Endokrynologia Polska最新文献

Introduction: The association between insulin resistance and lipid metabolism in acute ischemic stroke (AIS) remains unclear. To explore their relationship and elucidate potential biomarkers for stroke management, we investigated the association between the triglyceride-glucose index (TyG index) and remnant cholesterol (RC) in patients with AIS.

Material and methods: A total of 116 patients diagnosed with acute ischemic stroke (AIS) and admitted to the Xiong'an New District Rongcheng People's Hospital between December 2022 and June 2023 were randomly chosen for this study. Patients were categorized into three groups based on either the TyG index or RC tertiles. To assess the association between the TyG index and RC, Spearman's rank correlation analysis was conducted. Additionally, ANOVA was utilized to compare the levels of RC across different TyG index tertiles. To determine if RC could serve as a potential explanatory variable of the TyG index and vice versa, multiple linear regression analysis was employed. Furthermore, ordinal logistic regression analysis was carried out to explore the relationships among the TyG index, RC, and AIS severity.

Results: Spearman's rank correlation analysis showed that the TyG index was positively correlated with RC (r = 0.645, p < 0.0001). Multiple linear regression analysis showed that RC was associated with the TyG index (β = 0.695, p < 0.001) and vice versa (β = 0.212,p = 0.008). Ordinal logistic regression analysis indicated that RC was positively associated with AIS severity (estimate = 0.713, p = 0.038).

Conclusions: There is a strong correlation between the TyG index and RC in patients with AIS. In addition, RC was positively associated with the severity of AIS. The results of this study may promote a more comprehensive understanding of the association between insulin resistance and lipid metabolism in AIS.

Introduction: The authors of the latest recommendations state that osteoporosis diagnosis should not rely solely on densitometric (DXA) criteria. Fracture risk assessment is crucial for determining diagnosis and intervention thresholds. Comprehensive assessment of fracture risk requires consideration of bone mineral density (BMD) results, use of risk calculators like Fracture Risk Assessment Tool (FRAXTM), and analysis of clinical and lifestyle factors. Experts highlight the need to identify patients at very high fracture risk to justify starting anabolic therapy. This retrospective study assessed fracture risk in newly diagnosed osteoporosis patients, identifying those at high and very high risk.

Material and methods: The study included 159 postmenopausal women with newly diagnosed osteoporosis, identified by a T-score of ≤ -2.5 standard deviations (SD) from DXA scans of the femoral neck and/or lumbar spine. Demographic data and laboratory tests were collected, and the 10-year fracture risk for major osteoporotic fractures (FRAX MOF) and hip fractures (FRAX HF) was calculated using the FRAX-PL calculator, which included femoral neck BMD. Each patient was then classified into a risk group based on modified fracture risk assessment criteria.

Results: The study found that the most common risk factor for osteoporosis was a previous fracture (56.6%). Other common risk factors included smoking (21.38%), parental hip fracture (13.21%), and glucocorticoid use (10.70%). The FRAX calculator showed that 47.80% of patients were at very high risk for HF and 23.90% for MOF. A high HF risk was present in 10.06% of patients, and high MOF risk in 34.59%, whereas a medium and low MOF risk concerned 25.79% and 15.72% of the subjects, respectively. With expanded criteria, 72.33% of patients were classified at very high risk, compared to 23.90% for MOF and 47.80% for HF based solely on FRAX. Most patients met the T-score ≤ -3.0 SD criterion (52.20%) and FRAX > 15% for MOF or FRAX > 4.5% for HF (52.20%). Women aged 65-70 and 70-75 years are at the highest risk and qualify for anabolic therapy.

Conclusions: Our study highlights the importance of stratifying patients by fracture risk, showing that more individuals are identified at very high risk when using the expanded assessment criteria from the latest Polish guidelines.

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Through pleiotropic effects related to the presence of its receptors in major human organs, vitamin D (VD) plays an important role in systemic homeostasis, especially in the proper functioning of muscles and bones. In light of the published data from both animal and human studies, VD deficiency should be considered a risk factor for obesity-related morbidity, prediabetes, and type 2 diabetes (T2D); in addition, VD supplementation in VD deficiency has a beneficial effect on the effects of treatments aimed at normalization of body weight (including incretin drugs) and the metabolism of carbohydrates in prediabetes and T2D. The objective of this paper is to present the current knowledge and evidence on the relationship between VD deficiency and obesity, prediabetes, and T2D. The paper is intended to be used as a practical guide. The authors propose that serum 25(OH)D concentrations be determined in adults who are obese or overweight (i.e., belonging to the group presenting with a multiple increase in the risk of VD deficiency) or adults who are obese or overweight and have prediabetes or T2D. The baseline VD levels should determine the therapeutic dose and be helpful in assessing the effectiveness of therapy. The available literature lacks precise information regarding the recommended doses of VD in obese people, with 4000 IU being a frequently suggested daily dose. Most papers recommend that body weight be taken into account when determining the dose of VD in the obese; the dose should be higher than in individuals with normal body mass index (BMI). The authors suggest that in the case of low VD levels (< 20.0 ng/mL), quite frequently as low as 12.0-15.0 ng/mL, in an adult obese patient, VD therapy should be started at 20,000 IU two times per week or 50,000 IU once a week with 25(OH)D and calcium levels being checked after one month so that a decision can be made on the further course of therapy. The suggested 25(OH)D concentration target range is > 30-50 ng/mL. In a patient-tailored supplementation model, the dose of VD should depend on body weight and, most importantly, on the baseline VD level. In the absence of the expected effects, the authors suggest that the dose of VD (usually vitamin D3) be increased or the treatment be switched to calcifediol or alfacalcidol, or calcitriol in special cases such as impaired kidney or liver function. It is important to emphasize the need to individualize the management and monitor blood calcium and creatinine levels during chronic VD therapy, including high-dose therapy.

Introduction: The present study was undertaken to elucidate the expression status and molecular mechanism underlying microRNA-3127-5p (miR-3127-5p) in polycystic ovary syndrome (PCOS).

Material and methods: A total of 50 PCOS and 50 non-PCOS patients were recruited as research subjects. Quantitative real-time polymerase chain reaction was employed to assess the relative abundances of miR-3127-5p in serum, cumulus cells (CCs), and granulosa cells (GCs) from PCOS patients. Additionally, cellular activities and ferroptosis-related biomarkers were evaluated. Bioinformatics analysis was conducted to identify potential targets of miR-3127-5p. To validate the interaction between miR-3127-5p and sorbin and SH3 domain-containing protein 1 (SORBS1), a luciferase reporter assay was conducted.

Results: Enforced miR-3127-5p expression was detected in serum, CCs, and GCs from PCOS patients, demonstrating a robust diagnostic capacity for effectively distinguishing between PCOS and non-PCOS patients. Furthermore, the reduction of miR-3127-5p expression was found to enhance cell viability and inhibit cell apoptosis in human granulosa-like tumor cell line (KGN) and the luteinized granulosa cell line (SVOG) cells. Concurrently, its down-regulation led to attenuated levels of iron, malondialdehyde (MDA), and reactive oxygen species (ROS), while simultaneously increasing the expression of glutathione peroxidase 4 (GPX4). Notably, miR-3127-5p expression exhibited an inverse relationship with SORBS1. Rescue experiments revealed that the effects of downregulated miR-3127-5p expression on cellular behaviors and ferroptosis were reserved through the transfection of si-SORBS1.

Conclusion: The downregulation of miR-3127-5p expression facilitates cell growth and attenuates ferroptosis by targeting SORBS1, thereby playing a pivotal role in the initiation and development of PCOS.

Plasma calcium levels are regulated by many factors, including the levels of calcium-sensitive receptors, parathyroid hormone, parathyroid hormone receptors, vitamin D, vitamin D receptors, and other proteins. Plasma calcium is also related to genetic structure; albumin, creatinine, and phosphorus levels; and blood pH. Multiple factors affect hypercalcemia in children, making its management challenging. These factors have led to accurate diagnosis for mostly mild and moderate cases of hypercalcemia, resulting in a management dilemma. In many clinics, physicians face undiagnosed cases of hypercalcemia even if the hypercalcemia algorithms are followed accurately. In this narrative review, we discuss a logical approach to the investigation and subsequent clinical management of hypercalcemia in children.

Introduction: The analysis of the costs associated with treating acromegaly and its complications is important in planning diagnostics and treatment for a single patient, as well as in establishing the standard of care for the entire population of acromegaly patients. Data on the actual costs of treating patients with acromegaly in Poland are limited.

Aims of the study: To determine the direct cost (hospital stays, diagnostic imaging, surgical treatment, pharmacotherapy, tumour irradiation) of treating patients with acromegaly and its complications, assessing the relationship between acromegaly treatment costs and the radical nature of the treatment.

Materials and methods: A retrospective analysis of medical records was carried out in 124 patients with acromegaly who were hospitalised in the Department of Endocrinology in 2011-2016, including a group of 39 patients who were successfully operated on, 73 patients requiring treatment with a somatostatin analogue, and 12 patients with newly diagnosed disease. The costs of surgical procedures, hospitalisation, diagnostic tests, and the cost of pharmacological treatment of acromegaly and its complications were analysed and estimated based on the system of homogeneous groups of patients.

Results: The mean total annual cost of acromegaly treatment was PLN 43,419 (EUR 9731). The mean annual cost of treating patients undergoing effective neurosurgical treatment was lower than in the other groups, and the costs of pharmacological and surgical treatment of complications of acromegaly were also lower. The costs of hospitalisation and additional diagnostic tests were highest in patients with newly diagnosed acromegaly.

Conclusions: Treatment with somatostatin analogues is the major cost factor in patients requiring chronic therapy. Effective radical neurosurgical treatment reduces the incidence of chronic complications of acromegaly and lowers the overall treatment costs.

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