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.

Graves' disease is an autoimmune disorder with various clinical manifestations. Thyrotropin receptor antibodies (TRAbs), the circulating autoantibodies specific to Graves' disease, are the cause for hyperthyroidism, the most prevalent abnormality. Hyperthyroidism leads to increased bone turnover and a negative bone balance. The aims of the present study were to determine the relationship between TRAbs and bone mineral density (BMD), to assess the extent of BMD change in patients with Graves' disease, and to determine the impact of conservative and surgical therapy on BMD. Fifty female postmenopausal patients with Graves' disease were chosen for this study. Twenty women had a recent diagnosis of Graves' disease, 30 women presented with a compensated disease state after either conservative or surgical treatment, and 30 healthy postmenopausal women served as controls. Thyroid parameters were measured, and BMD values were obtained by dual energy x-ray absorptiometry scan.Femoral neck and lumbar spine BMD and T-scores were significantly lower in newly diagnosed patients compared with the control group, but a difference was not observed between the treated and control groups. Statistical analysis revealed a strong and significant negative correlation between femoral neck and lumbar spine BMD and TRAb values.Both surgical and conservative therapies are effective for restoring BMD in postmenopausal patients with Graves' disease, and the increased level of TRAb can be a useful marker of bone density impairment.

AIM:The role of behavioural factors and sleep duration and quality is important in the pathogenesis of obesity. The aim of our study was to evaluate the effects of behavioural risk factors on melatonin secretion in women.SUBJECTS AND METHODS:In total, 120 female patients were enrolled in the study and divided into two groups according to the body mass index. Detailed history, anthropometric measurements, urine and blood samples were evaluated for each patient.RESULTS:Two groups significantly differed in weight, BMI, and waist circumference, and were 94.2 ± 14.9 kg, 33.4 ± 5.23 kg/m2 and 99.2 ± 12.6 cm for the study group and 56.0 ± 5.2 kg, 20.0 ± 1.8 kg/m2 and 60.1 ± 10.4 cm for the control group, respectively, sleep disruptions were detected in 48 patients from study group, with mean score 6.76 ± 3.6, and only 10 patients were detected in the control group, with mean score 4.42 ± 1.68. Eating disturbances were revealed in 66 patients from the study group and 21 patients from the control group. Melatonin levels were 17% higher in the study group, compared to control group.CONCLUSION:Higher melatonin levels in patients with obesity and concomitant behavioural impairments may be due to its protective effect to fight free radicals and to induce vasodilatation. Further studies are needed to confirm our finding.

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BACKGROUND AND AIM: Leptin was assessed to play a coordinating role in obesity and its cardio-vascular complications, however the findings are conflicting and further clinical investigation is required. The aim of the present study was to evaluate the association of serum leptin with cardio-vascular risk factors in different body mass index and age groups.MATERIALS AND METHODS:  One hundred and forty nine female patients were enrolled in the study and divided into groups according to body mass index (BMI) and age. Following measurements were carried out: height, weight, BMI, waist circumference, blood pressure. Venous blood sample was obtained for plasma leptin, insulin, glucose and lipid profile analysis. Insulin resistance index was calculated for each patient. Body fat distribution was measured using Dual energy X-ray Absorbtiometry.RESULTS: The lowest leptin concentration was observed in overweight patients, the highest concentration was seen in obese patients. The difference between leptin levels were not observed in age groups. Leptin positively correlated with high density lipoprotein cholesterol levels in obese and elder patients.CONCLUSION: Leptin might act as a preventive measure for cardiovascular complications only in the presence of sufficient amount of fat mass. Further studies are warranted in order to support these results