Background: Thyroid dysfunction includes hyper- and hypofunction of the thyroid gland (hyperthyroidism and hypothyroidism). The spectrum encompasses both subclinical and clinical disease presentation. The etiology is vast and varied, as are the risk factors and simptoms. Objective: The main aim of the research is to indicate the leading symptom for initial thyroid hormone status evaluation, as well as to identify the distribution of positive and negative test results, and specific disorders according to sex and age groups. Methods: The research is designed as a retrospective, clinical, descriptive study. There were 500 participants included, 355 female and 145 male. Patients were referred to the Department of endocrinology by their primary care physicians. The data was collected through patient documentation. Results: The study included 500 participants, 71% of diagnostic requests made were for women. 80% of subjects had normal thyroid hormone status, p<0.001. Most requests were made for the 41-60 age group, p<0.001. Women had similar number of positive and negative test outcomes, as well as men. When it comes to the age groups, outcomes were similar in all of them, 15-23% positive and 77-85% negative. There were significant differences in the type of symptom expressed in both men and women, as well as all the age groups. Men reported high blood pressure as the most common symptom (30.3%), while women reported weight gain (22.3%). In the 18-25 and 26-40 age groups most common symptom belongs to the category of other. Age group of 41-60 reported weight gain as the most common symptom, while in participants older than 60, high blood pressure is proven to be the most common. Hypothyroidism is the most common disorder in both men and women, as well as in all age groups. Conclusion: It is statistically proven that there were more requests made for women, and older age groups. Leading symptom for initial thyroid hormone status evaluation is high blood pressure. There is no statistically significant difference in distribution of thyroid disorders according to sex or age groups.

Introduction Diabetes mellitus(DM) is considered an independent cardiovascular risk factor. Having in mind concomitant occurence of diabetes and other cardiovascular risk factors, it is expected that patients with poor glucoregulation will have more cardiovascular risk factors and higher cardiovascular risk than patients with good glucoregulation. Aim To compare cardiovascular risk and cardiovascular risk factors between patients with poorly controlled and patients with well-controlled Diabetes mellitus. Material and Methods Hundered ten patients aged 40-70 years suffering from Diabetes mellitus type 2 were included. Research is designed as a retrospective, descriptive study. Patients with glycosylated hemoglobin (HbA1c) > 7% were considered to have poorly controlled diabetes. The following data and parameters were monitored: age,sex, family history, data on smoking and alcohol consumption, BMI (body mass index), blood pressure, blood glucose, total cholesterol, triglycerides, LDL, HDL, fibrinogen, uric acid. For the assessment of cardiovascular risk, the WHO / ISH (World Health Organization/International Society of hypertension) tables of the 10-year risk were used, and due to the assessment of the risk factors prevalence, the optimal values of individual numerical variables were defined. Results Differences in the mean values of systolic, diastolic blood pressure, fasting glucose, total cholesterol, LDL cholesterol are statistically significant higher in patients with poorly controlled diabetes. Hypertension more frequently occurre in patients with poorly controlled DM. The majority of patients with well-controlled DM belong to the group of low and medium cardiovascular risk, while the majority of patients with poorly controlled DM belong to the group of high and very high cardiovascular risk. In our research, there was a significant difference in cardiovascular risk in relation to the degree of DM regulation, and HbA1c proved to be an important indicator for the emergence of the CVD. Conclusion There are significant differences in certain risk factors between patients with poorly controlled and well controlled DM. Patients with poorly controlled diabetes mellitus have a higher cardiovascular risk than patients with well controlled diabetes. The value of HbA1c should be considered when assessing cardiovascular risk.

Our aim was to determine the incidence of prediabetes and risk of developing cardiovascular disease (CVD) in women with polycystic ovary syndrome (PCOS). This prospective, observational study included 148 women with PCOS, without Type 2 diabetes mellitus (T2DM) and CVD present at baseline. In the fasting blood samples, we measured lipids, glucose, and insulin levels during oral glucose tolerance test, levels of C-reactive protein (CRP), steroids, 25-hydroxyvitamin D (25-OHD), prolactin, thyroid-stimulating hormone, and parathyroid hormone. The follow-up period was 3 years. At baseline, prevalent prediabetes was present in 18 (12%) of PCOS cases and it progressed to T2DM in 5 (3%) of the cases. Incident prediabetes during the follow-up was noted in 47 (32%) women or 4.7 per 1000 persons/year. Prediabetes was associated with elevated body mass index (BMI) (odds ratio [OR] = 1.089, confidence interval [CI]: 1.010; 1.174, p = 0.026), high baseline levels of CRP (OR = 3.286, CI: 1.299; 8.312, p = 0.012), homeostatic model assessment - insulin resistance (IR) (OR = 2.628, CI: 1.535; 4.498, p < 0.001), and high lipid accumulation product (LAP) (OR = 1.009, CI: 1.003; 1.016, p = 0.005). Furthermore, prediabetes was associated with low 25-OHD (OR = 0.795, CI: 0.724; 0.880, p ≤ 0.05). In addition, cardiovascular risk in PCOS women with prediabetes was high (hazard ratio = 1.092, CI: 1.036; 1.128, p < 0.001). We showed association of prediabetes with high BMI, IR, markers of inflammation, LAP, and low serum 25-OHD concentration. IR appears to be more relevant than the other predictors of prediabetes risk in this study. PCOS women are considered as a high-risk population for prediabetes.

Introduction: Diabetes mellitus, the most frequent endocrinology disease is a predisposing factor for infections. Diabetic patients have 4,4 times greater risk of systemic infection than non diabetics. Aim: a) To determine the prevalence and characteristics of acute infectious diseases in hospitalized diabetics; b) To correlate values of blood glucose levels and HbA1c with acute infections in hospitalized diabetics; c) To identify the etiology of infectious diseases. Material and methods: The study included 450 diabetic patients hospitalized in the 24-month period in the Intensive care unit of the Clinic for Endocrinology, Diabetes and Metabolic Disorders CCUS. In 204 patients (45,3%) there was an acute infectious condition and the following data was registered: a) gender and age; b) basic illness; c) laboratory parameters of inflammation (Le, CRP); d) blood glucose upon admission, parameters of glucoregulation (HbA1c, fructosamine); e) type of infection; f) verification of etiological agent; g) late complications of diabetes; and h) outcome. Results: Out of 204 diabetic patients with infection, there was 35,3% men and 64,7% women. More than half of patients (61%) were in the age group 61-80 years. The most common primary disease was Diabetes mellitus type 2. HbA1c and fructosamine were significantly increased in diabetic patients with acute infection compared to diabetics without acute infection. There is a positive correlation between HbA1c levels and CRP, and blood glucose and CRP in diabetic patients with acute infection. Most frequent infections: urinary tract infection (70,0%), followed by respiratory infections (11,8%), soft tissue infections (10,3%), generalized–bacteremia / sepsis (6,9%). The most common cause of urinary infection and generalized infection was Escherichia colli. The most common bacteria causing soft tissue infections was Staphylococcus aureus. Conclusion: Almost half (45,3%) of hospitalized diabetic patients had acute infectious condition. They present most frequently in women, aged 61-80 years, with Type 2 Diabetes mellitus. HbA1c and fructosamine were significantly increased in diabetic patients with acute infection. There is a positive correlation between the parameters of inflammation and glucoregulation in diabetics with acute infection. Most frequent was a urinary tract infection and the most common causative agent was Escherichia coli. The most common cause of soft tissue infections was Staphylococcus aureus. Out of 21 patients with verified soft tissue infections, 18 of them (85,7%) had confirmed diagnosis of diabetic microangiopathy diabetica. A total of 96,1% of patients fully recovered.

INTRODUCTION Diabetes mellitus, the most frequent endocrinology disease is a predisposing factor for infections. Diabetic patients have 4,4 times greater risk of systemic infection than non diabetics. AIM a) To determine the prevalence and characteristics of acute infectious diseases in hospitalized diabetics; b) To correlate values of blood glucose levels and HbA1c with acute infections in hospitalized diabetics; c) To identify the etiology of infectious diseases. MATERIAL AND METHODS The study included 450 diabetic patients hospitalized in the 24-month period in the Intensive care unit of the Clinic for Endocrinology, Diabetes and Metabolic Disorders CCUS. In 204 patients (45,3%) there was an acute infectious condition and the following data was registered: a) gender and age; b) basic illness; c) laboratory parameters of inflammation (Le, CRP); d) blood glucose upon admission, parameters ofglucoregulation (HbA1c, fructosamine); e) type of infection; f) verification of etiological agent; g) late complications of diabetes; and h) outcome. RESULTS Out of 204 diabetic patients with infection, there was 35,3% men and 64,7% women. More than half of patients (61%) were in the age group 61-80 years. The most common primary disease was Diabetes mellitus type 2. HbA1c and fructosamine were significantly increased in diabetic patients with acute infection compared to diabetics without acute infection. There is a positive correlation between HbA1c levels and CRP, and blood glucose and CRP in diabetic patients with acute infection. Most frequent infections: urinary tract infection (70,0%), followed by respiratory infections (11,8%), soft tissue infections (10,3%), generalized-bacteremia / sepsis (6,9%). The most common cause of urinary infection and generalized infection was Escherichia colli. The most common bacteria causing soft tissue infections was Staphylococcus aureus. CONCLUSION Almost half (45,3%) of hospitalized diabetic patients had acute infectious condition. They present most frequently in women, aged 61-80 years, with Type 2 Diabetes mellitus. HbA1c and fructosamine were significantly increased in diabetic patients with acute infection. There is a positive correlation between the parameters of inflammation and glucoregulation in diabetics with acute infection. Most frequent was a urinary tract infection and the most common causative agent was Escherichia coli. The most common cause of soft tissue infections was Staphylococcus aureus. Out of 21 patients with verified soft tissue infections, 18 of them (85,7%) had confirmed diagnosis of diabetic microangiopathy diabetica. A total of 96,1% of patients fully recovered.

INTRODUCTION Dipeptidyl peptidase-4 (DPP-4) inhibitors are a new class of antihyperglycemic drugs that block degradation ofincretin hormones. GOAL To assess the effects oftreatment with DPP-4 inhibitors on glucoregulation and body weight in obese patients with type 2 diabetes mellitus. PATIENTS AND METHODS The study included 9 females and 9 males with type 2 diabetes (n=18), BMI=31.24 +/- 2,26 kg/m2, mean age 58 +/- 6,8 years. The patients have been thoroughly evaluated before treatment, and 6 months after treatment with DPP-4 inhibitor (sitagliptin) in combination with metformin. RESULTS After 6 months of treatment with DPP-4 inhibitors in combination with metformin HbAlc (-1,49%)., FBG (-3.75 mmol/L) and PBG (-5.79 mmol/L) significantly reduced (p=0.000). Mean body weight also significantly reduced (-12.5%; p=0.000). Reduction of mean fasting insulin was 5.46 mIU/L or 27% (p=0.000). Mean HOMA-IR change was -1.64 (p=0.000). Also there was significant decreasing of systolic blood pressure (p=0.001), cholesterol (p=0.004), triglycerides (p=0.001), LDL (p=0.002) and increasing of HDL (p=0.002). Hypoglycaemia was not registered in any of the patients. CONCLUSION These results show that in obese patients with type 2 diabetes, DPP-4 inhibitors treatment in combination with metformin was associated with improvements in glycaemic control, and a reduction in body weight.