BackgroundMultiple epidemiological studies have shown that low testosterone levels are associated with and predict the future development of type 2 diabetes mellitus and the metabolic syndrome.The aim of our study was to show the influence of testosterone replacement therapy on obesity, HbA1c level, hypertension and dyslipidemia in patients with diabetes mellitus and androgen deficiency.MethodsOne hundred and twenty-five male patients with diabetes mellitus were screened; 85 subjects aged 41 to 65 years, with BMI from 27.0 to 48.0 kg/m2, were randomized in a placebo-controlled study. They also underwent a routine physical examination and selected by free testosterone examination. We divided patients into two groups: 1) treatment group, where we used diet, physical activity, patient’s antidiabetic therapy and testosterone replacement therapy; 2) placebo group, where we used diet, physical activity, patient’s antidiabetic therapy and placebo.ResultsAfter 6 months of treatment we repeated the diagnostic assessments: lipid profile was improved in both groups but in first group it was clinically significant. Free testosterone level increased in all groups, but in group I was clinically significant. HbA1c decreased in both groups, but in group I we obtained the best result. Leptin level after treatment was approximately the same in both groups. Also, blood pressure was reduced in both groups but results were similar.ConclusionsOur study demonstrated that it is possible to break this metabolic vicious circle by raising testosterone levels in diabetic men with androgen deficiency. Re-instituting physiological levels of testosterone, as the study has shown, has an important role in reducing the prevalence of diabetic complications.
Background: Autoimmune thyroid diseases (AITD) are the most prevalent organ-specific autoimmune disorders. Vitamin B12 plays an important role in the proper functioning of the immune system. The aim of this study was therefore to investigate the correlation between vitamin B12 deficiency and AITD. Methods and Materials: A total of 306 patients (aged 18-65 years, mean - 37.6 ± 11.3 years) and comprising 87 males and 219 females)were studied retrospectively (observational study). Patients were divided into groups: with and without vitamin B12 deficiency, and with and without AITD. Differences between groups were evaluated by Fisher’s exact test for qualitative variables and by Student’s t-test for quantitative variables. Correlations for quintitative factors were determined by the Pearson correlation coefficient and for qualitative factors be Spearman correlation analysis. The sensitivity and specificity of vitamin B12 deficiency for AITD were calculated by ROC analysis. Results: The vitamin B12 level was significantly lower in patients with AITD (and 200.70+108.84 ) compared to controls (393.41+150.78 p<0.0001) Patients with vitamin B12 deficiency were characterized by significantly higher mean values of anti-TPO ( 236.60+455.74) compared to controls (39.51+165.57 p<0.0001). Vitamin B12 levels were inversely correlated with anti-TPO levels ( r=-0.233, p<0.001). Roc analysis of vitamin B12 as a diagnostic test for AITD gave the area under curve as 0.881(95%CI: 0.839-0.924),a sensitivity of– 0.947 a specificity of– 0.768,and a cut off value of - 178.9. Conclusions: The vitamin B12 level correlates significantly with AITD. The concentration of vitamin B12 should therefore be determined in patients with autoimmune thyroiditis as a diagnostic test with high sensitivity and good specificity.
The aim of our study was comparative analysis of anthropometric characteristics in children and adolescents significantly correlated with the parameters of metabolic syndrome. The study group is consisted of 113 children and adolescents (study group) with excessive body weight and obesity (group 1—BMI percentile; group 2—waist circumference; group 3—waist to height ratio). The control group consisted of 113 children and adolescents without. Comparative analysis of obtained data have been carried out by multiple regression analysis. BMI percentile is more an indicator of a generalized obesity; WC and WHR percentiles better describe visceral obesity and metabolic disorders—insulin resistance, hypertension and dyslipidemia. However, the WHR Percentile may be a more useful tool. To assess obesity in children and adolescents, it is necessary to evaluate together BMI, WC, and WHR percentiles. It can be also concluded that these findings indicate the need to continue research in this direction.
Introduction: Recently, Growth hormone deficiency (GHD) has become one of the reasons of significant metabolic and psychological morbidity in children and adults. The aim of our study was to find out the impact of GH replacement therapy on lipid profile in Georgian patients with GHD, which was caused by surgical resection. Design: Double Blind placebo controlled study for 12 months and an open study for another 12 months. Patients and Methods: 20 Georgian adults, aged 40.75±2.2 years (mean ± SE, range 20.5-60), with adult onset GH deficiency were enrolled in the study. The patients were selected from the basis of National Institute of Endocrinology. We set the inclusive and exclusive criteria to study these patients, who needed the growth hormone replacement therapy. We collected standardized information about central and peripheral hormones, metabolic activity and physical features. Results: after 12 months of GH replacement, there was no significant improvement of lipid profile in the GH deficient patients. After 24 months of the treatment, the study showed the upward trend of Triglycerides, Total cholesterol and HDL-CH, and a decrease of LDL-CH. Conclusion: The response of lipid profile to the 12 and 24 months of GH replacement in patients with GH deficiency was disappointing. The results significantly differ from the ones, provided by the European Endocrine societies. Thus, longer-term studies are required, in order to investigate accurately the whole lipid profile among our patients for the following years.
Patients with insulin resistance (IR) have a higher thyroid volume therefore the aim of our study is to examine the correlation between IR and thyroid volume in the residents of Georgia. Methods: 413 patients with a mean age of 37.3and 11.4 years were included in this study. Out of those, 120 were males, and 293 were females who were studied retrospectively. They had hyperinsulinemia and were referred to the clinic from 2017 to 2019. The factors studied were age, sex, body mass index (BMI), clinical signs, thyroid ultrasound, alanine aminotransferase (ALT), aspartate aminotransferase (AST), lipids, fasting insulin, fasting glucose, thyroid stimulating hormone (TSH), Free thyroxine (FT4), and Zinc (Zn). objective: Patients were referred to the National Institute of Endocrinology of Georgia from 2017 to 2019 and were considered as patients who had hyperinsulinemia. We considered fasting hyperinsulinemia as compensatory hyperinsulinemia during IR. On the basis of which individuals with hyperinsulinemia were included in the study IR group. The control group consisted of 161 individuals with normoinsulinemia. Results: IR was detected in 252 individuals. The frequency of men with insulin resistance was significantly higher than in the control group - 72.50%, and 56.31%, respectively (F=9.55, p=0.0021). Mean thyroid volume in the patients with IR was significantly higher compared to the controls 20.52+6.39 cm3 and 15.25+6.55 cm3, respectively (p<0.001). Hyperinsulinemia had a significant positive correlation with Goiter r=0.445, p<0.0001. The associated factors for hyperinsulinemia are: Goiter (1) - OR=5.12 (95%CI:3.02-8.69); Cholesterol - OR= OR=3.31(95%CI:1.54-7.14); Triglycerides - OR=3.23(95%CI:1.02-10.28); Obesity (1)- OR=3.94(95%CI:2.23-6.98); Thyroid structural changes (1) - OR=2.01(95%CI:1.12-3.60); ALT/AST- OR=4.53(95%CI:2.33-8.80); Zn decreased Odds Ratio hyperinsulinemia - OR=0.95(95%CI:0.94-0.97); method: 413 patients (age range - 20-75 years; mean age - 37.311.4 years; 120 males, 293 females) - have been studied retrospectively Conclusion: Hyperinsulinemia is the most common cause of diffuse goiter and the heterogeneous structure of the thyroid. The volume of the thyroid gland shows a significant positive association with the characteristics of metabolic syndrome and increased thyroid volume predictors of metabolic syndrome. result: The hyperinsulinemia was detected in 252 individuals. The IR rate was significantly higher in females than in males - 79.5% vs. 65.49% (p = 0.0021), respectively.
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