scholarly journals Hypertension in pregnancy: Role of body mass index, insulin resistance, aldosterone, and calcium homeostasis

2019 ◽  
Vol 21 (5) ◽  
pp. 624-626 ◽  
Author(s):  
Decio Armanini ◽  
Alessandra Andrisani ◽  
Guido Ambrosini ◽  
Gabriella Donà ◽  
Luciana Bordin ◽  
...  
2001 ◽  
Vol 86 (8) ◽  
pp. 3761-3767 ◽  
Author(s):  
Héctor F. Escobar-Morreale ◽  
Rosa M. Calvo ◽  
José Sancho ◽  
José L. San Millán

To evaluate the role of TNF-α in the pathogenesis of hyperandrogenism, we have evaluated the serum TNF-α levels, as well as several polymorphisms in the promoter region of the TNF-α gene, in a group of 60 hyperandrogenic patients and 27 healthy controls matched for body mass index. Hyperandrogenic patients presented with mildly increased serum TNF-α levels as compared with controls (mean[median] ± sd: 7.2[7.0] ± 3.3 pg/ml vs. 5.6[4.4] ± 4.0 pg/ml, P < 0.02). Although no differences in body mass index and insulin resistance indexes were observed between patients and controls, when subjects were classified by body weight, serum TNF-α was increased only in lean patients as compared with lean controls, but this difference was not statistically significant when comparing obese patients with obese controls. The TNF-α gene polymorphisms studied here (−1196C/T, −1125G/C,− 1031T/C, −863C/A, −857C/T, −316G/A, −308G/A, −238G/A, and− 163G/A) were equally distributed in hyperandrogenic patients and controls. However, carriers of the −308A variant presented with increased basal and leuprolide-stimulated serum androgens and 17-hydroxyprogesterone levels when considering patients and controls as a group. No differences were observed in serum TNF-α levels, body mass index, and insulin resistance indexes, depending on the presence or absence of these variants. In conclusion, our present results suggest that the TNF-α system might contribute to the pathogenesis of hyperandrogenism, independent of obesity and insulin resistance. However, elucidation of the precise mechanisms underlying the relationship between the TNF-α system and androgen excess is needed before considering TNF-α as a significant contributing factor to the development of hyperandrogenism.


Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Shengxu Li ◽  
Xu Xiong ◽  
Camilo Fernandez ◽  
Wei Chen ◽  
Sathanur R Srinivasan ◽  
...  

Background: Few studies have examined whether hypertension in pregnancy imposes long-term cardiovascular risk compared to a normal pregnancy. The objective of this study was to examine if previous history of hypertension in pregnancy is a risk for hypertension after pregnancy. Methods: A case-control analysis was performed using the Bogalusa Heart Study database. Cases were defined as women whose systolic blood pressure ≥140 mmHg or diastolic ≥ 90 mmHg, or having hypertension treatment. Controls were defined as women with normal blood pressure. After exclusions, 604 women (67% white and 33% black, aged 32-44 years) were included for analysis. Univariable and multivariable logistic regression were used to estimate the odds ratio (OR) and 95% confidence interval (CI). Results: The prevalence of hypertension in women was 12.1% (73/604). Hypertensive women had higher proportion of previous history of hypertension in pregnancy (25/73, 34%) than normotensive controls (83/531, 13.7%), with an OR of 2.81 (95% CI: 1.64-4.81). After adjustment for age, race, body mass index and smoking, adjusted OR (aOR) of having previous history of hypertension in pregnancy for developing hypertension later was 1.36 (1.00-3.75). In addition, age, black ethnicity and body mass index were associated with hypertension, with aORs of 1.16 (1.09-1.25), 3.73 (2.13-6.52), and 1.09 (1.05-1.13), respectively. Conclusions: Hypertension in pregnancy may be associated with an increased risk of hypertension in later life. Further studies are needed to separate the effect of pregnancy-induced hypertension and pre-exiting chronic hypertension on the subsequent risk of hypertension later in life.


2019 ◽  
pp. 931-938
Author(s):  
Ľ. Cibičková ◽  
K. Langová ◽  
H. Vaverková ◽  
J. Lukeš ◽  
N. Cibiček

Coronary risk evaluation by conventional factors (age, gender, smoking, blood pressure and cholesterol) may further be specified by facets of the metabolic syndrome, namely insulin resistance, hypertriglyceridemia and obesity. Although obesity is usually defined as elevated body mass index (BMI), recent data indicate a superior role of waist circumference or hypertri-glyceridemic waist (HTGW) over BMI in the assessment of cardiometabolic risk. In dyslipidemic patients, the specific contributions of risky waist, HTGW or BMI have not been evaluated as yet. 686 dyslipidemic subjects (322 males and 364 females) were enrolled into a cross-sectional study. In each subject basic antropometry (i.e. waist circumference, HTGW, BMI) and laboratory parameters of lipid profile and insulin resistance were determined. Cardiometabolic risk was given by fulfilling the criteria (harmonized definition) of metabolic syndrome. The significance of risky waist, HTGW and BMI were assessed by comparing the respective predictive values for the presence of metabolic syndrome. Dyslipidemic patients with risky waist, HTGW or high BMI have a more atherogenic lipid profile and higher insulin resistance compared to those without risky waist, HTGW or high BMI. Risky waist is stronger predictor of metabolic syndrome (PPV 66 %, NPV 90 %) and thus posesa greater cardiometabolic risk than higher BMI per se does (PPV 42 %, NPV 97 %). The contribution of triglycerides (i.e. HTGW) to these predictive values is marginal (PPV 66 %, NPV 92 %). The present results highlight the superior role of waist circumference as a screening tool over BMI for the evaluation of cardiometabolic risk in dyslipidemic subjects. HTGW brings little additional benefit in risk stratification. Lower BMI proved to be optimal for identifying the subjects with inferior risk.


2019 ◽  
Vol 4 (6) ◽  
pp. 150-156
Author(s):  
M. M. Kochuieva ◽  
◽  
V. G. Psarova ◽  
N. M. Kyrychenko ◽  
L. A. Ruban ◽  
...  

2020 ◽  
Vol 66 (1) ◽  
pp. 71-78
Author(s):  
Lev Bershteyn ◽  
Aleksandr Ivantsov ◽  
Aglaya Ievleva ◽  
A. Venina ◽  
I. Berlev

The aim of this study was to evaluate steroid receptors’ status of tumor tissue in different molecular biological types of endometrial cancer (EC), subdivided according to the current classification, and their colonization by lymphocytic and macrophage cells, taking into account body mass index of the patients. Materials and methods: Material from treatment-naive patients with EC (total n = 229) was included; the number of sick persons varied depending on the method used. The average age of patients was close to 60 years, and about 90% of them were postmenopausal. It was possible to divide the results of the work into two main subgroups: a) depending on the molecular biological type of the tumor (determined on the basis of genetic and immunohistochemical analysis), and b) depending on the value of the body mass index (BMI). The latter approach was used in patients with EC type demonstrating a defective mismatch repair of the incorrectly paired nucleotides (MMR-D) and with a type without characteristic molecular profile signs (WCMP), but was not applied (due to the smaller number of patients) in EC types with a POLE gene mutation or with expression of the oncoprotein p53. According to the data obtained, when comparing various types of EC, the lowest values of Allred ER and PR scores were revealed for POLE-mutant and p53 types, while the “triple-negative” variant of the tumor (ER-, PR-, HER2/neu-) was most common in POLE-mutant (45.5% of cases) and WCMP (19.4%) types of EC. The p53+ type of EC is characterized by inclination to the higher expression of the macrophage marker CD68 and lymphocytic Foxp3, as well as mRNA of PD-1 and SALL4. In addition to the said above, for WCMP type of EC is peculiar, on the contrary, a decrease in the expression of lymphocytic markers CD8 (protein) and PD-L1 (mRNA). When assessing the role of BMI, its value of >30.0 (characteristic for obesity) was combined with an inclination to the increase of HER-2/neu expression in the case of MMR-D EC type and to the decrease of HER-2 /neu, FOXp3 and ER expression in WCMP type. Conclusions: The accumulated information (mainly describing here hormonal sensitivity of the tumor tissue and its lymphocytic-macrophage infiltration) additionally confirms our earlier expressed opinion that the differences between women with EC are determined by both the affiliation of the neoplasm to one or another molecular biological type (subdivided according to the contemporary classification), as well as by body mass value and (very likely) the associated hormonal and metabolic attributes.


Author(s):  
Ana P. Sehn ◽  
Anelise R. Gaya ◽  
Caroline Brand ◽  
Arieli F. Dias ◽  
Roya Kelishadi ◽  
...  

AbstractObjectivesThe combination of sleep duration, television (TV) time and body mass index (BMI) may be related to the alteration of cardiometabolic risk. However, there are few studies that use these variables grouped, and showing the moderating role of age. This study aimed to verify if the combination of sleep duration, TV time and BMI is associated with cardiometabolic risk and the moderating role of age in this relationship in youth.MethodsCross-sectional study conducted with 1411 adolescents (611 male), aged 10–17 years. Sleep duration, TV time and BMI were assessed and grouped into eight categories. Cardiometabolic risk was assessed by a continuous metabolic risk score, including the following variables: low HDL-cholesterol, elevated triglycerides, dysglycemia, high systolic blood pressure, high waist circumference and low cardiorespiratory fitness. Generalized linear models were used to test moderation of age in the relationship between the eight categories of sleep duration/television time/BMI with cardiometabolic risk.ResultsCardiometabolic risk factor showed association with all overweight or obesity independent of sleep time and TV time. Age moderated the relationship between sleep duration/television time/BMI with cardiometabolic risk. This association was stronger in younger adolescents (11 and 13 years), indicating that individuals with inadequate sleep, prolonged TV time and overweight/obesity present higher cardiometabolic risk values when compared to 15-year-old adolescents.ConclusionOverweight/obesity, independently of sleep duration and TV time, is the main risk factor for cardiometabolic disorders in adolescence. When moderated by age, younger adolescents that presented the combination of risk factors had higher cardiometabolic risk.


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