[Rare cause of hypercalcemia].

We report a 47-year-old women who presented to her general practitioner and our hospital with weight loss of unknown etiology. Eight years previously she had undergone a hemithyroidectomy for nodular goiter with one cold nodule. Laboratory results revealed hypercalcemia, evidence of primary hyperparathyroidism and computer tomography of the thorax showed bilateral pulmonary metastasis.

Five commercially available insulin-like growth factor I (IGF-I) assays in comparison to the former Nichols Advantage IGF-I in a growth hormone treated population.

Background: The serum insulin-like growth factor I (IGF-I) level is accepted to diagnose the growth hormone (GH) status. Here, we evaluated the DRG IGF-I 600 ELISA, DSL IGF-I ELISA, IDS OCTEIA IGF-I, Mediagnost IGF-I-ELISA, and the Siemens Immulite 2500 IGF-I in comparison to the former Nichols Advantage IGF-I assay.

Methods: Imprecision was determined by use of a serum pool and commercial control materials.

Are serum thyrotropin levels within the reference range associated with endothelial function?

Aims: High serum thyrotropin (TSH) levels within the reference range might be associated with an increased cardiovascular risk. In the present study, we investigated the association between serum TSH levels and flow-mediated dilation (FMD) as a measure of endothelial dysfunction.

Methods And Results: The study population comprised 1364 subjects (670 women) aged 25-85 years with serum TSH levels between 0.

Health-related quality of life and IGF-1 in GH-deficient adult patients on GH replacement therapy: analysis of the German KIMS data and the Study of Health in Pomerania.

Objective: To analyse 12-month response to GH treatment in a single-country cohort of hypopituitary adult patients with GH deficiency (GHD) in regards to health-related quality of life (HRQoL) and insulin-like growth factor-1 (IGF-1) compared with values from general population sample. Moreover, association between the response in HRQoL and the IGF-1 values in patients and in the background population was investigated.

Design: HRQoL was assessed by quality of life assessment of GH deficiency in adults (QoL-AGHDA) in 651 patients retrieved from the German KIMS (Pfizer International Metabolic Database) before and after 12 months of GH replacement and in a sample drawn from a cross-sectional study in Germany (n=2734).

Extended recruitment efforts minimize attrition but not necessarily bias.

Objectives: There has been a debate about the effect of extended recruitment efforts on attrition and bias. The aims of the present study are (1) to investigate the effectiveness of extensive multimode recruitment procedures; (2) to study their effect on attrition and bias; and (3) to determine the potential predictors of attrition.

Study Design And Setting: We used data from the longitudinal population-based study of health in Pomerania.

Growth hormone deficient patients after traumatic brain injury--baseline characteristics and benefits after growth hormone replacement--an analysis of the German KIMS database.

Objective: In recent years, traumatic brain injury (TBI) has been identified as a significant cause of growth hormone deficiency (GHD). The aim of the present study was to characterize adult TBI patients with GHD to elucidate the effect of human growth hormone (hGH) replacement in TBI patients as documented in the German Pfizer International Metabolic (KIMS) database.

Design: As of October 2006, 84 TBI patients had been included in the German KIMS database (n=28 childhood-onset and 54 adult-onset GHD).

Smoking as a risk factor for thyroid volume progression and incident goiter in a region with improved iodine supply.

Objective: The role of smoking in the pathogenesis of thyroid enlargement is currently under debate. It has been hypothesized that the effect of smoking on increased thyroid volume is larger in regions with than in regions without iodine deficiency. The aim of this paper was to investigate the association of smoking with thyroid volume progression and incident goiter for different age-strata in a region with improved iodine supply.

Does response bias influence population studies of thyroid disorders?

Background: Monitoring of iodine fortification programs is required for early recognition of oversupply or ineffective supply with iodine. We investigated the potential role of selection bias for studies performed to monitor the iodine supply and prevalence of thyroid disorders.

Methods: We used the baseline population of 3949 subjects recruited for the Study of Health in Pomerania as a hypothesized source population and associated the information on response behavior from the 5-year follow-up examinations with baseline sociodemographic and thyroid-related characteristics.

Reference ranges for serum dehydroepiandrosterone sulfate and testosterone in adult men.

Dehydroepiandrosterone (DHEA) is the main adrenal androgen, which mostly exists in a sulfated version (DHEAS). Both DHEA and DHEAS are metabolic intermediates in the biosynthesis of the male sex hormone testosterone. In men, testosterone is involved in the regulation of fertility, libido, and muscle mass and is valuable for the assessment of gonadal, adrenal, and pituitary function and for the diagnosis of hypogonadism.

The association of thyroid function with carotid artery plaque burden and strokes in a population-based sample from a previously iodine-deficient area.

Background: Thyroid dysfunction is associated with detrimental cardiovascular effects. We analyzed whether thyroid status is related to carotid artery plaques and prevalent strokes.

Design, Patients And Measurements: Data from 2128 subjects (1157 men and 971 women) aged > or =45 years without thyroid diseases participating in the Study of Health in Pomerania were analyzed.

Short-term changes in hsCRP and NT-proBNP levels in hypertensive emergencies.

Hypertension is associated with high cardiovascular risk. Both hsCRP and NT-proBNP also have been associated with elevated cardiovascular risk, at least in the long term. Much less is known about the short-term changes in these markers, for example, in hypertensive emergencies.

The association of thyroid function and heart valve sclerosis. Results from a population-based study.

Objectives: Thyroid dysfunction is associated with detrimental cardiovascular effects. We analyzed whether thyroid status is associated with aortic valve sclerosis (AVS) and mitral annular calcification (MAC) as markers of generalized atherosclerosis.

Design: Data of 2065 subjects (923 women and 1142 men) aged > or =45 years from the Study of Health in Pomerania (SHIP) were analyzed with respect to low, medium and high TSH levels.

Association between parity and autoimmune thyroiditis in a general female population.

Background: Autoimmune thyroid disease (AIT) is more common in females than in males. Furthermore, it is well documented that the risk of thyroid autoimmunity increases during pregnancy and in the postpartum period. The objective of the present study was to analyse the association between parity and AIT by using ultrasound and serological data.

Association between depression and subclinical carotid atherosclerosis in patients with Type 1 diabetes.

Aims: Recent studies have suggested an association between depression and subclinical atherosclerosis as measured by presence of carotid atherosclerotic plaque and increased intima-media thickening in non-clinical populations. Given the high prevalence of depression in patients with Type 1 diabetes and the diabetes-related risk factors for atherosclerosis, we hypothesized that this relation might also be of special relevance in Type 1 diabetic patients.

Methods: Intima-media thickness (IMT) and the presence of plaques in the carotid arteries were quantitatively assessed by high-resolution ultrasound in 175 adults (89 men, 86 women) with an established diagnosis of Type 1 diabetes.

Inverse association between periodontitis and respiratory allergies in patients with type 1 diabetes mellitus.

Aim: In a general adult population, we have demonstrated an inverse association between periodontitis and respiratory allergies that is in line with the hygiene hypothesis suggesting a protective effect of infections against the development of allergies. The objective of the present study was to investigate the association between periodontitis and respiratory allergies in a type 1 diabetes mellitus population.

Material And Methods: The study population comprised 170 patients with type 1 diabetes mellitus aged 17-80 years.

Self-reported halitosis and gastro-esophageal reflux disease in the general population.

Background: Patients with halitosis contact primary care practitioners, dentists, and gastroenterologists alike.

Objectives: It is unclear whether gastroesophageal reflux disease (GERD) is a risk factor for halitosis. DESIGN AND PATIENTS/PARTICIPANTS: We studied this possible relationship in the general population using the cross-sectional Study of Health in Pomerania (SHIP).

Operative treatment of prolactinomas: indications and results in a current consecutive series of 212 patients.

Objective: Medical therapy with dopamine agonists (DA) is the primary treatment of choice in most patients with prolactinomas. 'Classical' surgical indications are intolerance or lack of efficiency of DA therapy. Focusing on a possible shift of recent indications, we retrospectively analyzed our results of surgical treatment in prolactinomas.

Reference ranges of serum IGF-1 and IGFBP-3 levels in a general adult population: results of the Study of Health in Pomerania (SHIP).

Objective: Insulin-like growth factor I (IGF-1), which is mostly carried by IGF binding protein 3 (IGFBP-3), mediates endocrine actions of growth hormone and represents an important prognostic factor for systemic diseases. The main objectives of the present study were (1) to calculate age- and sex-specific reference values for serum IGF-1 and IGFBP-3 levels using the Gaussian mean+/-1.96 *standard deviation method and the quantile regression method and (2) to perform a comparison of the results from both statistical methods.

Association between serum insulin-like growth factor-I levels and thyroid disorders in a population-based study.

Objective: There is current debate on whether serum IGF-I levels are associated with thyroid disorders. The aims of the present study were: 1) to investigate possible associations between serum IGF-I levels and thyroid disorders and 2) to analyze the role of serum IGF binding protein (IGFBP)-3 and TSH levels for these associations.

Design: This was a cross-sectional Study of Health in Pomerania.

Normal levels of serum IGF-I: determinants and validity of current reference ranges.

Insulin like growth factor I (IGF-I) represents the key marker for the evaluation of Growth hormone (GH) status. As a large number of determinants including age, gender, genetic factors, nutrition, and disease states influence IGF-I serum levels, accurate normative data are essential to translate patient data into diagnostic meaning or even use IGF-I levels for adequate monitoring of patients with an over- or under-active GH axis. Even though reference ranges have been developed in large cohorts of healthy subjects, the dependency of these data on a given assay technology argues for assay specific normative data for IGF-I.

Review: The association of thyroid dysfunction with all-cause and circulatory mortality: is there a causal relationship?

Context: Currently there is ongoing debate on whether subclinical and overt thyroid dysfunction may exert deleterious effects on the cardiovascular system with the consequence of increased mortality in affected individuals. We systematically review studies on the relation of thyroid dysfunction with all-cause and circulatory mortality questioning whether thyroid dysfunction is a causal factor for mortality.

Methods: Two investigators independently searched the MEDLINE database.

Increased prolactin in acute coronary syndromes as putative Co-activator of ADP-stimulated P-selectin expression.

Prolactin and leptin are newly recognized platelet co-stimulators due to enhancement of ADP-induced platelet aggregation. The aim of our study was to assess whether both hormones prolactin and leptin play a role as co-activators of platelet activation in patients with acute coronary syndromes. Twenty-one patients with acute coronary syndromes, 10 with stable angina pectoris and 10 controls were studied.

Effects of growth hormone treatment on B-type natriuretic peptide as a marker of heart failure in adults with growth hormone deficiency.

Objective: Patients with growth hormone deficiency (GHD) have abnormalities of cardiac structure and function. Growth hormone replacement (GHR) therapy can induce an increase in cardiac mass and improvement in left ventricular ejection fraction. B-type natriuretic peptide (BNP) levels have been successfully used to identify patients with heart failure and they correlate with both disease severity and prognosis.