We assessed the effects of sodium valproate and carbamazepine monotherapy on bone mineral density (BMD) in children. BMD at the lumbar vertebrae (L1-L4) and radius-ulna was measured by the dual-energy x-ray absorptiometry (DEXA) method in 19 children (9 girls, 10 boys) with uncomplicated epilepsy and in 57 healthy children (28 girls, 29 boys), between the ages of 6 and 12 years. The study patients had been receiving either sodium valproate (n = 13) or carbamazepine (n = 6) monotherapy for more than 6 months. There were no significant differences between the control and study patients in age, height, weight, physical activity, or of serum concentrations of calcium, phosphate, and transaminases (aspartate aminotransferase, alanine aminotransferase). However, the serum alkaline phosphatase concentration was greater in the patient group as compared with the control group. BMD values were lower in girl patients (L1-L4; 0.497 +/- 0.08 vs 0.566 +/- 0.07 g/cm2, p < 0.05), but not in boys (0.534 +/- 0.06 vs 0.530 +/- 0.08 g/cm2). While BMD reduction was 8% in valproate therapy (midregion of radius-ulna; 0.287 +/- 0.03 vs 0.312 +/- 0.04 g/cm2, p < 0.04), it was reduced only 4.5% in the carbamazepine-treated group (0.298 +/- 0.01 vs 0.312 +/- 0.04 g/cm2, statistically not significant), although the mean durations of monotherapy with valproate (1.8 +/- 0.7 years) and carbamazepine (1.7 +/- 0.8 years) were similar. Thus decreased bone mineralization was observed in children with epilepsy, treated with sodium valproate even though treatment was for a rather short time.

Background: Skinfold thickness (SFT) and bioelectrical impedance (BIA) are readily available and commonly used techniques in patient monitoring for body composition analysis (BCA) in clinical practise. Another one, dual-energy X-ray absorptiometry (DEXA) method became popular in body composition analysis (BCA) in recent years. Its results have been reported to be quite accurate and precise, in comparison with in vivo or in vitro multiple component reference methods. The aim of the present study was to assess the degree of agreement between SFT and DEXA, and BIA and DEXA methods, in obese and nonobese patients. Methods: Body fat mass (FM) was measured in 16 nonobese (mean body mass index; BMI = 22.2 ± 2.2 kg/m²) and in 21 obese (BMI = 34.5 ± 6.1 kg/m²) women with DEXA, SFT, and BIA in the same morning. Results: Mean (± SD) FM (kg) was 16.3 ± 5.5, 15.0 ± 5.1, 14.7 ± 4.9 in nonobese subjects and 38.8 ± 10.1, 36.3 ± 10.0, 37.1 ± 12.0 in obese patients, by DEXA, SFT and BIA, respectively. Comparison of the DEXA-BIA and DEXA-STF methods showed high correlation in regression line analysis in nonobese subjects as, r² = 0.93 and 0.89, respectively. Regression coefficents were 0.84 and 0.75 in obese patients. However, reanalysis of the data by the Bland and Altman method revealed an obvious lack of agreement between the DEXA-BIA and DEXA-SFT methods in obese patients. In addition, FM was underestimated by BIA and SFT as compared to DEXA in both of the study groups. Besides, better precision was obtained by DEXA method among the others. Conclusion: The SFT or BIA method would be preferred to monitor BCA in non-obese subjects in clinical routine. However, DEXA should be considered as the method of choice in obese patient monitoring, since reproducibility gains special importance, other than the accuracy in the context.

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The aim of the present study was to evaluate whether there is a relationship between bone mineral density (BMD) and insulin resistance and hyperinsulinemia in women with polycystic ovary syndrome (PCOS). The study consisted of 28 amenorrheic women with PCOS and 11 amenorrheic women without PCOS. Fifteen healthy women with normal ovulatory function, matched for age and body mass index (BMI), served as controls. BMD was measured at the lumbar spine and left femoral neck with dual-energy X-ray absorptiometry. Blood samples were obtained to measure serum levels of insulin, follicle-stimulating hormone, luteinizing hormone, sex hormone-binding globulin (SHBG), total and free testosterone, androstenedione and estradiol by radioimmunassay. Insulin resistance was estimated by the in sulin tolerance test (ITT), and K(ITT) was taken as the insulin sensitivity index. In the PCOS group, K(ITT) was significantly lower and insulin levels were higher than in either of the control groups (P < 0.001). BMD in the PCOS group was lower than in the healthy group and higher than in the amenorrheic control group (P < 0.05). In the PCOS group, there were positive correlations of BMD of the lumbar spine with insulin (r = 0.42: P < 0.05) and negative correlations of BMD with K(ITT) (r = -0.58; P < 0.001) and SHBG (r = -0.38; P < 0.05). The inverse association of BMD and K(ITT) was independent of BMI, insulin, SHBG, androstenedione, and free testosterone. In conclusion, insulin resistance and hyperinsulinemia in women with PCOS may be a relative protective factor against bone mineral loss.

Objective: To assess sarcopenia status in women with rheumatoid arthritis (RA). Material and Methods: Thirty female patients with RA and 30 female controls without RA were enrolled in this study. Sarcopenia status in patients with RA was evaluated by assessing body composition using dual X-ray absorptiometry (DXA). C-reactive protein (CRP) levels and erythrocyte sedimentation rate (ESR) were measured, and body mass index (BMI) and Disease Activity Score (DAS28) were calculated. Because sarcopenia differs between men and women, the study groups comprised only females.Results: It was found that skeletal muscle index (SMI) was lower in patients with RA (5.83±0.807) than in controls (7.30±1.640). Sarcopenia (in females with an SMI of ≤5.75 kg/m 2 ) was more common in the RA group and the difference was statistically significant (p=0.004). Sarcopenia was more common in patients with RA who were normal or overweight than in those who were obese according to their BMI. There was no relationship between sarcopenia and DAS28 in the RA group (p=0.530), whereas CRP levels were significantly higher in patients with sarcopenia (p=0.230). No relationship was found between drug use and sarcopenia in the RA group.Conclusion: It was found that SMI was decreased and sarcopenia risk was elevated in patients with RA and the risk was higher in nonobese patients.

Leptin and zinc are involved in the regulation of appetite. Copper is a trace element regulating the functions of several cuproenzymes that are essential for life. To evaluate the relationship between zinc and copper status and the leptin system in humans, we examined whether leptin concentrations in the mother and the newborn correlate with the weight of mother, placenta and newborn. A total of 88 pregnant women at 38-42 weeks' gestation were studied. All infants were categorized as small for gestational age (SGA) (n = 16), average for gestational age (AGA) (n = 59) or large for gestational age (LGA) (n = 13). Leptin, zinc, and copper levels were measured in maternal and cord serum at birth. Maternal BMI and placental weight of the LGA groups were significantly higher than those of the SGA and AGA groups. Cord and maternal leptin levels of the SGA groups were significantly lower than those of the AGA and LGA groups. Maternal serum leptin levels were positively correlated with BMI and maternal zinc levels in all groups. Cord serum leptin levels of all groups were positively correlated with birth weight and placental weight. Birth weight was negatively correlated with maternal and cord copper level of all groups. Umbilical leptin concentrations of SGA newborns correlated with leptin concentrations of their mothers. In all pregnancies, birth weight increases in association with increase in cord leptin level. Our results suggest that maternal zinc but not copper level has an effect on maternal serum leptin levels. The increase in copper level in both maternal and cord blood may contribute to restriction in fetal growth.

Cervicovaginal beta-hCG measurement in patients with preterm labor may be used as a predictive test. Cervicovaginal prolactin is not a sensitive test compared with the beta-hCG test.

Objective: This study was set up to investigate the relationship between immune process and high levels of human chorionic gonadotropin-β (βhCG) in hyperemesis patients with or without hyperthyroxinemia. Methods: βhCG, immune parameters and thyroid related hormones were assayed in hyperemesis patients and in controls. Results: Mean serum βhCG, fT₄ and TSH levels were significantly higher in hyperemesis patients than in controls (p < 0.01, p < 0.01, p < 0.05, respectively). Further, immune parameters regarding IgG, IgM, C₃, C₄ and lymphocyte count were significantly higher in patients than in controls (p < 0.05, p < 0.01, p < 0.01, p < 0.05, p < 0.01, respectively). In hyperemesis patients with hyperthyroxinemia, mean serum βhCG, IgG and IgM were significantly higher than in hyperemesis women without hyperthyroxinemia (p < 0.001, p< 0.05, p < 0.05, respectively). βhCG was positively correlated with fT₄ (r = 0.45, p < 0.05), with lymphocyte count (r = 0.47, p < 0.01), with IgM (r = 0.38, p < 0.05) and with C₃ (r = 0.40, p < 0.05) in hyperemesis patients. A negative correlation between βhCG and TSH (r = –0.43, p < 0.05) was noted in the hyperemesis group. Free T₄ showed a positive association to IgM (r = 0.49, p < 0.01), to IgG (r = 0.40, p < 0.05), to lymphocyte count (r = 0.45, p < 0.05). Conclusion: Immunologic activity in pregnancy may have an effect or role on the stimulatory mechanism of βhCG in hyperemesis patients with or without hyperthyroxinemia.