Author: Luminita Suveica

A pilot study in menopausal women with prediabetes: refining the blood exerkine irisin assay in relationship with the calcium-phosphorus metabolism

Objective. In this pilot study, we aimed to analyze the blood irisin levels in relation to glucose and mineral metabolism assays in menopausal women with non-diabetic altered glucose regulation: impaired fasting glucose (IFG) or impaired glucose tolerance (IGT). Methods. This was a prospective, transversal, non-interventional, bi-centric (bi-country) study, between December 2024 and October 2025. Results. The patients (N=47) with IGT (N=21) or IFG (N=26) had a similar age (63±9.24 versus 63.46±8.16years, p=0.856), menopause duration (14.05±9.37 versus 16.76±8.07years, p=0.297), and body mass index with mean values within the obesity range (34.84±5.07 versus 31.34±6.46kg/sqm, p=0.765). Average 25-hydroxyvitamin D showed an insufficiency (28.62±8.09 versus 28.06± 6.99ng/mL). The IGT versus IFG group were found with statistically significantly higher 1-hour glycaemia in the oral glucose tolerance test (207.04±34.72 versus 179.40±33.91mg/dL, p=0.009), 2-hour insulin (101.44±67.26 versus 48.97±34.35 µUI/mL, p=001), fasting insulin (13.00±7.38 versus 8.36±3.96µUI/mL, p=0.008); HOMA-IR (3.53±2.32 versus 2.27±1.17; p=0.21) with mean levels sustaining insulin resistance. Conclusion. Circulating irisin was marginally elevated in the IGT versus the IFG group and positively correlated with body mass index in both. We found no correlation with the glucose profile, but with selective mineral metabolism assays. This pilot study requires an expansion of the sample size to pinpoint the potential practical utility of irisin as a biomarker.

An exploratory study on microarray technology-based biomarkers in post-menopausal women with obesity: focus on blood levels of adipsin, adiponectin and agouti-related peptide

Background. A novel framework to assess obesity and its complications involves the evaluation of fat-derived factors as potential biomarkers of the cardio-metabolic outcome and long-term management. In this exploratory study, we aimed to evaluate microarray-based circulating levels of adiponectin, adipsin, and AgRP in menopausal women with obesity. Methods. This is a pilot, bi-centric study according to a protocol based on Quantibody® Human Obesity Array 3 (RayBiotech, Norcross, GA, USA). Patients with obesity-associated complications (hypertension, diabetes, dyslipidaemia) were excluded. Results. In the study population (N = 24, median age of 60 years) adiponectin correlated with lipocalin-2 (r = 0.943, p = 0.0048) and plasminogen activation inhibitor-1 (r = 0.829, p = 0.0416). Adipsin correlated with inteleukin-8 (r = 0.786, p = 0.0362), and leptin (r = 0.832, p = 0.0008). Conclusion. Apparently healthy obese menopausal individuals present a landscape of circulating adipokines that might be placed in relationship with the inflammatory and coagulation panel, across a complex inter-play. In addition, agouti-related peptide, despite being a well- known central orexigenic factor, might serve as circulating biomarker, too, noting its correlations with interleukin-6 and glycaemia at 120 minute during oral glucose tolerance test.

A study of treatment-naive patients with systemic lupus erythematosus: focus on the status of thyroid profile across a real-life clinical setting

Background: Systemic Lupus Erythematosus (SLE) is potentially associated with thyroid disturbances, which might remain underdiagnosed. The objective was to analyse the thyroid profile in adults newly diagnosed with SLE. Methods: In this observational, real-life, cross-sectional study, treatment-naïve SLE subjects were compared to (SLE-free) controls in terms of thyroid profile and clinical, hematologic, electrophoretic, immunologic, and metabolic parameters. Individuals with a prior history of autoimmune diseases, thyroidectomy, and thyroid ailments were excluded. The statistical significance cut-off was p < 0.05. Results: SLE patients (N=22) versus age- and gender-matched controls (N=50) had a higher prevalence of thyroid dysfunction (22.7% versus 2%, p=0.001), mostly subclinical hypothyroidism, with similar TSH (thyroid-stimulating hormone), free thyroxine, and anti-thyroperoxidase (TPO) antibody levels. The prevalence of autoimmune thyroiditis (as defined by positive TPO) in the SLE group (27.3%) versus controls (14%) was not statistically significant (p=0.236). Thyroid ultrasound findings, namely, the highest size-based nodules category rates, displayed no between-group differences. Additional parameters (25-hydroxyvitamin D and glucose status) showed a similar profile. SELENA-SLEDAI score correlated with gamma-globulins (rho=0.55, p=0.008) and glycated haemoglobin A1c (rho=0.50, p=0.017), but not with thyroid function or TPO. Conclusion: Commonalities in the fields of thyroid and SLE should be taken into account from SLE onset, especially thyroid function. Indirect interplay might involve the glucose profile and vitamin D status.

Unravelling the serum calcium-to-magnesium ratio: a study in 474 individuals with/without adrenal tumors in relationship with central DXA results

Background/Objective: In order to address the current knowledge gap with regard to serum calcium-to-magnesium ratio (Ca/Mg) in patients with adrenal incidentalomas, we aimed to analyze Ca/Mg in menopausal women diagnosed with these tumors versus (tumor-free) controls across DXA categories. Methods. This is a retrospective, real-world, cross-sectional study in 474 menopausal women admitted at a single tertiary center of endocrinology. Results. Tumor group (N=111) had osteoporosis/osteopenia/normal DXA prevalence: 17.1%, 36.9% and 46%, respectively, control group: 13.8%, 45.5%, and 40.8%. Ca/Mg ratio was similar between DXA sub-groups in each group. Tumor group: Ca/Mg corelated with age (r=0.288, p=0.047), P1NP (r= -0.459, p=0.011), osteocalcin (r= -0.37, p=0.026) and CrossLaps (r= -0.446, p=0.006) in subjects with normal DXA (N=51), while in those osteoporotic (N=19), with glycated hemoglobin A1c (r=0.596, p=0.025). Control group (N=363): Ca/Mg corelated with age (N=165, r=0.178, p=0.034), fasting glycemia (r=0.253, p=0.003), glycated hemoglobin A1c (r=0.22, p=0.045), osteocalcin (r= -0.196, p=0.03), and CrossLaps (r= -0.193, p=0.034) in osteopenic subjects (N=165) and with P1NP (r= -0.249, p=0.027) in normal DXA (N=148). Conclusion. Osteopenic subjects (regardless tumor diagnosis) showed a direct age-Ca/Mg association, while the ratio was correlated with the bone turnover biomarkers distinctively across DXA sub-groups. Additionally, the ratio might reflect a more severe glucose profile.