scholarly journals Peculiarities of carbohydrate and lipid metabolism in infertile patients with clomifen-resistant form of polycystic ovarian syndrome and obesity

2021 ◽  
Vol 11 (10) ◽  
pp. 275-288
Author(s):  
V. Kaminsky ◽  
V. Chaika

Medical ovulation induction with clomiphene citrate is currently the first line treatment for anovulatory women with PCOS. Clomiphene resistance (failure to ovulate after taking clomiphene) is common, occurring in approximately 15% to 40% of women with PCOS. Resistance is associated with an increased body mass index. The aim of the study was to elucidate the characteristics of carbohydrate and lipid metabolism in patients with clomiphene-resistant PCOS and obesity. Material and methods. A comprehensive examination of 97 infertile patients with PCOS with obesity and clomiphene-resistant PCOS and 46 conditionally healthy normoovulatory women of control group K with 18.5 ≤ body mass index (BMI) < 25 kg/m2, without clinical or biochemical signs of hyperandrogenism, with ovarian volume less than 9 cm3 and without previously known endocrine disease. Clinical-anamnestic, anthropometric, sonographic, immunochemical, enzyme-linked immunosorbent assay, colorimetric, statistical research methods are used. Results and discussion. It was found that the most characteristic features of carbohydrate metabolism disorders in clomiphene-resistant women with PCOS and obesity are increased levels of hypoglycemic index, C-peptide, glucose levels after 2 h in oral glucose tolerance test, HOMA index; and of lipid metabolism - an increase in atherogenic factor, triglycerides, total cholesterol on the background of increased production of leptin and vaspin and decreased secretion of adiponectin, omentin and visfatin.. Conclusions. Visceral obesity plays an important role in the development of insulin resistance and hyperinsulinemia in infertile patients with clomiphene-resistant PCOS and obesity. This category of women in preconception training, before carrying out ovarian drilling or controlled ovarian stimulation, it is necessary to correct disorders of carbohydrate and lipid metabolism.

2021 ◽  
Vol 93 (8) ◽  
pp. 869-875
Author(s):  
Irina V. Kozlova ◽  
Anna P. Bykova

Aim. To determine clinical features and some mechanisms of osteosarcopenia development in patients with chronic pancreatitis (CP). Materials and methods. A casecontrol study was conducted on the basis of the Saratov State Clinical Hospital 5 in 20152018 of patients with CP. In a study of 161 patients with CP included, the control group 30 healthy individuals. Patients were divided into groups according to the etiology of CP: 79 with toxic-metabolic CP, 82 with biliary CP. To determine the risks of low-energy fractures, 154 patients were tested with the Fracture risk assessment tool (FRAX). Along with the standard examination, 30 patients with CP dual-energy X-ray absorptiometry was performed. To assess the state of skeletal muscles, body mass index was determined, hand-held dynamometry was performed, and a set of Short Physical Performance Battery (SPPB) tests was used. Along with the assessment of traditional risk factors for osteosarcopenia gender, age, state of reproductive function in women, body mass index, functional state of the pancreas (pancreas) the quantitative content of interleukins (IL)-2, 6, 8 in in colonic biopsies was analyzed by enzyme-linked immunosorbent assay (ELISA). Results. Bone disorders, according to densitometry, was detected in 70.0% of patients with CP, in 13.3% of the control group. Presarcopenia was detected in 62 (38.5%) patients with CP, sarcopenia in 34 (21.1%), in the control group presarcopenia and sarcopenia were not detected. Sarcopenia was statistically significantly more common in toxic-metabolic CP than in biliary CP (2=11.6; p0.001). Correlations of the lumbar spine T-score and IL-6 (r=-0.29; p=0.03), IL-8 (r=-0.29; p=0.04) were revealed. Correlations between sarcopenia and the concentration of cytokines in the in the colon mucosa in CP were determined (IL-2: r=0.44; p0.001; IL-6: r=0.48; p0.001; IL-8: r=0.42; p0.001). Conclusion. The development of osteopenia and sarcopenia syndromes in CP is interrelated and associated with both traditional risk factors and an increased concentration of cytokines in the in the colon mucosa.


1996 ◽  
Vol 134 (5) ◽  
pp. 549-553 ◽  
Author(s):  
Edelweiss F Tavares ◽  
Ivaldir S Dalbosco ◽  
Julio Abucham ◽  
Ewaldo MK Russo

Tavares EF, Dalbosco IS, Abucham J, Russo EMK. True insulin and intact proinsulin levels in acromegalic patients. Eur J Endocrinol 1996;134:549–53. ISSN 0804–4643 To determine whether proinsulin (PI) contributes significantly to the immunoreactive insulin (IRI) concentrations in acromegalics, we measure PI, "true insulin" and IRI in a group of acromegalics compared with a control group. Serum PI was determined by the immunofluroimetric assay (IFMA). Insulin was also determined by an IFMA that measures true insulin and by a radioimmunoassay (RIA). We performed an oral glucose tolerance test (OGTT) in a total group of 46 subjects: 10 controls with normal OGTT and body mass index <25 kg/m2 (control group I), 10 controls with normal OGTT and body mass index > 25 kg/m2 (control group II), 15 patients with active acromegaly and normal OGTT and 11 patients with active acromegaly and IGT. Plasma glucose, serum GH, insulin and proinsulin were measured in all OGTT samples. Basal levels of insulin-like growth factor I (IGF-I) were measured in acromegalics. Mean body mass index in acromegalics with normal and impaired glucose tolerance were significantly higher compared with control group I and similar when compared with control group II. Proinsulin increased during OGTT in acromegalics with impaired glucose tolerance compared to control group I, and only fasting proinsulin compared to control group II. In normal OGTT acromegalics, only fasting proinsulin was increased. The RIA insulin during OGTT was significantly higher for both acromegalic groups compared to control group I and only at fasting when compared with control group II. This difference was not evident when insulin was measured by IFMA. These results suggest that in acromegalics, hyperinsulinism measured by RIA was at least in part due to hyperproinsulinism. Ewaldo MK Russo, PO Box 20266, CEP 04034-970, Sáo Paulo, SP, Brazil


2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Wei Yang ◽  
Yun Li ◽  
Tian Tian ◽  
Li Wang

Aims. This study was to evaluate the association of serum vaspin concentrations with body mass index (BMI) among elderly patients (>60 years old). Methods. A total of 227 elderly individuals included 76 healthy with normal glucose tolerance, which divided into normal weight control (BMI < 25, n=38) and overweight or obese control (BMI ≥ 25, n=38) subgroups, and 150 T2DM patients, which divided into normal weight diabetes (BMI < 25, n=55), overweight diabetes (30 > BMI ≥ 25, n=52), and obese diabetes (BMI ≥ 30, n=43) subgroups. Relevant parameters were matched for age and gender ratio. Serum vaspin concentrations were measured by enzyme-linked immunosorbent assay. Results. Serum vaspin concentration was significantly higher in the T2DM than the healthy (451.9±32.6 versus 284.2±21.7, P<0.01). In the diabetic patients, the vaspin concentration was significantly higher in the obese group than the normal weight group (498.2±17.1 versus 382.1±21.3, P<0.05). In addition, the concentration of vaspin in normal weight T2DM was higher than in healthy control group with normal weight (382.1±21.3 versus 192.5±45.2, P<0.05). Multiple regression analysis revealed that BMI was independent factors influencing the serum vaspin concentration in all participants. Conclusion. Vaspin may play an important compensatory role in obesity and insulin resistance in elderly people. The clinical trial registration number is ChiCTR-OPC-14005698.


Author(s):  
Hüseyin Dag ◽  
Nevin Cetin Dag ◽  
Emine Turkkan ◽  
Ebru Misirli Ozdemir ◽  
Okan Dikker

Background: Galectin-3 is a member of the family of soluble beta-galactoside binding lectins, which is involved in inflammation, cell differentiation, adhesion, proliferation, angiogenesis and cancer cell invasion. Increased galectin-3 levels in obese patients have been shown in previous studies. In our study; we aimed to investigate the galectin-3 levels in obese adolescents for the first time in the literature. Materials and methods: A total of 85 adolescent patients who were admitted to our pediatrics outpatient clinic between December 19th of 2018 and January 31st of 2019 were included in our study. Among those patients 52 were obese and 33 were normal-weighted. Adolescents having body mass index (BMI) 95% percentile and above according to their age and sex were defined as obese. Enzyme-Linked Immunosorbent Assay kit was used for the measurement of galectin-3 in serum. Laboratory tests (Galectin-3, HbA1c, glucose, insulin, HOMA-IR), sex, age and BMI were statistically compared between groups. Results: We found no statistically significant difference in terms of gender distribution rates, age, glucose or galectin-3 levels among obese adolescent and healthy control groups (p> 0.05). The BMI, HbA1c, HOMA-IR and insulin levels of the obese adolescent group were found to be significantly higher than the healthy control group (p <0.05). We found no statistically significant correlation between galectin-3 levels and other parameters in obese adolescent group (p> 0.05). Conclusion: In our study, we did not find any relationship between serum galectin-3 levels and obesity in adolescents. We believe that the effects of galectin-3 levels on obesity in adolescents should be more clearly explained by further investigations, which also measures other biomarkers of the mechanism of action. Keywords: Galectin-3, obesity, adolescent List of abbreviations: BMI: Body-Mass Index, CV: Variation coefficient, ELISA: Enzyme linked immunoassay, HOMA-IR: Homeostatic model of assessment-insulin resistance, IL: Interleukin, r: Correlation coefficient, SD: Standard deviation.


2020 ◽  
Vol 73 (7) ◽  
pp. 1373-1376
Author(s):  
Olga M. Shvets ◽  
Olga S. Shevchenko ◽  
Liliіa D. Todoriko ◽  
Rostyslav S. Shevchenko ◽  
Volodumur V. Yakimets ◽  
...  

The aim: To assess carbohydrate and lipid metabolic profiles of tuberculosis patients with bilateral injuries of the lungs and mycobacteria excretion. Materials and methods: Seventy two newly diagnosed pulmonary TB patients were examined. Group I – 17 newly diagnosed TB patients who had unilateral pulmonary lesions and had no mycobacteria excretion. Group II – 55 newly diagnosed TB patients who had bilateral pulmonary lesions and mycobacteria excretion. The control group included 20 healthy persons. Fasting insulin level, indices of lipidogram were measured, oral glucose tolerance test was performed. Statistical processing of the obtained results was carried out by analyzing the contingency tables using the StatisticaBasicAcademic 13 for Windows software package. Results: Tuberculosis patients develop insulin resistance – condition that is a precursor to developing type 2 diabetes and metabolic disorder of lipid exchange – dyslipidemia. Patients with bilateral pulmonary lesions and mycobacteria excretion have the most pronounced disorders of carbohydrate and lipid metabolism compared to patients with limited lesions of the lungs. Conclusions: We suppose that mycobacteria excretion and bilateral lesions of lungs may be the markers of the degree of carbohydrate and lipid metabolism disorders in patients with pulmonary tuberculosis. KEY WORDS: pulmonary tuberculosis, mycobacteria excretion, glucose metabolism, lipidogram


Author(s):  
K. A. Tarianyk

Objective — to evaluate the correlation between ghrelin levels, body mass index and the course of the disease in patients with Parkinson’s disease Methods and subjects. We examined 40 patients with Parkinson’s disease and 20 patients without signs of neurodegenerative disease (control group), who were examined and admitted to the neurological department. Patients were distributed into groups: 1 group — 20 patients with a disease duration of 12.1 ± 2.3 years, group 2 — 20 patients with a disease duration of 7.3 ± 1.6 years, group 3 — control, 20 patients without signs of morbidity. The diagnosis was made according to the criteria of the World Brain Bank of Great Britain. The severity of the disease was determined by the Hen and Yar scale. All patients, after signing the consent agreement, underwent a general clinical, neurological examination with assessment of anthropometric parameters: height, weight, body mass index. Also, patients underwent laboratory determination of serum ghrelin levels using the method of enzyme‑linked immunosorbent assay (ELISA) on the basis of the Research Institute of Genetic, Immunological Basis of Pathology and Pharmacogenetics of the Ukrainian Medical Dental Academy. Results. Studies indicate that in the group of patients with a longer course of the disease (group 1) there was an increase in BMI, which can be interpreted as obesity or overweight, compared with group 2 and control, where the rate was normal. In group 2, where the duration of the disease was shorter, there was a decrease in BMI, accompanied by weight loss of patients. In each group of examined patients there were patients with different forms of the disease, but in the second group patients with akinetic‑rigid form of the disease prevailed, so these patients in neurological status suffered more from stiffness, immobility. Normally, ghrelin level rises in the morning during hunger and decreases after eating. A similar picture was observed in the control group of patients, where the rate of morning ghrelin was elevated. When assessing fasting plasma ghrelin levels in groups of patients, there is a slight decrease in the indicator compared with the control group. Conclusions. There is a clear correlation between the duration of the disease, body mass index and hunger hormone levels in patients with Parkinson’s disease. In patients with the initial stages of the disease there is a decrease in body mass index, which is a prognostically unfavorable sign. Fluctuations in ghrelin levels may be associated with decreased energy intake due to gastrointestinal dysfunction, increased energy expenditure caused by motor manifestations of the disease, or increased glucose metabolism with the use of drugs and changes in the eating behavior of patients.  


2020 ◽  
Author(s):  
Lijun Zhu ◽  
Zhengmei Fang ◽  
Yuelong Jin ◽  
Weiwei Chang ◽  
Mengyun Huang ◽  
...  

Abstract Background: Hypertension and overweight are both independent risk factors for cardiovascular disease,and being overweight can more likely to develop high blood pressure. Recent research has shown that ErbB3/HER3 played a considerable role in the development of cardiovascular disease. However, ErbB3 levels effects in the hypertensive overweight patients are unknown. This study aimed to assess the association between ErbB3 levels and hypertension with overweight in Chinese population. Methods: 128 Chinese adults aged 33-79 years, both sexes, underwent evaluation of height and weight, blood pressure, biochemical indicators and ErbB3 levels. Plasma ErbB3 levels was assessed by the Enzyme-linked immunosorbent assay (ELISA), and body mass index (BMI) was calculated as body weight divided by height squared. Participants were allocated in three groups according to blood pressure and BMI: healthy control group (CNT; n = 31; normotensive and nonoverweight), hypertension group (HT; n = 33; hypertension and nonoverweight) and hypertension with overweight group (HTO; n = 64; hypertension and overweight). A 2-tailed P<0.05 was defined to be statistically significant. Results: The difference in mean of ErbB3 levels in three groups was not significant, but had a linear decrease in males, in CNT (1.13±0.36), HT (1.03±0.36) and HTO (0.84±0.26) ng/ml, with P was 0.007. In drinking population, the ErbB3 was significantly reduced in the HTO group as compared with the CNT and HT groups (0.76±0.23 versus 1.18±0.37 and 1.20±0.30, respectively). ErbB3 levels was negatively correlated with DBP in males(r=-0.293, P=0.012), in smoking populations (r=-0.47, P=0.004) and drinking populations (r=-0.387, P=0.008). Besides, BMI in males and in drinking populations and UA in males presented negatively correlations with ErbB3 (p<0.05). The multivariate conditional logistic regression showed that plasma ErbB3 levels was associated with reduced risk for HTO in males (OR 0.054; 95% CI: 0.007-0.412) and drink group(OR 0.002; 95% CI: 0.000-0.101). Conclusions:The apparent association between lower ErbB3 levels and overweight hypertensive patients suggested that ErbB3 may contribute to the pathogenesis to hypertension with overweight, with BMI, gender, and drinking all potentially modulating the process.Keywords: ErbB3; Hypertension; Overweight; Body mass index.


Author(s):  
Kashish Narula ◽  
Narendra Kumar Dara ◽  
Shyam Lal Meena

Background: Thyroid hormones influence nearly all major metabolic pathways. Their most obvious and well-known action is the increase in basal energy expenditure obtained by acting on protein, carbohydrate and lipid metabolism. The lipid metabolism is more influenced by the thyroid hormone. Methods: A cross-sectional study was conducted on 100 patients with suspicion of thyroid disorders were taken as cases. One hundred patients with normal thyroid profile and no history of other chronic diseases were taken as control group. Results: The serum TC, TG and LDL levels in hypothyroid individuals (both overt and subclinical) were significantly higher than euthyroid subjects but the levels were comparable between hyperthyroid and euthyroid group. Conclusion: Dyslipidemias are associated with thyroid disorders, so biochemical screening for thyroid dysfunction in all dyslipidemic patients. Therefore, patients presenting with dyslipidemia are recommended for investigation to explore thyroid dysfunction. Keywords: Thyroid profile, Total cholesterol, Triglycerides and LDL


2014 ◽  
Vol 21 (30) ◽  
pp. 3455-3465 ◽  
Author(s):  
G.D. Kolovou ◽  
V. Kolovou ◽  
P.M. Kostakou ◽  
S. Mavrogeni

2013 ◽  
Vol 32 (1) ◽  
pp. 26-31 ◽  
Author(s):  
Emina Čolak ◽  
Dragana Pap ◽  
Nada Majkić-Singh ◽  
Ivana Obradović

Summary Background: It has been reported that obesity is associated with metabolic syndrome, insulin resistance, cardiovascular risk but also with nonalcoholic fatty liver disease (NAFLD). The prevalence of obesity in children and adolescents is increasing rapidly all over the world. The aim of this study was to analyze the value of liver enzymes: AST, ALT and γGT in a group of obese students in order to establish their correlation to anthropometric parameters such as: BMI (body mass index), WC (waist circumference), HC (hip circumference), and WHR (waist-to-hip ratio) compared to non-obese students who comprised the control group (CG). Methods: In this study, 238 students from the University of Novi Sad of both sexes (126 men and 112 women) with a mean age of 22.32 ± 1.85 years were included. According to the body mass index (BMI) lower and higher than 25 kg/m2 and waist circumference (WC) lower and higher than 94 cm (80 cm for females) the whole group of 238 students was divided into 2 subgroups: the obese group at increased risk for CVD (Group 1) and the group at lower risk for CVD (Group 2). AST, ALT and γGT activities were determined in fasting blood samples. Results: Statistical processing data revealed significantly higher values of AST, ALT and γGT in the group of students with BMI>25 kg/m2, WC>94 cm for males and WC>80 cm for females, HC>108 cm for males and HC>111 cm for females, and WHR>0.90 for males and WHR>0.80 for females (P<0.001). Significant association was established between anthropometric parameters and liver enzyme levels (P<0.0001). Conclusions: Obese students with higher BMI, WC, HC and WHR values have higher liver enzyme activites and a higher chance to develop NAFLD in the future.


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