Estradiol promotes neuronal growth, transmission, survival, myelinization, plasticity, synaptogenesis, and dendritic branching and it improves cognitive function. Alzheimer’s disease (AD) is characterized by amyloid plaques, neurofibrillary tangles, and the loss of neuronal connection in the brain. Genomic analysis has concluded that hypoestrogenism influences the APOE gene and increases the risk of AD. Premature ovarian insufficiency (POI) is defined as oligo/amenorrhea in women below 40 years of age, low estradiol, and high-gonadotropin levels. Early symptoms and signs of POI must be detected in time in order to prevent subsequent complications, such as Alzheimer’s disease. Meta-analysis has shown favorable effects of estrogen in preventing Alzheimer’s. We measured some of the typical markers of AD in women with POI such as interleukin 6 (IL-6), interleukin 8 (IL-8), tissue necrosis factor α (TNFα), TAU1, TREM2, and amyloid precursor proteins (APP). While FSH, LH, and IL-8 were significantly higher in POI group, compared to controls, testosterone and DHEAS were lower. A significant decrease in IL-6 was found in the POI group during a 6-month therapy, as well as an increase in amyloid precursor proteins. CONCLUSION: Neurological complications of POI, such as declining short-term memory, cognitive function, and dementia, have to be promptly stopped by initiating estro-progestogen therapy in POI. A long-term continuation of the therapy would be strongly advised.

Background and Objectives: Chronic inflammation (CIn) is common among peritoneal dialysis (PD) patients and contributes to adverse outcomes. However, the prognostic value of the neutrophil-to-lymphocyte ratio (NLR) and fibrinogen-to-albumin ratio (FAR) in PD remains uncertain. Methodology: In this prospective cohort study, 65 PD patients were followed for 18 months. Baseline demographic, clinical and laboratory data were collected and inflammatory indices were calculated. The composite outcome was all-cause mortality or transfer to hemodialysis (HD). Logistic regression analyses were used to identify independent predictors of outcomes. Results: Over the 18-month follow-up, 23 patients (35.4%) died and 13 (20.0%) transferred to HD. Patients with adverse outcomes had higher baseline FAR, C-reactive protein (CRP) and serum glucose (Glc) levels and lower triglycerides (TG). In multivariate analysis, higher FAR (OR 5.28, 95% CI 1.16–24.12), CRP (OR 1.28, 95% CI 1.02–1.62) and PTH (OR 1.01, 95% CI 1.00–1.01) were independently associated with adverse outcomes, while NLR showed marginal significance. In the mortality-only model, FAR (OR 3.99, 95% CI 1.17–13.61) and PTH remained significant predictors. Conclusions: FAR demonstrated a significant prognostic association with mortality and composite adverse outcomes in PD patients, whereas NLR had limited predictive value. Albumin-based inflammatory indices such as FAR may complement established markers for risk stratification. Larger multicenter studies are warranted to validate these findings.

Fetuin A is a major systemic inhibitor of vascular calcifications. The aim of this study was to examine association of single nucleotide polymorphisms (SNP) in the gene for fetuin-A with fetuin-A serum levels, coronary arteries calcification (CAC) and mortality in renal transplant (RT) and chronic kidney (CKD) patients. This study included 88 patients (42 stable RT patients at least 6 months after transplantation and 46 CKD patients, stage 2-5 not requiring dialysis) followed five years. Detection and analysis of fetuin A gene polymorphisms in positions C742T (Thr248Met; rs4917) and C766G (Thr256Ser; rs4918) were performed using PCR method. Respondents with allele 742T had at the same time 766G. Combined genotypes TT/GG had lower serum fetuin A levels than CT /CG and CC/CC. Predictors of CAC in univariate analysis were age (p=0,000), serum fetuin-A levels (p=0.011) and rs 4917 polymorphism (p=0.021) while multivariate determined age (p=0.001) and fetuin-A levels (p=0.031). Patients who were homozygous for variant 742T and 766G (combined genotype TT/GG) had lowest survival rate. Our results suggest that allele 742T and 766G in gene for fetuin-A were associated with lower serum fetuin-A levels, higher CAC occurrence and higher mortality rate in RT and CKD patients.

Background: Less than 0.1% of ovarian cancers are ovarian steroid cell tumors, which are very uncommon sex cord-stromal neoplasms. A rare and usually benign form, stromal luteomas primarily affect postmenopausal women. These tumors can have major hormonal consequences despite their small size. The most common symptom is estrogen excess; androgen release with virilization is uncommon and might be challenging to spot, especially when imaging is subtle. Case Presentation: A 57-year-old postmenopausal woman presented with a three-year history of escalating hyperandrogenism, which included clitoromegaly, frontotemporal hair thinning, deeper voice, and quickly deteriorating hirsutism. Laboratory analyses revealed significantly elevated serum testosterone levels, reaching the male reference range, accompanied by reduced gonadotropins. Androstenedione and DHEAS levels were within normal ranges. Cushing’s syndrome and congenital adrenal hyperplasia were excluded. Although transvaginal color Doppler ultrasonography revealed asymmetric ovarian enlargement of the left ovary, initial imaging revealed neither ovarian nor adrenal tumors. The patient underwent a bilateral oophorectomy performed laparoscopically. A 1.5-cm steroid cell tumor of the left ovary, compatible with stromal luteoma, was verified by histopathology and immunohistochemistry. Following surgery, testosterone levels rapidly returned to normal, while virilizing features gradually regressed. Conclusions: This example highlights how, even in cases when initial imaging is unremarkable, postmenopausal women with rapid virilization and noticeably higher testosterone levels should be evaluated for rare androgen-secreting ovarian tumors. A timely diagnosis requires a complete assessment of ovarian morphology and a thorough endocrine evaluation. Both biochemical abnormalities and clinical signs can be resolved with surgical excision, which offers a definitive treatment.