Reduction in the level of antibodies against heat shock proteins 60 during different hormonal protocols in postmenopausal women.

INTRODUCTION: In current literature, the immune-inflammatory theory of atherosclerosis is widely discussed. The role of how heat shock proteins 60 (HSP60) lead to the development of the atheromatous plaque is especially underlined. The aim of the study is to estimate the influence of three hormonal protocols on behavior of antibodies against HSP60. It determines the state of endothelium in postmenopausal women. MATERIAL AND METHODS: The study was carried out on 90 women between 2007 and 2012. All the women were in their menopausal age (51 ± 3 years), from the south region of Poland, with a follicle stimulating hormone (FSH) level above 25 mIU/ml, and with menopausal symptoms disturbing their normal daily activity. The study was done for a period of 6 months. Three groups of 30 randomized patients were formed. In the first group we used transdermal estrogen therapy in a 37.5 µg/24 h dose combined with a 10 mg dose of dydrogesterone. In the second group we applied transdermal estrogen therapy in a 50 µg/24 h dose with 2.5 mg of oral medroxyprogesterone. In both these groups, gestagens were administered continuously. In the third group, we prescribed continuous, oral, low-dose combined estrogen-gestagen therapy with 1 mg of ethinyl estradiol and 0.5 mg of norethisterone acetate. The control group consisted of 30 volunteers who were also from the south region of Poland, in good health, with menopausal symptoms, no menstrual period for the last 12 months, selected considering their age and weight, with an FSH level above 25 mIU/ml and with normal levels of thyroid stimulating hormone (TSH) and prolactin. All patients treated and in the control group were seronegative to Chlamydia pneumonia for the entire duration of the study. In the analysis conducted, nonparametric tests were used (Mann-Whitney U test, Wilcoxon test, Kruskal-Wallis test - ANOVA). RESULTS: After 6 months of hormonal therapy, we found that all schemes of treatment promote a significant reduction in antibodies against HSP60 in all treated groups vs. the control group. CONCLUSIONS: All of the investigated estrogen protocols have a favorable impact on the blood level of HSP60 antibodies in early postmenopausal women who have no cardiovascular risk factors. It triggers a better condition of endothelium.

[The disturbances of the thyroid hormone homeostasis caused by chemical substances occurring in natural environment]. / Wielopoziomowe zaklócenia homeostazy hormonów tarczycy spowodowane przez substancje chemiczne wystepujace w srodowisku naturalnym.

The thyroid is an endocrine gland synthesizing, storaging and secreting thyroxine (T4) and triiodothyronine (T3). Currently, there are more and more reports and evidences that various chemical contaminants present in the environment, mainly polychlorinated biphenyls, interfere with stages of regulation, synthesis, secretion, transport of thyroid hormones. That can have a significant negative impact on the human body's endocrine homeostasis.

High live birth rate after conservative treatment of ectopic pregnancy with methotrexate.

OBJECTIVES: The aim of the study was to assess fertility in patients diagnosed with ectopic pregnancy and treated with methotrexate, as well as safety and efficacy of conservative treatment. Also, risk factors of recurrent ectopic pregnancies were determined. MATERIAL AND METHODS: The study included 86 female patients with ectopic pregnancy hospitalized and treated in the clinic of Gynecological Endocrinology, UJCM, Cracow, between 2007 and 2011. A total of 73 patients received a single dose of MTX in the amount of 50 mg/m2 of body surface area. Serum b-hCG concentration was measured on days 4 and 7. The treatment was considered successful when b-hCG concentrations dropped to less than 0.2 mIU/ml without surgery. RESULTS: Among 34 patients on follow-up, 8 (23.5%) did not attempt to conceive again, whereas 26 patients declared their wish to conceive again. The attempt proved to be successful in case of 16 women (61.53%), and they gave birth to healthy children. Average time to pregnancy was 14.9 months (SD +/- 10.9). The first pregnancy occurred after 6 months and the last after 35 months. No congenital birth defects were found in the newborns. CONCLUSIONS: Systemic, conservative treatment with methotrexate is an effective and safe way of managing ectopic pregnancy even in cases with higher b-hCG concentrations. Most patients can be successfully treated without surgery thus they may even be treated in outpatient settings. High fertility can be maintained and is independent of the skills of the operators and access to laparoscopic techniques. Conservative treatment does not increase the risk of recurrent ectopic pregnancy but should be offered in wards that provide 24-hour surgical care.

[Metformin--new treatment strategies for gynecologic neoplasms]. / Metformina--potencjalny nowy lek w terapii nowotworów ginekologicznych.

Metformin, a drug from the biguanide class, is now one of the most widely used drugs in the treatment of type 2 diabetes. This drug was also used in the treatment of polycystic ovarian syndrome and recent reports indicate the possibility of using this drug in oncology. Latest findings show that metformin has an anticancer effect. Influencing the transduction mechanisms primarily through activation of protein kinase activated by 5'AMP (AMPK) regulates the activity of the AMPK/mTOR signaling pathway. MTOR pathway dysregulation may be a factor in the pathogenesis of various human diseases, especially cancers. Overactivation of mTOR is observed in malignant cells and is associated with their resistance to treatment. It can therefore be concluded that metformin as an inhibitor of mTOR may be a factor that suppresses tumor development. There are also studies showing that metformin prevents the formation of metastases, reducing tumor vasculature and improves the effectiveness of anticancer drugs. The anticancer effect of metformin has been proven in the treatment of colorectal and breast cancer. The current studies reports the positive effects in the treatment of gynecological cancers such as ovarian, endometrial and cervical cancer. Incidence for these tumors in 2009 in Poland was: for ovarian cancer 11.01100000; for endometrial cancer 15.0/100000; for cervical cancer 10.5/100000. Metformin has antitumor activity in monotherapy and also synergistically with other anticancer agents. Metformin has antiproliferative properties; reduces the VEGF levels, causing a reduction in tumor vasculature; causes an increase in progesterone receptor, which increases the response to hormonal therapy; inhibits the expression of glyoxalase I, mediating resistance to chemotherapy; decreases in the concentration of human telomerase; reduces the activity of Akt and Erk kinases, key regulators of metabolism and progression of tumors and also inhibits the formation of metastases.

Markers of insulin resistance in perimenopausal women with endometrial pathology.

OBJECTIVES: To determine and compare the prevalence of insulin resistance and carbohydrate metabolism parameters in women with endometrial pathology MATERIAL AND METHODS: 100 perimenopausal women with abnormal uterine bleeding and/or abnormal endometrium were included into the study. Hysteroscopy with biopsy was performed. The study population was divided into four groups according to histopathological results of the endometrium: non-atypical endometrial hyperplasia, endometrial polyp, endometrial cancer and controls. Fasting glucose and insulin levels and OGTT, IR indexes, occurrence of diabetes, pre-diabetic state, overweight, obesity and hypertension were assessed. RESULTS: Insulin resistance was diagnosed in 41.0% of the patients. The prevalence of markers of insulin resistance increased to 57.1% in cases with confirmed endometrial pathology compared to 31.8% in histologically normal endometrium (p<0.01). The frequency of insulin resistance was 52.6% (p=0.059) and 55.5% (p=0.04), respectively in women with non-atypical hyperplasia and patients with endometrial polyps when compared to the control group. Abnormal parameters of carbohydrate metabolism indicate little sensitivity and specificity in predicting endometrial hyperplastic lesions. The insulin levels at 120 minutes of OGTT correlate best with such changes (concentration >57 microU/ml in case of hyperplasia and >61 microU/ml in endometrial polyps). CONCLUSION: Insulin resistance and carbohydrate metabolism disturbances are common in women with endometrial pathologies. In these patients there is clinical basis for recommending lifestyle modification (change of diet, more physical activity), or for introduction of pharmaceutical insulin-sensitizing agents.

One-year observation of inflammatory markers in patients with aortic valve stenosis who expressed high or low Chlamydia pneumoniae antibody titers.

BACKGROUND AND AIM OF THE STUDY: Aortic valve stenosis (AVS) and atherosclerosis can be regarded as two manifestations of the same pathological process. The study aim was to evaluate annually the plasma levels of C-reactive protein (CRP), interleukin-6 (IL-6) and tumor necrosis factor alpha (TNFalpha) in AVS patients, and to compare these data in AVS patients with and without high IgG, IgM, and IgA titers against Chlamydia pneumoniae. METHODS: Sixty patients with AVS who had declined the offer of remedial surgery were allocated to groups according to their antibody titers: group A (n=30, high IgG titer), group B (n=30, low IgG titer), group C (n=22, high IgA titer), group D (n=38, low IgA titer), group E (n=7, high IgM titer), and group F (n=53, low IgM titer) Antibody titers, serum levels of inflammatory markers and echocardiographic scans were monitored at 12-month intervals. RESULTS: During a one-year observation period, a greater number of patients in group A showed AVS deterioration compared to group B (p < 0.02). The mean IgA and IgM titers in group A were higher than in group B, while mean serum CRP and IL-6 levels, and IgG titer, tended to be higher in group C compared to group D. No statistically significant differences were identified in mean serum levels of CRP, IL-6, and TNFalpha between groups A and B. CONCLUSION: The results of the study suggested a possible association between C. pneumoniae infection and the progression of AVS.

Age, place of living and education influences the pregnancy universal thyroid function screening program attendance - questionnaire study.

BACKGROUND: The aim of this study was to assess attendance at the universal screening programme for thyroid function in pregnancy and attempt to evaluate the influence of age, number of past pregnancies, level of education, and place of residence on the attendance. The study was performed by means of a questionnaire. MATERIAL AND METHODS: Our study was performed on the basis of an anonymous questionnaire handed out to 543 women aged 16-45 years, on the third day of their puerperal stay in one of five obstetric wards in southern Poland. The questionnaire contained questions about participation in plasma level measurements of TSH, fT4, total T4, thyroid antibodies or thyroid ultrasound scanning at least once in pregnancy. RESULTS: The rate of attendance at any examination of thyroid function among pregnant women was 26.7%. The highest attendance rate (32.7%) was found among women living in provincial capitals or with higher education (41.3%), whereas the lowest was among women who had completed only primary school (11%) and those living in county towns (15%). The number of previous pregnancies did not influence the thyroid screening attendance. Women over 21 years of age participated in this screening programme more frequently (27.1-30%). CONCLUSION: Less than one third of pregnant women participated in the thyroid function screening. Place of living, education level, and age were the main factors influencing the attendance rate.

[Placenta endocrine function influence on fetal hypothalamo-hypophyseo-thyroid axis]. / Czynnosc endokrynna lozyska a os podwzgórzowo-przysadkowo-tarczycowa u plodu.

The conteporary views on the influence of placenta on the fetal hypothalamo-hypophyseo-thyroid axis has been given. The role of hCG, estrogens, deiodineses, transfereses and arylosulphateses has been presented. Transthyretin role has been mentioned.

[The role of thyroid antibodies in the pathogenesis of the infertility and miscarriage]. / Rola przeciwcial przeciwtarczycowych w potencjalnej przyczynie nieplodnosci i poronien.

There are discordant opinions about the influence of subclinical hypothyroidism to the fertility of the women. No unequivocal opinion has been presented concerning the purposefulness of the diagnostics process and treatment of the pregnant women with subclinical hypothyroidism. Few clinical studies suggest that there is a connection between thyroid antibodies and infertility, spontaneous miscarriages, implantation failures and fetal malformations.

Intake of iodine-containing multivitamin preparations by pregnant women from the Krakow region of Poland.

BACKGROUND: The aim of this study was to evaluate the number of women who take multivitamin formulations containing iodine. MATERIAL AND METHODS: A 34-question questionnaire was given to 500 women during their puerperal stay in two obstetrics/gynaecology wards in Krakow. RESULTS: 295 pregnant women (59%) took iodine-containing formulations. 205 pregnant women (41%) took multivitamin preparations without iodine. 49.7% of the women (91 out of 183) who inhabited rural areas and small towns were not supplemented with iodine during pregnancy. Women in Krakow took iodine-containing multivitamin formulations in 61.2% of cases. Women with primary and secondary education did not use iodine supplementation in 48.3% and 50.3% of cases respectively. Women with a university education did not use supplementation in 38.6% of cases. The prevalence of women using iodine-containing multivitamin preparation was similar in each age group. CONCLUSIONS: The promotion of iodine supplementation to pregnant women should be augmented at each level of contact with medical staff. Medical staff should be reminded about such promotion at each level of medical care and training (general practitioner, obstetrics/gynaecology specialist, endocrinologist, postgraduate training).

[Comparison of echocardiographic findings in AVS patients with and without high IgG, IgM, IgA titers against Chlamydia pneumoniae during 12 months' observation of AVS natural course]. / Porównanie parametrów echokardiograficznych w rocznej obserwacji naturalnego przebiegu nabytego zwezenia lewego ujscia tetniczego u chorych z wysokim i niskim mianem przeciwcial przeciw Chlamydia pneumoniae.

AIM: Comparison of echocardiographic findings in AVS patients with and without high IgG, IgM, IgA titers against Chlamydia pneumoniae during 12 months' observation of AVS natural course. PATIENTS: 60 AVS patients who did not agree for operational treatment were divided into group A (30 patients with high IgG titer) group B (30 patients with low IgG titer), group C (22 patients with high IgA titer) group D (38 patients with low IgA titer), group E (7 patients with high IgM titer), group F (53 patients with low IgA titer) Antibodies titers and echocardiographic scans were carried out every 12 months. RESULTS: There were more (p < 0.02) patients with AVS deterioration in group A compared to group B. Group A patients had lower left ventricle posteriori wall systolic diameter compared to group B. There were no differences in echocardiographic parameters between group C and D. Mean ejection fraction was lower and mean right atrium diameter was higher in group E compared to group F. CONCLUSION: The results may suggest link between Chlamydia pneumoniae and deterioration of AVS.

[Influence of estradiol administration mode on plasma insulin-like growth factor-I (IGF-I) and its binding proteins 1 and 3 concentration in postmenopausal women treated with norethisterone acetate]. / Wplyw drogi podania 17beta-estradiolu na stezenie insulinopodobnego czynnika wzrostu-I (IGF-I) i jego bialek wiazacych 1 i 3 w surowicy krwi u kobiet po menopauzie stosujacych octan norethisteronu.

AIM: The aim of the present work was to assess the influence of estradiol administration mode on the plasma IGF-I, IGFBP-1, IGFBP-3 levels in postmenopausal women treated with norethisterone acetate. MATERIAL AND METHODS: 39 women were enrolled into the study Group A--14 women received transdermal 17beta-estradiol (Oesclim 50--Fournier-Solvay) combined with oral norethisterone 2.5 mg daily (Primolut-Nor--Schering), Group B--10 women on oral 2 mg 17beta-estradiol combined with oral 1 mg daily norethisterone (Kliogest--Novo-Nordisk). Control group (group C) consisted of 15 postmenopausal women who received no treatment. Basic plasma FSH, estradiol and total IGF-I, IGFBP-1 as well as IGFBP-3 levels were measured initially and at the 52nd week of the study. RESULTS: The mean plasma FSH level was reduced and mean plasma estradiol level was increased in groups A and B during hormone therapy. Mean plasma levels of total IGF-I, IGFBP-1, IGFBP-3 as well as IGFBP-3/IGF-I ratio did not changed significantly during 52 weeks of observation in groups A, B and C. The comparison of plasma IGF-I, IGFBP-1, IGFBP-3 between groups at the initial visit and after 52 weeks showed the lowest concentration f IGBP-3 in group B. Other parameters showed no differences among the three groups. CONCLUSION: Mode of administration of estradiol did not influenced the plasma levels of IGF-I, IGFBP-1, IGFBP-3 in postmenopausal women treated with norethisterone acetate.

The somatotropic axis in postmenopausal women during six month of transdermal continuous 17beta-estradiol administration combined with oral medroxyprogesterone.

AIM: The evaluation of the influence of continuous transdermal estradiol supplementation combined with oral medroxyprogesterone on the somatotropic axis in postmenopausal women. MATERIAL AND METHODS: 25 women completed the study Group A--13 women received transdermal 17beta-estradiol (Oesclim 50 - Fournier-Solvay) combined with oral 5 mg daily medroxyprogesterone (Gestomikron - Adamed). Group B--12 women without treatment. Basic plasma FSH, estradiol, glucose, insulin, SHBG, hGH, total and free IGF-I, IGFBP-1 as well as IGFBP-3 were measured initially and at the 12th and 24th week of the study. RESULTS: The mean plasma FSH level was reduced and mean plasma estradiol level was increased in group A during estradiol supplementation. Mean plasma level of free IGF-I and free to total IGF-I ratio were increased in group A during 24 weeks of hormone therapy. In the control group (group B) there was the significant increase in mean plasma IGFBP-3 level. Other parameters showed no significant changes in the control group. CONCLUSION: The administration of transdermal 17beta-estradiol combined with oral medroxyprogesterone increases the IGF-I bioavailability. However this influence do not exceed the physiologial level of IGF-I bioavailability.

[Body mass index influence on aortic valve stenosis]. / Wskaznik masy ciala, a naturalny przebieg zwezenia lewego ujscia tetniczego.

AIM: The 12 months' observation of body mass index (BMI) influence on natural course of aortic valve stenosis (AVS). PATIENTS: 60 AVS patients who did not agree for operational treatment were divided into group A (n = 15) with BMI 20-25, group B (n = 27) with BMI 25,01-30 and group C BMI > 30. METHODS: Plasma Lp(a), total cholesterol, HDL-cholesterol, LDL-cholesterol, triglycerides and C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor (TNF-alpha) as well as titers of immunoglobulin (Ig) class G, A, M against chlamydia pneumoniae were measured every 12 months. Echo-cardiographic evaluation of aortic valve was also done every 12 months. RESULTS: Means serum CRP at 12 month was the highest in group C. No differences in mean serum TNF-alpha and IL-6 levels as well as in Ig titers between groups A, B, C were found. At 12 month of observation HDL/total cholesterol ratio as well as HDL/LDL-cholesterol ratio were the lowest in group B. Left atrium diameter and right ventricle diameter were bigger in groups B and C compared to group A at the visit I and after 12 months of observation. Systolic intraventricular septum (IVS syst) thickness was the highest in group C at visit I. Diastolic left ventricle posterior wall thickness (LVPW) was the highest in group C during 12 months of observation. CONCLUSION: The increase in fat tissue mass may lead to increase in inflammatory process and cardiac muscle remodeling in AVS patients.

[The impact of polychlorinated biphenyls on placental and ovarian steroidogenesis]. / Polichlorowane bifenyle, a sterydogeneza w lozysku i jajniku.

The structure and turnover of polichlorinated biphenyls (PCB) in environment was presented. The PCB absorption and metabolism in organisms as well as the PCB induced disruption of placental and ovarian steroidogenesis were discussed.

Overexpression of P53 protein and local hGH, IGF-I, IGFBP-3, IGFBP-2 and PRL secretion by human breast cancer explants.

BACKGROUND: Insulin-like growth factor-I (IGF-I) in concert with insulin-like binding protein 3 (IGFBP-3), insulin-like binding protein 2 (IGFBP-2), human growth hormone (GH) and P53 protein is involved in autocrine/paracrine growth signaling pathways as an adaptive response to environmental stimuli. OBJECTIVE: The study evaluated the local secretion of PRL, hGH, IGF-I, IGFBP-2 and IGFBP-3 by breast cancer tissue explants in relation to the overexpression of P53 protein in breast cancer tissue. MATERIALS AND METHODS: Breast cancer explants were obtained during radical mastectomies. The overexpression of P53 protein was assessed immunohistochemically using monoclonal antibody (DAKO, Anti-Human P53 protein, clone DO-7); the results of the reaction were stratified into 5 groups. The lack of P53 protein overexpression was defined as 0% of cells that overexpressed P53 protein. IGF-I, IGFBP-3, IGFBP-2, and hGH levels were measured with RIA kits, and prolactin was measured with the MEIA kit. RESULTS: The local secretion of hGH by tumour explants - presenting a positive immunohistochemical reaction (IHCR) to the product of P53 gene - was twice as high as those with no IHCR to product of P53 gene; the opposite was noted in the case of IGF-I, IGFBP-2 and IGFBP-3 secretion. In both cases, the level of hGH, IGF-I and IGFBP-3 secretion did not correlate with the ratio of cells overexpressing P53 protein. There was a significant decrease in local, basic IGFBP-2 secretion along with an increased ratio of cells with positive IHCR to product of P53 gene. Furthermore, local PRL secretion was not correlated with the ratio of cells overexpressing P53 protein in breast cancer tissue. Prolactin also exerts no influence on IGF-I secretion. CONCLUSION: Our results may suggest the presence of local hGH/IGF-I feedback in breast tissue as well as the possibility of P53/hGH/IGF-I/IGFBP-3 but not P53/PRL/IGF-I axis.

Beneficial influence of postmenopausal estrogen therapy on serum adhesion molecules is independent of the route and dose of administration.

OBJECTIVE: In current literature, the immune-inflammatory theory of atherosclerosis is widely discussed. The role of how adhesion molecules contribute to the development of atheromatic plaques is especially underlined. MATERIAL AND METHODS: 120 females in menopausal age were included in the study between 2004 and 2009. All the women were of menopausal age (51±3 years), from southern Poland, with FSH levels above 30 mIU/ml, and complaining of menopausal symptoms that disturbed normal daily activity. The study was conducted over a 6 month period. Three groups of 40 randomized patients were selected. The control group consisted of 40 volunteers, who were also from southern Poland, in good health, without menopausal symptoms, or menstrual periods in the last 6 months. Control subjects were match according to age and weight, with FSH levels above 25 mIU/ml and normal TSH and prolactin values. All patients, in the treatment and control groups were seronegative for Chlamydia pneumonia throughout the duration of the study. RESULTS: After 6 months, hormonal therapy was found to significantly reduce levels of sICAM-1 and sVCAM-1 in all treated groups compared to the control group and the results were statistically significant. Alternatively, in the latter group, we observed increased levels of the investigated adhesion molecules (group I: 37.5 µg/24h transdermal estradiol + dydrogesteron; group II 50 µg/24h transdermal estradiol + medroxyprogesteron; group III 1mg of oral estradiol + noretisteron sICAM-1 and control group; using paired Wilcoxon test). CONCLUSION: All of the investigated estrogen therapy schemas have a favorable impact on the blood levels of sICAM-1 and sVCAM-1 in postmenopausal women without cardiovascular risk factors, reducing their concentration.

One-year observation of inflammatory markers in patients with aortic valve stenosis.

BACKGROUND AND AIM OF THE STUDY: The study aim was to conduct an annual evaluation of plasma levels of C-reactive protein (CRP), tumor necrosis factor-alpha (TNF-alpha), interleukin-6 (IL-6) and antibodies against Chlamydia pneumoniae during a 12-month period following the natural course of aortic valve stenosis (AVS). METHODS: A total of 60 patients with AVS and 14 control subjects underwent echocardiographic examinations at the start of the study period, and again after a 12-month follow up period. Subsequently, the AVS patients were allocated retrospectively to two groups (n = 30 in each) according to their echocardiographic parameters: patients who showed a progressive deterioration of valvular function (PAVS group); and those who showed a lack of such progression (LPAVS group). Plasma concentrations of CRP, TNF-alpha, IL-6, and antichlamydial IgA, IgG, and IgM antibodies were evaluated at the start of the study, and again during the 12th month. RESULTS: During the study, CRP levels were increased only in the AVS group. TNF-alpha and IgM levels were higher in the AVS group compared to controls, at both the initial visit and the final observation. During the 12-month observation period the TNF-alpha level was increased in the PAVS group, whereas CRP levels in the LPAVS group were decreased. TNF-alpha levels were higher in the PAVS group than the LPAVS group, at both the initial visit and after 12 months; CRP levels did not differ between these groups. In the PAVS group, the IL-6 level was higher after 12 months, but the IgM level was higher at the initial visit. The results of a factorial analysis identified the main factors responsible for the decrease in aortic valve area to be TNF-alpha and CRP. CONCLUSION: TNF-alpha, CRP, and IgM antichlamydial antibodies should be further investigated as potential predictive factors for the progression of AVS.

Bimodal influence of plasma estradiol on relation between insulin-like growth factor-I (IGF-I) and estradiol in women.

OBJECTIVE: To compare the influence of low and normal endogenous estradiol concentration on circulating hGH, IGF-I and IGFBP-3 levels as well as on mutual correlations of these parameters. PATIENTS: 45 women (age 30.7 ± 9.0 years, BMI 25.7 ± 8.0) divided into group A - 15 hypoestrogenic women and group B - 30 normoestrogenic controls. Neither of the women was menopausal nor hyperprolactinemic. METHODS: Blood sample was taken at the standard conditions prior to the initiation of hormonal supplementation therapy in group A and at the day 3-5 of menstrual cycle in group B. Serum hGH, IGF-I, IGFBP-3, insulin, testosterone, sex hormone binding globulin (SHBG) dihydroepiandrosterone sulphate (DHEAS) and LH as well as prolactin (PRL), FSH and estradiol levels were measured by standard RIA kits. RESULTS: Mean IGF-1, LH, FSH, testosterone and estradiol and PRL plasma levels were lower in group A compared to group B. There were no significant differences in mean SHBG, insulin and DHEAS levels. There were also no differences in mean: age, body mass, BMI as well as percentage of each BMI range between groups. Regardless the estradiol level the IGF-I/age link was found in both groups. A IGF-I/IGFBP-3 relation was found in both groups. IGF-I/estradiol link was seen only in group A. In group B hGH/SHBG link was found, in group A this relation was indirect. A link between hGH and testosterone levels was found only in group B. SHBG was related in group B to IGFBP-3, testosterone and to DHEAS. Insulin/IGFBP-3 link was seen in group B. The stepwise multiple regression revealed DHEAS and LH as predictors of IGF-I level in group A, while in group B none of the parameters predicted IGF-I level. The results of the same analysis in case of hGH are as follows: in group A hGH level was predicted by estradiol and SHBG. In group B none of factors predicted hGH levels. CONCLUSION: Estradiol plasma level is correlated to circulating IGF-I, albeit the relation seems to be biphasic.

[Sprue--coeliac disease and fertlity]. / Choroba trzewna--celiakia a plodnosc.

The authors presented coeliac disease diagnostic and treatment methods and its links with infertility. The hormonal disturbances in women with coelic disease were also shown. Perinatal complications in pregnant women with the disease were presented. The need for involvement of coelic disease into differential diagnosis algorythm were given.