Joanna Syrycka

The influence of other than prolactin hormones on bone mineral density in women with hyperprolactinaemia of various origins

Objective. Hyperprolactinaemia may lead to bone loss, both due to hypogonadism and other hormonal disturbances. Aim of the case–control study was the analysis of influences of hormonal profiles associated with hyperprolactinaemia on the bone mineral density (BMD) in women with hyperprolactinaemia of various origin. Material and methods. The subjects were 32 patients with prolactinoma, 43 ones with functional hyperprolactinaemia and 29 healthy controls. All of them were studied for BMD (lumbar spine, proximal femur, forearm, total body) by dual-energy X-ray absorptiometry and their correlations with hormones levels (prolactin, oestradiol, luteinising hormone, follicle stimulating hormone, sex hormone binding globulin (SHBG), testosterone, dehydroepiandrosterone sulphate (DHEA-S), insulin-like growth factor-1 and intact parathyroid hormone) using Spearman correlation analysis and multiple regression analysis model. Results. Correlation analysis revealed the anabolic influence of PTH on lumbar spine in women with prolactinoma, and on ultradistal radius in functional hyperprolactinaemia. In multiple regression analysis, oestradiol had greatest influence on lumbar spine and total body BMD. Moreover, positive influence of testosterone, SHBG on spine BMD, and of oestradiol, testosterone, SHBG and DHEA-S on total body BMD were observed in patients with prolactinoma. Conclusion. Hormonal disturbances associated with hyperprolactinaemia influence BMD more in patients with prolactinoma than in ones with functional hyperprolactinaemia.

Quantitative Ultrasound at the Hand Phalanges in Adolescent Girls is Related to Their Overall Physical Fitness.

BACKGROUND Growing of the skeleton, depends on genetic, health, nutritional and environmental influences. OBJECTIVES The aim of the study was to assess the ultrasound properties of bone measured at hand phalanges in adolescent girls regarding the influence of pubertal status and level of physical fitness. MATERIAL AND METHODS The study group was 56 adolescent girls aged 12-14 yrs, the controls were 86 girls matched for age, recruited from 1256 subjects undergoing bone measurement for screening purposes. The skeletal status (amplitude-dependent speed of sound - Ad-SoS) was assessed by quantitative ultrasound (QUS) at proximal phalanges using DBM Sonic 1200. Physical fitness was assessed by the Zuchora index and pubertal development by the Tanner scale. RESULTS The adolescent girls from our study group had greater body weight, height, BMI and Ad-SoS values than the controls. Overall physical fitness was highest in girls with the lowest BMI and lowest in girls with the highest BMI values. The highest results of the Ad-SoS were reported in girls presenting highest level of physical fitness. They were statistically significantly higher than in girls with a minimal level of physical fitness. There was a statistically significant correlation between the overall physical fitness score and Ad-SoS results. No correlations between Ad-SoS and the Tanner scale, particular the elements of physical fitness (speed, jumping ability, flexibility, shoulder muscular strength, abdominal muscle strength) and BMI were shown. CONCLUSIONS The bone properties assessed by QUS at the hand phalanges in adolescent girls aged 12-14 years depend on their overall physical fitness. Pubertal development, body size and particular elements of physical fitness, especially shoulder muscular strength, have limited influence.

Interesting coincidence of atypical TSH-secreting pituitary adenoma and chronic lymphocytic leukemia

Thyrotropin-secreting adenomas (TSH-oma) are very rare pituitary tumours. They are macroadenomas usually presenting with signs and symptoms of hyperthyroidism, and mass effects. They can co-secrete other hormones such as growth hormone or prolactin. Different malignancies, including haematological ones, are reported in patients with pituitary diseases. Chronic lymphocytic leukemia (CLL) occurs mostly in older patients, more often in males. CLL is associated with increased risk of second malignancies such as other blood neoplasms, skin and solid tumours. We present a successful neurosurgical outcome in a patient with an interesting coincidence of atypical TSH-oma and asymptomatic CLL.

Quantitative ultrasound at the hand phalanges in adolescent boys in relation to their pubertal development and physical efficiency

INTRODUCTION Our aim was to assess the ultrasound properties of bone measured at hand phalanges in 55 adolescent boys aged 13-15 years regarding the influence of pubertal status and level of physical efficiency including muscular strength. MATERIAL AND METHODS They were divided into two age groups: Group I (n = 37, boys aged 159-171 months) and Group II (n = 18, aged 172-184 months). The controls were 94 boys matched for age, recruited from 1,256 subjects undergoing bone measurement for screening purposes. The skeletal status (amplitude-dependent speed of sound - Ad-SoS) was assessed by quantitative ultrasound (QUS) at proximal phalanges with the use of DBM Sonic 1200. Physical efficiency was assessed using Zuchoras test, and pubertal development by Tanners score. RESULTS There was no difference in mean Ad-SoS between the entire study group and controls. Ad-SoS values were greater in older than in younger boys, both in right and left hands. There were no differences between left and right hand measurements. There were positive correlations between Ad-SoS and shoulder muscle strength in boys. Negative correlations between Ad-SoS at phalanges of right and left hand and BMI were shown in younger adolescent boys only. Similarly, only in the younger group were positive correlations present between both hands Ad-SoS and overall physical efficiency and age. Ad-SoS correlated positively better with Tanners scale scoring in the older group. CONCLUSION QUS at hand phalanges in adolescent boys aged 13-15 years depends on pubertal development and shoulder muscle strength. The overall physical efficiency has limited influence on bone properties assessed by QUS.

Seven-year follow-up in a case of primary hyperparathyroidism using quantitative ultrasound and dual X-ray absorptiometry.

We have previously reported a case of a 36-year-old woman who was diagnosed with primary hyperparathyroidism following initial skeletal abnormalities in the hand phalanges and calcaneus revealed by quantitative ultrasound (QUS). Successful parathyroid adenoma surgery resulted in progressive increase of bone mineral density and QUS parameters within 6 months, 1 year and 2 years of follow-up. Now, 5 years after the last measurement and at the onset of her menopause, the study was repeated. It has shown further increase in some ultrasonic and densitometric parameters but decrease in others. This discrepancy could be associated with the early influence of perimenopause on trabecular bone. Based on the current report one can conclude that peripheral QUS used on the hand phalanges and calcaneus is a useful tool for the diagnosis and monitoring of skeletal alterations due to parathyroid dysfunction. Moreover, it can detect early changes associated with perimenopause.