INTRODUCTION: Identifying reliable biomarkers to predict spontaneous abortion (SA), particularly in pregnancies without fetal chromosomal abnormalities, remains a critical objective in obstetric care. This retrospective...INTRODUCTION: Identifying reliable biomarkers to predict spontaneous abortion (SA), particularly in pregnancies without fetal chromosomal abnormalities, remains a critical objective in obstetric care. This retrospective cohort study assessed the predictive utility of serum β-human chorionic gonadotropin (β-hCG), estradiol, and progesterone concentrations in patients experiencing SA with confirmed chromosomally normal chorionic villi. MATERIAL AND METHODS: A retrospective analysis was conducted on clinical and laboratory data from 76 patients who experienced SA between 5 and 10 weeks of gestation and received care at the Department of Obstetrics and Gynecology of our hospital between 2019 and 2024. All patients underwent uterine evacuation, and chorionic villus specimens were assessed for chromosomal abnormalities using next-generation sequencing (NGS). Based on NGS findings, two groups were defined: patients without fetal chromosomal abnormalities [n = 36; defined as no structural variants > 0.1 megabase pairs (Mb)] and patients with fetal chromosomal abnormalities (n = 40; variants > 1 Mb). An additional control group (n = 100) with uncomplicated, ongoing pregnancies was included for comparison. Serum concentrations of βhCG, estradiol, and progesterone were measured and compared across groups in the pregnant women. RESULTS: Peak serum β-hCG concentrations were significantly lower in the SA group without chromosomal abnormalities compared to both the chromosomally abnormal SA group and the control group. Similarly, peak progesterone and estradiol concentrations were lowest in the SA group without chromosomal abnormalities (p < 0.05). Among the three biomarkers, estradiol demonstrated the highest discriminatory capacity. A significantly higher rate of early serum estradiol decline was observed in the SA group without chromosomal abnormalities compared to the group with abnormalities (p = 0.027). In contrast, no significant differences were found in the rate of progesterone decline across the groups. The median estradiol concentration at the time of initial decline was also significantly lower in the SA group without chromosomal abnormalities than in the other two groups. CONCLUSION: Early decline in serum estradiol levels may serve as a superior biomarker for predicting SA not associated with fetal chromosomal abnormalities. In contrast, serum β-hCG and progesterone concentrations exhibited limited predictive value in this context. These findings support consideration of serum estradiol monitoring to facilitate timely clinical intervention in pregnancies at increased risk for non-chromosomal miscarriage.
INTRODUCTION: Peptide YY (PYY), a key satiety hormone, exhibits altered serum concentrations in body weight disorders, although its role remains debated. Conflicting adult studies highlight the need to clarify PYY 1-36 d...INTRODUCTION: Peptide YY (PYY), a key satiety hormone, exhibits altered serum concentrations in body weight disorders, although its role remains debated. Conflicting adult studies highlight the need to clarify PYY 1-36 dynamics in pediatric populations with anorexia nervosa (AN) and obesity (OB). MATERIAL AND METHODS: Fasting serum PYY 1-36 concentrations were analyzed in 199 girls: 58 with restrictive AN [median age 15.0 (interquartile range; IQR): 14.0-16.0 years], 52 with OB [14.3 (12.3-16.3) years], and 89 healthy controls (C) [16.5 (15.5-17.5) years]. Anthropometric and metabolic/hormonal parameters were assessed. Group differences were evaluated using the Kruskal-Wallis rank-sum test. Relationships between fasting serum peptide YY (PYY) 1-36 concentrations and demographic/clinical parameters were examined using Spearman rank correlation coefficients. RESULTS: AN patients had significantly higher PYY 1-36 levels [77.2 (71.1-82.4) pg/mL] compared to OB [36.0 (34.3-38.5) pg/mL] and C [49.7 (46.7-51.5) pg/mL; p < 0.001]. A strong inverse correlation between PYY and body mass index (BMI) was observed across all subjects (Rho = -0.8, p < 0.001). Receiver operating characteristic (ROC)-derived cut-offs differentiated AN (> 59.04 pg/mL; sensitivity 95%, specificity 100%) and OB (< 43.18 pg/mL; sensitivity 89%, specificity 90%) from C. CONCLUSIONS: 1. Our research underscores significant PYY concentration disparities among weight disorders. 2. Significant differences in PYY concentrations in girls with body weight disorders as compared to healthy girls with normal body weight may indicate a role of this peptide in the body's adaptation to maintain energy homeostasis in connection with the ongoing disease.
INTRODUCTION: Researchers reported on the pathogenic role of hypercholesterolemia in thyroid orbitopathy (TO) and the use of statins in its prevention and treatment. To confirm these observations, we conducted a prospect...INTRODUCTION: Researchers reported on the pathogenic role of hypercholesterolemia in thyroid orbitopathy (TO) and the use of statins in its prevention and treatment. To confirm these observations, we conducted a prospective study of patients with Graves' and Basedow's disease (GBD) to evaluate the relationship between the presence of TO and levels of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglyceride (TG), and apolipoproteins A1 and B (Apo A1, Apo B), along with the impact of immunosuppressive treatment on the lipid profile. MATERIAL AND METHODS: Forty-seven patients with GBD diagnosed within the past 12 months were eligible for the study. In the GBD group, 31 patients were diagnosed with active TO and qualified for immunosuppressive treatment, while 16 patients did not have TO. TC, TG, HDL-C, and LDL-C levels were measured in serum using enzymatic methods, and Apo A-1 and Apo B levels were determined by immunoturbidimetric methods. RESULTS: The mean TC concentration in patients with active TO who qualified for immunosuppressive treatment was 207.7 ± 42.7 mg/dL, significantly higher than the values in GBD patients without TO symptoms (191.5 ± 47.8 mg/dL). After completing immunosuppressive treatment, the mean TC concentration increased to 214.3 ± 49.8 mg/dL, remaining significantly higher than before treatment. The mean LDL-C concentration in patients with active TO was 131.6 ± 40.4 mg/dL and was higher, though not significantly, compared to the GBD group without TO symptoms (122.6 ± 49.0 mg/dL). After immunosuppressive treatment, the mean LDL-C levels increased to 142.1 ± 54.5 mg/dL and were also significantly higher than before treatment. Additionally, the mean Apo B concentration in patients with active TO was significantly higher than in patients without TO. After immunosuppressive treatment, the mean Apo B concentration increased and remained significantly higher than before treatment. There was no significant difference in HDL-C, Apo A1, and TG concentrations between the groups with and without TO, nor their levels after immunosuppressive treatment. CONCLUSIONS: The use of statins as adjunctive therapy in GBD patients with active TO qualified for immunosuppressive treatment is reasonable due to the increase in TC, LDL-C, and Apo B levels during treatment, as well as for their pleiotropic effects, including their anti-inflammatory effects.
INTRODUCTION: Polycystic ovary syndrome (PCOS) is a condition characterized by chronic hormonal and metabolic disturbances, commonly presenting with amenorrhea, hirsutism, and multiple ovarian cysts. Asprosin and subfati...INTRODUCTION: Polycystic ovary syndrome (PCOS) is a condition characterized by chronic hormonal and metabolic disturbances, commonly presenting with amenorrhea, hirsutism, and multiple ovarian cysts. Asprosin and subfatin are adipokines synthesized by adipose tissue and are associated with metabolic disorders. This study aimed to investigate these adipokines in normal-weight women with PCOS. MATERIAL AND METHODS: A total of 60 normal-weight women were recruited in the study, including 30 diagnosed with PCOS according to the Rotterdam criteria and 30 healthy controls. Serum samples were collected on the third day of the menstrual cycle after an overnight fast in the morning. Demographic, metabolic, and hormonal parameters of the participants were subsequently analyzed. RESULTS: In the PCOS group, levels of homeostatic model assessment of insulin resistance (HOMA-IR) index, insulin, asprosin, total testosterone, and Ferriman-Gallwey score were significantly higher compared with the control group. No significant difference was found in subfatin levels between the groups. Correlation analysis showed positive associations of asprosin with weight, body mass index (BMI), waist circumference, insulin, HOMA-IR, and C-reactive protein (CRP). In addition, receiver operating characteristic (ROC) analysis identified an asprosin cut-off value of 39.25 ng/mL, which yielded an area under the curve (AUC) of 0.760 [95% confidence interval (CI): 0.641-0.879], with a sensitivity of 66.7% and a specificity of 73.3% (p = 0.001). Furthermore, binary logistic regression analysis revealed that the plasma asprosin level was significantly correlated with PCOS in a model after controlling for age, BMI, and HOMA-IR [odds ratio (OR): 1.036, 95% CI: 1.000-1.073; p = 0.048], suggesting that asprosin could be an independent risk factor for PCOS. CONCLUSIONS: Asprosin, but not subfatin, was significantly elevated in non-obese women with PCOS. It may serve as a marker of PCOS independent of insulin resistance in normal-weight women.
INTRODUCTION: Polycystic ovary syndrome (PCOS) is characterized by ovulation disturbance, hyperandrogenemia, and polycystic ovary, causing infertility. There is a lack of unified conclusions on the pathogenesis of PCOS,...INTRODUCTION: Polycystic ovary syndrome (PCOS) is characterized by ovulation disturbance, hyperandrogenemia, and polycystic ovary, causing infertility. There is a lack of unified conclusions on the pathogenesis of PCOS, resulting in challenges in the clinical management. This study evaluated the potential of miR-1271-5p in diagnosing PCOS and its regulatory effect on granulosa cells, aiming to explore a potential therapeutic target for PCOS. MATERIAL AND METHODS: This study enrolled 189 PCOS patients with 107 healthy women as the control group. Serum miR-1271-5p was assessed by quantitative polymerase chain reaction (qPCR), and its clinical significance was evaluated from the perspectives of diagnosis and correlation with clinical symptoms. In vitro, the regulatory effects of miR-1271-5p on granulosa cell injury (KGN cell induced by lipopolysaccharide, LPS) were evaluated from the perspectives of cell growth, apoptosis, oxidative stress, and inflammation. The regulatory mechanism was estimated through the target prediction. RESULTS: miR-1271-5p was upregulated in PCOS, discriminating PCOS patients and correlated with obesity, insulin resistance, and hormone disturbance of PCOS patients. miR-1271-5p, and insulin resistance- and hormone-related features, was identified as risk factors for PCOS. In KGN cells, miR-1271-5p targeted PRKAR1A and negatively regulated its expression. Silencing miR-1271-5p could alleviate LPS-induced cell injury, including reduced cell viability, oxidative stress, and inflammation. Knocking down PRKAR1A could reverse the protective effects of miR-1271-5p on KGN cells. CONCLUSIONS: miR-1271-5p served as a biomarker for PCOS, predicting disease risk and diagnosing disease onset. The miR-1271-5p/PRKAR1A axis regulated granulosa cell injury under LPS, which can be considered a potential therapeutic target for PCOS.
INTRODUCTION: Primary thyroid lymphoma (PTL) is a rare thyroid malignancy, usually presenting as a rapidly enlarging neck mass. We aimed to describe its clinical, biochemical, imaging, and pathological features. MATERIAL...INTRODUCTION: Primary thyroid lymphoma (PTL) is a rare thyroid malignancy, usually presenting as a rapidly enlarging neck mass. We aimed to describe its clinical, biochemical, imaging, and pathological features. MATERIAL AND METHODS: Retrospective single-center study, including 20 patients diagnosed with PTL between 2000 and 2023 (median age 76 years, range 47-84; 85% female). Clinical presentation, thyroid function, imaging, histopathology, treatment, and outcomes were reviewed. RESULTS: Nineteen patients (95%) presented with a rapidly growing neck mass with a median duration of one month. Compressive symptoms occurred in 70%, and B symptoms in 20%. Hypothyroidism was present in 45%, and thyroid autoimmunity in 67% of patients with available data. Ultrasound (performed in 16 patients) showed hypoechoic nodules in most cases, with a mean size of 49.7 mm; cervical lymphadenopathy was observed in 20%. Fine-needle aspiration (FNA) suggested lymphoma in 78%. Histological confirmation was obtained by core-needle biopsy in 70%, incisional biopsy in 10%, and surgery in 15%. Nineteen patients (95%) had diffuse large B-cell lymphoma, and one had mucosa-associated lymphoid tissue (MALT) lymphoma. At presentation, 59% had localized disease, 12% regional, and 29% disseminated. Two patients died before treatment. Most received R-CHOP (rituximab, cyclophosphamide, adriamycin, vincristine, and prednisolone) or reduced-dose R-CHOP (R-miniCHOP); three also underwent radiotherapy. Complete remission was achieved in 61% of patients. Median follow-up was 2.5 years. CONCLUSIONS: PTL should be suspected in patients with a rapidly enlarging thyroid mass. While FNA is often informative, biopsy is usually required for diagnosis. Most cases are diffuse large B-cell lymphoma, with chemotherapy as the mainstay of treatment. Larger studies are needed to refine diagnostic pathways and prognostic markers.
INTRODUCTION: Radioiodine-refractory differentiated thyroid cancer (RAIR DTC), although rare, constitutes a real clinical challenge due to its prognosis despite a growing number of available treatment modalities. This st...INTRODUCTION: Radioiodine-refractory differentiated thyroid cancer (RAIR DTC), although rare, constitutes a real clinical challenge due to its prognosis despite a growing number of available treatment modalities. This study aimed to analyze the real-world efficacy and toxicity of lenvatinib therapy in a group of Polish patients with advanced RAIR DTC. MATERIAL AND METHODS: A group of 27 patients was eligible for lenvatinib therapy due to measurable, progressive, RAIR DTC, of whom 21 ultimately received the treatment. Treatment outcomes were assessed in terms of Response Evaluation Criteria in Solid Tumors (RECIST) as well as Kaplan-Meier estimates of overall survival and progression-free survival (PFS) for the whole cohort and for subgroups receiving lenvatinib as the first or subsequent line of targeted therapy. PFS was reported using both intention-to-treat (ITT) and per-protocol (PP) definitions, depending on whether treatment discontinuation was treated as censoring. Treatment toxicity was evaluated according to Common Terminology Criteria for Adverse Events (CTCAE). RESULTS: Median overall survival (OS) in the whole group was 38.9 months [95% confidence interval (CI): 23.8- not reached (NR)], while one-year and two-year survival rates were 0.85 (95% CI: 0.72-1.00) and 0.63 (95% CI 0.45-0.89), respectively. ITT-PFS was 21.3 months (95% CI: 12.2-NR). One-year ITT-PFS was 0.75 (95% CI: 0.57- .00), while 2-year ITT-PFS was 0.44 (95% CI: 0.22-0.76). Similar estimates were obtained using the PP-PFS definition. All patients reported treatment-related side effects, the most common being proteinuria, weight loss, hypertension, and mucositis. CONCLUSION: This retrospective analysis of a Polish RAIR thyroid cancer cohort demonstrated very good efficacy of lenvatinib in the first-line setting, while its activity in the second-line setting, although still present, was reduced. Based on these results, we suggest that lenvatinib should again be available for the treatment of RAIR thyroid cancer in Poland.
INTRODUCTION: Sodium-glucose cotransporter 2 inhibitors (SGLT2i) have demonstrated cardiovascular benefits in patients with type 2 diabetes mellitus (T2DM). The aim of this study was to assess the effects of SGLT2i thera...INTRODUCTION: Sodium-glucose cotransporter 2 inhibitors (SGLT2i) have demonstrated cardiovascular benefits in patients with type 2 diabetes mellitus (T2DM). The aim of this study was to assess the effects of SGLT2i therapy on heart failure (HF)-related biomarkers - galectin‑3 (GAL‑3) and N-terminal pro-B-type natriuretic peptide (NT‑proBNP) - as well as on echocardiographic parameters of cardiac function in patients with T2DM and established cardiovascular disease (CVD). MATERIAL AND METHODS: This prospective study included 61 patients with T2DM, all naïve to SGLT2i and with documented CVD. Patients were initiated on dapagliflozin or empagliflozin and followed for a minimum of 6 months (mean follow-up: 9 months). Baseline and post-treatment levels of GAL‑3 and NT‑proBNP were measured. Echocardiographic evaluation included left ventricular ejection fraction (LVEF) and diastolic function parameters. RESULTS: Following treatment, a significant reduction in NT‑proBNP concentrations was observed (p = 0.002), along with reductions in GAL‑3 levels, body weight, and body mass index (BMI). LVEF significantly improved, with concomitant reductions in interventricular septum (IVS) and posterior wall thickness. NT‑proBNP concentrations were higher in patients with atrial fibrillation, whereas GAL‑3 levels were lower in those with BMI ≥ 30 kg/m². A significant inverse correlation between estimated glomerular filtration rate (eGFR) and NT‑proBNP was noted. No major adverse cardiovascular events occurred, and no patient required intensification of HF therapy. Two patients discontinued treatment due to urogenital tract infections. CONCLUSIONS: In patients with T2DM and established CVD, SGLT2i therapy was associated with significant improvements in left ventricular function and reductions in HF-related biomarkers, supporting the cardioprotective and nephroprotective effects of this drug class.
INTRODUCTION: Type 2 diabetes mellitus (T2DM) with secondary cerebral infarction often leads to cognitive dysfunction (CD), impacting patients' quality of life and prognosis. The aim of the study was to explore factors i...INTRODUCTION: Type 2 diabetes mellitus (T2DM) with secondary cerebral infarction often leads to cognitive dysfunction (CD), impacting patients' quality of life and prognosis. The aim of the study was to explore factors influencing CD in T2DM patients with cerebral infarction and develop a prediction model. MATERIAL AND METHODS: This was a retrospective analysis of 244 T2DM patients with cerebral infarction treated from January 2020 to December 2023. Patients were split into a training set (n = 170) and a test set (n = 74). Logistic regression and random forest models were developed using RStudio. RESULTS: Logistic regression analysis indicated that age, 25-hydroxyvitamin D [25(OH)D], and triglyceride (TG) were independent influencing factors for CD in patients. In the random forest model, the variables were prioritized based on their importance, with 25(OH)D ranked highest, followed by age, TG, National Institute of Health stroke scale (NIHSS) score, duration of T2DM, and diabetic neuropathy. The area under the receiver operating characteristic curve (AUC) for the Logistic model was 0.799 in the training set and 0.793 in the test set, while the AUC values for the random forest model were recorded at 0.875 and 0.804, respectively. The predicted probabilities of both models in the training and test sets aligned well with the actual incidence of CD. CONCLUSION: Age, 25(OH)D, and TG are key factors for CD in T2DM patients with cerebral infarction. The random forest model showed superior predictive performance, making it a promising tool for clinical use.
INTRODUCTION: MicroRNAs (miRNAs) are involved in the pathogenesis of various diseases. Although the role of miR-490-5p in bone-related disorders has been reported, its regulatory mechanism in osteoporotic fractures remai...INTRODUCTION: MicroRNAs (miRNAs) are involved in the pathogenesis of various diseases. Although the role of miR-490-5p in bone-related disorders has been reported, its regulatory mechanism in osteoporotic fractures remains unclear. Therefore, this study aims to investigate the functional mechanism of miR-490-5p in osteoporotic fractures. MATERIAL AND METHODS: Human osteoblast cells (hFOB1.19) were induced to undergo differentiation, during which the expression levels of miR-490-5p, forkhead box P3 (FOXP3), and claudin 14 (CLDN14) were quantified using real-time quantitative polymerase chain reaction (RT-qPCR). Osteoporotic animal models and osteoporotic fracture models were established to evaluate miR-490-5p expression. Osteoporosis-related biomarkers were assessed via alkaline phosphatase (ALP) activity assays and commercial assay kits. Rescue experiments were performed to validate the findings. RESULTS: miR-490-5p inhibited osteoblast differentiation. It was highly expressed in osteoporotic bone tissue and at the fracture ends of osteoporotic fractures. Mechanistically, miR-490-5p inhibited the expression of FOXP3 by binding to the 3'UTR of FOXP3, thereby suppressing RUNX1 transcriptional activation of CLDN14, leading to the progression of osteoporotic fractures. CONCLUSION: miR-490-5p inhibits RUNX1 transcriptional activation of CLDN14 through FOXP3, promoting the development of osteoporotic fractures.
Obesity, regardless of age, is associated with various metabolic disorders. Amino acids, as essential food ingredients, play a critical role in regulating glucose and energy metabolism. Thus, their plasma concentrations...Obesity, regardless of age, is associated with various metabolic disorders. Amino acids, as essential food ingredients, play a critical role in regulating glucose and energy metabolism. Thus, their plasma concentrations may reflect the metabolic state of the individual. This narrative review aims to find out similarities in plasma amino acid profiles across the selected obese individuals (children, adolescents, and adults). An analysis of 21 original studies revealed similar amino acid alterations regardless of the age group- in particular, elevated levels of branched-chain amino acids (BCAAs: isoleucine, leucine, valine), tyrosine, glutamic acid, alanine, and proline, as well as decreased concentrations of glutamine, serine, glycine, and asparagine. These findings suggest the presence of a common, age-independent metabolic signature of amino acids in obesity. Such changes may reflect impaired amino acid catabolism and have been linked to insulin resistance, increased risk of type 2 diabetes risk, and other metabolic complications. There is a need to establish age- and population-specific reference values for plasma amino acids to use amino acid profiling as a diagnostic and prognostic tool management of obesity. Accurate plasma amino acid profile measurements could support early detection of obesity-related metabolic disturbances and the implementation of targeted nutritional and therapeutic strategies.