Vitamin D deficiency and thyroid autoantibody fluctuations in patients with Graves' disease - A mere coincidence or a real relationship?

PURPOSE

The aim of this study was to evaluate the association between vitamin D (vitD) and changes in the titers of anti-TSH receptor (TSHR-Abs), antithyroglobulin (Tg-Abs), and antiperoxidase (TPO-Abs) autoantibodies.

MATERIALS/METHODS

The study involved 269 patients with Graves' disease (GD), divided into four subgroups (1-4), i.e. 65 smokers treated with vitD(+) (1), 76 smokers not treated with vitD(-) (2), 61 non-smokers treated with vitD(+) (3) and 67 non-smokers with vitD(-) (4). All thyroid parameters were analyzed at entry and 1, 3, 6, 9 and 12 months later.

RESULTS

The titer of TSHR-Abs in group 3 was significantly lower than in groups 1 and 2 across all time points. At 3, 6 and 12 months, the titers of TSHR-Abs were also lower in group 4 compared to groups 1 and 2. At 9 months, the titers in group 3 were lower than in all other groups. There was a significant inverse correlation between baseline levels of vitD and baseline titers of Tg-Abs (in group 1 only), Tg-Abs after 12 months (in group 1 only), TPO-Abs after 12 months (in groups 1 and 3), fT4 (in group 4 only), and a significant positive correlation with TPO-Abs (in group 2 only). VitD levels at 12 months were inversely correlated with Tg-Abs in group 1.

CONCLUSIONS

VitD measurements in patients with GD, especially smokers with an increased TSHR-Ab titers before 131I therapy, are recommended. Immunological remission is more likely in patients with GD who receive vitD, particularly smokers.

Analysis of Answers to Queries among Anonymous Users with Gastroenterological Problems on an Internet Forum

Internet forums are an attractive source of health-related information. We aimed to investigate threads in the gastroenterological section of a popular Polish medical forum for anonymous users. We characterised the following aspects in threads: the main problem of the original poster, declared ailments and rationale of the responses (rational, neutral, harmful or not related to the problem of the original poster). We analysed over 2717 forum threads initiated in the years 2010–2018. Users mostly asked for diagnosis of the problem [1814 (66.8%)], treatment [1056 (38.9%)] and diagnostic interpretation [308 (11.3%)]. The most commonly declared symptoms were abdominal pain [1046 (38.5%)], diarrhea [454 (16.7%)] and bloating [354 (13.0%)]. Alarm symptoms were mentioned in 309 (11.4%) threads. From the total 3550 responses, 1257 (35.4%) were assessed as rational, 693 (19.5%) as neutral, 157 (4.4%) as harmful and 1440 (40.6%) as not related to the user’s problem. The original poster’s declaration of blood in stool, dyspepsia, pain in the abdominal right lower quadrant, weight loss or inflammatory bowel disease was positively related to obtaining at least one potentially harmful response. Advice from anonymous users on Internet forums may be irrational and disregards alarm symptoms, which can delay the diagnosis of life-threatening diseases.

Abdominal Pain and Disturbed Bowel Movements are Frequent among Young People. A Population Based Study in Young Participants of the Woodstock Rock Festival in Poland

BACKGROUND AND AIMS

Functional gastrointestinal disorders are prevalent worldwide and alterations of gut-brain axis and intestinal barrier integrity may play a pivotal role in both the pathophysiology and clinical course of these bowel malfunctions. We aimed to assess the prevalence of abdominal pain in a selected adult population of Poland to determine potential environmental factors associated with gastrointestinal complaints.

METHODS

There were 1479 individuals - 657 women (44.42%) and 822 men (55.58%), aged 24.20±6.08 years. The responders fulfilled an authors' questionnaire based on Rome II and III criteria focused on the abdominal pain prevalence and environmental factors involved in its occurrence.

RESULTS

The frequency of abdominal pain was found to be as high as 19.2%. Male gender (n=822) and basic education level (n=151) lowered the risk of abdominal pain occurrence (OR=0.7, p<0.012 and OR=0.5, p<0.021, respectively). Psychological distress, proton pump inhibitors (PPIs) and antibiotics usage were found as risk factors of abdominal pain (OR=2.503, p<0.01; OR=3.308, p<0.01; OR=3.105, p<0.01, respectively).

CONCLUSIONS

Abdominal pain is prevalent in young adult inhabitants of Poland, especially in women. Intense psychological stress, as well as PPIs and antibiotics usage elevate the risk.

Fruit and vegetable consumption among the young Polish population

Introduction

Vegetables and fruit are an essential part of a healthy and balanced diet. It has been shown that regular consumption of fruit and vegetables can reduce the risk of chronic diseases. However, in the past 8 years fruit and vegetable consumption among Polish youth has significantly decreased.

Materials and methods

Patients involved in the project were participants of the Woodstock Festival Poland 2014. During three days of the festival, 615 young adults (18–35 years) were enrolled in the study. The study participants had to fill in a questionnaire that included questions about the frequency of fruit and vegetable consumption, portion sizes, and knowledge of the recommended daily intake. We also measured basic anthropometric parameters.

Results

The data from our study showed that 97.6% of respondents consumed fewer than 4 servings of vegetables and fruit. In addition 39% of them ate 2 or fewer vegetable servings per day. We found that men ate significantly less fruit and fewer vegetables than women (p < 0.05). Additionally, almost 75% of men responded that proper consumption of fruit and vegetables should be at the level of 2–3 servings, and only 22.3% of them said that the proper level is 4–5 servings.

Conclusions

We need to keep in mind that only clear information about vegetables and fruit, as well as highlighting the importance of the principles of nutrition, can give effective results in the future. It also appears that nutritional education should be conducted not only at the early stages of development but also in adolescents.

Effect of inderal on insulin secretion, glycemia and FFA concentration in normal subjects and diabetics

In 20 cases of adult-type diabetes and in 10 healthy controls insulinemia, glycemia and free acids concentration were determined under basal conditions, after glucose load and after administration of inderal and glucose. After intravenous injection of inderal basal insulinemia fell in controls but this fall was statistically not significant, while in diabetics no evident changes of insulinemia were observed. Following inderal injection and oral glucose a statistically significant drop in insulinemia was observed in controls but not in diabetics. In both groups inderal injection was without any significant effect on glycemia before as well as after glucose load. In both groups a significant decrease occurred in the level of free fatty acids and inderal had no effect on it.