Relationship between pituitary-thyroid axis hormones and anthropometric parameters in Czech adult population.

Although the relationships between thyroid function and anthropometric parameters were studied in patients with thyroid disorders and in morbidly obese subjects, such data in normal healthy population are scarce. In our study, relationships between factors of body composition, fat distribution and age with hormones of the pituitary-thyroid axis were evaluated in a large, randomly selected sample of normal adult Czech population comprising of 1012 men and 1625 women. Our results exhibited weak, but significant relationships between body composition, body fat distribution and the parameters of pituitary-thyroid axis. Some of these associations were gender-specific. As shown by backward stepwise regression model, body fat distribution evaluated by centrality index (subscapular/triceps skinfold ratio) was negatively associated with free triiodothyronine (fT3) serum levels only in women, while a positive correlation of fT3 with BMI was specific for men. BMI was inversely related to free thyroxine (fT4) concentrations in women but not in men. The centrality index (CI) was positively related to TSH levels in both genders. The fT3/fT4 ratio, reflecting deiodinase activity, was inversely related to age and positively related to BMI in both genders, while the highly significant negative correlation between CI and fT3/fT4 ratio was specific for women.

An analysis of the relationship between insulin resistance and the activity of steroid C17,20-lyase and 3beta-hydroxysteroid dehydrogenase in ovaries and adrenals in women with polycystic ovary syndrome.

Polycystic ovary syndrome (PCOS) is connected with insulin resistance (IR), and often with the hypersecretion of adrenal androgens. Mutual relationships between IR and adrenal and ovarian steroidogenesis were investigated in the group of 19 oligo/amenorhoeic women with PCOS. The age and body mass index (BMI) of the patients were 21+/-4.7 years and 26.4+/-5 kg/m2 (average+/-SD), respectively. All underwent a 60-minute adrenocorticotrophic hormone (ACTH) stimulation test, a gonadoliberin analogue (GnRHa) test with buserelin and an oral glucose tolerance test (oGTT) in the early follicular phase of the menstrual cycle. When absolute stimulated steroid levels after GnRHa were studied, a significant positive correlation between DHEA and area under curve during oGTT for C peptide (AUC-CP) (r=0.477, p= 0.039) and a borderline negative correlation (r=-0.404, p= 0.087) between AUC-CP and 17-OH progesterone, were found. Considering steroid values after ACTH, a significant positive correlation of IR index was found only with 17-OH-progesterone (r=0.499, p= 0.03). When stimulated enzymatic activities (expressed as product/ precursor ratios) were analyzed using factor analysis, a positive relationship between IR and ovarian C17,20-lyase in both delta4 and delta5 pathway was revealed. On the other hand, no relationship was confirmed between IR and enzymatic activities in the adrenals. The authors conclude that insulin resistance and/or hyperinsulinemia is probably not the primary factor responsible for the exaggerated adrenal androgen secretion found in a great number of patients with PCOS.

[Ultrasound densitometry of the heel bone in a random sample of the adult Czech population]. / Ultrazvuková denzitometrie patní kosti (CUBA) u náhodne vybraného vzorku dospelé ceské populace.

To assess the state of the skeleton of 870 subjects selected at random the authors used ultrasound densitometry of the talus. The assessment was made using a Cuba Clinical apparatus (McCue Ultrasonic Ltd.UK). The assessed parameters were BUA in db/MHz (broad band ultrasound attenuation) and VOS in m/s (velocity of sound). From the results it is apparent that the BUA values in men reach their peak at the age of 31-35 years. In women the BUA values are highest between 18 and 20 years, then follows a decline and again a rise between 41 and 45 years. The VOS values in men are highest between 18 and 20 years, followed by a drop and slight increase between 56 and 60 years. In women the VOS values reach their maximum between 18 and 20 years. The assessed values obtained in a random sample of the population from three regions are the basis for evaluation of bone densitometry obtained by means of questionnaire in the adult Czech population.

[Dermatoglyphics--an attempt to predict diabetes]. / Dermatoglyfy--pokus o predikci diabetu.

Dermatoglyphs do not change throughout life. The authors sought their "predictive type" for diabetes with regard to the possibility of early prediction and thus prevention of the development of diabetes, in particular type 2. They used a point score of the abnormality in three qualitative and two quantitative signs and found, as compared with the normal population, in groups of subjects with impaired glucose tolerance, DM II and DM I deviations with an increasing significance. The frequency of thus assessed abnormalities in each subject on both hands (0-10) was compared in relations to the diagnosis and family-history of diabetes and the authors evaluated the incidence of different abnormalities in the whole group of 300 subjects and in sub-groups. After statistical evaluation the authors conclude that the abnormality of the qualitative sign of the C line (lacking or reduced) could be considered as another early predictive factor: in the offsprings of diabetics for both types of diabetes, in the remainder for DM type 1.

[Thyroglobulin and microsome autoantibodies and their clinical significance in adult type I diabetics]. / Výskyt protilátek proti tyreoglobulinu a proti mikrosomum u dospelých diabetiku I. typu a jejich mozný klinický význam.

In 34 patients with type 1 diabetes manifested in postadolescent age (mean age at time of diagnosis 25 years, 18 women and 16 men) after the establishment of the diagnosis perspectively the presence of antibodies against thyroglobulin and the microsomal fraction and their relation to affection of the thyroid gland was investigated. During an investigation of 20% of the patients the authors provided repeatedly evidence of the presence of both antibodies, in 23% repeatedly only against microsomes. In 21% some antibodies were detected only once. In the course of the investigation in 65% of the patients thyroid antibodies were found. The clinically most serious affection of the thyroid gland (from the sonographic an functional aspect) was found in groups 1 an 2, while in groups 3 and 4 in the majority of patients the thyroid gland was not affected. A different pathogenesis of the disease in the above groups is suggested in the areas of DR and DQ during HLA typing, the behaviour of other antibodies and differences in dermatoglyphic examinations. Moreover there is a high ratio of women in the first two groups (61%) and conversely of men in groups 3 and 4. In the discussion attention is drawn to the different course of diabetes in patients with thyroid autoimmunity.

[Comparison of basic somatometric characteristics in randomly selected populations from Prague and Vsetín]. / Porovnání základních somatometrických charakteristik u náhodne vybraných osob prazské a vsetínské oblasti.

In 1991-1992 in the Czech Republic an epidemiological survey was conducted focused on prevention of iodine deficiency and the incidence of some thyropathies. The authors examined samples of the Prague and Vsetín population selected at random. The clinical examination comprised also somatometric assessment. In a group of 1,100 subjects from Prague and Vsetín anthropometry of basic somatometric characteristics was performed (height, body weight, BMI and four skinfolds). From comparison of the two groups ensues that the Vsetín population is shorter, as compared with the Prague population, the BMI values are significantly higher and so is the percentage of subcutaneous body fat.

[Iodine status and incidence of thyropathies in the Czech population]. / Stav zásobení jodem a výskyt tyreopatií v nasí populaci.

Based on clinical experience on the rising incidence of some thyropathies in our population, the authors examined a random sample of the Prague population. They assessed and evaluated iodinuria, the sonographic finding of the thyroid gland, the palpation finding of the thyroid and a clinical examination which comprised a detailed case-history (a questionnaire checked during the examination) and a clinical and anthropometric examination. The results indicate that iodinuria (which reflects the iodine intake) reaches the recommended optimum (above 150 micrograms iodine/l) only in 11.4% of boys, 14% men, 6.3% girls and 5.4% women. A quite inadequate intake (less than 50 g iodine/l) was recorded in 13.2% boys, 15.2% men, 17% girls and 33.1% women. When evaluating the thyroid volume, an enlarged volume is found in 20.4-58.3% and on evaluation by palpation pathological changes are found in a considerable proportion of the examined population. The findings suggest that the iodine supply of the Prague population is inadequate and the incidence of abnormal findings on the thyroid gland is high. It will be necessary to verify these findings in other random population samples from other localities. If the adverse position will be confirmed, this will call for an urgent solution, i.e. a better iodine supply of the population.

[Selected anthropometric findings in women with disorders of glucose tolerance with hypertension]. / Vybrané antropometrické nálezy u zen s porusenou glukózovou tolerancí a s hypertenzí.

In a group of 26 women with an impaired glucose tolerance anthropometric measurements of basic somatometric characteristics were made with special attention to the subcutaneous fat distribution and compared the findings with the healthy Czech population. Changes in body build, BMI, subcutaneous body fat distribution were evaluated and the causality of the relationship between blood pressure and gluteofemoral and abdominal obesity was investigated. From the author's observations ensues that in the group of women with impaired glucose tolerance overweight was recorded, as compared with the normal population, disproportions in the circumferences of the trunk and extremities, an excessive percentage of body fat, well developed muscles. In abdominal obesity a significant increase of the blood pressure and BMI was found.

Androgen administration to transsexual women. II. Hormonal changes.

The authors administered to six transsexual women at three-month intervals androgenic depot preparations: testosterone undecanoate (Andriol-Organon) by the oral route and testosterone isobutyrate (Agovirin depot-Spofa) in injections. The achieved changes were evaluated by clinical and laboratory examinations, i.e. somatic changes as well as changes of hormonal indicators in plasma, urine and saliva, changes in the TeBG binding capacity, the effect of the administered hormones on liver functions, glucose metabolism and secretory insulin response. The high plasma androgen level did not vary substantially. After Andriol administration, a significant decrease of plasma TeBG was achieved, and an increase of the free testosterone fraction in saliva which was retained three months after discontinuation of the treatment. Both preparations caused the required virilization, whereby the action of Agovirin depot-Spofa in the selected dose was, as regards the speed of onset and intensity of the androgenization symptoms, more effective. The gonadotropin levels were not changed significantly during short-term administration. No interference with liver functions and glucose metabolism was observed. The patients tolerated both preparations well.

The use of andriol in treatment of androgen deficiency in transsexual women.

In search of a non-invasive, long-term acting form of androgen to be used in female-to-male transsexuals, testosterone undecanoate (Andriol, Organon) was investigated from clinical and laboratory points of view. The therapy resulted in a significant elevation of androgens with a considerable increase of the free testosterone fraction, desired virilization and somatic changes to a masculine phenotype. Testosterone undecanoate provides sufficiently high androgen levels without significant influence on the hypothalamo-pituitary-gonadal axis. The treatment impaired neither liver function nor glucose tolerance. It is concluded that this drug is suitable for hormonal preparation before the reconstructive therapy to males.