BackgroundConstitutional delay of growth and puberty (CDGP) is a variation of the onset and timing of pubertal development without a defined endocrine abnormality. Recently published studies indicate that leptin and ghrelin play a role in puberty initiation and progress. They have been implicated in regulation of GnRH secretion, with ghrelin having inhibitory and leptin, facilitatory effects. We hypothesized that elevated ghrelin and reduced leptin concentrations could be implicated in altering the tempo of puberty in adolescents with CDGP. So in the current study we evaluate variations in leptin and ghrelin levels in adolescent boys with CDGP, the relationships between both hormones and reproductive hormones including LH, FSH and testosterone were also evaluated.MethodsThe study enrolled 23 adolescent boys with CDGP and 20 healthy controls matched for age and sex. Weight, height, BMI, testicular volume, bone age, bone age delay, serum FSH, LH, testosterone, leptin and ghrelin were assessed.ResultsAdolescent boys with CDGP had significantly lower leptin and higher ghrelin than normal controls. Leptin was positively correlated with BMI, bone age, testicular volume, FSH, LH and testosterone and negatively correlated with delayed bone age and ghrelin. Ghrelin was negatively correlated with BMI, bone age, testicular volume, FSH, LH and testosterone. With multiple regression analysis BMI, FSH, LH, testosterone and ghrelin remained independently correlated with leptin while BMI, LH and testosterone remained independently correlated with ghrelin.ConclusionElevated serum ghrelin and decreased leptin concentrations and their associations with reproductive hormones may explain the sexual immaturity in adolescent boys with CDGP.

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BackgroundRecent evidence has suggested an association between subclinical hypothyroidism (SCH) and microalbuminuria in patients with type 2 diabetes. However, whether SCH is related to microalbuminuria among subjects with prediabetes has not been studied. Thus, we evaluated the association between SCH and microalbuminuria in a cohort of prediabetic Egyptian adults.MethodsA total of 147 prediabetic subjects and 150 healthy controls matched for age and sex were enrolled in this study. Anthropometric measurements, plasma glucose, lipid profile, homeostasis model assessment of insulin resistance (HOMA-IR), thyroid stimulating hormone (TSH), free thyroxine, triiodothyronine levels, and urinary albumin-creatinine ratio (UACR) were assessed.ResultsThe prevalence of SCH and microalbuminuria in the prediabetic subjects was higher than that in the healthy controls (16.3% vs. 4%, P<0.001; and 12.9% vs. 5.3%, P=0.02, respectively). Prediabetic subjects with SCH were characterized by significantly higher HOMA-IR, TSH levels, UACR, and prevalence of microalbuminuria than those with euthyroidism. TSH level was associated with total cholesterol (P=0.05), fasting insulin (P=0.01), HOMA-IR (P=0.01), and UACR (P=0.005). UACR was associated with waist circumference (P=0.01), fasting insulin (P=0.05), and HOMA-IR (P=0.02). With multiple logistic regression analysis, SCH was associated with microalbuminuria independent of confounding variables (β=2.59; P=0.01).ConclusionOur findings suggest that prediabetic subjects with SCH demonstrate higher prevalence of microalbuminuria than their non-SCH counterparts. SCH is also independently associated with microalbuminuria in prediabetic subjects. Screening and treatment for SCH may be warranted in those patients.

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Non-alcoholic steatohepatitis can progress to cirrhosis and hepatocellular carcinoma. Our aim is to evaluate serum ferritin and iron levels in patients with non-alcoholic steatohepatitis (NASH). 53 patients with NASH (36 males and 17 females) were selected from the Specialized Medical Hospital, Mansoura, Egypt. This is in addition to 50 apparently healthy subjects (30 males and 20 females) of age and sex matched as a control group. We detected serum ferritin, iron, immune-reactive insulin (IRI) and the calculated homeostasis model for assessment of insulin resistance (HOMA-IR), in addition to markers of oxidative stress (MDA and thiol) and tumor necrosis factor alpha (TNF-α).Patients with NASH have higher levels of ferritin, iron, IRI, HOMA-IR, MDA, TNF-α (p= 0.001) and thiol (p= 0.01) than control subjects. Serum ferritin has a significant positive correlation with body mass index, ALT, AST, fasting plasma glucose (FPG), total cholesterol, triglyceride, IRI, MDA, in NASH patients. However, after adjustment for age, sex, BMI and HOMA-IR in cases of NASH, ferritin still has a significant positive correlation with ALT, FPG, total cholesterol, MDA (p=0.001) and thiol (p=0.003). Serum iron has no significant correlation with grade of NASH or fibrosis. Serum ferritin level is higher in patients with NASH more than control subjects. Moreover it has a significant positive correlation with oxidative stress even after adjustment for age, sex, BMI and HOMA-IR.