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Paltoglou G, Stefanaki C, Chrousos GP. Functional MRI Techniques Suggesting that the Stress System Interacts with Three Large Scale Core Brain Networks to Help Coordinate the Adaptive Response: A Systematic Review. Curr Neuropharmacol 2024; 22:976-989. [PMID: 37533249 PMCID: PMC10845086 DOI: 10.2174/1570159x21666230801151718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 03/16/2023] [Accepted: 04/06/2023] [Indexed: 08/04/2023] Open
Abstract
OBJECTIVE Synthesis of functional MRI (fMRI) and functional connectivity (FC) analysis data on human stress system (SS) function, as it relates to the dynamic function of the Salience (SN), Default Mode (DMN) and Central Executive (CEN) networks. METHODS Systematic search of Medline, Scopus, Clinical Trials.gov, and Google Scholar databases of studies published prior to September 2022 resulted in 28 full-text articles included for qualitative synthesis. RESULTS Acute stress changes the states of intra-/inter- neural network FCs and activities from those of resting, low arousal state in the SN, DMN and CEN, during which intra- and inter-network FCs and activities of all three networks are low. SS activation is positively linked to the activity of the SN and negatively to that of the DMN, while, in parallel, it is associated with an initial decrease and a subsequent increase of the intra- network FC and activity of the CEN. The FC between the DMN and the CEN increases, while those between the SN and the CEN decrease, allowing time for frontal lobe strategy input and "proper" CEN activity and task decision. SN activation is linked to sensory hypersensitivity, "impaired" memory, and a switch from serial to parallel processing, while trait mindfulness is associated with FC changes promoting CEN activity and producing a "task-ready state". CONCLUSION SS activation is tightly connected to that of the SN, with stress hormones likely potentiating the intra-network FC of the latter, attenuating that of the DMN, and causing a biphasic suppression- to-activation response of the CEN, all adaptive changes favoring proper decisions and survival.
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Affiliation(s)
- George Paltoglou
- University Research Institute of Maternal and Child Health and Precision Medicine, Medical School, National and Kapodistrian University of Athens, “Aghia Sophia” Children's Hospital, Athens 11527, Greece
- Second Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, “A. & P. Kyriakou” Children's Hospital, Athens 11527, Greece
- UNESCO Chair on Adolescent Health Care, Medical School, National and Kapodistrian University of Athens, Athens 11527, Greece
| | - Charikleia Stefanaki
- University Research Institute of Maternal and Child Health and Precision Medicine, Medical School, National and Kapodistrian University of Athens, “Aghia Sophia” Children's Hospital, Athens 11527, Greece
- UNESCO Chair on Adolescent Health Care, Medical School, National and Kapodistrian University of Athens, Athens 11527, Greece
| | - George P. Chrousos
- University Research Institute of Maternal and Child Health and Precision Medicine, Medical School, National and Kapodistrian University of Athens, “Aghia Sophia” Children's Hospital, Athens 11527, Greece
- UNESCO Chair on Adolescent Health Care, Medical School, National and Kapodistrian University of Athens, Athens 11527, Greece
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Tragomalou A, Paltoglou G, Manou M, Kostopoulos IV, Loukopoulou S, Binou M, Tsitsilonis OE, Bacopoulou F, Kassari P, Papadopoulou M, Mastorakos G, Charmandari E. Non-Traditional Cardiovascular Risk Factors in Adolescents with Obesity and Metabolic Syndrome May Predict Future Cardiovascular Disease. Nutrients 2023; 15:4342. [PMID: 37892418 PMCID: PMC10609627 DOI: 10.3390/nu15204342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 09/28/2023] [Accepted: 10/03/2023] [Indexed: 10/29/2023] Open
Abstract
Obesity in adolescence is associated with significant morbidity and predisposes adolescents to the development of cardiovascular disease (CVD). Although a number of traditional CVD risk factors have been identified in youth, limited data exist regarding non-traditional CVD risk factors. In 89 adolescents with metabolic syndrome (MetS), with 60 age-, gender-, and BMI-matched controls, we determined the non-traditional CVD risk factors (hs-CRP, TG/HDL ratio, ApoB/ApoA1 ratio, NAFLD) in order to investigate whether they may be used as biomarkers for predicting future CVD, and we evaluated their response to the implementation of a multidisciplinary, personalized, lifestyle intervention program for 1 year. We demonstrated that the TG/HDL ratio, IL-2, IL-6, IL-17A, and INF-γ were significantly increased in subjects with MetS than in controls, and may be used as biomarkers to predict future CVD. Subjects with MetS had an increased mean carotid intima-media thickness (cIMT) and prevalence of NAFLD than the controls, while the prevalence of NAFLD correlated strongly with cIMT and IL-6 concentrations. Most of the non-traditional cardiovascular risk factors improved following the implementation of a lifestyle intervention program. These findings indicate that adolescents with MetS may have a greater risk for developing atherosclerosis early in life, while early lifestyle intervention is crucial for preventing the arteriosclerotic process in youth.
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Affiliation(s)
- Athanasia Tragomalou
- Center for the Prevention and Management of Overweight and Obesity, Division of Clinical and Translational Research in Endocrinology, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, ‘Aghia Sophia’ Children’s Hospital, 11527 Athens, Greece; (A.T.); (G.P.); (M.M.); (M.B.); (P.K.); (M.P.)
- Division of Endocrinology and Metabolism, Center of Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens, 11527 Athens, Greece
| | - George Paltoglou
- Center for the Prevention and Management of Overweight and Obesity, Division of Clinical and Translational Research in Endocrinology, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, ‘Aghia Sophia’ Children’s Hospital, 11527 Athens, Greece; (A.T.); (G.P.); (M.M.); (M.B.); (P.K.); (M.P.)
- Division of Endocrinology and Metabolism, Center of Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens, 11527 Athens, Greece
| | - Maria Manou
- Center for the Prevention and Management of Overweight and Obesity, Division of Clinical and Translational Research in Endocrinology, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, ‘Aghia Sophia’ Children’s Hospital, 11527 Athens, Greece; (A.T.); (G.P.); (M.M.); (M.B.); (P.K.); (M.P.)
| | - Ioannis V. Kostopoulos
- Flow Cytometry Unit, Section of Animal and Human Physiology, Department of Biology, National and Kapodistrian University of Athens, 15784 Athens, Greece; (I.V.K.); (O.E.T.)
| | - Sofia Loukopoulou
- Department of Pediatric Cardiology, ‘Aghia Sophia’ Children’s Hospital, 11527 Athens, Greece;
| | - Maria Binou
- Center for the Prevention and Management of Overweight and Obesity, Division of Clinical and Translational Research in Endocrinology, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, ‘Aghia Sophia’ Children’s Hospital, 11527 Athens, Greece; (A.T.); (G.P.); (M.M.); (M.B.); (P.K.); (M.P.)
| | - Ourania E. Tsitsilonis
- Flow Cytometry Unit, Section of Animal and Human Physiology, Department of Biology, National and Kapodistrian University of Athens, 15784 Athens, Greece; (I.V.K.); (O.E.T.)
| | - Flora Bacopoulou
- Center for Adolescent Medicine in Adolescent Health Care, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, ‘Aghia Sophia’ Children’s Hospital, 11527 Athens, Greece;
| | - Penio Kassari
- Center for the Prevention and Management of Overweight and Obesity, Division of Clinical and Translational Research in Endocrinology, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, ‘Aghia Sophia’ Children’s Hospital, 11527 Athens, Greece; (A.T.); (G.P.); (M.M.); (M.B.); (P.K.); (M.P.)
- Division of Endocrinology and Metabolism, Center of Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens, 11527 Athens, Greece
| | - Marina Papadopoulou
- Center for the Prevention and Management of Overweight and Obesity, Division of Clinical and Translational Research in Endocrinology, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, ‘Aghia Sophia’ Children’s Hospital, 11527 Athens, Greece; (A.T.); (G.P.); (M.M.); (M.B.); (P.K.); (M.P.)
| | - George Mastorakos
- Division of Endocrinology, Diabetes Mellitus and Metabolism, Second Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens Medical School, ‘Aretaieion’ University Hospital, 11527 Athens, Greece;
| | - Evangelia Charmandari
- Center for the Prevention and Management of Overweight and Obesity, Division of Clinical and Translational Research in Endocrinology, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, ‘Aghia Sophia’ Children’s Hospital, 11527 Athens, Greece; (A.T.); (G.P.); (M.M.); (M.B.); (P.K.); (M.P.)
- Division of Endocrinology and Metabolism, Center of Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens, 11527 Athens, Greece
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Aung Y, Kokotsis V, Yin KN, Banerjee K, Butler G, Dattani MT, Dimitri P, Dunkel L, Hughes C, McGuigan M, Korbonits M, Paltoglou G, Sakka S, Shah P, Storr HL, Willemsen RH, Howard SR. Key features of puberty onset and progression can help distinguish self-limited delayed puberty from congenital hypogonadotrophic hypogonadism. Front Endocrinol (Lausanne) 2023; 14:1226839. [PMID: 37701896 PMCID: PMC10493306 DOI: 10.3389/fendo.2023.1226839] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 08/11/2023] [Indexed: 09/14/2023] Open
Abstract
Introduction Delayed puberty (DP) is a frequent concern for adolescents. The most common underlying aetiology is self-limited DP (SLDP). However, this can be difficult to differentiate from the more severe condition congenital hypogonadotrophic hypogonadism (HH), especially on first presentation of an adolescent patient with DP. This study sought to elucidate phenotypic differences between the two diagnoses, in order to optimise patient management and pubertal development. Methods This was a study of a UK DP cohort managed 2015-2023, identified through the NIHR clinical research network. Patients were followed longitudinally until adulthood, with a definite diagnosis made: SLDP if they had spontaneously completed puberty by age 18 years; HH if they had not commenced (complete, cHH), or had commenced but not completed puberty (partial, pHH), by this stage. Phenotypic data pertaining to auxology, Tanner staging, biochemistry, bone age and hormonal treatment at presentation and during puberty were retrospectively analysed. Results 78 patients were included. 52 (66.7%) patients had SLDP and 26 (33.3%) patients had HH, comprising 17 (65.4%) pHH and 9 (34.6%) cHH patients. Probands were predominantly male (90.4%). Male SLDP patients presented with significantly lower height and weight standard deviation scores than HH patients (height p=0.004, weight p=0.021). 15.4% of SLDP compared to 38.5% of HH patients had classical associated features of HH (micropenis, cryptorchidism, anosmia, etc. p=0.023). 73.1% of patients with SLDP and 43.3% with HH had a family history of DP (p=0.007). Mean first recorded luteinizing hormone (LH) and inhibin B were lower in male patients with HH, particularly in cHH patients, but not discriminatory. There were no significant differences identified in blood concentrations of FSH, testosterone or AMH at presentation, or in bone age delay. Discussion Key clinical markers of auxology, associated signs including micropenis, and serum inhibin B may help distinguish between SLDP and HH in patients presenting with pubertal delay, and can be incorporated into clinical assessment to improve diagnostic accuracy for adolescents. However, the distinction between HH, particularly partial HH, and SLDP remains problematic. Further research into an integrated framework or scoring system would be useful in aiding clinician decision-making and optimization of treatment. .
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Affiliation(s)
- Yuri Aung
- Centre for Endocrinology, William Harvey Research Institute, Queen Mary, University of London (QMUL), London, United Kingdom
- Department of Paediatric Endocrinology, Royal London Children’s Hospital, Barts Health NHS Trust, London, United Kingdom
| | - Vasilis Kokotsis
- Centre for Endocrinology, William Harvey Research Institute, Queen Mary, University of London (QMUL), London, United Kingdom
| | - Kyla Ng Yin
- Centre for Endocrinology, William Harvey Research Institute, Queen Mary, University of London (QMUL), London, United Kingdom
| | - Kausik Banerjee
- Department of Paediatrics, Barking, Havering and Redbridge University Hospitals NHS Trust, London, United Kingdom
| | - Gary Butler
- Department of Paediatric and Adolescent Endocrinology, University College London Hospital NHS Foundation Trust, London, United Kingdom
- UCL Great Ormond Street (GOS) Institute of Child Health, University College London, London, United Kingdom
| | - Mehul T. Dattani
- Department of Paediatric and Adolescent Endocrinology, University College London Hospital NHS Foundation Trust, London, United Kingdom
- UCL Great Ormond Street (GOS) Institute of Child Health, University College London, London, United Kingdom
- Department of Paediatric Endocrinology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom
| | - Paul Dimitri
- Department of Paediatric Endocrinology, Sheffield Children’s Hospital NHS Foundation Trust, Sheffield, United Kingdom
| | - Leo Dunkel
- Centre for Endocrinology, William Harvey Research Institute, Queen Mary, University of London (QMUL), London, United Kingdom
| | - Claire Hughes
- Department of Paediatric Endocrinology, Royal London Children’s Hospital, Barts Health NHS Trust, London, United Kingdom
| | - Michael McGuigan
- Department of Paediatrics, Countess of Chester NHS Foundation Trust, Chester, United Kingdom
| | - Márta Korbonits
- Centre for Endocrinology, William Harvey Research Institute, Queen Mary, University of London (QMUL), London, United Kingdom
- Department of Endocrinology, Barts Health NHS Trust, London, United Kingdom
| | - George Paltoglou
- 2nd Department of Paediatrics, National and Kapodistrian University of Athens (NKUA), “P. & A. Kyriakou” Children’s Hospital, Athens, Greece
| | - Sophia Sakka
- Department of Paediatric Endocrinology, Evelina Children’s Hospital, Guys and St Thomas’ NHS Foundation Trust, London, United Kingdom
| | - Pratik Shah
- Centre for Endocrinology, William Harvey Research Institute, Queen Mary, University of London (QMUL), London, United Kingdom
- Department of Paediatric Endocrinology, Royal London Children’s Hospital, Barts Health NHS Trust, London, United Kingdom
| | - Helen L. Storr
- Centre for Endocrinology, William Harvey Research Institute, Queen Mary, University of London (QMUL), London, United Kingdom
- Department of Paediatric Endocrinology, Royal London Children’s Hospital, Barts Health NHS Trust, London, United Kingdom
| | - Ruben H. Willemsen
- Department of Paediatric Endocrinology, Royal London Children’s Hospital, Barts Health NHS Trust, London, United Kingdom
| | - Sasha R. Howard
- Centre for Endocrinology, William Harvey Research Institute, Queen Mary, University of London (QMUL), London, United Kingdom
- Department of Paediatric Endocrinology, Royal London Children’s Hospital, Barts Health NHS Trust, London, United Kingdom
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Herouvi D, Paltoglou G, Soldatou A, Kalpia C, Karanasios S, Karavanaki K. Lifestyle and Pharmacological Interventions and Treatment Indications for the Management of Obesity in Children and Adolescents. Children (Basel) 2023; 10:1230. [PMID: 37508727 PMCID: PMC10378563 DOI: 10.3390/children10071230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 07/04/2023] [Accepted: 07/14/2023] [Indexed: 07/30/2023]
Abstract
Obesity is a multifactorial chronic impairment that further decreases quality of life and life expectancy. Worldwide, childhood obesity has become a pandemic health issue causing several comorbidities that frequently present already in childhood, including cardiovascular (hypertension, dyslipidemia), metabolic (Type 2 diabetes mellitus, fatty liver disease, metabolic syndrome), respiratory, gastrointestinal and musculoskeletal disorders. In addition, obese children frequently experience stress and psychosocial symptoms, including mood disorders, anxiety, prejudice and low self-esteem. Given that cardiovascular risk factors and pediatric obesity have the tendency to pertain into adulthood, obesity management, including weight control and physical activity, should start before the late teens and certainly before the first signs of atherosclerosis can be detected. This review aims to concisely present options for childhood obesity management, including lifestyle modification strategies and pharmacological treatment, as well as the respective treatment indications for the general practitioner.
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Affiliation(s)
- Despina Herouvi
- Diabetes and Metabolism Clinic, 2nd Department of Pediatrics, University of Athens, "P&A Kyriakou" Children's Hospital, 11527 Athens, Greece
| | - George Paltoglou
- Diabetes and Metabolism Clinic, 2nd Department of Pediatrics, University of Athens, "P&A Kyriakou" Children's Hospital, 11527 Athens, Greece
| | - Alexandra Soldatou
- Diabetes and Metabolism Clinic, 2nd Department of Pediatrics, University of Athens, "P&A Kyriakou" Children's Hospital, 11527 Athens, Greece
| | - Christina Kalpia
- Diabetes and Metabolism Clinic, 2nd Department of Pediatrics, University of Athens, "P&A Kyriakou" Children's Hospital, 11527 Athens, Greece
| | - Spyridon Karanasios
- Diabetes and Metabolism Clinic, 2nd Department of Pediatrics, University of Athens, "P&A Kyriakou" Children's Hospital, 11527 Athens, Greece
| | - Kyriaki Karavanaki
- Diabetes and Metabolism Clinic, 2nd Department of Pediatrics, University of Athens, "P&A Kyriakou" Children's Hospital, 11527 Athens, Greece
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Kaza M, Tsentidis C, Vlachopapadopoulou E, Karanasios S, Sakou II, Paltoglou G, Mastorakos G, Karavanaki K. The impact of physical activity, quality of life and eating habits on cardiometabolic profile and adipokines in youth with T1D. Endocrine 2023; 80:541-551. [PMID: 37085722 DOI: 10.1007/s12020-023-03370-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Accepted: 04/06/2023] [Indexed: 04/23/2023]
Abstract
PURPOSE Individuals with Type-1-Diabetes (T1D) are at higher risk of having premature cardiovascular-disease (CVD). Physical activity and healthy lifestyle are major components in the prevention of diabetes' related comorbidities and complications. The aim of this study was to investigate the impact of physical activity, eating habits and quality of life in children and adolescents with T1D on diabetic control, cardiovascular and biochemical profile, infection indices, and adipokine levels. METHODS This cross-sectional study involved 80 participants (36 boys/44 girls) with T1D, aged (mean ± SD) 14.9 ± 3.4 years, who attended the Diabetes and Metabolism Clinic of a University Children's Hospital, using anthropometric studies, lipid profile, high-sensitivity-C-Reactive-Protein(hs-CRP), Interleukin-6(IL6), leptin and adiponectin levels. Physical activity was assessed with pedometers (total-steps/week) and questionnaire. RESULTS In 20(25%) children the level of exercise was >75th percentile, in 20(25%) <25th percentile and in 40(50%) children ranged between 25-75th percentile, respectively. Higher levels of physical activity were associated with weight (beta = -0.053, p < 0.001), waist circumference (beta = -0.077, p < 0.001), BMI (beta = -0.167, p = 0.009), muscle mass (beta = -0.0619, p = 0.001) and HDL-C (beta = 0.039, p = 0.033). Quality of life was positively related to weight (beta = 5.49511, p = 0.002), waist circumference (beta = 6.593345, p = 0.012), muscle mass (beta = 7.324088, p < 0.001) and T1D duration (beta = 19.22442, p = 0.005). Lipid profile was positively associated with sweets and chocolate consumption (beta = 0.348, p < 0.05), while vegetable (beta = -0.245, p < 0.05) and white milk consumption (beta = -0.2295, p < 0.05) were negatively associated with waist/height ratio. CONCLUSIONS In the present study, higher levels of physical activity were associated with improved lipid profile (HDL-C, triglycerides) and body composition [waist circumference, Body-Mass-Index (BMI] of children and adolescents with T1D. Higher scoring in quality-of-life questionnaires were related to older children with longer diabetes duration. Unhealthy eating habits unfavorably affected lipid profile and body composition in T1D youth.
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Affiliation(s)
- Maria Kaza
- Diabetes and Metabolism Unit, 2nd Department of Pediatrics, National and Kapodistrian University of Athens, "P&A Kyriakou" Children's Hospital, 11527, Athens, Greece.
| | - Charalampos Tsentidis
- Department of Endocrinology, Metabolism & Diabetes Mellitus, General Hospital of Nikaia-Piraeus "Agios Panteleimon", 18454, Piraeus, Greece
| | - Elpis Vlachopapadopoulou
- Department of Endocrinology Growth and Development, "P&A Kyriakou" Children's Hospital, 11527, Athens, Greece
| | - Spyridon Karanasios
- Diabetes and Metabolism Unit, 2nd Department of Pediatrics, National and Kapodistrian University of Athens, "P&A Kyriakou" Children's Hospital, 11527, Athens, Greece
| | - Irine- Ikbale Sakou
- Diabetes and Metabolism Unit, 2nd Department of Pediatrics, National and Kapodistrian University of Athens, "P&A Kyriakou" Children's Hospital, 11527, Athens, Greece
| | - George Paltoglou
- Diabetes and Metabolism Unit, 2nd Department of Pediatrics, National and Kapodistrian University of Athens, "P&A Kyriakou" Children's Hospital, 11527, Athens, Greece
| | - George Mastorakos
- Endocrine Unit, "Aretaieion" Hospital, National and Kapodistrian University of Athens, 11528, Athens, Greece
| | - Kyriaki Karavanaki
- Diabetes and Metabolism Unit, 2nd Department of Pediatrics, National and Kapodistrian University of Athens, "P&A Kyriakou" Children's Hospital, 11527, Athens, Greece
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Vourdoumpa A, Paltoglou G, Charmandari E. The Genetic Basis of Childhood Obesity: A Systematic Review. Nutrients 2023; 15:1416. [PMID: 36986146 PMCID: PMC10058966 DOI: 10.3390/nu15061416] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 03/05/2023] [Accepted: 03/10/2023] [Indexed: 03/17/2023] Open
Abstract
Overweight and obesity in childhood and adolescence represents one of the most challenging public health problems of our century owing to its epidemic proportions and the associated significant morbidity, mortality, and increase in public health costs. The pathogenesis of polygenic obesity is multifactorial and is due to the interaction among genetic, epigenetic, and environmental factors. More than 1100 independent genetic loci associated with obesity traits have been currently identified, and there is great interest in the decoding of their biological functions and the gene-environment interaction. The present study aimed to systematically review the scientific evidence and to explore the relation of single-nucleotide polymorphisms (SNPs) and copy number variants (CNVs) with changes in body mass index (BMI) and other measures of body composition in children and adolescents with obesity, as well as their response to lifestyle interventions. Twenty-seven studies were included in the qualitative synthesis, which consisted of 7928 overweight/obese children and adolescents at different stages of pubertal development who underwent multidisciplinary management. The effect of polymorphisms in 92 different genes was assessed and revealed SNPs in 24 genetic loci significantly associated with BMI and/or body composition change, which contribute to the complex metabolic imbalance of obesity, including the regulation of appetite and energy balance, the homeostasis of glucose, lipid, and adipose tissue, as well as their interactions. The decoding of the genetic and molecular/cellular pathophysiology of obesity and the gene-environment interactions, alongside with the individual genotype, will enable us to design targeted and personalized preventive and management interventions for obesity early in life.
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Affiliation(s)
- Aikaterini Vourdoumpa
- Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, ‘Aghia Sophia’ Children’s Hospital, 11527 Athens, Greece
| | - George Paltoglou
- Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, ‘Aghia Sophia’ Children’s Hospital, 11527 Athens, Greece
| | - Evangelia Charmandari
- Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, ‘Aghia Sophia’ Children’s Hospital, 11527 Athens, Greece
- Division of Endocrinology and Metabolism, Center for Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens, 11527 Athens, Greece
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Stefanaki C, Paltoglou G, Mastorakos G, Chrousos GP. Chronic Stress and Steatosis of Muscles, Bones, Liver, and Pancreas: A Review. Horm Res Paediatr 2023; 96:66-73. [PMID: 35144259 DOI: 10.1159/000522540] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Accepted: 02/05/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Chronic stress is a recognized risk factor for poor health, body composition disequilibrium, impaired mental health, and deterioration of quality of life. Chronic stress-related cortisol oversecretion and circadian dysregulation and associated systemic low grade, injurious inflammation ("para-inflammation") contribute to steatosis in various metabolically active solid organs, affecting both their structure and function. The aim of this review was to summarize current knowledge on the impact of chronic stress and associated para-inflammation on skeletal muscle, bone, liver, and pancreas, leading to their steatosis. Current management of these maladaptive conditions is also included and underscored in this review. SUMMARY Steatosis of metabolically active solid organs is involved in various metabolic processes and considered a risk factor for chronic noncommunicable diseases, yet its role in chronic stress physiology and pathophysiology has been overlooked. KEY MESSAGES Chronic stress-associated steatosis of several solid organs is generally disregarded in current clinical practice. Physicians should be alert for these steatoses and should address them adequately so as to provide appropriate medical care. New guidelines generated by learned societies are needed, along with large observational studies, to offer novel solutions to this old problem.
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Affiliation(s)
- Charikleia Stefanaki
- Unit of Endocrinology, Diabetes Mellitus, and Metabolism, School of Medicine, Aretaieion Hospital, National and Kapodistrian University of Athens, Athens, Greece.,University Research Institute of Maternal and Child Health & Precision Medicine, and UNESCO Chair on Adolescent Health Care, "Aghia Sophia" Children's Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - George Paltoglou
- Unit of Endocrinology, Diabetes Mellitus, and Metabolism, School of Medicine, Aretaieion Hospital, National and Kapodistrian University of Athens, Athens, Greece.,University Research Institute of Maternal and Child Health & Precision Medicine, and UNESCO Chair on Adolescent Health Care, "Aghia Sophia" Children's Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - George Mastorakos
- Unit of Endocrinology, Diabetes Mellitus, and Metabolism, School of Medicine, Aretaieion Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - George P Chrousos
- University Research Institute of Maternal and Child Health & Precision Medicine, and UNESCO Chair on Adolescent Health Care, "Aghia Sophia" Children's Hospital, National and Kapodistrian University of Athens, Athens, Greece
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Raftopoulou C, Abawi O, Sommer G, Binou M, Paltoglou G, Flück CE, van den Akker ELT, Charmandari E. Leukocyte Telomere Length in Children With Congenital Adrenal Hyperplasia. J Clin Endocrinol Metab 2023; 108:443-452. [PMID: 36181470 DOI: 10.1210/clinem/dgac560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 09/21/2022] [Indexed: 01/20/2023]
Abstract
CONTEXT Exposure to chronic stress and hypercortisolism is associated with decreased leukocyte telomere length (LTL), a marker for biological aging and cardiovascular disease. Children with congenital adrenal hyperplasia (CAH) are treated with glucocorticoids. OBJECTIVE To investigate LTL in children with CAH. METHODS In this prospective observational cohort study, conducted at 4 academic pediatric endocrinology outpatient clinics, children with genetically confirmed CAH were assessed at 2 follow-up visits (mean 4.1 ± 0.7 months apart). At each visit, LTL was determined by quantitative real-time PCR. All subjects underwent detailed clinical and endocrinologic evaluation and were classified as undertreated, optimally treated, or overtreated, accordingly. The influence of clinical factors on LTL was investigated using linear mixed models adjusted for age, sex, and BMI-z. RESULTS We studied 76 patients, of whom 31 (41%) were girls, 63 (83%) had classic CAH, 67 (88%) received hydrocortisone, and 8 (11%) prednisolone. Median age at first visit was 12.0 years (IQR, 6.3-15.1), and median BMI-z was 0.51 (IQR, -0.12 to 1.43). LTL was shorter in patients with classic vs nonclassic CAH (-0.29, P = 0.012), in overtreated than in optimally treated patients (-0.07, P = 0.002), and patients receiving prednisolone compared with hydrocortisone (-0.34, P < 0.001). LTL was not associated with undertreatment or daily hydrocortisone-equivalent dose (P > 0.05). CONCLUSION LTL is shorter in patients with classic than nonclassic CAH, and in those who are overtreated with hydrocortisone or treated with long-acting glucocorticoids. These findings may be attributed to chronic exposure to supraphysiologic glucocorticoid concentrations and indicate that LTL may be used as a biomarker for monitoring glucocorticoid treatment.
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Affiliation(s)
- Christina Raftopoulou
- Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, 'Aghia Sophia' Children's Hospital, Athens 11527, Greece
- Division of Endocrinology and Metabolism, Center for Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens, Athens 11527, Greece
| | - Ozair Abawi
- Division of Endocrinology, Department of Pediatrics, Erasmus MC-Sophia Children's Hospital, University Medical Center Rotterdam, Rotterdam 3000 CA, The Netherlands
| | - Grit Sommer
- Pediatric Endocrinology, Diabetology and Metabolism, Department of Pediatrics, Bern and Department of BioMedical Research, University Hospital Inselspital, University of Bern, Bern 3010, Switzerland
| | - Maria Binou
- Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, 'Aghia Sophia' Children's Hospital, Athens 11527, Greece
- Division of Endocrinology and Metabolism, Center for Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens, Athens 11527, Greece
| | - George Paltoglou
- Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, 'Aghia Sophia' Children's Hospital, Athens 11527, Greece
- Division of Endocrinology and Metabolism, Center for Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens, Athens 11527, Greece
| | - Christa E Flück
- Pediatric Endocrinology, Diabetology and Metabolism, Department of Pediatrics, Bern and Department of BioMedical Research, University Hospital Inselspital, University of Bern, Bern 3010, Switzerland
| | - Erica L T van den Akker
- Division of Endocrinology, Department of Pediatrics, Erasmus MC-Sophia Children's Hospital, University Medical Center Rotterdam, Rotterdam 3000 CA, The Netherlands
| | - E Charmandari
- Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, 'Aghia Sophia' Children's Hospital, Athens 11527, Greece
- Division of Endocrinology and Metabolism, Center for Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens, Athens 11527, Greece
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Karampatsou SI, Paltoglou G, Genitsaridi SM, Kassari P, Charmandari E. The Effect of a Comprehensive Life-Style Intervention Program of Diet and Exercise on Four Bone-Derived Proteins, FGF-23, Osteopontin, NGAL and Sclerostin, in Overweight or Obese Children and Adolescents. Nutrients 2022; 14:3772. [PMID: 36145151 PMCID: PMC9505283 DOI: 10.3390/nu14183772] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 09/05/2022] [Accepted: 09/07/2022] [Indexed: 11/17/2022] Open
Abstract
The adipose and bone tissues demonstrate considerable interconnected endocrine function. In the present study, we determined the concentrations of fibroblast growth factor-23 (FGF-23), osteopontin, neutrophil gelatinase-associated lipocalin (NGAL) and sclerostin in 345 children and adolescents who were overweight or obese (mean age ± SD mean: 10.36 ± 0.16 years; 172 males, 173 females; 181 prepubertal; and 164 pubertal) before and after their participation in a comprehensive life-style intervention program of diet and exercise for one year. Following the one-year life-style interventions, there was a significant decrease in BMI (p < 0.01), FGF-23 (p < 0.05), osteopontin (p < 0.01) and NGAL (p < 0.01), and an increase in sclerostin (p < 0.01) concentrations. BMI z-score (b = 0.242, p < 0.05) and fat mass (b = 0.431, p < 0.05) were the best positive predictors and waist-to-height ratio (WHtR) (b = −0.344, p < 0.05) was the best negative predictor of the change of osteopontin. NGAL concentrations correlated positively with HbA1C (b = 0.326, p < 0.05), WHtR (b = 0.439, p < 0.05) and HOMA-IR (b = 0.401, p < 0.05), while BMI (b = 0.264, p < 0.05), fat mass (b = 1.207, p < 0.05), HDL (b = 0.359, p < 0.05) and waist circumference (b = 0.263, p < 0.05) were the best positive predictors of NGAL. These results indicate that FGF-23, osteopontin, NGAL and sclerostin are associated with being overweight or obese and are altered in relation to alterations in BMI. They also indicate a crosstalk between adipose tissue and bone tissue and may play a role as potential biomarkers of glucose metabolism. Further studies are required to delineate the physiological mechanisms underlying this association in children and adolescents.
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Affiliation(s)
- Sofia I. Karampatsou
- Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, ‘Aghia Sophia’ Children’s Hospital, 11527 Athens, Greece
| | - George Paltoglou
- Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, ‘Aghia Sophia’ Children’s Hospital, 11527 Athens, Greece
- Division of Endocrinology and Metabolism, Center for Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens, 11527 Athens, Greece
| | - Sofia M. Genitsaridi
- Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, ‘Aghia Sophia’ Children’s Hospital, 11527 Athens, Greece
| | - Penio Kassari
- Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, ‘Aghia Sophia’ Children’s Hospital, 11527 Athens, Greece
- Division of Endocrinology and Metabolism, Center for Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens, 11527 Athens, Greece
| | - Evangelia Charmandari
- Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, ‘Aghia Sophia’ Children’s Hospital, 11527 Athens, Greece
- Division of Endocrinology and Metabolism, Center for Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens, 11527 Athens, Greece
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Christopoulos P, Eleftheriades A, Paltoglou G, Paschalidou E, Kalampokas E, Florentin L, Billi C, Eleftheriades M. Familial Aggregation of a Novel Missense Variant of COL2A1 Gene Associated with Short Extremities: Case Report and Review of the Literature. Children (Basel) 2022; 9:children9081229. [PMID: 36010119 PMCID: PMC9406900 DOI: 10.3390/children9081229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 04/16/2022] [Accepted: 04/16/2022] [Indexed: 11/25/2022]
Abstract
We present two cases of family members (first cousins) with short extremities caused by a novel variant of COL2A1 gene (NM_001844.5). Case 1 description: A 29-year-old woman presented in her first pregnancy for a second trimester anomaly scan at 23 weeks of gestation. Fetal long bones were measured below the third centile for gestational age. Follow-up scans revealed fetal long bone growth deceleration. Initial genetic work-up was negative and the rest of the maternal follow-up was unremarkable. A male baby weighing 3180 g was delivered at 39 weeks and 4 days of gestation. Case 2 description: A 33-year-old pregnant woman presented for a routine second trimester anomaly scan at 20 weeks and 4 days of gestation. All fetal measurements were appropriate for the gestational age. The routine growth scan performed at 32 weeks showed fetal long bone measurements below the third centile for gestational age, while the follow-up growth scan at 36 weeks and 4 days of gestation revealed consistent, below the third centile, fetal long bone growth. Given that the fetuses of these two cases were related (first cousins), whole exome sequencing (WES) was performed on Case 2. WES revealed a novel heterozygous missense variant c.1132G>A (p. Gly378Ser) of COL2A1 gene (NM_001844.5). Subsequently, targeted genetic sequencing for the variant was performed on Case 1 and the same novel variant was found. Targeted sequencing revealed the same variant in the mother of Case 1 and the father of Case 2 (siblings). A female baby weighing 3200 g was delivered at 40 weeks and 4 days of gestation.
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Affiliation(s)
- Panagiotis Christopoulos
- Second Department of Obstetrics and Gynaecology, ‘Aretaieio’ Hospital, Medical School, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | - Anna Eleftheriades
- Second Department of Obstetrics and Gynaecology, ‘Aretaieio’ Hospital, Medical School, National and Kapodistrian University of Athens, 11528 Athens, Greece
- Postgraduate Programme “Maternal Fetal Medicine”, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
- Correspondence:
| | - George Paltoglou
- First Department of Pediatrics, ‘Aghia Sophia’ Children’s Hospital, Division of Endocrinology, Metabolism and Diabetes, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Eleni Paschalidou
- Second Department of Obstetrics and Gynaecology, ‘Aretaieio’ Hospital, Medical School, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | - Emmanouil Kalampokas
- Second Department of Obstetrics and Gynaecology, ‘Aretaieio’ Hospital, Medical School, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | | | | | - Makarios Eleftheriades
- Second Department of Obstetrics and Gynaecology, ‘Aretaieio’ Hospital, Medical School, National and Kapodistrian University of Athens, 11528 Athens, Greece
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11
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Vasilakis IA, Paltoglou G, Gavra M, Charmandari E. A rare case of a giant prolactinoma with atypical histological features: 5 years of follow-up. Hormones (Athens) 2022; 21:323-327. [PMID: 35143036 DOI: 10.1007/s42000-022-00350-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 01/10/2022] [Indexed: 11/04/2022]
Abstract
BACKGROUND Giant prolactinomas are rare in childhood and adolescence and represent a challenge in diagnosis and management. CASE PRESENTATION A 15.7-year-old male adolescent presented with short stature and delayed puberty. On clinical examination, mild right central VII paresis, gait instability, decreased visual acuity, and impaired visual fields were noted. Investigations showed hyperprolactinemia (2209 ng/mL), secondary hypothyroidism, hypogonadotropic hypogonadism, and growth hormone deficiency. Imaging studies showed an enormous invasive skull base mass. Craniotomy was undertaken to debulk the tumor and perform biopsies. Histology revealed a very large atypical, prolactin-secreting pituitary macroadenoma, i.e., a giant prolactinoma. After commencing cabergoline treatment, prolactin concentrations decreased in 5 months and normalized 18 months later, while significant shrinkage of the tumor was observed. The diagnostic work-up for genetic syndromes often associated with sporadic macroadenomas was negative. CONCLUSION Giant prolactinomas presenting with multiple pituitary hormone deficiencies in childhood or adolescence are rare and require prompt diagnosis and multidisciplinary management.
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Affiliation(s)
- Ioannis-Anargyros Vasilakis
- Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, 'Aghia Sophia' Children's Hospital, Thivon & Levadeias Str., 11527, Athens, Greece
| | - George Paltoglou
- Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, 'Aghia Sophia' Children's Hospital, Thivon & Levadeias Str., 11527, Athens, Greece.
- University Research Institute of Maternal and Child Health & Precision Medicine, Thivon & Levadeias Str., 11527, Athens, Greece.
| | - Maria Gavra
- Division of CT and MRI, Radiology Department, 'Aghia Sophia' Children's Hospital, Thivon & Levadeias Str., 11527, Athens, Greece
| | - Evangelia Charmandari
- Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, 'Aghia Sophia' Children's Hospital, Thivon & Levadeias Str., 11527, Athens, Greece
- Division of Endocrinology and Metabolism, Center of Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens, 4 Soranou Ephessiou Str., 11527, Athens, Greece
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12
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Paschalidou E, Paltoglou G, Tsarna E, Toutoudaki K, Arapaki A, Christopoulos P. 078 A rare case of Mayer-Rokitansky-Küster-Hauser syndrome associated with bilateral ovarian agenesis in a normal karyotypic female. Eur J Obstet Gynecol Reprod Biol 2022. [DOI: 10.1016/j.ejogrb.2022.02.107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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13
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Raftopoulou C, Paltoglou G, Charmandari E. Association between Telomere Length and Pediatric Obesity: A Systematic Review. Nutrients 2022; 14:nu14061244. [PMID: 35334902 PMCID: PMC8949519 DOI: 10.3390/nu14061244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 03/08/2022] [Accepted: 03/10/2022] [Indexed: 12/10/2022] Open
Abstract
Objective: Telomere length (TL) is a robust marker of biological aging, and increased telomere attrition is noted in adults with obesity. The primary objective of this systematic review was to summarize current knowledge on the effects of childhood obesity in TL. The secondary objective was to assess the effect of weight management interventions in TL. Methods: The following databases were searched: PubMed, Scopus, Web of Science and Heal-link.gr from inception to September 2021. The search was performed using the following combinations of terms: “telomer*” [All Fields] AND (“length” [All Fields] OR “lengths” [All Fields]) AND “obes*” [All Fields] AND (“child*” [All Fields] OR “adolescen*” [All Fields]). Results: A total of 16 original articles were included in this systematic review. Eleven of them were cross-sectional and five were lifestyle interventions. Conclusions: There was a tendency towards a negative association between childhood obesity and TL. Life-style interventions in children have been associated with increased TL peripherally, indicating a possible association of the redistribution of younger cells in the periphery with the favorable effect of these interventions. Further prospective studies with larger sample sizes that employ other markers of cell aging would potentially elucidate this important mechanistic relation.
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Affiliation(s)
- Christina Raftopoulou
- Division of Endocrinology and Metabolism, Center of Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens, 11527 Athens, Greece;
| | - George Paltoglou
- Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, Aghia Sophia Children’s Hospital, 11527 Athens, Greece;
| | - Evangelia Charmandari
- Division of Endocrinology and Metabolism, Center of Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens, 11527 Athens, Greece;
- Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, Aghia Sophia Children’s Hospital, 11527 Athens, Greece;
- Correspondence: ; Tel./Fax: +30-213-2013-384
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14
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Tsarna E, Arapaki A, Tsomi E, Ziogou G, Paltoglou G, Valsamakis G, Christopoulos P. 182 The role of diet during pregnancy in prevention of gestational diabetes mellitus. Eur J Obstet Gynecol Reprod Biol 2022. [DOI: 10.1016/j.ejogrb.2021.11.237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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15
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Arapaki A, Paltoglou G, Ziogou G, Tsomi E, Toutoudaki K, Valsamakis G, Christopoulos P. 185 The effect of dietary patterns on excessive gestational weight gain in a sample of greek women. Eur J Obstet Gynecol Reprod Biol 2022. [DOI: 10.1016/j.ejogrb.2021.11.239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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16
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Christopoulos P, Paltoglou G, Paschalidou E, Tsarna E, Liakopoulou M, Triantafyllidou O, Eleftheriades M. 179 A novel misense mutation of col2a1 gene as a cause of short extremeties in two first cousins. Eur J Obstet Gynecol Reprod Biol 2022. [DOI: 10.1016/j.ejogrb.2021.11.060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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17
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Sakou II, Soldatou A, Seretis A, Karanasios E, Paltoglou G, Karavanaki K. Markedly elevated troponin and NT-proBNP and myocardial dysfunction in an adolescent with severe diabetic ketoacidosis: a case report. Clin Pediatr Endocrinol 2022; 31:192-198. [PMID: 35928382 PMCID: PMC9297169 DOI: 10.1297/cpe.2022-0017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 04/16/2022] [Indexed: 12/04/2022] Open
Abstract
Severe diabetic ketoacidosis (DKA), rarely, may be associated with elevated troponin and
proBNP levels in adults with a history of diabetes. However, few cases have reported this
association in children with severe and complicated DKA. We describe a case of severe DKA
(pH: 6.89, HCO3: 6.5) in a 14-yr-old female adolescent in which the symptoms of DKA were
presented days before the diagnosis. The patient was under the effect of acidosis
(Kussmaul respiration) for 12 h before admission to our hospital, where she was admitted
in a critical clinical condition. After successful treatment with DKA with intensive
intravenous fluid and regular insulin, the patient presented with abnormal cardiac rhythm,
disturbance of interventricular septum motility, a mild decrease in left ventricular
systolic function, negative T waves in leads III and aVF, and a marked increase in
troponin and brain natriuretic peptide (NT-proBNP) levels. All abnormal findings
completely resolved within 8 days after the initiation of DKA treatment. The phenomenon in
our case was transient, and the patient had a good long-term outcome. However, it
represents a challenge for clinicians; therefore, emphasis should be given to cardiac
monitoring during the course of severe and prolonged DKA in children and adolescents.
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Affiliation(s)
- Irine-Ikbale Sakou
- Diabetic Clinic, 2nd Department of Pediatrics, National and Kapodistrian University of Athens, “P&A Kyriakou” Children’s Hospital, Athens, Greece
| | - Alexandra Soldatou
- Diabetic Clinic, 2nd Department of Pediatrics, National and Kapodistrian University of Athens, “P&A Kyriakou” Children’s Hospital, Athens, Greece
| | - Aristeidis Seretis
- Cardiology Deparment, “P&A Kyriakou” Children’s Hospital, Athens, Greece
| | | | - George Paltoglou
- University Research Institute of Maternal and Child Health and Precision Medicine, Athens, Greece
| | - Kyriaki Karavanaki
- Diabetic Clinic, 2nd Department of Pediatrics, National and Kapodistrian University of Athens, “P&A Kyriakou” Children’s Hospital, Athens, Greece
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Koutaki D, Paltoglou G, Vourdoumpa A, Charmandari E. The Impact of Bisphenol A on Thyroid Function in Neonates and Children: A Systematic Review of the Literature. Nutrients 2021; 14:nu14010168. [PMID: 35011041 PMCID: PMC8746969 DOI: 10.3390/nu14010168] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Revised: 12/21/2021] [Accepted: 12/23/2021] [Indexed: 01/23/2023] Open
Abstract
Background: Bisphenol A (BPA) is an endocrine-disrupting chemical widely used in plastic products that may have an adverse effect on several physiologic functions in children. The aim of this systematic review is to summarize the current knowledge of the impact of BPA concentrations on thyroid function in neonates, children, and adolescents. Methods: A systematic search of Medline, Scopus, Clinical Trials.gov, Cochrane Central Register of Controlled Trials CENTRAL, and Google Scholar databases according to PRISMA guidelines was performed. Only case–control, cross-sectional, and cohort studies that assessed the relationship between Bisphenol A and thyroid function in neonates and children aged <18 years were included. Initially, 102 articles were assessed, which were restricted to 73 articles after exclusion of duplicates. A total of 73 articles were assessed by two independent researchers based on the title/abstract and the predetermined inclusion and exclusion criteria. According to the eligibility criteria, 18 full-text articles were selected for further assessment. Finally, 12 full-text articles were included in the present systematic review. Results: The presented studies offer data that suggest a negative correlation of BPA concentrations with TSH in children, a gender-specific manner of action, and a potential effect on proper neurodevelopment. However, the results are inconclusive with respect to specific thyroid hormone concentrations and the effect on thyroid autoimmunity. Conclusion: The potential negative effect of BPA in the developing thyroid gland of children that may affect proper neurodevelopment, suggesting the need to focus future research on designing studies that elucidate the underlying mechanisms and the effects of BPA in thyroid function in early life.
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Affiliation(s)
- Diamanto Koutaki
- Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, ‘Aghia Sophia’ Children’s Hospital, 11527 Athens, Greece; (D.K.); (G.P.); (A.V.)
| | - George Paltoglou
- Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, ‘Aghia Sophia’ Children’s Hospital, 11527 Athens, Greece; (D.K.); (G.P.); (A.V.)
| | - Aikaterini Vourdoumpa
- Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, ‘Aghia Sophia’ Children’s Hospital, 11527 Athens, Greece; (D.K.); (G.P.); (A.V.)
| | - Evangelia Charmandari
- Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, ‘Aghia Sophia’ Children’s Hospital, 11527 Athens, Greece; (D.K.); (G.P.); (A.V.)
- Division of Endocrinology and Metabolism, Center of Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens, 11527 Athens, Greece
- Correspondence: ; Tel./Fax: +30-213-2013-384
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Paltoglou G, Raftopoulou C, Nicolaides NC, Genitsaridi SM, Karampatsou SI, Papadopoulou M, Kassari P, Charmandari E. A Comprehensive, Multidisciplinary, Personalized, Lifestyle Intervention Program Is Associated with Increased Leukocyte Telomere Length in Children and Adolescents with Overweight and Obesity. Nutrients 2021; 13:nu13082682. [PMID: 34444842 PMCID: PMC8402072 DOI: 10.3390/nu13082682] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 07/19/2021] [Accepted: 07/21/2021] [Indexed: 01/12/2023] Open
Abstract
Leucocyte telomere length (LTL) is a robust marker of biological aging and is associated with obesity and cardiometabolic risk factors in childhood and adolescence. We investigated the effect of a structured, comprehensive, multidisciplinary, personalized, lifestyle intervention program of healthy diet and physical exercise on LTL in 508 children and adolescents (239 males, 269 females; 282 prepubertal, 226 pubertal), aged 10.14 ± 0.13 years. Participants were classified as obese (n = 267, 52.6%), overweight (n = 174, 34.2%), or of normal BMI (n = 67, 13.2%) according to the International Obesity Task Force (IOTF) cutoff points and were studied prospectively for one year. We demonstrated that LTL increased significantly after 1 year of the lifestyle interventions, irrespective of gender, pubertal status, or body mass index (BMI). Waist circumference was the best negative predictor of LTL at initial assessment. The implementation of the lifestyle interventions also resulted in a significant improvement in clinical (BMI, BMI z-score and waist to height ratio) and body composition indices of obesity, inflammatory markers, hepatic enzymes, glycated hemoglobin (HbA1C), quantitative insulin sensitivity check index (QUICKI), and lipid profile in all participants. These findings indicate that the increased LTL may be associated with a more favorable metabolic profile and decreased morbidity later in life.
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Affiliation(s)
- George Paltoglou
- Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, ‘Aghia Sophia’ Children’s Hospital, 11527 Athens, Greece; (G.P.); (N.C.N.); (S.M.G.); (S.I.K.); (M.P.); (P.K.)
| | - Christina Raftopoulou
- Division of Endocrinology and Metabolism, Center for Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens, 11527 Athens, Greece;
| | - Nicolas C. Nicolaides
- Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, ‘Aghia Sophia’ Children’s Hospital, 11527 Athens, Greece; (G.P.); (N.C.N.); (S.M.G.); (S.I.K.); (M.P.); (P.K.)
| | - Sofia M. Genitsaridi
- Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, ‘Aghia Sophia’ Children’s Hospital, 11527 Athens, Greece; (G.P.); (N.C.N.); (S.M.G.); (S.I.K.); (M.P.); (P.K.)
| | - Sofia I. Karampatsou
- Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, ‘Aghia Sophia’ Children’s Hospital, 11527 Athens, Greece; (G.P.); (N.C.N.); (S.M.G.); (S.I.K.); (M.P.); (P.K.)
| | - Marina Papadopoulou
- Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, ‘Aghia Sophia’ Children’s Hospital, 11527 Athens, Greece; (G.P.); (N.C.N.); (S.M.G.); (S.I.K.); (M.P.); (P.K.)
| | - Penio Kassari
- Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, ‘Aghia Sophia’ Children’s Hospital, 11527 Athens, Greece; (G.P.); (N.C.N.); (S.M.G.); (S.I.K.); (M.P.); (P.K.)
| | - Evangelia Charmandari
- Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, ‘Aghia Sophia’ Children’s Hospital, 11527 Athens, Greece; (G.P.); (N.C.N.); (S.M.G.); (S.I.K.); (M.P.); (P.K.)
- Division of Endocrinology and Metabolism, Center for Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens, 11527 Athens, Greece;
- Correspondence: ; Tel./Fax: +30-21-3201-3384
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Kardalas E, Maraka S, Papagianni M, Paltoglou G, Siristatidis C, Mastorakos G. TGF-β Physiology as a Novel Therapeutic Target Regarding Autoimmune Thyroid Diseases: Where Do We Stand and What to Expect. ACTA ACUST UNITED AC 2021; 57:medicina57060621. [PMID: 34198624 PMCID: PMC8232149 DOI: 10.3390/medicina57060621] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 06/07/2021] [Indexed: 02/07/2023]
Abstract
Transforming growth factor beta (TGF-β), as a master regulator of immune response, is deeply implicated in the complex pathophysiology and development of autoimmune thyroid diseases. Based on the close interplay between thyroid autoimmunity and TGF-β, scientific interest was shifted to the understanding of the possible role of this molecule regarding the diagnosis, prognosis, and therapy of these diseases. The main aim of this review is to present research data about possible treatment options based on the role of TGF-β in thyroid autoimmunity. Suggested TGF-β-mediated therapeutic strategies regarding autoimmune thyroid diseases include either the enhancement of its immunosuppressive role or inhibition of its facilitatory role in thyroid autoimmunity. For example, the application of hr-TGF-β can be used to bolster the inhibitory role of TGF-β regarding the development of thyroid diseases, whereas anti-TGF-β antibodies and similar molecules could impede its immune-promoting effects by blocking different levels of TGF-β biosynthesis and activation pathways. In conclusion, TGF-β could evolve to a promising, novel therapeutic tool for thyroid autoimmunity.
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Affiliation(s)
- Efstratios Kardalas
- Endocrine Unit, Aretaieion Hospital, Medical School, National and Kapodistrian University of Athens, Vasilissis Sofias Str. 76, 11528 Athens, Greece; (E.K.); (G.P.)
| | - Spyridoula Maraka
- Division of Endocrinology and Metabolism, Department of Internal Medicine, University of Arkansas for Medical Sciences, 4301 W. Markham St., Little Rock, AR 72501, USA;
| | - Maria Papagianni
- Unit of Endocrinology, Diabetes and Metabolism, 3rd Department of Pediatrics, Aristotle University School of Health Sciences, Hippokration Hospital of Thessaloniki, Konstantinoupoleos Str. 49, 54642 Thessaloniki, Greece;
| | - George Paltoglou
- Endocrine Unit, Aretaieion Hospital, Medical School, National and Kapodistrian University of Athens, Vasilissis Sofias Str. 76, 11528 Athens, Greece; (E.K.); (G.P.)
| | - Charalampos Siristatidis
- Assisted Reproduction Unit, Second Department of Obstetrics and Gynecology, Aretaieion Hospital, Medical School, National and Kapodistrian University of Athens, Vasilissis Sofias Str. 76, 11528 Athens, Greece;
| | - George Mastorakos
- Endocrine Unit, Aretaieion Hospital, Medical School, National and Kapodistrian University of Athens, Vasilissis Sofias Str. 76, 11528 Athens, Greece; (E.K.); (G.P.)
- Correspondence:
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Vrachnis N, Tsonis O, Vrachnis D, Antonakopoulos N, Paltoglou G, Barbounaki S, Mastorakos G, Paschopoulos M, Iliodromiti Z. The Effect of Thyrotropin-Releasing Hormone and Antithyroid Drugs on Fetal Thyroid Function. Children (Basel) 2021; 8:454. [PMID: 34071168 PMCID: PMC8228147 DOI: 10.3390/children8060454] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Revised: 05/21/2021] [Accepted: 05/25/2021] [Indexed: 01/06/2023]
Abstract
A euthyroid pregnant woman will normally have a fetus that displays normal fetal development. However, studies have long demonstrated the role of T3 (Triiodothyronine), T4 (Thyroxine), and TSH (Thyroid Stimulating Hormone) and their degree of penetrability into the fetal circulation. Maternal thyrotropin-releasing hormone (TRH) crosses the placental site and, from mid-gestation onward, is able to promote fetal TSH secretion. Its origin is not only hypothalamic, as was believed until recently. The maternal pancreas, and other extraneural and extrahypothalamic organs, can produce TRH variants, which are transported through the placenta affecting, to a degree, fetal thyroid function. Antithyroid drugs (ATDs) also cross the placenta and, because of their therapeutic actions, can affect fetal thyroid development, leading in some cases to adverse outcomes. Furthermore, there are a number of TRH analogues that share the same properties as the endogenous hormone. Thus, in this narrative review, we highlight the interaction of all the above with fetal growth in uncomplicated pregnancies.
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Affiliation(s)
- Nikolaos Vrachnis
- Third Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens Medical School, Attikon Hospital, 157 72 Athens, Greece;
- Vascular Biology, Molecular and Clinical Sciences Research Institute, St George’s University of London, London SW17 0RE, UK
| | - Orestis Tsonis
- Department of Obstetrics and Gynecology, University of Ioannina Medical School, University Hospital of Ioannina, 455 00 Ioannina, Greece; (O.T.); (M.P.)
| | - Dionisios Vrachnis
- Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, Alexandra Hospital, 157 72 Athens, Greece;
| | - Nikolaos Antonakopoulos
- Third Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens Medical School, Attikon Hospital, 157 72 Athens, Greece;
| | - George Paltoglou
- Endocrinology Unit, 2nd Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens Medical School, Aretaieio Hospital, 157 72 Athens, Greece; (G.P.); (G.M.)
| | | | - George Mastorakos
- Endocrinology Unit, 2nd Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens Medical School, Aretaieio Hospital, 157 72 Athens, Greece; (G.P.); (G.M.)
| | - Minas Paschopoulos
- Department of Obstetrics and Gynecology, University of Ioannina Medical School, University Hospital of Ioannina, 455 00 Ioannina, Greece; (O.T.); (M.P.)
| | - Zoi Iliodromiti
- Department of Neonatology, National and Kapodistrian University of Athens Medical School, Aretaieio Hospital, 157 72 Athens, Greece;
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Paltoglou G, Dimitropoulos I, Kourlaba G, Charmandari E. The effect of treatment with recombinant human growth hormone (rhGH) on linear growth and adult height in children with idiopathic short stature (ISS): a systematic review and meta-analysis. J Pediatr Endocrinol Metab 2020; 33:1577-1588. [PMID: 33035189 DOI: 10.1515/jpem-2020-0287] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Accepted: 08/23/2020] [Indexed: 01/16/2023]
Abstract
OBJECTIVES Idiopathic short stature (ISS) is a recognized, albeit a controversial indication for treatment with recombinant human growth hormone (rhGH).The objective of the present study was to conduct a systematic review of the literature and meta-analyses of selected studies about the use of rhGH in children with ISS on linear growth and adult height (AH). METHODS A systematic literature search was conducted to identify relevant studies published till February 28, 2017 in the following databases: Medline (PubMed), Scopus and Cochrane Central Registry of Controlled Trials. After exclusion of duplicate studies, 3,609 studies were initially identified. Of those, 3,497 studies were excluded during the process of assessing the title and/or the abstract. The remaining 112 studies were evaluated further by assessing the full text; 21 of them fulfilled all the criteria in order to be included in the current meta-analysis. RESULTS Children who received rhGH had significantly higher height increment at the end of the first year, an effect that persisted in the second year of treatment and achieved significantly higher AH than the control group. The difference between the two groups was equal to 5.3 cm (95% CI: 3.4-7 cm) for male and 4.7 cm (95% CI: 3.1-6.3 cm) for female patients. CONCLUSION In children with ISS, treatment with rhGH improves short-term linear growth and increases AH compared with control subjects. However, the final decision should be made on an individual basis, following detailed diagnostic evaluation and careful consideration of both risks and benefits of rhGH administration.
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Affiliation(s)
- George Paltoglou
- Department of Paediatric Endocrinology, Evelina Children's Hospital, London, UK.,Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, 'Aghia Sophia' Children's Hospital, Athens, Greece
| | | | - Georgia Kourlaba
- Center for Clinical Epidemiology and Outcomes Research (CLEO), Athens, Greece
| | - Evangelia Charmandari
- Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, 'Aghia Sophia' Children's Hospital, Athens, Greece.,Division of Endocrinology and Metabolism, Center for Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
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Genitsaridi SM, Karampatsou S, Papageorgiou I, Mantzou A, Papathanasiou C, Kassari P, Paltoglou G, Kourkouti C, Charmandari E. Hair Cortisol Concentrations in Overweight and Obese Children and Adolescents. Horm Res Paediatr 2020; 92:229-236. [PMID: 31851969 DOI: 10.1159/000504913] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Accepted: 11/19/2019] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Obesity in childhood and adolescence is associated with complications that resemble those seen in hypercortisolism. Hair cortisol concentration (HCC) in children is a reliable marker of long-term endogenous cortisol concentrations. We determined HCC in overweight and obese children and adolescents, and examined the relation between HCC and other cardiometabolic parameters. METHODS Three hundred children and adolescents aged 4-18 years (mean age ± standard error of the mean [SEM]: 10.49 ± 0.15 years; 140 [46.7%] obese, 94 [31.3%] overweight, 66 [22%] of normal BMI; 76 males, 224 females) were studied prospectively. Blood samples for determination of hematological, biochemical, and endocrinologic parameters were obtained. Systolic (SBP) and diastolic blood pressure (DBP) was determined. Scalp hair samples were collected from the posterior vertex, and HCC was measured using an electrochemiluminescence immunoassay. RESULTS Obese subjects had significantly higher SBP, DBP, waist and hip circumferences, waist-to-hip ratio, waist-to-height ratio, ALT, γ-GT, triglycerides, apolipoprotein-B, insulin, and HbA1C concentrations than overweight and normal-BMI subjects. HCC did not differ significantly among the three groups of subjects (mean ± SEM: 8.74 ± 0.43 vs. 8.88 ± 0.52 vs. 9.33 ± 0.72, all p > 0.05). No significant association was noted between HCC and cardiometabolic or body composition parameters. HCC was significantly higher in prepubertal girls than prepubertal boys (9.45 ± 0.38 vs. 7.35 ± 0.39, p = 0.007). CONCLUSION In our study, overweight and obesity was not associated with elevated HCC. Furthermore, no association was found between HCC with cardiometabolic parameters and fat mass. Further studies are required to delineate the association between overweight/obesity and HCC.
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Affiliation(s)
- Sofia-Maria Genitsaridi
- Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, "Aghia Sophia" Children's Hospital, Athens, Greece,
| | - Sofia Karampatsou
- Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, "Aghia Sophia" Children's Hospital, Athens, Greece
| | - Ifigeneia Papageorgiou
- Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, "Aghia Sophia" Children's Hospital, Athens, Greece
| | - Aimilia Mantzou
- Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, "Aghia Sophia" Children's Hospital, Athens, Greece
| | - Chryssanthi Papathanasiou
- Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, "Aghia Sophia" Children's Hospital, Athens, Greece
| | - Penio Kassari
- Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, "Aghia Sophia" Children's Hospital, Athens, Greece
| | - George Paltoglou
- Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, "Aghia Sophia" Children's Hospital, Athens, Greece
| | - Christie Kourkouti
- Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, "Aghia Sophia" Children's Hospital, Athens, Greece
| | - Evangelia Charmandari
- Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, "Aghia Sophia" Children's Hospital, Athens, Greece.,Division of Endocrinology and Metabolism, Center of Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
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Paltoglou G, Avloniti A, Chatzinikolaou A, Stefanaki C, Papagianni M, Papassotiriou I, Fatouros IG, Chrousos GP, Kanaka-Gantenbein C, Mastorakos G. In early pubertal boys, testosterone and LH are associated with improved anti-oxidation during an aerobic exercise bout. Endocrine 2019; 66:370-380. [PMID: 31378848 DOI: 10.1007/s12020-019-02037-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Accepted: 07/26/2019] [Indexed: 12/28/2022]
Abstract
PURPOSE To investigate the association of the hypothalamic-pituitary-testicular (HPT) axis with pro- and anti- oxidation, in relation to puberty and obesity in boys, before and after an aerobic exercise bout. METHODS This is a cross-sectional human observational study of 92 healthy normal-weight, obese pre- and early- pubertal boys that underwent a blood sampling, before, and after an aerobic exercise bout at 70% VO2max, until exhaustion. LH, FSH, total testosterone (tT) and markers of pro- (TBARS and PCs) and anti- (GSH, GSSG, GPX, catalase, TAC) oxidation were measured. RESULTS Baseline LH, FSH, and tT concentrations were greater in early, than in pre- pubertal boys, independently of weight status. Post-exercise, LH concentrations decreased in early pubertal boys while FSH concentrations did not change in any of the studied groups. Baseline and post-exercise tT concentrations were lower in obese than in normal-weight early pubertal boys, while baseline and post-exercise LH and FSH concentrations did not differ between these groups. Post-exercise tT concentrations increased in early pubertal obese boys. Baseline LH, FSH and tT concentrations correlated positively with baseline anti-oxidation markers concentrations in pre-pubertal boys. Baseline tT concentrations correlated positively with the increase of TAC concentrations in early pubertal normal-weight boys. In all boys, baseline LH concentrations were the best positive predictors for the exercise-associated increase of TAC concentrations. CONCLUSIONS It appears that the HPT axis maturation during puberty (in particular its LH and testosterone components) is positively associated with the increase of anti-oxidation during a bout of aerobic exercise.
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Affiliation(s)
- George Paltoglou
- Endocrine Unit, "Aretaieion" Hospital, National and Kapodistrian University of Athens - Faculty of Medicine, Athens, Greece
- Department of Paediatric and Adolescent Endocrinology, University College London Hospital, London, UK
| | - Alexandra Avloniti
- Department of Physical Education and Sports Sciences, Democritus University of Thrace, Komotini, Greece
| | - Athanasios Chatzinikolaou
- Department of Physical Education and Sports Sciences, Democritus University of Thrace, Komotini, Greece
| | - Charikleia Stefanaki
- Endocrine Unit, "Aretaieion" Hospital, National and Kapodistrian University of Athens - Faculty of Medicine, Athens, Greece
- Department of Pediatrics, General Hospital of Piraeus 'Aghios Panteleimon', Piraeus, Greece
| | - Maria Papagianni
- Third Department of Pediatrics, Aristotle University of Thessaloniki, School of Medicine, "Hippokrateion" General Hospital of Thessaloniki, Thessaloniki, Greece
| | - Ioannis Papassotiriou
- Department of Clinical Biochemistry, "Aghia Sophia" Children's Hospital, Athens, Greece
| | - Ioannis G Fatouros
- Department of Physical Education and Sports Sciences, University of Thessaly, Trikala, Greece
| | - George P Chrousos
- First Department of Pediatrics, "Aghia Sophia" Children's Hospital, National and Kapodistrian University of Athens - Faculty of Medicine, Athens, Greece
| | - Christina Kanaka-Gantenbein
- First Department of Pediatrics, "Aghia Sophia" Children's Hospital, National and Kapodistrian University of Athens - Faculty of Medicine, Athens, Greece
| | - George Mastorakos
- Endocrine Unit, "Aretaieion" Hospital, National and Kapodistrian University of Athens - Faculty of Medicine, Athens, Greece.
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Sakkas EG, Paltoglou G, Linardi A, Gryparis A, Nteka E, Chalarakis N, Mantzou A, Vrachnis N, Iliodromiti Z, Koukkou E, Deligeoroglou E, Sakkas GE, Mastorakos G. Associations of maternal oestradiol, cortisol, and TGF-β1 plasma concentrations with thyroid autoantibodies during pregnancy and postpartum. Clin Endocrinol (Oxf) 2018; 89:789-797. [PMID: 30151971 DOI: 10.1111/cen.13843] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Revised: 08/17/2018] [Accepted: 08/23/2018] [Indexed: 02/06/2023]
Abstract
BACKGROUND Thyroid physiology and autoimmunity are altered in pregnancy. While oestradiol, cortisol, and TGF-β1 are implicated in these phenomena outside pregnancy, their associations with thyroid autoantibodies during pregnancy and postpartum are not thoroughly examined. This study aimed to unravel their eventual associations during pregnancy and postpartum in the same cohort of 93 pregnant women studied prospectively from 2015 to 2017. METHODS Blood samples were drawn at the 24th and the 36th gestational week and at the 1st postpartum week for measurements of thyroid hormones, TSH, anti-TPO, anti-Tg, oestradiol, cortisol, and TGF-β1. RESULTS Serum anti-TPO was greater (P < 0.05) at the 1st postpartum than at the 24th and 36th gestational weeks. At the 36th gestational week, cortisol was greater (P < 0.05) and TGF-β1 lower (P < 0.05) than at the 24th gestational and the 1st postpartum weeks. At the 1st postpartum week, cortisol correlated negatively with anti-Tg (r = -0.419) (P < 0.05). ΔTGF-β1 was the best negative and Δoestradiol the best positive predictor of the 1st postpartum week anti-TPO (P < 0.05, b = -0.509; P < 0.05, b = 0.459 respectively). CONCLUSIONS At postpartum, increased TGF-β1 is related to a less pronounced anti-TPO increase as compared to the 3rd trimester, suggesting an immunosuppressive role for TGF-β1. During pregnancy and postpartum, oestradiol, cortisol, and TGF-β1 are associated with suppression of thyroid autoantibodies.
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Affiliation(s)
- Evangelos G Sakkas
- Unit of Endocrinology, Diabetes mellitus and Metabolism, 2nd Department of Obstetrics and Gynecology, Aretaieion Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - George Paltoglou
- Department of Endocrinology and Diabetes, Great Ormond Street Hospital, London, UK
| | | | - Alexandros Gryparis
- Unit of Endocrinology, Diabetes mellitus and Metabolism, 2nd Department of Obstetrics and Gynecology, Aretaieion Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Eleni Nteka
- Unit of Endocrinology, Diabetes mellitus and Metabolism, 2nd Department of Obstetrics and Gynecology, Aretaieion Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Nikos Chalarakis
- Unit of Endocrinology, Diabetes mellitus and Metabolism, 2nd Department of Obstetrics and Gynecology, Aretaieion Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Aimilia Mantzou
- Department of Endocrinology, Aghia Sophia Children's Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Nikolaos Vrachnis
- 2nd Department of Obstetrics and Gynecology, Aretaieion Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Zoe Iliodromiti
- Department of Neonatology, 2nd Department of Obstetrics and Gynecology, Aretaieion Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Eftychia Koukkou
- Endocrine Unit, Elena Venizelou Maternity Hospital, Athens, Greece
| | - Efthymios Deligeoroglou
- 2nd Department of Obstetrics and Gynecology, Aretaieion Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | | | - George Mastorakos
- Unit of Endocrinology, Diabetes mellitus and Metabolism, 2nd Department of Obstetrics and Gynecology, Aretaieion Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
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Sidiropoulou EJ, Paltoglou G, Valsamakis G, Margeli A, Mantzou A, Papassotiriou I, Hassiakos D, Iacovidou N, Mastorakos G. Biochemistry, hormones and adipocytokines in prepubertal children born with IUGR evoke metabolic, hepatic and renal derangements. Sci Rep 2018; 8:15691. [PMID: 30356143 PMCID: PMC6200759 DOI: 10.1038/s41598-018-34075-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Accepted: 10/08/2018] [Indexed: 12/15/2022] Open
Abstract
Children born with IUGR develop features of the metabolic syndrome and exhibit deranged markers of hepatorenal physiology. Metabolic and hepatorenal biochemistry and the rs9939609 FTO polymorphism were investigated in prepubertal children born with IUGR. Ninety-eight prepubertal children (46 IUGR and 52 AGA), subdivided in <5 years and >5 years old groups were included. Anthropometry; creatinine, eGFR, urea, AST, ALT, triglycerides, uric acid, total cholesterol, HDL-c, LDL-c, glucose, C-peptide, insulin and glucagon z-scores; HOMA-IR; leptin and adiponectin concentrations; rs9939609 FTO polymorphism frequency were measured. In males, weight and ALT were higher and adiponectin was lower, in IUGR < 5 years; C-peptide, insulin and leptin were higher in IUGR > 5 years; C-peptide was higher in all IUGR, than the respective AGA. In females, creatinine and triglycerides were higher in IUGR < 5 years old; creatinine was higher and eGFR was lower in all IUGR, than the respective AGA. In males and females, creatinine was higher in all IUGR, than the respective AGA; C-peptide, insulin and HOMA-IR were lower, and AST was higher in IUGR < 5 than in IUGR > 5 years old. FTO rs9939609 frequency did not differ between IUGR and AGA. In conclusion prepubertal males born with IUGR increased weight, insulin and leptin and decreased adiponectin, as compared to males born AGA, emerge as early metabolic syndrome characteristics. The concentrations of these hormones do not differ between prepubertal males and females born with IUGR. Weight control, healthy nutrition and physical exercise should be recommended to these children. The deranged renal (particularly evident in females below the age of 5) and liver biochemistry in prepubertal children born with IUGR suggests that hepatorenal derangements might commence in utero. Regular checkup of biochemical and lipid profile is recommended for all children born with IUGR.
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Affiliation(s)
- Elpida J Sidiropoulou
- Endocrine Unit, "Aretaieion" Hospital, National and Kapodistrian University of Athens, Faculty of Medicine, Athens, Greece
| | - George Paltoglou
- Endocrine Unit, "Aretaieion" Hospital, National and Kapodistrian University of Athens, Faculty of Medicine, Athens, Greece
- First Department of Pediatrics, "Aghia Sophia" Children's Hospital, National and Kapodistrian University of Athens, Faculty of Medicine, Athens, Greece
| | - George Valsamakis
- Endocrine Unit, "Aretaieion" Hospital, National and Kapodistrian University of Athens, Faculty of Medicine, Athens, Greece
| | - Alexandra Margeli
- Department of Clinical Biochemistry, "Aghia Sophia" Children's Hospital, Athens, Greece
| | - Aimilia Mantzou
- First Department of Pediatrics, "Aghia Sophia" Children's Hospital, National and Kapodistrian University of Athens, Faculty of Medicine, Athens, Greece
| | - Ioannis Papassotiriou
- Department of Clinical Biochemistry, "Aghia Sophia" Children's Hospital, Athens, Greece
| | - Dimitrios Hassiakos
- Second Department of Obstetrics and Gynecology, "Aretaieion" Hospital, National and Kapodistrian University of Athens, Faculty of Medicine, Athens, Greece
| | - Nicoletta Iacovidou
- Neonatal Department, "Aretaieion" Hospital, National and Kapodistrian University of Athens, Faculty of Medicine, Athens, Greece
| | - George Mastorakos
- Endocrine Unit, "Aretaieion" Hospital, National and Kapodistrian University of Athens, Faculty of Medicine, Athens, Greece.
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Paltoglou G, Schoina M, Valsamakis G, Salakos N, Avloniti A, Chatzinikolaou A, Margeli A, Skevaki C, Papagianni M, Kanaka-Gantenbein C, Papassotiriou I, Chrousos GP, Fatouros IG, Mastorakos G. Interrelations among the adipocytokines leptin and adiponectin, oxidative stress and aseptic inflammation markers in pre- and early-pubertal normal-weight and obese boys. Endocrine 2017; 55:925-933. [PMID: 28092067 DOI: 10.1007/s12020-017-1227-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2016] [Accepted: 01/04/2017] [Indexed: 12/17/2022]
Abstract
PURPOSE Presumed interrelationships among deleterious aspects of adipose tissue metabolism, inflammation, and cellular oxidative stress could be influenced by pubertal hormonal changes. They were investigated in pre- and early pubertal normal-weight and obese boys before and after an exercise bout employed as an energy demanding stimulator. METHODS Cross-sectional study. Seventy-six healthy pre- (mean ± SD, 10.6 ± 0.2 years old, 28 normal-weight, and 11 obese) and early-(11.4 ± 0.2 years old, 25 normal-weight, and 12 obese) pubertal boys, were blood-sampled before and after a bout of exercise at 70% VO2 max. Leptin, adiponectin, markers of inflammation (high-sensitivity C-reactive protein, high sensitivity IL-6), pro- (thiobarbitouric acid reactive substances, protein carbonyls) and anti- (glutathione, oxidized glutathione, glutathione peroxidase, catalase, total antioxidant capacity) oxidation were measured. RESULTS Baseline and post-exercise adiponectin was greater and leptin and high-sensitivity C-reactive protein were lower in normal-weight than in obese pre- and early pubertal boys, while high sensitivity IL-6 was greater in obese than in normal-weight pre-pubertal boys. In pre-pubertal obese boys: at baseline, high-sensitivity C-reactive protein correlated negatively with catalase; high sensitivity IL-6 correlated positively with protein carbonyls; Δ (difference during exercise) adiponectin correlated positively with Δcatalase. In all boys: at baseline, high sensitivity IL-6 correlated positively with leptin and was the best negative and the second best positive predictor for post-exercise glutathione/oxidized glutathione and protein carbonyls, respectively; leptin was the best negative predictor for post-exercise glutathione; waist to height ratio was the best positive predictor for post-exercise thiobarbitouric acid reactive substances; body mass index z-score and adiponectin were, respectively, the best positive predictor for post-exercise protein carbonyls and catalase. CONCLUSIONS In all subjects, leptin and adiponectin predict negatively and positively anti-oxidation, respectively, while high sensitivity IL-6 predicts positively and negatively pro- and anti-oxidation, respectively. High-sensitivity C-reactive protein is increased and negatively associated with anti-oxidation in pre-pubertal obese boys, suggesting that childhood obesity is associated with aseptic inflammation and oxidative stress.
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Affiliation(s)
- George Paltoglou
- Endocrine Unit, "Aretaieion" Hospital, National and Kapodistrian University of Athens - Faculty of Medicine, Athens, Greece
- First Department of Pediatrics, "Aghia Sophia" Children's Hospital, National and Kapodistrian University of Athens - Faculty of Medicine, Athens, Greece
| | - Maria Schoina
- Department of Physical Education and Sports Sciences, Democritus University of Thrace, Komotini, Greece
| | - George Valsamakis
- Endocrine Unit, "Aretaieion" Hospital, National and Kapodistrian University of Athens - Faculty of Medicine, Athens, Greece
| | - Nicolaos Salakos
- Second Department of Obstetrics and Gynecology, "Aretaieion" Hospital, National and Kapodistrian University of Athens - Faculty of Medicine, Athens, Greece
| | - Alexandra Avloniti
- Department of Physical Education and Sports Sciences, Democritus University of Thrace, Komotini, Greece
| | - Athanasios Chatzinikolaou
- Department of Physical Education and Sports Sciences, Democritus University of Thrace, Komotini, Greece
| | - Alexandra Margeli
- Department of Clinical Biochemistry, "Aghia Sophia" Children's Hospital, Athens, Greece
| | - Chrysanthi Skevaki
- Department of Clinical Biochemistry, "Aghia Sophia" Children's Hospital, Athens, Greece
| | - Maria Papagianni
- Pediatric Endocrinology Unit, Third Department of Pediatrics, "Hippokrateion" General Hospital of Thessaloniki, Aristotle University of Thessaloniki School of Medicine, Thessaloniki, Greece
| | - Christina Kanaka-Gantenbein
- First Department of Pediatrics, "Aghia Sophia" Children's Hospital, National and Kapodistrian University of Athens - Faculty of Medicine, Athens, Greece
| | - Ioannis Papassotiriou
- Department of Clinical Biochemistry, "Aghia Sophia" Children's Hospital, Athens, Greece
| | - George P Chrousos
- First Department of Pediatrics, "Aghia Sophia" Children's Hospital, National and Kapodistrian University of Athens - Faculty of Medicine, Athens, Greece
| | - Ioannis G Fatouros
- Department of Physical Education and Sports Sciences, University of Thessaly, Trikala, Greece
| | - George Mastorakos
- Endocrine Unit, "Aretaieion" Hospital, National and Kapodistrian University of Athens - Faculty of Medicine, Athens, Greece.
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Nezi M, Christopoulos P, Paltoglou G, Gryparis A, Bakoulas V, Deligeoroglou E, Creatsas G, Mastorakos G. Focus on BMI and subclinical hypothyroidism in adolescent girls first examined for amenorrhea or oligomenorrhea. The emerging role of polycystic ovary syndrome. J Pediatr Endocrinol Metab 2016; 29:693-702. [PMID: 27089404 DOI: 10.1515/jpem-2015-0312] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Accepted: 02/09/2016] [Indexed: 11/15/2022]
Abstract
BACKGROUND Primary amenorrhea, oligomenorrhea and secondary amenorrhea are diagnosed commonly during adolescence. Weight aberrations are associated with menstrual disorders. Autoimmune thyroiditis is frequent during adolescence. In this study, the commonest clinical and hormonal characteristics of amenorrhea or oligomenorrhea during adolescence were investigated. METHODS In this cross-sectional study, one hundred and thirty-eight consecutive young patients presenting with amenorrhea or oligomenorrhea referred to an adolescent endocrinology and gynecology university clinic were studied. Clinical examination and an abdominal ultrasound were performed. Testosterone, free-testosterone, estradiol (E2), follicle stimulating hormone (FSH), luteinizing hormone (LH), prolactin (PRL), dehydroepiandrosterone sulfate (DHEA-S), 17-OH progesterone, sex hormone binding globulin (SHBG), Δ4-androstenedione (Δ4A), free androgen index (FAI), insulin, glucose, thyroid stimulating hormone (TSH), total thyroxine (T4) (TT4), free T4 (FT4), total triiodothyronine (T3) (TT3) and free T3 (FT3). Concentrations were measured in blood samples. RESULTS Patients with primary and secondary amenorrhea presented more often with body mass index (BMI) <18.5 and BMI >25 kg/m2, respectively. BMI values correlated positively with insulin (r=0.742) and glucose (r=0.552) concentrations and negatively with glucose/insulin ratio values (r=-0.54); BMI values and insulin concentrations correlated positively with FAI values (r=0.629 and r=0.399, respectively). In all patients, BMI values correlated positively and negatively with free testosterone (r=0.249) and SHBG (r=-0.24) concentrations, respectively. In patients with secondary amenorrhea insulin concentrations correlated negatively with SHBG concentrations (r=-0.75). In patients with oligomenorrhea BMI values correlated positively with insulin (r=0.490) and TSH (r=0.325) concentrations, and negatively with SHBG (r=-0.33) concentrations. Seventy-two percent, 21% and 7% of patients presented with TSH concentrations <2.5 μIU/mL, between 2.5 μIU/mL, 4.5 μIU/mL and >4.5 μIU/mL (subclinical hypothyroidism), respectively. Following the definition of polycystic ovary syndrome (PCOS) according to either the National Institutes of Health (NIH) criteria or those proposed in the literature by Carmina and his team, patients presented mainly with oligomenorrhea or secondary amenorrhea. There was good agreement between patients with amenorrhea or oligomenorrhea fulfilling both of the PCOS definition criteria employed. CONCLUSIONS Among adolescent patients presenting with amenorrhea or oligomenorrhea for the first time those with low and high BMI present more often with primary and secondary amenorrhea, respectively. Obesity is involved in the development of hyperandrogenemia and hyperinsulinemia, particularly in PCOS patients. In these patients, subclinical hypothyroidism may be concealed and it should be investigated. These patients should be treated for abnormally increased or decreased BMI and be investigated for autoimmune thyroiditis.
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Paltoglou G, Fatouros IG, Valsamakis G, Schoina M, Avloniti A, Chatzinikolaou A, Kambas A, Draganidis D, Mantzou A, Papagianni M, Kanaka-Gantenbein C, Chrousos GP, Mastorakos G. Antioxidation improves in puberty in normal weight and obese boys, in positive association with exercise-stimulated growth hormone secretion. Pediatr Res 2015; 78:158-64. [PMID: 25938733 DOI: 10.1038/pr.2015.85] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2014] [Accepted: 01/23/2015] [Indexed: 01/21/2023]
Abstract
BACKGROUND Oxidative stress is associated with obesity while the evidence for the role of GH in pro- and antioxidation is inconclusive. This study investigates the relationships between growth hormone (GH), pro- and antioxidation in relation to obesity and puberty before and after an acute bout of exercise. METHODS In this case-control study, 76 healthy normal-weight and obese, prepubertal and pubertal boys underwent a blood sampling before and immediately after an aerobic exercise bout until exhaustion at 70% maximal oxygen consumption. Markers of prooxidation (thiobarbituric acid reactive substances (TBARS) and protein carbonyls (PCs)) and antioxidation (glutathione (GSH), oxidized glutathione disulfide (GSSG), GSH/GSSG ratio, glutathione peroxidase (GPX), catalase, and total antioxidant capacity (TAC)) and hormones (GH, insulin-like growth factor (IGF)-1, IGF-BP-3, luteinizing hormone, follicle-stimulating hormone, and testosterone) were measured. RESULTS Baseline and postexercise TBARS and PCs were greater, while baseline GSH, GSH/GSSG ratio, GPX, and TAC were lower in obese than that in normal-weight participants. In all participants, waist was the best negative and positive predictor for postexercise GPX and TBARS, respectively. Baseline TAC was greater in pubertal than that in pre-pubertal participants. In all participants, baseline GH was the best negative predictor for postexercise PCs. Significant positive linear correlation exists between the exercise-associated GH, and GSSG increases in pubertal normal-weight boys. CONCLUSIONS Higher prooxidation and lower antioxidation were observed in obese boys, while antioxidation improves with puberty and postexercise, paralleling GH accentuated secretion.
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Affiliation(s)
- George Paltoglou
- 1] Endocrine Unit, Aretaieion Hospital, University of Athens Medical School, Athens, Greece [2] First Department of Pediatrics, "Aghia Sofia" Children's Hospital, University of Athens Medical School, Athens, Greece
| | - Ioannis G Fatouros
- School of Physical Education and Sports Sciences, Democritus University of Thrace, Komotini, Greece
| | - George Valsamakis
- First Department of Pediatrics, "Aghia Sofia" Children's Hospital, University of Athens Medical School, Athens, Greece
| | - Maria Schoina
- School of Physical Education and Sports Sciences, Democritus University of Thrace, Komotini, Greece
| | - Alexandra Avloniti
- School of Physical Education and Sports Sciences, Democritus University of Thrace, Komotini, Greece
| | | | - Antonis Kambas
- School of Physical Education and Sports Sciences, Democritus University of Thrace, Komotini, Greece
| | - Dimitris Draganidis
- School of Physical Education and Sports Sciences, Democritus University of Thrace, Komotini, Greece
| | - Aimilia Mantzou
- Endocrine Unit, Evgenidion Hospital, University of Athens Medical School, Athens, Greece
| | - Maria Papagianni
- Pediatric Endocrinology Unit, Third Department of Pediatrics, Hippokrateion General Hospital of Thessaloniki, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Christina Kanaka-Gantenbein
- First Department of Pediatrics, "Aghia Sofia" Children's Hospital, University of Athens Medical School, Athens, Greece
| | - George P Chrousos
- First Department of Pediatrics, "Aghia Sofia" Children's Hospital, University of Athens Medical School, Athens, Greece
| | - George Mastorakos
- Endocrine Unit, Aretaieion Hospital, University of Athens Medical School, Athens, Greece
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Papatheodorou DC, Karagiannidis LK, Paltoglou G, Margeli A, Kaparos G, Valsamakis G, Chrousos GP, Creatsas G, Mastorakos G. Pulsatile interleukin-6 leads CRH secretion and is associated with myometrial contractility during the active phase of term human labor. J Clin Endocrinol Metab 2013; 98:4105-12. [PMID: 23928667 DOI: 10.1210/jc.2012-4023] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Our objective was to investigate IL-6 and CRH secretion during the active phase of human labor and to define their potential involvement in myometrial contractility. STUDY DESIGN Twenty-two primigravid women were studied for 90 minutes during the active phase of term labor by serial plasma sampling every 3 minutes for measurement of IL-6 and CRH concentrations. Uterine contractions, measured by cardiotocograph, were evaluated in Montevideo units. Basic, quantitative, pulsatility, and time cross-correlation statistical analyses were performed. RESULTS By linear regression analysis, a positive correlation was observed between IL-6 and CRH total mean area under the curve above 0 (r = 0.76184, P = .006). Mean number of pulses was 2.00 ± 0.70 and 3.33 ± 1.29 for IL-6 and CRH, respectively. There was a significant positive correlation between IL-6 and CRH over time, peaking at the 12-minute interval, with IL-6 leading CRH. Also, there was a significant positive correlation between myometrial contractility expressed in Montevideo units and IL-6 concentrations over time, starting at +51 minutes and ending at +57 minutes with myometrial contractility leading IL-6. No significant correlation was found between myometrial contractility and CRH concentrations over time. CONCLUSION IL-6 and CRH are both secreted in a pulsatile fashion during the active phase of human labor. The time-integrated concentrations of the two hormones are positively correlated, with IL-6 leading CRH secretion. It appears, thus, that proinflammatory mediators may be direct and/or indirect promoters of placental CRH release. Furthermore, the secretion of IL-6, which is a myokine, seems to be associated positively with uterine contractility. Additional studies are needed to elucidate the combined effect of inflammation, placental CRH release, and/or the receptors of the latter in parturition.
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Paltoglou G, Tavernarakis G, Christopoulos P, Vlassi M, Gazouli M, Deligeoroglou E, Creatsas G, Mastorakos G. PON1-108 TT and PON1-192 RR genotypes are more frequently encountered in Greek PCOS than non-PCOS women, and are associated with hyperandrogenaemia. Clin Endocrinol (Oxf) 2013; 79:259-66. [PMID: 23278234 DOI: 10.1111/cen.12139] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2012] [Revised: 08/02/2012] [Accepted: 12/21/2012] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To investigate the frequencies of three paraoxonase (PON)1 polymorphisms in Greek polycystic ovary syndrome (PCOS) and non-PCOS women, and their genotypes association with hyperandrogenaemia and insulin resistance. DESIGN Case-control genetic association study. SETTING University Hospital Endocrine Unit. PATIENTS A total of 142 PCOS cases (NIH criteria) and 112 controls. MAIN OUTCOME MEASURE Genotyping of the c.-108C>T (PON1-108), the c.163T>A (PON1-55) and the c.575A>G (PON1-192) polymorphisms and measurement of baseline androgen and insulin resistance profile. RESULTS The PON1-108 TT and PON1-192 RR genotypes were more frequently encountered in the PCOS than in the control group. The PON1-192 R allele frequency was greater in the PCOS than in the control group. Comparing the PCOS and the control groups, statistical significances favoured a recessive and a dominant genetic model, respectively, for the single PON1-108 T and PON1-192 R alleles. Free Androgen Index (FAI) levels were higher in patients with PON1-108 TT, whereas Testosterone, FAI and Dehydroepiandrosterone sulphate (DHEAS) levels were higher in patients with PON1-192 RR than patients with the wild or the heterozygous genotype. CONCLUSIONS The decreased PON1 activity-associated PON1-108 TT and the PON1-192 RR genotypes are more frequently found in Greek PCOS women and are associated with hyperandrogenaemia. Hyperandrogenaemia must depend also on other genetic factors because the same genotypes were not associated with hyperandrogenaemia in the control group. Through identification of the involved polymorphisms, women with PCOS could potentially have a better therapeutic screening.
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Affiliation(s)
- George Paltoglou
- 2nd Department of Obstetrics and Gynaecology, Aretaieion University Hospital, Athens Medical School, Athens, Greece
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Mastorakos G, Paltoglou G, Greene M, Ilias I, Papamichalopoulos A, Dimopoulos S, Pouliou E, Fatouros IG, Nanas S. Inappropriately normal plasma ACTH and cortisol concentrations in the face of increased circulating interleukin-6 concentration in exercise in patients with sarcoidosis. Stress 2013; 16:202-10. [PMID: 22871212 DOI: 10.3109/10253890.2012.715221] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Sarcoidosis is an autoimmune disease, and hypothalamic-pituitary-adrenal (HPA) axis activity is blunted in autoimmunity. Exercise stimulates the HPA axis, and we hypothesized that in sarcoidosis patients responses to treadmill exercise would be reduced. Hence, we studied 44 sarcoidosis patients [27 untreated (age, mean ± SD, 42 ± 2 years, 12 males, 15 females) and 17 dexamethasone treated (age, 46 ± 4 years, 7 males, 10 females)] and 20 healthy controls (40 ± 5 years old, 9 males, 11 females). Blood samples were drawn before, at peak (exhaustion), and 15 min after treadmill exercise for adrenocorticotropic hormone (ACTH), cortisol, tumor necrosis factor (TNF), interleukin-1β (IL-1β) and IL-6 measurements. At peak, plasma ACTH (pg/ml) was increased in untreated (mean ± SE, ΔACTH = 162.8 ± 29.9) and treated (ΔACTH = 123.3 ± 48.1) patients and controls (ΔACTH = 112.3 ± 41.7). Post-exercise, cortisol (ng/ml) was increased (p < 0.05) in untreated patients (Δcortisol = 48.4 ± 14.7) and controls (Δcortisol = 46.0 ± 15.9), but not significantly in treated patients (Δcortisol = 1.43 ± 2.56). At baseline, serum IL-6 (pg/ml) and TNF (pg/ml) were higher in untreated (3.02 ± 0.54 and 3.89 ± 0.72) and treated (1.75 ± 0.33 and 2.16 ± 1.00) patients, respectively, than in controls (0.80 ± 0.66 and 1.58 ± 0.32). At peak exercise, IL-6 was increased in untreated (ΔIL-6 = 0.96 ± 0.14) and treated (ΔIL-6 = 0.91 ± 0.47) patients and controls (ΔIL-6 = 0.96 ± 0.18); IL-1β was increased only in controls. Hence, the HPA axis of untreated sarcoidosis patients and controls responded similarly to treadmill exercise. In sarcoidosis patients, increased IL-6 was associated with HPA stimulation. Cortisol concentrations were similar between patients and controls, although IL-6 concentrations were higher in patients. Thus, in the face of chronically elevated IL-6 levels in sarcoidosis, there may be dysfunctional IL-6-induced HPA responses or HPA adaptation to high IL-6 concentrations.
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Affiliation(s)
- George Mastorakos
- Endocrine Unit, Second Department of Obstetrics and Gynecology, Aretaieion Hospital, Medical School, University of Athens, Athens, Greece.
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Ferenidou F, Salakos N, Vaidakis N, Paltoglou G, Bakalianou K, Papadimitriou G, Creatsas G. The impact of HPV diagnosis on women's sexual and mental health: preliminary findings. CLIN EXP OBSTET GYN 2012; 39:79-82. [PMID: 22675962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
PURPOSE OF INVESTIGATION The objective of the present study was to demonstrate the impact of HPV diagnosis on sexual function and mental health of Greek women. METHODS The study population included 51 patients who proceeded to the gynecological outpatient clinic of "Aretaieion" Hospital, Athens, during 2008-2009. The participants were asked to complete a questionnaire regarding demographic characteristics, knowledge on HPV, gynecological and sexual history, as well as questions regarding their mental and sexual health after the diagnosis. RESULTS Mean age of the participants was 36 years and mean age of their first Pap smear test was 24.4 years. Mean age of HPV diagnosis was 34 years and mean number of sexual partners was four. Regarding mental health, the majority experienced anxiety after the HPV diagnosis as well as fear regarding their health in the future. Nearly half of the women experienced guilt and anger and some of them distress, shame, diminution of self-esteem and stigmatization. Diminution in the level of sexual interest and desire and decrease in sexual intercourse frequency were quite often reported. CONCLUSION Except for the important physical impact of HPV infection, its diagnosis seems to trigger several negative feelings and reduce sexual desire.
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Affiliation(s)
- F Ferenidou
- 1st Department of Psychiatry, Eginition Hospital, University of Athens Medical School, Greece.
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Vlassi M, Gazouli M, Paltoglou G, Christopoulos P, Florentin L, Kassi G, Mastorakos G. The rs10830963 variant of melatonin receptor MTNR1B is associated with increased risk for gestational diabetes mellitus in a Greek population. Hormones (Athens) 2012; 11:70-6. [PMID: 22450346 DOI: 10.1007/bf03401539] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To investigate the association between Gestational Diabetes Mellitus (GDM) and the variants rs10830963 and rs1387153 in the MTNR1B locus in a sample of the Greek population. DESIGN One hundred seventy-five unrelated pregnant Greek women (77 with GDM and 98 non-diabetic control subjects) were enrolled and the SNaPshot method was employed in order to investigate the association between GDM and the variants rs10830963 and rs1387153 in the MTNR1B locus. Pregnant women were screened for GDM at the 26th week with the 75 g glucose oral glucose tolerance test according to the American Diabetes Association criteria. RESULTS The GG genotype and the G-allele of the rs10830963 (C/G) variant was found to be positively associated with a significantly increased risk for GDM (p = 0.047 and p = 0.012, respectively). No differences in fasting glucose and insulin levels were found between GDM patients with and without the studied variants. The MTNR1B locus (rs10830963 C/G) seems to predispose for GDM in Greek pregnant women. CONCLUSIONS Our study confirms the association of GDM with the rs10830963 (C/G) variant in a sample of the Greek population. Population based whole genome screening studies and larger studies with detailed phenotypic data in patients with GDM are needed to address the clinical significance of this finding.
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Affiliation(s)
- Margarita Vlassi
- Endocrine Unit, 2nd Department of Obstetrics and Gynaecology, Aretaieion University Hospital, Athens Medical School, Greece
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Fatouros I, Chatzinikolaou A, Paltoglou G, Petridou A, Avloniti A, Jamurtas A, Goussetis E, Mitrakou A, Mougios V, Lazaropoulou C, Margeli A, Papassotiriou I, Mastorakos G. Acute resistance exercise results in catecholaminergic rather than hypothalamic-pituitary-adrenal axis stimulation during exercise in young men. Stress 2010; 13:461-8. [PMID: 20666650 DOI: 10.3109/10253891003743432] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Exercise is a paradigm of a stress situation. The adaptive response to stressors comprises the activation of the hypothalamic-pituitary-adrenal (HPA) axis and components of the autonomic sympathetic system. An aseptic inflammatory reaction is triggered by exercise, involving the stimulation of the so-called proinflammatory cytokines, such as tumor necrosis factor α (TNFα), interleukin-1 (IL-1), and IL-6. The anti-inflammatory cytokines IL-2, IL-8, and IL-10 increase moderately during resistance exercise. To investigate the effect of a short bout of resistance exercise on components of the stress and inflammatory responses during the exercise period, 17 healthy, young, untrained male volunteers were studied during 3 equal consecutive cycles of resistance exercises of 30 min total duration. Blood sampling was performed at baseline and at the end of each cycle. Lactate, cortisol, catecholamines (epinephrine, norepinephrine), IL-1α, IL-1β, IL-2, IL-6, IL-8, IL-10, epidermal growth factor (EGF), and monocyte chemotactic protein-1 (MCP-1) were measured at all time-points. Circulating levels of catecholamines and lactate increased significantly (P < 0.05) whereas cortisol did not. During the time course of the exercise, circulating levels of TNFα, IL-2, and EGF increased, whereas MCP-1 decreased significantly. IL-1α, IL-1β, IL-6, IL-8, and IL-10 levels did not change significantly. Statistically significant positive linear correlations were found between areas under the curve for increases in levels of IL-2 and TNFα, TNFα and cortisol, as well as epinephrine and norepinephrine. We conclude that acute resistance exercise results in catecholaminergic, but not HPA axis stimulation during exercise, in parallel with a mild inflammatory reaction. The absence of a major inflammatory reaction and of a cortisol increase during acute resistance exercise makes this a good candidate for the exercise of sedentary individuals.
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Affiliation(s)
- Ioannis Fatouros
- Department of Physical Education and Sports Science, University of Thrace, Komotini, Greece
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Salakos N, Koumousidis A, Iavazzo C, Paltoglou G, Bakalianou K, Gregoriou O. The slow levonorgestrel-releasing intrauterine system (LNG-IUS) 20 mcg/day: a literature review. CLIN EXP OBSTET GYN 2010; 37:89-96. [PMID: 21077492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
The aim of the study is to present the mechanisms of action, indications, complications, contraindications and the necessary tests before the insertion of a levonorgestrel-releasing intrauterine system (Mirena). After a literature search in Pubmed, a narrative review in the field is presented.
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Affiliation(s)
- N Salakos
- 2nd Department of Obstetrics and Gynecology, University of Athens, Aretaieion Hospital, Athens, Greece
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Salakos N, Koumousidis A, Bakalianou K, Paltoglou G, Kalampokas T, Iavazzo C. Unwanted pregnancy and induced abortion among young women 16-22 years old in Greece: a retrospective study of the risk factors. CLIN EXP OBSTET GYN 2010; 37:303-309. [PMID: 21355463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
UNLABELLED Unwanted pregnancies and the subsequent induced abortions are common problems of our youths in modern Greece. The aim of this study was to recognize the risk factors of the problem in an effort to find the best possible solution out of this social dead end. MATERIALS AND METHOD We interviewed 1,320 young female individuals and analyzed their answers using statistical analysis. RESULTS Several useful conclusions were reached concerning the forces that are involved in unwanted pregnancy/induced abortions. DISCUSSION We have tried to underline the strategy to combat the problem. CONCLUSION Sexual education and the proper use of contraception remain the essential tools in this effort.
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Affiliation(s)
- N Salakos
- Family Planning Unit, 2nd Department of Obstetrics and Gynecology, Aretaieio Hospital, University of Athens Medical School, Athens, Greece
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Liapis A, Bakalianou K, Salakos N, Iavazzo C, Paltoglou G, Kondi-Pafiti A. Ectopic pelvic spleen. Presentation of two cases. CLIN EXP OBSTET GYN 2009; 36:187-188. [PMID: 19860367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
We present two cases of nulliparous women with ectopic pelvic spleens who were hospitalized in our department during the last decade. The clinical and laboratory characteristics and the management of such a rare entity are discussed.
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Affiliation(s)
- A Liapis
- 2nd Department of Obstetrics and Gynecology, University of Athens, Aretaieion Hospital, Athens, Greece
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Salakos N, Bakalianou K, Gregoriou O, Iavazzo C, Paltoglou G, Creatsas G. Abortion rates and the role of family planning: a presentation of the Greek reality. CLIN EXP OBSTET GYN 2008; 35:279-283. [PMID: 19205444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
OBJECTIVE Due to lack of consistent evidence, it is widely believed that Greece holds one of the highest abortion rates in Europe. The aim of this study is to clarify these rates. STUDY DESIGN The Greek Society of Obstetrics and Gynecology collected data demonstrating that abortion rates seem to be declining which coincides with the rise of the use of more effective methods of contraception. Data were collected both from public and private hospitals, and an attempt was made to correlate the data with the current trends of family planning and birth control. RESULTS A decline in abortion rates in Greece was found, which may be due to the better organization of counseling programmes in the field. CONCLUSION The programmes organized by the Greek Family Planning Association under the guidance of the University of Athens has led to a decline in abortion rates in Greece.
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Affiliation(s)
- N Salakos
- 2nd Department of Obstetrics and Gynecology, Aretaieion Hospital, Medical School of Athens, Greece
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Bakalianou K, Salakos N, Iavazzo C, Paltoglou G, Papadias K, Kondi-Pafiti A. A case of endometrial carcinoma arising in a 36-year-old woman with uterine atypical polypoid adenomyoma (APA). EUR J GYNAECOL ONCOL 2008; 29:298-299. [PMID: 18592801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Atypical polypoid adenomyomas are tumors of low malignant potential. We present a case of endometrial carcinoma arising in a 36-year-old woman with atypical polypoid adenomyoma. The diagnosis and treatment of such a tumor is discussed through an English literature review.
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Affiliation(s)
- K Bakalianou
- 2nd Department of Obstetrics and Gynecology, University of Athens, Aretaieion Hospital, Athens, Greece
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Liapis A, Bakalianou K, Iavazzo C, Salakos N, Paltoglou G, Kondi-Pafiti A. A retrospective analysis of borderline ovarian tumors in a Greek university hospital. EUR J GYNAECOL ONCOL 2008; 29:383-385. [PMID: 18714575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
PURPOSE The aim of this retrospective study was to analyze the pathologic and clinical characteristics of borderline ovarian tumors. METHODS/RESULTS During the period from January 1993 up to December 2002 we found 93 cases of borderline ovarian tumors. The mean age of patients was 44.3 years (range 28.9-59.7 years); 77.4%, 10.8% and 11.8% of patients had Stage I, II and III, respectively. The histological outcomes revealed 52.7% of serous and 41.9% of mucinous origin; 44.1% underwent radical surgery, whereas 55.9% had unilateral salpingo-oophorectomy or cystectomy. The mean follow-up was 84 +/- 22 months. The overall five-year survival was 97.4% and 98% for mucinous and serous tumors, respectively. The survival rate was 100%, 90% and 81.8% in Stages I, II and III, respectively. CONCLUSION From our results it can be concluded that borderline ovarian tumors have a favorable prognosis even after conservative management.
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Affiliation(s)
- A Liapis
- 2nd Department of Obstetrics and Gynecology, Medical School, University of Athens, Aretaieion Hospital, Athens, Greece
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Bakalianou K, Salakos N, Iavazzo C, Paltoglou G, Papadias K, Gregoriou O, Kondi-Pafiti A. Paget's disease of the vulva. A ten-year experience. EUR J GYNAECOL ONCOL 2008; 29:368-370. [PMID: 18714571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
BACKGROUND Paget's disease of the vulva is a rare neoplasmatic lesion which mainly affects postmenopausal women. RESULTS We conducted a retrospective study during the period January 1996 till December 2005 in which 11 cases of Paget's disease were detected. The clinical manifestations, management, specific pathological features, treatment and prognosis of each patient are presented. CONCLUSION Surgical treatment is the current standard and long-term follow-up is required.
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Affiliation(s)
- K Bakalianou
- 2nd Department of Obstetrics and Gynecology, University of Athens, Aretaieion Hospital, Athens, Greece
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Bakalianou K, Iavazzo C, Salakos N, Paltoglou G, Papadias K, Kondi-Pafiti A. Leiomyomatosis with multiple extrauterine pulmonary sites: an unusual case report. CLIN EXP OBSTET GYN 2008; 35:86-88. [PMID: 18390092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
The objective of the present study is to present a case of a 48-year-old woman with leiomyomatosis and multiple pulmonary metastases. The classification, pathophysiology, clinical signs, treatment and prognosis of this rare case are discussed. Leiomyomatosis is potentially life-threatening while patients with pulmonary metastases are usually asymptomatic and the condition is incidentally discovered. The treatment of leiomyomatosis is not standardized and many possible variations are under investigation. Still the prognosis is usually excellent.
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Affiliation(s)
- K Bakalianou
- 2nd Department of Obstetrics and Gynecology, Aretaieion University Hospital, Medical School, University of Athens, Greece
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Salakos N, Bakalianou K, Iavazzo C, Paltoglou G, Papadias K, Liapis A, Kondi-Pafiti A. The role of ovarian transposition in patients with early stage cervical cancer--two case reports. EUR J GYNAECOL ONCOL 2008; 29:280-281. [PMID: 18592796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
The aim of the study is to present two cases of premenopausal women with early stage cervical carcinoma who underwent ovarian transposition. The role and the advantages of this technique are discussed.
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Affiliation(s)
- N Salakos
- 2nd Department of Obstetrics and Gynecology, Medical School, University of Athens, Aretaieion Hospital, Athens, Greece
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Salakos N, Iavazzo C, Bakalianou K, Gregoriou O, Paltoglou G, Kalmantis K, Botsis D. Misoprostol use as a method of medical abortion. CLIN EXP OBSTET GYN 2008; 35:130-132. [PMID: 18581768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
AIM The aim of our study was to verify with the use of ultrasound (US) scanning the effectiveness of misoprostol in medical abortion. MATERIALS AND METHODS The study population included women with a medical miscarriage attending the 2nd Department of Obstetrics and Gynecology, University of Athens in Aretaieion Hospital, Athens, Greece. All women < 49 days since their last menstruation received 800 microg vaginal misoprostol. The diagnosis of complete abortion was possible by the US measurements as endometrial thickness of 15 mm by transvaginal US was used as a cutoff level for successful abortion. RESULTS The mean age of the study population was 27 years (ranging from 19 up to 37 years). Complete evacuation with misoprostol was performed in 149 women. The success rate was 85.2% (127/149). Twenty-two women experienced intrauterine echogenic structures with a diameter > 15 mm and all of them underwent surgical evacuation (14.8%). Vaginal bleeding was present in 17 patients after the procedure (11.4%). Less usual reported side-effects included nausea, vomiting, pain, or diarrhea. CONCLUSION Misoprostol use is an effective, safe and acceptable method of medical abortion for women.
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Affiliation(s)
- N Salakos
- 2nd Department of Obstetrics and Gynecology, University of Athens, Aretaieion Hospital, Athens, Greece
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