The comorbidity burden has strong impact on mortality in sarcoidosis. Thyroid diseases are more frequent in sarcoidosis than in non-sarcoid controls.

MTX as a single agent in the treatment of sarcoidosis has proved to be a safe and effective steroid alternative. Selected patients with chronic pulmonary sarcoidosis experience definite PFT improvements after MTX treatment. There is need to search for predictors of MTX treatment effectiveness.

Introduction: Sarcoidosis is a disease of unknown aetiology. Little is known of the predictive factors of fibrosis. It has been suggested that PAI-1, uPA, TGF-β1, VEGF, IL-8, TNF-α influence this process. The aim of the study was to assess airway inflammatory and fibrosis markers in EBC in sarcoidosis and the effects of fibreoptic bronchoscopy (FOB), bronchoalveolar lavage fluid (BALF), transbronchial lung biopsy (TBLB) and bronchial mu- cosa membrane biopsy on their production in the airways. Material and methods: The study group consisted of 11 patients (five women, six men, mean age 40 ± 9 yrs, mean ± SD) with sarcoidosis stage I–III. PAI-1 (ng/mL), uPA (ng/mL), TGF-β1 (pg/mL), VEGF (pg/mL), IL-8 (pg/mL), TNF-α (pg/mL) levels were measured in BALF and EBC collected before, and 48 h after, FOB. Results: No significant changes in EBC levels of VEGF, PAI-1, TGF-β1, TNF-α (respectively: 8.02 ± 4.97 pg/mL; 1.1 ± 1.2 ng/mL; 2909.7 ± 206.6 pg/mL; 10.7 ± 19.9 pg/mL) after FOB were observed when compared to baseline. In contrast, IL-8 concentration in EBC (pg/mL) decreased after FOB (0.073 ± 0.13 vs. 0.061 ± 0.1, p = 0.006) and was significantly lower than in BALF (BALF 0.95 ± 0.62, p < 0.05). Also, the mean level of VEGF was higher in BALF than in EBC both pre- and post- FOB (BALF 66.38 ± 36.95, EBC pre-FOB 6.75 ± 3.67 and EBC post-FOB 8.02 ± 4.97). A significant relationship between TNF-a in post-FOB EBC and BALF was also shown (β = 0.63, p = 0.04). Conclusions: FOB does not significantly affect levels of airway inflammation and fibrosis markers present in EBC before and after FOB; they were also comparable to the concentrations marked by BALF. The lack of correlation between marker levels in EBC and BALF indicates that these methods are not equivalent. Due to the possibility of repetition, and the less invasive, simpler method of the EBC test, it would seem reasonable to continue this research on a larger number of patients.

Introduction: OSA is a well-recognized risk factor of cardiovascular disorders and is related to metabolic syndrome. The aim of this study was to evaluate the effect of BMI and AHI/RDI on metabolic disturbances in patients suspected of OSA. Material and methods: Ninety-nine patients referred with suspected OSA underwent standard polysomnography or limited sleep study. AHI/RDI ≥ 10/h was considered relevant for OSA diagnosis. Subjects with AHI/RDI < 10 were considered as controls. We assessed apnea-hypopnea index or respiratory disturbances index (AHI/RDI), Epworth sleepiness scale (ESS), body mass index (BMI), C-reactive protein (CRP, mg/L), glycosylated haemoglobin (HbA1c, %), fasting serum total cholesterol, HDL-, LDL-cholesterol, triglycerides (TG), glucose (G), insulin (INS, IU/mL) and HOMA index. Results: Data are presented as mean ± SD or median (interquartile range) for parametric and nonparametric data respectively. Twenty-two patients were included as controls (age 51.8 ± 10 vs. 55 ± 11 in OSA; p = NS). AHI/RDI in the OSA group was 23 (16–31.3) and 7 (3.8–8.1) in controls (p < 0.001). BMI in OSA 32.2 ± 5.8 vs. 30.4 ± 4.6 in controls (p = NS). Patients with OSA had higher TG (160 ± 75.9 vs. 130.2 ± 51.9 mg/dL, p = 0.046), G (5.04 ± 0.6 vs. 4.47 ± 0.6, p = 0.0037), HOMA (2.31 ± 1.5 vs. 1.85 ± 1.7, p = 0.046). G correlated best with AHI/RDI (p < 0.001, r = 0.41). Significant differences were observed in OSA patients between obese (51 pts, BMI 35.2 ± 4.8) and non-obese (26 pts, BMI 26.61 ± 1.9) pts in: HDL-cholesterol (50.8 ± 13.2 vs. 60.9 ± 18.4 mg/dL; p = 0.02), TG (178.7 ± 69.9 vs. 124 ± 75.3 mg/dL, p < 0.001), G (5.15 ± 0.7 vs. 4.8 ± 0.5 mmol/L, p = 0.01), INS (11.7 ± 5.9 vs. 6.57 ± 4.7, p < 0.001), HOMA (2.7 ± 1.4 vs. 1.4 ± 1.2, p < 0.001), HbA1c (5.89 ± 0.9 vs. 5.4 ± 0.8, p = 0.03), CRP (2.2 ± 2.9 vs. 1.09 ± 1.2, p = 0.01). Conclusions: Our findings support the results of previous studies showing the influence of OSA alone on metabolic disturbances. However, BMI has major impact on metabolic variables.

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