Effect of special types of bread with select herbal components on postprandial glucose levels in diabetic patients.

BACKGROUND: Nutrition recommendations in patients with type 2 diabetes mellitus (T2DM) are to consume rye or integral bread instead of white bread. A positive effect on glucoregulation has been achieved by enriching food with various biologically active substances of herbal origin, so we formulated an herbal mixture that can be used as a supplement for a special type of bread (STB) to achieve better effects on postprandial glucose and insulin levels in patients with T2DM. AIM: To compare organoleptic characteristics and effects of two types of bread on postprandial glucose and insulin levels in T2DM patients. METHODS: This trial included 97 patients with T2DM. A parallel group of 16 healthy subjects was also investigated. All participants were given 50 g of rye bread and the same amount of a STB with an herbal mixture on 2 consecutive days. Postprandial blood glucose and insulin levels were compared at the 30th, 60th, 90th and 120th min. A questionnaire was used for subjective estimation of the organoleptic and satiety features of the two types of bread. RESULTS: Compared to patients who consumed rye bread, significantly lower postprandial blood glucose and insulin concentrations were found in T2DM patients who consumed STB. No relevant differences were found among the healthy subjects. Subjectively estimated organoleptic and satiety characteristics are better for STB than for rye bread. CONCLUSION: STB have better effects than rye bread on postprandial glucoregulation in T2DM patients. Subjectively estimated organoleptic and satiety characteristics are better for STB than for rye bread. Therefore, STB can be recommended for nutrition in T2DM patients.

Menopausal hyperinsulinism and hypertension - new approach.

Aim: to test effects of estradiol (E2) 1 mg and drospirenone (DRSP) 2 mg in treatment of normal weight menopausal women with typical menopausal symptoms, hyperinsulinism, and grade I hypertension.Material and methods: The participants were 133 menopausal women, mean age 51.82 ± 3.25 years, body mass index (BMI) 24.9 ± 2.6 kg/m2, waist/hip 0.80 ± 0.05, amenorrhoeic period 2.12 ± 2.10 years. All patients were treated with E2 1 mg and DRSP 2 mg during 12 months period. Blood samples were taken at 8 am before and during 12 months of therapy for: glycemia, lipids, hormonal analysis, follicle-stimulating hormone (FSH), luteinizing hormone (LH), E2, testosterone (T), prolactin (PRL), dehydroepiandrosterone sulfate (DHEAS), and sex hormone-binding globulin (SHBG). Oral glucose tolerance test (OGTT) was performed with 75 g glucose in order to assess insulin secretion. All had grade I hypertension 24 h blood pressure monitoring was performed before and after 12 months of therapy.Results: E2/DRSP significantly decreased total cholesterol, low-density lipoprotein (LDL), apolipoprotein B (ApoB), and increased high-density lipoprotein cholesterol (HDL) and apolipoprotein A (ApoA). Insulin area under the curve (AUC) significantly decreased (6586.1 ± 4194.2 vs. 5315.3 ± 2895.0, p < .05) and homeostatic model assessment (HOMA) (3.53 ± 2.18 vs. 3.0 ± 1.8, p < .05). FSH, LH decreased, E2 increased significantly. Of 24 h day blood pressure decreased significantly.Conclusions: E2/DRSP represents suitable therapy for hyperinsulinemic, grade I hypertensive menopausal women with typical symptoms and normal weight.

Matrix metalloproteinase-9 index as a possible parameter for predicting acute coronary syndrome in diabetics.

BACKGROUND/AIM: Matrix metalloproteinase-9 (MMP-9) index is the ratio of active MMP-9 and total MMP-9 levels. It reflects the importance of MMP-9 in acute coronary syndrome (ACS). METHODS: The study included 3 groups of patients (n = 87): the group 1 - non-diabetic subjects without ACS (control); the group 2 - diabetic patients with ACS [subgroups with unstable angina pectoris (UAP), myocardial infarction (MI) or reinfarction]; and the group 3 non-diabetics patients with ACS. Total and active MMP-9 were measured and used to create MIP-9 index. RESULTS: MMP-9 index, as a marker showed good sensitivity and specificity, of ACS in diabetics, with a cut-off value over 58.2. MMP-9 was higher in the study groups than in the control one. MMP-9 correlated with ACS occurrence and type of cardiovascular event. A statistically significant difference was found among the groups according to active MMP-9 (p < 0.001). The same was found with active MMP-9 between the control and the group with MI (p < 0.001). The control was highly statistically significantly different from the group of patients with UAP (p < 0.01). Statically significant differences in MMP-9 index was found between the control and the diabetics with ACS (P < 0.001). Statistically significant difference of MMP-9 index was also found in the controls compared to the value in non-diabetic patients with ACS (p < 0.01). CONCLUSION: MMP-9 index may be a possible marker of atheromatous plaque rupture in diabetics.

Metabolic syndrome in patients with myotonic dystrophy type 1.

INTRODUCTION: The aim of this study was to assess the frequency and features of metabolic syndrome (MetS) in myotonic dystrophy type 1 (DM1). METHODS: We studied 66 DM1 patients (50% men, aged 41.9 ± 10.5 years, disease duration of 19.3 ± 8.6 years). New worldwide consensus criteria for MetS from 2009 were used. RESULTS: Components of MetS were present at the following frequencies: hypertriglyceridemia 67%; low HDL cholesterol 35%; hypertension 18%; central obesity 14%; and hyperglycemia 9%. MetS was present in 11 (17%) patients. The presence of MetS was not associated with patients' gender, age, disease severity, disease duration, or CTG repeat length (P > 0.05). Patients with MetS had significantly lower total SF-36 scores as a measure of quality of life in comparison to patients without MetS (P < 0.05). CONCLUSION: Although certain components of MetS were very frequent in patients with DM1, only 17% met the criteria for MetS.

Association of renin-angiotensin system genes polymorphism with progression of diabetic nephropathy in patients with type 1 diabetes mellitus.

BACKGROUND/AIM: Diabetic nephropathy (DN) as a major microvascular complication of diabetes mellitus (DM) include a progressive increase in urinary albumin excretion in association with an increase in blood pressure and to end stage renal failure. Hypertension connected with renin-angiotensin system (RAS) hyperactivity and corresponding genotypes, angiotensinogen (AGT), angiotensine-converting enzyme (ACE) and angiotensin II type 1 receptor (AT1R), predispose the increasing risk of DN. The aim of this study was to assess the distribution of AGT, ACE and AT1R gene polymorphisms in patients with type 1 DM according to the level of DN and patients clinical characteristics. METHODS: The study included 79 type 1 diabetic patients. Inclusion criteria were: age between 20-40, duration of diabetes > 5 years, and no other severe diseases. Clinical characteristics were gained from interviewing the patients. Polymorphism was detected by polymerase chain reaction (PCR) and restriction fragment length polymorphism using restriction enzymes Psy I (Tth 111 I) and Hae III. RESULTS: The patients with proteinuria compared with normo- and microalbuminuric patients, highly differed in age, diabetes duration, blood pressure level, hypertension, rethynopathy and urinary albumin excretion values (p < 0.001). No statistically significant difference between the groups was found for the ACE and AT1R gene polymorphisms distribution. The presence of TT genotype of the M235T polymorphism was significantly higher in the group with proteinuria (p < 0.05). The patients with hypertension raised nephropathy 5.2 times higher (OR = 5.20, p < 0.05) while carriers of TT allel developed nephropathy 28.38 times higher (OR = 28.389, p < 0.01) than those with MM genotype. CONCLUSION: Increased association of hypertension and TT angiotensinogen gene polymorphism in patients with diabetes mellitus with proteinuria could be a significant marker of diabetic nephropathy.

The presence of dysautonomia in different subgroups of myasthenia gravis patients.

To analyze the presence of autonomic dysfunction in different subgroups of myasthenia gravis (MG) patients. Standard cardiovascular reflex tests according to Ewing, spectral and time domain analysis of heart rate variability (HRV) at rest were assessed in 27 patients with thymoma-associated acetylcholine receptor (AChR)-positive MG, 25 AChR-positive MG patients without thymoma and 23 patients with muscle-specific tyrosine kinase (MuSK) MG. All patients were compared to the healthy controls, matched for sex and age. In the group of AChR-positive MG patients with thymoma, hand grip (p < 0.05), orthostasis (p < 0.05), breathing test (p < 0.05) and Valsalva maneuver (p < 0.01) were more often pathological than in the controls. Analysis of the spectral domain of HRV showed increased low-frequency (p < 0.05) and decreased high-frequency component (p < 0.05). Time domain parameters of HRV and baroreflex sensitivity (BRS) at rest were significantly reduced (p < 0.01). In the patients with AChR MG without thymoma, Valsalva maneuver test was more often pathological (p < 0.05) and higher rate of supraventricular extrasystoles (p < 0.01) was registered than in the healthy controls. In the patients with MuSK-positive MG, hand grip and Valsalva maneuver tests were more often pathological than in the controls (p < 0.05). Low-frequency component of the spectral domain of HRV (p < 0.05) and the frequency of cardiac arrhythmia were increased. BRS at rest was significantly lower in patients compared to the controls (p < 0.01). We determined the presence of autonomic failure in all subgroups of MG patients. Since autonomic dysfunction can lead to cardiac arrhythmias and even sudden death, it is of major importance to be aware of this association and to properly diagnose and treat these patients.

Finger length ratios in Serbian transsexuals.

Atypical prenatal hormone exposure could be a factor in the development of transsexualism. There is evidence that the 2nd and 4th digit ratio (2D:4D) associates negatively with prenatal testosterone and positively with estrogens. The aim was to assess the difference in 2D:4D between female to male transsexuals (FMT) and male to female transsexuals (MFT) and controls. We examined 42 MFT, 38 FMT, and 45 control males and 48 control females. Precise measurements were made by X-rays at the ventral surface of both hands from the basal crease of the digit to the tip using vernier calliper. Control male and female patients had larger 2D:4D of the right hand when compared to the left hand. Control male's left hand ratio was lower than in control female's left hand. There was no difference in 2D:4D between MFT and control males. MFT showed similar 2D:4D of the right hand with control women indicating possible influencing factor in embryogenesis and consequently finger length changes. FMT showed the lowest 2D:4D of the left hand when compared to the control males and females. Results of our study go in favour of the biological aetiology of transsexualism.

Liver function test changes in centrally obese youth with metabolic syndrome in a Serbian population.

OBJECTIVE: The aim of this study was to investigate the association between metabolic syndrome and liver enzymes in overweight and obese adolescents and young adults. METHODS: A total of 126 overweight and obese adolescents and young adults (age, 15-26 years), 55 (43.6%) with metabolic syndrome and 71 (56.4%) without metabolic syndrome, were studied. RESULTS: Patients with metabolic syndrome had significantly higher alanine aminotransferase (ALT), γ-glutamyl transpeptidase (GGT), and alkaline phosphatase (ALP) levels compared to patients without metabolic syndrome [36.5±22.2 vs. 29.4±17.8 IU/L (P=0.043), 33.8±17.8 vs. 26.9±18.4 IU/L (P=0.002), and 84.3±32.2 vs. 75.7±29.5 IU/L (P=0.063)]. Aspartate aminotransferase (AST) levels were similar in both groups (24.1±9.8 vs. 23.3±9.0 IU/L, P=0.674). Elevated AST, ALT, GGT, and ALP levels were observed in 6, 15, 18, and 5 patients (11%, 27%, 14%, and 9%) with metabolic syndrome compared to 6, 17, 6, and 4 (8%, 24%, 8% and 5%) patients without metabolic syndrome (P=0.872, P=0.826, P<0.001, and P=0.035). In multivariate regression models adjusted for age and gender, metabolic syndrome was not a significant predictor of ALT (P=0.967), GGT (P=0.526), and ALP levels (P=0.221), but insulin resistance was a significant predictor for ALT and GGT levels (P=0.001, P=0.028). CONCLUSION: Changes in liver function tests were observed in obese patients with metabolic syndrome, compared to patients without metabolic syndrome, especially in ALT and GGT levels. Insulin resistance is an independent pathogenic mechanism in liver function test changes regardless of metabolic syndrome in nondiabetic centrally obese youth.

[Evaluation of neurophysiological parameters and good metabolic control in patients with type 1 diabetes mellitus].

INTRODUCTION: Numerous authors have indicated the beneficial effect of glycoregulation on micro- and macro-angiopathic complications. OBJECTIVE: The aim of the study was to examine whether intensive treatment with maintaining blood glucose concentrations close to normal range could improve electrophysiological parameters. METHODS: The study involved 81 patients with type 1 diabetes mellitus type 1 randomly assigned to intensive insulin therapy. The patients were followed for a period of 3 months by metabolic and electrophysiological control. The metabolic control included daily measurement of concentration of blood glucose and HbA1c and lipid status, while the neurophysiological control included nerve conduction velocity (NCV) of median, peroneal, tibial and sural nerve and latency of F wave. RESULTS: In the beginning of our study blood glucose was 9.10 +/- 3.69 mmol/l and HbA1c 8.12 +/- 1.20%. After 3 months of administered intensive insulin therapy, blood glucose was 7.88 +/- 2.79 mmol/l and HbA1c 6.63 +/- 1.33. After 3 months NCV improved in the tibial, median and sural nerve (p < 0.05) and latency of F wave. CONCLUSION: We found a significant association between the metabolic control and NCV findings which suggests that good metabolic control influences the improvement of neurophysiological parameters in patients with type 1 diabetes mellitus.

Influence of the metabolic control on latency values of visual evoked potentials (VEP) in patients with diabetes mellitus type 1.

The aim of our study was to investigate the relationship between the metabolic control parameters of diabetes mellitus (glycemia and HbA1c) and visual evoked potentials (VEP) latency values. The study included 61 patients with diabetes mellitus type 1 that were hospitalized at the Clinic for Endocrinology, Diabetes and Metabolic Diseases due to the poor metabolic control. All patients were divided into 3 groups. Group 1 consisted of patients on conventional insulin therapy (CT); Group 2 included patients on CT at the moment of hospitalization, with a change towards intensified insulin therapy (IIT); and Group 3 consisted of patients on IIT. Patients with diabetic retinopathy (DR) were excluded from the study. Metabolic control (glycemia and HbA1c) and VEP parameters were compared at the beginning of the study and six months later. After six months of strict glycoregulation, significant improvement in VEP parameters was followed by significant improvement of evaluated parameters of metabolic control. We found statistically significant reduction in frequency of pathological VEP findings, prolonged P100 latency and low amplitude potentials in Group 2, while in Groups 1 and 3 we found that these parameters did not significantly changed but the frequencies were lower. The VEP testing is a noninvasive diagnostic procedure which may help in early diagnosis of DR, prognosis during the metabolic control and treatment. If changes in the retina could be detected before DR is noticed using this noninvasive diagnostic procedure and include patients in a strict glycoregulation, we could be in the position to prevent serious complications that may cause blindness.

Correlation of color Doppler with multidetector CT angiography findings in carotid artery stenosis.

The aim of this paper was to examine the correlation between the Color Doppler ultrasound (CD-US) and multidetector CT angiography (MDCTA) diagnostic methods, and to define the degree and extent of stenosis in patients with internal carotid artery stenosis. This was a cross-sectional study with a consecutive series of patients. All US examinations were always carried out by the same physician-angiologist, while all CT examinations were always carried out by the same physician-radiologist. Both worked independently from each other. The stenosis area was measured at the narrowest point by NASCET criteria for US/CT. Peak systolic velocity (PSV) over 210 cm/sec and end diastolic velocity (EDV) over 110 cm/sec criteria were applied for stenoses with lumen narrowed over 70%, while PSV under 130 cm/sec and EDV under 100 cm/sec criteria were applied for those with lumen narrowed under 70%. A total of 124 carotid arteries were observed; namely, 89 narrowed and 68 surgically treated. All patients were reviewed by US and then by MDCTA; patients with 70-99% stenosis underwent surgery. The correlation coefficient between stenosis degree measured by US and MDCTA was 0.922; p < 0.01. The average difference between US and MDCTA diagnostic methods was 3% (Z = -1.438, p > 0.05). The US and CT matching level for stenoses from 70 to 99% was very high (kappa = 0.778, p < 0.01). In conclusion, there is a highly significant statistical correlation among both diagnostic methods when measuring stenosis degree and extent. US is more dependent on the physician, while MDCTA is more objective and independent from the physician. We think it would be appropriate to undertake an MDCTA exam for those patients who are candidates for carotid endarterectomy.

[Correlation between morphologic carotid plaque findings based on color-Doppler and CT multidetector angiography with intraopertive findings in carotid artery stenosis].

BACKGROUND/AIM: Vast majority of patients with corotid arthery sclerosis do not have transitory ischemic attacs (TIA) as working to the persistent silent disease, but stroke is the first sign. Precise and early diagnosis of the carotid artery disease and plaques are very important. The aim of this study was to determine how the composition/identity of diagnostic methods, color-Doppler, ultrasonography (US) CT-multidetector angio (MDCTA) scan and intraoperative (IO) findings, as well as the morphology of plaques in patients with haemodynamic significant stenosis of the internal carotid artery. METHODS: Carotid plaques were observed by two diagnostic methods, US and MDCTA, and these findings were correlated with the IO findings. RESULTS: In 62 patients both carotid artheries were examined and 83 plaques were observed. There were 68 surgical interventions. The structure of plaques was divided into four types: lipid, fibrous, fibrocalcified and calcified plaque. US showed: lipid plaques 10.8%; fibrous 1.2%; fibrocalcified 44.6% and calcified 43.4%, and the MDCTA lipid plaques 8.4%; fibrocalcified 48.2% and calcified 43.4%. Intraoperative findings were: lipid plaques 10.3%; fibrocalcified 41.2% and calcified 48.5%. A statistically highly significant agreement between the US and MDCTA in the diagnosis of plaque morphology was obtained (Cramer's V = 0.919, p < 0.01; Lambda = 0.921, p < 0.01) and also statistically significant agreement between US and IO findings (Cramer's V = 0.831,p < 0.01; Lambda = 0.859, p < 0.01). A statistically highly significant agreement between MDCTA and IO findings in plaque morphology was found, as well (Cramer's V = 0.815, p < 0.01; Lambda = 0.829, p < 0.01). CONCLUSION: There is statistically highly significant correlation between US and MDCTA diagnostic methods in the evaluation of plaque morphology in surgically significant stenosis of internal carotid artery as well as their agreement with the intraoperative finding.

Comparative analysis of collagenase XI and liberase H1 for the isolation of human pancreatic islets.

BACKGROUNDS/AIMS: The aim of this study was to compare efficacy of two enzymes, Liberase HI and Collagenase XI in human adult pancreatic islet isolation. METHODOLOGY: Pancreatic tissue samples were digested either with Liberase HI or Collagenase XI, using a non-automated method. We investigated the effect of both enzymes on yield, function and percent viability of the islets. RESULTS: No significant differences were found regarding islet yield when comparing Liberase HI to Collagenase XI. Viability of Collagenase-isolated islets was initially lower, but following 3 days of culture they attained a higher viability than the Liberase treated islets. Although the stimulation index tended to be higher in the Liberase-isolated islets no significant differences were observed between the two enzymes, except on the first day of cultivation; SI values for all Liberase concentrations were significantly higher than for Collagenase (p < 0.05). CONCLUSIONS: We conclude that during the isolation procedure using Collagenase XI, the functional capacity of the isolated islets decline, but this is restored during a subsequent cultivation. On the other hand, during digestion with Liberase HI, the islets suffer less functional damage, resulting in better preservation of their functional capacity immediately after the isolation, as well as the subsequent 7 days of cultivation.

Transsexualism in Serbia: a twenty-year follow-up study.

INTRODUCTION: Gender dysphoria occurs in all societies and cultures. The prevailing social context has a strong impact on its manifestations as well as on applications by individuals with the condition for sex reassignment treatment. AIM: To describe a transsexual population seeking sex reassignment treatment in Serbia, part of former Yugoslavia. METHODS: Data, collated over a period of 20 years, from subjects applying for sex reassignment to the only center in Serbia, were analyzed retrospectively. MAIN OUTCOME MEASURES: Age at the time of application, demographic data, family background, sex ratio, the prevalence of polycystic ovarian syndrome (PCOS) among female-to-male (FTM) transsexuals, and readiness to undergo surgical sex reassignment were tabulated. RESULTS: Applicants for sex reassignment in Serbia are relatively young. The sex ratio is close to 1:1. They often come from single-child families. More than 10% do not wish to undergo surgical sex reassignment. The prevalence of PCOS among FTM transsexuals was higher than in the general population but considerably lower than that reported in the literature from other populations. Of those who had undergone sex reassignment, none expressed regret for their decision. CONCLUSIONS: Although transsexualism is a universal phenomenon, the relatively young age of those applying for sex reassignment and the sex ratio of 1:1 distinguish the population in Serbia from others reported in the literature.

Prothrombogenic factors and reduced antioxidative defense in children and adolescents with pre-metabolic and metabolic syndrome.

BACKGROUND: The aim of this study was to examine prothrombogenic factors and antioxidative defense in obese children and adolescents with pre-metabolic and metabolic syndrome, and to analyze insulin secretion and resistance, early glycoregulation disorders and lipid status. METHODS: Insulin sensitivity was determined using the homeostasis model assessment for insulin resistance (HOMA-IR), while insulin secretion was determined using the homeostasis model assessment beta (HOMA-beta). Prothrombogenic factors analyzed were plasma plasminogen activator inhibitor-1 (PAI-1) and fibrinogen. Superoxide dismutase and glutathione peroxidase were measured as markers of antioxidative defense. RESULTS: Patients with metabolic syndrome were characterized with increased body mass index (BMI), waist circumference, and HOMA-IR and HOMA-beta levels, and all had increased blood pressure and triglyceride levels, low high-density lipoprotein cholesterol levels, increased PAI-1 levels and reduced antioxidative defense levels. Patients with pre-metabolic syndrome had higher levels of basal and mean insulinemia during an oral glucose tolerance test, higher levels of HOMA-beta and lower levels of antioxidative defense compared to patients with metabolic syndrome. CONCLUSIONS: Negative correlations between antioxidative defense parameters and BMI, abdominal obesity, insulin secretion, systolic blood pressure and atherogenic lipid factors, as well as correlations between PAI-1 and insulin resistance and basal glycemia in the metabolic syndrome group contribute to accelerated atherosclerosis. Positive correlations between PAI-1 and waist circumference and BMI, and negative correlations between BMI and antioxidative defense in the pre-metabolic syndrome patients show that this early stage preceding the metabolic syndrome is also characterized by atherosclerotic complication risks and evident hyperinsulinism and insulin resistance.

Changes in neuroendocrine and metabolic hormones induced by atypical antipsychotics in normal-weight patients with schizophrenia.

CONTEXT: Atypical antipsychotics (SGA) have the propensity to induce weight gain. OBJECTIVE: The aim was to evaluate early changes in hormones involved in neuroendocrine regulations (serum cortisol, growth hormone and prolactin) and positive energy balance (serum insulin, leptin and ghrelin) during SGA treatment in normal-weight patients with schizophrenia with the purpose of exploring the possibility to combat weight gain early through manipulation of circulating hormone levels. DESIGN: We conducted a randomized, partly cross-sectional and partly longitudinal, prospective study. SETTING AND PATIENTS: Eighteen normal-weight in-patients with schizophrenia treated with FGA (first-generation antipsychotics) were referred to the Institute of Psychiatry. Twenty age-, gender- and BMI-matched healthy subjects were investigated at the Neuroendocrine Unit, Belgrade University. INTERVENTION: Oral glucose tolerance test (OGTT) was performed at baseline in all and then 13 patients were assigned to receive SGA (risperidone or clozapine) and OGTT was repeated after 1 and 3 months. RESULTS: At baseline, patients with schizophrenia had higher peak glucose levels (p < 0.05), glucose area under the curve (AUC; p < 0.05), peak insulin levels (p < 0.05), insulin AUC values during OGTT (p < 0.01) and the calculated homeostasis model assessment (HOMA-IR) value than control subjects (p < 0.05). Patients with schizophrenia showed higher morning cortisol (p < 0.05) levels than control subjects. After 1 and 3 months of SGA therapy patients with schizophrenia gained bodyweight by 3.5 and 8.6%, respectively. Leptin levels steadily increased while cortisol levels decreased in the first month and remained so. Serum glucose, insulin and ghrelin levels on SGA were similar as at baseline. Circulating ghrelin levels decreased after OGTT during SGA which is consistent with a role for ghrelin in the initiation of meals. CONCLUSIONS: Treatment with SGA was associated with continuous weight gain, with an early increase in serum leptin levels and decrease in cortisol levels. Elevated circulating leptin was ineffective in the control of fat deposition. Similar plasma ghrelin levels and similar decrease pattern of ghrelin after OGTT compared to healthy subjects signify intact meal-promoting effects of ghrelin during SGA therapy, which at the same time renders anorexigenic pathways ineffective. This may lead to weight gain and further studies with a ghrelin antagonist may provide support for this hypothesis.

[Influence of hormone replacement therapy in postmenopausal women with type 2 diabetes and hyperlipidemia on lipid and glucose metabolism].

INTRODUCTION: Hormone replacement therapy (HRT) is less frequently prescribed to postmenopausal women with diabetes type 2 who have poor lipid status despite well known favorable effect of HRT on lipid levels. OBJECTIVE: The aim of this study was to assess the effect of oral HRT in postmenopausal women with type 2 diabetes and hyperlipidemia. METHOD: Continuously combined HRT, estradiol 2mg + norethisterone acetate 1mg was given to 30 women with diabetes type 2 and hyperlipidemia and two control groups of postmenopausal women (30 with hyperlipidemia only and 30 healthy women) over a 6-month period. Total cholesterol (t-HOL), triglycerides, LDL-cholesterol, HDL-cholesterol, glycosylated hemoglobin A1c (HbA1c) were evaluated in 3-month intervals. Fasting and postprandial glucose levels were evaluated monthly. RESULTS: HRT significantly decreased levels of t-HOL (X2(Friedman) = 11.712; p<0.01) and LDL-c (X2(Friedman) = 10.403; p<0.01) in postmenopausal women with type 2 diabetes. However, the effect was more pronounced in two control groups. Triglycerides (X2(Friedman) = 5.400; p > or = 0.05) and HDL-c (X2(Friedman) = 1.113; p>0.05) did not change in postmenopausal women with type 2 diabetes. Six month of oral HRT significantly decreased HbAlc (F=44.693; p<0.01). Fasting and postprandial glycemia was decreased but not significantly (X2Friedman=6.527; p>0.05). CONCLUSION: Six-month application of HRT is effective in lowering the lipid levels and HbA1c in postmenopausal women with type 2 diabetes. However, target lipid levels were not achieved.