Anna Modzelewska

Ghrelin in Gestational Diabetes: Serum Level and mRNA Expression in Fat and Placental Tissue

OBJECTIVES We studied the effect of an oral glucose load on circulating ghrelin, as well as ghrelin and ghrelin receptor (GHS-R1a) mRNA expression in subcutaneous adipose tissue (SAT), visceral adipose tissue (VAT) and placental tissue from pregnant women with gestational diabetes (GDM) and normal glucose tolerance (NGT). METHODS Plasma total ghrelin levels were measured in 58 patients with GDM and 61 women with NGT by radioimmunoassay. Ghrelin and GHS-R1a mRNA expression was studied in 16 subjects with GDM and 20 healthy pregnant women at term, using RT-PCR. RESULTS Basal ghrelin concentrations and the maximal decrease in ghrelin levels after glucose load did not differ in the women with GDM and NGT (399.1 [299.6-563.3] pg/ml vs. 400.9 [302.3-475.8] pg/ml and 127.6 [23.1-213.1] pg/ml vs. 101.7 [44.0-217.6] pg/ml, respectively). Ghrelin mRNA expression in placental tissue was significantly higher in the subjects with GDM than in the healthy pregnant women (0.06 [0.03-0.07] AU vs. 0.02 [0.015-0.03 AU], p=0.02), whereas GHS-R1a mRNA expression in all three tissues studied did not differ between the two groups. Multiple regression analysis revealed that ghrelin mRNA expression in SAT was significantly predicted by serum insulin (beta=0.62, p=0.01), explaining 42% of its variability. CONCLUSIONS Ghrelin mRNA expression in placental tissue was higher in the GDM than in NGT subjects, whereas no association between circulating ghrelin and GDM was observed.

The Changes in the Endothelial Function and Haemostatic and Inflammatory Parameters in Subclinical and Overt Hyperthyroidism

Introduction. The aim of the present study was to compare the levels of circulating markers of endothelial function and low-grade inflammation in patients with subclinical and overt hyperthyroidism (OH) due to Graves disease (GD) and toxic nodular goiter (TNG). Material and Methods. The group studied consisted of 42 patients with GD, 75 patients with TNG, and 39 healthy controls. Results. Circulating markers of endothelial dysfunction were elevated in the patients with both SH and OH, but the concentrations of interleukin-12 (IL-12) (P < 0.05), IL-18 (P < 0.05), fibrinogen (P < 0.01), and von Willebrand factor (vWF) (P < 0.05) were significantly higher in the OH than in the SH group. The highest levels of IL-6, IL-12, IL-18, vWF, sVCAM-1, and fibrinogen were found in the patients with GD, but the differences between the GD, and TNG groups were not significant. In the subjects with OH serum IL-6 was positively associated with FT3 (R = 0.276, P < 0.05), FT4 (R = 0.273, P < 0.05), and thyroid peroxidase antibodies (R = 0.346, P < 0.01) levels. Conclusion. Our results may suggest that both SH and OH may be associated with endothelial dysfunction, which is reflected by decreased fibrinolytic activity, hypercoagulability, and increased levels of IL-6, IL-12, and IL-18 and depends not only on the cause but also on the degree of hyperthyroidism.