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Introduction: Cardiovascular diseases are the leading cause of morbidity and mortality worldwide, and there is a need for the development of adjacent markers to assess cardiovascular risk. In this study, we examined the relationship between the areas of abdominal fat compartments, as measured by computed tomography (CT)-based planar measurements, and laboratory-validated cardiovascular risk markers. Methods: Fat distribution was measured on CT scans in 252 patients (M: F = 1.13) who underwent routine abdominal CT, using in-house and commercially available software. The included laboratory parameters were glucose, triglycerides, and the triglycerideglucose index. Results: The visceral abdominal fat (VAF) area and VAF percentage were lower in females compared to the VAF area and VAF percentage in males, (p=0.001, and p Conclusions: Areas of abdominal fat compartments correlate with metabolic parameters in the blood, and in the future, their assessment might be considered when constructing risk scores. Visceral fat content assessment for every abdominal computed tomography procedure might become a surrogate marker for cardio-vascular risk estimation after defining clear cut-off values and image analysis parameters.

Objectives. Numerous factors have been associated with hight prevalence of obesity, nutrition being the most important factor. The aim of this study was to evaluate the eating behavior of school children in Targu Mures and to evaluate the impact on auxological parameters. Material and method. The study included 213 children divided in 2 groups (107 females, 106 males), aged 5-18, evaluated in the Pediatrics I and Endocrinology Clinic in Târgu Mureș. The evaluation included: auxological data, body composition using bioimpedance. Participants reported eating behavior using a 126-item food frequency questionnaire. The results were classified as concentrated sweets, fats, meat, fruits and vegetables, cereals and dairy products. Results. There are no statistically significant differences between the 2 groups regarding the food pyramid. However, in boys, there are statistically significant correlations between fat consumption and weight (r = 0.198, p = 0.042) and body water (r = 0.209, p = 0.044), and the consumption of meat correlates with weight (r = 0.249, p = 0.010), abdominal circumference (r = 0.258, p = 0.008) and waist-height ratio (r = 0.193, p = 0.048). In girls, there is no singnificant correlations between intake of studied food group and anthropometric parameters. Conclusions. The results highlight the importance of eating behavior, which has a major impact in obesity prevalence. In our study, there are correlations between concentrated fats and meat consumption and adiposity markers in boys. Prospective studies are needed to identify how different types of food related to body composition and central obesity in pediatric population.

Obiective. Numeroși factori au fost asociați cu creșterea prevalenţei obezităţii, alimentaţia fiind cel mai important factor. Scopul acestui studiu a fost evaluarea comportamentului alimentar la copiii şcolari din Târgu Mureş şi evaluarea impactului acestuia asupra parametrilor auxologici. Material şi metodă. Lotul de studiu a inclus 213 copii (107 copii de sex feminin şi 106 de sex masculin),cu vârste cuprinse între 5 şi 18 ani, evaluați în Clinica de Pediatrie I și Endocrinologie din Târgu Mureș. Au fost evaluate date auxologice și compoziția corporală realizată cu ajutorul bioimpedanţei electrice. Participanții au raportat comportamentul alimentar, folosind un chestionar de frecvență alimentară semicantitativ, de 126 de itemi. Rezultatele au fost clasificate astfel: dulciuri concentrate, grăsimi, carne, fructe și legume, cereale și produse lactate. Rezultate. Piramida alimentară nu diferă semnificativ statistic la cele 2 grupuri studiate. Ȋnsă, la pacienţii de sex masculin, există corelaţii semnificative statistic ȋntre consumul de grăsimi şi greutate (r = 0,198, p = 0,042) şi cantitatea de apă corporală (r = 0,209, p = 0,044), iar consumul de carne se corelează cu greutatea (r = 0,249, p = 0,010), circumferinţa abdominală (r = 0,258, p = 0,008) şi indicele talie-ȋnălţime (r = 0,193, p = 0,048). La pacienţii de sex feminin, nu există corelaţii semnificative ȋntre grupurile alimentare studiate şi parametrii auxologici. Concluzii. Rezultatele subliniază importanţa unui comportament alimentar corespunzător, acesta având un impact major ȋn apariţia obezităţii. Ȋn studiul nostru, există corelaţii ȋntre consumul de grăsimi şi carne şi markeri ai adipozităţii la sexul masculin. Studii suplimentare prospective sunt necesare pentru a identifica influenţa diferitelor categorii alimentare asupra compoziţiei corporale şi obezităţii centrale la populaţia pediatrică.

Background Pediatric obesity continues to remain a serious health concern which has significantly increased the morbidity risk in adulthood. Recent studies have analyzed the impact of the two adipokines, RBP4 (retinol binding protein 4) and STRA6 (stimulated by retinoic acid 6) in pediatric obese subjects with contradictory results. Methods An observational study was conducted in the Pediatric and Endocrinology Departments, Targu-Mures, Romania, including 213 children between 5-17 years of age, divided into two groups according to body mass index (BMI) standard deviation score (SDS): case (overweight or obese) and control (normal SDS). Age, sex, basic anthropometric and biochemical measurements and genotype of rs3758539, and rs10882280 for RBP4 gene and rs974456 and rs351224 of STRA6 gene were analyzed. Statistical analysis used SPSS v. 25.0, with a level of significance α = 0.05. Results There is no association between the two gene's polymorphisms and obesity in our pediatric population. In regression analysis, with HOMA IR (homeostatic model assessment of insulin resistance) as the outcome, the plasmatic level of RBP4 and fat mass percentage are significant predictors, with the model explaining 42% of the HOMA variability. Hypercholesterolemia was significantly associated with male sex, carrying variant allele and heterozygote status of rs10882280 RBP4 gene and wild-type allele rs351224 of STRA6 gene. Conclusion There is no significant association between obesity and SNPs of the RBP4 and STRA6 in our population, but they seem to play a role in insulin resistance and hypercholesterolemia.

As type 2 diabetes mellitus (T2DM) reaches epidemic proportions in the developed world and the age at diagnosis decreases, more women of reproductive age are being affected. In this article, we provide a synoptic view on potential mechanisms and relevant factors underlying menstrual cycle disorders and fertility issues in women with T2DM. The article discusses the function of the hypothalamic-pituitary-ovarian (HPO) axis, the central role of the hypothalamus in the homeostasis of this system, the central modulators of the axis, and the peripheral metabolic signals involved in neuroendocrine control of reproduction. The available literature on the relationship between T2DM and the female reproductive lifespan, menstrual cycle disorders, fertility issues, and gestational health in women with T2DM are also discussed. The data so far indicate that there is a "U-shaped" relationship between menarche, menopause, and T2DM, both early and late menarche/menopause being risk factors for T2DM. Hyperglycemia and its consequences may be responsible for the effects of T2DM on reproductive health in women, but the exact mechanisms are not as yet fully understood; thus, more studies are needed in order to identify factors causing disruption of the HPO axis.

Background: Conflictual results regarding the relationship between plasmatic level of visfatin and obesity could be explained by the influence of the gene variants involved in the synthesis or action of these hormones. Objectives: The present study examined the potential implication of single nucleotide polymorphisms (SNPs) of nicotinamide phosphoribosyltransferase (NAMPT) gene that encodes visfatin, in obesity, in a Romanian pediatric population. Method: A case-control study was conducted on a group of 213 children, divided into two: the case group - 130 overweight and obese children with BMI >1 SD, and the control group - 83 children with normal BMI. The variables analyzed were age, sex, anthropometric parameters, body composition based on bioimpedance analysis, lipid profile, visfatin and insulin plasmatic levels, rs4730153 and rs2302559 visfatin SNPs. Results: Significant associations were not found between rs4730153 and rs2302559 visfatin SNPs and obesity. Regarding lipid metabolism, there are statistically significant differences between triglyceride levels according to NAMPT rs2302559 genotypes (p=0.045), with heterozygous genotype having the highest level of triglycerides, and also between cholesterol levels according to NAMPT rs4730153 genotypes (p=0.030), with carriers of heterozygote genotype having the highest level of cholesterol. There is a statistically significant difference between the studied parameters in the investigated groups, regarding cholesterol, in carrier of wild-type genotype of NAMPT rs2302559 (p=0.040) and carrier of wild-type genotype of NAMPT rs4730153 (p=0.036). We observed no association of NAMPT rs4730153 and rs2302559 with visfatin levels in the studied groups. Visfatin level was lower in the case group and was correlated with weight (p=0.042), abdominal circumference (p=0.010), waist to height ratio (p=0.040), but not with the elements of the metabolic profile. Conclusion: NAMPT rs2302559 and rs4730153 polymorphisms do not seem to have a major impact in the development of obesity in children, however there may be an association with lipid profile, but further studies are needed..

Secular trends in anthropometric parameters have been documented in most European countries, but no data is available regarding Romanian. The aim of the study was to calculate secular trend in height, body mass and mean menarche age for Romanian children and adolescents. Methods: A secondary data analysis was performed using ten data sets for urban and eight data sets for rural boys and girls, age 5&ndash, 15 years, covering 80 years (1936 to 2016). Secular trend in height (cm/decade), body mass(kg/decade) and mean menarche age (years) were calculated. Results: Overall, there was a positive secular trend for height in both genders, which parallels the gross domestic product (GDP)/capita difference, more pronounced in boys, across all age-groups, with a maximum for 15 years-old boys (~3 cm/decade) and 13 years-old girls (~2 cm/decade). Body mass trend was also positive, more accentuated in the rural population. Mean age at menarche was higher in rural compared to urban girls, had a negative trend with the disappearance of the difference in the latest available data set (2013). Conclusion: In summary, an overall positive and ongoing secular trend in height and body mass was documented in Romanian children and adolescents, especially for the pubertal age-range, in concordance to other western countries, but out of phase by approximately 20 years.

There are no new national growth references for the Romanian population and the current recommendations for short stature evaluation is the use of the Swiss growth charts developed based on a longitudinal study. The aim of the present paper is to present the new synthetic growth references for Romanian children. MATERIAL AND METHODS: We used local Romanian data from 9 studies with information on height and weight obtained between 1999 and 2016. Based on their plausibility and methodology six studies were selected for generating the National Synthetic Growth References for Romanian Children based on the specific methodology described previously. The selected studies included 8407 subjects measured in schools/kindergartens. Age is reported in years covering a range from 3-18 years. Height and weight were measured at a precision of 0.1 cm and 0.1 kg. All children were measured at normal temperature, in light clothes, without footwear. RESULTS: We present the charts and tables with the common centiles for height, weight and body mass index for boys and girls. CONCLUSION: We suggest synthetic growth references based upon recent growth data from 6 different Romanian regions as new National Growth Charts for Romanian children.

The impact of the two adipokines, visfatin and retinol-binding protein 4 (RBP-4) on bone mineral density (BMD) has been analysed in various studies with conflicting results. Visfatin is highly expressed in visceral fat with stimulatory effect on osteoblast proliferation and inhibition on osteoclast formation, while RBP-4 acts as a transporter protein for retinol, associated with changes in insulin sensitivity, independent of obesity, with no consensus on its effect on bone metabolism. We evaluated the relationship between serum concentrations of visfatin, RBP-4, markers of insulin resistance and current BMD in treated postmenopausal osteoporosis (PO). Demographics, previous treatment, metabolic status, anthropometry, serum Alkaline phosphatise (ALP), visfatin, RBP-4, the HOMA IR (homeostatic model assessment of insulin resistance) index and BMD were evaluated in 61 subjects with PO. Statistical analysis used SPSS v. 25.0, with a level of significance α = 0.05. Regression models were constructed to evaluate the relationship between adipokines and BMD, adjusting for covariates. In multilinear regression analysis, the strongest predictor for current BMD was a previous BMD, followed by ALP and age. RBP4 and HOMA IR were significant predictors, while visfatin had no significant effect. A significant correlation between body mass index (BMI) and BMD at the femoral neck was observed. ALP was negatively correlated with BMD and visfatin positively with RBP4. Data indicate a positive relationship between BMD and RBP-4, an inverse relationship between markers of insulin resistance, bone turn-over and current BMD. No significant effect of visfatin on BMD was observed.

Background: Neurofibromatosis type 1 is an autosomal dominant disorder associated with multiple neoplasms particularly those of ectodermal origin. Various endocrine pathologies are often present, among them, hyperparathyroidism and follicular thyroid lesion are very rare described and their coincidence in the same patient has not been described in the literature reviewed. Subject: A 59-years-old woman with clinical manifestation of neurofibromatosis type 1 developed dysphagia, dysphonia, choking sensation. Physical and imagistic examination revealed a multinodular goiter with microfollicular lesion on fine needle aspiration biopsy (FNAB), elevated parathormone levels and severe osteoporosis. The surgically removed thyroid contained a nodule with follicular architecture of uncertain malignant potential; the parathyroid tissue appeared normal. Discussion and conclusion: This case serves as a reminder to look for non-neurogenic tumors in patients with neurofibromatosis. Clinicians must be aware of the diverse clinical features of this genetic disorder.

The name and surname of the authors have been inverted. The correct order would be like this: Andrea Ildiko Gasparik, Gabriela Mihai, Charlotte Beaudart, Olivier Bruyere, Raluca-Monica Pop, Jean-Yves Reginster, Ionela Maria Pascanu.

Our study assessed the psychometric properties of the Romanian SarQoL® questionnaire. Normal distribution and high internal consistency were found. Sarcopenic subjects reported a reduced global quality of life compared to non-sarcopenics. The Romanian version of the SarQoL® questionnaire, conceptually and literally equivalent with the source instrument, is qualified in terms of psychometric properties. We have recently provided a translated and culturally tailored version of the first quality of life (QoL) questionnaire specific for sarcopenia, the SarQoL®, in Romanian language. The aim of this study was to assess the psychometric performances of the translated questionnaire. A total of 100 volunteers were enrolled in the study. Sarcopenia was diagnosed according to the algorithm proposed by the European Working Group on Sarcopenia in Older People (EWGSOP). To test the psychometric performance, discriminative power, internal consistency, floor and ceiling effects, and construct validity analyses were made. We assessed the correlation between SarQoL® and similar/different domains of other two QoL questionnaires. Sarcopenic subjects reported a reduced global QoL compared to non-sarcopenic individuals. Significantly (p = 0.018) higher total scores for non-sarcopenic subjects compared to those of sarcopenics indicate a good discriminative power of the Romanian questionnaire. Sarcopenic individuals had significantly lower scores in almost all domains. The Cronbach’s alpha value of 0.946 indicates a high internal consistency. No floor or ceiling effects were found. A strong positive correlation was also found between similar domain scores from SF-36 and EQ-5D questionnaires with the Total SarQoL® score. Moreover, lower scores of quality of life have been shown to be significantly associated with lower muscle strength, in univariate analyses, and lower gait speed, both in univariate and multivariate analyses. Our results indicate that the Romanian version of the SarQoL® questionnaire, qualified in terms of psychometric properties, could be a useful tool to assess the sarcopenia-related QoL among frail Romanian individuals.