ACTA ENDOCRINOLOGICA (BUC)

Background. Adiponectin, vaspin and leptin are only a few of these numerous adipocytokines. Little is known about the behavior of adipocytokines and how adipose tissue metabolism is affected in this Type 1 DM model. In this study we investigated the serum levels of adiponectin, leptin, vaspin in streptozotocin(STZ) induced diabetic rats. Material and methods. Twelve Spraque Dawley albino rats were included in the study. The animals were divided into two groups. The first group was diabetic (D) (n: 6) and 60mg / kg STZ was administered intraperitoneally (i.p.) to these rats. The second group was the non-diabetic control (ND) group (n: 6). All the animals were euthanized by cervical dislocation. Quantification of vaspin, Adiponectin, leptin in serum was performed using the ELISA kit. Results. Adiponectin, vaspin levels of diabetic group were found to be statistically lower than of control group (p<0.05). Leptin levels were significantly higher in the diabetic group (P<0.05). Conclusion. There is a need for new researches that can explain the relationship between Vaspin, Leptin and Adiponectin and Type 1 diabetes. New studies in this area will open new horizons for the identification of new biomarkers in the diagnosis and treatment of Type 1 diabetes.

Context. Studies investigating the association between serum IGF-1, and thyroid nodule, ovarian or thyroid volume in polycystic ovarian syndrome (PCOS) are limited. Objective. We aimed to analyze the association between serum IGF-1 level, and ovarian or thyroid volume, or thyroid nodule in PCOS. Design. The study was performed between June 2017 and August 2019 as prospective design. Subjects and Methods. Adult females with newonset PCOS were included. The patients having comorbid illness, or using medication were excluded. Basic tests, thyroid and ovarian sonography were performed. The patients were grouped according to thyroid nodule(absent/ present) and ovarian volume (<10mL/≥10mL). We planned to find a positive association between IGF-1, and thyroid nodule, thyroid or ovarian volume in PCOS. Results. Of total 118 patients, 11(9%) had thyroid nodule. The patients with thyroid nodule had a higher ovarian volume (p=0.006). No correlation was found between GH or IGF-1, and thyroid or ovarian volume. IGF-1 was not a predictor for thyroid nodule or higher ovarian volume. Thyroid nodule was a significant predictor for higher ovarian volume. Conclusion. Our study is the first to analyze the association between IGF-1 and thyroid nodule in PCOS. We found that thyroid nodule was associated with thyroid and ovarian volume, but IGF-1 was not associated with thyroid nodule, thyroid or ovarian volume.

Background. Composite adrenal pheochromocytoma-ganglioneuromas (PHEO-GNs) are well-defined neoplasms of the adrenal medulla, consisting of both endocrine and neural components. They are extremely rare. To date, only 46 cases have been reported in the English literature. Case report. We describe an adult case of endocrinologically active adrenal composite PHEO-GN diagnosed in a 62-year-old male patient with history of dizziness, headache, nausea, vomiting, and uncontrolled hypertension including intermittant hypertension attacks. On physical examination, he had a blood pressure (BP) of 170/110 mmHg. 18-fluorodeoxyglucose positron emission tomography-computed tomography showed a right adrenal tumor with increased metabolic activity. Urinary levels of catecholamines and their metabolites were prominently elevated. Right adrenalectomy was performed for treatment purposes. The histological diagnosis of the resected tumor was composite adrenal PHEO-GN. Conclusions. Composite adrenal PHEO-GN is a rare entity and preoperative diagnosis is difficult. Its hormonal activity and imaging characteristics are frequently very similar to those of other adrenal tumors, especially pure PHEO and adrenal carcinoma. Therefore, careful evaluation by endocrine tests and multiple imaging procedures are needed for providing a differential diagnosis. However, definitive diagnosis composite adrenal PHEO-GN is established by histological and immunochemical studies. To our knowledge, the present case is the first report that describes composite adrenal PHEO-GN in a patient from Turkey. We discuss this case and review the literature on this unusual entity.

Introduction. Estrogens are known to have a neuroprotective role and to influence the permeability of the blood brain barrier (BBB). An ongoing debate exists on the changing effects of estrogens on target tissues with advancing age and at menopause and on the potential disruptive role of increasing gonadotropin levels.\r\nThe aim of the present study was to assess the permeability of the BBB for estradiol, FSH and LH in three physiological states: early follicular phase, preovulatory phase and at menopause.\r\nMethod. Hormonal levels were assessed simultaneously in the serum and cerebrospinal fluid (CSF) of 15 women at menopause (mean age 60?8 years), 16 of reproductive age in early follicular phase and 11 in preovulatory phase (mean age 31?7 years), all undergoing surgery for benign gynecologic disorders. FSH, LH and estradiol levels were assessed using chemo luminescence and are expressed as median and 10-90 percentile interval. Statistical analysis assessed the serum-CSF correlation and the CSF/serum ratio for each hormone between groups.\r\nResults. Estradiol serum levels were 26.2 pg/ml (6.4-43.5) at menopause (n=15), 58.5 pg/ml (25.7-75.9) in early follicular phase (EFP, n=16) and 221.2 pg/ml (113.7-405.5) in preovulatory phase (PREOV, n=11). CSF estradiol is 18.5 pg/ml (0.4-30.5) at menopause, 5.4 pg/ml (2.2-10.2) in EFP (p<0.001) and 17.3 pg/ml (10.3-34.6) in PREOV patients. Estradiol serum and CSF levels correlate positively in the fertile cycle (r=0.72, p<0.0001) and negatively at menopause (r=-0.88, p<0.05). The CSF/serum ratio for estradiol is 0.8 (0.01-4.4) at menopause, 0.1 (0.04-0.13) in EFP and 0.1 (0.03-0.13) in PREOV patients. FSH serum levels were 75.8 mUI/ml (35.9-129.8) at menopause, 7.7 mUI/ml (3.5-11.4) in EFP and 7.3 mUI/ml (3.1-10.7) in PREOV patients. CSF FSH is 2.7 mUI/ml (0.4- 5.9) at menopause, significantly higher than 0.7 mUI/ml (0.3-1) in EFP (p<0.001) and 0.5 mUI/ml (0.2-1) in PREOV patients (p<0.05). FSH serum and CSF levels correlate positively in the fertile cycle (r=0.8, p<0.0001) and do not correlate at menopause (p=NS). The CSF/serum ratio for FSH is 0.03 (0.01-0.1) at menopause, significantly lower than 0.09 (0.06-0.16) in EFP (p<0.001) and is 0.06 (0.03-0.13) in PREOV phase. LH serum levels were 57.4 mUI/ml (27.5-84.8) at menopause, 4.7 mUI/ml (1.7-7.1) in EFP and 5.5 mUI/ml (4.9-8.02) in PREOV phase. CSF LH is 1.6 mUI/ml (0.7-2.6) at menopause, significantly higher than 0.4 mUI/ml (0.1-1) in EFP (p<0.001) and 0.5 mUI/ml (0.2-0.9) in preovulatory phase (p<0.05). The CSF/serum ratio for LH is 0.03 (0.01-0.07) at menopause, it is significantly lower than 0.09 (0.03-0.27) in EFP (p<0.001) and is 0.07 (0.03-0.14) in preovulatory phase.\r\nConclusions. This study shows the negative correlation of serum and CSF estradiol levels at menopause reflecting the need of constant estrogen levels within the CSF despite low chronic serum levels. Simultaneously, the CSF/serum ratio for gonadotrophins is\r\nreduced significantly at menopause and the positive correlation of serum and CSF levels is lost, reflecting a protective mechanism against rising levels of FSH and LH.

Objective. In our study, we aimed to investigate the levels of irisin, nesfatin-1 and the relationship between levels of these relatively new molecules with cardiometabolic risk markers; carotid intima-media thickness (CIMT), epicardial adipose tissue (EAT) thickness in patients with nonfunctional adrenal incidentaloma (NFAI). Materials and Methods. Patients with NFAI (n=59) and age, sex and body mass index-matched healthy control subjects (n=59) were enrolled in this study. Serum glucose, insulin, C-reactive protein (CRP), lipid, irisin and nesfatin-1 levels and echocardiographic CIMT and EAT thickness measurements were performed in patients and controls. Results. The irisin level was 17.58 ± 4.38 pg/mL in the NFAI group, significantly higher (p<0.001) than 14.03 ± 4.03 pg/mL in the control group. Nesfatin-1 level was significantly lower in the NFAI group 194.98 ± 119.15 pg/ mL ((p < 0.001)) versus 303.48 ± 200.78 pg/mL in the control group. A positive correlation was found between irisin and nesfatin-1 levels and CIMT and EAT thickness in the NFAI group. Conclusions. In our study, we found that irisin level was higher and nesfatin-1 level was lower in patients with NFAI, and both irisin and nesfatin-1 levels were associated with CIMT and EAT thickness in NFAI patients.

Background. Hyperuricemia is associated with non-alcoholic fatty liver disease (NAFLD). Aim. We therefore aimed at evaluating the influence of allopurinol on the course of NAFLD in rats. Study Design. We divided 21 mature albino Sprague Dawley rats into three groups: controls (n = 7, normal diet for 12 weeks); NAFLD rat models (by feeding water containing 30% fructose for first 8 weeks) treated with allopurinol subsequently for the next 4 weeks (n = 7); and similar case treated with placebo (saline) subsequently for the next 4 weeks (n = 7). Methods. We compared the histopathological scores, IL-1 and IL-2 immunoexpression levels across the groups. Liver histopathological score was determined by observing the steatosis (the percentage of liver cells containing fat): <25% = 1+, 25% - 50% = 2+, 51% - 75% = 3+, >75% = 4+; inflammation and necrosis: 1 focus per low-power field = 1+; and 2 or more foci = 2+. The number of liver IL-1 and IL-2 positive cells was measured by systematically scoring at least 100 hepatocyte cells per field in 10 fields of tissue sections by a magnification of 100. Results. Xanthine oxidase (XO) activity and lipid peroxidation was significantly different in the allopurinol group compared to the saline group (XO; 0.098 ± 0.006 mU/mg vs. 0.162 ± 0.008 mU/mg, p = 0.01, 0.116 ± 0.040 nmol malondialdehyde/mg versus 0.246 ± 0.040 nmol malondialdehyde /mg, p = 0.01). The allopurinol group had lower histopathological scores, IL-1 and IL-2 immunoexpression levels in the liver compared to the saline group (2.13 ± 0.35 against 5.45 ± 0.24, p = 0.003, IL-1; 5.76 ± 0.43 against 12.85 ± 3.26, p = 0.023, IL-2; 8.55 ± 1.14 against 56.23 ± 7.12, p = 0.002). Conclusions. Allopurinol has a therapeutic role against the progression of NAFLD of the rats.

Background. Pomegranate is a rich source of many polyphenolic compounds including ellagitannins (punicalagin, punicalin and others). Aim. The effects of punicalagin and punicalin on adipogenesis were investigated in this study. Materials and Methods. To examine the effect of punicalagin and punicalin on adipocyte differentiation, various concentrations of punicalagin and punicalin (2- 10 μM) were applied to differentiated 3T3-L1 cells. Glyceraldehyde-3-phosphate dehydrogenase (GPDH) activity, Oil red O staining, intracellular triglyceride levels, and gene expressions of transcription factors (Peroxisome proliferator-activated receptor-γ (PPARγ), CCAATenhancer- binding proteins-α (C/EBPα), Sterol regulatory element-binding protein 1c (SREBP-1c)) and lipolysisassociated genes (hormone-sensitive lipase (HSL), Perilipin A, tumor necrosis factor-α (TNF-α)) were examined in order to investigate the effects of punicalagin and punicalin on adipocyte differentiation. Results. Punicalagin and punicalin applications caused a continuous decrease in cell size and intracellular triglyceride accumulation. GPDH activity and transcription gene expressions decreased significantly in groups that were applicated punicalagin and punicalin at high concentrations. Punicalagin, but not punicalin, down-regulated the expression of HSL and perilipin A and up-regulated the expression of TNF-α in a dose-dependent manner. In conclusion, both punicalagin and punicalin were able to inhibit the adipocyte differentiation.

Background. The occurrence of mixed dementia defined as the association of Alzheimer’s disease with vascular dementia is increasing due to the global aging of the human population. Since thyroid hormones play a role in cognition and alterations of the thyroid axis occur with aging it is reasonable to assume that thyroid function and cognitive decline in mixed dementia are linked. Objective. To investigate whether there is a link between TSH, oxidative stress, cognitive decline and depression in female patients with mixed dementia. Methods. Fourty female patients with mixed dementia and 10 healthy controls were included in the study. MMSE, depression score (Cornel Scale of depression), TSH, MDA, glutathione were determined. Serum TSH levels correlated with the cognitive decline measured by MMSE (r=0.55 p=0.0002) and with de depression score (r=0.34 p=0.0314). Furthermore an increase in the oxidative stress marker MDA (p=0.0004) and in the antioxidant defense marker Glutathione (p=0.0013) was observed in patients with mixed dementia. In addition the levels of Glutathione correlated with cognitive decline (r=-0.4997 p=0.001) and with the levels of TSH (r=-0.4997 p=0.001). Conclusion. Our results suggest that thyroid function, oxidative stress and mixed dementia are corelated. However, a possible cause and effect relationship is not yet proved.

Purpose. We aimed to assess the relationship between the regional body fat distribution and insulin resistance and pancreas volume (PV) in type-2 diabetes (DM) patients. Methods. Fifty-three consecutive type-2 diabetic and 51 non-diabetic patients matched by age, gender and body mass index (BMI) were enrolled. Subcutaneous adipose tissue (SAT), visceral adipose tissue (VAT), waist circumference, and PV were measured with computed tomography. Insulin resistance was assessed by the homeostasis model assessment of insulin resistance (HOMA-IR). Results. Patients with type-2 DM had significantly lower PV than non-diabetic individuals. HOMA-IR ranged from 0.74 to 6.24; and from 0.37 to 3.26, in type-2 DM patients and non-diabetics, respectively. VAT was positively correlated with HOMA-IR in two groups. There were inverse correlations between PV and VAT and VAT/SAT but only in diabetics. Conclusions. The VAT/SAT ratio may reflect the possible role of VAT to better understand the pathogenesis of obesity-related disorders in patients with type-2 DM.

Objective. Medical Nutrition Therapy (MNT) is important in the treatment and regulation of diabetic patients. In this study, it was aimed to evaluate the effects of medical nutrition therapy on Pentraxin-3, hsCRP and body composition analysis in Type 2 diabetes patients (DM). Methods. This study included 160 individuals who were admitted and diagnosed with Type 2 DM. Laboratory, clinical, anthropometric and body composition parameters were obtained 3 months after baseline evaluation of the patients and the MNT was given by the dietitian. Results. After 3 months MNT, weight, body mass index, waist circumference, body fat weight, body fat ratio and visceral fat area (p<0.001), glucose (p<0.001), insulin (p=0.033), HOMA index (p=0.004), HbA1c (p<0.001), total cholesterol (p=0.001), LDL (p=0.008), ALT (p<0.001) and hsCRP (p<0.001) levels were significantly lower than they were before MNT. There wasn’t significant difference in triglyceride (p=0.509), HDL (p=0.079), Pentraxin-3 (p=0.706) levels and waist-to-hip ratio (p=0.802). The level of Framingham risk score after MNT was significantly lower (p<0.001). Conclusion. In this study, it was cocluded that MNT, applied to patients with Type 2 DM decreased cardiovascular risk and inflammation, contributed to the maintenance of glycemic control, and a significantly improved the body composition.