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Hypoparathyroidism (hypoPT) is a relatively rare endocrine disease, mainly due to thyroid surgery. The classical supplementation with calcium and active vitamin D may represent a challenge to the clinician.

Objective: to describe the results from intravenous calcium loads in patients with suspected PHPT.

Objective: Graves’ disease (GD) is characterized by elevated TSH-receptor antibodies (TRAb) and less often – thyroid peroxidase (TPOAb) and thyroglobulin antibodies (TgAb). Our aim was to examine the hormonal and ultrasound characteristics of patients with newly diagnosed GD with differing positive thyroid antibodies.

Obesity has been linked with vitamin D deficiency in a number of cross-sectional studies, reviews and meta-analyses. The aim of the present study was to assess the correlations of plasma 25(OH) vitamin D levels with indices of body composition examined by DXA with an emphasis on lean and bone mass as well as on indices such as android/gynoid fat, appendicular lean mass, fat-mass indexes (FMI) and fat-free mass indexes (FFMI). 62 adult subjects consented to participate – 27 men (43.5%) and 35 women (56.5%). Their mean age was 45.3 ± 9.5 years. Fan-beam dual-energy X-ray (DXA) body composition analysis was performed on a Lunar Prodigy Pro bone densitometer with software version 12.30. Vitamin D was measured by electro-hemi-luminescent detection as 25(OH) D Total (ECLIA, Elecsys 2010 analyzer, Roche Diagnostics). Statistical analyses were done using the SPSS 23.0 statistical package. The serum 25(OH)D level was correlated significantly only to the whole body bone mineral content, the appendicular lean mass index (ALMI) and the ALM-to-BMI index, underlining a predominant role for lean and fat-free mass. Vitamin D showed a very weak correlation to % Body Fat and the Fat Mass Index (FMI) in men only. Moreover, the multiple regression equation including the associated parameters could explain only 7% of the variation in the serum 25(OH) D levels. Our conclusion was, that there are differences in the associations of the vitamin D levels with the different body composition indices, but these associations are generally very weak and therefore – negligible.

To assess the current practice patterns in the diagnosis and treatment of male osteoporosis based on questionnaires. Questionnaires were presented and filled out by osteoporosis experts from Austria, Bulgaria, the Czech Republic, Hungary, Poland, Romania, Slovakia, Slovenia and Russia. The questions included focused on the proportion of male referrals to DXA, the main reasons for referral, the preferred measurement sites and reference database, the definition of male osteoporosis, needed laboratory investigations, data on calcium and vitamin D supplementation as well as on treatment modalities and their reimbursement rate. Men comprised 5 to 10% of all DXA referrals. The main reasons for referral were low back pain and fractures. Most of the respondents used the International male reference database. The diagnosis of osteoporosis was based mainly on a T-score below −2.5 after the age of 50, but a few respondents added fractures as a necessary condition. Only 1/3 of men visiting DXA sites are expected to have normal BMD. A consensus for the use of laboratory investigations in male osteoporosis is practically lacking. Treatment modalities include alendronate, risedronate, zoledronate, denosumab, rhPTH and strontium (with some restrictions for the latter three). Data on treatment adherence and persistence are generally lacking except for Austria, Romania and Slovakia. The levels of reimbursement vary a lot across countries. Osteoporosis in men is an under-recognized problem in CEE countries, leading to a tremendous gap in the diagnosis and treatment.

Data from different studies correlating the serum 25(OH)D levels with the metabolic and glycemic parameters in type 2 diabetes patients are still varying. The objective if this study was to describe the correlation between serum 25(OH)D levels and some metabolic parameters in Bulgarian type 2 diabetes patients on oral antidiabetic drugs. One hundred type 2 diabetes patients participated - 56 men and 44 women. The mean age and diabetes duration of the women was 59.0 and 9.8 years, of the men - 58.0 and 7.7 years respectively. Complete patient history was taken and physical examination was performed (body weight and height, waist circumference). Body composition was measured on a leg-to-leg body impedance analyzer (TBF-215, Tanita Corp., Tokyo, Japan). Serum levels of vitamin D were measured by electro-hemi-luminescent detection as 25-(ОН) D Total (ECLIA, Elecsys 2010, Roche Diagnostics, Switzerland). Glycated hemoglobin A1c was measured on a NycoCard reader (Alere™). Total, HDL-cholesterol (direct) and triglycerides were analyzed on a Cobas Integra 400+ analyzer. Correlation analysis was performed on a SPSS 13.0 for Windows platform and included 10 curves. The data were first analyzed for the group as a whole and then separately for men and women as well as in the different vitamin D tertiles. The mean serum 25-OH-vitamin D levels were 23.8 ± 12.1 nmol/l in women and 33.3 ± 20.0 nmol/l in men. We were unable to find any statistically significant correlation between serum 25(OH) vitaminand the serum lipids (cholesterol profile and triglycerides). On the contrary, there was a weak correlation with the glycated hemoglobin A1c (cubic model, R2 = 0.178, p = 0.05) and the BMI (inverse model, R2 = 0.101, p = 0.038). The sub-analyses (men versus women or according to tertiles of vitamin D) did not produce any additional information. The influence of vitamin D on the parameters of the metabolic control in type 2 diabetes is very weak on an individual level. It might be only demonstrated in large epidemiological surveys.

Plamen Kinov1, Mihail Boyanov21Department of Orthopedics and Traumatology, University Hospital Queen Giovanna – ISUL, 2Department of Internal Medicine, Clinic of Endocrinology, University Hospital Alexandrovska, Medical University of Sofia, Sofia, BulgariaAbstract: Bisphosphonates are the most widely prescribed treatment for postmenopausal osteoporosis, secondary osteoporosis, and male osteoporosis. Notwithstanding their high effectiveness and favorable safety profile, the adherence to bisphosphonate treatment remains low. Different treatment strategies aim to improve the clinical effectiveness of bisphosphonate therapy. This review paper assesses the clinical utility of oral intermittent risedronate in the treatment of postmenopausal osteoporosis. The new delayed-release risedronate formulation is a safer and easy to use alternative to other risedronate therapy. Oral risedronate, a potent nitrogen-containing bisphosphonate, has been extensively studied using daily regimens. A new intermittent (weekly) dosing regimen confirmed its clinical effectiveness in relation to vertebral and nonvertebral fracture prevention. The absence of significant differences in the incidence of adverse effects confirmed the favorable tolerability of the weekly dosage. In efforts to improve patient adherence to treatment, an innovative, delayed-release formulation of risedronate, which ensures adequate bioavailability of the active compound when taken with food, was introduced. The once-weekly delayed-release formulation of risedronate proved to be noninferior to the daily dosage of risedronate in terms of bone mineral density and markers of bone turnover. In addition, the incidence of new morphometric vertebral fractures was comparable in both treatment regimens. The new delayed-release formulation of risedronate showed a favorable safety profile. Delayed-release risedronate is a promising, new, effective, and convenient alternative to current bisphosphonate treatments. It appears to allow better patient adherence to antiresorptive treatment.Keywords: osteoporosis, risedronate, bisphosphonates, delayed-release, bone mineral density

The intracellular granules containing ferric and ferrous iron formed in Shewanella putrefaciens CN32 during dissimilatory reduction of solid-phase ferric iron is reported. It is the first in situ detection at high resolution of a mixed-valence metal particle residing within a prokaryotic cell of Fe(III) reduction which might indicate a respiratory role.

Objective. To describe the correlations between serum 25(OH) vitamin D and anthropometric and metabolic parameters in adult outpatients of both sexes with different BMI coming from an urban community. Subjects and Methods. 264 subjects referred for obesity assessment participated - 109 men and 155 women (20-60 years). Body weight and height, waist circumference (WC), blood pressure were recorded. Body composition was assessed by bioelectrical impedance (BIA) on a Tanita BC 420 MA analyzer (Tanita Inc., Japan). Serum 25(OH)D Total, Insulin, High-sensitivity C-reactive protein, blood glucose, total, HDL-cholesterol and triglycerides were measured. The insulin resistance index was calculated (HOMA-IR). Participants with BMI>25.0 kg/m2 underwent standard 75 g OGTT. Statistical analysis was performed on an IBM SPSS Statistics 19.0 for Windows platform (Chicago, IL). Results. Normal weight was found in 27.2% of the participants, 24.6% had overweight, 29.2% -class I obesity, and 18.9% - class II or III. Vitamin D was weakly and inversely correlated to different variables in the whole group - such as weight, WC, WC/Height, % body fat and HOMA-IR index (r=-0.231, -0.283, -0.307, -0.339, -0.328 respectively, all p<0.001). Building subgroups based on BMI led to loss of significance. Backward analysis revealed Total-C/LDL-C ratio, and LDL-C/HDL-C ratio as strongest predictors of serum vitamin D (p=0.001; R2=0.204). Conclusion. The association of vitamin D with blood pressure, plasma lipids, glucose and insulin is very weak on an individual level. However, several obesity indices (WC, WC/height ratio, % Body fat from BIA) might be used as a screening tool for subjects at risk for vitamin D deficiency. [ABSTRACT FROM AUTHOR]

This study aims to explore the correlations of body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR), waist-to-hip ratio (WHR) and body composition with levels of asymmetric dimethylarginine (ADMA), endothelin 1(ET-1), N-terminal brain natriuretic pro-peptide (NT-proBNP) and calculated cardiovascular risks.

Dual-energy X-ray absorptiometry of the lumbar spine (anteroposterior (AP) L1-L4 DXA) is one of the standards for testing bone density (BMD). Whole-body (WB) DXA scanning allows analysis of the L-spine (WB-LS). The objective of this study was (i) to predict the AP L1-L4 BMD from the WB-LS BMD, and (ii) to compare WB and AP L1-L4 T-scores. 132 women participated in the study (age, 50.84±9.69 years; range, 21-74 years). AP L1-L4 BMD was measured on a Hologic QDR 4500-A densitometer, and was followed by a WB scan. Linear regression analyses and curve estimations were performed for area, bone mineral content (BMC), BMD and T-scores. Precision errors for BMD from AP scans and WB-LS scans were 1.37% and 1.65%, respectively. The best linear correlations were found for BMD, followed by the T-scores (R 5 0.882 and 0.871; p,0.001). A power model for BMC (R²=0.630) and a model S for BMD and the scanned area (R²=0.841 and 0.539) were built. Discordant classification between AP L1-L4 and WB T-scores was found in 12.73% and 19.09% cases, respectively. WB T-score cut-off values of -2.35 and -0.90 produced the best sensitivity-to-specificity ratio in the diagnosis of lumbar spine osteoporosis and low bone mass. In conclusion, WB-LS analysis may provide data for the indirect estimation of spinal BMD. [ABSTRACT FROM AUTHOR]

Introduction: Diabetes mellitus (DM) is estimated to affect 2-37% of COPD patients, results varying widely between studies. DM may also correlate with quality of life and lung function.

Background: Treatment of simple goiter (SG) growing over time with thyroid hormone (TH) therapy is discouraged by international guidelines., Purpose: To ascertain views of European thyroid specialists about TH treatment for euthyroid patients with growing SG and explore associations with management choice., Methods: Online survey on the use of TH for growing SG among thyroid experts from 28 European countries., Results: The response rate was 31.5% (5430/17,247). Most respondents were endocrinologists. Twenty-eight percent asserted that TH therapy may be indicated in euthyroid patients with a growing SG. National and regional differences were noted, from 7% of positive responses in The Netherlands to 78% in Czech Republic (p < 0.0001). TH was more frequently prescribed by respondents over 40 years old (OR 1.77, 2.13, 2.41 if 41-50, 51-60, >60, respectively), and working in areas of former iodine insufficiency (OR 1.24, 95% CI 1.03-1.50). TH was less frequently prescribed by endocrinologists (OR 0.77, 95% CI 0.62-0.94) and respondents working in Southern Europe (OR 0.40, 95% CI 0.33-0.48), Northern Europe (OR 0.28, 95% CI 0.22-0.36) and Western Asia (OR 0.16, 95% CI 0.11-0.24) compared to Western Europe. Associations with respondents' sex, country, availability of national thyroid guidelines, and gross national income per capita were absent or weak., Conclusions: Almost a third of European thyroid specialists support treating SG with TH, contrary to current guidelines and recommendations. This calls for urgent attention., Competing Interests: Compliance with ethical standards. Conflict of interest: All support for the present manuscript (e.g., funding, provision of study materials, medical writing, article processing charges, etc.): during the period when data were collected from the Danish Endocrinologists, K.R.R. received her salary from a grant from the Danish Medicines Agency. Grants or contracts from any entity: D.F.S. from German Research Foundation (CRC/Transregio 296 LOCOTACT); MKrš from Czech grant agency as coinvestigator for research related to gestational diabetes. Consulting fees: E.V.N., L.H., and P.P. from IBSA; E.P. from IBSA and Terumo; T.B. from Merck KGaA; J.C.G. from IBSA and Abbott; L.H. from Horizon; MKre from Merck; MKrš from Recordati rare diseases; C.M. from Egetis Pharmaceuticals; P.K. from the Swiss National Foundation for Science. Payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events: PP from IBSA; A.M.B. from Berlin-Chemie Menarini, and Merck; T.B. from Berlin-Chemie Menarini, Ipsen, Merck KGaA, Roche Diagnostics; J.C.G. from IBSA and Abbott; L.H. from IBSA, Berlin-Chemie, and Merck; MKre from Merck; MKrš from Recordati rare diseases and Merck; C.M. from Bahrain Diabetes & Endocrine Review Conference, Qatar Diabetes Endocrinology and Metabolic conference, Indiana University, Indonesian Society of Endocrinology meeting, 1st Annual Arab Thyroid Association Congress, European College of Veterinary Internal Medicine Annual Congress, and Thyroid Disease MSc Clinical Chemistry Trinity College Dublin; DAN from Merck Romania; ER from Merck, CTS Israel, Roche; MR from Merck, IBSA, Berlin-Chemie; PK from Merck, Ascendis. Support for attending meetings and/or travel: RA from IBSA; PP from IBSA; E.P. from IBSA; T.B. from Berlin-Chemie Menarini; H.D. from German Society for Endocrinology; J.C.G. from IBSA and Abbott; L.H. from IBSA, Berlin-Chemie, and Merck; MKre from Merck; MKrš from Novo Nordisk and Merck; F.M.P. from Lilly, Sanofi, Novo Nordisk; E.R. from Roche. Participation on a Data Safety Monitoring Board or Advisory Board: E.P., E.V.N., L.H., and P.P. were members of the IBSA scientific board; D.F.S. for IBSA; MKrš for Recordati rare diseases (osilodrostat and pasireotide); C.M. for Egetis Pharmaceuticals, Health products regulatory authority (HPRA) Ireland, LIONNS D2 Study; M.R. for IBSA and Merck. Leadership or fiduciary role in other board, society, committee or advocacy group, paid or unpaid: AMB from Bulgarian Society for Endocrinology (no payment); D.F.S. for AWMF-German Thyroid cancer guideline (including diagnosis and therapy of thyroid nodules); MKrš is the current President of the Czech Society of Endocrinology; C.M. is member of Executive Committee of European Thyroid Association (ETA), Chair of Study Review Committee on TRIAC withdrawal study (ReTRIACt, Egetis Pharmaceuticals), Programme Committee Member 2019–2023 for Society for Endocrinology, Secretary or Assistant Secretary 2017–2022 for British Thyroid Association, Lead of ETA Taskforce on Guidelines for Interference in Immunoassays of Hormones used in Thyroid Function Tests, Member of Committee of ETA Guideline on Diagnosis and Management of Syndromes of Resistance to Thyroid Hormone, previous invited Member expert working group on rare thyroid disorders for the European Reference Networks, National convenor Society for Endocrinology Thyroid Network. P.K. American Thyroid Association (no payment), Swiss Society for Endocrinology and Diabetology (no payment). Other financial or non-financial interests: C.M. received Publication Fees from IBSA for another publication., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)