Electronic Library of Scientific Literature


Volume 32 / No. 4 / 1998



Z. Ostrowska, K. Zwirska-Korczala, M. Pardela, M. Drozdz, Kos-Kudla B., B. Buntner

1st Department of Pathophysiology and Clinical Biochemistry, 2nd Department of General and Vascular Surgery, Silesian School of Medicine, 41-800 Zabrze

Objective. To assess the 24 h profile of androgenemia related to the androgens of both the ovarian and adrenal origin in obese women with menstrual disturbances.
Methods. The association of body mass and body fat distribution with circadian variations of selected androgens of ovarian and adrenal origin was examined in 16 obese women with menstrual disturbances (BMI between 38 and 51 kg/m2; WHR between 0.80 and 0.99) and in 16 healthy volunteers with normal body weight (BMI between 21 and 24.6 kg/m2; WHR between 0.73 and 0.76). The age range of all subjects was 29 to 40 (mean: 36.9±3.2 years).
Results. Both the patients and control subjects showed a significant 24 h rhythm of androstenedione (A) and free testosterone (FT), while the circadian oscillations of dehydroepiandrosterone sulphate (DHEAS) did not differ significantly. In all obese women mean 24 h A, DHEAS and FT levels were significantly higher than those in controls. Moreover, the disturbances of DHEAS and FT secretion in the form of acrophase shift (for DHEAS from 7.37 to 3.45 h and for FT from 6.04 to 3.31 h) and the elevation of their 24 h amplitude values were observed. All obese women showed higher values of FT/A and FT/DHEAS indexes in selected clock time of day/night cycle (except those at 8.00 h for FT/A and at 5.00 h for FT/DHEAS) when compared to control group. A positive correlation was noted in all women studied between the values of BMI index, WHR ratio and mean 24 h level of androgens studied as well as FT/A and FT/ DHEAS indexes. A weaker correlation was found between body mass and body fat distribution on the one hand and fasting level of hormones studied on the other. Higher correlation between the values of WHR ratio and mean 24 h FT levels as well as FT/DHEAS indexes were obtained in obese women when compared to those of healthy subjects.
Conclusions. Our findings suggest that, when assessing the androgen disturbances in obese patients, it is more useful to determine their circadian pattern than the basal level. The most reliable indicators of hyperandrogenism in obese women are: the 24 h concentration profile of FT and the value of FT/DHEAS index, not only during fasting but also after a meal at various time intervals. Circadian FT concentration and FT/DHEAS index values are essential indicators for visceral distribution of adipose tissue.

Key words: Obese Women - Androstenedione - Dehydroepiandrosterone Sulfate - Free Testosterone - Circadian Variations
pp. 169-176

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Z. Ostrowska, K. Zwirska-Korczala, B. Buntner, M. Pardela, M. Drozdz

1st Department of Pathophysiology and Clinical Biochemistry, 2nd Department of General and Vascular Surgery, Silesian School of Medicine, 41-800 Zabrze

Objective. To evaluate the bone metabolism in obese women by the estimation of selected markers of bone formation.
Methods. The concentration of plasma parathyroid hormone (PTH) and selected markers of bone formation [osteocalcin (BGP) in plasma, carboxyterminal propeptide of type I procollagen (PICP) and alkaline phosphatase (AP) activity in blood serum] and bone resorption [cross-linked carboxyterminal telopeptide of type I collagen (ICTP) in blood serum and urinary excretion of calcium (Ca)] in 18 extremely obese women (BMI>40 kg/m2) with android phenotype (WHR>0.8) and in 20 healthy women with normal body weight. The age range of all subjects was 25 to 42 years (mean: 36.82 ± 3.95).
Results. All obese women showed significantly increased concentration of plasma PTH, BGP and serum PICP, ICTP and elevated urinary excretion of Ca.
Conclusion. The obtained results show that in extremely obese women with android phenotype bone metabolism disturbances may occur pointing at increased bone formation and resorption.

Key words: Bone Metabolism - Extremely Obese Women - Android Phenotype
pp. 177-181

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T. Mitsuma, Yo. Ito, Yo. Hirooka, M. Kayama. M. Izumi, M. Hasegawa, K. Shin, Yu. Mori, K. Adachi, Ts. Sato, H. Tauchi

4th Department of Internal Medicine,
Institute of Gerontology and
Medical Laboratory, Aichi Medical University, Nagakute, Aichi 480-11, Japan

Objective. To estimate the effect of soybean diet on serum level of thyroid hormone, its metabolites and thyrotropin (TSH) during aging in rats.
Methods. Male Donryu rats were fed laboratory chow containing 40 (Group A) or 10 volume percent (Group B) soybean protein, while controls (Group C) received regular laboratory chow. Groups of 10 animals of each groups were sacrificed by decapitation at the age of 12, 18, 24 and 30 months. Serum total thyroxine (T4), free thyroxine (FT4), 3,5,3'-triiodothyronine (T3), 3,3',5'-triiodothyronine (rT3) and 3,3'-diiodothyronine (3,3'-T2) and TSH concentrations were measured by specific radioimmunoassays.
Results. In Group A the level of T3 decreased significantly at from the age of 18 months, while in other groups such decrease was found only from the age of 24 months. Such changes were closely resembled by these in the level of 3,3'-T2, while inverse changes were observed in the level of rT3 which was increased in Group A from the age of 18 months and in the other groups from the age of 24 months. Serum T4 and FT4 level was decreased in all groups at the age of 30 months and no changes were observed in the level of TSH.
Conclusions. The findings suggest that the level of T4, FT4 and T3 with its metabolite 3,3'-T2 stepwise decreased with aging, while that of rT3 showed inversely and increase. These changes were influenced by the content of soybean protein in the diet, the most rapid changes being found in the group with the high content of such protein.

Key words: Thyroxine - Triiodothyronine - Reverse triiodothyronine - Thyrotropin - Aged rats - Soybean diet
pp. 183-186

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F. Taneri, A. Poyraz, E. Tekin, E. Ersoy, A. Dursun

Gazi University Medical Faculty Departments of General Surgery and Pathology, Besevler, Ankara, Turkey

Objective. In the retrospective study to review the records of patients who had undergone thyroid surgery between 1986-1995 and to determine the need of frozen section (FS) following FNA biopsy.
Methods. The records of 2083 patients who had thyroid surgery in Gazi University Medical Faculty Department of General Surgery between 1986-1995 were retrospectively reviewed to determine and compare the accuracy and significance of fine-needle aspiration (FNA) cytology and intraoperative frozen section (FS).
Results. In 61 patients, both FNA and FS diagnosis were available for the comparison with the final pathologic diagnosis. In 196 patients, FNA diagnosis was available for the comparison with the final pathological diagnosis by permanent section and in 377 patients FS diagnosis was available for the comparison with the final pathological diagnosis. The sensitivity value for detection of malignancy by means of FNA was 57.1 % compared to 82.2 % by means of FS, and FS diagnosis was more specific (99 %) than FNA diagnosis (90.9 %). FNA diagnosis of benign conditions was correct in 141 of 150 (94 %) patients. FS diagnosis of benign conditions was correct in 313 of 321 (97.5 %) patients. Nine patients had the FNA findings that were positive for malignancy and FS confirmed this diagnosis in 8 patients.
Conclusions. FNA is an important diagnostic tool for eliminating benign nodules, but it is not perfect. FS is very important for determining the surgical procedure, and because of direct observation of suspicious nodule, it is even more accurate. Using these tools together is more reliable, since the number of false positive and false negative values is lower than if only the individuals methods are used.

Key words: Fine-Needle Aspiration - Frozen Section - Thyroid - Surgery
pp. 187-191

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P. Langer

Institute of Experimental Endocrinology, Slovak Academy of Sciences, 833 06 Bratislava, Slovakia

pp. 193-203

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Szépalma (Zirc), Hungary, November 13-15, 1998

MEWPE 1998 Organizing Committee:
F. PÉTER - Budapest (Hungary), Chairperson 1998
H. FRISCH - Wien (Austria)
C. KRŽIŠNIK - Ljubljana (Slovenia)
J. LEBL - Praha (Czech Republic)
Ž. MIŠÍKOVÁ - Bratislava (Slovakia)

Growing interest in pediatric endocrinology together with improving possibilities of international cooperation stimulated the effort to organize Middle European Workshops in pediatric endocrinology. This series of meetings was established to stimulate close personal communications among pediatric endocrinologists from several neighbouring countries of Central Europe. Discussions on unresolved problems and the presentation of some interesting and comicated cases have been proposed to be main topics of these events.

The short history shows that so far following meetings were organized:
1994 - Saint Oswald (Austria)
1995 - Tøeboò (Czech Republic)
1996 - Bled (Slovenia)
1997 - Smolenice Castle near Bratislava (Slovakia)

pp. 205-215

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pp. 216-218

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