Iron status was studied in 126 female endurance athletes and 52 control subjects, all aged 16-20 years. The study aimed at identifying factors responsible for iron deficiency. Twenty-six percent of athletes and 50% of controls had latent iron-deficiency without anemia symptoms. A too low intake of iron (especially heme iron: 0.3 mg daily), and of nutrients influencing iron metabolism, were identified as main causes of iron deficiency in control subjects. In athletes, whose iron intake was sufficient (14.6 mg), the principal cause of iron deficiency were blood losses due to menstruation. High level of physical activity, expressed as training volume and experience, did not adversely affect iron stores, as these were higher than in control subjects and the incidence of iron deficiency was much lower than in the control group. It was concluded that an increased intake of iron and of dietary factors involved in iron metabolism prevented possible exercise-induced losses of iron in young athletes.

The transferrin receptor-ferritin index (sTfR/logFerr) was determined in 131 male and 121 female athletes in order to assess the frequency of iron deficiency (threshold value of that index taken as 1.8). Blood was drawn for determining morphological indices as well as sTfR, ferritin, iron, total iron binding capacity (TIBC), and haptoglobin. A significantly (p <.01) higher incidence of iron deficiency was observed in women (26%) than in men (11%). The iron deficiency was latent, since no subject was found to be anemic. The plasma iron was significantly lower and TIBC higher (p <.001) in both iron-deficient subgroups than in the non-deficient ones. This confirmed the latent character of iron deficiency. Some hematological indices (Hb, MCH, MCHC, MCV) were significantly lower in iron-deficient female athletes than in male athletes, which suggested a more profound iron deficiency in the former. The sTfR/logFerr index might thus be useful in detecting iron deficiency in athletes, especially in those with erythropoiesis disorders, since physical loads may affect the widely used ferritin levels.

The aim of the study was to assess the within-subject (day-to-day) variability for iron status variables: ferritin (ferr) and soluble transferrin receptor (sTfR) concentrations in plasma and the sTfR/log ferr index in athletes subjected daily to high physical loads. Blood was sampled in the morning from 8 healthy male elite judoists, aged 20 - 31 years, for 10 consecutive days while at training camp. Mean concentrations of ferritin and sTfR in plasma for the 10 day period were 32.0. 1.771(+/-1) and 2.41. 1.324(+/-1) mg/l, respectively. The average within-subject, day-to-day variability for ferritin was 27.4 % (range: 16 - 44 %), and was much lower for sTfR (6.7 %; range: 4 - 15 %). Ferritin concentrations were significantly, albeit weakly, correlated with training loads on the preceding day (r = 0.256; p < 0.05) and with creatine kinase (CK) activities on the same day (r = 0.397; p < 0.001), while sTfR did not correlate with either training loads or CK activities. Mean day-to-day variability for the sTfR/log ferr index was 11.8 % (range: 5 - 21 %), i.e. markedly lower than for ferritin. Although the physical load-induced changes in iron metabolism indices in male subjects were similarly oriented as in the earlier reported female ones representing the same sport, the magnitude of those changes was less pronounced than in the females. This was evidenced by a markedly lower within-subject day-to-day variability in ferritin, still significant but weak correlation between load magnitude and ferritin levels, and a significant, negative correlation between ferritin and sTfR concentrations, not found previously in the female athletes. However, despite lower variability in ferritin than in women, the exercise-induced ferritin increases in male athletes might make a reliable assessment of iron stores in them difficult. The present results confirm our earlier reports that sTfR levels are stable under high physical loads, thus making them a useful indicator of iron status. Also sTfR/log ferr index is of a much higher diagnostic value than ferritin, despite high variability of the latter. That index is particularly valuable in detecting iron-deficient erythropoiesis.

A case of acromegaly, secondary to GHRH secretion by a large bronchial carcinoid is reported. A 61-year-old woman presented with typical symptoms and signs of acromegaly for at least 10 years. She suffered from recurrent pneumonias, but repeated chest X-ray examinations failed to demonstrate the bronchial tumor. The diagnosis was confirmed by elevated GH, IGF-1 and GHRH secretion. We have shown an enlarged pituitary gland without focal lesions together with a cerebral meningioma on MRI and the presence of a bronchial carcinoid tumor. The latter was confirmed by histology carried out after bronchoscopy and tumor excision. We observed partial suppression of GH secretion following short-term oral bromocriptine administration in this patient. Surgical removal of the carcinoid tumor resulted in a complete clinical, hormonal and radiological cure of acromegaly. This case of acromegaly due to ectopic GHRH secretion by bronchial carcinoid differs from others described in the literature by an atypical large tumor size, the suppression of elevated GH secretion by oral bromocriptine and a concomitant meningioma.

We present an unusual coincidence of acromegaly and Turner's syndrome. A girl was diagnosed with Turner's syndrome when she presented with short stature, primary amenorrhea, Hashimoto's thyroiditis, and some heart and renal anomalies. No therapy with growth hormone and only a few months treatment with estrogen-progestin was given. A typical picture of acromegaly occurred in the third decade of her life. Bone radiographs and densitometry suggested the more pronounced influence of acromegaly within the skeleton, but no features typical for acromegaly were found in the cardiovascular system. To our knowledge no case of coincidence of the above mentioned conditions has been reported to date. The influence of both of these conditions on bones and heart is discussed.