concentration of 25(OH)D in NET patients did not differ significantly from that of the control group. However, the average level of 25(OH)D in both groups met the criteria of vitamin D deficiency. Importantly, SSA therapy did not aggravate vitamin D deficiency. Moreover, the concentration of 25(OH)D in the studied group was not significantly influenced by primary tumor localization, patient age, or season. Vitamin D deficiency is a widespread disorder affecting both NET patients and individuals without other health problems, and SSA and gastrointestinal tumor localization do not exacerbate this condition.

Ultrafiltration - an alternative method to polyethylene glycol precipitation for macroprolactin detection.

INTRODUCTION: The aim of the study was to evaluate two methods of macroprolactin (MaPRL) detection - precipitation with polyethylene glycol (PEG) and ultrafiltration and to compare these techniques with "gold standard" - gel filtration chromatography (GFC). MATERIAL AND METHODS: The study was conducted on 245 patients - 45 with organic and 200 with functional hyperprolactinaemia. In all the subjects MaPRL was detected by precipitation with PEG and ultrafiltration. Additionally, gel filtration chromatography was performed in some of the serum samples. RESULTS: Macroprolactinaemia was detected in 27 patients - 8 with prolactinoma and 19 with functional hyperprolactinaemia. Assessing positive and negative results for MaPRL, we observed high diagnostic agreement (95.9%) and positive correlation (r = 0.506, p < 0.001) between the methods. The results of precipitation and ultrafiltration positive for MaPRL were concordant in 63%. The dominance of MaPRL detected with precipitation and/or ultrafiltration was confirmed by GFC in 76% of cases (all patients with functional hyperprolactinaemia). Among 6 examined patients with prolactinoma, GFC showed four false-positive results - 1 case of precipitation and 3 cases of ultrafiltration. CONCLUSIONS: Efficacy of MaPRL detection with precipitation and ultrafiltration is comparable especially in cases of functional hyperprolactinaemia. In patients with prolactinoma, precipitation seems to be a more efficient separation method.

Decreased serum level of IL-7 in patients with active Graves' disease.

BACKGROUND: Graves' disease (GD) is a common autoimmune disease which is one of the major causes of hyperthyroidism. Interleukin 7 (IL-7) has been recently reported to play an important role in various autoimmune diseases, but its role in the pathogenesis of GD has not been assessed. The aim of this study was to evaluate the levels of IL-7 and the soluble form of its receptor (sIL-7R) in the serum of GD patients, and to identify their association with disease activity. METHODS: A total of 37 GD patients were enrolled into the experimental group and 16 individuals into the control group. All patients were further classified into three subgroups: a GD-active group (hyperthyroidism and TRAb (thyroid stimulating hormone receptor antibody) >7.5 U/L) (N=15), a GD-inactive group (euthyreosis and TRAb<1 U/L) (N=8), and other GD patients (euthyreosis and TRAb>1 U/L) (N=14). Concentrations of IL-7 and sIL-7R were assayed with ELISA. Additionally, the relationship between IL-7 and sIL-7R serum concentrations with disease activity (free triiodothyronine [FT3], free thyroxine [FT4], thyroid stimulating hormone [TSH] and TRAb) was also analyzed. RESULTS: The serum concentrations of IL-7 in GD-active patients were significantly lower than those of the control group as well as the GD-inactive and GD-other groups. The serum level of IL-7 in GD patients negatively correlated with FT4 and TRAb concentrations. Moreover, no significant difference was observed in the serum level of sIL-7R in GD patients compared to the control group. CONCLUSIONS: These observations suggest that IL-7 may play a role in the pathogenesis of GD and may be associated with its clinical activity. To this end, the serum level of IL-7 could be an additional diagnostic biomarker predictive of the disease and could be particularly valuable for TRAb-negative GD patients.

Overexpression of prothymosin alpha is related to pituitary adenoma recurrence but not to adenoma invasiveness and proliferation.

INTRODUCTION: Prothymosin alpha (ProTα) is a peptide initially considered as a thymic hormone, but further studies have shown its wide distribution in different tissues and organs. It has a prevalent nuclear localisation and is thought to be involved in the control of proliferation and apoptosis. In earlier studies, the overexpression of ProTα was found in several human tumours, including pituitary adenomas. The present study deals with the relations of ProTα to the pituitary adenoma hormonal phenotype, proliferation, recurrence and invasiveness. MATERIAL AND METHODS: Sixty two pituitary adenomas were included in the study. The invasiveness of the tumours was estimated before surgery by means of magnetic resonance imaging. The paraffin sections of the tumours were immunostained with an antibody against the C-terminal fragment (101-109) of ProTα and with anti-Ki-67 antibody. The hormonal phenotype of the investigated pituitary adenomas had been established previously by means of immunostaining with antibodies to pituitary hormones (GH, PRL, FSH, LH, TSH, ACTH and α-subunit). RESULTS: Strong immunostaining with anti-ProTα antibody occurred in the subpopulation of cell nuclei and the walls of intratumoural blood vessels. ProTα index is higher in clinically non-functioning pituitary adenomas (CNFPA) compared to any type of functioning adenomas. There was no difference in the percentage of ProTα- positive cell nuclei in non-invasive vs. invasive adenomas, but it was significantly more frequent in recurrent than in primary tumours. Moreover, the decrease of ProTα index was found in somatotroph tumours treated with somatostatin analogues vs. untreated ones. The percentage of ProTα nuclei did not correlate with Ki-67 index. CONCLUSIONS: The overexpression of nuclear ProTα in pituitary adenomas is related to tumour recurrence, but not to proliferation or invasiveness.

Expression of follicle stimulating hormone receptors in pituitary adenomas - a marker of tumour aggressiveness?

INTRODUCTION: In our earlier study, we found that pituitary adenomas, like other human tumours, express ectopically follicle stimulating hormone receptors (FSHR) in intratumoural blood vessels endothelia and/or tumoural cells. The aim of the present paper was to provide more detailed data on FSHR expression in different subtypes of pituitary adenomas and to evaluate its possible role as a prognostic and/ or predictive biomarker in these tumours. MATERIAL AND METHODS: Forty two pituitary adenomas, surgically removed, were immunostained with antibodies against the pituitary hormones, antigen Ki-67 and 1-190 fragment of FSHR. RESULTS: The positive FSHR immunostaining was found in blood vessels endothelia of 88% of adenomas and in tumoural cells of 40% adenomas. In tumoural cells, the incidence of at least moderate FSHR immunostaining is significantly higher in invasive tumours (68%) compared to non-invasive (12%) ones, and higher (albeit not statistically significantly) in invasive-proliferating adenomas (Ki-67 > 3%, grade 2b) compared to invasive but non-proliferating (Ki-67 < 3%, grade 2a) ones. CONCLUSIONS: The present study confirms that pituitary adenomas ectopically express FSHR in intratumoural blood vessels endothelia and tumoural cells. Moreover, the expression in tumoural cells is prevalent in invasive and proliferating adenomas vs. non-invasive and non-proliferating tumours.

Long-term impact of vertical banded gastroplasty (VBG) on plasma concentration of leptin, soluble leptin receptor, ghrelin, omentin-1, obestatin, and retinol binding protein 4 (RBP4) in patients with severe obesity.

Restrictive type bariatric surgery is an effective therapeutic approach that decreases overall mortality in patients with severe obesity. Several new cytokines, including adipocytokines that control energy metabolism, have been discovered recently, but their role in obesity is not fully recognized. The aim of the study was to evaluate the influence of vertical banded gastroplasty (VBG), one of restrictive type bariatric surgery, on peripheral blood concentrations of some adipocytokines and hormones involved in the control of food intake and energy turnover. The studied group comprised 12 females and 2 males aged from 31 to 59years (46.6±7.4) with simple obesity (BMI: 44.9±7.2) and metabolic syndrome. The patients were examined both before and 3, 6, 12, 24months after bariatric surgery (eight patients were also checked after 36 and six patients after 48months). Measurements of peripheral blood concentration of glucose, insulin, leptin, soluble leptin receptor, obestatin, ghrelin, omentin-1, and retinol binding protein 4 (RBP4) by ELISA method have been performed. After the surgery body weight, BMI and waist circumference significantly decreased. Positive changes considering the components of metabolic syndrome have been noted. Namely glucose, insulin and triglycerides' levels decreased, accompanied by the significantly lower HOMA index. Conversely, HDL cholesterol concentrations increased. Furthermore, peripheral blood concentration of leptin decreased, but the blood levels of soluble leptin receptor and ghrelin gradually increased. The positive correlations between leptin and body weight and BMI were noted as well as between the RBP4 and total cholesterol and LDL cholesterol levels. We did not observe significant differences in levels of obestatin, omentin-1 and RBP4 after surgery. In conclusion, VBG is an effective type of bariatric surgery. Fast decrease of body weight in morbidly obese patients treated by restrictive bariatric surgery leads to significant changes in peripheral blood levels of some adipokines and hormones controlling energy turnover and appetite (leptin and soluble leptin receptor) as well as ghrelin but not omentin-1, obestatin or retinol binding protein (RBP-4).

The detection of macroprolactin by precipitation and ultrafiltration methods.

BACKGROUND: Prolactin (PRL) exists in human blood in several molecular forms. Macroprolactin (MaPRL), which most often consists of monomeric PRL and immunoglobulin G, has the highest molecular weight but no biological activity. Immunoassays do not distinguish MaPRL from monomeric PRL, what can lead to an incorrect diagnosis of hyperprolactinaemia. The most commonly used technique to separate the isoforms of PRL is precipitation with polyethylene glycol (PEG). Another technique - ultrafiltration - seems to be useful in MaPRL detection. The aim of this study was to evaluate the occurrence of MaPRL in hyperprolactinaemic patients and to compare the results obtained by precipitation and ultrafiltration. MATERIAL AND METHODS: The study was conducted on 120 sera obtained from patients hospitalised in the Department of Clinical Endocrinology, Medical University of Lodz, in whom PRL concentration was above 30 ng/mL Of these 120 patients, 25 had pituitary adenoma, 52 had polycystic ovary syndrome (PCOS), and 43 had idiopathic hyperprolactinaemia (HPRL). Macroprolactin was detected using two methods: precipitation with PEG and ultrafiltration. Concentration of PRL was measured by Immulite 1000 immunoassay (Siemens). RESULTS: We detected a predominance of MaPRL in ten patients (three with macroprolactinoma, three with PCOS and four with HPRL) using precipitation and ultrafiltration. Positive correlation and diagnostic concordance between the results of precipitation and ultrafiltration were noted, especially in the group with functional hyperprolactinaemia. In half of the patients with macroprolactinaemia, and in 12 of the 110 subjects without significant amounts of MaPRL, real PRL concentration was within the reference range. CONCLUSIONS: MaPRL is not a significant clinical problem in the studied population. However, in patients with hyperprolactinaemia, especially non-organic, screening for macroprolactinaemia should be performed. The effectiveness of the precipitation and ultrafiltration methods for detecting MaPRL is comparable in functional hyperprolactinaemia, but the usefulness of ultrafiltration in patients with pituitary adenoma requires further examination.

Impact of vertical banded gastroplasty on body weight, insulin resistance, adipocytokine, inflammation and metabolic syndrome markers in morbidly obese patients.

INTRODUCTION: Diet, exercise, and pharmacological therapy have been shown to be unsatisfactory treatments for severe obesity in the long term. Bariatric surgery is the most effective means to achieve weight loss in morbidly obese subjects. The aim of this study was to evaluate the action of a number of adipocytokines, as well as the metabolic syndrome parameters of obese patients, before and after vertical banded gastroplasty (VBG). MATERIAL AND METHODS: The test subjects comprised eight males and 20 females (total 28 patients) aged from 20 to 59 years (43.7 ± 10.0) with simple obesity and the presence of metabolic syndrome, both before and 3, 6, 12, and 24 months after bariatric surgery (six patients were also checked after 36 and 48 months). RESULTS: After surgical treatment (at 24 months), the values of body weight, BMI, waist circumference, blood pressure (RR-S, RR-D), HOMA-IR and blood concentrations of CRP, TG, IRI, AUC-IRI, and AUC-GLU gradually decreased. We did not observe any significant differences of fasting glucose, leptin, total cholesterol and LDL-cholesterol concentrations before or after surgery. The blood levels of HDL, adiponectin, resistin, and ghrelin gradually increased after treatment. CONCLUSIONS: The significant decrease of body weight after vertical banded gastroplasty, as well as improvement of the main metabolic syndrome parameters and some adipocytokine blood levels, indicate the use of bariatric surgery as a valuable method of treating morbidly obese patients.

Systemic blood osteopontin, endostatin, and E-selectin concentrations after vertical banding surgery in severely obese adults.

BACKGROUND: Obesity is associated with endothelial dysfunction and increased inflammation as well as with expansion of the capillary bed in regional adipose deposits, and a balance between these factors is involved in angiogenesis. Osteopontin (OPN) is a proinflammatory cytokine involved in regulating immune processes and mediating chronic inflammation. Its level is usually elevated in the plasma and adipose tissue of obese subjects. E-selectin, an adhesion molecule which is released by dysfunctional endothelial cells, is believed to be a marker of an early atherosclerotic process. Endostatin (END), an angiogenesis inhibitor, is present in the blood of obese subjects. The most effective treatment to achieve weight loss in morbidly obese subjects is bariatric surgery. The aim of the study was to evaluate and compare the circulating concentrations of OPN, E-selectin and END as well as the insulin resistance (HOMA-IR) of severely obese patients with metabolic syndrome before and after vertical banded gastroplasty (VBG). MATERIAL AND METHODS: The test cohorts comprised eight males and 20 females (total 28 patients) aged from 20 to 59 years with simple obesity and the presence of metabolic syndrome, both before and 3, 6, 12, 24 months after bariatric surgery (six patients were also checked after 36 and four after 48 months). RESULTS: Bariatric surgery significantly reduced (over 24 months) body weight, BMI, waist circumference, HOMA-IR and blood concentrations of CRP. Plasma OPN gradually increased after VBG and E-selectin in systemic blood decreased. We did not observe any differences in END concentrations from 12 to 48 months after surgery. CONCLUSION: VBG improves metabolic syndrome parameters, decreases E-selectin and gradually increases OST blood concentrations but it does not have any significant influence on END levels.

Expression of somatostatin receptor subtypes in primary and recurrent gonadotropinomas: are somatostatin receptors involved in pituitary adenoma recurrence?

OBJECTIVE: Surgical treatment of pituitary macroadenomas often fails because of tumor recurrence after the operation. The causes of tumor recurrence are complex, but one of them may be the high growth potential of the adenoma. As somatostatin receptors mediate antiproliferative, anti-angiogenic and pro-apoptotic actions, it seemed reasonable to investigate their expression in dependence on the adenoma recurrence. METHODS: Samples of primary and recurrent gonadotropinomas excised surgically from patients were examined. This type of pituitary adenomas was chosen because of its relatively high recurrence rate. The adenoma phenotype and expression of somatostatin receptor subtypes 1-5 (SSTR 1-5) were investigated by immunohistochemistry, and the level of SSTR expression was semiquantitatively scored. RESULTS: It was found that the adenomas undergoing the early recurrence have lower expression of SSTR 2A and 3 in comparison to those which did not recur during 5 years lasting observation. On the other hand, the recurrent tumors show higher expression of SSTR 1, 2A, 3 and 5 subtypes than their primary counterparts. CONCLUSIONS: It is hypothesized that SSTR may, at least in part, counteract adenoma recurrence. On the other hand, it can be also presumed that the recurrent gonadotropinomas may be more sensitive to somatostatin analog treatment than primary ones. These hypotheses need to be confirmed in further studies.

The effects of melatonin, N-acetylserotonin, and 6-hydroxymelatonin on the ultrastructure of the pinealocytes of the Syrian hamster (Mesocricetus auratus).

OBJECTIVES: The aim of this study was to examine the effects of melatonin as well as of its precursor (N-acetylserotonin) and metabolite (6-hydroxymelatonin) on the ultrastructure of the pinealocytes of the Syrian hamster. MATERIAL AND METHODS: The pineal glands of 2-month-old male Syrian hamsters were examined. The animals were divided into the following groups of four animals each: group 1 - melatonin treatment; group 2 - N-acetylserotonin treatment; group 3 - 6-hydroxymelatonin treatment (all substances given subcutaneously at doses of 25 microg per animal between 16.00 and 17.00 h daily for seven weeks). Group 4 was given solvent treatment only and served as controls. The animals were killed by decapitation between 09:00 and 10.00 h. Routine electron microscopical techniques were used to obtain quantitative data on pinealocyte ultrastructure. RESULTS: Melatonin administration did not influence the size of the hamster pinealocytes, whereas administration of N-acetylserotonin and 6-hydroxymelatonin caused a significant reduction in cell size in comparison to the melatonin-treated and control groups. There were changes in the relative volumes of the mitochondria, Golgi apparatus and lysosomes in the pinealocytes of the studied groups, while the volumes of granular endoplasmic reticulum and lipid droplets were unchanged. The dense-core vesicles were more numerous in the pinealocytes of the melatonin and 6-hydroxymelatonin-treated groups in comparison to those of animals treated with N-acetylserotonin or the controls. CONCLUSIONS: The changes observed in the ultrastructure of hamster pinealocytes indicate that administration of melatonin as well as of its precursor or metabolite influences the morphology of these cells and also, perhaps, their secretory activity.