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Controlled Clinical Trial 2008; 29(1): 117-124 PubMed PMID: 18283240 Citation  Keywords:  Adult, Bacterial Translocation:physiology, Brain:physiopathology, Depressive Disorder, Major:immunology, Enterobacteriaceae:metabolism, Female, Gastrointestinal Tract:physiopathology, Humans, Immunoglobulin A:blood, Immunoglobulin M:blood, Intestinal Muco.   

: There is now evidence that major depression (MDD) is accompanied by an activation of the inflammatory response system (IRS) and that pro-inflammatory cytokines and lipopolysacharide (LPS) may induce depressive symptoms. The aim of the present study was to examine whether an increased gastrointestinal permeability with an increased translocation of LPS from gram negative bacteria may play a role in the pathophysiology of MDD. Toward this end, the present study examines the serum concentrations of IgM and IgA against LPS of the gram-negative enterobacteria, Hafnia Alvei, Pseudomonas Aeruginosa, Morganella Morganii, Pseudomonas Putida, Citrobacter Koseri, and Klebsielle Pneumoniae in MDD patients and normal controls. We found that the prevalences and median values for serum IgM and IgA against LPS of enterobacteria are significantly greater in patients with MDD than in normal volunteers. These differences are significant to the extent that a significant diagnostic performance is obtained, i.e. the area under the ROC curve is 90.1%. The symptom profiles of increased IgM and IgA levels are fatigue, autonomic and gastro-intestinal symptoms and a subjective feeling of infection. The results show that intestinal mucosal dysfunction characterized by an increased translocation of gram-negative bacteria (leaky gut) plays a role in the inflammatory pathophysiology of depression. It is suggested that the increased LPS translocation may mount an immune response and thus IRS activation in some patients with MDD and may induce specific "sickness behaviour" symptoms. It is suggested that patients with MDD should be checked for leaky gut by means of the IgM and IgA panel used in the present study and accordingly should be treated for leaky gut....

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Journal Article 2008; 29(1): 178-184 PubMed PMID: 18283239 Citation  Keywords:  Adult, Alkaline Phosphatase:blood, Bone Density:physiology, Bone Diseases, Metabolic:blood, Bone and Bones:metabolism, Case-Control Studies, Female, Humans, Hyperprolactinemia:blood, Middle Aged, Parathyroid Hormone:blood, Peptide Fragments:blood, Prognos.   

OBJECTIVES: Hyperprolactinemia could be one of possible causes of bone loss. The reason is thought to be connected with hypogonadism due to PRL excess and the role of other hormones like PTH and PTH-rP. There is no data on the influence of PTH fractions (CAP and CIP) on bone turnover and density in hyperprolactinemia. The aim of the study was to assess the influence of PTH and its fractions on bone metabolism in hyperprolactinemia of various origin.

MATERIAL AND METHODS: The study was carried out in 75 women. Group I consisted of 32 women with prolactinoma, group II consisted of 43 women with functional hyperprolactinemia. Both groups were subdivided in patients with hypogonadism and normal gonadal function. The control group consisted of 29 healthy women. In all subjects PRL, PTH and its fractions (CAP, CIP), and bone turnover markers (BAP, ICTP) were studied. BMD measurement was carried out using DXA.

RESULTS: In patients with functional hyperprolactinemia i-PTH and CAP levels were lower than in controls. CIP concentrations were lower in patients than in controls. CAP/CIP ratio was higher in patients with prolactinoma than in patients with functional hyperprolactinemia and controls. Higher values of bone turnover markers (BAP, ICTP) in patients groups and subgroups were shown as compared to controls. Some correlations between PTH and its fractions, and BMD and bone turnover were observed.

CONCLUSIONS: There is no direct benefit from the assessment of parathormone fractions and CAP/CIP ratio in the prognosis of bone metabolism changes in hyperprolactinemia of various origin....

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Journal Article 2008; 29(1): 37-40 PubMed PMID: 18283238 Citation  Keywords:  Anorexia Nervosa:physiopathology, Humans, Hypothalamo-Hypophyseal System:physiopathology, Intracellular Signaling Peptides and Proteins:physiology, Leptin:physiology, Neuropeptides:physiology, Orexins, Pituitary-Adrenal System:physiopathology, Psychomotor.   

: Anorexia nervosa (AN) belongs to a group of eating disorders and is characterized by extreme body weight loss. AN patients show combination of physical, psychological and behavioral disturbances. Neuropeptides partly control energy homeostasis and modulate hormone release. Leptin, a peptide secreted by adipocytes, may influence the interactions between central and peripheral signals. Hypoleptinaemia found in AN is connected with disturbed control of appetite and hormonal dysfunction as well as has implications for the hypothalamo-pituitary-gonadal axis, bone mineral density and physical hyperactivity. Low leptin levels are increased with refeeding. However, the prolonged hypoleptinaemia in weight recovered AN patients may result in persistent hypothalamic amenorrhoea. The hyperactivity has been observed in 31-80 % of AN cases. The mechanisms underlying the hyperactivity found in patients with anorexia nervosa seem to be more complicated as many factors including neuropeptides may be involved. Orexins may affect not only appetite but also behavior and psychophysical activity as they may regulate reproductive and stress hormone secretion, stimulate a variety of stereotypic behaviors including eating and stress reaction, and affect the hypothalamo-pituitary-adrenal (HPA) axis, alter glucocorticoid and catecholamine secretion and activate the sympathetic nervous system. Orexins influence the mechanism regulating arousal and sleep, cardiovascular function, temperature, metabolic rate and locomotive activity. It is worth considering how abnormal activity of hypothalamic neuropeptides or their receptors may play a role in the mechanisms of hyperactivity, disturbed control of appetite and hormonal dysfunction in patients with anorexia nervosa....

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Journal Article 2007; 28(6): 807-810 PubMed PMID: 18063948 Citation  Keywords:  Adolescent, Adult, Area Under Curve, Blood Glucose:metabolism, Body Mass Index, Chi-Square Distribution, Diabetes Mellitus, Type 2:blood, Energy Metabolism:physiology, Fasting:blood, Female, Glucose Tolerance Test, Homeostasis:physiology, Humans, Insulin:.   

OBJECTIVE: To analyze the clinical and metabolic characteristics of large-scale Chinese women with polycystic ovary syndrome (PCOS).

DESIGN: Retrospective study.

SETTING: Hospital-based IVF center.

PATIENT(S): Patients with PCOS.

METHODS: In the present study, one thousand and forty PCOS patients were selected from women who visited the Reproductive Medicine Center at Shandong Provincial Hospital Shandong University between January 2002 and December 2006. All the patients had been performed a 75 g OGTT. Clinical characteristics, serum hormonal levels, glucose levels, insulin levels and lipid profiles were reviewed.

INTERVENTIONS: An oral glucose tolerance test and insulin release test were performed for each woman. After overnight fasting, blood samples were collected to determine fasting blood glucose, blood glucose and insulin (30 min, 60 min, 120 min, 180 min) after digesting 75 g glucose, luteotrophic hormone (LH), follicle-stimulating hormone (FSH), testosterone (T), prolactin (PRL), estradiol (E2), and blood lipid levels.

MAIN OUTCOME MEASURES: Height, weight, waistline, hip circumference, F-G grade for hirsutism, gonadal hormone results, blood lipid level, blood glucose tolerance, each-moment insulin level, and family history were determined.

RESULTS: (i) The presence of oligomenorrhea was 62.6% while amenorrhea was 19.71%. Menstrual disorder of all the adult patients could be traced back to their adolescent menarche. There were 450 obesity cases of which 259 patients were central obesity. The incidence of acanthosis nigricans was 15.19%, 65.19% with obesity. (ii) Cholesterol (4.8 +/- 0.98 vs 4.61 +/- 0.86) and LDL (3.80 +/- 6.92 vs 2.88 +/- 1.01) were both significantly higher in the obesity patients than the non obesity patients. (iii) 173 patients were diagnosed as diabetes mellitus (DM), 179 IGT, 27 IFG and 9 (IFG and IGT). Those women with plasma glucose values abnormality of 0, 30 min, 60 min, 120 min, 180 min were 19 cases 0.98% (19/173), 74 cases 42.77% (74/173), 110 cases 63.58% (110/173), 42 cases 24.28% (42/173) and 12 cases 6.94% (12/173) respectively. Ten (10/173) patients would have been undetected if fasting plasma glucose levels were not evaluated, while omission of 30 min, 60 min, 120 min, or 180 min plasma glucose levels would have resulted in 16 cases (16/173), 50 cases (50/173), 28 cases (28/173) and 1 case (1/173) being missed respectively. If we took three times blood samples to evaluate plasma glucose levels, 39 cases (39/173) (0 min + 30 min +60 min), 102 cases (0 min + 30 min + 120 min), 21 cases (0 min + 30 min + 180 min), 34 cases (0 min + 60 min + 120 min), 45 cases (0 min + 60 min + 180 min), 123 cases (0 min + 120 min + 180 min) would be missed. Compared AUC of plasma glucose and insulin in 5 times with 3 times (0 min + 30 min + 60 min), the differences were statistically significant. Body mass index (BMI) was positively correlated with HOMA-IR (r = 0.29987 (P<0.01) as well as WHR (r = 0.12441, P<0.0001).

CONCLUSIONS: (i) The prevalence rate of obesity was higher in PCOS. The state of obesity had a positive relation with insulin resistance. (ii) The prevalence rate of lipid profiles abnormality in obesity group was higher than in non-obesity. (iii) OGTT was the essential examination for all the PCOS patients....

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Comparative Study 2007; 28(6): 765-774 PubMed PMID: 18063946 Citation  Keywords:  Adolescent, Analysis of Variance, Chi-Square Distribution, Child, Child, Preschool, Circadian Rhythm:physiology, Female, Growth Disorders:blood, Human Growth Hormone:deficiency, Humans, Hypopituitarism:blood, Hypothalamo-Hypophyseal System:abnormalities, .   

OBJECTIVES: Prolactin (Prl) secretion in children manifests circadian rhythm. The aim of the study was to assess circadian Prl pattern in children with growth hormone deficiency (GHD) and congenital organic disorders in the hypothalamic-pituitary region (HPR).

MATERIAL AND METHODS: The analysis comprised 47 children (aged: 11.05+/-3.5 years) with GHD, divided (based on MRI) into subgroups: NORM (no disturbances in HPR); HP (pituitary hypoplasia) and PSIS (pituitary stalk interruption syndrome). The profile of circadian Prl secretion was determined, based on Prl measurements in serum every 3 hours during 24 hours. The macroscopic analysis of circadian Prl rhythm in particular groups was performed. The comparison group consists of 41 children (aged: 11.45+/-3.20 years) with idiopathic short stature (ISS).

RESULTS: In GHD-HP, diurnal and nocturnal Prl concentrations were low but with the dispersion between them and with normal rhythm in most of cases. In GHD-PSIS, diurnal and nocturnal Prl concentrations were on the same level and the rhythm was not observed in most of cases. No significant differences were found in Prl secretions and Prl rhythm between GHD-NORM and ISS. The rhythm of Prl secretion was disturbed in: 72.7% of children with GHD-PSIS, 23.5% - with GHD-HP, 10.5% with GHD-NORM and 7.3% with ISS, only.

CONCLUSIONS: Congenital organic lesions of HPR are associated with quantitative disorders and changes of the circadian pattern of Prl secretion. In children with GHD without organic lesions of HPR, the circadian rhythm of Prl secretion was not different from that with ISS....

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Comparative Study 2007; 28(6): 801-806 PubMed PMID: 18063945 Citation  Keywords:  Adult, Age Factors, Aging:physiology, Anthropometry, Biomarkers, Blood Pressure:physiology, Body Mass Index, Humans, Male, Middle Aged, Paraplegia:physiopathology, Reference Values, Vision Tests, Vision, Ocular:physiology, Vital Capacity:physiology,.   

: The actual level of the true aging of an organism is characterized by its biological age. By the means of measuring the function ability of its physiological systems, it is possible to evaluate the biological age and use it as an indicator of premature aging. Inclusion of the biological age screening among the basic health precautions should offer yet another viewpoint on how to objectively measure the changes in an organism corresponding to aging. The article presents a comparison of age dependency of selected biomarkers between groups of healthy men and paraplegics. The measurement of the battery of biomarkers was run in a group of 25 healthy male adults between 36 and 54 years of age. The second group was formed by 20 paraplegics - men between 33 and 50 years of age. In spite of small size of the groups, significant differences were found in 4 of 6 biomarkers....

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Journal Article 2007; 28(6): 723-726 PubMed PMID: 18063944 Citation  Keywords:  Consciousness:physiology, Cortical Synchronization:psychology, Dissociative Disorders:complications, Humans, Perception:physiology, Perceptual Disorders:complications, Schizophrenia:complications, Schizophrenic Psychology,.   

: At this time is thought that binding of synchronized and distributed activity is crucial for the mechanism of consciousness. There are suggestive findings that disturbances in this feature binding produce disintegration of consciousness in schizophrenia. It leads to disturbances in reflection of the self and dissociated psychic fragments may be experienced as parts of the external world. Disturbances in the feature binding that lead to disintegration in neural communication among some parts of the brain thus seem to be a neurophysiological counterpart of psychological dissociative processes related to stress response and cognitive, affective and neuroendocrine dysregulation....

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Comparative Study 2007; 28(6): 868-874 PubMed PMID: 18063940 Citation  Keywords:  Adult, Case-Control Studies, Cerebrum:physiopathology, Depressive Disorder:complications, Dissociative Disorders:complications, Electroencephalography, Epilepsy, Complex Partial:complications, Female, Functional Laterality:physiology, Galvanic Skin Respon.   

OBJECTIVES: Recent evidence indicates frequent EEG abnormalities in dissociated patients. This evidence is in agreement with findings that in certain psychiatric patients, psychosensory symptoms of epileptogenic nature, the so-called complex partial seizure-like symptoms occur. With respect to these findings, a hypothesis examined in this study states that increased level of experienced traumatic stress and dissociation in pathological conditions such as schizophrenia or depression relates to increased score of complex partial seizure-like symptoms. Also is suggested that the complex partial seizure-like symptoms might be related to unilateral hemispheric electrophysiological dysfunction, stress and dissociation.

PARTICIPANTS AND METHODS: Psychometric assessment of dissociation, stress and measurement of right-left asymmetry of bilateral EDA in patients with schizophrenia (N=34) and depression (N=41) in comparison to healthy controls (N=36).

RESULTS: Results indicate that increased traumatic stress and dissociation in both groups of patients significantly relate to increased level of complex partial seizure-like symptoms, and may cause the right-left EDA asymmetry.

CONCLUSIONS: The data suggest relationship between left-hemispheric asymmetry and sympathetic over-activation in schizophrenia, and between right-hemispheric asymmetry with sympathetic under-activation in depression....

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