Biomedical subjects

I Lazurova

Publications and source records attributed to I Lazurova.

8 recordsLinked to original sources

PubMed2004

Metformin versus sibutramine in the treatment of hyperinsulinemia in chronically anovulating women.

Aim of this study was to compare the effects of metformin and a body weight reduction regimen using sibutramine on insulinemia, insulin sensitivity, and ovarian function in women with anovulatory cycles or infertility. 30 women with anovulatory cycles and hyperinsulinemia were treated with metformin and 15 anovulating women with obesity were treated with sibutramine in combination with a caloric restriction diet and physical exercise. In the metformin group there was a mild decrease of the body mass index (BMI), a decrease of fasting and stimulated insulinemia (I0, p < 0.05, I120, p < 0.01), a significant reduction of insulin resistance calculated as index FIRI (p < 0.05), serum LH (p < 0.05) and testosterone levels (p < 0.05). There was an improvement of menstrual cycles in 21 (70 %) of women, and 6 of them became pregnant. In the sibutramine group we found a significant decrease of BMI (p < 0.01), waist circumference (p < 0.01), fasting and stimulated insulinemia (p < 0.05, p < 0.01) and a significant improvement of insulin sensitivity (FIRI, p < 0.01). However, the levels of FSH, LH, and testosterone were not significantly changed. There was a significantly greater reduction of insulin levels and FIRI after sibutramine treatment compared with metformin treatment, while the changes of LH were not signifcantly different. Testosterone was changed more after metformin therapy. We conclude that although the body weight reduction using sibutramine has a more pronounced effect on insulinemia and insulin sensitivity, metformin may be more effective in the prompt restoration of ovarian function. (Tab. 3, Ref. 24.).

Adult↗

PubMed2003

Relationship between plasma aldosterone and left ventricular structure and function in patients with essential hypertension.

Recent experimental studies demonstrated that elevation of plasma aldosterone is associated with an increased collagen accumulation resulting in myocardial fibrosis. The aim of this study was to evaluate the association of circulating aldosterone with cardiac structural and functional changes in patients with essential hypertension. The authors examined 39 patients (aged 51 +/- 14 years, 13 male, 26 female) with essential hypertension. M-mode and two-dimensional echocardiography was performed in each subject. Plasma renin activity (PRA) and plasma aldosterone (PA) at baseline and after 4 hours upright posture were measured. Mean levels of baseline and stimulated PRA were similar in hypertensives and control group of normotensives. Baseline and stimulated PA levels were mildly but not significantly higher compared to control group. Using Tukey Kramer multiple analysis we found a significant positive correlation of both baseline and stimulated PA with echocardiographic parameters of left ventricle in hypertensive subjects: IVSd (p<0.001), PWd (p<0.001), LVIDd (p<0.001) and E/A (p<0.001). However, no correlation between PRA and left ventricular structure and function was found in this group of patients. The authors conclude that plasma aldosterone levels are related to the structure and function of left ventricle. (Tab. 3, Ref. 20.).

Aldosterone↗

PubMed2003

Obesity is the major factor determining an insulin sensitivity and androgen production in women with anovulary cycles.

Aim of this study was to test the hypothesis that obesity promotes the insulin-sensitivity and ovarian hyperandrogenism in anovulating women independently of the polycystic ovary syndrome (PCOS). We examined 80 women of reproductive age (19-38 years, mean 28.5 +/- 0.6 years) with anovulary cycles. 45 subjects had PCOS and 35 had chronic anovulation without hormonal and ultrasound criteria of PCOS. The control group consisted of 12 healthy females with normal ovulary menstrual cycle (age 26.4 +/- 0.6 years). We evaluated plasma insulin level baselines (I0); 120 min after oral administration of 75g of glucose (I120), we examined FSH, LH, prolactin, testosterone, 17 OH progesterone and DHEAS and calculated indexes of insulin sensitivity, i.e. FIRI and G/I. Women with anovulary cycles yielded a significant increase in I0 (p < 0.01), I120 (p < 0.01), FIRI (p < 0.01), FSH, LH (both p < 0.05) and testosterone (p < 0.01), and a significantly decrease in G/I (p < 0.01) in comparison to controls with normal weight. There was a significant correlation between BMI and insulin levels, BMI and FIRI, and between WHR or waist circumference and FIRI, or G/I. The highest levels of insulinemia and the highest degree of insulin resistance were found in obese women (BMI > 30 kg/m2). In the group of obese anovulating women we found a positive correlation between I0 and testosterone (p < 0.01). In PCOS group, we found a negative correlation between I0 and LH (p < 0.01), and FIRI and LH (p < 0.01). In the group of obese PCOS women there were significantly higher levels of plasma insulin, and lower insulin sensitivity as compared to lean PCOS patients. However, lean PCOS women were more hyperinsulinemic and insulin resistant than the control group of lean women. Our results indicate, that obesity is the important factor determinating the insulin sensitivity and hyperinsulinemia in PCOS women. Moreover, the body weight is the major determinant of insulinemia, insulin sensitivity and ovarian hyperandrogenism, independently of PCOS. (Tab. 5, Fig. 4, Ref. 23.).

Adult↗

PubMed2001

[Adrenal incidentalomas].

The extensive use and progress in the improvement of imaging techniques brings about the growing incidence of incidentalomas, i.e. adrenal lesions accidentally revealed during the imaging of the abdominal cavity which was originally focused on the visualisation of organs other than adrenal glands. Despite the fact than the majority of incidentalomas (55-91%) represent benign adrenocortical adenomas, it is necessary to focus the diagnostic approach on the exclusion of malignity and hormonal activity. However, no common consent has been yet achieved in the management of incidentalomas. The authors review the literature data on the prevalence, diagnosis (namely hormonal assessments as well as imaging methods) and the current suggestion of the necessity of further investigation and treatment of adrenal incidentalomas. (Tab. 1, Fig. 5, Ref. 64.)

Adrenal Gland Neoplasms↗

PubMed2001

[Effect of passive leg lifting on sodium excretion in patients with liver cirrhosis].

18 healthy subjects and 15 patients with liver cirrhosis were examined using a 2-hour method of passive leg rising (PLR). Renal and hormonal responses to PLR were investigated. There was a significant increase in diuresis (p < 0.01) and sodium excretion (p < 0.01) simultaneously with a decrease in plasma renin activity (p < 0.01) and plasma aldosterone (p < 0.01) in the group of healthy subjects. Similarly, in the group of patients with liver cirrhosis a significant increase in diuresis (p < 0.01), natriuresis (p < 0.05) together with a decrease in plasma renin activity (p < 0.05) and aldosterone (p < 0.01) were detected. 3 of 15 patients were nonrespondents. We conclude that PLR leads to central volume expansion which causes suppression of sodium retaining factors, and the increase in diuresis and natriuresis not only in healthy objects but also in cirrhotics. This simple method may be used as the first therapeutic regimen in patients with cirrhosis and edemas. (Tab. 2, Fig. 3, Ref. 13.)

Adolescent↗

PubMed2000

[Hormonal and morphologic characteristics of adrenal incidentalomas].

The authors analyse hormonal and morphological characteristics of adrenal incidentalomas, i.e. pathological adrenal masses accidentally found on CT scan performed due to extraadrenal causes of other causes of adrenal pathology. The group of patients was consisted by 42 patients at the age 24-79 years (27 females and 15 males). The most frequent clinical symptoms included arterial hypertension, diabetes mellitus and obesity. CT examinations revealed 36 cases of unilateral lesions (in 21 cases the lesions were localised on the right and in 15 cases on the left) and 6 bilateral lesions. The size of adrenal masses ranged from 7 mm to 12 cm. The CT examination helped in characterising myelolipomas in 3 cases, cysts in two cases, and pre-assuming malignity in 6 cases. Hormonal analyses have revealed primary aldosteronism in 2 cases, subclinical hypercortisolism in 1, steroid enzymopathy in 2 and secondary hyperaldosteronism in 2 patients. No patient had catecholamine overproduction. 19 patients were indicated for adrenalectomy with the following histological findings.: adenoma (n = 5), cyst (n = 2), myelolipoma (n = 3), carcinoma (n = 3), feochromocytoma, ganglioneuroma, metastases, lymphoma, sarcoidosis and pseudodrenal structure--Gravitz tumor (n = 1, respectively). The size of all neoplasms exceeded 3 cm, therefore the authors recommend adrenalectomy in incidentalomas with hormonal activity exceeding 3 cm in size. (Tab. 2, Fig. 1, Ref. 17.)

Adrenal Gland Diseases↗

PubMed1999

[Incidence of primary hyperaldosteronism in hospitalized patients with hypertension].

AIMS: To detect the incidence of primary hyperaldosteronism (PH) in hospitalized hypertensive patients. METHODS: Authors assessed plasma renin activity (PRA) and plasma aldosterone (PA) in 100 patients with arterial hypertension hospitalized at the II. department of Internal medicine in Kosice because of resistance to ambulatory treatment, eventually with the aim of differential diagnosis of arterial hypertension. RESULTS: From 100 hypertensive patients 90 (90%) have had essential hypertension (EH), 8 (8%) PH, 2 (2%) renovascular hypertension and 1 patient (1%) pheochromocytoma. Aldosterone-renin ratio was in PH patients 10-fold higher comparing with EH patients. From the 8 patients with PH 4 have had adenoma and in 3 patients hyperplasia was diagnosed with the use of CT or histology, 1 case was idiopathic hyperaldosteronism without CT hyperplasia evidence. In all PH patients the level of kalemia was less than 4 mmol/l, i.e. kalemia 4.0 mmol/l has 100% sensitivity for PH detection. CONCLUSION: Introduction of PRA and PA examinations in the diagnostic process of arterial hypertension led to more frequent diagnosis of PH, which may probably represent the most frequent form of endocrine hypertension. Although ARR is a reliable test for PH screening, routine ARR examinations in ambulatory practice are technically complicated and connected with high costs. Increasing the threshold level of kalemia for PH detection led to higher sensitivity and that is why the authors consider ARR examination rational in every patient with kalemia level less than 4 mmol/l. (Tab. 4, Ref. 18.)

Adult↗

PubMed1998

Aldosterone-producing adenoma associated with foci of myelolipoma.

The simultaneous occurrence of adrenal myelolipoma and endocrine disorders is rare. Myelolipomas have occasionally been found in patients with Cushing's syndrome, pheochromocytoma and hyperthyroidism. A recently published study described one well-documented case of adrenal adenoma and myelolipoma in a patient with Conn's syndrome. In this report the patient had a one-year history of treated hyperthyroidism and diagnosed aldosterone-producing adenoma. A disseminated adrenal myelolipoma was found within the adrenocortical adenoma. To our knowledge this histological finding has not been previously reported in association with both Conn's syndrome and hyperthyroidism.

Adenoma↗