Nowadays, severe deficiency of vitamin D is not a common finding in most developed countries. However, the prevalence of vitamin D insufficiency is relatively high and it can contribute to the ...descent of bone mass in osteoporosis risk populations. The objective of our study was to evaluate the prevalence of vitamin D insufficiency in postmenopausal women (PMW), patients with inflammatory bowel disease (IBD) and corticosteroid-dependent asthmatic patients (CAP) and to analyze its relationship with bone mineral density (BMD) and calciotropic hormones.
We studied 299 patients (PMW: 161; IBD: 61; CAP: 77). In all cases, serum levels of PTH and 25OHD were determined and the BMD (DXA, Hologic QDR1000) in lumbar spine (LS) and femoral neck (FN) was measured.
Vitamin D insufficiency (25OHD < 15 ng/ml) was observed in 39.1% patients with PMW, 70.7% patients with IBD and 44.2% patients with CAP. 25OHD concentrations were lower in EII patients (p = 0.003) and PTH concentrations were higher in MPM (p < 0.001). We found a negative correlation between PTH and 25OHD in the overall group and this correlation persisted after considering each group separately. After adjusting for remaining variables, 25OHD was found to be significantly associated with BMD at lumbar spine and/or femoral neck in the three groups.
In populations at risk of osteoporosis, there is a high prevalence of vitamin D insufficiency. This insufficiency has a significant effect on bone integrity.
Resumen Objetivos Los pacientes con hiperparatiroidismo primario (HPP), incluso asintomático, presentan un mayor riesgo cardiovascular. Sin embargo, los datos sobre la reversibilidad o mejoría de las ...alteraciones cardiovasculares con la cirugía son controvertidos. Los objetivos de nuestro estudio fueron evaluar la prevalencia de factores de riesgo cardiovascular clásicos en pacientes con HPP asintomático, examinar su relación con los niveles de calcio y PTH y analizar el efecto de la paratiroidectomía sobre los mismos. Pacientes y métodos Estudio retrospectivo observacional de 2 grupos de pacientes con HPP asintomático: 40 pacientes en observación y 33 pacientes intervenidos. Se recogieron datos clínicos y bioquímicos relacionados con el HPP y de diversos factores de riesgo cardiovascular en todos los pacientes de forma basal, y al año de la cirugía en el grupo de pacientes intervenidos. Resultados Encontramos una elevada prevalencia de obesidad (59,9%), diabetes mellitus tipo 2 (25%), hipertensión arterial (47,2%) y dislipidemia (44,4%) en la muestra total, sin diferencias entre los grupos de estudio. En el grupo que se mantuvo en observación las concentraciones séricas de calcio y PTH se relacionaron positivamente con el IMC (r = 0,568, p = 0,011 y r = 0,509, p = 0,026 respectivamente). En los pacientes intervenidos, al año de la cirugía no hubo mejoría de los factores de riesgo cardiovascular considerados. Conclusiones Nuestros resultados confirman la elevada prevalencia de obesidad, diabetes mellitus tipo 2, hipertensión arterial y dislipidemia en pacientes con HPP asintomático. Sin embargo, el tratamiento quirúrgico no supuso una mejoría en estos factores de riesgo cardiovascular.
The effectiveness of elcatonin was assessed in a prospective study of patients with a diagnosis of postmenopausal/senile osteoporosis. In the first stage, 521 patients (490 women mean time since ...menopause, 14.4 years and 31 men; mean age, 61.4 years) with clinical evidence of osteoporosis were recruited. Bone mineral density (BMD) was measured in 486 of the patients, and pain and ability to function were assessed. In the second stage, the patients whose results for lumbar BMD were lower by 1 standard deviation than the peak bone mass of the normal reference population were treated with 40 U of parenteral elcatonin daily for 10 consecutive days and then on alternate days for the remaining 20 days of the first month, and in subsequent months for only the first 10 days of the month. A supplement of 1 g/d of oral calcium was recommended. Clinical examination was done at the beginning of the study and then at 3-month intervals. Densitometry was performed at the start and after 6, 12, and 24 months. The data were collected by 48 specialists, each of whom chose a group of patients who had not been treated for osteoporosis in the previous year. A total of 130 patients completed a year of treatment with elcatonin; 67% of these were responders, as shown by an increase of 3.53% in lumbar BMD using analysis of variance (
P = 0.001). According to Wilcoxon's test, there was a progressive fall in pain severity on the visual analog scale (VAS) from 63 mm to 31 mm and 22 mm after treatment for 6 and 12 months, respectively (
P < 0.0001). Absence of impairment of function rose from 18% of the patients at the beginning of the study to 69% at 12 months (
P < 0.0001). Sixty-eight patients completed treatment for 2 years; there was a positive response in bone mass in 72.1%, with a rise in lumbar BMD of 9.86% (
P < 0.001). At 24 months, pain severity had fallen from 58 mm at the start of the study to 23 mm (
P < 0.0001) on the VAS. There was no impairment of function in 85% of the patients at 24 months (
P < 0.001). In conclusion, our study confirmed that elcatonin therapy is an effective choice for long-term treatment of patients with osteoporosis.
Abstract Objectives Patients with primary hyperparathyroidism (PHP), even asymptomatic, have an increased cardiovascular risk. However, data on reversibility or improvement of cardiovascular ...disorders with surgery are controversial. Our aims were to assess the prevalence of classic cardiovascular risk factors in patients with asymptomatic PHP, to explore their relationship with calcium and PTH levels, and analyze the effect of parathyroidectomy on those cardiovascular risk factors. Patients and methods A retrospective, observational study of two groups of patients with asymptomatic PHP: 40 patients on observation and 33 patients who underwent surgery. Clinical and biochemical data related to PHP and various cardiovascular risk factors were collected from all patients at baseline and one year after surgery in the operated patients. Results A high prevalence of obesity (59.9%), type 2 diabetes mellitus (25%), high blood pressure (47.2%), and dyslipidemia (44.4%) was found in the total sample, with no difference between the study groups. Serum calcium and PTH levels positively correlated with BMI ( r = 0.568, p = 0.011, and r = 0.509, p = 0.026 respectively) in non-operated patients. One year after parathyroidectomy, no improvement occurred in the cardiovascular risk factors considered. Conclusions Our results confirm the high prevalence of obesity, type 2 diabetes mellitus, high blood pressure, and dyslipidemia in patients with asymptomatic PHP. However, parathyroidectomy did not improve these cardiovascular risk factors.
Virilizing mature ovarian cystic teratomas LOPEZ-BELTRAN, A; CALANAS, A. S; JIMENA, P ...
Virchows Archiv : an international journal of pathology,
08/1997, Letnik:
431, Številka:
2
Journal Article
Recenzirano
Three further cases of mature benign cystic teratomas of the ovary associated with virilization are added to the three previously reported in the literature. They were found in postmenopausal, obese, ...diabetic women aged 52, 61, and 67 years. The patients presented with hirsutism and voice changes and clitoromegaly was present in one. Testosterone and androstenedione levels were elevated but promptly regressed after removal of the tumours. Histologically, sheets of stromal luteinized cells were found peripherally at the interface between the neoplasm and ovarian tissue. Luteinization of ovarian stroma induced by an unknown factor related to diabetes mellitus is the origin of the virilization.
The aim of this study was to assess thyroid dysfunction and autoimmunity in pregnant insulin-dependent diabetes mellitus (IDDM) women during pregnancy and early post partum. Fifteen pregnant IDDM ...women and 77 healthy pregnant women were studied. Free T4, TSH, TPO-Ab and Tg-Ab were assayed during the first and third trimester of pregnancy and 3 months post partum. In IDDM women FT4 levels significantly decreased (p < 0.05) during third trimester and 3 months post partum and also TPO-Ab during third trimester (p < .01). 26% of IDDM and 4% of the controls presented post partum thyroid dysfunction. We recommend that prepregnant IDDM be screened for TPO-Ab. Those with a positive result would be followed with serial monitoring of free T4 and TSH levels during each trimester as well as during the post partum period.
