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Kuzma M.,Comenius University | Homerova Z.,Comenius University | Dlesk A.,Comenius University | Koller T.,Comenius University | And 3 more authors.
Bratislava Medical Journal | Year: 2013

Background: Growth hormone deficiency (GHD) is associated with reduced bone mineral content and increased risk of osteoporotic fractures. Reduced peak bone mass might explain the low bone mineral density (BMD) among patients with childhood onset GHD (CO-GHD) whilst the cause of osteopenia in adult-onset GHD (AO-GHD) is not fully understood. Objectives: Prospective multicentric study to asses bone status in GHD adults after two years of recombinant growth hormone replacement treatment. Methods: In 94 GHD adults (49 men; Ø 34.5 yrs) we have measured BMD and bone markers (CTX, osteocalcin) during two years of rhGH treatment (at baseline, after 3 and 6 months, and after 1 and 2 years). Patients were adequately substituted for GHD and other pituitary deficiencies. Results: We have observed an increase in BMD-lumbar spine: n=42, 0.8155→0.9418 g/cm2, p<0.0001; femoral neck n=41; 0.8468→0.9031; p= 0.0004; BMD-whole body 1.0179→1.0774; p=0.0003. We have compared gender difference: BMD-L-spine by 15.8 % in men (n=21) and by 5.6 % in women (n=19) (p= 0.008); BMDfemoral neck increased by 11.03 % in men and by about 3.0 % in women (p=0.032). In women, the initial decrease in BMD was recorded after 3 months. CO-GHD adults yielded a higher increase in BMD -L-spine (16.6 %, p=0.022). A correlation exists between IGF-I levels and BMD in lumbar spine (1st year: R=0.348, p=0.026; 2nd year: R= 0.33, p=0.0081) and between IGF-I and osteocalcin (1st year: R=0.383; p=0.0038). Conclusion: Two-year therapy with recombinant human growth hormone improved bone status. IGF-I appears to be a good indicator of rhGH effect on bone.

Hodosy J.,Comenius University | Ostatnikova D.,Comenius University | Caganova M.,Comenius University | Kovacsova M.,Faculty Hospital | And 4 more authors.
Pharmacology Biochemistry and Behavior | Year: 2012

Testosterone affects behavior. Whether regular physical training does influence these effects is unknown. The assumption that testosterone induces muscular hypertrophy if combined with physical training has not been confirmed experimentally. The aim of this study was to evaluate whether activity and/or testosterone treatment affects depression-like behavior and to observe the effects of activity and testosterone on muscle fiber diameter. Forty-three male rats were divided into 4 groups: two groups (TST act and TST lazy) were treated with testosterone (5 mg/kg) and two groups were used as control (CTRL act and CTRL lazy). Two of the groups (CTRL act and TST act) underwent 2 weeks of exercise. The forced swim test was used as a test of depression-like behavior. Sex steroids were measured and the diameter of skeletal muscle fibers was evaluated. Testosterone was significantly higher in both testosterone-treated groups (p < 0.001). Physically active groups had higher immobility times in the forced swim test than inactive groups. Groups CTRL act and TST lazy showed significantly larger diameter of muscle fibers in comparison to the TST act group. Our results suggest that physical activity induces depression-like behavior in rats. Controversial antagonistic effects of testosterone and physical activity on muscle fiber diameter were found. © 2011 Elsevier Inc.

Pirags V.,University of Latvia | El Damassy H.,Ain Shams University | Dabrowski M.,University of Rzeszow | Gonen M.S.,Selcuk University | And 4 more authors.
International Journal of Clinical Practice | Year: 2012

Aims: The choice of insulin at initiation in type 2 diabetes remains controversial. The aim of this study was to assess the occurrence of self-reported severe hypoglycaemia associated with premixed insulin analogues in routine clinical care. Methods: A 12-month, prospective, observational, multicentre study in patients starting a commonly prescribed premixed insulin analogue (either insulin lispro 25/75 or biphasic insulin aspart 30/70, twice daily) after suboptimal glycaemic control on oral antidiabetic agents. Treatment decisions were made solely in the course of usual practice. Results: Study follow-up was completed by 991 (85.5%) of the 1150 patients enrolled. At baseline, mean (SD) age was 57.9 (10.1) years; mean diabetes duration was 9.2 (5.9) years; mean haemoglobin A1c (HbA1c) was 9.9 (1.8) % and the rate of severe hypoglycaemia was 0.03 episode/patient-year. At 12 months, the rate of severe hypoglycaemia was 0.04 episode/patient-year (95% CI 0.023, 0.055 episode/patient-year) and mean insulin dose was 41.5 (19.4) units. Changes from baseline to 12 months for mean fasting plasma glucose and HbA 1c were -5.1 mmol/l and -2.5%, respectively. Conclusions: After initiation of premixed insulin analogues in patients with type 2 diabetes in real-world settings, the incidence of severe hypoglycaemia was lower than expected from previously reported studies. © 2012 Blackwell Publishing Ltd.

Javor J.,Comenius University | Ferencik S.,University of Duisburg - Essen | Bucova M.,Comenius University | Stuchlikova M.,Comenius University | And 5 more authors.
Archivum Immunologiae et Therapiae Experimentalis | Year: 2010

Numerous cytokines have been shown to participate in the pathogenesis of type 1 diabetes (T1D). As gene polymorphisms can influence cytokine production or function, they may potentially contribute to genetic predisposition to the disease. The aim of this study was therefore to investigate the role of 22 single nucleotide polymorphisms (SNPs) in 13 cytokine and cytokine receptor genes in genetic susceptibility to T1D. Polymerase chain reaction with sequence-specific primers was used to genotype cytokine SNPs and HLA-DRB1 alleles in 151 diabetics and 140 healthy individuals of Slovak origin. Univariate analysis showed that transforming growth factor (TGF)-β1 codon 10 TT homozygotes were significantly more susceptible to developing T1D than C allele carriers (P c = 0.0066, OR = 2.46). Furthermore, tumor necrosis factor (TNF)-α -308 A allele carriers were also significantly overrepresented among the diabetics (P c = 0.0031, OR = 2.62); however, the association of the -308 A allele with T1D might be due to its strong linkage disequilibrium with the susceptibility allele HLA-DRB1*0301. An association was also found with interleukin (IL)-6 -174 G/C and nt565 G/A SNPs; however, its significance was lost when statistical correction was applied. These data suggest that the TGF-β1 codon 10 SNP is among numerous genetic variations with small individual effects on T1D development. Moreover, a possible role of TNF-α and IL-6 SNPs cannot be ruled out, although their association with T1D was due to strong LD with the HLA class II susceptibility allele or did not withstand statistical correction, respectively. © 2010 L. Hirszfeld Institute of Immunology and Experimental Therapy, Wroclaw, Poland.

Tomkova S.,University of P.J. Safarik | Telepkova D.,Private Practice | Vanuga P.,National Institute of Endocrinology and Diabetology | Killinger Z.,Comenius University | And 4 more authors.
International Journal of Clinical Pharmacology and Therapeutics | Year: 2014

Objective: Adherence of patients to therapy is a major determinant of therapeutic success, which is not included in most clinical studies. This is especially true for chronic diseases with few subjective symptoms, such as osteoporosis. The aim of our study was to describe and to analyze the therapeutic adherence to several widely used anti-osteoporotic medications in real-world medicine in Slovakia. Methods: Using a retrospective approach, data about drug prescriptions for 8,223 patients from 3 consecutive years were analyzed regarding compliance and persistence. Compliance was measured as medication possession ratio-ratio between the supply of the drugs in the treatment time according to the prescriptions and the time of observation. Persistence was assessed as the percentage of patients who used the drug without a gap for the given time period. Results: The average compliance was 70%, 59%, and 4% for 6, 12, and 24 months, respectively. Average persistence was very low with 54%, 42%, and 22% for 6, 12, and 24 months, respectively. Total average persistence was only 9.8 months. Medications with lower frequency of application tended to be associated with higher adherence. Conclusion: In conclusion, the therapeutic adherence to anti-osteoporotic treatments varies between the available drugs and drug regimens. In general, the adherence is very low but comparable to previously published studies from other countries. This variability of adherence should be considered in clinical decision making together with the variability of therapeutic efficiency found in clinical studies. ©2014 Dustri-Verlag Dr. K. Feistle.

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