Małgorzata Syrenicz

Publications of Małgorzata Syrenicz

• Changes in inflammatory biomarkers after successful lifestyle intervention in obese children.

  Authors: Barbara Garanty-Bogacka, Małgorzata Syrenicz, Joanna Goral, Beata Krupa, Justyna Syrenicz, Mieczysław Walczak, Anhelli Syrenicz

  Endokrynologia Polska. 01/2011; 62(6):499-505.

  Obesity has been associated with low-grade systemic inflammation, potentially leading to insulin resistance, type 2 diabetes, dyslipidemia, and cardiovascular diseases. Even moderate weight lossObesity has been associated with low-grade systemic inflammation, potentially leading to insulin resistance, type 2 diabetes, dyslipidemia, and cardiovascular diseases. Even moderate weight loss through dietary changes and physical exercise is effective in preventing and managing obesity-associated disorders. The aim of this study was to determine the effect of weight loss in response to a lifestyle modification on the serum levels of inflammatory markers in obese children and adolescents. Fifty obese subjects completed a six-month programme consisting of combined hypocaloric diet and moderate physical activity. High-sensitive C-reactive protein (CRP), interleukin-6 (IL-6), fibrinogen (FB), white blood count (WBC), glucose, insulin, insulin resistance index (HOMA IR), glycosylated haemoglobin (HbA(1c)), lipids as well as systolic (SBP) and diastolic blood pressure (DBP) were measured before and after intervention. Patients had a 5.3 ± 3.4 kg average weight loss, with significant decreases of SDS-BMI, percentage of body fat, SDS-waist, SBP and DBP, HOMA-IR, HbA(1c) and reductions in serum IL-6, CRP, WBC, FB. In the multivariable linear models, changes in percentage of body fat and HOMA-IR were positively associated with favourable changes in inflammatory parameters. This study demonstrates that weight reduction after successful lifestyle intervention results in improvements of blood inflammatory markers in obese children and adolescents.

• Serum 25-hydroxyvitamin D (25-OH-D) in obese adolescents.

  Authors: Barbara Garanty-Bogacka, Małgorzata Syrenicz, Joanna Goral, Beata Krupa, Justyna Syrenicz, Mieczysław Walczak, Anhelli Syrenicz

  Endokrynologia Polska. 01/2011; 62(6):506-11.

  There is increasing evidence that vitamin D deficiency is common and has been associated with several non-bone related outcomes, including insulin resistance, type 2 diabetes and cardiovascularThere is increasing evidence that vitamin D deficiency is common and has been associated with several non-bone related outcomes, including insulin resistance, type 2 diabetes and cardiovascular disease. The influences of gender, puberty, and adiposity on serum hydroxyvitamin D (25-OH-D) levels and the relationship between 25-OH-D and insulin resistance in obese children were studied. Age, gender, pubertal stage, weight status (standard deviation score of body mass index: BMI-SDS, percentage body fat, waist circumference), 25-OH-D levels, and insulin resistance index calculated by homeostasis model assessment (HOMA-IR) were evaluated in 64 obese adolescents. Multivariable linear regression was used to determine factors associated with decreased serum 25-OH-D levels and to study the relationship between 25-OH-D and HOMA-IR. Median serum 25-OH-D level was 10.1 ng/mL (25.2 nmol/L). 14% of patients were vitamin D-sufficient (25-OH-D ≥ 20 ng/mL), 36% had intermediate values (11-19 ng/mL), and 50% were deficient (25-OH-D ≤ 10 ng/mL). In the multivariable model, older age, puberty, higher value of percentage of body fat, and the presence of acanthosis nigricans (AN) were all negatively associated with 25-OH-D. Lower 25-OH-D levels were also associated with higher blood glucose, insulin and HOMA-IR after adjustment for puberty and SDS-BMI. Summer positively correlated with 25-OH-D level. Our study confirms that obesity is a risk factor for vitamin D deficiency. Hypovitaminosis D, common in obese adolescents at risk for type 2 diabetes (older age, puberty, acanthosis nigricans) is associated with worse insulin resistance.

• Serum leptin concentrations in children with mild and moderate malnutrition.

  Authors: Grazyna Czaja-Bulsa, Barbara Garanty-Bogacka, Aneta Gebala, Małgorzata Syrenicz, Beata Krupa

  Annales Academiae Medicae Stetinensis. 01/2010; 56(2):22-7.

  Numerous studies have reported a strong relationship between plasma leptin concentration and percentage of body fat, fat mass, and body mass index (BMI) in obese and non-obese children. The objectiveNumerous studies have reported a strong relationship between plasma leptin concentration and percentage of body fat, fat mass, and body mass index (BMI) in obese and non-obese children. The objective of the present study was to assess the usefulness of serum leptin concentration in disclosing prepubertal malnutrition. Leptin concentrations in serum were determined and anthropometric parameters were measured in 149 children (3-6 and 7-10 years old). The Cole index of nutritional status was calculated. 44 children (I) presented with long-standing malnutrition due to celiac disease or food allergy and 105 children (II) were healthy. Leptin concentrations in both age groups of undernourished boys (median 2.7 and 2.7 microg/L) and in younger undernourished girls (median 4.2 microg/L) did not differ from concentrations in healthy children (median 2.9, 2.9, and 3.4 microg/L, respectively). Leptin concentrations in older undernourished girls were significantly lower than in healthy girls (median 4.2 vs. 8.8 microg/L, respectively; p < 0.05) of comparable age. In healthy children, leptin levels correlated with gender, body mass, BMI, Cole ratio (r = 0.39-0.41, r = 0.33, r = 0.28, r = 0.22, respectively; p < 0.005), and height (r = 0.19; p < 0.05). Serum leptin concentrations in undernourished children correlated with gender, arm circumference, and BMI (r = 0.27-0.35, r = 0.27, r = 0.25, respectively; p < 0.05). Our results show that serum leptin concentration is not a useful indicator of mild and moderate malnutrition in prepubertal children.

• [Bone mineral density as an indicator of hormonal and metabolic disturbance in girls in developmental period]

  Authors: Elzbieta Sowińska-Przepiera, Elzbieta Andrysiak-Mamos, Małgorzata Syrenicz, Katarzyna Wachowiak-Ochmańska, Zbigniew Friebe, Anhelli Syrenicz

  Ginekologia polska. 11/2008; 79(10):674-80.

  PURPOSE OF THE WORK: To assess bone mineral density (BMD) in girls with menstruation disorders in the first years after menarche and to demonstrate that BMD value may be one of the indicatorsPURPOSE OF THE WORK: To assess bone mineral density (BMD) in girls with menstruation disorders in the first years after menarche and to demonstrate that BMD value may be one of the indicators confirming an early diagnosis of hypothalamic hypogonadism or androgenisation complex. MATERIAL AND METHODS: The research included 155 girls at the ages of 16-17, observed due to rare menstruation or secondary amenorrhea. In case of 71 girls functional, hypothalamic disorders were found (Group A), in 35 girls increasing androgenisation features were diagnosed additionally (Group B), and 49 healthy girls represented Group C--control group. BMI was determined, as well as FSH, LH, T, E2, PRL concentrations and the BMD test of lumbar spine section was made in all of the cases. RESEARCH RESULTS: The average values of BMI and BMD in Group A were the lowest compared to Group B (p<0.001) and Group C (p<0.001). E2 concentrations in Group A was the lowest and in Group B--the highest (p<0.001). T concentrations in Group B girls was the highest and SHBG--the lowest compared to Groups A and C (p<0.001; p<0.01). FSH concentrations in Group A were the lowest compared to Groups B and C (p<0.01), while LH in Group B was the highest (p<0.001; p<0.01). Basic PRL concentrations were not essentially different. In groups (A + B + C) together, a statistically significant correlation between BMD and BMI values was found (r=0.67; p<0.001), E2 (r=0.38; p<0.01) and T (r=0.56; p<0.001). CONCLUSIONS: Low bone mineral density value compared to the age value may signify long-term hypoestrogenism, and high value - a complex of metabolic disorders with high concentration of androgens. Therefore, bone mineral density may be a reliable and highly sensitive metabolic and hormonal indicator of menstruation disorders of hypothalamic, functional type or androgenisation complex.

• Analysis of the sodium iodide symporter expression in histological slides from a nodular goiter.

  Authors: Anhelli Syrenicz, Małgorzata Wolny, Andrzej Kram, Krzysztof Sworczak, Małgorzata Syrenicz, Barbara Garanty-Bogacka, Mieczysław Walczak

  Archives of medical research. 03/2007; 38(2):219-26.

  BACKGROUND: The aim of the study was analysis at both the level and the cell site of the sodium/iodide symporter (NIS) in histological slides from hot, warm, and cold nodules and extranodularBACKGROUND: The aim of the study was analysis at both the level and the cell site of the sodium/iodide symporter (NIS) in histological slides from hot, warm, and cold nodules and extranodular parenchyma according to scintigraphy. METHODS: The study population consisted of 97 people who underwent surgery for a toxic nodular goiter (26 patients) or a non-toxic nodular goiter (71 patients). Immunohistochemical study was performed with 198 histological slides from hot, warm, and cold nodules (study slides) and the extranodular parenchyma (control slides). The level of NIS expression was estimated objectively using the computerized image analysis system, Quantimet 600S (Leica, Cambridge, UK). RESULTS: We found significantly higher NIS expression in hot nodules than in cold nodules and in warm nodules than in cold ones. We found significantly higher NIS expression in hot and warm nodules than in the surrounding parenchyma. The level of NIS expression did not differ significantly between cold nodules and the collateral tissues. CONCLUSIONS: Our data indicate that NIS protein participates in the development of hyperthyroidism in the course of a nodular goiter. We confirm that the functional state of a nodular goiter is determined by NIS expression in nodules, not in collateral parenchyma. The low metabolism of cold nodules does not simply result from decreased level of NIS protein or its defective targeting to the cell membrane. The observation of NIS in the cell cytoplasm of hot nodules seems to indicate that the intracellular localization of NIS does not determine loss of its activity.

• Low-grade systemic inflammation and the risk of type 2 diabetes in obese children and adolescents.

  Authors: Anhelli Syrenicz, Barbara Garanty-Bogacka, Małgorzata Syrenicz, Aneta Gebala, Mieczysław Walczak

  Neuro endocrinology letters. 09/2006; 27(4):453-8.

  BACKGROUND: There is growing evidence that low-grade systemic inflammation is closely involved in the pathogenesis of type 2 diabetes. OBJECTIVE: The aim of this study was to investigate theBACKGROUND: There is growing evidence that low-grade systemic inflammation is closely involved in the pathogenesis of type 2 diabetes. OBJECTIVE: The aim of this study was to investigate the relationship between serum inflammatory markers and selected parameters known as risk factors of type 2 diabetes in obese children and adolescents. SUBJECTS AND METHODS: Fasting levels of C-reactive protein (CRP), fibrinogen (FB) interleukin-6 (IL-6), interleukin 1-beta (IL-1beta), glucose, insulin, total, HDL and LDL cholesterol, triglycerides, white blood cell count (WBC) and fasting glucose to insulin ratio (FGIR) were measured in 281 obese children and adolescents. Pearson's correlation was used for assessing the relationship between inflammatory markers and selected clinical parameters. RESULTS: Inflammatory markers correlated significantly with insulin resistance indices, HbA1c, lipid profile, hypertension, positive family history of type 2 diabetes, low physical fitness, and mixed high-fat and high-carbohydrate diet. CONCLUSIONS: Serum inflammatory markers were significantly correlated with most factors implicated in the development of type 2 diabetes. These data provide additional support for previously reported in adults relationship between subclinical inflammation and the risk of type 2 diabetes.

• Relation of low-grade inflammation and endothelial activation to blood pressure in obese children and adolescents.

  Authors: Anhelli Syrenicz, Barbara Garanty-Bogacka, Małgorzata Syrenicz, Aneta Gebala, Grazyna Dawid, Mieczysław Walczak

  Neuro endocrinology letters. 09/2006; 27(4):459-64.

  OBJECTIVE: To determine the role of low-grade, systemic inflammation and endothelial activation in the modulation of blood pressure (BP) independently of other traditional risk factors in obeseOBJECTIVE: To determine the role of low-grade, systemic inflammation and endothelial activation in the modulation of blood pressure (BP) independently of other traditional risk factors in obese children and adolescents. DESIGN: We surveyed 281 obese subjects, aged 6-18 years to investigate the relationship of serum inflammation and endothelial activation markers and blood pressure. MEASUREMENTS: Clinical variables, indices of obesity, ambulatory 24-h blood pressure and serum concentrations of C-reactive protein (CRP), interleukin-6 (IL-6), interleukin-1 beta (IL-1 beta), intercellular cell adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1), glucose and insulin. HOMA IR was used as a marker of insulin resistance (IR). RESULTS: CRP, IL-6, IL-1 beta, and ICAM-1 correlated significantly with mean 24-h systolic BP, whereas CRP and IL-6 was positively correlated with mean 24-h diastolic BP. Multiple regression analysis showed that serum IL-6 (P < .001) concentration, HOMA IR (P < .01), and waist to hip ratio (P < .05) were the significant determinants of systolic BP, whereas CRP (P < .05) level was the only predictor of diastolic BP. There were no significant associations of cell adhesion molecules with BP. CONCLUSIONS: These results indicate that low-grade inflammation may play a role in the modulation of arterial BP relatively early in life.

• [Correlation between serum homocysteine levels and selected atherosclerosis risk factors in children and adolescents with simple obesity]

  Authors: Barbara Garanty-Bogacka, Małgorzata Syrenicz, Paula Szołomicka-Kurzawa, Aneta Gebala, Joanna Goral, Beata Krupa

  Przegla̧d lekarski. 02/2006; 63(8):645-9.

  Homocysteine is known as an independent risk factor of atherosclerosis. The aim of this study was assessment of serum homocysteine concentrations in obese children and evaluation of possibleHomocysteine is known as an independent risk factor of atherosclerosis. The aim of this study was assessment of serum homocysteine concentrations in obese children and evaluation of possible relationship between homocysteine and risk factors of atherosclerosis. 498 children with simple obesity were included into our study. There was a significant correlation between serum homocysteine levels and both traditional and new risk factors of atherosclerosis. The issues confirm a necessity of evaluation serum homocysteine levels of obese children in estimation of cardiovascular disease risk.

• Relation of acute-phase reaction and endothelial activation to insulin resistance and adiposity in obese children and adolescents.

  Authors: Barbara Garanty-Bogacka, Małgorzata Syrenicz, Anhelli Syrenicz, Aneta Gebala, Mieczysław Walczak

  Neuro endocrinology letters. 11/2005; 26(5):473-9.

  OBJECTIVES: There is increasing evidence that an ongoing cytokine-induced acute-phase response is closely involved in the pathogenesis of type 2 diabetes and associated complications such asOBJECTIVES: There is increasing evidence that an ongoing cytokine-induced acute-phase response is closely involved in the pathogenesis of type 2 diabetes and associated complications such as dyslipidemia and atherosclerosis. The aim of this study was to investigate the relationship of inflammation and endothelial activation with insulin resistance in childhood obesity. METHODS: Two hundred and eleven (122 boys) obese children and adolescents were examined. Fasting levels of ultra-sensitive C-reactive protein (CRP), fibrinogen (FB), interleukin-6 (IL-6), interleukin-1beta (IL-1beta), intercellular cell adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1), von Willebrand factor (vWF), glucose, insulin, and HbA1c were determined. Insulin resistance was assessed by the homeostasis method. RESULTS: HOMA IR correlated significantly with all measures of adiposity as well as with majority of inflammation and endothelial dysfunction markers. After adjustment for age, gender, BMI and fat mass, the correlation with insulin resistance remained significant for CRP, ICAM-1 and von Willebrand factor. There was a trend for association between HOMA IR and IL-6 as well as HOMA IR and fibrinogen. CONCLUSION: Acute-phase reaction and endothelial activation correlate with insulin resistance in obese youth. It is possible that the cluster of these pro-atherogenic factors may contribute to the accelerated atherosclerosis in obese children.

• Serum markers of inflammation and endothelial activation in children with obesity-related hypertension.

  Authors: Barbara Garanty-Bogacka, Małgorzata Syrenicz, Anhelli Syrenicz, Aneta Gebala, Danuta Lulka, Mieczysław Walczak

  Neuro endocrinology letters. 07/2005; 26(3):242-6.

  OBJECTIVES: It has been suggested that a rise in blood pressure (BP) causes low-grade inflammation of the endothelium which, in turn, may be responsible for further damage of endothelium andOBJECTIVES: It has been suggested that a rise in blood pressure (BP) causes low-grade inflammation of the endothelium which, in turn, may be responsible for further damage of endothelium and worsening of BP control. The aim of the study was to evaluate serum levels of inflammation and endothelial activation markers in children with obesity-related hypertension and normotensive controls in relation to other traditional risk factors of arterial hypertension. METHODS: Plasma insulin, glucose, C-reactive protein (CRP), fibrinogen (FB) interleukin-6 (IL-6), interleukin-1 beta (IL-1 beta), intercellular cell adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1) and lipids levels were determined in 50 children with obesity-related hypertension and 143 obese children with normal BP. Insulin resistance was assessed by the homeostasis model. RESULTS: Children with hypertension had significantly higher levels of all inflammatory markers as well as endothelial activation indices compared with normotensive subjects. In the stepwise regression model significant independent correlates for systolic BP were CRP, FB, VCAM-1, HOMA IR, LDL cholesterol and fat mass, whereas CRP, IL-6, ICAM-1, FB, LDL and HDL cholesterol were the determinants of diastolic BP in children with obesity-related hypertension. CONCLUSION: These results indicate that low-grade inflammation and endothelial dysfunction are closely involved in the pathogenesis of obesity-related hypertension relatively early in life.

• [The influence of treatment with substitutive or suppressive doses of thyroxine on biochemical bone turnover markers]

  Authors: Agnieszka Kosińska, Anhelli Syrenicz, Małgorzata Syrenicz, Bogusław Kosiński, Tomasz Miazgowski, Barbara Garanty-Bogacka

  Annales Academiae Medicae Stetinensis. 02/2005; 51(2):97-104.

  PURPOSE: Thyroid hormones belong to essential regulators of growth and remodelling of bones. The development of modern radioimmunological and immunoenzymatic methods opened the way to studies on thePURPOSE: Thyroid hormones belong to essential regulators of growth and remodelling of bones. The development of modern radioimmunological and immunoenzymatic methods opened the way to studies on the influence of exogenous thyroxine on the metabolism of osseous tissue. The activity of osteoblasts and the osteoclast ratio is a measure of the process termed "bone turnover" which can be assessed by determining concentrations of enzymes and bone matrix proteins in serum. The aim of this study was to evaluate the influence of a twelve-month regimen with substitutive or suppressive doses of thyroxine on bone alkaline phosphatase (BAP) concentrations in serum and deoxypyridoline (DPR) concentrations in the urine of women with hypothyroidism or with simple goitre. MATERIAL AND METHODS: We enrolled 26 women with not-treated hypothyroidism (Group I) and 41 with not-treated simple goitre (group II). The age of the patients ranged from 29 to 66 years. Patients were qualified for treatment with substitutive (hypothyroidism) or suppressive (goitre) doses of thyroxine. Each group was divided into two subgroups: IA--15 premenopausal patients with hypothyroidism (mean age 41.53 +/- 1.39 years); IB--11 postmenopausal patients with hypothyroidism (mean age 53.18 +/- 1.66 years); IIA--24 premenopausal patients with simple goitre (mean age 39.71 +/- 0.98 years); IIB--17 postmenopausal patients with simple goitre (mean age 53.82 +/- 1.35 years). Evaluations of bone turnover markers in serum (BAP) and in twenty-four hour urine collection (DPR) and serum concentrations of TSH, FT3 and FT4 were carried out prior to treatment and after 1, 3, 6, 9 and 12 months ofthyroxine administration. RESULTS: Bone turnover markers increased during treatment with substitutive or suppressive doses of thyroxine, especially in postmenopausal women. CONCLUSIONS: 1. Treatment with substitutive or suppressive doses of thyroxine stimulates osteogenic and osteoclastic processes in pre- and postmenopausal women. 2. Suppressive doses of thyroxine are more potent in increasing bone turnover than substitutive doses. 3. The osteoclastic process is more intense in postmenopausal women on substitutive or suppressive doses of thyroxine.

• [Immaturity or hypotrophy? The cord blood leptin levels in preterm and small-for-gestational age neonates]

  Authors: Barbara Garanty-Bogacka, Maria Beata Czeszyńska, Małgorzata Syrenicz, Aneta Gebala, Agnieszka Kordek, Dorota Janus, Mieczysław Walczak, Beata Krupa, Paula Szołomicka-Kurzawa, Ryszard Czajka

  Ginekologia polska. 06/2003; 74(5):356-61.

  OBJECTIVES: To assess cord blood leptin levels in preterm and small-for-gestational age neonates and determine whether fetal leptin levels correlate with selected clinical parameters associated withOBJECTIVES: To assess cord blood leptin levels in preterm and small-for-gestational age neonates and determine whether fetal leptin levels correlate with selected clinical parameters associated with prematurity and undernutrition at birth. DESIGN: Study of preterm newborns (p-AGA; n = 31) and small-for-gestational age (t-SGA; n = 23) cases in a population of neonates born in Szczecin between September 2001 and June 2002. METHODS: Fetal cord blood was sampled after delivery. Leptin levels were measured by RIA. Anthropometric data (birth weight, birth length, head and chest circumferences, body mass index, Ponderal index) were also recorded. RESULTS: Cord blood leptin levels did not differ significantly between p-AGA and t-SGA neonates with similar birthweight. Among the two groups of newborns the correlations between fetal leptin and anthropometric data were only observed in p-AGAs, but not in t-SGA group. CONCLUSIONS: We suggest that cord blood leptin level depends on body mass rather than maturity of newborn. It is also hypothesized that leptin level in SGA neonates is determined by other than anthropometric parameters used in this study.

• Reversal of the sex difference in plasma leptin levels in obese children with impaired glucose tolerance.

  Authors: Barbara Garanty-Bogacka, Małgorzata Syrenicz, Anhelli Syrenicz, Aneta Gebala, Mieczysław Walczak

  Endokrynologia Polska. 56(6):917-20.

  INTRODUCTION: Basal leptin level has been demonstrated to correlate positively with many indices of obesity, as well as insulin resistance. However, to date, little is known about regulation ofINTRODUCTION: Basal leptin level has been demonstrated to correlate positively with many indices of obesity, as well as insulin resistance. However, to date, little is known about regulation of leptin in obese children with incipient glucose metabolic disorders. OBJECTIVE: The aim of this study was to define the precise influence of the glucose tolerance status on plasma leptin in obese boys and girls separately. MATERIAL AND METHODS: 70 obese children with impaired glucose tolerance (IGT) and well-matched 70 normal glucose-tolerant (NGT) subjects were examined. Fasting and 2-h post glucose load plasma glucose and insulin levels as well as fasting leptin levels were determined, apart from anthropometric measurements. RESULTS: Leptin levels were significantly lower in girls with IGT compared to NGT girl (17.7+/-6.5 microg/L vs. 23.1+/-7.7 microg/L; p<.001). No such difference was observed in boys. In a multiple regression analysis adjusting for age and adiposity, in the female group plasma glucose and insulin levels 2-h after glucose load were the best predictors of fasting plasma leptin (r=-0.49, p<.005 and r=0.34, p<.05; respectively). In boys, plasma insulin level 2-h after glucose load was the independent determinant of leptin (r=0.36, p<.05). CONCLUSION: The differences between regulation of leptin synthesis in girls and boys with simple obesity were found. The stimulatory effect of insulin on leptin synthesis was greater in girls with normoglycemia than in girls with impaired glucose tolerance.

• [Hashimoto disease and hypothyroidism in child-bearing period--essential problem for woman and her child]

  Authors: Anhelli Syrenicz, Małgorzata Syrenicz, Krzysztof Sworczak, Barbara Garanty-Bogacka, Anna Zimnicka, Mieczysław Walczak

  Endokrynologia Polska. 56(6):1008-15.

  Hashimoto disease is the most frequent cause of women's hypothyroidism in the reproductive period. It can, both directly and indirectly, influence the fertility, pregnancy, and fetus development.Hashimoto disease is the most frequent cause of women's hypothyroidism in the reproductive period. It can, both directly and indirectly, influence the fertility, pregnancy, and fetus development. Nevertheless congenital hypothyroidism is very occasionally the consequence of chronic autoimmune thyroiditis. The neonatal hypothyroidism screening makes the early thyroxin treatment possible and prevents the development of complications from central nervous system. The authors showed main problems of Hashimoto disease in women during pregnancy as well as pregestational and postgestational period. The reasons of congenital hypothyroidism taking into account both iodine deficiency and excess were also presented.

• [Osteoporosis in thyroid diseases]

  Authors: Agnieszka Kosińska, Anhelli Syrenicz, Bogusław Kosiński, Barbara Garanty-Bogacka, Małgorzata Syrenicz, Elwira Gromniak

  Endokrynologia Polska. 56(2):185-93.

  Thyroid hormones play the essential role in the regulation of metabolism and bone remodeling in physiological conditions and in the course of thyroid dysfunction. Introduction of densitometry to theThyroid hormones play the essential role in the regulation of metabolism and bone remodeling in physiological conditions and in the course of thyroid dysfunction. Introduction of densitometry to the diagnostics of osteoporosis has made possible the evaluation of influence of both hyperthyroidism and hypothyroidism and their treatment on bone mineral density. Moreover it became possible to estimate the influence of treatment with exogenous thyroid hormones on the skeletal system. Authors presented mechanisms of the thyroid hormones action on bone tissue and analysed current state of knowledge concerning the influence of the thyroxine treatment with replacement and suppressive doses on the bone mineral density. The influence of thyroid hormones on the skeletal system with respect to premenopausal and postmenopausal period was also discussed. Great discrepancies in literature data and its reasons were underlined.

• [Atypical forms of hyperthyroidism]

  Authors: Anhelli Syrenicz, Małgorzata Syrenicz, Krzysztof Sworczak, Barbara Garanty-Bogacka

  Endokrynologia Polska. 57(5):518-24.

  Except from well-known the most frequent reasons of the hyperthyroidism such as the Graves-Basedow disease, multinodular goitre and the autonomous adenoma we should also remember the other rarerExcept from well-known the most frequent reasons of the hyperthyroidism such as the Graves-Basedow disease, multinodular goitre and the autonomous adenoma we should also remember the other rarer illnesses leading to the excess of thyroid hormones in the serum. Authors presented the problem of atypical forms of thyrotoxicosis which run without the overproduction of thyroid hormones and are characterized by low 24 h 131 J uptake by the thyroid gland. So called masks of hyperthyroidism such as apathetic, neuromuscular, gastrointestinal and cardiovascular forms were also discussed in the article.