Association between serum osteocalcin, adiposity and metabolic risk in obese children and adolescents.

INTRODUCTION: Childhood obesity has been associated with the development of insulin resistance, potentially leading to several metabolic disorders. Osteocalcin has been reported to contribute to the regulation of glucose tolerance and insulin sensitivity. The purpose of this study was to examine the relationship between serum osteocalcin and metabolic risk factors in obese children and adolescents. MATERIAL AND METHODS: Age, gender, pubertal stage, adiposity markers (standard deviation score of body mass index: BMI-SDS, percentage of body fat, waist circumference), blood pressure, serum osteocalcin (OC), fasting plasma glucose and insulin, glycated haemoglobin level (HbA1c), insulin resistance estimated by homeostasis model assessment (HOMA-IR), lipid profile, C-reactive protein (CRP), fibrinogen (FB), white blood cell count (WBC) and 25-hydroxyvitamin D (25-OH-D) were evaluated in 142 obese children and adolescents. Stepwise multiple regression analysis was used to determine the relationship between serum osteocalcin and metabolic risk parameters. RESULTS: Mean serum osteocalcin level was 72.0 ± 20.5 µg/L (range: 16.8-181.5 µg/L). After adjustment for multiple potential confounders, serum osteocalcin concentration was inversely associated with adiposity markers as well as HOMA-IR, HbA1c, triglycerides, CRP, FB and positively with 25-OH-D and HDL-cholesterol. In stepwise multiple linear regression analysis adjusted for age, gender and pubertal stage, osteocalcin was significantly negatively related to HOMA-IR, triglycerides and waist circumference. CONCLUSIONS: Serum osteocalcin concentration is associated with blood markers of dysmetabolic phenotype and measures of adiposity, suggesting that osteocalcin is important not only for bones but also for glucose and fat metabolism as early as during childhood.

Polymorphism of CD36 gene, carbohydrate metabolism and plasma CD36 concentration in obese children. A preliminary study.

INTRODUCTION: CD36 may play an important role in removal of oxidized LDLs from plasma, protein glycation, the pathogenesis of insulin resistance, type 2 diabetes, and diabetic micro- and macroangiopathy. Some reports have pointed to decreased expression of macrophages in association with mutations of the CD36 gene in hyperglycemic and obese subjects. The aim of the study was to search for an association between CD36 gene polymorphism and carbohydrate metabolism disturbances or variability of plasma soluble CD36 concentrations in obese children. MATERIAL/METHODS: The study included 60 children aged 10 to 15 years: 30 with (study group) and 30 without (control group) obesity. Each patient's glycated hemoglobin, weight, height, waist and hip circumference, and systolic and diastolic blood pressure were measured, BMI, WHR and MAP were calculated, and oral glucose tolerance test was performed with glucose and insulin concentration measurements. Amplicons of exons 4-6 of CD36 were studied using DHPLC technique. The PCR products with alterations were bidirectionally sequenced. Plasma concentrations of human antigen CD36 was measured using a commercially available enzyme-linked immunosorbent assay (ELISA). RESULTS: We found two intronic alterations: IVS3-6 T/C (rs3173798) and IVS4-10 G/A (rs3211892), one nonsynonymous substitution: G367A (Glu123Lys, rs183461468) in exon 5 and two synonymous transitions in exon 6: G573A (Pro191Pro, rs5956) and A591T (Thr197Thr, rs141680676). There were no significant differences in any biochemical or morphometric parameters between genotype groups. DISCUSSION: The polymorphisms of the studied fragment of CD36 are not associated with carbohydrate metabolism disturbances or the variability of plasma soluble CD36 concentrations in obese children, but further research is necessary to assess their functional implications.

Changes in inflammatory biomarkers after successful lifestyle intervention in obese children.

BACKGROUND: Obesity has been associated with low-grade systemic inflammation, potentially leading to insulin resistance, type 2 diabetes, dyslipidemia, and cardiovascular diseases. Even moderate weight loss through dietary changes and physical exercise is effective in preventing and managing obesity-associated disorders. The aim of this study was to determine the effect of weight loss in response to a lifestyle modification on the serum levels of inflammatory markers in obese children and adolescents. MATERIAL AND METHODS: Fifty obese subjects completed a six-month programme consisting of combined hypocaloric diet and moderate physical activity. High-sensitive C-reactive protein (CRP), interleukin-6 (IL-6), fibrinogen (FB), white blood count (WBC), glucose, insulin, insulin resistance index (HOMA IR), glycosylated haemoglobin (HbA(1c)), lipids as well as systolic (SBP) and diastolic blood pressure (DBP) were measured before and after intervention. RESULTS: Patients had a 5.3 ± 3.4 kg average weight loss, with significant decreases of SDS-BMI, percentage of body fat, SDS-waist, SBP and DBP, HOMA-IR, HbA(1c) and reductions in serum IL-6, CRP, WBC, FB. In the multivariable linear models, changes in percentage of body fat and HOMA-IR were positively associated with favourable changes in inflammatory parameters. CONCLUSION: This study demonstrates that weight reduction after successful lifestyle intervention results in improvements of blood inflammatory markers in obese children and adolescents.

Serum 25-hydroxyvitamin D (25-OH-D) in obese adolescents.

BACKGROUND: There is increasing evidence that vitamin D deficiency is common and has been associated with several non-bone related outcomes, including insulin resistance, type 2 diabetes and cardiovascular disease. The influences of gender, puberty, and adiposity on serum hydroxyvitamin D (25-OH-D) levels and the relationship between 25-OH-D and insulin resistance in obese children were studied. MATERIAL AND METHODS: Age, gender, pubertal stage, weight status (standard deviation score of body mass index: BMI-SDS, percentage body fat, waist circumference), 25-OH-D levels, and insulin resistance index calculated by homeostasis model assessment (HOMA-IR) were evaluated in 64 obese adolescents. Multivariable linear regression was used to determine factors associated with decreased serum 25-OH-D levels and to study the relationship between 25-OH-D and HOMA-IR. RESULTS: Median serum 25-OH-D level was 10.1 ng/mL (25.2 nmol/L). 14% of patients were vitamin D-sufficient (25-OH-D ≥ 20 ng/mL), 36% had intermediate values (11-19 ng/mL), and 50% were deficient (25-OH-D ≤ 10 ng/mL). In the multivariable model, older age, puberty, higher value of percentage of body fat, and the presence of acanthosis nigricans (AN) were all negatively associated with 25-OH-D. Lower 25-OH-D levels were also associated with higher blood glucose, insulin and HOMA-IR after adjustment for puberty and SDS-BMI. Summer positively correlated with 25-OH-D level. CONCLUSION: Our study confirms that obesity is a risk factor for vitamin D deficiency. Hypovitaminosis D, common in obese adolescents at risk for type 2 diabetes (older age, puberty, acanthosis nigricans) is associated with worse insulin resistance.

[Maternal active or passive smoking in relation to some neonatal morphological parameters and complications]. / Palenie czynne lub bierne w okresie ciazy a wybrane parametry morfologiczne i powiklanma okresu noworodkowego.

OBJECTIVE: To determine the relationship between maternal active and passive smoking and neonatal morphological parameters, as well as some neonatal complications in full-term newborns. METHODS: 150 women with uncomplicated, singleton pregnancies were assessed by means of a patient questionnaire. Neonates were divided into 3 groups according to obtained information on maternal smoking status--active smoking: n=51, passive smoking: n=49, non-smoking: n=50. Immediately after birth morphological parameters such as: birthweight, body length, head and chest circumference were assessed. RESULTS: Values of birthweight, body length, head and chest circumference in newborns born to active smoking mothers were significantly lower than in newborns of passive smoking and non-smoking mothers. No significant differences in values of RBC, WBC, PLT Hemoglobin and Hematocrit between the studied groups have been detected. Oxygen hood was applied significantly more often in case of newborns from active smoking mothers than in the control subjects. In groups of newborns from active and passive smoking mothers, hyperbilirubinemia and signs of early onset infection were diagnosed significantly more frequently than in the control subjects. CONCLUSIONS: Active maternal smoking, as opposed to passive maternal smoking, leads to decreased birthweight, body length, head and chest circumference. Full-term newborns born to active smoking mothers often need to be treated with oxygen hood during the first hours after birth. Maternal smoking, both active and passive, leads to an increased risk of hyperbilirubinemia and early onset infection in neonates.

Analysis of human CD36 gene sequence alterations in the oxidized low-density lipoprotein-binding region using denaturing high-performance liquid chromatography.

Denaturing high-performance liquid chromatography (DHPLC) has been employed as a prescreening tool to reduce the amount of DNA sequencing. It could be a simple and cost-effective screening method for mutations and polymorphisms in exons 4, 5, and 6 of the CD36 gene, which encode the protein region responsible for the removal of oxidized low-density lipoprotein. Genomic DNA was isolated from 306 Caucasian infants of Polish origin. Six single-nucleotide substitutions were detected by DHPLC and confirmed by direct sequencing. The A591T, G550A, and C572T alterations have not been described so far. Each of two nonsynonymous substitutions (Asp184Asn, Pro191Leu) was found in one subject (0.2% minor allele frequency). The results suggest that nonsynonymous alterations in the analyzed CD36 region are rare in Caucasians. DHPLC is a specific and cost-effective technique that may prove to be particularly useful for the identification of polymorphisms and mutations in the CD36 gene.

Serum leptin concentrations in children with mild and moderate malnutrition.

INTRODUCTION: Numerous studies have reported a strong relationship between plasma leptin concentration and percentage of body fat, fat mass, and body mass index (BMI) in obese and non-obese children. The objective of the present study was to assess the usefulness of serum leptin concentration in disclosing prepubertal malnutrition. MATERIAL AND METHOD: Leptin concentrations in serum were determined and anthropometric parameters were measured in 149 children (3-6 and 7-10 years old). The Cole index of nutritional status was calculated. 44 children (I) presented with long-standing malnutrition due to celiac disease or food allergy and 105 children (II) were healthy. RESULTS: Leptin concentrations in both age groups of undernourished boys (median 2.7 and 2.7 microg/L) and in younger undernourished girls (median 4.2 microg/L) did not differ from concentrations in healthy children (median 2.9, 2.9, and 3.4 microg/L, respectively). Leptin concentrations in older undernourished girls were significantly lower than in healthy girls (median 4.2 vs. 8.8 microg/L, respectively; p < 0.05) of comparable age. In healthy children, leptin levels correlated with gender, body mass, BMI, Cole ratio (r = 0.39-0.41, r = 0.33, r = 0.28, r = 0.22, respectively; p < 0.005), and height (r = 0.19; p < 0.05). Serum leptin concentrations in undernourished children correlated with gender, arm circumference, and BMI (r = 0.27-0.35, r = 0.27, r = 0.25, respectively; p < 0.05). CONCLUSIONS: Our results show that serum leptin concentration is not a useful indicator of mild and moderate malnutrition in prepubertal children.

Analysis of the sodium iodide symporter expression in histological slides from a nodular goiter.

BACKGROUND: The aim of the study was analysis at both the level and the cell site of the sodium/iodide symporter (NIS) in histological slides from hot, warm, and cold nodules and extranodular parenchyma according to scintigraphy. METHODS: The study population consisted of 97 people who underwent surgery for a toxic nodular goiter (26 patients) or a non-toxic nodular goiter (71 patients). Immunohistochemical study was performed with 198 histological slides from hot, warm, and cold nodules (study slides) and the extranodular parenchyma (control slides). The level of NIS expression was estimated objectively using the computerized image analysis system, Quantimet 600S (Leica, Cambridge, UK). RESULTS: We found significantly higher NIS expression in hot nodules than in cold nodules and in warm nodules than in cold ones. We found significantly higher NIS expression in hot and warm nodules than in the surrounding parenchyma. The level of NIS expression did not differ significantly between cold nodules and the collateral tissues. CONCLUSIONS: Our data indicate that NIS protein participates in the development of hyperthyroidism in the course of a nodular goiter. We confirm that the functional state of a nodular goiter is determined by NIS expression in nodules, not in collateral parenchyma. The low metabolism of cold nodules does not simply result from decreased level of NIS protein or its defective targeting to the cell membrane. The observation of NIS in the cell cytoplasm of hot nodules seems to indicate that the intracellular localization of NIS does not determine loss of its activity.

[Atypical forms of hyperthyroidism]. / Nietypowe postacie nadczynnosci tarczycy.

Except from well-known the most frequent reasons of the hyperthyroidism such as the Graves-Basedow disease, multinodular goitre and the autonomous adenoma we should also remember the other rarer illnesses leading to the excess of thyroid hormones in the serum. Authors presented the problem of atypical forms of thyrotoxicosis which run without the overproduction of thyroid hormones and are characterized by low 24 h 131 J uptake by the thyroid gland. So called masks of hyperthyroidism such as apathetic, neuromuscular, gastrointestinal and cardiovascular forms were also discussed in the article.

Relation of low-grade inflammation and endothelial activation to blood pressure in obese children and adolescents.

OBJECTIVE: To determine the role of low-grade, systemic inflammation and endothelial activation in the modulation of blood pressure (BP) independently of other traditional risk factors in obese children and adolescents. DESIGN: We surveyed 281 obese subjects, aged 6-18 years to investigate the relationship of serum inflammation and endothelial activation markers and blood pressure. MEASUREMENTS: Clinical variables, indices of obesity, ambulatory 24-h blood pressure and serum concentrations of C-reactive protein (CRP), interleukin-6 (IL-6), interleukin-1 beta (IL-1 beta), intercellular cell adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1), glucose and insulin. HOMA IR was used as a marker of insulin resistance (IR). RESULTS: CRP, IL-6, IL-1 beta, and ICAM-1 correlated significantly with mean 24-h systolic BP, whereas CRP and IL-6 was positively correlated with mean 24-h diastolic BP. Multiple regression analysis showed that serum IL-6 (P < .001) concentration, HOMA IR (P < .01), and waist to hip ratio (P < .05) were the significant determinants of systolic BP, whereas CRP (P < .05) level was the only predictor of diastolic BP. There were no significant associations of cell adhesion molecules with BP. CONCLUSIONS: These results indicate that low-grade inflammation may play a role in the modulation of arterial BP relatively early in life.

Low-grade systemic inflammation and the risk of type 2 diabetes in obese children and adolescents.

BACKGROUND: There is growing evidence that low-grade systemic inflammation is closely involved in the pathogenesis of type 2 diabetes. OBJECTIVE: The aim of this study was to investigate the relationship between serum inflammatory markers and selected parameters known as risk factors of type 2 diabetes in obese children and adolescents. SUBJECTS AND METHODS: Fasting levels of C-reactive protein (CRP), fibrinogen (FB) interleukin-6 (IL-6), interleukin 1-beta (IL-1beta), glucose, insulin, total, HDL and LDL cholesterol, triglycerides, white blood cell count (WBC) and fasting glucose to insulin ratio (FGIR) were measured in 281 obese children and adolescents. Pearson's correlation was used for assessing the relationship between inflammatory markers and selected clinical parameters. RESULTS: Inflammatory markers correlated significantly with insulin resistance indices, HbA1c, lipid profile, hypertension, positive family history of type 2 diabetes, low physical fitness, and mixed high-fat and high-carbohydrate diet. CONCLUSIONS: Serum inflammatory markers were significantly correlated with most factors implicated in the development of type 2 diabetes. These data provide additional support for previously reported in adults relationship between subclinical inflammation and the risk of type 2 diabetes.

[Correlation between serum homocysteine levels and selected atherosclerosis risk factors in children and adolescents with simple obesity]. / Zaleznosc pomiedzy stezeniem homocysteiny a wybranymi czynnikami ryzyka miazdzycy u dzieci i mlodziezy z otyloscia prosta.

Homocysteine is known as an independent risk factor of atherosclerosis. The aim of this study was assessment of serum homocysteine concentrations in obese children and evaluation of possible relationship between homocysteine and risk factors of atherosclerosis. 498 children with simple obesity were included into our study. There was a significant correlation between serum homocysteine levels and both traditional and new risk factors of atherosclerosis. The issues confirm a necessity of evaluation serum homocysteine levels of obese children in estimation of cardiovascular disease risk.

[Osteoporosis in thyroid diseases]. / Osteoporoza w chorobach tarczycy.

Thyroid hormones play the essential role in the regulation of metabolism and bone remodeling in physiological conditions and in the course of thyroid dysfunction. Introduction of densitometry to the diagnostics of osteoporosis has made possible the evaluation of influence of both hyperthyroidism and hypothyroidism and their treatment on bone mineral density. Moreover it became possible to estimate the influence of treatment with exogenous thyroid hormones on the skeletal system. Authors presented mechanisms of the thyroid hormones action on bone tissue and analysed current state of knowledge concerning the influence of the thyroxine treatment with replacement and suppressive doses on the bone mineral density. The influence of thyroid hormones on the skeletal system with respect to premenopausal and postmenopausal period was also discussed. Great discrepancies in literature data and its reasons were underlined.

Relation of acute-phase reaction and endothelial activation to insulin resistance and adiposity in obese children and adolescents.

OBJECTIVES: There is increasing evidence that an ongoing cytokine-induced acute-phase response is closely involved in the pathogenesis of type 2 diabetes and associated complications such as dyslipidemia and atherosclerosis. The aim of this study was to investigate the relationship of inflammation and endothelial activation with insulin resistance in childhood obesity. METHODS: Two hundred and eleven (122 boys) obese children and adolescents were examined. Fasting levels of ultra-sensitive C-reactive protein (CRP), fibrinogen (FB), interleukin-6 (IL-6), interleukin-1beta (IL-1beta), intercellular cell adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1), von Willebrand factor (vWF), glucose, insulin, and HbA1c were determined. Insulin resistance was assessed by the homeostasis method. RESULTS: HOMA IR correlated significantly with all measures of adiposity as well as with majority of inflammation and endothelial dysfunction markers. After adjustment for age, gender, BMI and fat mass, the correlation with insulin resistance remained significant for CRP, ICAM-1 and von Willebrand factor. There was a trend for association between HOMA IR and IL-6 as well as HOMA IR and fibrinogen. CONCLUSION: Acute-phase reaction and endothelial activation correlate with insulin resistance in obese youth. It is possible that the cluster of these pro-atherogenic factors may contribute to the accelerated atherosclerosis in obese children.

Serum markers of inflammation and endothelial activation in children with obesity-related hypertension.

OBJECTIVES: It has been suggested that a rise in blood pressure (BP) causes low-grade inflammation of the endothelium which, in turn, may be responsible for further damage of endothelium and worsening of BP control. The aim of the study was to evaluate serum levels of inflammation and endothelial activation markers in children with obesity-related hypertension and normotensive controls in relation to other traditional risk factors of arterial hypertension. METHODS: Plasma insulin, glucose, C-reactive protein (CRP), fibrinogen (FB) interleukin-6 (IL-6), interleukin-1 beta (IL-1 beta), intercellular cell adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1) and lipids levels were determined in 50 children with obesity-related hypertension and 143 obese children with normal BP. Insulin resistance was assessed by the homeostasis model. RESULTS: Children with hypertension had significantly higher levels of all inflammatory markers as well as endothelial activation indices compared with normotensive subjects. In the stepwise regression model significant independent correlates for systolic BP were CRP, FB, VCAM-1, HOMA IR, LDL cholesterol and fat mass, whereas CRP, IL-6, ICAM-1, FB, LDL and HDL cholesterol were the determinants of diastolic BP in children with obesity-related hypertension. CONCLUSION: These results indicate that low-grade inflammation and endothelial dysfunction are closely involved in the pathogenesis of obesity-related hypertension relatively early in life.

Reversal of the sex difference in plasma leptin levels in obese children with impaired glucose tolerance.

INTRODUCTION: Basal leptin level has been demonstrated to correlate positively with many indices of obesity, as well as insulin resistance. However, to date, little is known about regulation of leptin in obese children with incipient glucose metabolic disorders. OBJECTIVE: The aim of this study was to define the precise influence of the glucose tolerance status on plasma leptin in obese boys and girls separately. MATERIAL AND METHODS: 70 obese children with impaired glucose tolerance (IGT) and well-matched 70 normal glucose-tolerant (NGT) subjects were examined. Fasting and 2-h post glucose load plasma glucose and insulin levels as well as fasting leptin levels were determined, apart from anthropometric measurements. RESULTS: Leptin levels were significantly lower in girls with IGT compared to NGT girl (17.7+/-6.5 microg/L vs. 23.1+/-7.7 microg/L; p<.001). No such difference was observed in boys. In a multiple regression analysis adjusting for age and adiposity, in the female group plasma glucose and insulin levels 2-h after glucose load were the best predictors of fasting plasma leptin (r=-0.49, p<.005 and r=0.34, p<.05; respectively). In boys, plasma insulin level 2-h after glucose load was the independent determinant of leptin (r=0.36, p<.05). CONCLUSION: The differences between regulation of leptin synthesis in girls and boys with simple obesity were found. The stimulatory effect of insulin on leptin synthesis was greater in girls with normoglycemia than in girls with impaired glucose tolerance.

Reversal of the sex difference in plasma leptin levels in obese children with impaired glucose tolerance.

INTRODUCTION: Basal leptin level has been demonstrated to correlate positively with many indices of obesity, as well as insulin resistance. However, to date, little is known about regulation of leptin in obese children with incipient glucose metabolic disorders. OBJECTIVE: The aim of this study was to define the precise influence of the glucose tolerance status on plasma leptin in obese boys and girls separately. MATERIAL AND METHODS: 70 obese children with impaired glucose tolerance (IGT) and well-matched 70 normal glucose-tolerant (NGT) subjects were examined. Fasting and 2-h post glucose load plasma glucose and insulin levels as well as fasting leptin levels were determined, apart from anthropometric measurements. RESULTS: Leptin levels were significantly lower in girls with IGT compared to NGT girl (17.7+/-6.5 microg/L vs. 23.1+/-7.7 microg/L; p<.001). No such difference was observed in boys. In a multiple regression analysis adjusting for age and adiposity, in the female group plasma glucose and insulin levels 2-h after glucose load were the best predictors of fasting plasma leptin (r=-0.49, p<.005 and r=0.34, p<.05; respectively). In boys, plasma insulin level 2-h after glucose load was the independent determinant of leptin (r=0.36, p<.05). CONCLUSION: The differences between regulation of leptin synthesis in girls and boys with simple obesity were found. The stimulatory effect of insulin on leptin synthesis was greater in girls with normoglycemia than in girls with impaired glucose tolerance.

[Hashimoto disease and hypothyroidism in child-bearing period--essential problem for woman and her child]. / Chroba Hashimoto i niedoczynnosc tarczycy w okresie rozrodczym--istotny problem dla kobiety i jej dziecka.

Hashimoto disease is the most frequent cause of women's hypothyroidism in the reproductive period. It can, both directly and indirectly, influence the fertility, pregnancy, and fetus development. Nevertheless congenital hypothyroidism is very occasionally the consequence of chronic autoimmune thyroiditis. The neonatal hypothyroidism screening makes the early thyroxin treatment possible and prevents the development of complications from central nervous system. The authors showed main problems of Hashimoto disease in women during pregnancy as well as pregestational and postgestational period. The reasons of congenital hypothyroidism taking into account both iodine deficiency and excess were also presented.

[The influence of treatment with substitutive or suppressive doses of thyroxine on biochemical bone turnover markers]. / Wplyw leczenia substytucyjnymi i supresyjnymi dawkami tyroksyny na zachowanie sie markerów przebudowy kostnej.

PURPOSE: Thyroid hormones belong to essential regulators of growth and remodelling of bones. The development of modern radioimmunological and immunoenzymatic methods opened the way to studies on the influence of exogenous thyroxine on the metabolism of osseous tissue. The activity of osteoblasts and the osteoclast ratio is a measure of the process termed "bone turnover" which can be assessed by determining concentrations of enzymes and bone matrix proteins in serum. The aim of this study was to evaluate the influence of a twelve-month regimen with substitutive or suppressive doses of thyroxine on bone alkaline phosphatase (BAP) concentrations in serum and deoxypyridoline (DPR) concentrations in the urine of women with hypothyroidism or with simple goitre. MATERIAL AND METHODS: We enrolled 26 women with not-treated hypothyroidism (Group I) and 41 with not-treated simple goitre (group II). The age of the patients ranged from 29 to 66 years. Patients were qualified for treatment with substitutive (hypothyroidism) or suppressive (goitre) doses of thyroxine. Each group was divided into two subgroups: IA--15 premenopausal patients with hypothyroidism (mean age 41.53 +/- 1.39 years); IB--11 postmenopausal patients with hypothyroidism (mean age 53.18 +/- 1.66 years); IIA--24 premenopausal patients with simple goitre (mean age 39.71 +/- 0.98 years); IIB--17 postmenopausal patients with simple goitre (mean age 53.82 +/- 1.35 years). Evaluations of bone turnover markers in serum (BAP) and in twenty-four hour urine collection (DPR) and serum concentrations of TSH, FT3 and FT4 were carried out prior to treatment and after 1, 3, 6, 9 and 12 months ofthyroxine administration. RESULTS: Bone turnover markers increased during treatment with substitutive or suppressive doses of thyroxine, especially in postmenopausal women. CONCLUSIONS: 1. Treatment with substitutive or suppressive doses of thyroxine stimulates osteogenic and osteoclastic processes in pre- and postmenopausal women. 2. Suppressive doses of thyroxine are more potent in increasing bone turnover than substitutive doses. 3. The osteoclastic process is more intense in postmenopausal women on substitutive or suppressive doses of thyroxine.

[Immaturity or hypotrophy? The cord blood leptin levels in preterm and small-for-gestational age neonates]. / Niedojrzalosc czy niedozywienie? Poziom leptyny we krwi pepowinowej noworodków urodzonych przedwczesnie i z hipotrofia wewnatrzmaciczna.

OBJECTIVES: To assess cord blood leptin levels in preterm and small-for-gestational age neonates and determine whether fetal leptin levels correlate with selected clinical parameters associated with prematurity and undernutrition at birth. DESIGN: Study of preterm newborns (p-AGA; n = 31) and small-for-gestational age (t-SGA; n = 23) cases in a population of neonates born in Szczecin between September 2001 and June 2002. METHODS: Fetal cord blood was sampled after delivery. Leptin levels were measured by RIA. Anthropometric data (birth weight, birth length, head and chest circumferences, body mass index, Ponderal index) were also recorded. RESULTS: Cord blood leptin levels did not differ significantly between p-AGA and t-SGA neonates with similar birthweight. Among the two groups of newborns the correlations between fetal leptin and anthropometric data were only observed in p-AGAs, but not in t-SGA group. CONCLUSIONS: We suggest that cord blood leptin level depends on body mass rather than maturity of newborn. It is also hypothesized that leptin level in SGA neonates is determined by other than anthropometric parameters used in this study.