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Verena Schwetz
Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, Graz, Austria

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Journal article
Published: 26 April 2021 in BMC Endocrine Disorders
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Background Hyperprolactinaemia might cause adverse metabolic effects. The aim of our study was to compare parameters of body composition, glucose and lipid metabolism between untreated patients with prolactinoma and controls and to assess changes after initiation of cabergoline. Methods Case-control study with a retrospectively analyzed follow-up in patients with prolactinoma after initiation of cabergoline therapy. Results 21 patients with prolactinoma (9 micro- and 12 macroprolactinomas; 7 females) and 30 controls were analyzed. Patients with prolactinoma had significantly higher BMI than controls; fat mass did not differ between groups. Only men - but not women - with prolactinoma had significantly higher fat mass at all six sites measured compared to controls. Levels of LDL (130 (107–147.5) vs. 94.5 (80–127.5) mg/dl, p < 0.001) were significantly higher, levels of HDL (56 ± 16.7 vs. 69.2 ± 14.6 mg/dl, p = 0.004) significantly lower than in controls. Fasting glucose, HOMA-IR, HbA1c, adiponectin, CRP, and homocysteine did not differ between groups. After a median of 10 weeks (IQR 7–18 weeks) after initiation of cabergoline, total (from 212.5 ± 36.2 to 196.9 ± 40.6 mg/dl, p = 0.018) and LDL cholesterol (130 (107–147.5) to 106.5 (94.3–148) mg/dl, p = 0.018) had significantly decreased. Analyzing men and women separately, this change occurred in men only. Conclusions Reasons for the association between prolactin and metabolic parameters include direct effects of prolactin on adipose tissue, hyperprolactinaemia-triggered hypogonadism and dopamine-agonist therapy per se. Altered lipid metabolism in patients with prolactinoma might imply an increased cardiovascular risk, highlighting the necessity to monitor metabolic parameters in these patients.

ACS Style

Anna Sophia Posawetz; Christian Trummer; Marlene Pandis; Felix Aberer; Thomas R. Pieber; Barbara Obermayer-Pietsch; Stefan Pilz; Verena Theiler-Schwetz. Adverse body composition and lipid parameters in patients with prolactinoma: a case-control study. BMC Endocrine Disorders 2021, 21, 1 -9.

AMA Style

Anna Sophia Posawetz, Christian Trummer, Marlene Pandis, Felix Aberer, Thomas R. Pieber, Barbara Obermayer-Pietsch, Stefan Pilz, Verena Theiler-Schwetz. Adverse body composition and lipid parameters in patients with prolactinoma: a case-control study. BMC Endocrine Disorders. 2021; 21 (1):1-9.

Chicago/Turabian Style

Anna Sophia Posawetz; Christian Trummer; Marlene Pandis; Felix Aberer; Thomas R. Pieber; Barbara Obermayer-Pietsch; Stefan Pilz; Verena Theiler-Schwetz. 2021. "Adverse body composition and lipid parameters in patients with prolactinoma: a case-control study." BMC Endocrine Disorders 21, no. 1: 1-9.

Review
Published: 12 March 2021 in International Journal of Molecular Sciences
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During the last two decades, the potential impact of vitamin D on the risk of cardiovascular disease (CVD) has been rigorously studied. Data regarding the effect of vitamin D on CVD risk are puzzling: observational data indicate an inverse nonlinear association between vitamin D status and CVD events, with the highest CVD risk at severe vitamin D deficiency; however, preclinical data and randomized controlled trials (RCTs) show several beneficial effects of vitamin D on the surrogate parameters of vascular and cardiac function. By contrast, Mendelian randomization studies and large RCTs in the general population and in patients with chronic kidney disease, a high-risk group for CVD events, largely report no significant beneficial effect of vitamin D treatment on CVD events. In patients with rickets and osteomalacia, cardiovascular complications are infrequently reported, except for an increased risk of heart failure. In conclusion, there is no strong evidence for beneficial vitamin D effects on CVD risk, either in the general population or in high-risk groups. Whether some subgroups such as individuals with severe vitamin D deficiency or a combination of low vitamin D status with specific gene variants and/or certain nutrition/lifestyle factors would benefit from vitamin D (metabolite) administration, remains to be studied.

ACS Style

Armin Zittermann; Christian Trummer; Verena Theiler-Schwetz; Elisabeth Lerchbaum; Winfried März; Stefan Pilz. Vitamin D and Cardiovascular Disease: An Updated Narrative Review. International Journal of Molecular Sciences 2021, 22, 2896 .

AMA Style

Armin Zittermann, Christian Trummer, Verena Theiler-Schwetz, Elisabeth Lerchbaum, Winfried März, Stefan Pilz. Vitamin D and Cardiovascular Disease: An Updated Narrative Review. International Journal of Molecular Sciences. 2021; 22 (6):2896.

Chicago/Turabian Style

Armin Zittermann; Christian Trummer; Verena Theiler-Schwetz; Elisabeth Lerchbaum; Winfried März; Stefan Pilz. 2021. "Vitamin D and Cardiovascular Disease: An Updated Narrative Review." International Journal of Molecular Sciences 22, no. 6: 2896.

Journal article
Published: 18 February 2021 in Journal of Clinical Medicine
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Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in premenopausal women, with a wide spectrum of possible phenotypes, symptoms and sequelae according to the current clinical definition. However, there are women who do not fulfill at least two out of the three commonly used “Rotterdam criteria” and their risk of developing type 2 diabetes or obesity later in life is not defined. Therefore, we addressed this important gap by conducting a retrospective analysis based on 750 women with and without PCOS. We compared four different PCOS phenotypes according to the Rotterdam criteria with women who exhibit only one Rotterdam criterion and with healthy controls. Hormone and metabolic differences were assessed by analysis of variance (ANOVA) as well as logistic regression analysis. We found that hyperandrogenic women have per se a higher risk of developing insulin resistance compared to phenotypes without hyperandrogenism and healthy controls. In addition, hyperandrogenemia is associated with developing insulin resistance also in women with no other Rotterdam criterion. Our study encourages further diagnostic and therapeutic approaches for PCOS phenotypes in order to account for varying risks of developing metabolic diseases. Finally, women with hyperandrogenism as the only symptom should also be screened for insulin resistance to avoid later metabolic risks.

ACS Style

Valentin Borzan; Elisabeth Lerchbaum; Cornelia Missbrenner; Annemieke Heijboer; Michaela Goschnik; Christian Trummer; Verena Theiler-Schwetz; Christoph Haudum; Roswitha Gumpold; Natascha Schweighofer; Barbara Obermayer-Pietsch. Risk of Insulin Resistance and Metabolic Syndrome in Women with Hyperandrogenemia: A Comparison between PCOS Phenotypes and Beyond. Journal of Clinical Medicine 2021, 10, 829 .

AMA Style

Valentin Borzan, Elisabeth Lerchbaum, Cornelia Missbrenner, Annemieke Heijboer, Michaela Goschnik, Christian Trummer, Verena Theiler-Schwetz, Christoph Haudum, Roswitha Gumpold, Natascha Schweighofer, Barbara Obermayer-Pietsch. Risk of Insulin Resistance and Metabolic Syndrome in Women with Hyperandrogenemia: A Comparison between PCOS Phenotypes and Beyond. Journal of Clinical Medicine. 2021; 10 (4):829.

Chicago/Turabian Style

Valentin Borzan; Elisabeth Lerchbaum; Cornelia Missbrenner; Annemieke Heijboer; Michaela Goschnik; Christian Trummer; Verena Theiler-Schwetz; Christoph Haudum; Roswitha Gumpold; Natascha Schweighofer; Barbara Obermayer-Pietsch. 2021. "Risk of Insulin Resistance and Metabolic Syndrome in Women with Hyperandrogenemia: A Comparison between PCOS Phenotypes and Beyond." Journal of Clinical Medicine 10, no. 4: 829.

Journal article
Published: 07 February 2021 in Nutrients
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Vitamin D (VD) might play an important role in polycystic ovary syndrome (PCOS) and female fertility. However, evidence from randomized controlled trials (RCT) is sparse. We examined VD effects on anti-Müllerian hormone (AMH) and other endocrine markers in PCOS and non-PCOS women. This is a post hoc analysis of a single-center, double-blind RCT conducted between December 2011 and October 2017 at the endocrine outpatient clinic at the Medical University of Graz, Austria. We included 180 PCOS women and 150 non-PCOS women with serum 25-hydroxyvitamin D (25(OH)D) concentrations p = 0.031) and LH/FSH ratio (mean treatment effect −0.335, 95% CI −0.621 to 0.050, p = 0.022), whereas no significant effect was observed in non-PCOS women. In PCOS women, VD treatment for 24 weeks had a significant effect on FSH and LH/FSH ratio but no effect on AMH levels.

ACS Style

Elisabeth Lerchbaum; Verena Theiler-Schwetz; Martina Kollmann; Monika Wölfler; Stefan Pilz; Barbara Obermayer-Pietsch; Christian Trummer. Effects of Vitamin D Supplementation on Surrogate Markers of Fertility in PCOS Women: A Randomized Controlled Trial. Nutrients 2021, 13, 547 .

AMA Style

Elisabeth Lerchbaum, Verena Theiler-Schwetz, Martina Kollmann, Monika Wölfler, Stefan Pilz, Barbara Obermayer-Pietsch, Christian Trummer. Effects of Vitamin D Supplementation on Surrogate Markers of Fertility in PCOS Women: A Randomized Controlled Trial. Nutrients. 2021; 13 (2):547.

Chicago/Turabian Style

Elisabeth Lerchbaum; Verena Theiler-Schwetz; Martina Kollmann; Monika Wölfler; Stefan Pilz; Barbara Obermayer-Pietsch; Christian Trummer. 2021. "Effects of Vitamin D Supplementation on Surrogate Markers of Fertility in PCOS Women: A Randomized Controlled Trial." Nutrients 13, no. 2: 547.

Journal article
Published: 30 November 2020 in Journal of Clinical Medicine
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Nitric oxide (NO) synthesis markers, comprising L-homoarginine, asymmetric dimethylarginine (ADMA) and symmetric dimethylarginine (SDMA), are significantly associated with cardiovascular events and mortality. Being involved in NO pathways, they may be of high importance regulating vascular tone and arterial hypertension, but data on this topic are sparse and controversial. In this study, we evaluated whether these NO synthesis markers are associated with blood pressure values and pulse wave velocity (PWV). This analysis was based on the data of the Styrian Vitamin D Hypertension Trial, which included adults with arterial hypertension. We analyzed correlations of NO synthesis markers with 24 h ambulatory blood pressure values and PWV (primary outcomes), as well as with anthropometric and laboratory data. A total of 509 patients were included in the present analysis. The mean age was 61.2 ± 10.5 years, mean PWV was 8.6 ± 2.4 m/s, mean 24 h systolic blood pressure was 127.5 ± 13.8 mmHg and mean 24 h diastolic blood pressure was 76.4 ± 9.5 mmHg. In bivariate analyses, there was a significant positive correlation between homoarginine and 24 h diastolic blood pressure (r = 0.1; p = 0.02), which was revealed to be no longer significant after adjustment for age, gender and glomerular filtration rate (GFR) in multivariate regression analysis. No other significant correlations of any NO synthesis markers with blood pressure or PWV were observed. In line with previous studies, there were inverse associations between homoarginine and age and between ADMA or SDMA and GFR (p < 0.05 for all). This study did not reveal a significant association between homoarginine, ADMA or SDMA and blood pressure or PWV in hypertensive adults. These results suggested that the associations of these parameters with adverse outcome may not be mediated by hypertension and/or endothelial dysfunction.

ACS Style

Oliver Malle; Christian Trummer; Verena Theiler-Schwetz; Andreas Meinitzer; Martin H. Keppel; Martin R. Grübler; Andreas Tomaschitz; Jakob Voelkl; Winfried März; Stefan Pilz. NO Synthesis Markers are Not Significantly Associated with Blood Pressure and Endothelial Dysfunction in Patients with Arterial Hypertension: A Cross-Sectional Study. Journal of Clinical Medicine 2020, 9, 3895 .

AMA Style

Oliver Malle, Christian Trummer, Verena Theiler-Schwetz, Andreas Meinitzer, Martin H. Keppel, Martin R. Grübler, Andreas Tomaschitz, Jakob Voelkl, Winfried März, Stefan Pilz. NO Synthesis Markers are Not Significantly Associated with Blood Pressure and Endothelial Dysfunction in Patients with Arterial Hypertension: A Cross-Sectional Study. Journal of Clinical Medicine. 2020; 9 (12):3895.

Chicago/Turabian Style

Oliver Malle; Christian Trummer; Verena Theiler-Schwetz; Andreas Meinitzer; Martin H. Keppel; Martin R. Grübler; Andreas Tomaschitz; Jakob Voelkl; Winfried März; Stefan Pilz. 2020. "NO Synthesis Markers are Not Significantly Associated with Blood Pressure and Endothelial Dysfunction in Patients with Arterial Hypertension: A Cross-Sectional Study." Journal of Clinical Medicine 9, no. 12: 3895.

Originalien
Published: 28 August 2020 in Journal für Klinische Endokrinologie und Stoffwechsel
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Schilddrüsenfunktionsstörungen gehören zu den häufigsten endokrinen Nebenwirkungen, die unter einer Immuncheckpoint-Inhibitor-Therapie auftreten können. Sie sind unter Anti-PD-1- („Anti-programmed cell death 1“) häufiger als unter Anti-CTLA-4-Antikörpern („Anti-Cytotoxic-T-lymphocyte-antigen-4“), und die Inzidenz steigt mit einer Kombinationstherapie an. Pathophysiologisch scheint eine destruktive Thyreoiditis ähnlich einer Postpartum-Thyreoiditis vorzuliegen, im Rahmen derer es meistens zu einer kurzen Hyperthyreosephase kommt, gefolgt von einer Hypo- oder Euthyreose. Auch die Entwicklung einer alleinigen Hypothyreose ist möglich. Therapeutisch steht Observanz der Hyperthyreose im Vordergrund mit Einsatz einer Betablocker-Therapie, wenn eine symptomatische Therapie erforderlich ist. Der Einsatz von Glukokortikoiden oder Thyreostatika ist nicht sinnvoll. Bei Entwicklung einer symptomatischen Hypothyreose mit einem TSH (Thyroidea-stimulierendes Hormon) von 5–10 μU/ml oder einem TSH > 10 μU/ml sollte unabhängig von der Symptomatik eine Levothyroxin-Therapie eingeleitet werden. Aufgrund der häufig oligo- oder asymptomatischen klinischen Präsentation sollte ein regelmäßiges Screening auf Schilddrüsenfunktionsstörungen und Hypophysitis, beginnend vor Immuntherapieeinleitung und hiernach monatlich in den ersten 6 Monaten, durchgeführt werden inkl. TSH, freiem Trijodthyronin (fT3), freiem Thyroxin (fT4), Cortisol und adrenokortikotropem Hormon (ACTH). Nach den ersten 6 Monaten können die Kontrollintervalle ausgeweitet werden. Die Entwicklung von Schilddrüsenfunktionsstörungen sollte in der Regel nicht zu einer Unterbrechung der Immuntherapie führen, da diese häufig transient, mild und einfach behandelbar sind.

ACS Style

Verena Theiler-Schwetz; Christian Trummer; Erika Richtig; Georg Richtig; Stefan Pilz. Schilddrüsenfunktionsstörungen unter Immuncheckpoint-Inhibitor-Therapie. Journal für Klinische Endokrinologie und Stoffwechsel 2020, 13, 1 -4.

AMA Style

Verena Theiler-Schwetz, Christian Trummer, Erika Richtig, Georg Richtig, Stefan Pilz. Schilddrüsenfunktionsstörungen unter Immuncheckpoint-Inhibitor-Therapie. Journal für Klinische Endokrinologie und Stoffwechsel. 2020; 13 (3):1-4.

Chicago/Turabian Style

Verena Theiler-Schwetz; Christian Trummer; Erika Richtig; Georg Richtig; Stefan Pilz. 2020. "Schilddrüsenfunktionsstörungen unter Immuncheckpoint-Inhibitor-Therapie." Journal für Klinische Endokrinologie und Stoffwechsel 13, no. 3: 1-4.

Originalien
Published: 28 August 2020 in Journal für Klinische Endokrinologie und Stoffwechsel
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Die häufigsten Ursachen für die Entstehung einer Hyperthyreose sind die Immunthyreopathie Basedow sowie die Schilddrüsenautonomie. Für die Diagnosestellung sind die Bestimmung der TSH-Rezeptor-Antikörper (TRAK) nebst Thyroidea-stimulierendem Hormon (TSH), freiem Thyroxin (fT4) und freiem Trijodthyronin (fT3) wichtig. Die Bestimmung der T3/T4-Ratio kann in der Abgrenzeng einer Immunthyreopathie Basedow zu einer destruktiven Thyreoiditis hilfreich sein. Bei der Immunthyreopathie Basedow sind das typische sonographische Bild einer hypoechogenen Schilddrüse mit erhöhter Vaskularisation und zunehmend auch die quantitative Bestimmung der Durchblutung in Form der „peak systolic velocity“ (PSV) weitere diagnostische Hilfsmittel. Die Szintigraphie hat bei der Diagnosestellung der Schilddrüsenautonomie nach wie vor ihren Stellenwert. Therapeutisch steht bei der Immunthyreopathie Basedow die medikamentöse, thyreostatische Therapie vorrangig mit Thiamazol in Form des Titrationsschemas im Vordergrund, die für 12–18 Monate durchgeführt wird. Liegen die TRAK dann im Normbereich, kann ein Absetzversuch unternommen werden. Wenn nicht, oder wenn es zum Auftreten eines Rezidivs kommt, sollte eine definitive Therapie mittels Radiojodtherapie oder Thyreoidektomie erwogen werden. Zur symptomatischen Behandlung können Betablocker wie Propranolol eingesetzt werden. Es gibt Hinweise, dass die lange praktizierte Jodrestriktion im Management der Immunthyreopathie Basedow vermieden werden sollte. Zum Einsatz von Selen liegen positive, aber noch großteils inkonsistente Daten vor, sodass eine Therapieempfehlung derzeit nicht ausgesprochen werden kann. In der Therapie der Schilddrüsenautonomie stehen Radiojodtherapie und die Operation im Vordergrund. Die Diagnose einer thyreotoxischen Krise ist eine klinische und wird anhand des Burch-Wartofsky-Scores gestellt – das Management erfordert meist intensivmedizinische Betreuung.

ACS Style

Verena Theiler-Schwetz; Christian Trummer; Stefan Pilz. Hyperthyreose – Fokus Immunthyreopathie Basedow. Journal für Klinische Endokrinologie und Stoffwechsel 2020, 13, 1 -9.

AMA Style

Verena Theiler-Schwetz, Christian Trummer, Stefan Pilz. Hyperthyreose – Fokus Immunthyreopathie Basedow. Journal für Klinische Endokrinologie und Stoffwechsel. 2020; 13 (3):1-9.

Chicago/Turabian Style

Verena Theiler-Schwetz; Christian Trummer; Stefan Pilz. 2020. "Hyperthyreose – Fokus Immunthyreopathie Basedow." Journal für Klinische Endokrinologie und Stoffwechsel 13, no. 3: 1-9.

Journal article
Published: 19 February 2020 in Journal of Clinical Medicine
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The 25-Hydroxyvitamin D (25[OH)D) serum concentration depends on vitamin D intake, endogenous vitamin D production and genetic factors. The latter have been demonstrated in large genome-wide association studies indicating that single nucleotide polymorphisms (SNPs) in genes related to the vitamin D metabolism are as important for serum 25(OH)D levels as the influence of season. The mechanism on how these SNPs influence serum 25(OH)D levels are still unclear. The aim of the present study was to investigate the genetic effects of ten selected SNPs related to vitamin D metabolism on 25-hydroxyvitamin D increase (∆25(OH)D) after vitamin D supplementation in three randomized controlled trials. Genotypes of SNPs related to vitamin D metabolism were determined in 411 participants with 25(OH)D concentrations < 75 nmol/l receiving 20,000 IU cholecalciferol per week for 8 or 12 weeks after study inclusion. For the vitamin D receptor (VDR) rs10783219 polymorphism, the minor A-allele was associated with lower ∆25(OH)D values in the entire study population (p = 0.022), which was not consistent in all three cohorts when analysed separately. VDR rs10783219 might therefore be a genetic modulator of increasing 25-hydroxyvitamin D concentrations. Considering the wide-spread use of vitamin D supplementation, future large and well-designed randomized controlled trials (RCTs) should investigate the clinical impact of this polymorphism.

ACS Style

Olivia Trummer; Natascha Schweighofer; Christoph W. Haudum; Christian Trummer; Stefan Pilz; Verena Theiler-Schwetz; Martin H. Keppel; Martin Grübler; Thomas R. Pieber; Wilfried Renner; Barbara Obermayer-Pietsch; Elisabeth Lerchbaum. Genetic Components of 25-Hydroxyvitamin D Increase in Three Randomized Controlled Trials. Journal of Clinical Medicine 2020, 9, 570 .

AMA Style

Olivia Trummer, Natascha Schweighofer, Christoph W. Haudum, Christian Trummer, Stefan Pilz, Verena Theiler-Schwetz, Martin H. Keppel, Martin Grübler, Thomas R. Pieber, Wilfried Renner, Barbara Obermayer-Pietsch, Elisabeth Lerchbaum. Genetic Components of 25-Hydroxyvitamin D Increase in Three Randomized Controlled Trials. Journal of Clinical Medicine. 2020; 9 (2):570.

Chicago/Turabian Style

Olivia Trummer; Natascha Schweighofer; Christoph W. Haudum; Christian Trummer; Stefan Pilz; Verena Theiler-Schwetz; Martin H. Keppel; Martin Grübler; Thomas R. Pieber; Wilfried Renner; Barbara Obermayer-Pietsch; Elisabeth Lerchbaum. 2020. "Genetic Components of 25-Hydroxyvitamin D Increase in Three Randomized Controlled Trials." Journal of Clinical Medicine 9, no. 2: 570.

Originalien
Published: 06 November 2019 in Journal für Klinische Endokrinologie und Stoffwechsel
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Zusammenfassung Die chronische Nebenniereninsuffizienz ist trotz adäquater Hormonersatzstrategien nach wie vor mit einer erhöhten Mortalität assoziiert. Der Grund hierfür liegt im Auftreten von Addison-Krisen, hervorgerufen durch einen Zustand eines akuten Cortisolmangels in erster Linie durch erhöhten Bedarf (beispielsweise bei Gastroenteritis, Infektionskrankheiten, inadäquater Medikamenteneinnahme etc.). Eine pragmatische Definition der Addison-Krise ist eine Verschlechterung des Allgemeinzustands mit absoluter (systolischer Blutdruck

ACS Style

Christian Trummer; Birgit Ratz; Marlene Pandis; Stefan Pilz; Verena Theiler-Schwetz. Addison-Krise – Strategien zu Therapie und Prävention. Journal für Klinische Endokrinologie und Stoffwechsel 2019, 12, 141 -145.

AMA Style

Christian Trummer, Birgit Ratz, Marlene Pandis, Stefan Pilz, Verena Theiler-Schwetz. Addison-Krise – Strategien zu Therapie und Prävention. Journal für Klinische Endokrinologie und Stoffwechsel. 2019; 12 (4):141-145.

Chicago/Turabian Style

Christian Trummer; Birgit Ratz; Marlene Pandis; Stefan Pilz; Verena Theiler-Schwetz. 2019. "Addison-Krise – Strategien zu Therapie und Prävention." Journal für Klinische Endokrinologie und Stoffwechsel 12, no. 4: 141-145.

Randomized controlled trial
Published: 21 October 2019 in Nutrients
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25-hydroxyvitamin D (25(OH)D) is commonly measured to assess vitamin D status. Other vitamin D metabolites such as 24,25-dihydroxyvitamin D (24,25(OH)2D) provide additional insights into vitamin D status or metabolism. Earlier studies suggested that the vitamin D metabolite ratio (VMR), calculated as 24,25(OH)2D/25(OH)D, could predict the 25(OH)D increase after vitamin D supplementation. However, the evidence for this additional value is inconclusive. Therefore, our aim was to assess whether the increase in 25(OH)D after supplementation was predicted by the VMR better than baseline 25(OH)D. Plasma samples of 106 individuals (25(OH)D < 75 nmol/L) with hypertension who completed the Styrian Vitamin D Hypertension Trial (NC.T.02136771) were analyzed. Participants received vitamin D (2800 IU daily) or placebo for 8 weeks. The treatment effect (ANCOVA) for 25(OH)D3, 24,25(OH)2D3 and the VMR was 32 nmol/L, 3.3 nmol/L and 0.015 (all p < 0.001), respectively. Baseline 25(OH)D3 and 24,25(OH)2D3 predicted the change in 25(OH)D3 with comparable strength and magnitude. Correlation and regression analysis showed that the VMR did not predict the change in 25(OH)D3. Therefore, our data do not support routine measurement of 24,25(OH)2D3 in order to individually optimize the dosage of vitamin D supplementation. Our data also suggest that activity of 24-hydroxylase increases after vitamin D supplementation.

ACS Style

Vito Francic; Stan R. Ursem; Niek F. Dirks; Martin H. Keppel; Verena Theiler-Schwetz; Christian Trummer; Marlene Pandis; Valentin Borzan; Martin R. Grübler; Nicolas D. Verheyen; Winfried März; Andreas Tomaschitz; Stefan Pilz; Annemieke C. Heijboer; Barbara Obermayer-Pietsch. The Effect of Vitamin D Supplementation on its Metabolism and the Vitamin D Metabolite Ratio. Nutrients 2019, 11, 2539 .

AMA Style

Vito Francic, Stan R. Ursem, Niek F. Dirks, Martin H. Keppel, Verena Theiler-Schwetz, Christian Trummer, Marlene Pandis, Valentin Borzan, Martin R. Grübler, Nicolas D. Verheyen, Winfried März, Andreas Tomaschitz, Stefan Pilz, Annemieke C. Heijboer, Barbara Obermayer-Pietsch. The Effect of Vitamin D Supplementation on its Metabolism and the Vitamin D Metabolite Ratio. Nutrients. 2019; 11 (10):2539.

Chicago/Turabian Style

Vito Francic; Stan R. Ursem; Niek F. Dirks; Martin H. Keppel; Verena Theiler-Schwetz; Christian Trummer; Marlene Pandis; Valentin Borzan; Martin R. Grübler; Nicolas D. Verheyen; Winfried März; Andreas Tomaschitz; Stefan Pilz; Annemieke C. Heijboer; Barbara Obermayer-Pietsch. 2019. "The Effect of Vitamin D Supplementation on its Metabolism and the Vitamin D Metabolite Ratio." Nutrients 11, no. 10: 2539.

Randomized controlled trial
Published: 14 August 2019 in Nutrients
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Vitamin D might play a role in metabolic processes and obesity. We therefore examined vitamin D effects on metabolic markers and obesity in a randomized controlled trial (RCT). This is a post-hoc analysis of the Graz Vitamin D&TT-RCT, a single-center, double-blind, randomized placebo-controlled trial. We included 200 healthy men with serum 25-hydroxyvitamin D (25(OH) D) levels

ACS Style

Elisabeth Lerchbaum; Christian Trummer; Verena Theiler-Schwetz; Martina Kollmann; Monika Wölfler; Stefan Pilz; Barbara Obermayer-Pietsch. Effects of Vitamin D Supplementation on Body Composition and Metabolic Risk Factors in Men: A Randomized Controlled Trial. Nutrients 2019, 11, 1894 .

AMA Style

Elisabeth Lerchbaum, Christian Trummer, Verena Theiler-Schwetz, Martina Kollmann, Monika Wölfler, Stefan Pilz, Barbara Obermayer-Pietsch. Effects of Vitamin D Supplementation on Body Composition and Metabolic Risk Factors in Men: A Randomized Controlled Trial. Nutrients. 2019; 11 (8):1894.

Chicago/Turabian Style

Elisabeth Lerchbaum; Christian Trummer; Verena Theiler-Schwetz; Martina Kollmann; Monika Wölfler; Stefan Pilz; Barbara Obermayer-Pietsch. 2019. "Effects of Vitamin D Supplementation on Body Composition and Metabolic Risk Factors in Men: A Randomized Controlled Trial." Nutrients 11, no. 8: 1894.

Randomized controlled trial
Published: 29 March 2019 in Nutrients
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Vitamin D is well known for its effects on calcium and mineral metabolism. However, vitamin D effects on bone turnover markers (BTMs), which are used together with bone mineral density (BMD) to evaluate bone health, are less clear. We therefore examined vitamin D effects on BTMs (beta-cross laps (CTX) and osteocalcin (OC)) and BMD in a post-hoc analysis of a randomized controlled trial (RCT). This is a post-hoc analysis of the Graz Vitamin D&TT-RCT, a single-center, double-blind, randomized placebo-controlled trial conducted between December 2012 and November 2017 at the endocrine outpatient clinic at the Medical University of Graz, Austria. A total of 200 healthy men with serum 25-hydroxyvitamin D (25(OH)D) levels 0.05 for all). In middle-aged healthy men, vitamin D treatment for 12 weeks had no significant effect on BTMs or BMD.

ACS Style

Elisabeth Lerchbaum; Christian Trummer; Verena Theiler-Schwetz; Martina Kollmann; Monika Wölfler; Stefan Pilz; Barbara Obermayer-Pietsch. Effects of Vitamin D Supplementation on Bone Turnover and Bone Mineral Density in Healthy Men: A Post-Hoc Analysis of a Randomized Controlled Trial. Nutrients 2019, 11, 731 .

AMA Style

Elisabeth Lerchbaum, Christian Trummer, Verena Theiler-Schwetz, Martina Kollmann, Monika Wölfler, Stefan Pilz, Barbara Obermayer-Pietsch. Effects of Vitamin D Supplementation on Bone Turnover and Bone Mineral Density in Healthy Men: A Post-Hoc Analysis of a Randomized Controlled Trial. Nutrients. 2019; 11 (4):731.

Chicago/Turabian Style

Elisabeth Lerchbaum; Christian Trummer; Verena Theiler-Schwetz; Martina Kollmann; Monika Wölfler; Stefan Pilz; Barbara Obermayer-Pietsch. 2019. "Effects of Vitamin D Supplementation on Bone Turnover and Bone Mineral Density in Healthy Men: A Post-Hoc Analysis of a Randomized Controlled Trial." Nutrients 11, no. 4: 731.

Journal article
Published: 20 March 2019 in Clinical Nutrition
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Vitamin D supplementation may affect glycemic as well as hormonal regulation. Thus, the aim of the current study was to investigate whether vitamin D supplementation has any significant effects on metabolic and endocrine parameters in healthy premenopausal women. Primary outcome measure was the plasma glucose area under the curve (AUCgluc). The current study was a single-center, double-blind, randomized placebo-controlled trial that was conducted at the Medical University of Graz, Austria, between March 2013 and October 2017. One-hundred and fifty healthy premenopausal women with 25-hydroxyvitamin D [25(OH)D] concentrations <75 nmol/L once weekly received either 20,000 IU of cholecalciferol or placebo (2:1 ratio) over a total of 24 weeks. In total, 127 women [age 36.2 ± 8.7 years; BMI 25.3 ± 5.6 kg/m2; baseline 25(OH)D 55.8 ± 19.7 nmol/L] completed the study. Vitamin D supplementation had no significant effect on AUCgluc (mean treatment effect 11.70; p = 0.069), while it had a significant treatment effect on homeostatic model assessment-insulin resistance (HOMA-IR; mean treatment effect 0.31; p = 0.019) and quantitative insulin-sensitivity check index (QUICKI; mean treatment effect −0.019; p = 0.013). There was no significant effect on the remaining secondary outcome parameters. In this randomized-controlled trial in healthy premenopausal women, there was a significant treatment effect of vitamin D supplementation on HOMA-IR and QUICKI, while there was no significant treatment effect on AUCgluc.

ACS Style

Christian Trummer; Verena Theiler-Schwetz; Martina Kollmann; Monika Wölfler; Julia Münzker; Stefan Pilz; Thomas R. Pieber; Annemieke C. Heijboer; Barbara Obermayer-Pietsch; Elisabeth Lerchbaum. Effects of vitamin D supplementation on metabolic and endocrine parameters in healthy premenopausal women: A randomized controlled trial. Clinical Nutrition 2019, 39, 718 -726.

AMA Style

Christian Trummer, Verena Theiler-Schwetz, Martina Kollmann, Monika Wölfler, Julia Münzker, Stefan Pilz, Thomas R. Pieber, Annemieke C. Heijboer, Barbara Obermayer-Pietsch, Elisabeth Lerchbaum. Effects of vitamin D supplementation on metabolic and endocrine parameters in healthy premenopausal women: A randomized controlled trial. Clinical Nutrition. 2019; 39 (3):718-726.

Chicago/Turabian Style

Christian Trummer; Verena Theiler-Schwetz; Martina Kollmann; Monika Wölfler; Julia Münzker; Stefan Pilz; Thomas R. Pieber; Annemieke C. Heijboer; Barbara Obermayer-Pietsch; Elisabeth Lerchbaum. 2019. "Effects of vitamin D supplementation on metabolic and endocrine parameters in healthy premenopausal women: A randomized controlled trial." Clinical Nutrition 39, no. 3: 718-726.

Review article
Published: 03 August 2018 in Biochimica et Biophysica Acta (BBA) - Molecular Basis of Disease
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Glucocorticoids are regulators of stress response essential for survival. Liver disease can alter this homeostatic mechanism in patients with liver cirrhosis – a finding that might mirror the controversially discussed condition of critical illness related corticosteroid insufficiency. Underlying mechanisms might be shared molecular pathways in both bile acid as well as glucocorticoid metabolism at the level of synthesis, catabolism or the hypothalamus and the pituitary gland. Molecular links include the farnesoid X receptor FXR or the G protein-coupled bile acid receptor TGR5 expressed in the liver and the adrenals. In this review we sum up knowledge on the regulation of adrenal gland function and steroidogenesis, focussing on bile acids and potential alterations under cholestatic conditions, depict molecular links between glucocorticoid and bile acid metabolism and discuss the difficulties of assessment of adrenal function in humans in general and more specifically in liver diseases.

ACS Style

Verena Theiler-Schwetz; Alex Zaufel; Hansjörg Schlager; Barbara Obermayer-Pietsch; Peter Fickert; Gernot Zollner. Bile acids and glucocorticoid metabolism in health and disease. Biochimica et Biophysica Acta (BBA) - Molecular Basis of Disease 2018, 1865, 243 -251.

AMA Style

Verena Theiler-Schwetz, Alex Zaufel, Hansjörg Schlager, Barbara Obermayer-Pietsch, Peter Fickert, Gernot Zollner. Bile acids and glucocorticoid metabolism in health and disease. Biochimica et Biophysica Acta (BBA) - Molecular Basis of Disease. 2018; 1865 (1):243-251.

Chicago/Turabian Style

Verena Theiler-Schwetz; Alex Zaufel; Hansjörg Schlager; Barbara Obermayer-Pietsch; Peter Fickert; Gernot Zollner. 2018. "Bile acids and glucocorticoid metabolism in health and disease." Biochimica et Biophysica Acta (BBA) - Molecular Basis of Disease 1865, no. 1: 243-251.

Randomized controlled trial
Published: 17 June 2017 in Nutrients
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Increasing evidence suggests a possible interaction between vitamin D and insulin-like growth factor-1 (IGF-1). We aimed to investigate effects of vitamin D supplementation on IGF-1 (primary outcome) and calcitriol (1,25(OH)2D) concentrations (secondary outcome). This is a post-hoc analysis of the Styrian Vitamin D Hypertension Trial—a single-center, double-blind, randomized, placebo-controlled trial (RCT) conducted from 2011 to 2014 at the Medical University of Graz, Austria. Two-hundred subjects with arterial hypertension and 25(OH)D concentrations <30 ng/mL were randomized to either receive 2800 IU of vitamin D daily or placebo for eight weeks. A total of 175 participants (mean ± standard deviation age, 60 ± 11 years; 49% women) with available IGF-1 concentrations were included in the present analysis. At baseline, IGF-1 concentrations were significantly correlated with 1,25(OH)2D (r = 0.21; p = 0.005) but not with 25(OH)D (r = −0.008; p = 0.91). In the RCT, vitamin D had no significant effect on IGF-1 (mean treatment effect 3.1; 95% confidence interval −5.6 to 11.9 ng/mL; p = 0.48), but it increased 1,25(OH)2D concentrations (mean treatment effect 9.2; 95% confidence interval 4.4 to 13.9 pg/mL; p ≤ 0.001). In this RCT, in hypertensive patients with low 25(OH)D concentrations, there was no significant effect of vitamin D supplementation on IGF-1 concentrations. However, we observed a cross-sectional correlation between 1,25(OH)2D and IGF-1 and an increase of 1,25(OH)2D after vitamin D supplementation.

ACS Style

Christian Trummer; Verena Schwetz; Marlene Pandis; Martin R. Grübler; Nicolas Verheyen; Martin Gaksch; Armin Zittermann; Winfried März; Felix Aberer; Angelika Lang; Claudia Friedl; Andreas Tomaschitz; Barbara Obermayer-Pietsch; Thomas R. Pieber; Stefan Pilz; Gerlies Treiber. Effects of Vitamin D Supplementation on IGF-1 and Calcitriol: A Randomized-Controlled Trial. Nutrients 2017, 9, 623 .

AMA Style

Christian Trummer, Verena Schwetz, Marlene Pandis, Martin R. Grübler, Nicolas Verheyen, Martin Gaksch, Armin Zittermann, Winfried März, Felix Aberer, Angelika Lang, Claudia Friedl, Andreas Tomaschitz, Barbara Obermayer-Pietsch, Thomas R. Pieber, Stefan Pilz, Gerlies Treiber. Effects of Vitamin D Supplementation on IGF-1 and Calcitriol: A Randomized-Controlled Trial. Nutrients. 2017; 9 (6):623.

Chicago/Turabian Style

Christian Trummer; Verena Schwetz; Marlene Pandis; Martin R. Grübler; Nicolas Verheyen; Martin Gaksch; Armin Zittermann; Winfried März; Felix Aberer; Angelika Lang; Claudia Friedl; Andreas Tomaschitz; Barbara Obermayer-Pietsch; Thomas R. Pieber; Stefan Pilz; Gerlies Treiber. 2017. "Effects of Vitamin D Supplementation on IGF-1 and Calcitriol: A Randomized-Controlled Trial." Nutrients 9, no. 6: 623.

Randomized controlled trial
Published: 27 April 2017 in Nutrients
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Bone turnover markers (BTMs) are used to evaluate bone health together with bone mineral density and fracture assessment. Vitamin D supplementation is widely used to prevent and treat musculoskeletal diseases but existing data on vitamin D effects on markers of bone resorption and formation are inconsistent. We therefore examined the effects of vitamin D supplementation on bone-specific alkaline phosphatase (bALP), osteocalcin (OC), C-terminal telopeptide (CTX), and procollagen type 1 N-terminal propeptide (P1NP). This is a post-hoc analysis of the Styrian Vitamin D Hypertension Trial, a single-center, double-blind, randomized, placebo-controlled trial (RCT) performed at the Medical University of Graz, Austria (2011–2014). Two hundred individuals with arterial hypertension and 25-hydroxyvitamin D (25[OH]D) levels <75 nmol/L were randomized to 2800 IU of vitamin D daily or placebo for eight weeks. One hundred ninety-seven participants (60.2 ± 11.1 years; 47% women) were included in this analysis. Vitamin D had no significant effect on bALP (mean treatment effect (MTE) 0.013, 95% CI −0.029 to 0.056 µg/L; p = 0.533), CTX (MTE 0.024, 95% CI −0.163 to 0.210 ng/mL, p = 0.802), OC (MTE 0.020, 95% CI −0.062 to 0.103 ng/mL, p = 0.626), or P1NP (MTE −0.021, 95% CI −0.099 to 0.057 ng/mL, p = 0.597). Analyzing patients with 25(OH)D levels <50 nmol/L separately (n = 74) left results largely unchanged. In hypertensive patients with low 25(OH)D levels, we observed no significant effect of vitamin D supplementation for eight weeks on BTMs.

ACS Style

Verena Schwetz; Christian Trummer; Marlene Pandis; Martin R. Grübler; Nicolas Verheyen; Martin Gaksch; Armin Zittermann; Winfried März; Felix Aberer; Angelika Lang; Gerlies Treiber; Claudia Friedl; Barbara Obermayer-Pietsch; Thomas R. Pieber; Andreas Tomaschitz; Stefan Pilz. Effects of Vitamin D Supplementation on Bone Turnover Markers: A Randomized Controlled Trial. Nutrients 2017, 9, 432 .

AMA Style

Verena Schwetz, Christian Trummer, Marlene Pandis, Martin R. Grübler, Nicolas Verheyen, Martin Gaksch, Armin Zittermann, Winfried März, Felix Aberer, Angelika Lang, Gerlies Treiber, Claudia Friedl, Barbara Obermayer-Pietsch, Thomas R. Pieber, Andreas Tomaschitz, Stefan Pilz. Effects of Vitamin D Supplementation on Bone Turnover Markers: A Randomized Controlled Trial. Nutrients. 2017; 9 (5):432.

Chicago/Turabian Style

Verena Schwetz; Christian Trummer; Marlene Pandis; Martin R. Grübler; Nicolas Verheyen; Martin Gaksch; Armin Zittermann; Winfried März; Felix Aberer; Angelika Lang; Gerlies Treiber; Claudia Friedl; Barbara Obermayer-Pietsch; Thomas R. Pieber; Andreas Tomaschitz; Stefan Pilz. 2017. "Effects of Vitamin D Supplementation on Bone Turnover Markers: A Randomized Controlled Trial." Nutrients 9, no. 5: 432.

Review
Published: 19 October 2016 in International Journal of Environmental Research and Public Health
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Aside from its well-known effects on bone and mineral metabolism, vitamin D may also play an important role in extra-skeletal processes like immunologic diseases, cancer, or cardiovascular diseases. Even though meta-analyses showed that vitamin D supplementation reduces fractures, falls, and overall mortality, its potential benefits did not find universal acclaim. Several health care authorities published Recommended Dietary Allowances (RDAs) for vitamin D, most of them ranging from 600 to 800 international units (IU) per day, corresponding to a serum level of 25-hydroxyvitamin D of at least 20 ng/mL (50 nmol/L). However, studies conducted in the general population revealed a much lower overall intake of vitamin D than the proposed RDAs. Thus, strategies to increase the vitamin D intake in the general population, e.g., food fortification or vitamin D supplementation, are needed to match the existing evidence and recommendations. Therefore, several currently ongoing projects aim to investigate the effect of vitamin D supplementation in the general population and try to establish food-based solutions to improve vitamin D status.

ACS Style

Christian Trummer; Marlene Pandis; Nicolas Verheyen; Martin R. Grübler; Martin Gaksch; Barbara Obermayer-Pietsch; Andreas Tomaschitz; Thomas R. Pieber; Stefan Pilz; Verena Schwetz. Beneficial Effects of UV-Radiation: Vitamin D and beyond. International Journal of Environmental Research and Public Health 2016, 13, 1028 .

AMA Style

Christian Trummer, Marlene Pandis, Nicolas Verheyen, Martin R. Grübler, Martin Gaksch, Barbara Obermayer-Pietsch, Andreas Tomaschitz, Thomas R. Pieber, Stefan Pilz, Verena Schwetz. Beneficial Effects of UV-Radiation: Vitamin D and beyond. International Journal of Environmental Research and Public Health. 2016; 13 (10):1028.

Chicago/Turabian Style

Christian Trummer; Marlene Pandis; Nicolas Verheyen; Martin R. Grübler; Martin Gaksch; Barbara Obermayer-Pietsch; Andreas Tomaschitz; Thomas R. Pieber; Stefan Pilz; Verena Schwetz. 2016. "Beneficial Effects of UV-Radiation: Vitamin D and beyond." International Journal of Environmental Research and Public Health 13, no. 10: 1028.

Original article
Published: 15 August 2016 in Metabolic Brain Disease
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Previous studies suggest that hyperprolactinaemia might have adverse effects on lipid and glucose metabolism. We therefore aimed to evaluate whether dopamine agonist treatment with cabergoline has significant effects on blood lipids, fasting glucose and HbA1c levels in patients with micro- or macroprolactinoma. In this retrospective observational study the main outcome measures are changes in parameters of glucose and lipid metabolism compared at hyperprolactinaemia and after achievement of normoprolactinaemia by cabergoline treatment. We enrolled 53 study participants (22 females; median [interquartile range] age: 40.0 [27.5 to 50.0] years), 22 (41.5 %) with micro-, and 31 (58.5 %) with macroprolactinomas. After a median follow-up of 9 months, prolactin levels decreased from 220.6 (80.7-913.4) to 11.2 (3.5-18.7) ng/mL (p < 0.001). There was a significant decrease in median levels of low-density lipoprotein (LDL) from 121.6 (±39.4) to 110.6 mg/dl (±37.6, p = 0.005) and total cholesterol from 191 (168.5-241) to 181 mg/dl (162-217, p < 0.001), but no change in high-density lipoprotein (HDL), triglycerides, fasting glucose and HbA1c. We observed a significant increase in testosterone in men and in oestradiol in women. In linear regression analyses using the change in total cholesterol or LDL as dependent, and the change in prolactin, oestradiol, and testosterone as independent variables, no significant predictor of the change in total cholesterol or LDL was identified. In patients with prolactinomas, normalisation of elevated prolactin levels by cabergoline treatment was accompanied by significant reductions in LDL and total cholesterol. Further studies are warranted to confirm our findings and to evaluate the clinical implications of lipid levels in the monitoring and treatment of patients with prolactinomas.

ACS Style

Verena Schwetz; Rosaria Librizzi; Christian Trummer; Georg Theiler; Claudia Stiegler; Thomas R. Pieber; Barbara Obermayer-Pietsch; Stefan Pilz. Treatment of hyperprolactinaemia reduces total cholesterol and LDL in patients with prolactinomas. Metabolic Brain Disease 2016, 32, 155 -161.

AMA Style

Verena Schwetz, Rosaria Librizzi, Christian Trummer, Georg Theiler, Claudia Stiegler, Thomas R. Pieber, Barbara Obermayer-Pietsch, Stefan Pilz. Treatment of hyperprolactinaemia reduces total cholesterol and LDL in patients with prolactinomas. Metabolic Brain Disease. 2016; 32 (1):155-161.

Chicago/Turabian Style

Verena Schwetz; Rosaria Librizzi; Christian Trummer; Georg Theiler; Claudia Stiegler; Thomas R. Pieber; Barbara Obermayer-Pietsch; Stefan Pilz. 2016. "Treatment of hyperprolactinaemia reduces total cholesterol and LDL in patients with prolactinomas." Metabolic Brain Disease 32, no. 1: 155-161.

Multicenter study
Published: 01 March 2016 in Bone
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Osteocalcin (OC), an aboundant non-collagenous bone protein, is inversely associated with parameters of glucose metabolism. Interactions between bone tissue and energy metabolism have not been thoroughly investigated during childhood. This study investigated OC, metabolic parameters and anthropometric characteristics in normal weight and overweight/obese children. This study comprised 108 (46 normal weight/62 overweight/obese) Swedish 2-9year old children. Anthropometric data, insulin, glucose, glycosylated haemoglobin (HbA1c), HOMA index, vitamin D, adiponectin, total OC, carboxylated OC (cOC) and undercarboxylated OC (ucOC) were analysed. No difference was found for total OC between the normal and overweight/obese groups, with a mean (±SD) value of 82.6 (±2.8) ng/mL and 77.0 (±2.4) ng/mL, (P=0.11), respectively. Overweight children had lower cOC levels, mean 69.1 (±2.2) ng/mL, vs. normal weight children, mean 75.6 (±2.5) ng/mL (P=0.03). The mean ucOC levels of 7.9 (±0.4) ng/mL in overweight children did not differ vs. normal weight children, mean level 7.0 (±0.4) ng/mL, (P=0.067). None of the three OC forms correlated with any of the measured parameters. The cOC levels were lower in overweight children. There was no correlation between the three OC forms and any of the measured anthropometric or metabolic parameters. OC has been suggested to have a possible metabolic role, but in general the current study in prepubertal children does not support the hypothesis of an association between OC and a positive metabolic profile.

ACS Style

Bojan Tubic; Per Magnusson; Staffan Mårild; Monica Leu; Verena Schwetz; Isabelle Sioen; Diana Herrmann; Barbara Obermayer-Pietsch; Lauren Lissner; Diana Swolin-Eide. Different osteocalcin forms, markers of metabolic syndrome and anthropometric measures in children within the IDEFICS cohort. Bone 2016, 84, 230 -236.

AMA Style

Bojan Tubic, Per Magnusson, Staffan Mårild, Monica Leu, Verena Schwetz, Isabelle Sioen, Diana Herrmann, Barbara Obermayer-Pietsch, Lauren Lissner, Diana Swolin-Eide. Different osteocalcin forms, markers of metabolic syndrome and anthropometric measures in children within the IDEFICS cohort. Bone. 2016; 84 ():230-236.

Chicago/Turabian Style

Bojan Tubic; Per Magnusson; Staffan Mårild; Monica Leu; Verena Schwetz; Isabelle Sioen; Diana Herrmann; Barbara Obermayer-Pietsch; Lauren Lissner; Diana Swolin-Eide. 2016. "Different osteocalcin forms, markers of metabolic syndrome and anthropometric measures in children within the IDEFICS cohort." Bone 84, no. : 230-236.

Journal article
Published: 01 June 2015 in Endocrinology, Diabetes & Metabolism Case Reports
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Summary Cushing's syndrome (CS) due to ectopic ACTH production accounts for about 10% of all types of CS and is frequently associated with metabolic alkalosis. Treatment of CS involves surgical resection and/or medical therapy to control hypercortisolism. We present the case of an 80-year-old woman affected by CS due to an unknown cause. The patient had severe metabolic alkalosis with refractory hypokalemia. To treat the underlying CS, fluconazole was initiated due to unavailability of ketoconazole. In spite of markedly decreasing cortisol levels, metabolic alkalosis persisted. Treatment of metabolic alkalosis with acetazolamide was thus initiated and pH levels successfully lowered. This case report shows that hypercortisolism can be effectively treated with fluconazole in cases where ketoconazole is unavailable or not tolerated and that persistent severe metabolic alkalosis caused by glucocorticoid excess can be safely and successfully treated with acetazolamide. Learning points Hypercortisolism can be effectively treated with fluconazole where ketoconazole is unavailable or not tolerated. Glucocorticoid excess can cause severe metabolic alkalosis. Persistent severe metabolic alkalosis can be safely and successfully treated with acetazolamide.

ACS Style

Verena Schwetz; Felix Aberer; Claudia Stiegler; Thomas R Pieber; Barbara Obermayer-Pietsch; Stefan Pilz. Fluconazole and acetazolamide in the treatment of ectopic Cushing's syndrome with severe metabolic alkalosis. Endocrinology, Diabetes & Metabolism Case Reports 2015, 2015, 150027 .

AMA Style

Verena Schwetz, Felix Aberer, Claudia Stiegler, Thomas R Pieber, Barbara Obermayer-Pietsch, Stefan Pilz. Fluconazole and acetazolamide in the treatment of ectopic Cushing's syndrome with severe metabolic alkalosis. Endocrinology, Diabetes & Metabolism Case Reports. 2015; 2015 (1):150027.

Chicago/Turabian Style

Verena Schwetz; Felix Aberer; Claudia Stiegler; Thomas R Pieber; Barbara Obermayer-Pietsch; Stefan Pilz. 2015. "Fluconazole and acetazolamide in the treatment of ectopic Cushing's syndrome with severe metabolic alkalosis." Endocrinology, Diabetes & Metabolism Case Reports 2015, no. 1: 150027.