Faculty of Medicine
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Item type:Publication, Incidence of Cushing’s Disease in the Republic of North Macedonia for the period from 2013 to 2020, according to data derived from the national health system.(University Clinic of Endocrinology, Diabetes and Metabolic Disorders, Medical Faculty, University “Ss. Cyril and Methodius” - Skopje, 2022-10-13); ;Zhivkovic Hristova, Marija; ; Stevchevska, AleksandraCushing’s disease is a rare endocrine disorder characterized by increased secretion of adrenocorticotrophic hormone (ACTH) by a corticotropic pituitary adenoma. In our country there are no data on the incidence of Cushing’s disease and only sporadic case report have been published. Aim: To find the annual incidence rates of Cushing’s disease in the Republic of North Macedonia for the period from 2013 to 2020, based on data derived from the National eHealth System. Methods: The National eHealth System was searched for all patients with ICD-10 diagnosis E24.0 in their electronic healthcare records. The annual incidence rate of Cushing’s disease was estimated per 106 persons, according to the initial occurrence of the diagnosis. The National Data records from State Statistical Office (MAKSTAT) for the population per year were used. Results: The number of newly diagnosed registered cases with Cushing’s disease was 3 in year 2013, 4 in 2014, 5 in 2015, 2 in 2016, 4 in 2017, 4 in 2018 and there were no new cases diagnosed in 2019 and 2020. Compared to the registered number of citizens by years, the annual incidence rate of Cushing’s disease was 1.45 per one million for 2013; 1.93 /106 for 2014; 2.4/106 for 2015; 0.96 /106 for 2016; 1.93 /106 for 2017 and 1.92 /106 for 2018. The average annual incidence rate for Cushing’s disease was 1.77 cases per 100000 inhabitants. Conclusion: The worldwide incidence rate of Cushing’s disease is 1.2-2.4 cases in a million. The average annual incidence rate in our country corresponds to the reported global incidence. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Body fat distribution changes during weight loss determined by dual-enerrgy X-ray absorptiometric indexes(2019); ;Zivkovikj, Marija - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Unilateral Graves Orbitopathy-case report(Bioscientifica, 2022-08) ;Stevchevska, Aleksandra; ; Graves’ Orbitopathy (GO) is the most common extra thyroidal feature of autoimmune thyroid disease presentation. It is characterized by development of orbital inflammation that involves both, adipose tissue and extra-ocular muscles. The condition is associated with increased psychological burden and in severe cases may lead to optic nerve damage, causing blindness. While most patients with GO present with bilateral disease, asymmetric or unilateral GO may affect a significant proportion of patients diagnosed with the condition. It has been shown that older age, male sex, active and severe disease are the most significant factors for development of unilateral form of the disease. The pathophysiological mechanisms of unilateral presentation of GO still remains uncertain. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Assessment of Prevalence and Risk Factors for Diabetic Retinopathy in Patients with Type 1 and Type 2 Diabetes Examined at a Tertiary Care(Walter de Gruyter GmbH, 2023-07-01); ; ;Nakova, Valentina Velkoska; Guceva Laban, Nevenka<jats:title>Abstract</jats:title> <jats:p> <jats:bold>Introduction</jats:bold>: Diabetic retinopathy (DR) is a microvascular complication of diabetes mellitus and the leading cause of visual impairment and blindness. The aim of the study was to estimate and compare the prevalence of DR and to determine an association between DR and systemic risk factors in hospitalized type 1 (DMT1) and type 2 (DMT2) diabetic patients.</jats:p> <jats:p> <jats:bold>Material and methods</jats:bold>: We analyzed 260 patients with diabetes, 43 with DMT1 and 217 with DMT2. The following data were collected: age, gender, type and duration of diabetes, glycemic control, blood pressure, estimated glomerular filtration rate, ophthalmologic examinations and routine biochemical parameters.</jats:p> <jats:p> <jats:bold>Results</jats:bold>: Out of the total number of 260 patients, 77 (29.6%) had non-proliferative DR (NPDR), 21 (8.1%) had proliferative DR (PDR), 29 (11.1%) had diabetic macular edema (DME), and 69 (23.5%) had diabetic cataracts. Forty-three (16.5%) patients were previously diagnosed with DMT1 and 217 (83.5%) with DMT2. The duration of diabetes was not significantly longer in DMT1 (12.8±11.2 years) in comparison to DMT2 (11.07±8.1 years). The prevalence of NPDR and PDR did not differ statistically in either groups. DME was more prevalent in DMT2 than in DMT1 (P<0.05). Diabetic cataract was found in 26.7% vs. 6.7% of patients with DMT2 and DMT1, respectively (p<0.01). The duration of diabetes significantly correlated with NPDR and PDR in DMT1 (r=o.31, p<0.05; r=0.55, p<0.001, respectively). In DMT2, significant correlations were found between the duration of diabetes and cataract, NPDR, PDR and DME (r=0.31, p<0.001; r=0.43 p<0.01, r=0.16 p<0.05 and r=0.20 p<0.01, respectively). Fasting plasma glucose (FPG) significantly correlated with PDR (r=0.258, p<0.05), while HbA1c with DME (r= 0.15 p<0.05).</jats:p> <jats:p> <jats:bold>Conclusion</jats:bold>: The duration of diabetes and hyperglycemia were associated with DR in both types of diabetes.</jats:p> - Some of the metrics are blocked by yourconsent settings
Item type:Publication, SP136DEGREE OF CHRONIC KIDNEY DISEASE (CKD) IN TYPE 2 DIABETIC PATIENTS INCREASE THE PREVALENCE OF FOOT ULCERATION(Oxford University Press (OUP), 2018-05-01); ; ;Busletikj Rambabova, Irena - Some of the metrics are blocked by yourconsent settings
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Item type:Publication, A CASE OF IDIOPATHIC OSTEOPOROSIS IN 43 YEARS OLD MALE PATIENT(Scientific association of endocrinologists and diabetologists of Macedonia, 2022-10) ;Stevchevska Aleksandra ;Todorova Biljana; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, LONGTERM DEFICIENT CALCIUM INTAKE ASSOCIATION WITH BONE TURNOVER MARKERS, HIP AND SPINE BONE MINERAL DENSITY IN POSTMENOPAUSAL WOMEN(2019); ;Zivkovic, MarijaIntroduction: Calcium (Ca) deficit is very important risk factor for osteoporosis development and bone turnover markers disturbance. Objective: The influence of long-term Ca deficit on bone turnover, bone loss and osteoporotic risk was determined. Material and methods: Postmenopausal women (n=120) were divided into 3 groups according to their mean Ca intake: 1st gr. with Ca intake <500mg/day, 2nd gr. 500-1000mg/day and 3rd gr. >1000mg/day. Bone resorption marker C-terminal telopeptide of type I collagen (CTX) was determined as well as spine and hip bone mineral density (BMD) and T-score with dual-energy Xray absorptiometry (DXA). Results: CTX levels were 0.58±0.23ng/ml in the 1st gr, 0.48±0.22ng/ml in the 2nd gr. and 0.38±0.22ng/ml in the 3rd gr., and they were significantly different among the groups (p<0.007). Mean hip neck BMD was 0.76±0.08gr/cm2 in the 1st gr, 0.82±0.09gr/cm2 in the 2nd gr, 0.86±0.12 gr/cm2 in the 3rd gr (p<0.022). Mean neck T-score was -1.67±0.81 in the 1st gr, -1.39±0.84 in the 2nd gr and -0.98±1.12 in the 3rd gr (p<0.023). Mean % of hip BMD reduction in the 1st gr was 27.5±11.33%, in the 2nd gr 19.56±10.62% and in the 3rd gr it was 16.5±11.2% (p<0.005). Mean spine BMD in the 1st gr was 0.89±0.14gr/cm2 , in the 2nd gr 0.93±0.15gr/cm2 and in the 3rd gr 1.02±0.1gr/cm2 (p<0.05). Conclusion: Long-term lower Ca intake induces increased bone turnover, increased bone resorption with significantly higher CTX levels, significant hip and spine BMD and T-score lower values, indicating increased bone loss and increased osteoporotic risk. Bone turnover markers are important in determining of the osteoporotic risk in postmenopausal women with deficient Ca intake. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, ANTHROPOMETRIC INDEXES OF VISCERAL OBESITY RELATIONS TO DYSLIPIDEMIC PROFILE IN METABOLIC SYNDROME(2019); ; Zivkovic, MarijaIntroduction: Visceral obesity and dyslipidemia are the main characteristics of the metabolic syndrome. Objective: The relationship of abdominal sagittal diameter to thigh circumference ratio (SD/T) with anthropometric indexes of visceral obesity waist circumference (WC) and waist hip ratio (WHR) was determined as well as their association with lipid levels. Material and methods: Triglyceride (TG), cholesterol (C), HDL and LDL levels, LDL/HDL, C/HDL as well as WC, WHR and SD/T were determined in 250 healthy women divided into 3 groups according to body fat distribution by their WHR values: 1stgr WHR<0.85; 2ndgr WHR (0.85-1.0) and 3rdgr WHR>1.0. Results: SD/T correlated significantly positively with TG and C (p<0.0001), LDL (p<0.006), LDL/HDL and C/HDL (p<0.0001), also with WC and WHR (p<0.0001), and negatively with HDL (p<0.001). WC and SD/T levels were significantly higher in the 3rd gr (125.16±15.26cm; 0.49±0.38) compared to the 2nd gr (109±14cm; 0.39±0.43) and the 1stgr (88±17cm; 0.32±0.37)(p<0.0001). TG levels in the 3rd gr (1.87±0.69ng/ml) were significantly higher compared to the 1st gr (1.03±0.42ng/ml) and the 2ndgr (1.69±0.92ng/ml) (p<0.0001). HDL in the 3 rd gr was (0.95±0.23ng/ml), significantly lower compared to the 1stgr. (1.24±0.27ng/ml) (p<0.001) and 2n dgr (1.07±0.39ng/ml) (p<0.028). LDL, C/HDL, LDL/HDL and C levels were also significantly higher in the 3rdgr. Conclusion: Visceral obesity was characterized with increased values of WHR, WC and SD/T, which were positively related to dyslipidemic profile. Positive relation of SD/T with atherogenic lipids, atherogenic indexes, WHR and WC, and negative relation with HDL, confirmed it as an important anthropometric diagnostic parameter of visceral obesity in metabolic syndrome. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, BODY FAT DISTRIBUTION CHANGES DURING WEIGHT LOSS DETERMINED BY DUAL-ENERGY X-RAY ABSORPTIOMETRIC INDEXES OF ABDOMINAL OBESITY(2019); ;Zivkovic, MarijaMladenovska, Ivana
