Hormonal Profile Of Patients Research Articles

Importance of neurotransmitters in the regulation of the reproductive system

Hypothesis/aims of study. Recently, due to empowering the improvement of care for patients with traumatic brain injury and creating effective methods of intensive therapy for severe brain lesions of various genesis, there has been a tendency towards an increased number of patients who have gone out of a coma into an unconscious state a vegetative state or an unresponsive wakefulness syndrome (BS / UWS). The functions of the brain stem and hypothalamus in patients in a BS / UWS are preserved. The aim of this study was to evaluate the significance of the relationship between the regulation of sex steroid hormones and the secretion of neurotransmitters.
 Study design, materials and methods. The study was performed using systematic analysis and compilation of literature data obtained by foreign and domestic authors over the period from 1931 to 2018.
 Results. This article reviews publications covering the relationship between the regulation of sex steroid hormones and the secretion of neurotransmitters, as well as their effect on the reproductive system. The theory of neurosecretion depicting the mechanisms of positive and negative feedback of the synthesis of neurotransmitters and sex steroid hormones, and the characteristics of the secretion machineries for sex hormones with normogonadotropic and hypogonadotropic pituitary insufficiency, and nonendocrine manifestations of the pathology of the hypothalamus is highlighted in this review.
 Conclusion. The hormonal profile of patients with chronic disorders of consciousness remains almost unstudied. A further study of the hormonal profile in this patient category will create the prerequisites for the development of pathogenetically substantiated hormone-modifying replacement therapy, which may have a positive effect on the dynamics of recovery of consciousness and improve treatment outcomes.

The early luteal hormonal profile in IVF patients triggered with hCG.

What is the early luteal phase hormonal profile in patients undergoing ovarian stimulation for IVF/ICSI followed by hCG trigger and a freeze-all strategy without luteal phase support? The peak concentration of progesterone occurred 4days after oocyte pick-up (OPU + 4), with an average 35% fall from OPU + 4 to OPU + 6, and progesterone levels before and 12h after hCG administration predicted levels during the early luteal phase. The luteal phase during IVF differs from that during normal cycles, particularly with respect to the serum progesterone level profile. This can cause asynchrony between the embryo and the endometrium, potentially resulting in implantation failure and poor reproductive outcomes. This prospective study included 161 women with normal ovarian reserve receiving GnRH antagonist co-treatment during ovarian stimulation with FSH who were followed up to 6days after OPU in a single IVF cycle. Women aged 18-42years undergoing IVF with ovarian stimulation using FSH were included. Ovulation was triggered with recombinant hCG 250μg. Hormone levels were determined from blood samples taken on the day of trigger, before hCG, at 12, 24 and 36h after hCG and at 1, 2, 3, 4, 5 and 6days after OPU. The primary endpoint was early luteal phase serum concentrations of progesterone, LH, estradiol and hCG. One outlier with a pre-hCG serum progesterone level of 11.42ng/mL was excluded, so all analyses included 160 subjects. Progesterone levels began to increase 1day after OPU, peaked 4days after OPU (114ng/mL), then declined from OPU + 5 onwards. Peak progesterone levels were at OPU + 4, OPU + 5 or OPU + 6 in 38.8, 29.4 and 13.8% of patients, respectively. Approximately two-thirds of patients had a fall in serum progesterone from OPU + 4 to OPU + 6. Pre-hCG progesterone levels correlated significantly with those at 24h after hCG (r2= 0.28; P< 0.001), which in turn correlated significantly with progesterone at OPU + 4 (r2= 0.32; P< 0.001). LH peaked (4.4IU/L) 12h after hCG trigger, persisting for 24h but was barely elevated compared with physiological levels. Serum estradiol peaked twice: at 24h post-trigger and at OPU + 4. Highest hCG levels (130mIU/mL) occurred at 24h post-injection. The best correlations between the number of follicles ≥11mm and serum progesterone level were seen at 24 and 36h after hCG and OPU + 1. The influence of different profiles of serum progesterone on reproductive outcomes could not be determined because a freeze-all strategy was used in all patients. In addition, data were not available to relate serum hormone level findings with endometrial histology or endometrial receptivity analysis to clearly identify the relationship between serum hormones and the window of implantation. Detailed information about early luteal phase hormone levels could be used to optimize and individualize luteal phase support to improve reproductive outcomes. This study was funded by My Duc Hospital, Ho Chi Minh City, Vietnam. All authors state that they have no conflicts of interest to disclose. NCT02798146; NCT03174691.

Changes in the hormonal profile in patients with polycystic ovary syndrome and infertility after surgical treatment

Changes in the hormonal profile in patients with polycystic ovary syndrome and infertility after surgical treatment

Relationship of Immune Status Indicators and Hormonal Profile in Patients with Coxarthrosis

Background. The dynamic balance between the immune and neuroendocrine systems and their mutual regulation provide the formation of protective reactions of the body in conditions of pathology and various stress-inducing effects. The aim of the research was to establish the nature of the relationship between the indicators of the immune status and hormonal profile in patients with coxarthrosis before and after hip replacement. Material and methods . The study involved 73 patients with stage HI dysplastic coxarthrosis, who, using cluster analysis according to immunological parameters, were divided into two groups. The first clinical group included 46 patients, the second - 27 patients. The control group consisted of 28 clinically healthy individuals. Results. In the preoperative period, correlations between indicators of the immune status and hormonal profile were different in patients of the 1st and 2nd groups and depended on the level of hormones. Moreover, in patients of the 1st group, the hormones of the stress-limiting system made the greatest contribution to this dependence, and in patients of the 2nd group - peripheral thyroid hormones. After endoprosthetics, the correlation dependence in patients of the 1st group differed from the initial one in a number of indicators of the immune status and hormonal profile, which reflects the coordinated work of these body systems under the influence of stress factors. In patients of the 2nd group, the spectrum of these indicators was limited, which indicates the failure ofmechanisms, in particular, limiting the intensity ofinflammatory reactions after surgery. Conclusion. The relationship of the studied parameters in patients of the 1st group indicates the adaptive nature of the immune and endocrine reactions in response to surgery. In patients of the 2nd group, they reflect disadaptive rearrangement, which leads to an increased risk of postoperative complications.

Amount of Progesterone Consumed Based on Varying Fat Concentrations, Dietary Recommendations, and Estimated Safe Levels in Commercial Cow Origin Liquid Dairy Products.

Federal guidelines recommend that food with hormone content fall below 1% of endogenous production in the subset of the population with the lowest daily production. The majority of dairy products are obtained from pregnant cows, which increase the level of hormones present. The purpose of this article was to perform theoretical evaluation of the quantity of progesterone in cow's milk based on fat percentages and to assess whether this was within the recommended range. Daily recommended dairy product intake from various countries worldwide was researched. This was compared to the concentration of progesterone previously identified in varying fat contents of cow origin milk to assess the amount of progesterone (mg/day) that would be consumed if the guidelines were followed. The maximum daily progesterone consumption suggested will be met by ingestion of 2.7 L, 1.42 L, 1.13 L, 940 mL, 810 mL, 650 mL of 0% (skim), 1%, 2%, 3.25%, 10% (cream), and 35% (whipping cream) fat liquid cow origin dairy product, respectively. Therefore, ingestion of the highest amount of recommended daily dairy intake fell below 1% of the daily endogenous quantity produced, except in the unlikely case of consumption of 650 mL of 35% fat. Studies demonstrating an effect of cow's liquid dairy product intake may need to be revisited, since levels of progesterone consumption remain within the recommended levels. However, it should be considered that ingestion of cow's milk might have a potential effect on the hormonal profile in patients; however, this seems unlikely.

Preoperative contrast-enhanced computed tomographic characterisation of pancreatic cystic lesions: A prospective study.

BackgroundCharacterisation of pancreatic cystic lesions has a direct role in their management and computed tomography is the mainstay of investigation for diagnosing and characterising them.ObjectivesThe aim of this study was to prospectively assess the diagnostic accuracy of contrast-enhanced computed tomography (CECT) in preoperative characterisation of pancreatic cystic lesions with histopathology as the reference standard.MethodA total of 38 patients with cystic pancreatic lesions diagnosed after clinical, laboratory and sonographic evaluation, irrespective of age, were preoperatively evaluated with CECT. Images were reviewed for the general characteristics of the lesions on pre-contrast and portal venous phase images and overall diagnostic accuracy calculated. Imaging findings were compared with histopathology, or cytology and/or intra-operative findings.ResultsSerous cystadenoma (SCA) was the most common cystic pancreatic lesion found in 31.6% of patients followed by mucinous cystadenoma (MCA) (26.3%), solid pseudo-papillary tumour (SPT) (21.1%) and intra-ductal papillary mucinous neoplasm (IPMN) (10.5%). Three patients (7.9%) had simple cysts and one patient (2.6%) had a lymphangioma. The diagnostic accuracy of CECT for pancreatic cystic lesions was found to be 72.5%ConclusionThe diagnostic accuracy of computed tomography (CT) was high for SCA, IPMN and pancreatic cysts, and low for MCA and SPT. Combination of a multiloculated cystic lesion with locule size of less than 20 mm, septal enhancement with relative lack of wall enhancement, central scar and lobulated outline are highly specific for SCA. Unilocular or macro-cystic pattern with locule size of more than 20 mm, female gender and wall enhancement with smooth external contour are pointers towards MCA. Solid cystic pancreatic head lesions in young females may be suggestive of SPT. A dilated main pancreatic duct in a cystic lesion with internal septations may point towards IPMN. Fluid attenuation lesions with imperceptible non-enhancing wall indicate pancreatic cysts. Lastly, pseudocysts and neuroendocrine tumours with cystic components are great mimickers of pancreatic cystic lesions, and a history of pancreatitis and hormonal profile of patients should always be sought.

Evaluation of anterior pituitary hormonal profile in patients with first seizure of tonic-clonic and temporal lobe epilepsies in Al-Zahra hospital of Isfahan, Iran, during 2014-2016: comparison of hormonal profiles in 2 types of epilepsy

Background and aims: Temporal lobe and tonic-clonic seizures are the most common types of epilepsy. It is a disease that disrupts the regulation of the hypothalamic pituitary adrenal (HPA) axis. The disturbance in the regulation of this axis affects the secretion of hormones from the anterior pituitary. Due to the different origins of these 2 types of epilepsy listed above, this study aimed to examine their differences in the level of anterior pituitary hormones. Methods: This cross-sectional study was conducted in Al-Zahra hospital of Isfahan, Iran, from 2014 to 2016. A total of 36 patients with the idiopathic first seizure were selected for the examination including 20 patients with tonic-clonic seizure and 16 patients with temporal lobe seizure. The diagnosis of epilepsy was confirmed by a neurologist along with electroencephalogram (EEG) findings. The levels of anterior pituitary hormones including thyroid-stimulating hormone (TSH), adrenocorticotrophic hormone (ACTH), GH (growth hormone), follicle-stimulating hormone (FSH), luteinizing hormone (LH) and PRL (prolactin) were measured and compared using ELISA method in both groups. Results: The results indicated that all the anterior pituitary hormones except TSH and ACTH had higher means in the temporal lobe epilepsy than in the tonic-clonic epilepsy, but a significant difference (mean ± SD) was reported only in GH (4.59±2.95) (2.55±1.87) (P&lt;0.005) and FSH (19.4±14.06) (4.34±2.37) (P&lt;0.033) respectively in the temporal lobe and tonic-clonic seizures. Meanwhile, there was a significant relationship between seizure, regardless of its type, and the level of growth hormone and FSH. Conclusion: In the future, hormonal changes may be used as an adjunct to diagnose the type of epilepsy. More studies are required to confirm the findings.

The Effect of Sleeve Gastrectomy on the Hormonal Profile of Patients with Polycystic Ovary Syndrome

To prospectively evaluate the hormonal profile and weight loss of women with obesity and PCOS submitted to sleeve gastrectomy (SG). A Prospective study carried out at the Hospital das Clínicas, Federal University of Pernambuco, Recife, Brazil, in 2018, where 18 patients with PCOS, whose age varied from 18 to 40years, with an indication for bariatric surgery were evaluated. Plasma estradiol (E2), fasting insulin, luteinizing hormone (LH), and follicle-stimulating hormone (FSH) were measured prior to bariatric surgery and 3months after surgery. The LH/FSH ratio and BMI of the study participants were also calculated. Postoperative E2 levels were higher (preoperative mean of 63.4pg/dL versus postoperative mean of 91.0pg/dL), with no statistical significance then (p = 0.139). It was observed, at the postoperative period, statistically significant decreases in mean fasting insulin levels (24.4mIU/mL vs. 9.0mIU/mL; p < 0.001), LH levels (7.2 vs. 4.5; p = 0.047), and an inverted LH/FSH ratio (1.5 vs. 0.9; p = 0.008); relevant weight loss occurred (mean BMI, 40.5kg/m2 vs. 33.4kg/m2; p < 0.001). Relevant changes in the hormone profile and significant alterations in the gonadotropic and insulin patterns were seen. In addition to satisfactory weight loss, the observed endocrine alterations revealed an internal environment that was more homeostatic and conducive to reproduction, indicating that SG was able to produce attractive physiological outcomes for women with PCOS.

Thyroid profile as a marker of poor prognostic factor in patients with acute coronary syndrome: a tertiary care hospital based observational study

Background and aims: Serum thyroid hormonal changes can occur in acute or chronic non-thyroidal systemic illness including acute coronary syndrome in otherwise euthyroid individuals. In this study we aimed to assess thyroid hormonal profile in patients presenting with acute coronary syndromes (ACS) and compare between ST segment elevated myocardial infarction and unstable angina/Non ST segment elevated myocardial infarction.Methods: A hospital based, retrospective, observational comparative study was designed. Data of all patients with acute coronary syndrome presenting to hospital were collected from July 2015 through June 2017 in a pre-structured proforma and analyzed.Results: A total of 200 ACS patients between 23 years to 88 years with mean age of 61.33 ± 12.30 years were studied. One hundred and twenty seven (63.5%) were males. Among them 116 (58%) was ST segment elevated myocardial infarction (STEMI) patients while 84 (42%) were unstable angina/ non-ST elevated myocardial infarction (UA/ NSTEMI) patients. Total 47 (23.5%) patients had abnormal TFT of which 28(59.5%) had Euthyroid Sick Syndrome, 12(25.5%) had subclinical hypothyroidism, 5(10.6%) had subclinical hyperthyroidism and 2(4.25%) had low fT4 with normal fT3 and normal TSH. There was significant difference in TFT in patients with STEMI and UA/NSTEMI (P=0.006).There were higher rates of heart failure (p= 0.001 &amp; 0.003 in STEMI &amp; UA/NSTEMI respectively), longer length of hospital stay (3+0.17 days) and high mortality (more than 4 fold) in all types of ACS patients with abnormal TFT than ACS patients with normal TFT.Conclusion: There is higher prevalence of abnormal thyroid hormonal findings in ACS causing significant morbidity and mortality.

The Epidemiology and Hormonal Assessment of Patients with Empty Sella on Pituitary Magnetic Resonance: A Retrospective Single Centre Study in Saudi Community Based Hospital

Background: No large enough series have been reported to allow a detailed definition of the epidemiology of primary empty sella (PES) and diagnostic anterior pituitary hormones abnormalities in Saudi Arabia. Objective: To evaluate the epidemiological and hormonal profile of patients with PES. Design: Retrospective analysis of pituitary Magnetic Resonance Image (MRI) and hormonal data of patients with PES between January 2008 and December 2017. Settings: Departments of Endocrinology and Radiology at King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia. Patients: 537 patients with clinical, hormonal and radiological data. Main outcome measures: The frequency of PES in patients and associated abnormal pituitary hormones. Results: Over the 9-year period, Out of 537 patients; 161 (30 %) were male and 376 (70 %) were female with mean age 35.4 ± 13.7. Among them we found 50 (9.3%) cases with PES on MRI. 11 (22 %) cases were male and 39 (78 %) were female with female to male ratio of 3.5 to 1. Cases with PES were significantly older than cases with pituitary adenoma and normal MRI, 45.3 ± 19.6 vs. 35.3 ± 13.9, p value &lt;0.0001. PES occurred with the greatest frequency at the fourth decade. During the hormonal assessment, 34 (68%) cases of PES were found to have some degree of anterior pituitary hormones abnormailities. No anterior pituitary hormones abnormalities were found in 16 (32%) of cases. Hyperprolactinemia was found in 26 (52%) of cases. Cases of hypogonadotropic hypogonadism and central hypothyroidism were equally distributed, 4 cases ( 8% ). Female predominance was found. Conclusion: In our study, PES was more common in middle aged female. The high incidence of endocrine abnormalities in patients with PES mandates that these patients should routinely be subjected to endocrine evaluation to detect these deficiencies early. Limitations: Question of clustering of cases within the study region and limited study sample size.

Long-term use of clomiphene citrate in induction of ovulation in PCO patients with clomiphene citrate resistance

ObjectiveThe aim of our study to evaluate the effect of extended clomiphene citrate treatment on the ovulation rate, pregnancy rate, and hormonal profile of clomiphene resistant PCOS. MethodologyThis a prospective study conducted in Maternity Hospital Minia University, 200 patients with PCOS recruited in the study during the period from September 2015 till February 2016 (6 months was duration of the study), they were diagnosed as PCO with clomiphene resistance before being recruited in the study. They received 150mg clomiphene citrate for 10 days start in 2nd day of cycle for three consecutive cycles, and followed up for another three months without treatment, last follow-up cycle was on February. We studied the effect of extended treatment with CC in ovulation rate, pregnancy rate and hormonal profile in patients before and after treatment. ResultsThere was significant improvement in ovulation rate in the patients after extended CC treatment for 3 months and 3 months follow-up (as 12 cases in the first cycle and 32 cases in the second cycle and increased to 76 cases in the third cycle) while no ovulation documented before treatment pregnancy rate was 17% itis generally low but it highly significant when compared with was zero preceding treatment. ConclusionExtended CC treatment is good method to improve ovulation and pregnancy rate in CC resistant PCOS but further multi-center studies are needed to provide more powerful evidence.

Comparative study of clinical features of patients with celiac disease & those with concurrent celiac disease & type 1 diabetes mellitus.

Background & objectives:Celiac disease (CD) and type 1 diabetes mellitus (T1DM) share a common genetic locus and clinical manifestations. The present study was planned to compare clinical, biochemical and hormonal profiles of patients with CD and CD with T1DM.Methods:Records of CD patients with age ≤20 yr, available anthropometric measurements, haematological, biochemical and hormonal workup with tissue transglutaminase IgA antibody and duodenal biopsy (Marsh grade) were screened. The patients were divided into two groups i.e., CD alone (Group A) and concurrent CD with T1DM (Group B).Results:One hundred and nine patients of CD (57 male) with a mean age of 14.9±2.9 yr were evaluated. Of these, 86 (78.9%) patients had CD alone and 23 (13 females) (21.1%) patients had CD with T1DM. The age at diagnosis and the lag duration for the diagnosis of CD were 11.5±4.6 versus 13.8±3.4 yr (P<0.05) and 48.8 ±43.3 versus 20.2±31.8 months (P<0.05) in groups A and B, respectively. The most common histopathological grade was type 3b (59.2%) in group A and type 2 (42.1%) in group B. Short stature (87% vs. 40.9%; P<0.01), anaemia (80.9% vs. 45%, P<0.01) and delayed puberty (61.9% vs. 29.4%; P<0.01) were more common in group A.Interpretation & conclusions:Patients with CD alone have a longer lag time to diagnosis and consequent sequel in the form of anaemia, short stature and delayed puberty, as compared to patients with concurrent CD and T1DM.

MANAGEMENT OF ENDOCRINE DISEASE: The impact of subclinical hypothyroidism on anthropometric characteristics, lipid, glucose and hormonal profile of PCOS patients: a systematic review and meta-analysis.

Subclinical hypothyroidism (SCH) is encountered in 10-25% of women with PCOS. To date, it remains unclear whether this coexistence influences the severity of metabolic and hormonal profile of these patients. The purpose of our systematic review is to investigate this potential relation. We systematically searched Medline, Scopus, ClinicalTrials.gov, Cochrane Central Register of Controlled Trials (CENTRAL) and Google Scholar databases together with reference lists from included studies. All prospective and retrospective observational cohort studies that investigated the impact of subclinical hypothyroidism on hormonal and metabolic parameters of PCOS patients were included. The methodological quality of studies was assessed with the Ottawa-Newcastle criteria. Statistical meta-analysis was performed with the RevMan 5.3 software. Twelve studies were finally included in the present review, which enrolled 2341 PCOS patients. Among them, 577 had subclinical hypothyroidism, whereas the remaining 2077 were PCOS women with normal thyroid function. The presence of SCH significantly affected HDL (MD -3.92 mg/dL 95% CI: -6.56, -1.29) and triglycerides levels (26.91 mg/dL 95% CI: -3.79, 50.02). HOMA-IR was also affected (MD 0.82 95% CI: 0.15, 1.50). On the other hand, LDL, fasting glucose and 2-h OGTT were not influenced. Similarly, prolactin, FSH, LH, LH/FSH ratio and sex hormone-binding globulin remained unaffected. Subclinical hypothyroidism does not influence the hormonal profile of women with PCOS. On the other hand, it results in mild metabolic abnormalities, which are not clinically important in a short-term setting.

Bee Stings at Sites of Acupuncture as a Potential Therapy for Idiopathic Premature Ovarian Failure: A Pilot Study

Objectives:To evaluate administration of bee stings at sites of acupuncture on the hormonal profile of patients with idiopathic premature ovarian failure (POF). Study design: A pilot study carried at Obstetrics and Gynaecology Department, Tanta University Hospital, and at the Entomology Unit, Zoology Department, Faculty of Science, Tanta University from June 2015 to December 2015. Patients and Methods: 20 patients aged 18 to 40 years with idiopathic POF were included in a case series study. Measurement of serum concentrations of Follicle Stimulating Hormone (FSH), Luteinizing Hormone (LH), 17β-estradiol (E2) and Anti-Mullerian hormone (AMH) with calculation of Antral Follicles Count (AFC) and volume of ovaries was done before and after bee stings that were administered for 3 months, 2 sessions per week. Every session was 15 minutes with a range of 3-8 stings per session at the site of acupuncture. The outcome measures were changes in estimated variables within one month after bee stings. Results:FHS and LH significantly decreased from 54.5 ± 3.2 to 27.1 ± 5 mIU/mL and from 53.8 ± 2.7 to 25.2 ± 4.1 mIU/mL respectively (P value< 0.001). E2 significantly increased from 38.7 ± 3.3 to 92.5 ± 2.9 Pg/mL (P value< 0.05). Ovarian volume, AFC and AMH were not specifically different after bee stings.Conclusion:Bee stings at the sites of acupunctures significantly reduced the serum levels of both FSH and LH and increased serum concentrations of E2 with improvement in hot flushes and vaginal dryness. Bee stings had no effect on AFC, AMH or ovarian volume. The use of bee venom (stings) therapy at the sites of acupunctures for patients with idiopathic POF is recommended.

Hormonal evaluation in relation to phenotype and genotype in 286 patients with a disorder of sex development from Indonesia.

The objective of this study was to determine the aetiological spectrum of disorders of sex development (DSD) in a large cohort of underprivileged and undiagnosed patients from Indonesia. A total of 286 patients with atypical external and/or internal genitalia were evaluated using clinical, hormonal, molecular genetic and histological parameters. The age (years) at presentation was 0-0·5 in 41 (14·3%), >0·5-12 in 181 (63·3%) and >12 in 64 cases (22·4%). 46,XY DSD was most common (68·2%, n = 195), 46,XX DSD was found in 23·4% (n = 67) and sex chromosomal DSD in 8·4% (n = 24). In 61·2% of 46,XX DSD patients, 17·9% of 46,XY DSD patients and all sex chromosome DSD patients (29·4% in total), a final diagnosis was reached based on genetic or histological gonadal tissue evaluation. 17-hydroxyprogesterone and androstenedione levels were the most distinctive parameters in 46,XX DSD patients. In 46,XY DSD, diagnostic groups were identified based on the external masculinization score: androgen action disorder (AAD), unknown male undermasculinization (UMU), and gonadal dysgenesis (GD). LH, FSH and testosterone levels were most informative especially in the older age group. HCG tests were of no additional value as no patients with androgen synthesis disorders were found. Hormonal profiles of patients with sex chromosome DSD and a Y-chromosome sequence containing karyotype showed high levels of LH and FSH, and low levels of AMH, inhibin B and testosterone compared with the normal male range. Gene mutations were found in all patients with CAH, but in only 24·5% and 1·8% of patients with AAD and UMU. In 32% of 46,XY GD patients, copy number variants of different genes were found. A stepwise diagnostic approach led to a molecularly or histologically proven final diagnosis in 29·4% of the patients. The most informative parameters were serum levels of 17-hydroxyprogesterone and androstenedione in 46,XX DSD patients, and serum LH, FSH and testosterone levels in 46,XY DSD patients.

Hormonal Profile in Patients With Dilated Cardiomyopathy.

Background:There is increasing evidence that endocrine system may be dysfunctional in patients with heart failure.Objectives:In the present study, we investigated hormonal abnormalities in heart failure and the effect of disturbed hormonal balance on prognostic outcomes of patients with systolic heart failure.Patients and Methods:Among patients followed in Heart Failure and Transplantation Clinic, 33 men with a diagnosis of idiopathic dilated cardiomyopathy receiving guidelines-directed medical therapies and with New York Heart Association Class II-III were enrolled. Serum concentrations of growth hormone (GH), insulin-like growth factor 1 (IGF-1), thyroid hormones, free testosterone, high-sensitive C-reactive protein (hs-CRP), and N-terminal pro-brain natriuretic peptide (NT Pro-BNP) were measured in all the patients. The physical performance of patients was assessed by six-minute walk test (6MWT). The patients were subsequently followed for a year and the data regarding their death, transplantation, or hospitalizations due to acute heart failure were recorded.Results:Except for testosterone level, the levels of GH, IGF-1, T3, and T4 concentrations in the patients were significantly lower than the normal values (P < 0.05). Among different hormone, only GH had correlation with NT Pro-BNP, hs-CRP, and 6MWT. There was no association between the occurrence of the combined events and different hormonal levels in multivariate analysis.Conclusions:The hormonal levels were low in patients with idiopathic dilated cardiomyopathy. However, the prognostic significance of different hormonal deficiencies was not clear in our study populations who were receiving standard therapies for heart failure and had a relatively stable clinical condition.

Do patients with celiac disease patients differ from those with concurrent celiac disease with type 1 diabetes mellitus?

Background and objectives Celiac disease (CD) and type 1 diabetes mellitus (T1DM) share common genetic loci. Patients with T1DM developing CD may remain asymptomatic and some of the common symptoms of CD may be considered as part of the chronic complications of diabetes like gastrointestinal intolerance, diarrhea, nocturnal diarrhea, alternate diarrhea and constipation. There are no reports on comparison of presenting features of patients with CD and those with CD and T1DM together. The present study was planned to compare clinical, biochemical and hormonal profile of patients of CD and CD with T1DM. Patients and methods Consecutive CD patients with and without T1DM ≤ 20 years seen by us were evaluated clinically and underwent thyroid, gonadal function tests (where applicable) and serum cortisol, besides routine hemogram and biochemical tests. Patients were subjected to screening for CD by anti tissue transglutaminase antibodies (tTGAb) and those positive were subjected to endoscopy of descending part of the duodenum, and 3 biopsies were taken. Histological interpretation was done by an experienced pathologist and recorded as per modified Marsh classification [1]. Patients were diagnosed to have CD as per modified ESPGHAN criteria [2] and T1DM as per ADA position statement [3]. All patients received gluten free diet (GFD) and / or diabetic diet. Patients with CD alone (group A) were compared with those having CD with T1DM (Group B). Results 109 patients (57 males) with mean age of 14.9±2.9 year fulfilled the eligibility criteria. 23 (21.1%) had T1DM

Cortisol and testosterone in hair as biological markers of systolic heart failure

Congestive heart failure (CHF) is associated with increased stress and alterations in metabolism, favoring catabolism over anabolism. Hormonal profiles of patients with heart failure have been assessed using serum and saliva as matrices, which are only point measurements and do not provide long-term information. Scalp hair is a novel matrix that allows for measurement of hormones over a period of several months. We aimed to evaluate whether levels of cortisol and testosterone and their ratio (C/T) in hair correlate with severity of heart failure. We conducted a prospective study in ambulatory male patients with a left ventricular ejection fraction (LVEF)≤40%. Hormone levels were measured using immunoassays in the proximal 2 cm of hair (representing approximately two months of systemic hormone exposure). Primary endpoints included the correlation of hair cortisol, testosterone, and C/T levels with the New York Heart Association (NYHA) class, LVEF, exercise capacity and NT-proBNP. The 44 CHF patients had a median hair level (range) of cortisol of 207 (117.7-1277.3)ng/g. Hair cortisol levels correlated positively with NYHA class (r=0.48, p=0.001) and negatively with treadmill stress test performance, (r=-0.37, p<0.05). The hair testosterone was 5.17 (2.39-24.64)ng/g and the C/T ratio was 39.89 (12.98-173.73). No associations were found between hair testosterone and C/T ratio and heart failure severity; however, the C/T ratio was higher in patients who required a CHF-related hospitalization than in patients who did not require this in the year following the inclusion in the study. Hair cortisol levels correlate with heart failure severity as assessed by the NYHA class and exercise capacity, while hair testosterone and C/T levels do not correlate with heart failure severity.

Female sex hormones and cytokine secretion in women with multiple sclerosis

Data from experimental and clinical research suggest that sex hormones may influence the autoimmune process in multiple sclerosis (MS). Studies on the hormonal profile of patients with MS and its relation to the disease activity provide heterogeneous results.Objectives: The aim of this study is to investigate the changes in serum levels of estradiol and progesterone and their correlations with the cytokine profile and the degree of disability in women with relapsing-remitting MS (RRMS).Methods: The serum concentrations of estradiol, progesterone, tumor necrosis factor-alpha (TNF-alpha), interferon-gamma (IFN-gamma), interleukine-4 (IL-4) and interleukine-10 (IL-10) were measured and the degree of disability was determined in 35 women with RRMS, during relapse and remission. Serum levels of hormones were measured by micro-particle enzyme immunoassay and ELISA was used for the cytokines concentrations. The degree of disability was assessed by the Expanded Disability Status Scale and the Scripps Neurological Rating Scale.Results: Sixty per cent of patients had serum concentrations of estradiol and/or progesterone below the lower limit of normal in one or both phases of MS. Hormonal levels increased significantly during remission in these patients. Women with and without hormonal abnormalities differed in terms of cytokine profile during relapse and remission. Significantly higher TNF-alpha in both phases and IFN-gamma in remission was found for the patients with hormonal disturbances compared to these with normal hormonal status.Conclusions: Our study finds high frequency of hormonal disturbances among female patients with RRMS. Abnormally low concentrations of sex hormones are associated with higher serum levels of TNF-alpha and IFN-gamma, which could suggest suppressive effect of estradiol and progesterone on pro-inflammatory cytokine secretion.

A study on the clinical and hormonal profile of patients with hirsutism

Dr. Puri underwent analyses of 50 hirsutism patients in light particularly of virilization clinically, causes of hirsutism, associated diseases of hirsutism and pervic ultrasonograpy [1]. The population of hirsutism patients in the study is relatively high considering that hirsutism is rather rare disease. From his/her study, I have known that almost half the hirsutism patients are caused by unknown, idiopathic origin and the other 40% are by polycystic ovarian disease and rarely by congenital adrenal hyperplasia or hypothyroidism. The major underlying diseases of hirsutism are obesity, acne, striae, acanthosis nigricans and menstrual irregularities. So, we have to check and treat these dermatologic or systemic disorders if we see hirsutism patients. Ultrasonography showed that 40% of hirsutism patients showed ovarian cysts. These detailed ultrasonographic analyses are extremely helpful for physicians: if we see polycystic or monocystic ovary by ultrasonography accidentally, we have to check virilization signs. Further accumulation of patients of hirsutism patients is required to confirm if this speculation is true. I also propose to see if the differences of race can affect these findings. Even so, I was highly impressed by this analysis reported by only one author. REFERENCES