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15 pages, 1576 KiB  
Case Report
Kenny–Caffey Syndrome Type 2 (KCS2): A New Case Report and Patient Follow-Up Optimization
by Kyriaki Hatziagapiou, Amalia Sertedaki, Vasiliki Dermentzoglou, Nataša Čurović Popović, George I. Lambrou, Louis Papageorgiou, Trias Thireou, Christina Kanaka-Gantenbein and Sophia D. Sakka
J. Clin. Med. 2025, 14(1), 118; https://doi.org/10.3390/jcm14010118 - 28 Dec 2024
Viewed by 385
Abstract
Background/Objectives: Kenny–Caffey syndrome 2 (KCS2) is a rare cause of hypoparathyroidism, inherited in an autosomal dominant mode, resulting from pathogenic variants of the FAM111A gene, which is implicated in intracellular pathways regulating parathormone (PTH) synthesis and skeletal and parathyroid gland development. Methods: [...] Read more.
Background/Objectives: Kenny–Caffey syndrome 2 (KCS2) is a rare cause of hypoparathyroidism, inherited in an autosomal dominant mode, resulting from pathogenic variants of the FAM111A gene, which is implicated in intracellular pathways regulating parathormone (PTH) synthesis and skeletal and parathyroid gland development. Methods: The case of a boy is reported, presenting with the characteristic and newly identified clinical, biochemical, radiological, and genetic abnormalities of KCS2. Results: The proband had noticeable dysmorphic features, and the closure of the anterior fontanel was delayed until the age of 4 years. Biochemical evaluation at several ages revealed persistent hypocalcemia, high normal phosphorous, and inappropriately low normal PTH. To exclude other causes of short stature, the diagnostic approach revealed low levels of IGF-1, and on CNS MRI, small pituitary gland and empty sella. Nocturnal levels of growth hormone were normal. MRI also revealed bilateral symmetrical microphthalmia and torturous optic nerves. Skeletal survey was compatible with cortical thickening and medullary stenosis of the long bones. Genomic data analysis revealed a well-known pathogenic variant of the FAM111A gene (c.1706G>A, p. R569H), which is linked with KCS2 or nanophthalmos. Conclusions: KCS2, although a rare disease, should be included in the differential diagnosis of hypoparathyroidism and short stature. Understanding the association of pathogenic variants with KCS2 phenotypic variability will allow the advancement of clinical genetics and personalized long-term follow-up and will offer insights into the role of the FAM111A gene in the disease pathogenesis and normal embryogenesis of implicated tissues and organs. Full article
(This article belongs to the Special Issue Endocrine Disorders in Children)
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<p>Anthropometric measurements: height (cm), weight (kg), head circumference (cm), and BMI (kg/m<sup>2</sup>) of the proband (WHO Child Growth Standards) [<a href="#B23-jcm-14-00118" class="html-bibr">23</a>].</p>
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<p>(<b>A</b>) T1-w midsagittal image shows hypoplasia of the anterior pituitary with a concave surface and almost empty sella appearance (arrow). The stalk is normal, and the posterior pituitary is orthotopic. (<b>B</b>) T2-w sagittal image demonstrates tortuosity of the optic nerve (arrow) and dilatation of the subarachnoid space surrounding its anterior portion (arrowhead). (<b>C</b>) T1-w axial image depicts bilateral symmetrical microphthalmia. X-rays of the (<b>D</b>) femur, (<b>E</b>) tibia, and (<b>F</b>) humerus show increased cortical thickness of the diaphysis, with mild narrowing of the medullary cavities. Relative flaring of the proximal tibial metaphysis.</p>
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<p>The <span class="html-italic">FAM111A</span> gene variants associated with KCS2 and other related diseases. Pathogenic variants that have been directly associated with KCS2 (red) and likely pathogenic variants (yellow).</p>
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16 pages, 1461 KiB  
Article
Micronutrient Status in Patients with Severe Obesity Before and After Laparoscopic Sleeve Gastrectomy
by Daniela Ciobârcă, Adriana Florinela Cătoi, Cătălin Copăescu, Mihaela Iancu, Ioana Delia Pop, Dan Cristian Vodnar, Andra Diana Cecan, Doina Miere, Lorena Filip and Gianina Crișan
Nutrients 2024, 16(24), 4386; https://doi.org/10.3390/nu16244386 - 20 Dec 2024
Viewed by 476
Abstract
Background: Micronutrient deficiencies (MNDs) are commonly reported after bariatric and metabolic surgery, including laparoscopic sleeve gastrectomy (LSG). Nevertheless, the micronutrient status changes over time and the influence of sex or initial body mass index (BMI) on these changes are less explored. This study [...] Read more.
Background: Micronutrient deficiencies (MNDs) are commonly reported after bariatric and metabolic surgery, including laparoscopic sleeve gastrectomy (LSG). Nevertheless, the micronutrient status changes over time and the influence of sex or initial body mass index (BMI) on these changes are less explored. This study aims to investigate the changes in micronutrient levels at 6 and 12 months after LSG and the potential influence of sex or baseline BMI (≥40 kg/m2) on these changes in patients submitted to LSG. Additionally, the frequency of MNDs before and at 12 months after the procedure was investigated. Materials and methods: Fifty patients with obesity underwent LSG and were assessed anthropometrically and nutritionally at baseline and at 6 and 12 months, respectively, after LSG. The changes in micronutrients levels over time were tested by a linear mixed model. Results: Vitamin B12 and vitamin D [25(OH)D] did not change significantly, while iron (p < 0.001), calcium (p = 0.01), and parathormone (p < 0.001) differed significantly from baseline to 12 months after LSG. Ferritin significantly decreased from baseline to 6 months and 12 months after LSG (LS-means, 95% CI: 202 [163, 240] vs. 160 [130, 191] vs. 150 [115, 185]). Sex or initial severe obesity (BMI ≥ 40 kg/m2) exhibited significant modifying effects for 25(OH)D and calcium, respectively. The 25(OH)D levels increased significantly in men, but not in women, while the calcium plasma concentration changed significantly only in patients with initial severe obesity. No significant changes over time were found for MNDs’ frequency (p > 0.05). The most consistent deficiency frequency was observed for 25(OH)D both before and after LSG. Conclusions: Overall, our findings revealed changes in micronutrient status across the follow-up period, except for vitamin B12. Variations in 25(OH)D levels were reported exclusively in men, suggesting that they depend on sex. The calcium plasma concentration showed significant changes exclusively in patients with BMI ≥ 40 kg/m2. MNDs’ frequency was not significantly altered during the study follow-up. Our results reinforce the need for developing national dietary guidelines tailored for Romanian patients following LSG. Full article
(This article belongs to the Special Issue Nutritional Implications in Obesity and Bariatric Surgery)
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<p>Changes in %EWL, %EBMIL, and %TWL during the post-surgery period. Results are represented as violin plots. Solid error bars on plots represent mean value (observed mean) with standard deviation calculated at each time points (6 MTH = at six months and 12 MTH = at 12 months after LSG) for males (magenta color) and females (grey color).</p>
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13 pages, 724 KiB  
Article
Uric Acid Correlates with Serum Levels of Mineral Bone Metabolism and Inflammation Biomarkers in Patients with Stage 3a–5 Chronic Kidney Disease
by Francisco Mendoza Carrera, Gloria Elizabeth Vázquez Rivera, Caridad A. Leal Cortés, Lourdes del Carmen Rizo De la Torre, Renato Parra Michel, Rosalba Orozco Sandoval and Mariana Pérez Coria
Medicina 2024, 60(12), 2081; https://doi.org/10.3390/medicina60122081 - 19 Dec 2024
Viewed by 511
Abstract
Background and Objectives: Uric acid (UA) and the markers of mineral bone metabolism and inflammation are commonly altered in patients with chronic kidney disease (CKD) and are associated with the risk of cardiovascular complications and death. Studies point to a link between [...] Read more.
Background and Objectives: Uric acid (UA) and the markers of mineral bone metabolism and inflammation are commonly altered in patients with chronic kidney disease (CKD) and are associated with the risk of cardiovascular complications and death. Studies point to a link between high serum UA and mineral bone homeostasis and inflammation, but controversy remains. The aim of this study was to evaluate the relationship between UA levels and mineral bone metabolism and inflammation biomarkers in a sample of Mexican patients with CKD 3a–5. Materials and Methods: This cross-sectional study included 146 Mexican patients with CKD 3a–5. In addition, 25 healthy subjects were included in the study with the aim of generating reference data for comparisons. Metabolic parameters including UA serum concentrations, mineral bone metabolism (parathormone (PTH), fibroblast growth factor 23 (FGF23), calcium, and phosphate), and inflammation (interleukin (IL)-1β, IL-6, and tumor necrosis factor-alpha (TNF-α)) biomarkers were measured in all of the samples and compared as a function of the estimated glomerular function rate (eGFR) or UA levels. Results: Intact PTH, FGF23, and cytokines were higher in advanced CKD stages. Patients with hyperuricemia had significantly higher values of FGF23 and TNF-α compared with those without hyperuricemia. The eGFR was found to be significantly and negatively correlated with all markers. Uric acid was significantly correlated with phosphate, iPTH, FGF23, and TNF-α, whereas iPTH was significantly correlated with FGF23, TNF-α, and FGF23. Finally, a multivariate analysis confirmed the relationship of eGFR with all the tested biomarkers, as well as other relationships of iPTH with UA and TNF-α and of FGF23 with UA and TNF-α. Conclusions: This study supports the relationship between uric acid and levels of mineral bone metabolism and inflammation biomarkers in patients with CKD at middle to advanced stages. In the follow-up of patients with CKD, monitoring and controlling UA levels through nutritional or pharmacological interventions could help in the prevention of alterations related to mineral bone metabolism. Full article
(This article belongs to the Section Urology & Nephrology)
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<p>Serum concentrations of uric acid, mineral bone metabolism, and inflammation biomarkers according to the CKD stage. The <span class="html-italic">p-</span>values are obtained from ANOVA or Kruskal–Wallis tests, as appropriate. Abbreviations: HS: healthy subjects; iPTH, intact parathyroid hormone; FGF23, fibroblast growth factor 23; IL, interleukin; TNF, tumor necrosis factor.</p>
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13 pages, 494 KiB  
Systematic Review
High Doses of Vitamin D and Specific Metabolic Parameters in Type 2 Diabetes Patients: Systematic Review
by Filip Max, Andrea Gažová, Juraj Smaha, Martin Jankovský, Tomáš Tesař, Peter Jackuliak, Martin Kužma, Juraj Payer and Ján Kyselovič
Nutrients 2024, 16(22), 3903; https://doi.org/10.3390/nu16223903 - 15 Nov 2024
Viewed by 1410
Abstract
Background/Objectives: Type II diabetes mellitus (T2DM) is recognized as a condition of mild chronic inflammation, marked by increased levels of acute-phase proteins and various inflammatory indicators. These inflammatory substances, along with inflammation of adipose tissue and the secretion of adipocytokines, can contribute to [...] Read more.
Background/Objectives: Type II diabetes mellitus (T2DM) is recognized as a condition of mild chronic inflammation, marked by increased levels of acute-phase proteins and various inflammatory indicators. These inflammatory substances, along with inflammation of adipose tissue and the secretion of adipocytokines, can contribute to insulin resistance and β cell dysfunction. By influencing both innate and adaptive immunity, vitamin D can inhibit the production of inflammatory cytokines and help mitigate the low-grade chronic inflammation associated with T2DM. Several strategies have been proposed to increase vitamin D levels effectively and safely, but the recent and strong ones have common tactics. Short-term high doses increase the level acutely, and long-term lower doses maintain sufficient levels. Methods: The aim of our work was to determine and verify the effectiveness of high doses of vitamin D to safely increase its level in patients with type 2 diabetes mellitus, as well as the effect of these doses on selected metabolic parameters. Data from 20 studies (vitamin D group n = 612, and control group n = 592) regarding the influence of vitamin D supplementation with doses above 4000 IU on serum 25(OH)D, fasting blood glucose (FBG), hemoglobin A1c (HbA1c), blood pressure, serum calcium, and parathormone were pooled. Results: Vitamin D supplementation significantly improved serum 25(OH)D levels, with an average increase after intervention versus baseline at 177.09%. Our studies suggest that vitamin D supplementation may benefit various parameters in T2DM patients, including glycemic control, blood pressure, and PTH levels. Conclusions: Vitamin D supplementation may have beneficial effects on various parameters in type 2 diabetes patients, including glycemic control, blood pressure, and parathormone levels. However, the results are only sometimes consistent across all studies. Further examination is needed. Full article
(This article belongs to the Special Issue Role of Vitamin D in Chronic Diseases—2nd Edition)
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<p>Flowchart of the search strategy and data extraction based on PRISMA 2020.</p>
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12 pages, 1884 KiB  
Article
Hemodialysis Patients May Benefit from Cholecalciferol Treatment Targeting High Level of 25(OH)D
by Agnieszka Tarasewicz, Małgorzata Dąbrowska, Michał Komorniczak, Agnieszka Zakrzewska, Bogdan Biedunkiewicz, Sylwia Małgorzewicz, Magdalena Jankowska, Katarzyna Jasiulewicz, Natalia Płonka, Alicja Dębska-Ślizień and Leszek Tylicki
Medicina 2024, 60(11), 1831; https://doi.org/10.3390/medicina60111831 - 7 Nov 2024
Viewed by 810
Abstract
(1) Background and Objectives: Vitamin D is implicated in the pathogenesis of Chronic Kidney Disease—Mineral and Bone Disorder (CKD-MBD) in hemodialysis (HD) patients, including the development of secondary hyperparathyroidism (SHP). While cholecalciferol supplementation is recommended for vitamin D deficiency correction, its impact [...] Read more.
(1) Background and Objectives: Vitamin D is implicated in the pathogenesis of Chronic Kidney Disease—Mineral and Bone Disorder (CKD-MBD) in hemodialysis (HD) patients, including the development of secondary hyperparathyroidism (SHP). While cholecalciferol supplementation is recommended for vitamin D deficiency correction, its impact on CKD-MBD remains inconsistent. The aim of this observational prospective study was to assess the effect of cholecalciferol in achieving high–normal serum 25-hydroxycholecalciferol (25(OH)D > 75 ng/mL) levels and its impact on CKD-MBD biochemical markers, including 1,25-dihydroxycholecalciferol (1,25(OH)2D) and parathormone (PTH) in HD patients. The study also evaluated the maintenance dosage required to sustain 25(OH)D levels within the 50–75 ng/mL range. (2) Materials and Methods: A total of 22 HD patients with baseline 25(OH)D levels 30–50 ng/mL received cholecalciferol (70,000 IU/week) to achieve the target serum 25(OH)D > 75 ng/mL. Baseline data on calcium, phosphate, 1–84 PTH, 25(OH)D, and 1,25(OH)2D serum levels were compared with the data when 25(OH)D > 75 ng/mL was targeted or when the highest 25(OH)D levels were noted. (3) Results: Cholecalciferol significantly improved vitamin D status in HD patients, with 73% reaching the target 25(OH)D level >75 ng/mL in a median time of 7.5 weeks, with a median total dose of 525,000 IU. This was associated with a significant rise in 1,25(OH)2D, decrease in 1–84 PTH, and no significant effect on calcium and phosphate levels. The median maintenance dose of cholecalciferol was established at 30,000 IU/week. (4) Conclusions: The findings support the use of cholecalciferol targeting high normal 25(OH)D levels to improve biochemical markers of CKD-MBD in HD patients. Full article
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<p>Study flow chart. All patients upon study initiation entered the therapeutic phase, during which they supplemented cholecalciferol at a dose of 70,000 IU/week. Serum 25(OH)D levels were monitored weekly, and if 25(OH)D concentrations reached above 75 ng/mL, patients transitioned to the decline phase, during which cholecalciferol administration was suspended. The reintroduction of cholecalciferol occurred upon 25(OH)D levels falling below 55 ng/mL and completed the decline phase and the beginning of the maintenance phase. Patients who did not achieve a 25(OH)D concentration above 75 ng/mL by week 24 of the study immediately transitioned to the maintenance phase (without the decline phase), during which they were administered 20,000 IU cholecalciferol/week. In the maintenance phase, 25(OH)D levels were monitored every 4 weeks, and the dose was adjusted to maintain levels within the range of 50–75 ng/mL.</p>
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<p>Correlation between serum concentration of 25(OH)D and 1,25(OH)<sub>2</sub>D throughout the entire study period. The solid line represents the line of best fit, while the dashed lines indicate the confidence interval lines.</p>
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<p>A scatter plot of the correlation between the serum concentration of 1–84 PTH and 1,25(OH)<sub>2</sub>D (<b>A</b>) and between 1–84 PTH and 25(OH)D (<b>B</b>) throughout the entire study period. The correlation coefficient (R) and <span class="html-italic">p</span>-value (<span class="html-italic">p</span>) are provided on the graph. The solid line represents the line of best fit, while the dashed lines indicate the confidence interval lines.</p>
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<p>Median concentration of 25(OH)D during the study at 4 time points: at the beginning of the study (T0), at the point of the highest achieved concentration (Tmax), at the end of the decline phase (Tend), and at the end of the study (T48). The Tmax point for patients who achieved a concentration of 25(OH)D above 75 ng/mL (<b>A</b>) was equivalent to the end of the therapeutic phase and the beginning of the decline phase. For patients who did not achieve a concentration of 25(OH)D above 75 ng/mL (<b>B</b>) within 24 weeks of using cholecalciferol at a dose of 70,000 IU per week, they immediately transitioned (without a decline phase) to the maintenance phase. The doses of cholecalciferol used in each phase are provided below the phase names.</p>
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18 pages, 11247 KiB  
Article
Bone Regeneration with Dental Pulp Stem Cells in an Experimental Model
by Haifa Hamad-Alrashid, Sandra Muntión, Fermín Sánchez-Guijo, Javier Borrajo-Sánchez, Felipe Parreño-Manchado, M. Begoña García-Cenador and F. Javier García-Criado
J. Pers. Med. 2024, 14(11), 1075; https://doi.org/10.3390/jpm14111075 - 25 Oct 2024
Viewed by 720
Abstract
Background/Objectives: The therapeutic approach to bone mass loss and bone’s limited self-regeneration is a major focus of research, emphasizing new biomaterials and cell therapy. Tissue bioengineering emerges as a potential alternative to conventional treatments. In this study, an experimental model of a critical [...] Read more.
Background/Objectives: The therapeutic approach to bone mass loss and bone’s limited self-regeneration is a major focus of research, emphasizing new biomaterials and cell therapy. Tissue bioengineering emerges as a potential alternative to conventional treatments. In this study, an experimental model of a critical bone lesion in rats was used to investigate bone regeneration by treating the defect with biomaterials Evolution® and Gen-Os® (OsteoBiol®, Turín, Italy), with or without mesenchymal stromal cells from dental pulp (DP-MSCs). Methods: Forty-six adult male Wistar rats were subjected to a 5-mm critical bone defect in the right mandible, which does not regenerate without intervention. The rats were randomly assigned to a Simulated Group, Control Group, or two Study Groups (using Evolution®, Gen-Os®, and DP-MSCs). The specimens were euthanized at three or six months, and radiological, histological, and ELISA tests were conducted to assess bone regeneration. Results: The radiological results showed that the DP-MSC group achieved uniform radiopacity and continuity in the bone edge, with near-complete structural defect restitution. Histologically, full bone regeneration was observed, with well-organized, vascularized lamellar bone and no lesion edges. These findings were supported by increases in endoglin, transforming growth factor-beta 1 (TGF-β1), protocollagen, parathormone, and calcitonin, indicating a conducive environment for bone regeneration. Conclusions: The use of DP-MSCs combined with biomaterials with appropriate three-dimensional matrices is a promising therapeutic option for further exploration. Full article
(This article belongs to the Section Regenerative Medicine and Therapeutics)
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<p>Study experimental design. Group C: rats with bone defect. Group G + M: rats with bone defect plus scaffolds and membrane. Group G + M + S: rats with bone defect plus scaffolds, membrane, and MSCs from dental pulp.</p>
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<p>Access to insertion crest. Circular osteotomy with trephine drill.</p>
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<p>Extraction of pulp.</p>
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<p>Brightfield microscopy of rat DP-MSCs at different culture passages: (<b>A</b>) at passage 4, (<b>B</b>) at passage 7, and (<b>C</b>) at passage 10. Image magnitude 10×.</p>
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<p>Illustration of the gating strategy used to identify the MSC population in the rat dental pulp isolates. (<b>A</b>) The gates were determined in the unstained samples (<b>B</b>) and applied to the stained samples. (<b>C</b>) The expression levels of CD29, CD49e, and CD90-1 were analyzed as shown in the above histograms, respectively. In total, from six rats, this population of MSCs was identified in 94.58% ± 3.62 of the isolates. From passage two, all the samples already presented with 90% of the population having the characteristics of MSCs (Lineage-CD90-1 + CD29+) and were maintained until passage 10.</p>
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<p>Differentiation ability of DP-MSCs from rats. Control, osteogenic, and adipogenic differentiation. Objective 10×.</p>
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<p>Micro-CT images of defects in different groups at 3 and 6 months: The arrows indicate the site of the bone defect. (<b>A</b>) defect in Group C at 3 months, (<b>B</b>) defect in Group C at 6 months, (<b>C</b>) defect in G + M Group at 3 months, (<b>D</b>) defect in G + M Group at 6 months, (<b>E</b>) defect in G + M + S Group at 3 months, and (<b>F</b>) defect in G + M + S Group at 6 months. Scale bar for Micro-CT images is 5 mm.</p>
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<p>(<b>A</b>) Hematoxylin and eosin staining of the bone defect in Group C at 3 months (20× magnification). (<b>B</b>) Hematoxylin and eosin staining of the bone defect in Group C at 6 months (40× magnification). The image shows a fibrotic reaction in the untreated lesion. The fibrous cicatricial reaction overran the edges of the lesion. There is no sign of any reactive bone regeneration.</p>
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<p>(<b>A</b>) Hematoxylin and eosin staining of the bone defect in Group G + M at 3 months (magnifications: 4×, 20×, 40×). Various biomaterial particles and a chronic inflammatory component are visible. (<b>B</b>) Hematoxylin and eosin staining of the bone defect in Group G + M + S at 3 months (magnifications: 4×, 20×, 40×). Evidence of osteogenesis is observed. Black arrows indicate osteoblasts embedded in osteoid and signs of neovascularization.</p>
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<p>(<b>A</b>) Hematoxylin and eosin staining of the bone defect in Group G + M at 6 months (magnifications: 4×, 20×, 40×), showing chronic inflammation. (<b>B</b>) Hematoxylin and eosin staining of the bone defect in Group G + M + S at 6 months (magnifications: 4×, 20×, 40×), showing evidence of osteogenesis.</p>
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<p>Serum concentration of endoglin (pg/mL) in various groups at 3 and 6 months (Kruskal–Wallis multiple comparison test and Dunn’s test). * <span class="html-italic">p</span> &lt; 0.05 compared to the Control group; # <span class="html-italic">p</span> &lt; 0.05 compared to the Sham group; + <span class="html-italic">p</span> &lt; 0.05 compared to the G + M group.</p>
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<p>Serum concentration of TGF-β1 (pg/mL) in various groups at three and six months (Kruskal–Wallis multiple comparison test and Dunn’s test). * <span class="html-italic">p</span> &lt; 0.05 compared to the Control group; # <span class="html-italic">p</span> &lt; 0.05 compared to the Sham group; + <span class="html-italic">p</span> &lt; 0.05 compared to the G + M group.</p>
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<p>Serum concentration of procollagen (pg/mL) in various groups at three and six months (Kruskal–Wallis multiple comparison test and Dunn’s test). <b>*</b> <span class="html-italic">p</span> &lt; 0.05 compared to the Control group; <b>#</b> <span class="html-italic">p</span> &lt; 0.05 compared to the Sham group; + <span class="html-italic">p</span> &lt; 0.05 compared to the G + M group.</p>
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<p>Serum concentration of parathormone (pg/mL) in the various groups at 3 and 6 months (Kruskal–Wallis multiple comparison test and Dunn’s test). <b>*</b> <span class="html-italic">p</span> &lt; 0.05 compared to the Control group; <b>#</b> <span class="html-italic">p</span> &lt; 0.05 compared to the Sham group; + <span class="html-italic">p</span> &lt; 0.05 compared to the G + M group.</p>
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<p>Serum concentration of calcitonin (pg/mL) in various groups at three and six months (Kruskal–Wallis multiple comparison test and Dunn’s test). <b>*</b> <span class="html-italic">p</span> &lt; 0.05 compared to the Control group; # <span class="html-italic">p</span> &lt; 0.05 compared to the Sham group; + <span class="html-italic">p</span> &lt; 0.05 compared to the G + M group.</p>
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15 pages, 1533 KiB  
Article
The Importance of Biochemical Parameters, Immunonutritional Status, and Social Support for Quality of Life in Chronic Hemodialysis Patients
by Batric Babovic, Natasa Belada Babovic, Filip Tomovic, Snezana Radovanovic, Mladen Debeljevic, Dusan Mustur and Olgica Mihaljevic
Medicina 2024, 60(11), 1751; https://doi.org/10.3390/medicina60111751 - 24 Oct 2024
Viewed by 1056
Abstract
Background and Objectives: Chronic kidney disease (CKD) is a growing public health problem and one of the leading causes of premature death worldwide. The progressive nature of CKD is associated with serious complications that can reduce the quality of life in CKD [...] Read more.
Background and Objectives: Chronic kidney disease (CKD) is a growing public health problem and one of the leading causes of premature death worldwide. The progressive nature of CKD is associated with serious complications that can reduce the quality of life in CKD patients. Additional factors that can worsen well-being include dialysis treatment, malnutrition, inflammation, and lack of social support. The aim of our study was to analyze the quality of life of CKD patients undergoing hemodialysis and its association with certain biochemical and immunonutritional parameters, as well as with social support. Materials and Methods: This research was conducted as a cross-sectional study that included 170 patients, divided into two groups: a group of patients undergoing hemodialysis (HD group) (n = 85), and a control group of non-hemodialysis patients (group with CKD stage 3–4) (n = 85). The Health-Related Quality of Life (HRQoL) score was used to assess the quality of life of the study population. Measurement of biochemical and immunonutritional parameters was also performed in all patients. The Oslo-3 Social Support Scale (OSSS-3) was used to analyze social support. Results: The HRQoL score was significantly lower in HD patients compared to patients with CKD stage 3–4 (0.701 ± 0.137 vs. 0.832 ± 0.122, p < 0.001). It declined significantly as the concentrations of urea (β = −0.347, p < 0.001), creatinine (β = −0.699, p = 0.005), uric acid (β = −0.184, p = 0.016), β2-microglobulin (β = −0.432, p < 0.001), and parathormone (β = −0.209, p = 0.006) increased in HD patients. In addition to uremic toxins, an increase in glucose (β = −0.278, p = 0.010) and triglyceride (β = −0.354, p = 0.001) concentrations was associated with poor HRQoL in patients with CKD stage 3–4. There was a significant connection between the Hemoglobin, Albumin, Lymphocyte, and Platelet (HALP) score and HRQoL in HD patients (β = 0.229, p = 0.035). Additionally, C-reactive protein (β = −0.361, p < 0.001) and neutrophil-to-lymphocyte ratio (β = −0.288, p < 0.001), as markers of systemic inflammation, directly affected HRQoL in HD patients. In both study groups, perceived social support positively influenced the HRQoL scores (β = 0.192, p = 0.012 for hemodialysis; β = 0.225, p = 0.038 for non-hemodialysis). Conclusions: There is a decline in HRQoL in chronic hemodialysis patients, significantly affected by certain biochemical and immunonutritional parameters, along with perceived social support. Full article
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<p>The distribution of the study population according to the main cause of chronic kidney disease.</p>
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<p>Histograms of HRQoL score distribution in hemodialysis patients (<b>A</b>) and CKD stage 3–4 patients (<b>B</b>).</p>
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<p>OSSS-3 scores in the study population.</p>
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12 pages, 449 KiB  
Article
Heterogeneous Transcriptional Landscapes in Human Sporadic Parathyroid Gland Tumors
by Chiara Verdelli, Silvia Carrara, Riccardo Maggiore, Paolo Dalino Ciaramella and Sabrina Corbetta
Int. J. Mol. Sci. 2024, 25(19), 10782; https://doi.org/10.3390/ijms251910782 - 7 Oct 2024
Viewed by 953
Abstract
The expression of several key molecules is altered in parathyroid tumors due to gene mutations, the loss of heterozygosity, and aberrant gene promoter methylation. A set of genes involved in parathyroid tumorigenesis has been investigated in sporadic parathyroid adenomas (PAds). Thirty-two fresh PAd [...] Read more.
The expression of several key molecules is altered in parathyroid tumors due to gene mutations, the loss of heterozygosity, and aberrant gene promoter methylation. A set of genes involved in parathyroid tumorigenesis has been investigated in sporadic parathyroid adenomas (PAds). Thirty-two fresh PAd tissue samples surgically removed from patients with primary hyperparathyroidism (PHPT) were collected and profiled for gene, microRNA, and lncRNA expression (n = 27). Based on a gene set including MEN1, CDC73, GCM2, CASR, VDR, CCND1, and CDKN1B, the transcriptomic profiles were analyzed using a cluster analysis. The expression levels of CDC73 and CDKN1B were the main drivers for clusterization. The samples were separated into two main clusters, C1 and C2, with the latter including two subgroups of five PAds (C2A) and nineteen PAds (C2B), both differing from C1 in terms of their lower expression of CDC73 and CDKN1B. The C2A PAd profile was also associated with the loss of TP73, an increased expression of HAR1B, HOXA-AS2, and HOXA-AS3 lncRNAs, and a trend towards more severe PHPT compared to C1 and C2B PAds. C2B PAds were characterized by a general downregulated gene expression. Moreover, CCND1 levels were also reduced as well as the expression of the lncRNAs NEAT1 and VLDLR-AS1. Of note, the deregulated lncRNAs are predicted to interact with the histones H3K4 and H3K27. Patients harboring C2B PAds had lower ionized and total serum calcium levels, lower PTH levels, and smaller tumor sizes than patients harboring C2A PAds. In conclusion, PAds display heterogeneous transcriptomic profiles which may contribute to the modulation of clinical and biochemical features. The general downregulated gene expression, characterizing a subgroup of PAds, suggests the tumor cells behave as quiescent resting cells, while the severity of PHPT may be associated with the loss of p73 and the lncRNA-mediated deregulation of histones. Full article
(This article belongs to the Special Issue State-of-the-Art Molecular Endocrinology and Metabolism in Italy)
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<p>Hierarchical cluster analysis of analyzed PAd series based on the expression of the genes known to be pathogenic in parathyroid tumorigenesis. (<b>a</b>) Dendrogram identifying 3 clusters; distance, also known as dissimilarity, is represented on the vertical scale. (<b>b</b>) Heatmap representing the expression levels of each analyzed gene in each PAd sample.</p>
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20 pages, 920 KiB  
Article
Vitamin D Supplementation Does Not Enhance Gains in Muscle Strength and Lean Body Mass or Influence Cardiorespiratory Fitness in Vitamin D-Insufficient Middle-Aged Men Engaged in Resistance Training
by Lauri Savolainen, Saima Timpmann, Martin Mooses, Evelin Mäestu, Luule Medijainen, Märt Lellsaar, Kristi Tiimann, Anneli Piir, Mihkel Zilmer, Eve Unt and Vahur Ööpik
Nutrients 2024, 16(19), 3356; https://doi.org/10.3390/nu16193356 - 2 Oct 2024
Viewed by 1430
Abstract
Background: This study checked whether vitamin D (Vit-D) supplementation improves the efficacy of resistance training (RT) in terms of increasing muscle strength and lean body mass (LBM), and influencing cardiorespiratory fitness (VO2max) in Vit-D-deficient middle-aged healthy men. Methods: Participants (n [...] Read more.
Background: This study checked whether vitamin D (Vit-D) supplementation improves the efficacy of resistance training (RT) in terms of increasing muscle strength and lean body mass (LBM), and influencing cardiorespiratory fitness (VO2max) in Vit-D-deficient middle-aged healthy men. Methods: Participants (n = 28) were quasi-randomly assigned to one of two groups, which, in a double-blind manner, supplemented their diet daily with either Vit-D (8000 IU; VD) or placebo (PLC) during participation in a 12-week supervised RT program. Results: During the intervention, serum Vit-D concentrations increased 2.6-fold (p < 0.001) in the VD group, while no changes occurred in the PLC group. Muscle strength gains (p < 0.001) as measured in seven exercises performed on RT equipment and increases (p < 0.001) in LBM were similar in the two groups. Total fat mass, percent total fat, and percent android fat decreased (p < 0.05) to a similar extent in both groups, but there was no change in VO2max in either group. Conclusions: In conclusion, in healthy Vit-D-insufficient middle-aged men engaged in resistance training, Vit-D supplementation increases serum 25(OH)D levels but does not enhance gains in muscle strength and LBM, or decreases in fat mass and fat percentage, and does not affect cardiorespiratory fitness. Full article
(This article belongs to the Special Issue Vitamins and Human Health: 2nd Edition)
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<p>Study design. Arrows indicate time points for measuring body mass (BM), body composition (DXA), maximal oxygen uptake (VO<sub>2</sub>max), venous blood sampling (Blood), and beginning (PLC/VD+) and end (PLC/VD−) of placebo or vitamin D supplementation. Grey and striped cells indicate the weeks during which muscle strength was assessed and 4-day food diaries were completed, respectively.</p>
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<p>Serum 25(OH)D concentrations. Data are presented as mean ± SD, <span class="html-italic">n</span> = 14 in placebo, and <span class="html-italic">n</span> = 14 in vitamin D group. Significantly different (<span class="html-italic">p</span> &lt; 0.05): * from Week −4; <sup>#</sup> from previous week; <sup><span>$</span></sup> from placebo group.</p>
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<p>Changes in 1-repetition maximum during 12-week supplementation and resistance training period. Data are presented as mean ± SD, <span class="html-italic">n</span> = 14 in placebo, and <span class="html-italic">n</span> = 14 in vitamin D group.</p>
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12 pages, 702 KiB  
Article
Iron Deficiency Is Associated with Elevated Parathormone Levels, Low Vitamin D Status, and Risk of Bone Loss in Omnivores and Plant-Based Diet Consumers
by M. Pilar Vaquero, Elena García-Maldonado, Angélica Gallego-Narbón, Belén Zapatera, Alexandra Alcorta and Miriam Martínez-Suárez
Int. J. Mol. Sci. 2024, 25(19), 10290; https://doi.org/10.3390/ijms251910290 - 24 Sep 2024
Viewed by 1352
Abstract
A cross-sectional study was performed in healthy adults (mean age 28 y, 67% women) whose habitual diet was an omnivore, lacto-ovo vegetarian, or vegan diet. The total sample (n = 297) was divided into two groups according to the parathormone (PTH) cut-off [...] Read more.
A cross-sectional study was performed in healthy adults (mean age 28 y, 67% women) whose habitual diet was an omnivore, lacto-ovo vegetarian, or vegan diet. The total sample (n = 297) was divided into two groups according to the parathormone (PTH) cut-off value of 65 pg/mL of either normal-PTH (n = 228) or high-PTH (n = 69). Vitamin D status (25-hydroxycholecalciferol, 25-OHD), PTH, and bone formation (bone alkaline phosphatase, BAP) and bone resorption (N-telopeptides of type I collagen, NTx) markers were determined. Hematocrit, erythrocytes, hemoglobin, platelets, serum iron, serum transferrin, transferrin saturation, and serum ferritin were also measured. In the total sample, 25-OHD and PTH were negatively correlated, and all subjects with high PTH presented vitamin D insufficiency (25-OHD < 75 nmol/L). High bone remodeling was observed in the high-PTH group, with significantly higher NTx and marginally higher BAP compared to the normal-PTH group. Hematocrit and ferritin were significantly lower in the high-PTH compared to the normal-PTH group. However, serum iron was higher in the high-PTH group, which was only observed for the lacto-ovo vegetarian and vegan subjects. It is concluded that both low vitamin D and low iron status are associated with elevated PTH and bone resorption, more in vegetarians than omnivores, which is in line with the hypothesis that chronic iron deficiency in adulthood mainly predisposes to osteoporosis in postmenopausal women and the elderly. Full article
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<p>Serum iron and log-ferritin, according to PTH status and diet. Boxplots show the median with the 25th and 75th percentiles and the minimum and maximum values. Boxes with different colors indicate <span class="html-fig-inline" id="ijms-25-10290-i001"><img alt="Ijms 25 10290 i001" src="/ijms/ijms-25-10290/article_deploy/html/images/ijms-25-10290-i001.png"/></span> omnivores, <span class="html-fig-inline" id="ijms-25-10290-i002"><img alt="Ijms 25 10290 i002" src="/ijms/ijms-25-10290/article_deploy/html/images/ijms-25-10290-i002.png"/></span> lacto-ovo vegetarians, and <span class="html-fig-inline" id="ijms-25-10290-i003"><img alt="Ijms 25 10290 i003" src="/ijms/ijms-25-10290/article_deploy/html/images/ijms-25-10290-i003.png"/></span> vegans. * Significantly different compared to omnivores (general linear model with Bonferroni correction for multiple comparisons).</p>
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<p>Proposed mechanisms of the relationship between both iron and vitamin D deficiencies and risk of bone loss in the present study. HIFs, hypoxia-inducible factors; EPO, erythropoietin; red lines, inhibition; blue lines, activation; blue curve lines, feedback regulation. Iron deficit (left cascade) at the rough endoplasmic reticulum can reduce the enzymatic activity of prolyl- and lysyl-hydroxylases that catalyze the first step of procollagen synthesis from the α-chains of pre-collagen. Shortage of oxygen in the same reaction stimulates HIFs, which can induce osteoclast formation in the bone marrow, but it is possible that the main effect is to secrete EPO by the renal interstitium, which is a powerful hormone that activates the hematopoiesis and osteopoiesis in the bone marrow. Under conditions of vitamin D insufficiency (right cascade) due to low intake or low sunlight exposure, additional iron deficiency reduces the formation of the main active metabolite of vitamin D, 1,25-(OH)2D, by reducing the 25- and 1α-hydroxylations, and also the final 24-hydroxylation that involves catabolism of the vitamin D. A decrease in 1,25-(OH)2D limits intestinal calcium absorption and lowers ionic calcium in the circulation, which is the main stimulus for PTH secretion. PTH activates the renal expression of the 1α-hydroxylase, which increases 1,25(OH)2-D levels to restore ionic calcium by increasing intestinal calcium absorption, reducing its urinary excretion, and increasing bone resorption.</p>
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9 pages, 537 KiB  
Article
Plasma Parathormone Levels during Citrate Anticoagulated Continuous Venovenous Hemofiltration in ICU Patients
by Carlos V. Elzo Kraemer, Natasha M. Appelman-Dijkstra, Bart E. P. B. Ballieux, Nadia A. du Fossé, David J. van Westerloo and Evert de Jonge
Kidney Dial. 2024, 4(3), 154-162; https://doi.org/10.3390/kidneydial4030013 - 20 Aug 2024
Viewed by 929
Abstract
Continuous venovenous hemofiltation (CVVH) with citrate anticoagulation has been shown to be associated with substantial losses of calcium and negative calcium balance in ICU patients, which may lead to excessive bone loss and osteoporosis. The aim of this study is to investigate whether [...] Read more.
Continuous venovenous hemofiltation (CVVH) with citrate anticoagulation has been shown to be associated with substantial losses of calcium and negative calcium balance in ICU patients, which may lead to excessive bone loss and osteoporosis. The aim of this study is to investigate whether plasma parathormone monitoring can identify patients with negative calcium balance during CVVH. This is a retrospective single-center study of all adult ICU patients treated with citrate CVVH from 2021 to 2023. PTH was measured routinely once per week. Calcium excretion in ultrafiltrate fluid and CVVH calcium balance were measured daily. In total, 274 PTH measurements were performed in 111 patients. In 61 measurements (22%), PTH was higher than the upper limit of normal (>8 pmol/L). If PTH was higher than normal, plasma ionized calcium was less than 1.16 mmol/L in 77% of cases and hypercalcemia was never present. In a subgroup of patients treated with CVVH for at least 36 h in the preceding 72 h, PTH values were similar for quartiles by cumulative calcium balance. Increased plasma concentrations of PTH are frequently found in ICU patients treated with citrate CVVH, but no association was found between PTH and the CVVH calcium balance over the last 72 h. Full article
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<p>Plasma PTH concentrations by the concomitantly measured ionized calcium. n = 274 measurements. Numbers on top of bars represent the number of measurements within that category. <span class="html-italic">p</span> &lt; 0.001 by One-way Anova.</p>
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<p>Plasma ionized calcium concentrations (mmol/L) in patients with normal PTH (&lt;8 pmol/L), n = 213) or PTH higher than normal (&gt;8 pmol/L, n = 61). <span class="html-italic">p</span> &lt; 0.001 by One-way Anova.</p>
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<p>PTH by quartiles of cumulative CVVH calcium balance over the preceding 72 h for 181 PTH measurements in 87 patients treated with citrate CVVH for at least 36 h within the three days preceding the PTH measurement. Q1: ≤2.26 mmol; Q2: 2.27–19.77 mmol; Q3: 19.78–41.86 mmol; Q4: ≥41.87 mmol. <span class="html-italic">p</span> = 0.35 by Oneway Anova.</p>
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20 pages, 2297 KiB  
Article
Chest X-ray Findings and Prognostic Factors in Survival Analysis in Peritoneal Dialysis and Hemodialysis Patients: A Retrospective Cross-Sectional Study
by Nilgun Tan Tabakoglu and Osman Nuri Hatipoglu
Medicina 2024, 60(8), 1331; https://doi.org/10.3390/medicina60081331 - 16 Aug 2024
Viewed by 1137
Abstract
Background and Objectives: This study aims to analyze survival in peritoneal and hemodialysis patients using chest radiography and biochemical parameters, determine common dialysis etiologies and causes of death, reveal prognostic factors, and contribute to clinical practice. Materials and Methods: A retrospective [...] Read more.
Background and Objectives: This study aims to analyze survival in peritoneal and hemodialysis patients using chest radiography and biochemical parameters, determine common dialysis etiologies and causes of death, reveal prognostic factors, and contribute to clinical practice. Materials and Methods: A retrospective cross-sectional study was conducted with data from 33 peritoneal dialysis and 37 hemodialysis patients collected between October 2018 and February 2020. Survival and mortality were retrospectively tracked over 70 months (October 2018–June 2024). Chest X-ray measurements (cardiothoracic index, pulmonary vascular pedicle width, right pulmonary artery diameter, diaphragmatic height) and biochemical parameters (urea, albumin, creatinine, parathormone, ferritin, hemoglobin, arterial blood gas, potassium) were analyzed for their impact on survival. Statistical analyses included descriptive statistics, chi-square test, Fisher’s exact test, Bayesian analysis, McNemar test, Kaplan–Meier survival analysis, Cox regression, Bayesian correlation test, linear regression analysis (scatter plot), and ROC analysis. SPSS 20.0 was used for data analysis, with p < 0.05 considered statistically significant. Results: Hypertension, type 2 diabetes, and urogenital disorders were the main dialysis etiologies. Peritonitis (38.5%) and cardiovascular diseases (47.4%) were the leading causes of death in peritoneal and hemodialysis patients, respectively. Significant chest X-ray differences included pulmonary vascular pedicle width and pulmonary artery diameter in hemodialysis and diaphragm height in peritoneal dialysis. Kaplan–Meier showed no survival difference between methods. Cox regression identified age, intact parathormone levels, iPTH/PVPW ratio, and clinical status as survival and mortality factors. The iPTH/PVPW ratio cut-off for mortality prediction was ≤6.8. Conclusions: Age, intact parathormone levels, pulmonary vascular pedicle width, and clinical status significantly impact survival in dialysis patients. Management of hypertension and diabetes, management and follow-up of urogenital disorders, infection control, patient education, and regular cardiovascular check-ups may improve survival rates. Additionally, the iPTH/PVPW ratio can predict mortality risk. Full article
(This article belongs to the Section Urology & Nephrology)
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<p>Chest radiograph measurements. Orange line: cardiothoracic index; green line: pulmonary vascular pedicle width; yellow line: right pulmonary artery diameter; blue line: diaphragmatic height; gray arrows: pulmonary redistribution.</p>
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<p>Survival rate according to total dialysis duration in PD and HD patients.</p>
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<p>Correlation between iPTH levels and PVPW in dialysis patients.</p>
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<p>ROC curve for iPTH/pulmonary vascular pedicle width.</p>
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6 pages, 747 KiB  
Case Report
Parathyroid Adenoma Detected in 68Ga-PSMA PET/CT but Not in the Dedicated Imaging Modalities
by Maja Cieślewicz, Natalia Andryszak, Kacper Pełka, Ewelina Szczepanek-Parulska, Marek Ruchała, Jolanta Kunikowska and Rafał Czepczyński
Diagnostics 2024, 14(15), 1690; https://doi.org/10.3390/diagnostics14151690 - 5 Aug 2024
Viewed by 1266
Abstract
Background: Primary hyperparathyroidism is a common endocrine disorder characterised by excessive parathormone secretion that results in hypercalcemia, primarily caused by parathyroid adenoma. Accurate localisation of hyperfunctioning tissue is essential for curative surgical treatment. Although conventional imaging modalities like ultrasonography and 99mTc-MIBI scintigraphy [...] Read more.
Background: Primary hyperparathyroidism is a common endocrine disorder characterised by excessive parathormone secretion that results in hypercalcemia, primarily caused by parathyroid adenoma. Accurate localisation of hyperfunctioning tissue is essential for curative surgical treatment. Although conventional imaging modalities like ultrasonography and 99mTc-MIBI scintigraphy (SPECT) along with 18F-fluorocholine PET/CT are commonly employed, there are cases with false-negative imaging results. Case presentation: This case report presents a patient with primary hyperparathyroidism and a parathyroid adenoma detected solely through 68Ga-PSMA-11 PET/CT, typically used for prostate cancer diagnosis. The lesion observed in the PET/CT was confirmed as a parathyroid adenoma through laboratory evaluation, while other imaging techniques failed to detect it. Conclusions: This finding suggests that the PSMA ligands’ particular affinity for neovascularisation in focal changes may facilitate the visualisation of parathyroid adenomas. The utilisation of 68Ga-PSMA-11 PET/CT in primary hyperparathyroidism could potentially improve the preoperative localization of parathyroid adenomas when conventional imaging methods are inconclusive. Full article
(This article belongs to the Special Issue Research Update on Nuclear Medicine)
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<p>Parathyroid adenoma (red arrows) visualized in <sup>68</sup>Ga-PMSA-11 PET/CT ((<b>A</b>)—PET image, (<b>B</b>)—fused transaxial PET/CT image, (<b>C</b>)—transaxial CT image). In the <sup>99m</sup>Tc-MIBI scan ((<b>D</b>)—fused transaxial SPECT/CT image) and in <sup>18</sup>F-fluorocholine PET/CT ((<b>E</b>)—fused transaxial PET/CT image), the lesion is visible in the CT, but it shows no uptake of the radiotracer.</p>
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<p>Ultrasound picture of the lesion corresponding to the parathyroid adenoma. The USG was performed March 2023. (<b>A</b>)—conventional ultrasound examination; transverse section of the neck; hypoechogenic oval lesion on the postero-lateral wall of the thyroid, located extracapsularly. (<b>B</b>)—conventional ultrasound examination; a longitudinal section of the neck; hypoechogenic oval lesion on the posteriori wall of the thyroid, located extracapsularly. (<b>C</b>)—the polar vessel sign on superb microvascular imaging. (<b>D</b>)—high elasticity of the lesion depicted by strain elastography. (<b>E</b>)—high elasticity of the lesion depicted by shear wave elastography. All features suggestive of parathyroid adenoma.</p>
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17 pages, 888 KiB  
Article
Leptin Is Associated with Testosterone, Nutritional Markers, and Vascular Muscular Dysfunction in Chronic Kidney Disease
by Crina Claudia Rusu, Ina Kacso, Diana Moldovan, Alina Potra, Dacian Tirinescu, Maria Ticala, Remus Orasan, Cristian Budurea, Florin Anton, Ana Valea, Cosmina Ioana Bondor and Mara Carsote
Int. J. Mol. Sci. 2024, 25(14), 7646; https://doi.org/10.3390/ijms25147646 - 12 Jul 2024
Viewed by 1319
Abstract
Chronic kidney disease (CKD) causes specific hormonal disturbances, such as variations in leptin and testosterone levels and function. These disturbances can promote errors in signaling interaction and cellular information processing and can be implicated in the pathogenesis of atherosclerosis. This study investigates the [...] Read more.
Chronic kidney disease (CKD) causes specific hormonal disturbances, such as variations in leptin and testosterone levels and function. These disturbances can promote errors in signaling interaction and cellular information processing and can be implicated in the pathogenesis of atherosclerosis. This study investigates the factors that affect leptin in CKD patients and examines how leptin is related to markers of vascular disease. We conducted a cross-sectional study of 162 patients with CKD in pre-dialysis and dialysis stages. We recorded clinical and laboratory data, including leptin, testosterone, and subclinical atherosclerosis markers like brachial–ankle pulse wave velocity (ba PWV) in pre-dialysis CKD patients and flow-mediated vasodilation (FMD) and nitroglycerin-mediated vasodilation (NMD) in hemodialysis (HD) patients. Leptin was significantly correlated with testosterone in CKD pre-dialysis stages (p < 0.001) and also in HD (p = 0.026), with adipose tissue mass in pre-dialysis stages (p < 0.001), and also in HD (p < 0.001). In women HD patients, leptin correlated with NMD (p = 0.039; r = −0.379); in all HD patients, leptin correlated with C reactive protein (p = 0.007; r = 0.28) and parathormone (p = 0.039; r = −0.220). Our research emphasizes the connection between leptin, adipose tissue, and testosterone in all stages of CKD. Leptin was associated with NMD in HD women and correlated with inflammatory syndrome and parathyroid hormone in all HD patients. Full article
(This article belongs to the Special Issue Hormone Signaling in Human Health and Diseases, 2nd Edition)
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<p>Variation in testosterone according to leptin in hemodialysis (HD) group A.</p>
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<p>Variation in adipose tissue mass (ATM) according to leptin in hemodialysis (HD) group A.</p>
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<p>Variation in testosterone according to leptin in pre-dialysis chronic kidney disease (CKD) patients.</p>
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<p>Variation in adipose tissue mass (ATM) according to leptin in pre-dialysis chronic kidney disease (CKD) patients.</p>
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19 pages, 1466 KiB  
Review
Bone: A Neglected Endocrine Organ?
by Anna Szeliga, Monika Grymowicz, Anna Kostrzak, Roman Smolarczyk, Gregory Bala, Katarzyna Smolarczyk, Blazej Meczekalski and Katarzyna Suchta
J. Clin. Med. 2024, 13(13), 3889; https://doi.org/10.3390/jcm13133889 - 2 Jul 2024
Viewed by 1664
Abstract
Bone has traditionally been viewed in the context of its structural contribution to the human body. Foremost providing necessary support for mobility, its roles in supporting calcium homeostasis and blood cell production are often afterthoughts. Recent research has further shed light on the [...] Read more.
Bone has traditionally been viewed in the context of its structural contribution to the human body. Foremost providing necessary support for mobility, its roles in supporting calcium homeostasis and blood cell production are often afterthoughts. Recent research has further shed light on the ever-multifaceted role of bone and its importance not only for structure, but also as a complex endocrine organ producing hormones responsible for the autoregulation of bone metabolism. Osteocalcin is one of the most important substances produced in bone tissue. Osteocalcin in circulation increases insulin secretion and sensitivity, lowers blood glucose, and decreases visceral adipose tissue. In males, it has also been shown to enhance testosterone production by the testes. Neuropeptide Y is produced by various cell types including osteocytes and osteoblasts, and there is evidence suggesting that peripheral NPY is important for regulation of bone formation. Hormonal disorders are often associated with abnormal levels of bone turnover markers. These include commonly used bone formation markers (bone alkaline phosphatase, osteocalcin, and procollagen I N-propeptide) and commonly used resorption markers (serum C-telopeptides of type I collagen, urinary N-telopeptides of type I collagen, and tartrate-resistant acid phosphatase type 5b). Bone, however, is not exclusively comprised of osseous tissue. Bone marrow adipose tissue, an endocrine organ often compared to visceral adipose tissue, is found between trabecula in the bone cortex. It secretes a diverse range of hormones, lipid species, cytokines, and other factors to exert diverse local and systemic effects. Full article
(This article belongs to the Section Endocrinology & Metabolism)
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<p>Materials and methods.</p>
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<p>Interplay of PTH, vitamin D, and FGF23 in calcium and phosphorus level regulation. Ca—calcium, P—phosphorus, PTH—parathyroid hormone, 1,25(OH)D—1,25-dihydrocholecalciferol, RANKL—receptor activator for nuclear factor kB ligand, FGF23—fibroblast growth factor 23.</p>
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<p>Division of bone MAT (marrow adipose tissue). rMAT—regulated MAT; cMAT—constitutive MAT.</p>
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<p>MAT secretory function. IL-6—interleukin 6; RANKL—receptor activator for nuclear factor κ B ligand; FABP4—fatty acid-binding protein 4; PAI-1—human plasminogen activator inhibitor-1; TNFα—tumor necrosis factor α.</p>
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<p>Factors and states that influence bone MAT level.</p>
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