LIST DO CZYTELNIKÓW/LETTER TO READERS
Dear Colleagues and Readers,
In the atmosphere of the picturesque Polish autumn, we present you with the penultimate issue of “Endokrynologia Polska” this year. Despite our participation in numerous endocrinology congresses and conferences this autumn we have managed to compile for you some interesting scientific reports and materials we hope you will find useful in your clinical practice.
The Original papers section starts with a report by researchers from the Oncology Institute in Gliwice, Poland, who analysed the transcriptome of follicular tumours of the thyroid by gene expression profiling using the oligonucleotide array method. The study checked whether gene expression profiling using the unsupervised method offered the possibility of differentiating between follicular carcinoma and follicular adenoma, an issue that is particularly interesting in light of the very limited knowledge on the molecular aspects of follicular thyroid carcinoma. The authors used the unsupervised analysis to show that the malignant nature of the follicular tumour may be one of the main sources of variability in the transcriptome of these neoplasms. This method is not, however, a sufficient tool for the classification of these tumours.
In another original paper, a joint team of surgeons and endocrinologists from Gdansk, Poland, reports on a prospective randomised study to assess the efficacy of using a hand-held gamma probe in completion thyroidectomy of well-differentiated thyroid carcinoma. Attention was drawn to the fact that patients after complete primary thyroid resection for papillary or follicular thyroid carcinoma require radicalisation of surgical treatment, which is associated with a more difficult anatomy complicated by cicatricial tissue. The study showed that the intraoperative use of the gamma detector may be useful in achieving a better radicality of initially incomplete resections.
The therapeutic effect of radioiodine in benign goitre is based on the emission of tissue-destructive beta-radiation, whose range is up to 2.4 mm. As the range of beta-radiation may include the adjacent parathyroid glands, it would not be unreasonable to expect the development of iatrogenic hypoparathyroidism following treatment with 131I. Clinicians from Białystok, Poland, present a very valuable paper in which they demonstrate that radioiodine treatment of benign thyroid pathologies leads to a transient hyperparathyroidism of up to 10 months’ duration after administration of radioiodine that is not, however, associated with clinically significant abnormalities in serum levels of calcium or phosphate.
Obesity in children is association with the development of insulin resistance and the risk of multiple metabolic abnormalities. On the other hand, osteocalcin plays a role in promoting glucose tolerance and insulin sensitivity. Investigators from Szczecin, Poland, assessed these relationships and showed an association of serum osteocalcin with metabolic markers and adiposity measures. It therefore follows that in children, osteocalcin exhibits “extraskeletal” actions: it may play a role in glucose and lipid metabolism.
Authors from the Lower and Upper Silesia, Poland, assessed the ultrasound properties of phalanges of the fingers in boys aged 13–15 years relative to their pubertal maturity and physical capacity, including muscle strength. The study also showed that the data obtained by quantitative ultrasound (QUS) in adolescent boys depend on their pubertal maturity and shoulder muscle strength in contrast to general physical capacity.
The paper authored by the investigators from the Centre for Postgraduate Medical Education, Warsaw, Poland, addresses one of the current trends, namely the search for biochemical markers of functioning tumours. The study described in this paper leads to a valuable clinical conclusion. Normal levels of CgA found during the initial evaluation of patients with an adrenal mass may be a helpful marker for ruling out the diagnosis of phaeochromocytoma. The other reason why this finding is valuable is the fact that in many facilities the results of determination of blood CgA levels become available much sooner than the results of determination of blood levels and urinary excretion of catecholamines and their derivatives.
Investigators from the Cardiology Institute in Warsaw, Poland, report in their original paper on a study attempting to assess the association of primary aldosteronism and obstructive sleep apnoea with the severity of metabolic abnormalities and the structural and functional changes in the left ventricle in patients with true resistant hypertension. The authors showed that both the metabolic abnormalities and the severity of target organ changes were most pronounced in patients with true resistant hypertension, in whom they coexisted with primary aldosteronism and obstructive sleep apnoea.
In another original article, investigators from the Medical University in Łódź assessed the effects of various angiomodulators on the growth of the PC12 rat phaeochromocytoma cell line. They showed that IFN-α suppressed the growth of this cell line and confirmed the inhibitory effect of rapamycin on this cell line, concluding that IFN-α and mTOR pathway inhibitors may be potentially effective in the treatment of malignant phaeochromocytomas.
The last original paper published in the current issue of “Endokrynologia Polska” has been authored by researchers from Lublin, Poland. They assessed the safety and efficacy of the GLP-1 analogue exenatide versus the long-acting insulin analogue glargine in patients with type 2 diabetes mellitus suboptimally controlled with oral combination therapy who participated in the Polish group of the 26-week multicentre open-label randomised clinical study GWAA. It was shown in the treatment group of 80 patients with type 2 diabetes mellitus and obesity suboptimally controlled with oral combination therapy (metformin plus sulfonylurea) that exenatide and glargine were equally effective in providing glycaemic control. Exenatide was more effective in reducing postprandial glucose levels, while insulin treatment resulted in lower fasting glucose levels. The advantages of exenatide lay in the weight loss and the reduced number of hypoglycaemic episodes, although this was associated with a higher rate of gastrointestinal side effects.
The Review papers section contains a paper by authors from the Silesian Medical University who present an ample review of the current knowledge on transforming growth factor beta-1 (TGF-b1) and its effects on a number of physiological and pathological processes. Previous similar papers on VEGF generated enormous interest among our Readers, which has significantly increased the number of citations of our journal in other journals worldwide.
The Case report in this issue discusses the clinical presentation and the results of hormonal and molecular investigations in a female patient undergoing diagnostic evaluation for primary amenorrhoea. The authors from Lodz, Poland, found a new mutation in the androgen receptor gene in this 46, XY patient with androgen insensitivity syndrome.
The Postgraduate education section contains two papers. The first one originates from Bytom, Poland, a university facility with years of ample experience in the surgical treatment of hyperparathyroidism. The paper’s primary focus is on the preoperative imaging evaluation of primary hyperparathyroidism.
The other paper, authored by Prof. Andrzej Milewicz M. D., Ph. D., Chair of the Polish Endocrine Society, summarises the current state of knowledge on polycystic ovary syndrome and the use of metformin in its management.
We hope the selection of reports published in the present issue of “Endokrynologia Polska” will meet your expectations.
On behalf of the Editors