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Marycz K, Wiatrak B, Irwin-Houston JM, Marcinkowska K, Mularczyk M, Bourebaba L. Sex hormone binding globulin (SHBG) modulates mitochondrial dynamics in PPARγ-depleted equine adipose derived stromal cells. J Mol Med (Berl) 2024:10.1007/s00109-024-02459-z. [PMID: 38874666 DOI: 10.1007/s00109-024-02459-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 03/28/2024] [Accepted: 06/05/2024] [Indexed: 06/15/2024]
Abstract
Peroxisome proliferator-activated receptor gamma (PPARγ) is a transcription factor that promotes adipogenesis, lipid uptake and storage, insulin sensitivity, and glucose metabolism. Hence, defects in PPARγ have been associated to the development of metabolic disorders. Sex hormone-binding globulin (SHBG) is a glycoprotein primarily produced in the liver that regulates the bioavailability of sex hormones. Alike PPARγ, low SHBG levels have been correlated with insulin resistance and associated endocrine abnormalities. Therefore, this study aimed to verify whether SHBG may restore depleted PPARγ functions and thus serve as a new candidate for the management of metabolic conditions. A model of equine adipose-derived stromal cells (EqASCs) has been used, in which a PPARγ silencing and SHBG treatment have been achieved to determine the changes in cell viability, premature senescence, oxidative stress, and mitochondrial functions. Obtained data demonstrated that loss in PPARγ triggers cell apoptosis which is not reversed by SHBG application. Moreover, PPARγ knockdown cells exhibited premature senescence, which has been substantially alleviated by SHBG concomitantly to increased BAX/BCL2 ratio, suggesting a possible effect on senescence-induced apoptosis resistance. Interestingly, PPARγ silencing induced a significant alteration in mitochondrial membrane potential as well as the expression of dynamics and metabolism-related markers. SHBG treatment enabled to ameliorate the transmembrane potential, to normalize the expression levels of key dynamics and metabolism mediators, and to restore the protein levels of PINK, which is critically involved in mitochondria recycling machinery. Presented data suggest that SHBG may provide new mechanistic insights into the regulation of PPARγ functions, and thus offers a preliminary picture on a possible SHBG-PPARγ metabolic crosstalk. KEY MESSAGES : PPARγ is a transcription factor that tightly regulates cell metabolism. Low SHBG levels correlate with insulin resistance and associated endocrine abnormalities. PPARγ silencing reduces cell viability, triggers premature senescence and profound mitochondrial failure in equine ASCs. SHBG protein reverses senescent phenotype and apoptosis resistance of PPARγ- ASCs. SHBG improves mitochondrial dynamics and metabolism following PPARγ knockdown. SHBG might serve as a PPARγ potential mimicking agent for the modulation of ASCs metabolic processes.
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Affiliation(s)
- Krzysztof Marycz
- Department of Experimental Biology, Faculty of Biology and Animal Science, Wrocław University of Environmental and Life Sciences, Norwida 27B, 50-375, Wrocław, Poland
- International Institute of Translational Medicine, Jesionowa 11, Malin, 55-114, Wisznia Mała, Poland
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, Davis, CA, 95516, USA
| | - Benita Wiatrak
- Department of Experimental Biology, Faculty of Biology and Animal Science, Wrocław University of Environmental and Life Sciences, Norwida 27B, 50-375, Wrocław, Poland
| | - Jennifer M Irwin-Houston
- Department of Experimental Biology, Faculty of Biology and Animal Science, Wrocław University of Environmental and Life Sciences, Norwida 27B, 50-375, Wrocław, Poland
| | - Klaudia Marcinkowska
- Department of Experimental Biology, Faculty of Biology and Animal Science, Wrocław University of Environmental and Life Sciences, Norwida 27B, 50-375, Wrocław, Poland
| | - Malwina Mularczyk
- Department of Experimental Biology, Faculty of Biology and Animal Science, Wrocław University of Environmental and Life Sciences, Norwida 27B, 50-375, Wrocław, Poland
- International Institute of Translational Medicine, Jesionowa 11, Malin, 55-114, Wisznia Mała, Poland
| | - Lynda Bourebaba
- Department of Experimental Biology, Faculty of Biology and Animal Science, Wrocław University of Environmental and Life Sciences, Norwida 27B, 50-375, Wrocław, Poland.
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Tishova Y, Kalinchenko S, Mskhalaya G, Hackett G, Livingston M, König C, Strange R, Zitzmann M, Mann A, Maarouf A, Ramachandran S. Testosterone therapy reduces insulin resistance in men with adult-onset testosterone deficiency and metabolic syndrome. Results from the Moscow Study, a randomized controlled trial with an open-label phase. Diabetes Obes Metab 2024; 26:2147-2157. [PMID: 38433502 DOI: 10.1111/dom.15520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 02/01/2024] [Accepted: 02/11/2024] [Indexed: 03/05/2024]
Abstract
AIMS To describe changes in homeostasis model assessment of insulin resistance index (HOMA-IR) following testosterone therapy in men with hypogonadism and metabolic syndrome (MetS). MATERIALS AND METHODS A randomized, placebo-controlled, double-blind randomized controlled trial (RCT) comprising 184 men with MetS and hypogonadism (testosterone undecanoate [TU]: 113 men, placebo: 71 men) was conducted. This was followed by an open-label phase in which all men were given TU. We focused on men who were not receiving antiglycaemic agents (TU: 81 men; placebo: 54 men) as these could affect HOMA-IR. Inter-group comparison of HOMA-IR was restricted to the RCT (30 weeks), whilst intra-group comparison was carried out on men provided TU during the RCT and open-label phases (study cohort) and men given placebo during the RCT and then switched to TU during the open-label phase (confirmatory cohort). Regression analysis was performed to identify factors associated with change in HOMA-IR (∆HOMA-IR). RESULTS The median HOMA-IR was significantly reduced at almost every time point (after 18 weeks) compared to baseline in men receiving TU in both the study and confirmatory cohorts. There was a significant decrease in median values of fasting glucose (30 weeks: -2.1%; 138 weeks: -4.9%) and insulin (30 weeks: -10.5%; 138 weeks: -35.5%) after TU treatment. Placebo was not associated with significant ∆HOMA-IR. The only consistent predictor of HOMA-IR decrease following TU treatment was baseline HOMA-IR (r2 ≥ 0.64). CONCLUSIONS Baseline HOMA-IR predicted ΔHOMA-IR, with a greater percentage change in insulin than in fasting glucose. In men with MetS/type 2 diabetes (T2DM) not on antiglycaemic therapy, improvements in HOMA-IR may be greater than suggested by change in fasting glucose. Our results suggest that hypogonadism screening be included in the management of men with MetS/T2DM.
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Affiliation(s)
- Yuliya Tishova
- Department of Endocrinology, Medical Clinic K-medicine, Moscow, Russia
| | - Svetlana Kalinchenko
- Department of Endocrinology, People's Friendship University of Russia, Moscow, Russia
| | - George Mskhalaya
- Department of Preventive Medicine, European Medical Center, Moscow, Russia
| | - Geoffrey Hackett
- School of Health and Life Sciences, Aston University, Birmingham, UK
| | - Mark Livingston
- Department of Clinical Biochemistry, Black Country Pathology Services, Walsall Manor Hospital, UK
- School of Medicine and Clinical Practice, Faculty of Science and Engineering, The University of Wolverhampton, Wolverhampton, UK
| | - Carola König
- Department of Mechanical and Aerospace Engineering, Brunel University, London, UK
| | - Richard Strange
- School of Pharmacy and Bioengineering, Keele University, Staffordshire, UK
| | - Michael Zitzmann
- Department of Clinical and Surgical Andrology, Centre of Reproductive Medicine and Andrology, Munster University Hospital, Munster, Germany
| | - Amar Mann
- Department of Clinical Biochemistry, University Hospitals Birmingham NHS Foundation Trust, West Midlands, UK
| | - Amro Maarouf
- Department of Clinical Biochemistry, University Hospitals Birmingham NHS Foundation Trust, West Midlands, UK
| | - Sudarshan Ramachandran
- Department of Mechanical and Aerospace Engineering, Brunel University, London, UK
- School of Pharmacy and Bioengineering, Keele University, Staffordshire, UK
- Department of Clinical Biochemistry, University Hospitals Birmingham NHS Foundation Trust, West Midlands, UK
- Department of Clinical Biochemistry, University Hospitals of North Midlands NHS Foundation Trust, Staffordshire, UK
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Zhang J, Gu W, Zhai S, Liu Y, Yang C, Xiao L, Chen D. Phthalate metabolites and sex steroid hormones in relation to obesity in US adults: NHANES 2013-2016. Front Endocrinol (Lausanne) 2024; 15:1340664. [PMID: 38524635 PMCID: PMC10957739 DOI: 10.3389/fendo.2024.1340664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Accepted: 02/19/2024] [Indexed: 03/26/2024] Open
Abstract
Background Obesity and metabolic syndrome pose significant health challenges in the United States (US), with connections to disruptions in sex hormone regulation. The increasing prevalence of obesity and metabolic syndrome might be associated with exposure to phthalates (PAEs). Further exploration of the impact of PAEs on obesity is crucial, particularly from a sex hormone perspective. Methods A total of 7780 adult participants in the National Health and Nutrition Examination Survey (NHANES) from 2013 to 2016 were included in the study. Principal component analysis (PCA) coupled with multinomial logistic regression was employed to elucidate the association between urinary PAEs metabolite concentrations and the likelihood of obesity. Weighted quartiles sum (WQS) regression was utilized to consolidate the impact of mixed PAEs exposure on sex hormone levels (total testosterone (TT), estradiol and sex hormone-binding globulin (SHBG)). We also delved into machine learning models to accurately discern obesity status and identify the key variables contributing most to these models. Results Principal Component 1 (PC1), characterized by mono(2-ethyl-5-carboxypentyl) phthalate (MECPP), mono(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP), and mono(2-ethyl-5-oxohexyl) phthalate (MEOHP) as major contributors, exhibited a negative association with obesity. Conversely, PC2, with monocarboxyononyl phthalate (MCNP), monocarboxyoctyl phthalate (MCOP), and mono(3-carboxypropyl) phthalate (MCPP) as major contributors, showed a positive association with obesity. Mixed exposure to PAEs was associated with decreased TT levels and increased estradiol and SHBG. During the exploration of the interrelations among obesity, sex hormones, and PAEs, models based on Random Forest (RF) and eXtreme Gradient Boosting (XGBoost) algorithms demonstrated the best classification efficacy. In both models, sex hormones exhibited the highest variable importance, and certain phthalate metabolites made significant contributions to the model's performance. Conclusions Individuals with obesity exhibit lower levels of TT and SHBG, accompanied by elevated estradiol levels. Exposure to PAEs disrupts sex hormone levels, contributing to an increased risk of obesity in US adults. In the exploration of the interrelationships among these three factors, the RF and XGBoost algorithm models demonstrated superior performance, with sex hormones displaying higher variable importance.
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Affiliation(s)
- Jiechang Zhang
- Department of Cardiology, Zhuhai People's Hospital (Zhuhai Clinical Medical College of Jinan University), Zhuhai, Guangdong, China
| | - Wen Gu
- Department of Biostatistics, School of Public Health, Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Shilei Zhai
- Department of Biostatistics, School of Public Health, Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Yumeng Liu
- Department of Biostatistics, School of Public Health, Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Chengcheng Yang
- Department of Ophthalmology, The Fifth Affiliated Hospital, Sun Yat-Sen University, Zhuhai, Guangdong, China
| | - Lishun Xiao
- Department of Biostatistics, School of Public Health, Xuzhou Medical University, Xuzhou, Jiangsu, China
- Center for Medical Statistics and Data Analysis, Xuzhou Medical University, Xuzhou, Jiangsu, China
- Key Laboratory of Human Genetics and Environmental Medicine, Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Ding Chen
- School of Medical Information and Engineering, Xuzhou Medical University, Xuzhou, Jiangsu, China
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Tűű L, Nas K, Török M, Várbíró S. SHBG Levels Do Not Correlate with Insulin Levels in PCOS with Appropriate Fasting Insulin Sensitivity. J Clin Med 2024; 13:838. [PMID: 38337532 PMCID: PMC10856642 DOI: 10.3390/jcm13030838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Revised: 01/25/2024] [Accepted: 01/29/2024] [Indexed: 02/12/2024] Open
Abstract
Introduction: There are several phenotypes of polycystic ovarian syndrome (PCOS), and the different phenotypes may differ metabolically. Methods: In the present retrospective study, women with PCOS having normal fasting insulin sensitivity (n = 88) were compared with women with PCOS showing impaired insulin sensitivity (n = 46) using the HPCOS (Hungarian Polycystic ovarian syndrome) database. Results: The impaired insulin sensitivity group has significantly higher body mass index (BMI) and HOMA index than the normal fasting insulin sensitivity group (BMI (kg/m2): 22.0 vs. 28.1, p < 0.0001, HOMA index: 0.96 vs. 2.38, p < 0.0001). The sex hormone binding globulin (SHBG) level was significantly lower, and the free androgen index proved itself significantly higher in the impaired insulin sensitivity group (p < 0.05). Linear regression analysis showed a negative association of BMI with SHBG levels in both groups, while BMI had a positive correlation with insulin concentrations in both groups. However, the SHBG levels were negatively associated with insulin concentrations in the impaired insulin sensitivity group, but this inverse association could not be observed in the normal fasting insulin sensitivity group. Conclusions: The inverse linear correlation of SHBG with HOMA index and serum insulin level is not evident in all PCO syndrome phenotypes, thus SHBG has limited applicability for characterizing carbohydrate metabolism and serum insulin sensitivity.
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Affiliation(s)
- László Tűű
- EndoCare Institute, Endocrinology Center, 1095 Budapest, Hungary; (L.T.); (K.N.)
- School of PhD Studies, Semmelweis University, 1085 Budapest, Hungary
| | - Katalin Nas
- EndoCare Institute, Endocrinology Center, 1095 Budapest, Hungary; (L.T.); (K.N.)
- School of PhD Studies, Semmelweis University, 1085 Budapest, Hungary
| | - Marianna Török
- Department of Obstetrics and Gynecology, Semmelweis University, 1082 Budapest, Hungary
- Workgroup of Research Management, Doctoral School, Semmelweis University, 1085 Budapest, Hungary
| | - Szabolcs Várbíró
- Department of Obstetrics and Gynecology, Semmelweis University, 1082 Budapest, Hungary
- Workgroup of Research Management, Doctoral School, Semmelweis University, 1085 Budapest, Hungary
- Department of Obstetrics and Gynecology, University of Szeged, 6725 Szeged, Hungary
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Sun M, Wu Y, Yuan C, Lyu J, Zhao X, Ruan YC, Guo J, Chen H, Huang WQ. Androgen-induced upregulation of CFTR in pancreatic β-cell contributes to hyperinsulinemia in PCOS model. Endocrine 2024; 83:242-250. [PMID: 37922092 DOI: 10.1007/s12020-023-03516-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 08/30/2023] [Indexed: 11/05/2023]
Abstract
PURPOSE Polycystic ovarian syndrome (PCOS) is an endocrine-metabolic condition affecting 5-10% of reproductive-aged women and characterized by hyperandrogenism, insulin resistance (IR), and hyperinsulinemia. CFTR is known to be regulated by steroid hormones, and our previous study has demonstrated an essential role of CFTR in β-cell function. This study aims to investigate the contribution of androgen and CFTR to hypersecretion of insulin in PCOS and the underlying mechanism. METHODS We established a rat PCOS model by subcutaneously implanting silicon tubing containing Dihydrotestosterone (DHT). Glucose tolerance test with insulin levels was performed at 9 weeks after implantation. A rat β-cell line RINm5F, a mouse β-cell line β-TC-6, and mouse islets were treated with DHT, and with or without the androgen antagonist flutamide for CFTR and insulin secretion-related functional assays or mRNA/protein expression measurement. The effect of CFTR inhibitors on DHT-promoted membrane depolarization, glucose-stimulated intracellular Ca2+ oscillation and insulin secretion were examined by membrane potential imaging, calcium imaging and ELISA, respectively. RESULTS The DHT-induced PCOS model showed increased body weight, impaired glucose tolerance, and higher blood glucose and insulin levels after glucose stimulation. CFTR was upregulated in islets of PCOS model and DHT-treated cells, which was reversed by flutamide. The androgen receptor (AR) could bind to the CFTR promoter region, which was enhanced by DHT. Furthermore, DHT-induced membrane depolarization, enhanced glucose-stimulated Ca2+ oscillations and insulin secretion, which could be abolished by CFTR inhibitors. CONCLUSIONS Excessive androgen enhances glucose-stimulating insulin secretion through upregulation of CFTR, which may contribute to hyperinsulinemia in PCOS.
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Affiliation(s)
- Mengzhu Sun
- Department of Transfusion Medicine, Shenzhen Hospital, Southern Medical University, Shenzhen, Guangdong, China
| | - Yong Wu
- Department of Physiology, School of Medicine, Jinan University, Guangzhou, Guangdong, China
| | - Chun Yuan
- State Key Laboratory of Reproductive Medicine, Clinical Centre of Reproductive Medicine, First Affiliated Hospital, Nanjing Medical University, Nanjing, China
| | - Jingya Lyu
- Department of Physiology, School of Medicine, Jinan University, Guangzhou, Guangdong, China
| | - Xinyi Zhao
- Department of Physiology, School of Medicine, Jinan University, Guangzhou, Guangdong, China
| | - Ye Chun Ruan
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong, China
| | - Jinghui Guo
- School of Medicine, The Chinese University of Hong Kong, Shenzhen, 518172, Guangdong, China.
| | - Hui Chen
- Biotherapy Centre, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510630, China.
- Cell-Gene Therapy Translational Medicine Research Centre, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510630, China.
| | - Wen Qing Huang
- Department of Transfusion Medicine, Shenzhen Hospital, Southern Medical University, Shenzhen, Guangdong, China.
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Bourebaba L, Kępska M, Qasem B, Zyzak M, Łyczko J, Klemens M, Mularczyk M, Marycz K. Sex hormone-binding globulin improves lipid metabolism and reduces inflammation in subcutaneous adipose tissue of metabolic syndrome-affected horses. Front Mol Biosci 2023; 10:1214961. [PMID: 38146533 PMCID: PMC10749534 DOI: 10.3389/fmolb.2023.1214961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Accepted: 11/14/2023] [Indexed: 12/27/2023] Open
Abstract
Equine metabolic syndrome (EMS) is a steadily growing endocrine disorder representing a real challenge in veterinary practice. As a multifactorial condition, EMS is characterized by three main metabolic abnormalities including insulin resistance, increased adiposity or obesity and hoof laminitis. Adipose tissue dysfunction is recognized as a core pathophysiological determinant of EMS, as it strongly participates to lipotoxicity and systemic metaflammation, both of which have been closely linked to the development of generalized insulin resistance. Besides, sex hormone binding globulin (SHBG) is an important sex steroids transporters that has been recently proposed as an important metabolic mediator. Therefore, the aim of this study was to verify whether SHBG treatment may ameliorate subcutaneous adipose tissue metabolic failure under EMS condition in terms of lipidome homeostasis, lipid metabolism programs, insulin signalling and local inflammation. Subcutaneous adipose tissue (SAT) biopsies were collected post-mortem from healthy (n = 3) and EMS (n = 3) slaughtered horses. SHBG protein has been applied to SAT samples from EMS horses for 24 h at a final concentration of 50 nM, while control groups (healthy and untreated EMS) were cultured in the presence of SHBG-vehicle only. Tissues from all groups were afterwards secured for downstream analysis of gene expression using RT-qPCR, protein levels by Western blot and ELISA assay and lipidomics through GC-MS technique. Obtained results showcased that SHBG intervention efficiently normalized the altered fatty acids (FAs) profiles by lowering the accumulation of saturated and trans FAs, as well as the pro-inflammatory arachidonic and linoleic acids. Moreover, SHBG showed promising value for the regulation of adipocyte lipolysis and engorgement by lowering the levels of perilipin-1. SHBG exerted moderated effect toward SCD1 and FASN enzymes expression, but increased the LPL abundance. Interestingly, SHBG exhibited a negative regulatory effect on pro-adipogenic stimulators and induced higher expression of KLF3, IRF3 and β-catenin, known as strong adipogenesis repressors. Finally, SHBG protein showed remarkable ability in restoring the insulin signal transduction, IR/IRS/Pi3K/AKT phosphorylation events and GLUT4 transporter abundance, and further attenuate pro-inflammatory response by lowering IL-6 tissue levels and targeting the PDIA3/ERK axis. Overall, the obtained data clearly demonstrate the benefice of SHBG treatment in the regulation of adipose tissue metabolism in the course of EMS and provide new insights for the development of molecular therapies with potential translational application to human metabolic disorders.
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Affiliation(s)
- Lynda Bourebaba
- Department of Experimental Biology, Faculty of Biology and Animal Science, Wrocław University of Environmental and Life Sciences, Wrocław, Poland
| | - Martyna Kępska
- Department of Experimental Biology, Faculty of Biology and Animal Science, Wrocław University of Environmental and Life Sciences, Wrocław, Poland
| | - Badr Qasem
- Department of Experimental Biology, Faculty of Biology and Animal Science, Wrocław University of Environmental and Life Sciences, Wrocław, Poland
| | - Magdalena Zyzak
- Department of Experimental Biology, Faculty of Biology and Animal Science, Wrocław University of Environmental and Life Sciences, Wrocław, Poland
| | - Jacek Łyczko
- Department of Food Chemistry and Biocatalysis, Faculty of Biology and Animal Science, Wrocław University of Environmental and Life Sciences, Wrocław, Poland
| | - Marta Klemens
- Department of Food Chemistry and Biocatalysis, Faculty of Biology and Animal Science, Wrocław University of Environmental and Life Sciences, Wrocław, Poland
| | - Malwina Mularczyk
- Department of Experimental Biology, Faculty of Biology and Animal Science, Wrocław University of Environmental and Life Sciences, Wrocław, Poland
- International Institute of Translational Medicine, Wisznia Mała, Poland
| | - Krzysztof Marycz
- Department of Experimental Biology, Faculty of Biology and Animal Science, Wrocław University of Environmental and Life Sciences, Wrocław, Poland
- International Institute of Translational Medicine, Wisznia Mała, Poland
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, Davis, CA, United States
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Mahmoud MM, Rashed LA, Soliman SA, Sayed SM, Kamel O, Kamar SS, Hussien RES. SGLT-2 inhibitors enhance the effect of metformin to ameliorate hormonal changes and inflammatory markers in a rat PCOS model. Physiol Rep 2023; 11:e15858. [PMID: 37985173 PMCID: PMC10659952 DOI: 10.14814/phy2.15858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Revised: 10/30/2023] [Accepted: 10/30/2023] [Indexed: 11/22/2023] Open
Abstract
Polycystic ovary syndrome (PCOS) is a common endocrine, reproductive, and metabolic disorder affecting females. The management of PCOS is challenging and current interventions are not enough to deal with all consequences of this syndrome. We explored the beneficial effect of combined sodium glucose co transporter-2 inhibitor (SGLT-2i); (empagliflozin) and metformin on hormonal and metabolic parameters in an animal model of PCOS and insulin resistance (IR). Forty adult female Wistar rats divided into five groups: control, PCOS-IR, PCOS-IR treated with metformin, PCOS-IR treated with empagliflozin, and PCOS-IR treated with combined metformin and empagliflozin. Single modality treatment with metformin or empagliflozin yielded significant improvement in body mass index, insulin resistance, lipid profile, sex hormones, inflammatory markers, and ovarian cystic follicles. Combined metformin with empagliflozin expressed further significant improvement in sex hormones, inflammatory markers with disappearance of ovarian cystic follicles. The superior significant improvement with combined treatment over the single modality was in line with significant improvement in the ovarian AMPKα-SIRT1 expression.
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Affiliation(s)
| | - Laila Ahmed Rashed
- Department of Biochemistry Faculty of MedicineCairo UniversityCairoEgypt
| | | | | | - Omneya Kamel
- Department of Physiology, School of MedicineNew Giza UniversityCairoEgypt
| | - Samaa Samir Kamar
- Department of Histology, Faculty of MedicineCairo UniversityCairoEgypt
- Department of HistologyArmed Forces College of MedicineCairoEgypt
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Zhao S, Li Y, Su C. Assessment of common risk factors of diabetes and chronic kidney disease: a Mendelian randomization study. Front Endocrinol (Lausanne) 2023; 14:1265719. [PMID: 37780623 PMCID: PMC10535100 DOI: 10.3389/fendo.2023.1265719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Accepted: 08/25/2023] [Indexed: 10/03/2023] Open
Abstract
Background The increasing prevalence of diabetes and its significant impact on mortality and morbidity rates worldwide has led to a growing interest in understanding its common risk factors, particularly in relation to chronic kidney disease (CKD). This research article aims to investigate the shared risk factors between type 1 diabetes (T1D), type 2 diabetes (T2D), and CKD using a Mendelian randomization (MR) design. Methods The study utilized genome-wide association study (GWAS) datasets for T1D, T2D, and CKD from the FinnGen research project. GWAS summary statistics datasets for 118 exposure traits were obtained from the IEU OpenGWAS database. MR analyses were conducted to examine the causal relationships between exposure traits and each of the three outcomes. Multiple methods, including inverse-variance weighted, weighted median, and MR-Egger, were employed for the MR studies. Results Phenome-wide MR analyses revealed that eosinophil percentage exhibited a significant and suggestive causal association with T1D and CKD, respectively, suggesting its potential as a shared risk factor for T1D and CKD. For T2D, 34 traits demonstrated significant associations. Among these 34 traits, 14 were also significantly associated with CKD, indicating the presence of common risk factors between T2D and CKD, primarily related to obesity, height, blood lipids and sex hormone binding globulin, blood pressure, and walking pace. Conclusion This research has uncovered the eosinophil percentage as a potential common risk factor for both T1D and CKD, while also identifying several traits, such as obesity and blood lipids, as shared risk factors for T2D and CKD. This study contributes to the understanding of the common risk factors between diabetes and CKD, emphasizing the need for targeted interventions to reduce the risk of these diseases.
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Affiliation(s)
- Shuwu Zhao
- Department of Pain, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Changsha, Hunan, China
| | - Yiming Li
- School of Basic Medicine Science, Naval Medical University/Second Military University, Shanghai, China
| | - Chen Su
- Department of Pain, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Changsha, Hunan, China
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Di Lorenzo M, Cacciapuoti N, Lonardo MS, Nasti G, Gautiero C, Belfiore A, Guida B, Chiurazzi M. Pathophysiology and Nutritional Approaches in Polycystic Ovary Syndrome (PCOS): A Comprehensive Review. Curr Nutr Rep 2023; 12:527-544. [PMID: 37213054 PMCID: PMC10444658 DOI: 10.1007/s13668-023-00479-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/06/2023] [Indexed: 05/23/2023]
Abstract
PURPOSE OF REVIEW Polycystic ovary syndrome (PCOS) is the most common endocrine and metabolic disorder in women of reproductive age worldwide. This disease causes menstrual, metabolic, and biochemical abnormalities such as hyperandrogenism, oligo-anovulatory menstrual cycles, polycystic ovary, hyperleptinemia, insulin resistance (IR), and cardiometabolic disorders, often associated with overweight or obesity and visceral adiposity. RECENT FINDINGS The etiology and pathophysiology of PCOS are not yet fully understood, but insulin seems to play a key role in this disease. PCOS shares an inflammatory state with other chronic diseases such as obesity, type II diabetes, and cardiovascular diseases; however, recent studies have shown that a healthy nutritional approach can improve IR and metabolic and reproductive functions, representing a valid therapeutic strategy to ameliorate PCOS symptomatology. This review aimed to summarize and collect evidence about different nutritional approaches such as the Mediterranean diet (MedDiet) and the ketogenic diet (KD), as well as bariatric surgery and nutraceutical supplementation as probiotics, prebiotics, and synbiotics, among the others, used in patients with PCOS.
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Affiliation(s)
- M Di Lorenzo
- Department of Clinical Medicine and Surgery, University of Naples "Federico II", Naples, Italy
- Infectious Diseases and Gender Medicine Unit, Cotugno Hospital, AO Dei Colli, Naples, Italy
| | - N Cacciapuoti
- Department of Clinical Medicine and Surgery, University of Naples "Federico II", Naples, Italy
| | - M S Lonardo
- Department of Clinical Medicine and Surgery, University of Naples "Federico II", Naples, Italy
| | - G Nasti
- Department of Clinical Medicine and Surgery, University of Naples "Federico II", Naples, Italy
| | - C Gautiero
- Department of Clinical Medicine and Surgery, University of Naples "Federico II", Naples, Italy
| | - A Belfiore
- Department of Clinical Medicine and Surgery, University of Naples "Federico II", Naples, Italy
| | - B Guida
- Department of Clinical Medicine and Surgery, University of Naples "Federico II", Naples, Italy
| | - M Chiurazzi
- Department of Clinical Medicine and Surgery, University of Naples "Federico II", Naples, Italy.
- Department of Medical Oncology, AO "A. Cardarelli", Naples, Italy.
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Yu X, Sun F, Ming J, Liang S, Zhang W, Wang L, Li Q, Xu Q, Wang L, Shi L, Gao B, Ji Q. Serum uric acid to high-density lipoprotein cholesterol ratio is a promising marker for identifying metabolic syndrome in nondiabetic Chinese men. Postgrad Med 2023; 135:741-749. [PMID: 37750609 DOI: 10.1080/00325481.2023.2263372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 09/18/2023] [Indexed: 09/27/2023]
Abstract
OBJECTIVES To explore the relationship between serum uric acid (UA) and high-density lipoprotein cholesterol (HDL-C) ratio (UHR) and metabolic syndrome (MetS) in nondiabetic individuals. METHODS A total of 15,760 nondiabetic participants were screened from the China National Diabetes and Metabolic Disorders Study. Pearson correlation was used to determine the correlation between the components of MetS and UHR, HDL-C, and UA. Receiver operating characteristic curves were used to evaluate the ability of UHR, HDL-C, and UA to identify MetS in the nondiabetic population. RESULTS A total of 6,386 men and 9,374 women were enrolled in this study. There were 1,480 (23.2%) men and 1,828 (19.5%) women with MetS. UHR significantly correlated with the components of MetS in men and women, especially with waist circumference and triglyceride. In men, although HDL-C showed a higher specificity index, UHR presented higher sensitivity index and area under the curve (AUC) than HDL-C (P = 0.0001) and UA (P < 0.0001), with AUC (95% CI) of 0.762 (0.752-0.773). Higher AUCs of UHR relative to HDL-C and UA were also observed in the age groups <40 and 40-59 years. There was no significant difference in AUC between UHR and HDL-C in the age group ≥60 years (P = 0.370). However, similar results were not observed in women. CONCLUSION UHR significantly correlated with the components of MetS and could serve as a novel and reliable marker for identifying the population at a high risk of MetS in nondiabetic men, especially in younger adults.
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Affiliation(s)
- Xinwen Yu
- Department of Endocrinology, Tangdu Hospital, Air Force Medical University, Xi'an, China
| | - Fei Sun
- Department of Endocrinology, Tangdu Hospital, Air Force Medical University, Xi'an, China
| | - Jie Ming
- Department of Endocrinology, Xijing Hospital, Air Force Medical University, Xi'an, China
| | - Shengru Liang
- Department of Endocrinology, Tangdu Hospital, Air Force Medical University, Xi'an, China
| | - Wencheng Zhang
- Department of Endocrinology, Tangdu Hospital, Air Force Medical University, Xi'an, China
| | - Li Wang
- Department of Endocrinology, Xijing Hospital, Air Force Medical University, Xi'an, China
| | - Qiaoyue Li
- Department of Endocrinology, Xijing Hospital, Air Force Medical University, Xi'an, China
| | - Qian Xu
- Department of Endocrinology, Xijing Hospital, Air Force Medical University, Xi'an, China
| | - Li Wang
- Department of Endocrinology, Xijing Hospital, Air Force Medical University, Xi'an, China
| | - Lei Shi
- Medical Service Training Base, Air Force Medical University, Xi'an, China
| | - Bin Gao
- Department of Endocrinology, Tangdu Hospital, Air Force Medical University, Xi'an, China
| | - Qiuhe Ji
- Department of Endocrinology, Xi'an International Medical Center Hospital, Xi'an, China
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11
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Bilder DA, Worsham W, Sullivan S, Esplin MS, Burghardt P, Fraser A, Bakian AV. Sex-specific and sex-independent steroid-related biomarkers in early second trimester maternal serum associated with autism. Mol Autism 2023; 14:30. [PMID: 37573326 PMCID: PMC10422808 DOI: 10.1186/s13229-023-00562-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 08/01/2023] [Indexed: 08/14/2023] Open
Abstract
BACKGROUND Prenatal exposure to maternal metabolic conditions associated with inflammation and steroid dysregulation has previously been linked to increased autism risk. Steroid-related maternal serum biomarkers have also provided insight into the in utero steroid environment for offspring who develop autism. OBJECTIVE This study examines the link between autism among offspring and early second trimester maternal steroid-related serum biomarkers from pregnancies enriched for prenatal metabolic syndrome (PNMS) exposure. STUDY DESIGN Early second trimester maternal steroid-related serum biomarkers (i.e., estradiol, free testosterone, total testosterone, and sex hormone binding globulin) were compared between pregnancies corresponding to offspring with (N = 68) and without (N = 68) autism. Multiple logistic regression analyses were stratified by sex and gestational duration. One-way ANCOVA with post hoc tests was performed for groups defined by autism status and PNMS exposure. RESULTS Increased estradiol was significantly associated with autism only in males (AOR = 1.13 per 100 pg/ml, 95% CI 1.01-1.27, p = 0.036) and only term pregnancies (AOR = 1.17 per 100 pg/ml, 95% CI 1.04-1.32, p = 0.010). Autism status was significantly associated with decreased sex hormone binding globulin (AOR = 0.65 per 50 nmol/L, 95% CI 0.55-0.78, p < 0.001) overall and when stratified by sex and term pregnancy status. The inverse association between sex hormone binding globulin and autism was independent of PNMS exposure. LIMITATIONS The relative racial and ethnic homogeneity of Utah's population limits the generalizability of study results. Although significant differences by autism status were identified in concentrations of sex hormone binding globulin overall and of estradiol in participant subgroups, differences by PNMS exposure failed to reach statistical significance, which may reflect insufficient statistical power. CONCLUSION Both elevated maternal serum estradiol in males only and low maternal serum sex hormone binding globulin in both sexes are associated with increased autism risk. Further investigation is merited to identify how steroid, metabolic, and inflammatory processes can interact to influence neurodevelopment in early second trimester.
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Affiliation(s)
- Deborah A Bilder
- University of Utah Huntsman Mental Health Institute, 383 Colorow Drive, Room 360, Salt Lake City, UT, 84108, USA.
| | - Whitney Worsham
- University of Utah School of Medicine, Salt Lake City, UT, USA
| | | | - M Sean Esplin
- University of Utah School of Medicine, Salt Lake City, UT, USA
- Intermountain Healthcare, Salt Lake City, UT, USA
| | | | - Alison Fraser
- University of Utah Huntsman Cancer Institute, Salt Lake City, UT, USA
| | - Amanda V Bakian
- University of Utah Huntsman Mental Health Institute, 383 Colorow Drive, Room 360, Salt Lake City, UT, 84108, USA
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12
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Li Z, Shen G, Shi M, Zheng Y, Guan Y, Xin Y, Wang M, Zhao F, Ren D, Zhao J. Association between high body mass index and prognosis of patients with early-stage breast cancer: A systematic review and meta-analysis. CANCER PATHOGENESIS AND THERAPY 2023; 1:205-215. [PMID: 38327841 PMCID: PMC10846319 DOI: 10.1016/j.cpt.2023.03.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 03/10/2023] [Accepted: 03/28/2023] [Indexed: 02/09/2024]
Abstract
Background A high body mass index (BMI) can indicate overweight or obesity and is a crucial risk factor for breast cancer survivors. However, the association between high BMI and prognosis in early-stage breast cancer (EBC) remains unclear. We aimed to assess the effects of high BMI on the prognosis of patients with EBC. Methods The PubMed, Embase, and Cochrane Library databases and proceedings of major oncological conferences related to the effects of BMI on the prognosis of breast cancer were searched up to November 2021. Fixed- and random-effects models were used for meta-analyses. Pooled hazard ratios (HRs) and 95% confidence intervals (CIs) for disease-free survival (DFS) and overall survival (OS) were extracted from the included literature. Results Twenty retrospective cohort studies with 33,836 patients with EBC were included. Overweight patients had worse DFS (HR: 1.16, 95% CI: 1.05-1.27, P = 0.002) and OS (HR: 1.20; 95% CI: 1.09-1.33, P < 0.001). Obesity also had adverse effects on DFS (HR: 1.17, 95% CI: 1.07-1.29, P = 0.001) and OS (HR: 1.30, 95% CI: 1.17-1.45, P < 0.001). Likewise, patients with high BMI had worse DFS (HR: 1.16, 95% CI: 1.08-1.26, P < 0.001) and OS (HR: 1.25, 95% CI: 1.14-1.39, P < 0.001). In subgroup analyses, overweight had adverse effects on DFS (HR: 1.11, 95% CI: 1.04-1.18, P = 0.001) and OS (HR: 1.18, 95% CI: 1.11-1.26, P < 0.001) in multivariate analyses, whereas the relationship that overweight had negative effects on DFS (HR: 1.21, 95% CI: 0.99-1.48, P = 0.058) and OS (HR: 1.39, 95% CI: 0.92-2.10, P = 0.123) was not statistically significant in univariate analysis. By contrast, obesity had adverse effects on DFS (HR: 1.21, 95% CI: 1.06-1.38, P = 0.004 and HR: 1.14, 95% CI: 1.08-1.22, P < 0.001) and OS (HR: 1.33, 95% CI: 1.15-1.54, P < 0.001 and HR: 1.23, 95% CI: 1.15-1.31, P < 0.001) in univariate and multivariate analyses, respectively. Conclusions Compared with normal weight, increased body weight (overweight, obesity, and high BMI) led to worse DFS and OS in patients with EBC. Once validated, these results should be considered in the development of prevention programs.
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Affiliation(s)
| | | | | | - Yonghui Zheng
- Breast Disease Diagnosis and Treatment Center of the Affiliated Hospital of Qinghai University and the Affiliated Cancer Hospital of Qinghai University, Xining, Qinghai 810000, China
| | - Yumei Guan
- Breast Disease Diagnosis and Treatment Center of the Affiliated Hospital of Qinghai University and the Affiliated Cancer Hospital of Qinghai University, Xining, Qinghai 810000, China
| | - Yuanfang Xin
- Breast Disease Diagnosis and Treatment Center of the Affiliated Hospital of Qinghai University and the Affiliated Cancer Hospital of Qinghai University, Xining, Qinghai 810000, China
| | - Miaozhou Wang
- Breast Disease Diagnosis and Treatment Center of the Affiliated Hospital of Qinghai University and the Affiliated Cancer Hospital of Qinghai University, Xining, Qinghai 810000, China
| | - Fuxing Zhao
- Breast Disease Diagnosis and Treatment Center of the Affiliated Hospital of Qinghai University and the Affiliated Cancer Hospital of Qinghai University, Xining, Qinghai 810000, China
| | - Dengfeng Ren
- Breast Disease Diagnosis and Treatment Center of the Affiliated Hospital of Qinghai University and the Affiliated Cancer Hospital of Qinghai University, Xining, Qinghai 810000, China
| | - Jiuda Zhao
- Breast Disease Diagnosis and Treatment Center of the Affiliated Hospital of Qinghai University and the Affiliated Cancer Hospital of Qinghai University, Xining, Qinghai 810000, China
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Persky V, Abasilim C, Tsintsifas K, Day T, Sargis RM, Daviglus ML, Cai J, Freels S, Unterman T, Chavez N, Kaplan R, Isasi CR, Pirzada A, Meyer ML, Talavera GA, Thyagarajan B, Peters BA, Madrigal JM, Grieco A, Turyk ME. Sex Hormones and Diabetes in 45- to 74-year-old Men and Postmenopausal Women: The Hispanic Community Health Study. J Clin Endocrinol Metab 2023; 108:1709-1726. [PMID: 36633580 PMCID: PMC10271226 DOI: 10.1210/clinem/dgad018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 12/14/2022] [Accepted: 01/06/2023] [Indexed: 01/13/2023]
Abstract
Previous studies demonstrated associations of endogenous sex hormones with diabetes. Less is known about their dynamic relationship with diabetes progression through different stages of the disease, independence of associations, and role of the hypothalamic-pituitary gonadal axis. The purpose of this analysis was to examine relationships of endogenous sex hormones with incident diabetes, prediabetes, and diabetes traits in 693 postmenopausal women and 1015 men aged 45 to 74 years without diabetes at baseline participating in the Hispanic Community Health Study/Study of Latinos and followed for 6 years. Baseline hormones included estradiol, luteinizing hormone (LH), follicle stimulating hormone (FSH), sex hormone-binding globulin (SHBG), dehydroepiandrosterone sulfate (DHEAS), and, in men, testosterone and bioavailable testosterone. Associations were analyzed using multivariable Poisson and linear regressions. In men, testosterone was inversely associated with conversion from prediabetes to diabetes (incidence rate ratio [IRR] for 1 SD increase in testosterone: 0.821; 95% CI, 0.676, 0.997; P = 0.046), but not conversion from normoglycemia to prediabetes. Estradiol was positively associated with increase in fasting insulin and homeostatic model assessment of insulin resistance. In women, SHBG was inversely associated with change in glycosylated hemoglobin, postload glucose, and conversion from prediabetes to diabetes (IRR = 0.62; 95% CI, 0.44, 0.86, P = 0.005) but not from normoglycemia to prediabetes. Relationships with other hormones varied across glycemic measures. Stronger associations of testosterone and SHBG with transition from prediabetes to diabetes than from normoglycemic to prediabetes suggest they are operative at later stages of diabetes development. Biologic pathways by which sex hormones affect glucose homeostasis await future studies.
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Affiliation(s)
- Victoria Persky
- Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois Chicago, Chicago, IL,USA
| | - Chibuzor Abasilim
- Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois Chicago, Chicago, IL,USA
| | - Konstantina Tsintsifas
- Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois Chicago, Chicago, IL,USA
| | - Tessa Day
- Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois Chicago, Chicago, IL,USA
| | - Robert M Sargis
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Illinois Chicago and Medical Service, Jesse Brown VA Medical Center, Chicago, IL,USA
| | - Martha L Daviglus
- Institute for Minority Health Research, University of Illinois Chicago, Chicago, IL,USA
| | - Jianwen Cai
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC,USA
| | - Sally Freels
- Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois Chicago, Chicago, IL,USA
| | - Terry Unterman
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Illinois Chicago and Medical Service, Jesse Brown VA Medical Center, Chicago, IL,USA
| | - Noel Chavez
- Division of Community Health Sciences, School of Public Health, University of Illinois Chicago, Chicago, IL,USA
| | - Robert Kaplan
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
- Public Health Sciences Division, Fred Hutchinson Cancer Center, Seattle, WA, USA
| | - Carmen R Isasi
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Amber Pirzada
- Institute for Minority Health Research, University of Illinois Chicago, Chicago, IL,USA
| | - Michelle L Meyer
- Department of Emergency Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC,USA
| | | | - Bharat Thyagarajan
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN, USA
| | - Brandilyn A Peters
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Jessica M Madrigal
- Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois Chicago, Chicago, IL,USA
| | - Arielle Grieco
- Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois Chicago, Chicago, IL,USA
| | - Mary E Turyk
- Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois Chicago, Chicago, IL,USA
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14
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Soraya N, Parwanto E. The Controversial Relationship between Body Mass Index and Handgrip Strength in the Elderly: An Overview. Malays J Med Sci 2023; 30:73-83. [PMID: 37425376 PMCID: PMC10325128 DOI: 10.21315/mjms2023.30.3.6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 02/03/2022] [Indexed: 07/11/2023] Open
Abstract
Body mass index (BMI) is one of the most commonly used anthropometric measurements. BMI is measured by dividing an individual's weight by their height. In the elderly, the aging process causes physiological changes to organ systems as well as body composition. The most noticeable changes occur in the musculoskeletal system-that is, of decreased muscle strength. Handgrip strength is one of the most commonly considered criteria to measure muscle strength. Various factors, including age, gender and anthropometric measurements such as BMI, are known to affect a person's muscle strength. In addition, weight and height affect the handgrip strength of an elderly person. However, whether BMI directly affects handgrip strength in the elderly is still debated. Several studies have stated that BMI has a relationship with handgrip strength in the elderly, while other studies have found no relationship between BMI and handgrip strength. BMI and handgrip strength is still controversial and requires further research.
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Affiliation(s)
- Nadine Soraya
- Medical Science Study Program, Faculty of Medicine, Universitas Trisakti, Indonesia
| | - Edy Parwanto
- Department of Biology, Faculty of Medicine, Universitas Trisakti, Indonesia
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15
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Singh J, Sahoo AK, Swain J, Mangaraj S, Kanwar JB, Manglunia A. Assessment of hypogonadism and its determinants among adult men with type 2 diabetes mellitus. Prim Care Diabetes 2023:S1751-9918(23)00099-2. [PMID: 37188551 DOI: 10.1016/j.pcd.2023.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 03/31/2023] [Accepted: 05/11/2023] [Indexed: 05/17/2023]
Abstract
BACKGROUND AND AIMS The impact of utilizing both symptoms as well as biochemically confirmed androgen deficiency in diagnosis of hypogonadism among type 2 diabetic men is relatively less studied. Furthermore, various determinants of hypogonadism in these men especially the role of insulin resistance and hypogonadism were studied. METHODS This is a cross sectional study of 353 T2DM men aged 20-70 years of age. Hypogonadism was defined by taking both symptoms as well as calculated testosterone levels. Symptoms were defined using androgen deficiency in ageing male (ADAM) criteria. Various metabolic and clinical parameters were assessed and evaluated with regards to presence or absence of hypogonadism. RESULTS Among 353 patients, 60 had both symptoms as well as biochemical evidence of hypogonadism. Assessment of calculated free testosterone but not total testosterone identified all such patients. Body mass index, HbA1c, fasting triglyceride level and HOMA IR inversely correlated with calculated free testosterone. We found that insulin resistance (HOMA IR) was independently associated with hypogonadism (odds ratio=1.108). CONCLUSION Assessment of both symptoms of hypogonadism and calculated free testosterone represents a better way for correct identification of hypogonadal diabetic men. Insulin resistance has a strong association with hypogonadism independent of obesity and complication status of diabetes.
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Affiliation(s)
- Jaspreet Singh
- Department of Endocrinology, IMS & SUM Medical College and Hospital, Bhubaneswar, Odisha, India
| | - Abhay Kumar Sahoo
- Department of Endocrinology, IMS & SUM Medical College and Hospital, Bhubaneswar, Odisha, India
| | - Jayshree Swain
- Department of Endocrinology, IMS & SUM Medical College and Hospital, Bhubaneswar, Odisha, India.
| | - Swayamsidha Mangaraj
- Department of Endocrinology, IMS & SUM Medical College and Hospital, Bhubaneswar, Odisha, India
| | - Jaya Bhanu Kanwar
- Department of Endocrinology, IMS & SUM Medical College and Hospital, Bhubaneswar, Odisha, India
| | - Ankit Manglunia
- Department of Endocrinology, IMS & SUM Medical College and Hospital, Bhubaneswar, Odisha, India
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16
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Crafa A, Cannarella R, Barbagallo F, La Vignera S, Condorelli RA, Calogero AE. Effects of assisted reproductive techniques on offspring gonadal function: a systematic review and meta-analysis. F&S REVIEWS 2023; 4:152-173. [DOI: 10.1016/j.xfnr.2023.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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17
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Mohammadrezaei A, Mokhtari Ardekani A, Abbasalizad-Farhangi M, Mesgari-Abbasi M, Mousavi R. Association Between Sex Hormone-Binding Globulin, Atherogenic Indices of Plasma Among Young Sedentary Males. Nutr Metab Insights 2023; 16:11786388231155006. [PMID: 36860914 PMCID: PMC9969450 DOI: 10.1177/11786388231155006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 01/16/2023] [Indexed: 02/26/2023] Open
Abstract
Background Males are more likely than females to suffer from cardiovascular disease (CVD). So, sex hormones may modify these variations and affect the lipid profile. We examined the relationship between sex hormone-binding globulin (SHBG) and CVD risk factors among young males in this study. Methods Using a cross-sectional design, we measured total testosterone, SHBG, lipids, glucose, insulin, antioxidant parameters, and anthropometric factors in 48 young males in the age range of 18 to 40 years. Atherogenic indices of plasma were calculated. In this study, a partial correlation analysis was carried out to assess the relationship between SHBG and other variables after adjustment for confounders. Results According to the results of multivariable analyses adjusted for age and energy, SHBG had a negative correlation with total cholesterol (r = -.454, P =.010), low-density lipoprotein cholesterol (r = -.496, P =.005), quantitative insulin-sensitivity check index, and positive correlation with high-density lipoprotein cholesterol (r = .463, P =.009). No significant correlation was observed between SHBG and triglycerides (P >.05). Several atherogenic indices of plasma have a negative correlation with SHBG levels. These include Atherogenic Index of Plasma (r = -.474, P = .006), Castelli Risk Index (CRI)1 (r = -.581, P < .001), CRI2 (r = -.564, P = .001), and Atherogenic Coefficient (r = -.581, P < .001). Conclusion Among young men, high plasma SHBG was associated with reduced CVD risk factors, modified lipid profile and atherogenic ratios, and better glycemic markers. Therefore, reduced SHBG concentrations could be a prognostic marker of CVD among young sedentary males.
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Affiliation(s)
- Ali Mohammadrezaei
- Molecular Medicine Research Center,
Tabriz University of Medical Sciences, Tabriz, Iran
| | - Abnoos Mokhtari Ardekani
- Endocrinology and Metabolism Research
Center, Institute of Basic and Clinical Physiology Science, & Physiology
Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Mahdieh Abbasalizad-Farhangi
- Department of Community Nutrition,
Faculty of Nutrition, Tabriz University of Medical Sciences, Tabriz, Iran,Mahdieh Abbasalizad-Farhangi, Tabriz
University of Medical Sciences, Attar Neyshabouri Street, Bolvar Daneshgah
Avenue, Tabriz 5166/15731, Iran.
| | | | - Reihaneh Mousavi
- 29-Bahman Hospital, Iranian Social
Security Organization, Tabriz, Iran
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18
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Pathophysiology of obesity and its associated diseases. Acta Pharm Sin B 2023. [DOI: 10.1016/j.apsb.2023.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
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19
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Erectile Dysfunction Severity: The Role of Glycometabolic Compensation and Antihyperglycemic Drugs. J Clin Med 2022; 11:jcm11237214. [PMID: 36498788 PMCID: PMC9740756 DOI: 10.3390/jcm11237214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 11/29/2022] [Accepted: 11/30/2022] [Indexed: 12/12/2022] Open
Abstract
Background: The aim of this study was to evaluate the prevalence of DM among patients with ED and the impact of glycometabolic compensation and antihyperglycemic treatment on ED severity. Methods: In total, 1332 patients with ED were enrolled. The diagnosis was performed through the International-Index-of-Erectile-Function questionnaire. ED severity was considered according to presence/absence of spontaneous erections, maintenance/achievement deficiency and response to PDE5-i. DM patients were clustered according to antihyperglycemic treatment: “metformin”/“insulin”/“old antihyperglycemic drugs”/“new antihyperglycemic drugs”. Results: The prevalence of DM patients was 15.8% (Group A, patients with ED and DM). Among these, the prevalence of spontaneous erections (21.0%) was lower than in the remaining patients (Group B, patients with ED without DM) (32.0%, p < 0.001). The prevalence of poor response to PDE5-i was lower in Group B (10.0%) than in Group A (35.0%, p < 0.001). Patients with good response to PDE5-i therapy showed lower HbA1c values than patients with poor/no response (6.6 ± 1.1% vs. 7.7 ± 1.9%, p = 0.02). The prevalence of absent response to PDE5-i was higher in patients treated with old antidiabetic drugs than in the population treated with new drugs (p = 0.03). Conclusion: The severity of ED and lower response to PDE5-i were higher in DM patients. A better glycometabolic profile, as well as new antihyperglycemic drugs, seem to have a positive effect on ED.
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Matta RA, Farrage HM, Saedii AA, Abdelrahman MM. Male subclinical hypogonadism and late-onset hypergonadotrophic hypogonadism: mechanisms, endothelial function, and interplay between reproductive hormones, undercarboxylated osteocalcin, and endothelial dysfunction. Aging Male 2022; 25:72-87. [PMID: 35291927 DOI: 10.1080/13685538.2022.2049744] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Pathogenesis and endothelial function in subclinical hypogonadism (SCH) remain unclear. Undercarboxylated osteocalcin (ucOC) participates in atherosclerosis and reproduction. We explored the underlying mechanisms and interplay of endothelial dysfunction, unOC and reproductive hormones in SCH and primary late-onset hypogonadism (LOH). METHODS In the SCH, LOH, and healthy eugonadal male groups, we measured serum unOC, calculated luteinizing hormone/testosterone (LH/T), LH.T product, and estradiol/T (E/T) as indicators of impaired Leydig cells, androgen sensitivity index (ASI), and aromatase activity, respectively (LH set-point regulators), and assessed flow-mediated dilation of the brachial artery (FMD%), carotid-intima media thickness (CIMT), and aortic stiffness (AS). RESULTS ↑LH/T, ↑ASI, ↓aromatase activity, normal T, follicle-stimulating hormone (FSH) and sex hormone-binding globulin (SHBG) levels, ↑unOC, and enhanced atherosclerotic markers (↓FMD%, ↑CIMT, ↑AS) are characteristics of SCH. Testosterone was positively correlated with FMD% in SCH. The independent predictors were: SHBG and LH for FMD% and CIMT, respectively, and LH/T, ucOC, FSH, estradiol, and E/T ratio for AS in the LOH group; and LH for FMD% & AS and LH and LH/T for CIMT in all study subjects. CONCLUSIONS SCH is a distinct clinical entity characterized by impaired androgen sensitivity and aromatase activity, compensatory elevated unOC, endothelial dysfunction, and anti-atherogenic role of testosterone.
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Affiliation(s)
- Ragaa Abedelshaheed Matta
- Diabetes and Endocrinology Unit, Department of Internal Medicine, Faculty of Medicine, Minia University, Minia, Egypt
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Lamri A, De Paoli M, De Souza R, Werstuck G, Anand S, Pigeyre M. Insight into genetic, biological, and environmental determinants of sexual-dimorphism in type 2 diabetes and glucose-related traits. Front Cardiovasc Med 2022; 9:964743. [PMID: 36505380 PMCID: PMC9729955 DOI: 10.3389/fcvm.2022.964743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 10/21/2022] [Indexed: 11/25/2022] Open
Abstract
There is growing evidence that sex and gender differences play an important role in risk and pathophysiology of type 2 diabetes (T2D). Men develop T2D earlier than women, even though there is more obesity in young women than men. This difference in T2D prevalence is attenuated after the menopause. However, not all women are equally protected against T2D before the menopause, and gestational diabetes represents an important risk factor for future T2D. Biological mechanisms underlying sex and gender differences on T2D physiopathology are not yet fully understood. Sex hormones affect behavior and biological changes, and can have implications on lifestyle; thus, both sex-specific environmental and biological risk factors interact within a complex network to explain the differences in T2D risk and physiopathology in men and women. In addition, lifetime hormone fluctuations and body changes due to reproductive factors are generally more dramatic in women than men (ovarian cycle, pregnancy, and menopause). Progress in genetic studies and rodent models have significantly advanced our understanding of the biological pathways involved in the physiopathology of T2D. However, evidence of the sex-specific effects on genetic factors involved in T2D is still limited, and this gap of knowledge is even more important when investigating sex-specific differences during the life course. In this narrative review, we will focus on the current state of knowledge on the sex-specific effects of genetic factors associated with T2D over a lifetime, as well as the biological effects of these different hormonal stages on T2D risk. We will also discuss how biological insights from rodent models complement the genetic insights into the sex-dimorphism effects on T2D. Finally, we will suggest future directions to cover the knowledge gaps.
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Affiliation(s)
- Amel Lamri
- Department of Medicine, McMaster University, Hamilton, ON, Canada,Population Health Research Institute (PHRI), Hamilton, ON, Canada
| | - Monica De Paoli
- Department of Medicine, McMaster University, Hamilton, ON, Canada,Thrombosis and Atherosclerosis Research Institute (TaARI), Hamilton, ON, Canada
| | - Russell De Souza
- Population Health Research Institute (PHRI), Hamilton, ON, Canada,Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
| | - Geoff Werstuck
- Department of Medicine, McMaster University, Hamilton, ON, Canada,Thrombosis and Atherosclerosis Research Institute (TaARI), Hamilton, ON, Canada
| | - Sonia Anand
- Department of Medicine, McMaster University, Hamilton, ON, Canada,Population Health Research Institute (PHRI), Hamilton, ON, Canada,Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
| | - Marie Pigeyre
- Department of Medicine, McMaster University, Hamilton, ON, Canada,Population Health Research Institute (PHRI), Hamilton, ON, Canada,*Correspondence: Marie Pigeyre
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22
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Quotah OF, Poston L, Flynn AC, White SL. Metabolic Profiling of Pregnant Women with Obesity: An Exploratory Study in Women at Greater Risk of Gestational Diabetes. Metabolites 2022; 12:metabo12100922. [PMID: 36295825 PMCID: PMC9612230 DOI: 10.3390/metabo12100922] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 09/26/2022] [Accepted: 09/27/2022] [Indexed: 11/16/2022] Open
Abstract
Gestational diabetes mellitus (GDM) is one of the most prevalent obstetric conditions, particularly among women with obesity. Pathways to hyperglycaemia remain obscure and a better understanding of the pathophysiology would facilitate early detection and targeted intervention. Among obese women from the UK Pregnancies Better Eating and Activity Trial (UPBEAT), we aimed to compare metabolic profiles early and mid-pregnancy in women identified as high-risk of developing GDM, stratified by GDM diagnosis. Using a GDM prediction model combining maternal age, mid-arm circumference, systolic blood pressure, glucose, triglycerides and HbA1c, 231 women were identified as being at higher-risk, of whom 119 women developed GDM. Analyte data (nuclear magnetic resonance and conventional) were compared between higher-risk women who developed GDM and those who did not at timepoint 1 (15+0−18+6 weeks) and at timepoint 2 (23+2−30+0 weeks). The adjusted regression analyses revealed some differences in the early second trimester between those who developed GDM and those who did not, including lower adiponectin and glutamine concentrations, and higher C-peptide concentrations (FDR-adjusted p < 0.005, < 0.05, < 0.05 respectively). More differences were evident at the time of GDM diagnosis (timepoint 2) including greater impairment in β-cell function (as assessed by HOMA2-%B), an increase in the glycolysis-intermediate pyruvate (FDR-adjusted p < 0.001, < 0.05 respectively) and differing lipid profiles. The liver function marker γ-glutamyl transferase was higher at both timepoints (FDR-adjusted p < 0.05). This exploratory study underlines the difficulty in early prediction of GDM development in high-risk women but adds to the evidence that among pregnant women with obesity, insulin secretory dysfunction may be an important discriminator for those who develop GDM.
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Affiliation(s)
- Ola F. Quotah
- Department of Women and Children’s Health, School of Life Course and Population Sciences, King’s College London, 10th Floor North Wing, St Thomas’ Hospital, Westminster Bridge Road, London SE1 7EH, UK
- Department of Clinical Nutrition, Faculty of Applied Medical Science, King Abdulaziz University, Jeddah 999088, Saudi Arabia
| | - Lucilla Poston
- Department of Women and Children’s Health, School of Life Course and Population Sciences, King’s College London, 10th Floor North Wing, St Thomas’ Hospital, Westminster Bridge Road, London SE1 7EH, UK
| | - Angela C. Flynn
- Department of Women and Children’s Health, School of Life Course and Population Sciences, King’s College London, 10th Floor North Wing, St Thomas’ Hospital, Westminster Bridge Road, London SE1 7EH, UK
- Department of Nutritional Sciences, School of Life Course and Population Sciences, King’s College London, Franklin-Wilkins Building, 150 Stamford Street, London SE1 9NH, UK
| | - Sara L. White
- Department of Women and Children’s Health, School of Life Course and Population Sciences, King’s College London, 10th Floor North Wing, St Thomas’ Hospital, Westminster Bridge Road, London SE1 7EH, UK
- Correspondence:
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23
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Moukarzel LA, Ferrando L, Stylianou A, Lobaugh S, Wu M, Nobre SP, Iasonos A, Zoppoli G, Giri DD, Abu-Rustum NR, Broach VA, Iyengar NM, Weigelt B, Makker V. Impact of obesity and white adipose tissue inflammation on the omental microenvironment in endometrial cancer. Cancer 2022; 128:3297-3309. [PMID: 35793549 PMCID: PMC9976596 DOI: 10.1002/cncr.34356] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 05/09/2022] [Accepted: 05/26/2022] [Indexed: 11/09/2022]
Abstract
BACKGROUND A complex relationship between adipose tissue and malignancy, involving an inflammatory response, has been reported. The goal of this work was to assess the prevalence of white adipose tissue (WAT) inflammation in patients with endometrial cancer (EC), and the association with circulating inflammation markers. Furthermore, the aim was to characterize the pathways activated in and the cell type composition of adipose tissue in patients with EC. METHODS Adipose tissue and blood samples were prospectively collected from 101 patients with EC at initial surgery. WAT inflammation was determined based on adipocytes surrounded by macrophages forming crown-like structures. Circulating levels of metabolic syndrome-associated and inflammatory markers were quantified. RNA-sequencing was performed on adipose samples (n = 55); differential gene expression, pathway, and cellular decomposition analyses were performed using state-of-the-art bioinformatics methods. RESULTS WAT inflammation was identified in 46 (45.5%) of 101 EC patients. Dyslipidemia, hypertension, and diabetes mellitus were significantly associated with WAT inflammation (p < .05). WAT inflammation was associated with greater body mass index (p < .001) and higher circulating levels of leptin, high-sensitivity C-reactive protein, and interleukin-6, as well as lower levels of adiponectin and sex hormone-binding globulin (p < .05). Transcriptomic analysis demonstrated increased levels of proinflammatory and pro-neoplastic-related gene expression in inflamed omental adipose tissue. CONCLUSIONS WAT inflammation is associated with metabolic syndrome, obesity, and inflammatory markers, as well as increased expression of proinflammatory and proneoplastic genes.
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Affiliation(s)
- Lea A. Moukarzel
- Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Lorenzo Ferrando
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY
- Department of Internal Medicine, University of Genoa, Genoa, Italy
| | - Anthe Stylianou
- Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Stephanie Lobaugh
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Michelle Wu
- Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Silvana Pedra Nobre
- Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Alexia Iasonos
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Gabriele Zoppoli
- Department of Internal Medicine, University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Dilip D. Giri
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Nadeem R. Abu-Rustum
- Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY
- Department of OB/GYN, Weill Cornell Medical College, New York, NY
| | - Vance A. Broach
- Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY
- Department of OB/GYN, Weill Cornell Medical College, New York, NY
| | - Neil M. Iyengar
- Breast Medicine Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
- Department of Medicine, Weill Cornell Medical College, New York, NY
| | - Britta Weigelt
- Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Vicky Makker
- Department of Medicine, Weill Cornell Medical College, New York, NY
- Gynecologic Medical Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
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24
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Caba L, Florea L, Braha EE, Lupu VV, Gorduza EV. Monitoring and Management of Bardet-Biedl Syndrome: What the Multi-Disciplinary Team Can Do. J Multidiscip Healthc 2022; 15:2153-2167. [PMID: 36193191 PMCID: PMC9526427 DOI: 10.2147/jmdh.s274739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Accepted: 09/16/2022] [Indexed: 11/23/2022] Open
Abstract
Bardet – Biedl syndrome is a rare autosomal recessive multisystem non-motile ciliopathy. It has heterogeneous clinical manifestations. It is caused by mutations in 26 genes encoding BBSome proteins, chaperonines, and IFT complex. The main clinical features are: retinal cone-rod dystrophy, central obesity, postaxial polydactyly, cognitive impairment, hypogonadism and genitourinary anomalies, and kidney disease. The onset of clinical manifestations is variable which makes the diagnosis difficult in some patients. Because of the multiple system involvement, a multidisciplinary approach is necessary. The purpose of this review is to provide monitoring and management directions for a better approach to these patients.
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Affiliation(s)
- Lavinia Caba
- Department of Mother and Child Medicine – Medical Genetics, “Grigore T. Popa” University of Medicine and Pharmacy, Iaşi, Romania
- Correspondence: Lavinia Caba, Department of Medical Genetics, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 16 University Street, Iasi, 700115, Romania, Email
| | - Laura Florea
- Department of Nephrology - Internal Medicine, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, Iasi, Romania
| | | | - Valeriu Vasile Lupu
- Department of Mother and Child Medicine – Pediatrics, “Grigore T. Popa” University of Medicine and Pharmacy, Iaşi, Romania
| | - Eusebiu Vlad Gorduza
- Department of Mother and Child Medicine – Medical Genetics, “Grigore T. Popa” University of Medicine and Pharmacy, Iaşi, Romania
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25
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Rami Y, Ebrahimpour K, Maghami M, Shoshtari-Yeganeh B, Kelishadi R. The Association Between Heavy Metals Exposure and Sex Hormones: a Systematic Review on Current Evidence. Biol Trace Elem Res 2022; 200:3491-3510. [PMID: 34668113 DOI: 10.1007/s12011-021-02947-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Accepted: 08/10/2021] [Indexed: 10/20/2022]
Abstract
The general population is voluntarily or unintentionally exposed to heavy metals through ingestion of food, polluted water, or contact with soil, dust, or polluted air. A number of metals are considered as endocrine disruptors and can alter the level of reproductive hormones. This study aims to systematically review the epidemiological studies on the association between heavy metals exposure and sex hormones level. We conducted a systematic search from available databases, including PubMed, Clarivate Web of Science, Scopus, Google Scholar, and Cochrane Collaboration, until April 2021. The relevant studies were selected, and two reviewers conducted the quality assessment. Then, data were extracted based on the inclusion criteria. We identified nine articles related to the association between heavy metals exposure and sex hormones level. We summarized the relevant information. Due to the diversity of metals and the variety of sex hormones, the effect of exposure on hormones level was not clear; however in most studies, at least for one metal, a significant association (inverse or positive) was observed between metals exposure and hormones level. Heavy metals exposure may potentially alter sex hormone levels; however, further research is needed to evaluate the impact of this association.
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Affiliation(s)
- Yasaman Rami
- Environment Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Karim Ebrahimpour
- Environment Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mahboobeh Maghami
- Department of Bio-Statistics and Epidemiology, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Bahareh Shoshtari-Yeganeh
- Environment Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Roya Kelishadi
- Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
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26
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Akkaliyev M, Aukenov N, Massabayeva M, Apsalikov B, Rakhyzhanova S, Kuderbaev M, Sadykov N. Effect of SHBG Polymorphism on the Levels of Bioavailable Testosterone and Lipid Metabolism in Older Men of the Kazakh Population. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.8145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
This study is aimed at investigating the effect of SHBG (rs727428; rs10822184) and LPL (rs754493647) single nucleotide polymorphisms on the concentration of the bioavailable fraction of testosterone in older men.
Materials and methods To study gene mutations, 417 residents of the East Kazakhstan region of Kazakh nationality were examined. The main group included 135 men with signs of hypogonadism (AMS 37-49), and the control group consisted of 282 healthy men (AMS 17-26) of the corresponding age (p = 0.5). Single nucleotide polymorphisms rs 727428 [C / T]; rs10822184 [T / C]; rs754493647 [T / C], was determined by the TaqMan method.
Results Analysis of the rs727428 polymorphism has revealed that the TT allele (rs727428) has a lower level of albumin (p = 0.03), bioavailable testosterone (p = 0.04), and free testosterone (p = 0.6) than in carriers of the CC and CT genotypes. Also, it has shown a decrease in total testosterone (p = 0.001) and an increase in SHBG levels (p = 0.07) in men with the TT genotype of the rs727428 gene polymorphism. The rs10822184 polymorphism demonstrated an increase in triglyceride and LDL levels in TT genotype (p ≤ 0.04), in comparison with CC and CT genotypes.
Conclusion It has been proven that rs727428 (p = 0.001) is associated with testosterone levels and therefore can determine the concentration of bioavailable testosterone. Decreased levels of bioavailable testosterone are a sign of male hypogonadism. This study confirms the effect of rs10822184 on LDL (p = 0.01) and triglyceride (p = 0.04) levels, but its association with androgen levels has not been proven. Our results may be of interest for understanding the etiology of early development of hypogonadism and lipid metabolism disorders in men. To confirm the conclusions, a more detailed study with a large sample of men from the Kazakh population may be required.
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27
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Gołacki J, Matuszek M, Matyjaszek-Matuszek B. Link between Insulin Resistance and Obesity—From Diagnosis to Treatment. Diagnostics (Basel) 2022; 12:diagnostics12071681. [PMID: 35885586 PMCID: PMC9321808 DOI: 10.3390/diagnostics12071681] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 06/29/2022] [Accepted: 07/09/2022] [Indexed: 11/25/2022] Open
Abstract
Insulin resistance (IR) has become a common health issue in medical practice. There are no detailed data on IR prevalence, but it is an increasing problem due to its close association with obesity. However, IR is not considered as a separate nosological entity and the diagnostic criteria are not well defined, which leads to overdiagnosis of IR and an inappropriate approach. This review aims to summarize the available literature on IR pathophysiology, its relationship with obesity, as well as diagnostic methods, clinical presentation and treatment. Excessive energy intake results in cell overload that triggers mechanisms to protect cells from further energy accumulation by reducing insulin sensitivity. Additionally, hypertrophied adipocytes and macrophage infiltration causes local inflammation that may result in general inflammation that induces IR. The clinical picture varies from skin lesions (e.g., acanthosis nigricans) to metabolic disorders such as diabetes mellitus or metabolic-associated fatty liver disease. There are numerous IR laboratory markers with varying sensitivities and specificities. Nutrition changes and regular physical activity are crucial for IR management because a reduction in adipose tissue may reverse the inflammatory state and consequently reduce the severity of insulin resistance. In cases of obesity, anti-obesity medications can be used.
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Affiliation(s)
- Jakub Gołacki
- Department of Endocrinology, Diabetology and Metabolic Diseases, Medical University of Lublin, Jaczewskiego 8, 20-954 Lublin, Poland;
- Correspondence:
| | - Małgorzata Matuszek
- Student’s Scientific Society at the Department of Endocrinology, Diabetology and Metabolic Diseases, Medical University of Lublin, 20-954 Lublin, Poland;
| | - Beata Matyjaszek-Matuszek
- Department of Endocrinology, Diabetology and Metabolic Diseases, Medical University of Lublin, Jaczewskiego 8, 20-954 Lublin, Poland;
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28
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Madsen A, Almås B, Bruserud IS, Oehme NHB, Nielsen CS, Roelants M, Hundhausen T, Ljubicic ML, Bjerknes R, Mellgren G, Sagen JV, Juliusson PB, Viste K. Reference Curves for Pediatric Endocrinology: Leveraging Biomarker Z-Scores for Clinical Classifications. J Clin Endocrinol Metab 2022; 107:2004-2015. [PMID: 35299255 PMCID: PMC9202734 DOI: 10.1210/clinem/dgac155] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Indexed: 12/13/2022]
Abstract
CONTEXT Hormone reference intervals in pediatric endocrinology are traditionally partitioned by age and lack the framework for benchmarking individual blood test results as normalized z-scores and plotting sequential measurements onto a chart. Reference curve modeling is applicable to endocrine variables and represents a standardized method to account for variation with gender and age. OBJECTIVE We aimed to establish gender-specific biomarker reference curves for clinical use and benchmark associations between hormones, pubertal phenotype, and body mass index (BMI). METHODS Using cross-sectional population sample data from 2139 healthy Norwegian children and adolescents, we analyzed the pubertal status, ultrasound measures of glandular breast tissue (girls) and testicular volume (boys), BMI, and laboratory measurements of 17 clinical biomarkers modeled using the established "LMS" growth chart algorithm in R. RESULTS Reference curves for puberty hormones and pertinent biomarkers were modeled to adjust for age and gender. Z-score equivalents of biomarker levels and anthropometric measurements were compiled in a comprehensive beta coefficient matrix for each gender. Excerpted from this analysis and independently of age, BMI was positively associated with female glandular breast volume (β = 0.5, P < 0.001) and leptin (β = 0.6, P < 0.001), and inversely correlated with serum levels of sex hormone-binding globulin (SHBG) (β = -0.4, P < 0.001). Biomarker z-score profiles differed significantly between cohort subgroups stratified by puberty phenotype and BMI weight class. CONCLUSION Biomarker reference curves and corresponding z-scores provide an intuitive framework for clinical implementation in pediatric endocrinology and facilitate the application of machine learning classification and covariate precision medicine for pediatric patients.
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Affiliation(s)
- Andre Madsen
- Correspondence: André Madsen, PhD, Hormone Laboratory, Department of Medical Biochemistry and Pharmacology, Haukeland University Hospital, N-5021 Bergen, Norway.
| | - Bjørg Almås
- Hormone Laboratory, Department of Medical Biochemistry and Pharmacology, Haukeland University Hospital, Bergen, Norway
| | - Ingvild S Bruserud
- Faculty of Health, VID Specialized University, Bergen, Norway
- Department of Pediatrics, Haukeland University Hospital, Bergen, Norway
| | | | - Christopher Sivert Nielsen
- Department of Chronic Diseases and Ageing, Norwegian Institute of Public Health, Oslo, Norway
- Department of Pain Management and Research, Oslo University Hospital, Oslo, Norway
| | - Mathieu Roelants
- Environment and Health, Department of Public Health and Primary Care, KU Leuven, University of Leuven, Leuven, Belgium
| | - Thomas Hundhausen
- Department of Medical Biochemistry, Southern Norway Hospital Trust, Kristiansand, Norway
- Department of Natural Sciences, University of Agder, Kristiansand, Norway
| | - Marie Lindhardt Ljubicic
- Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, and International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Copenhagen, Denmark
| | - Robert Bjerknes
- Department of Pediatrics, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Gunnar Mellgren
- Hormone Laboratory, Department of Medical Biochemistry and Pharmacology, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Science, University of Bergen, Bergen, Norway
- Mohn Nutrition Research Laboratory, University of Bergen, Bergen, Norway
| | - Jørn V Sagen
- Hormone Laboratory, Department of Medical Biochemistry and Pharmacology, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Science, University of Bergen, Bergen, Norway
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Cienfuegos S, Corapi S, Gabel K, Ezpeleta M, Kalam F, Lin S, Pavlou V, Varady KA. Effect of Intermittent Fasting on Reproductive Hormone Levels in Females and Males: A Review of Human Trials. Nutrients 2022; 14:nu14112343. [PMID: 35684143 PMCID: PMC9182756 DOI: 10.3390/nu14112343] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 05/27/2022] [Accepted: 06/01/2022] [Indexed: 12/27/2022] Open
Abstract
Intermittent fasting is a popular diet for weight loss, but concerns have been raised regarding the effects of fasting on the reproductive health of women and men. Accordingly, we conducted this literature review to clarify the effects of fasting on reproductive hormone levels in humans. Our results suggest that intermittent fasting decreases androgen markers (i.e., testosterone and the free androgen index (FAI)) while increasing sex hormone-binding globulin (SHBG) levels in premenopausal females with obesity. This effect was more likely to occur when food consumption was confined to earlier in the day (eating all food before 4 pm). In contrast, fasting did not have any effect on estrogen, gonadotropins, or prolactin levels in women. As for men, intermittent fasting reduced testosterone levels in lean, physically active, young males, but it did not affect SHBG concentrations. Interestingly, muscle mass and muscular strength were not negatively affected by these reductions in testosterone. In interpreting these findings, it is important to note that very few studies have been conducted on this topic. Thus, it is difficult to draw solid conclusions at present. From the limited data presented here, it is possible that intermittent fasting may decrease androgen markers in both genders. If this is the case, these results would have varied health implications. On the one hand, fasting may prove to be a valuable tool for treating hyperandrogenism in females with polycystic ovarian syndrome (PCOS) by improving menstruation and fertility. On the other hand, fasting may be shown to decrease androgens among males, which could negatively affect metabolic health and libido. More research is warranted to confirm these preliminary findings.
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30
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Cross-sectional metabolic subgroups and 10-year follow-up of cardiometabolic multimorbidity in the UK Biobank. Sci Rep 2022; 12:8590. [PMID: 35597771 PMCID: PMC9124207 DOI: 10.1038/s41598-022-12198-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 04/29/2022] [Indexed: 12/26/2022] Open
Abstract
We assigned 329,908 UK Biobank participants into six subgroups based on a self-organizing map of 51 biochemical measures (blinded for clinical outcomes). The subgroup with the most favorable metabolic traits was chosen as the reference. Hazard ratios (HR) for incident disease were modeled by Cox regression. Enrichment ratios (ER) of incident multi-morbidity versus randomly expected co-occurrence were evaluated by permutation tests; ER is like HR but captures co-occurrence rather than event frequency. The subgroup with high urinary excretion without kidney stress (HR = 1.24) and the subgroup with the highest apolipoprotein B and blood pressure (HR = 1.52) were associated with ischemic heart disease (IHD). The subgroup with kidney stress, high adiposity and inflammation was associated with IHD (HR = 2.11), cancer (HR = 1.29), dementia (HR = 1.70) and mortality (HR = 2.12). The subgroup with high liver enzymes and triglycerides was at risk of diabetes (HR = 15.6). Multimorbidity was enriched in metabolically favorable subgroups (3.4 ≤ ER ≤ 4.0) despite lower disease burden overall; the relative risk of co-occurring disease was higher in the absence of obvious metabolic dysfunction. These results provide synergistic insight into metabolic health and its associations with cardiovascular disease in a large population sample.
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Abstract
Middle-aged and older men with lower testosterone concentrations are more likely to have or to develop metabolic syndrome and type 2 diabetes. Central adiposity is a risk factor for metabolic syndrome and diabetes and predisposes to lower testosterone concentrations. Conversely, testosterone treatment reduces fat mass and insulin resistance. In a randomized controlled trial of 1007 men with either impaired glucose tolerance or newly diagnosed type 2 diabetes, 2 years of testosterone treatment on a background of lifestyle intervention reduced the risk of type 2 diabetes by 40%; this demonstrates the potential utility for testosterone pharmacotherapy to prevent diabetes in men.
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Affiliation(s)
- Bu B Yeap
- Medical School, University of Western Australia, Perth, Western Australia 6009, Australia; Department of Endocrinology and Diabetes, Fiona Stanley Hospital, Perth, Western Australia 6150, Australia.
| | - Gary A Wittert
- Freemasons Centre for Men's Health and Wellbeing, Medical School, University of Adelaide, Adelaide, South Australia 5000, Australia; Department of Endocrinology, Royal Adelaide Hospital, Adelaide, South Australia 5000, Australia; South Australian Health and Medical Research Institute, North Terrace, Adelaide, South Australia 5000, Australia
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32
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Rashid R, Mir SA, Kareem O, Ali T, Ara R, Malik A, Amin F, Bader GN. Polycystic ovarian syndrome-current pharmacotherapy and clinical implications. Taiwan J Obstet Gynecol 2022; 61:40-50. [PMID: 35181044 DOI: 10.1016/j.tjog.2021.11.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/10/2021] [Indexed: 12/15/2022] Open
Abstract
Polycystic ovary syndrome (PCOS), the most common endocrinopathy in women is characterized by polycystic ovaries, chronic anovulation and hyperandrogenism. The treatment in PCOS is mainly symptomatic and involves lifestyle interventions and medications such as Metformin, Oral contraceptives and Antiandrogens. However, the management of PCOS is challenging and current interventions are not able to deal with outcomes of this syndrome. This review encompasses latest pharmacotherapeutic and non-pharmacotherapeutic interventions currently in use to tackle various symptomatic contentions in PCOS. Our focus has been mainly on novel therapeutic modalities for treatment/management of PCOS, like use of newer insulin sensitizers viz., Inositols, Glucagon-like peptide-1(GLP-1) agonists, Dipeptidyl pepdidase-4 (DPP-4) inhibitors, and sodium-glucose transport protein 2 (SGLT2) inhibitors. Also, evidence suggesting the use of vitamin D, statins, and Letrozole as emerging therapies in PCOS have been summarized in this review. Additionally, novel cosmetic techniques like electrolysis, laser and use of topically applied eflornithine to tackle the most distressing feature of facial hirsutism associated with PCOS, non-pharmacological therapy like acupuncture and the role of herbal medicine in PCOS management have also been discussed.
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Affiliation(s)
- Rumaisa Rashid
- Department of Pharmaceutical Sciences, University of Kashmir, Hazratbal, Srinagar, 190006, India.
| | - Suhail Ahmad Mir
- Department of Pharmaceutical Sciences, University of Kashmir, Hazratbal, Srinagar, 190006, India.
| | - Ozaifa Kareem
- Department of Pharmaceutical Sciences, University of Kashmir, Hazratbal, Srinagar, 190006, India.
| | - Tabassum Ali
- Department of Pharmaceutical Sciences, University of Kashmir, Hazratbal, Srinagar, 190006, India.
| | - Rifat Ara
- Department of Obstetrics & Gynaecology, Sheri Kashmir Institute of Medical Sciences, Medical College & Hospital, Bemina, Srinagar, 190001, India.
| | - Anjum Malik
- Department of Obstetrics & Gynaecology, Sheri Kashmir Institute of Medical Sciences, Medical College & Hospital, Bemina, Srinagar, 190001, India.
| | - Fiza Amin
- Department of Gynaecology and Obstetrics, Lala Ded Hospital, Govt Medical College Srinagar, India.
| | - G N Bader
- Department of Pharmaceutical Sciences, University of Kashmir, Hazratbal, Srinagar, 190006, India.
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Sex Hormone-Binding Globulin and Its Association to Cardiovascular Risk Factors in an Italian Adult Population Cohort. REPORTS 2022. [DOI: 10.3390/reports5010005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Abnormal sex hormone-binding globulin (SHBG) and sex hormone concentrations are the cause or the consequence of cardiometabolic diseases, however, the clinical correlates of SHBG is clearly less understood. In our study we investigate sex- and age-specific serum SHBG levels and their association with cardiovascular risk (CVR) factors and high-risk conditions in an adult cohort of Italian population. Data from 1176 men and 2236 women, aged 20–81 were analyzed and serum SHBG determined in stored samples using an immunoassay. SHBG concentrations, higher in women than in men in the younger age groups, exhibited a curvilinear increase with age in men and a U-shaped curve across the lifespan in women, with a decrease from the 2nd to the 6th decade of age and an increase after the 6th decade when SHBG concentrations were similar in both sexes. Low SHBG serum levels correlated with the traditional CVR factors diabetes, obesity, and hypertension, whereas high level of SHBG correlated with cholesterol HDL. These associations were more numerous in women than in men, in whom decreased with age. The sex- and age specific differences observed in our population-based cohort should be considered in establishing reference ranges and clinical cut-off points to improve CVR score charts and therapeutic approaches.
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Defeudis G, Mazzilli R, Tenuta M, Rossini G, Zamponi V, Olana S, Faggiano A, Pozzilli P, Isidori AM, Gianfrilli D. Erectile dysfunction and diabetes: A melting pot of circumstances and treatments. Diabetes Metab Res Rev 2022; 38:e3494. [PMID: 34514697 PMCID: PMC9286480 DOI: 10.1002/dmrr.3494] [Citation(s) in RCA: 64] [Impact Index Per Article: 32.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Accepted: 09/03/2021] [Indexed: 02/06/2023]
Abstract
Diabetes mellitus (DM), a chronic metabolic disease characterised by elevated levels of blood glucose, is among the most common chronic diseases. The incidence and prevalence of DM have been increasing over the years. The complications of DM represent a serious health problem. The long-term complications include macroangiopathy, microangiopathy and neuropathy as well as sexual dysfunction (SD) in both men and women. Erectile dysfunction (ED) has been considered the most important SD in men with DM. The prevalence of ED is approximately 3.5-fold higher in men with DM than in those without DM. Common risk factors for the development of DM and its complications include sedentary lifestyle, overweight/obesity and increased caloric consumption. Although lifestyle changes may help improve sexual function, specific treatments are often needed. This study aims to review the definition and prevalence of ED in DM, the impact of DM complications and DM treatment on ED and, finally, the current and emerging therapies for ED in patients with DM.
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Affiliation(s)
- Giuseppe Defeudis
- Unit of Endocrinology and DiabetesDepartment of MedicineUniversity Campus Bio‐Medico di RomaRomeItaly
| | - Rossella Mazzilli
- Department of Clinical and Molecular MedicineSapienza University of RomeRomeItaly
| | - Marta Tenuta
- Department of Experimental MedicineSapienza University of RomeRomeItaly
| | - Giovanni Rossini
- Unit of Endocrinology and DiabetesDepartment of MedicineUniversity Campus Bio‐Medico di RomaRomeItaly
| | - Virginia Zamponi
- Department of Clinical and Molecular MedicineSapienza University of RomeRomeItaly
| | - Soraya Olana
- Department of Clinical and Molecular MedicineSapienza University of RomeRomeItaly
| | - Antongiulio Faggiano
- Department of Clinical and Molecular MedicineSapienza University of RomeRomeItaly
| | - Paolo Pozzilli
- Unit of Endocrinology and DiabetesDepartment of MedicineUniversity Campus Bio‐Medico di RomaRomeItaly
| | - Andrea M. Isidori
- Department of Experimental MedicineSapienza University of RomeRomeItaly
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Cai WY, Luo X, Song J, Ji D, Zhu J, Duan C, Wu W, Wu XK, Xu J. Effect of Hyperinsulinemia and Insulin Resistance on Endocrine, Metabolic, and Reproductive Outcomes in Non-PCOS Women Undergoing Assisted Reproduction: A Retrospective Cohort Study. Front Med (Lausanne) 2022; 8:736320. [PMID: 35071255 PMCID: PMC8777269 DOI: 10.3389/fmed.2021.736320] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 11/29/2021] [Indexed: 12/22/2022] Open
Abstract
Objective: To evaluate the effect of hyperinsulinemia (HI) and insulin resistance (IR) on endocrine, metabolic, and reproductive outcomes in women without polycystic ovary syndrome (PCOS) undergoing assisted reproduction. Materials and Methods: The study included 1,104 non-PCOS women undergoing in vitro fertilization/intracytoplasmic sperm injection-fresh embryo transfer. HI was evaluated by serum fasting insulin (FIN), and IR was evaluated by homeostatic model assessment of insulin resistance index (HOMA-IR). In addition, biometric, sex hormone, and metabolic parameters were measured. Independent t-test, linear, and logistic regression examined associations between HI, IR, and endocrine, metabolic, ovarian stimulation characteristics, and reproductive outcomes. Results: Women with HI and IR had lower levels of progesterone, luteinizing hormone, follicle-stimulating hormone, estradiol, high-density lipoproteins, and increased levels of triglycerides low-density lipoproteins. For ovarian stimulation characteristics, those with HI and IR had a longer duration of stimulation, a higher total gonadotropin dose, and a lower peak estradiol level. Linear regression confirmed these associations. For reproductive outcomes, HI and IR were not associated with clinical pregnancy, live birth, and miscarriage. Conclusions: HI and IR did not impair reproductive outcomes in non-PCOS women undergoing assisted reproduction.
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Affiliation(s)
- Wang-Yu Cai
- Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, China
| | - Xi Luo
- Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Jianyuan Song
- Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, China
| | - Danpin Ji
- Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Jun Zhu
- Zhejiang University School of Medicine, Hangzhou, China
| | - Cuicui Duan
- Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Wei Wu
- Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, China
| | - Xiao-Ke Wu
- Department of Gynecology, First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, China.,Heilongjiang Province Hospital, Harbin, China
| | - Jian Xu
- Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, China.,Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China
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36
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Biernacka-Bartnik A, Kocełak P, Owczarek AJ, Choręza P, Puzianowska-Kuźnicka M, Markuszewski L, Madej P, Chudek J, Olszanecka-Glinianowicz M. Prediction of Insulin Resistance and Impaired Fasting Glucose Based on Sex Hormone-Binding Globulin (SHBG) Levels in Polycystic Ovary Syndrome. Int J Endocrinol 2022; 2022:6498768. [PMID: 35140785 PMCID: PMC8820943 DOI: 10.1155/2022/6498768] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 09/15/2021] [Accepted: 12/08/2021] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE Decreased synthesis of sex hormone-binding globulin (SHBG) related to hyperinsulinemia is one of the disturbances characteristic of polycystic ovary syndrome (PCOS). Hyperinsulinemia is a compensatory mechanism for liver insulin resistance (IR); thus, SHBG may be considered as a surrogate marker of liver IR. Therefore, this study aimed to assess the prediction of IR and impaired fasting glucose (IFG) based on SHBG levels in women with PCOS. METHODS This analysis included data retrieved from medical records of 854 patients with PCOS hospitalized in the Gynecological Endocrinology Clinic from 2012 to 2019. Data including anthropometric parameters, fasting plasma glucose, insulin, and SHBG levels were analyzed. BMI and HOMA-IR were calculated with standard formulas. RESULTS IFG and IR assessed based on HOMA-IR values > 2.0 were found in 19.5% and 47.8% of the study group, respectively. Empirical optimal cutoff values for SHBG levels were ≤41.5 nmol/L typical for IR (AUC 0.711, sensitivity 61.1%, specificity 71.6%, positive predictive value (PPV) 70.7%, and negative predictive value (NPV) 62.1%). The probability of insulin resistance occurrence for SHBG concentration 26.1 nmol/L (the lower normal range) was 61.6% (95% CI: 57.4%-65.8%). The SHBG concentration of 36.4 nmol/L and 8.1 nmol/L was related to a 10% and 20% probability of IFG, respectively. CONCLUSION In conclusion, this is the first study estimating the probability of liver IR and IFG occurrence based on SHBG levels in women with PCOS. Despite the low sensitivity, SHBG level below 42 nmol/L should cause closer monitoring for the fatty liver and prediabetes.
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Affiliation(s)
- Aleksandra Biernacka-Bartnik
- Department of Gynecological Endocrinology, Faculty of Medical Sciences in Katowice, Medical University of Silesia in Katowice, Katowice, Poland
| | - Piotr Kocełak
- Pathophysiology Unit, Department of Pathophysiology, Faculty of Medical Sciences in Katowice, Medical University of Silesia in Katowice, Katowice, Poland
| | - Aleksander Jerzy Owczarek
- Health Promotion and Obesity Management Unit, Department of Pathophysiology, Faculty of Medical Sciences in Katowice, Medical University of Silesia in Katowice, Katowice, Poland
| | - Piotr Choręza
- Department of Statistics, Department of Instrumental Analysis, Faculty of Pharmaceutical Sciences in Sosnowiec, Medical University of Silesia, Katowice, Poland
| | - Monika Puzianowska-Kuźnicka
- Department of Human Epigenetics, Mossakowski Medical Research Institute, Polish Academy of Sciences, Warsaw, Poland
- Department of Geriatrics and Gerontology, Medical Centre of Postgraduate Education, Warsaw, Poland
| | - Leszek Markuszewski
- Center Heart and Vascular Diseases Internal and Metabolic Diseases Mazovian Specialist Hospital in Radom, University of Humanities and Technology in Radom, Radom, Poland
| | - Paweł Madej
- Department of Gynecological Endocrinology, Faculty of Medical Sciences in Katowice, Medical University of Silesia in Katowice, Katowice, Poland
| | - Jerzy Chudek
- Pathophysiology Unit, Department of Pathophysiology, Faculty of Medical Sciences in Katowice, Medical University of Silesia in Katowice, Katowice, Poland
- Department of Internal Medicine and Oncological Chemotherapy, Faculty of Medical Sciences in Katowice, Medical University of Silesia in Katowice, Katowice, Poland
| | - Magdalena Olszanecka-Glinianowicz
- Health Promotion and Obesity Management Unit, Department of Pathophysiology, Faculty of Medical Sciences in Katowice, Medical University of Silesia in Katowice, Katowice, Poland
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37
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Armeni E, Lambrinoudaki I. Menopause, androgens, and cardiovascular ageing: a narrative review. Ther Adv Endocrinol Metab 2022; 13:20420188221129946. [PMID: 36325501 PMCID: PMC9619256 DOI: 10.1177/20420188221129946] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 09/09/2022] [Indexed: 11/07/2022] Open
Abstract
Cardiovascular disease is the leading cause of death worldwide; however, women tend to be less affected than men during their reproductive years. The female cardiovascular risk increases significantly around the time of the menopausal transition. The loss of the protective action of ovarian oestrogens and the circulating androgens has been implicated in possibly inducing subclinical and overt changes in the cardiovascular system after the menopausal transition. In vitro studies performed in human or animal cell lines demonstrate an adverse effect of testosterone on endothelial cell function and nitric oxide bioavailability. Cohort studies evaluating associations between testosterone and/or dehydroepiandrosterone and subclinical vascular disease and clinical cardiovascular events show an increased risk for women with more pronounced androgenicity. However, a mediating effect of insulin resistance is possible. Data on cardiovascular implications following low-dose testosterone treatment in middle-aged women or high-dose testosterone supplementation for gender affirmatory purposes remain primarily inconsistent. It is prudent to consider the possible adverse association between testosterone and endothelial function during the decision-making process of the most appropriate treatment for a postmenopausal woman.
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Affiliation(s)
| | - Irene Lambrinoudaki
- Second Department of Obstetrics and Gynecology, Aretaieio Hospital, National and Kapodistrian University of Athens, Athens, Greece
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38
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Early Identification of the Maternal, Placental and Fetal Dialog in Gestational Diabetes and Its Prevention. REPRODUCTIVE MEDICINE 2021. [DOI: 10.3390/reprodmed3010001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Gestational diabetes mellitus (GDM) complicates between 5 and 12% of pregnancies, with associated maternal, fetal, and neonatal complications. The ideal screening and diagnostic criteria to diagnose and treat GDM have not been established and, currently, diagnostic use with an oral glucose tolerance test occurs late in pregnancy and produces poor reproducibility. Therefore, in recent years, significant research has been undertaken to identify a first-trimester biomarker that can predict GDM later in pregnancy, enable early intervention, and reduce GDM-related adverse pregnancy outcomes. Possible biomarkers include glycemic markers (fasting glucose and hemoglobin A1c), adipocyte-derived markers (adiponectin and leptin), pregnancy-related markers (pregnancy-associated plasma protein-A and the placental growth factor), inflammatory markers (C-reactive protein and tumor necrosis factor-α), insulin resistance markers (sex hormone-binding globulin), and others. This review summarizes current data on first-trimester biomarkers, the advantages, and the limitations. Large multi-ethnic clinical trials and cost-effectiveness analyses are needed not only to build effective prediction models but also to validate their clinical use.
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Effects of Mixed of a Ketogenic Diet in Overweight and Obese Women with Polycystic Ovary Syndrome. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312490. [PMID: 34886216 PMCID: PMC8656706 DOI: 10.3390/ijerph182312490] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 11/24/2021] [Accepted: 11/25/2021] [Indexed: 11/16/2022]
Abstract
Polycystic ovary syndrome (PCOS) is a commonly occurring endocrine disorder characterized by hirsutism, anovulation, and polycystic ovaries. Often comorbid with insulin resistance, dyslipidemia, and obesity, it also carries significant risk for the development of cardiovascular and metabolic sequelae, including diabetes and metabolic syndrome. The relationship between central obesity and the development of insulin resistance is widely verified. Adipose tissue excess and the coexistent dysregulation of adipocyte functions directly contribute to the pathogenesis of the metabolic complications observed in women with PCOS. In the light of these evidence, the most therapeutic option prescribed to obese women with PCOS, regardless of the phenotype e from the severity of clinical expression, is lifestyle correction by diet and physical activity. The aim of this study is to evaluate the beneficial effects of ketogenic diet in 17 obese women with PCOS. Our results showed that the ketogenic diet inducing therapeutic ketosis, improves the anthropometric and many biochemical parameters such as LH, FSH, SHBG, insulin sensitivity and HOMA index. In addition, it induces a reduction in androgenic production, whereas the contextual reduction of fat mass reduced the acyclic production of estrogens deriving from the aromatization in the adipose tissue of the androgenic excess, with an improvement of the LH/FSH ratio. This is the first study on the effects of the ketogenic diet on PCOS, however, further studies are needed to elucidate the mechanism underlying ketogenic diet effects.
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Zhai J, Li S, Zhu Y, Sun Y, Chen ZJ, Du Y. Serum Sex Hormone Binding Globulin Concentration as a Predictor of Ovarian Response During Controlled Ovarian Hyperstimulation. Front Med (Lausanne) 2021; 8:719818. [PMID: 34805198 PMCID: PMC8600072 DOI: 10.3389/fmed.2021.719818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 10/12/2021] [Indexed: 11/30/2022] Open
Abstract
Purpose: Serum concentrations of sex hormone binding globulin (SHBG), a glycated homodimeric plasma transport protein, correlate positively with the total number of follicles in women with infertility. However, the relationship between serum SHBG concentrations and the ovarian response during controlled ovarian hyperstimulation (COH) and whether this relationship differs between women with and without polycystic ovary syndrome (PCOS) remains unclear. Methods: The study cohort included 120 participants (60 non-PCOS and 60 PCOS) undergoing in vitro fertilization. Serum samples were collected from each participant every 2–3 days during the COH cycle. The concentrations of serum SHBG and other sex hormones were determined to investigate the relationship between serum SHBG concentrations and the ovarian response in women with and without PCOS. Results: We found that the serum SHBG concentration was positively correlated with the ovarian response in non-PCOS patients but not in PCOS patients. Conclusion: The serum SHBG concentration may be clinically useful as a predictor of the ovarian response during COH in patients without PCOS.
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Affiliation(s)
- Junyu Zhai
- Center for Reproductive Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.,Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai, China
| | - Shang Li
- Center for Reproductive Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.,Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai, China
| | - Yinci Zhu
- Center for Reproductive Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.,Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai, China
| | - Yun Sun
- Center for Reproductive Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.,Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai, China
| | - Zi-Jiang Chen
- Center for Reproductive Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.,Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai, China.,Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, China.,National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, China.,Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, China
| | - Yanzhi Du
- Center for Reproductive Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.,Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai, China
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41
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Shang Y, Zhou H, He R, Lu W. Dietary Modification for Reproductive Health in Women With Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis. Front Endocrinol (Lausanne) 2021; 12:735954. [PMID: 34790167 PMCID: PMC8591222 DOI: 10.3389/fendo.2021.735954] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Accepted: 10/11/2021] [Indexed: 11/13/2022] Open
Abstract
Objective Diet has been reported as the first-line management of polycystic ovary syndrome (PCOS). However, the relationship between diet and fertility in PCOS is still controversial. This meta-analysis aimed to evaluate whether diet could promote reproductive health in women with PCOS while providing evidence-based nutrition advice for clinical practice. Methods Seven databases, including Cochrane Central Register of Controlled Trials, PubMed, Embase, Web of Science, and some Chinese database, were searched up to January 31, 2021. Randomized controlled trials evaluating the effects of diet in women with PCOS were included. Based on a preregistered protocol (PROSPERO CRD42019140454), the systematic review was performed following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Two reviewers made study selection, data extraction and bias assessment independently. Risk ratios and mean difference with 95% confidence intervals were assessed by a random-effects model. Statistical heterogeneity within comparisons was evaluated by Cochran's Q test and quantified by the I-squared (I2 ) statistic. Results Twenty RCTs with 1113 participants were included. Results showed diet significantly related to improved fertility outcomes (increasing clinical pregnancy, ovulation and menstrual regularity rate; reducing miscarriage rate), reproductive endocrine [increasing sex hormone-binding globulin (SHBG); decreasing Anti-Müllerian Hormone (AMH), free androgen index (FAI), total testosterone (T)] and clinical hyperandrogenism (hirsutism assessed by Ferriman-Gallwey score) in PCOS. Specifically, subgroup analyses indicated low-carbohydrate diets were superior in optimizing reproductive outcomes and calorie restriction was critical in ameliorating hyperandrogenism. Additionally, the positive effects were associated with the treatment duration. The longer the duration, the greater the improvement was. Conclusion Overall, diet is an effective intervention for improving fertility health, thus professional and dynamic dietary advice should be offered to all PCOS patients, based on the changeable circumstances, personal needs and expectations of the individuals.
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Affiliation(s)
- Yujie Shang
- Department of Gynecology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
- The First School of Clinical Medicine, Nanjing University of Chinese Medicine, Nanjing, China
| | - Huifang Zhou
- Department of Gynecology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
- The First School of Clinical Medicine, Nanjing University of Chinese Medicine, Nanjing, China
| | - Ruohan He
- Maternal and Child Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wentian Lu
- Department of Gynecology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
- The First School of Clinical Medicine, Nanjing University of Chinese Medicine, Nanjing, China
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42
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Burchard J, Polpitiya AD, Fox AC, Randolph TL, Fleischer TC, Dufford MT, Garite TJ, Critchfield GC, Boniface JJ, Saade GR, Kearney PE. Clinical Validation of a Proteomic Biomarker Threshold for Increased Risk of Spontaneous Preterm Birth and Associated Clinical Outcomes: A Replication Study. J Clin Med 2021; 10:5088. [PMID: 34768605 PMCID: PMC8584743 DOI: 10.3390/jcm10215088] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 10/20/2021] [Accepted: 10/22/2021] [Indexed: 12/22/2022] Open
Abstract
Preterm births are the leading cause of neonatal death in the United States. Previously, a spontaneous preterm birth (sPTB) predictor based on the ratio of two proteins, IBP4/SHBG, was validated as a predictor of sPTB in the Proteomic Assessment of Preterm Risk (PAPR) study. In particular, a proteomic biomarker threshold of -1.37, corresponding to a ~two-fold increase or ~15% risk of sPTB, significantly stratified earlier deliveries. Guidelines for molecular tests advise replication in a second independent study. Here we tested whether the significant association between proteomic biomarker scores above the threshold and sPTB, and associated adverse outcomes, was replicated in a second independent study, the Multicenter Assessment of a Spontaneous Preterm Birth Risk Predictor (TREETOP). The threshold significantly stratified subjects in PAPR and TREETOP for sPTB (p = 0.041, p = 0.041, respectively). Application of the threshold in a Kaplan-Meier analysis demonstrated significant stratification in each study, respectively, for gestational age at birth (p < 001, p = 0.0016) and rate of hospital discharge for both neonate (p < 0.001, p = 0.005) and mother (p < 0.001, p < 0.001). Above the threshold, severe neonatal morbidity/mortality and mortality alone were 2.2 (p = 0.0083,) and 7.4-fold higher (p = 0.018), respectively, in both studies combined. Thus, higher predictor scores were associated with multiple adverse pregnancy outcomes.
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Affiliation(s)
- Julja Burchard
- Sera Prognostics, Incorporated, Salt Lake City, UT 84109, USA; (J.B.); (A.D.P.); (A.C.F.); (T.L.R.); (M.T.D.); (T.J.G.); (G.C.C.); (J.J.B.); (P.E.K.)
| | - Ashoka D. Polpitiya
- Sera Prognostics, Incorporated, Salt Lake City, UT 84109, USA; (J.B.); (A.D.P.); (A.C.F.); (T.L.R.); (M.T.D.); (T.J.G.); (G.C.C.); (J.J.B.); (P.E.K.)
| | - Angela C. Fox
- Sera Prognostics, Incorporated, Salt Lake City, UT 84109, USA; (J.B.); (A.D.P.); (A.C.F.); (T.L.R.); (M.T.D.); (T.J.G.); (G.C.C.); (J.J.B.); (P.E.K.)
| | - Todd L. Randolph
- Sera Prognostics, Incorporated, Salt Lake City, UT 84109, USA; (J.B.); (A.D.P.); (A.C.F.); (T.L.R.); (M.T.D.); (T.J.G.); (G.C.C.); (J.J.B.); (P.E.K.)
| | - Tracey C. Fleischer
- Sera Prognostics, Incorporated, Salt Lake City, UT 84109, USA; (J.B.); (A.D.P.); (A.C.F.); (T.L.R.); (M.T.D.); (T.J.G.); (G.C.C.); (J.J.B.); (P.E.K.)
| | - Max T. Dufford
- Sera Prognostics, Incorporated, Salt Lake City, UT 84109, USA; (J.B.); (A.D.P.); (A.C.F.); (T.L.R.); (M.T.D.); (T.J.G.); (G.C.C.); (J.J.B.); (P.E.K.)
| | - Thomas J. Garite
- Sera Prognostics, Incorporated, Salt Lake City, UT 84109, USA; (J.B.); (A.D.P.); (A.C.F.); (T.L.R.); (M.T.D.); (T.J.G.); (G.C.C.); (J.J.B.); (P.E.K.)
| | - Gregory C. Critchfield
- Sera Prognostics, Incorporated, Salt Lake City, UT 84109, USA; (J.B.); (A.D.P.); (A.C.F.); (T.L.R.); (M.T.D.); (T.J.G.); (G.C.C.); (J.J.B.); (P.E.K.)
| | - J. Jay Boniface
- Sera Prognostics, Incorporated, Salt Lake City, UT 84109, USA; (J.B.); (A.D.P.); (A.C.F.); (T.L.R.); (M.T.D.); (T.J.G.); (G.C.C.); (J.J.B.); (P.E.K.)
| | - George R. Saade
- Department of Obstetrics & Gynecology, University of Texas Medical Branch, Galveston, TX 77555, USA;
| | - Paul E. Kearney
- Sera Prognostics, Incorporated, Salt Lake City, UT 84109, USA; (J.B.); (A.D.P.); (A.C.F.); (T.L.R.); (M.T.D.); (T.J.G.); (G.C.C.); (J.J.B.); (P.E.K.)
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Tuorila K, Ollila MM, Järvelin MR, Tapanainen JS, Franks S, Puukka K, Piltonen TT, Morin-Papunen L. Hyperandrogenemia in Early Adulthood Is an Independent Risk Factor for Abnormal Glucose Metabolism in Middle Age. J Clin Endocrinol Metab 2021; 106:e4621-e4633. [PMID: 34153097 PMCID: PMC8530724 DOI: 10.1210/clinem/dgab456] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Indexed: 11/19/2022]
Abstract
CONTEXT The role of androgen excess as a contributing factor to abnormal glucose metabolism (AGM) and insulin resistance in women remains controversial. OBJECTIVE To investigate whether hyperandrogenemia (HA) estimated by serum testosterone (T) level and free androgen index (FAI) at ages 31 and 46 years is associated with insulin resistance, insulin secretion and AGM by age 46. DESIGN Prospective study including 5889 females followed at ages 31 and 46 years. SETTING General community. PARTICIPANTS Women with HA were compared with normoandrogenic women at ages 31 and 46 years. INTERVENTION None. MAIN OUTCOME MEASUREMENTS AGM, including prediabetes and type 2 diabetes mellitus, homeostatic model assessments of insulin resistance (HOMA-IR) and of pancreatic β-cell function (HOMA-B). RESULTS At age 31 years, HA women displayed increased HOMA-IR (P = 0.002), HOMA-B (P = 0.007), and higher fasting insulin (P = 0.03) than normoandrogenic women after adjusting for body mass index (BMI). At age 46 years, there was a nonsignificant trend toward higher fasting glucose (P = 0.07) and glycated hemoglobin A1 (P = 0.07) levels in HA women. Women in the highest T quartile (odds ratio [OR] = 1.80; 95%CI, 1.15-2.82) at age 31 years and in the 2 highest FAI quartiles at ages 31 (Q4: OR = 3.76; 95% CI, 2.24-6.32) and 46 (Q4: OR = 2.79; 95% CI, 1.74-4.46) years had increased risk for AGM, independently of BMI, when compared with women in Q1. SHBG was inversely associated with AGM (at age 31 years: Q4: OR = 0.37; 95% CI, 0.23-0.60, at age 46 years: Q4: OR = 0.28; 95% CI, 0.17-0.44). CONCLUSION Hyperandrogenemia and low SHBG in early and middle age associates with AGM independently of BMI.
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Affiliation(s)
- Katri Tuorila
- Department of Obstetrics and Gynecology, University of Oulu and Oulu University Hospital, Medical Research Center, PEDEGO Research Unit, Oulu, Finland
| | - Meri-Maija Ollila
- Department of Obstetrics and Gynecology, University of Oulu and Oulu University Hospital, Medical Research Center, PEDEGO Research Unit, Oulu, Finland
| | - Marjo-Riitta Järvelin
- MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
- Center for Life Course Health Research, Faculty of Medicine, University of Oulu, Oulu, Finland
- Unit of Primary Health Care, Oulu University Hospital, OYS, Oulu, Finland
- Department of Life Sciences, College of Health and Life Sciences, Brunel University London, London, UK
| | - Juha S Tapanainen
- Department of Obstetrics and Gynecology, University of Oulu and Oulu University Hospital, Medical Research Center, PEDEGO Research Unit, Oulu, Finland
- Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Stephen Franks
- Institute of Reproductive and Developmental Biology, Imperial College London, London, UK
| | - Katri Puukka
- NordLab Oulu, Department of Clinical Chemistry, University of Oulu and Oulu University Hospital, Medical Research Center Oulu, Oulu, Finland
| | - Terhi T Piltonen
- Department of Obstetrics and Gynecology, University of Oulu and Oulu University Hospital, Medical Research Center, PEDEGO Research Unit, Oulu, Finland
| | - Laure Morin-Papunen
- Department of Obstetrics and Gynecology, University of Oulu and Oulu University Hospital, Medical Research Center, PEDEGO Research Unit, Oulu, Finland
- Correspondence: Laure Morin-Papunen, MD, PhD, Department of Obstetrics and Gynecology, Oulu University Hospital, PL 23 90029 OYS, Finland.
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Goudswaard LJ, Bell JA, Hughes DA, Corbin LJ, Walter K, Davey Smith G, Soranzo N, Danesh J, Di Angelantonio E, Ouwehand WH, Watkins NA, Roberts DJ, Butterworth AS, Hers I, Timpson NJ. Effects of adiposity on the human plasma proteome: observational and Mendelian randomisation estimates. Int J Obes (Lond) 2021; 45:2221-2229. [PMID: 34226637 PMCID: PMC8455324 DOI: 10.1038/s41366-021-00896-1] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 06/24/2021] [Accepted: 06/24/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND Variation in adiposity is associated with cardiometabolic disease outcomes, but mechanisms leading from this exposure to disease are unclear. This study aimed to estimate effects of body mass index (BMI) on an extensive set of circulating proteins. METHODS We used SomaLogic proteomic data from up to 2737 healthy participants from the INTERVAL study. Associations between self-reported BMI and 3622 unique plasma proteins were explored using linear regression. These were complemented by Mendelian randomisation (MR) analyses using a genetic risk score (GRS) comprised of 654 BMI-associated polymorphisms from a recent genome-wide association study (GWAS) of adult BMI. A disease enrichment analysis was performed using DAVID Bioinformatics 6.8 for proteins which were altered by BMI. RESULTS Observationally, BMI was associated with 1576 proteins (P < 1.4 × 10-5), with particularly strong evidence for a positive association with leptin and fatty acid-binding protein-4 (FABP4), and a negative association with sex hormone-binding globulin (SHBG). Observational estimates were likely confounded, but the GRS for BMI did not associate with measured confounders. MR analyses provided evidence for a causal relationship between BMI and eight proteins including leptin (0.63 standard deviation (SD) per SD BMI, 95% CI 0.48-0.79, P = 1.6 × 10-15), FABP4 (0.64 SD per SD BMI, 95% CI 0.46-0.83, P = 6.7 × 10-12) and SHBG (-0.45 SD per SD BMI, 95% CI -0.65 to -0.25, P = 1.4 × 10-5). There was agreement in the magnitude of observational and MR estimates (R2 = 0.33) and evidence that proteins most strongly altered by BMI were enriched for genes involved in cardiovascular disease. CONCLUSIONS This study provides evidence for a broad impact of adiposity on the human proteome. Proteins strongly altered by BMI include those involved in regulating appetite, sex hormones and inflammation; such proteins are also enriched for cardiovascular disease-related genes. Altogether, results help focus attention onto new proteomic signatures of obesity-related disease.
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Affiliation(s)
- Lucy J Goudswaard
- Medical Research Council (MRC) Integrative Epidemiology Unit at the University of Bristol, Bristol, UK.
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
- School of Physiology, Pharmacology and Neuroscience, University of Bristol, Bristol, UK.
- Bristol Heart Institute, Bristol, UK.
| | - Joshua A Bell
- Medical Research Council (MRC) Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - David A Hughes
- Medical Research Council (MRC) Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Laura J Corbin
- Medical Research Council (MRC) Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | | | - George Davey Smith
- Medical Research Council (MRC) Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Nicole Soranzo
- Wellcome Sanger Institute, Hinxton, UK
- Department of Haematology, School of Clinical Medicine, University of Cambridge, Cambridge, UK
- NIHR Blood and Transplant Research Unit in Donor Health and Genomics, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - John Danesh
- Wellcome Sanger Institute, Hinxton, UK
- NIHR Blood and Transplant Research Unit in Donor Health and Genomics, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- MRC/BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- British Heart Foundation Centre of Research Excellence, University of Cambridge, Cambridge, UK
- NIHR Cambridge Biomedical Research Centre, University of Cambridge and Cambridge University Hospitals, Cambridge, UK
- Health Data Research UK Cambridge, Wellcome Genome Campus and University of Cambridge, Cambridge, UK
| | - Emanuele Di Angelantonio
- NIHR Blood and Transplant Research Unit in Donor Health and Genomics, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- MRC/BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- British Heart Foundation Centre of Research Excellence, University of Cambridge, Cambridge, UK
- NIHR Cambridge Biomedical Research Centre, University of Cambridge and Cambridge University Hospitals, Cambridge, UK
- Health Data Research UK Cambridge, Wellcome Genome Campus and University of Cambridge, Cambridge, UK
| | - Willem H Ouwehand
- Wellcome Sanger Institute, Hinxton, UK
- Department of Haematology, School of Clinical Medicine, University of Cambridge, Cambridge, UK
- British Heart Foundation Centre of Research Excellence, University of Cambridge, Cambridge, UK
- NHS Blood and Transplant, Cambridge Biomedical Campus, Cambridge, UK
| | | | - David J Roberts
- NIHR Blood and Transplant Research Unit in Donor Health and Genomics, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- NHS Blood and Transplant-Oxford Centre, Level 2, John Radcliffe Hospital, Oxford, UK
- Radcliffe Department of Medicine, University of Oxford, John Radcliffe Hospital, Oxford, UK
| | - Adam S Butterworth
- NIHR Blood and Transplant Research Unit in Donor Health and Genomics, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- MRC/BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- British Heart Foundation Centre of Research Excellence, University of Cambridge, Cambridge, UK
- NIHR Cambridge Biomedical Research Centre, University of Cambridge and Cambridge University Hospitals, Cambridge, UK
- Health Data Research UK Cambridge, Wellcome Genome Campus and University of Cambridge, Cambridge, UK
| | - Ingeborg Hers
- School of Physiology, Pharmacology and Neuroscience, University of Bristol, Bristol, UK
- Bristol Heart Institute, Bristol, UK
| | - Nicholas J Timpson
- Medical Research Council (MRC) Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
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Aribas E, Kavousi M, Laven JSE, Ikram MA, Roeters van Lennep JE. Aging, Cardiovascular Risk, and SHBG Levels in Men and Women From the General Population. J Clin Endocrinol Metab 2021; 106:2890-2900. [PMID: 34197576 PMCID: PMC8475196 DOI: 10.1210/clinem/dgab470] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Indexed: 12/16/2022]
Abstract
AIMS Prior studies have reported inconsistent results for the association between sex hormone-binding globulin (SHBG) and cardiovascular disease among men and women. Although it is suggested that SHBG levels change with aging, the exact trend of SHBG across age and cardiovascular risk and the underlying mechanisms of these changes remain to be elucidated. METHODS Using data of 3264 men and women from a large population-based cohort study, we first visualized the distribution of serum SHBG levels across age. Second, we computed a cardiovascular risk factor sum score and investigated the mean SHBG levels across categories of the risk factor sum score and stratified per age-category. Next, linear regression models were used to investigate the associations between serum SHBG levels and age and potential regulators of SHBG, including body mass index (BMI), fasting insulin, sex steroids, thyroxine, and triglycerides. RESULTS Among men, a linear increase in SHBG levels with age and among women a U-shaped pattern was observed. Participants with larger number of cardiovascular risk factors had lower SHBG levels. When stratified by age, older participants had higher SHBG levels. A multivariate model including total testosterone and triglyceride levels in men and total testosterone, triglycerides, BMI, and fasting insulin in women explained, respectively, 46.2% and 31.8% of the variance in SHBG levels. CONCLUSION We observed a clear sex-specific pattern for SHBG levels with age. Our findings highlight the importance of taking into account the age-related changes in SHBG levels to avoid controversial results in the assessment of the cardiovascular risk associated with SHBG.
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Affiliation(s)
- Elif Aribas
- Department of Epidemiology, Erasmus Medical Center, University Medical Center, Rotterdam, The Netherlands
| | - Maryam Kavousi
- Department of Epidemiology, Erasmus Medical Center, University Medical Center, Rotterdam, The Netherlands
| | - Joop S E Laven
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Erasmus Medical Center, University Medical Center, Rotterdam, The Netherlands
| | - M Arfan Ikram
- Department of Epidemiology, Erasmus Medical Center, University Medical Center, Rotterdam, The Netherlands
| | - Jeanine E Roeters van Lennep
- Department of Internal Medicine, Erasmus Medical Center, University Medical Center, Rotterdam, The Netherlands
- Correspondence: Jeanine E. Roeters van Lennep, MD, PhD, Department of Internal Medicine, Erasmus Medical Center, Rotterdam 3015 GD, The Netherlands.
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46
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Hayón-Ponce M, García-Fontana B, Avilés-Pérez MD, González-Salvatierra S, Andújar-Vera F, Moratalla-Aranda E, Muñoz-Torres M. Lower trabecular bone score in type 2 diabetes mellitus: A role for fat mass and insulin resistance beyond hyperglycaemia. DIABETES & METABOLISM 2021; 47:101276. [PMID: 34517124 DOI: 10.1016/j.diabet.2021.101276] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 08/20/2021] [Accepted: 08/26/2021] [Indexed: 02/08/2023]
Abstract
AIMS To examine the clinical and biochemical determinants of trabecular bone score (TBS) in type 2 diabetes mellitus (T2DM) patients. METHODS Cross-sectional observational study in 137 T2DM patients (49-85 years). Whole-body fat percentage was estimated using the relative fat mass (RFM) equation. Bone mineral density (BMD) and TBS were assessed using dual-energy X-ray absorptiometry and TBS iNsight Software respectively. RESULTS T2DM patients showed significantly lower TBS values (P < 0.001) despite significantly higher lumbar spine BMD (LS-BMD) (P = 0.025) compared to controls. TBS values were negatively correlated with body mass index (BMI) (P < 0.001), waist circumference (P < 0.001), and HOMA-2IR index (P = 0.004) and positively correlated with sex hormone-binding globulin (SHBG) (P = 0.01) and LS-BMD (P = 0.003). RFM was negatively associated with TBS in both males (P < 0.001) and females (P = 0.005). The multivariate analysis showed that RFM, HOMA2-IR (negative), SHBG, and LS-BMD (positive) were the variables independently associated with TBS. ROC analysis revealed RFM as the variable with the highest predictive value for risk of degraded bone microarchitecture. CONCLUSIONS The adiposity estimated by RFM may negatively affect TBS and this relationship may be influenced by insulin resistance and SHBG. RFM could act as a key estimator of degraded bone microarchitecture risk in the T2DM population.
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Affiliation(s)
- María Hayón-Ponce
- Bone Metabolic Unit, Endocrinology and Nutrition Division. University Hospital Clínico San Cecilio. Av. de la Ilustración, s/n, 18016, Granada, Spain
| | - Beatriz García-Fontana
- Bone Metabolic Unit, Endocrinology and Nutrition Division. University Hospital Clínico San Cecilio. Av. de la Ilustración, s/n, 18016, Granada, Spain; Instituto de Investigación Biosanitaria de Granada (Ibs.GRANADA). Av. Madrid 15, 18012, Granada, Spain; CIBERFES, Instituto de Salud Carlos III. C/ Sinesio Delgado, 4, 28029, Madrid, Spain.
| | - María Dolores Avilés-Pérez
- Bone Metabolic Unit, Endocrinology and Nutrition Division. University Hospital Clínico San Cecilio. Av. de la Ilustración, s/n, 18016, Granada, Spain; Instituto de Investigación Biosanitaria de Granada (Ibs.GRANADA). Av. Madrid 15, 18012, Granada, Spain; CIBERFES, Instituto de Salud Carlos III. C/ Sinesio Delgado, 4, 28029, Madrid, Spain
| | - Sheila González-Salvatierra
- Bone Metabolic Unit, Endocrinology and Nutrition Division. University Hospital Clínico San Cecilio. Av. de la Ilustración, s/n, 18016, Granada, Spain; Instituto de Investigación Biosanitaria de Granada (Ibs.GRANADA). Av. Madrid 15, 18012, Granada, Spain; Department of Medicine. University of Granada. Av. de la Investigación, 11, 18016, Granada, Spain
| | - Francisco Andújar-Vera
- Instituto de Investigación Biosanitaria de Granada (Ibs.GRANADA). Av. Madrid 15, 18012, Granada, Spain
| | - Enrique Moratalla-Aranda
- Instituto de Investigación Biosanitaria de Granada (Ibs.GRANADA). Av. Madrid 15, 18012, Granada, Spain; Department of Nuclear Medicine, University Hospital Clínico San Cecilio. Av. de la Ilustración, s/n, 18016, Granada, Spain
| | - Manuel Muñoz-Torres
- Bone Metabolic Unit, Endocrinology and Nutrition Division. University Hospital Clínico San Cecilio. Av. de la Ilustración, s/n, 18016, Granada, Spain; Instituto de Investigación Biosanitaria de Granada (Ibs.GRANADA). Av. Madrid 15, 18012, Granada, Spain; CIBERFES, Instituto de Salud Carlos III. C/ Sinesio Delgado, 4, 28029, Madrid, Spain; Department of Medicine. University of Granada. Av. de la Investigación, 11, 18016, Granada, Spain.
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Wu TH, Lin CH, Goh KK, Chen CYA, Chen CH, Lane HY, Lu ML. The Relationships Between Hyperprolactinemia, Metabolic Disturbance, and Sexual Dysfunction in Patients With Schizophrenia Under Olanzapine Treatment. Front Pharmacol 2021; 12:718800. [PMID: 34421613 PMCID: PMC8374865 DOI: 10.3389/fphar.2021.718800] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 07/26/2021] [Indexed: 11/13/2022] Open
Abstract
The aim of the study was to assess the relationship between prolactin levels and sexual dysfunction in patients with schizophrenia who use olanzapine medication. The potential risk factors of hyperprolactinemia and sexual dysfunction were also investigated. Patients with schizophrenia undergoing olanzapine monotherapy were invited to participate in this cross-sectional study. The Arizona Sexual Experiences Scale (ASEX) and the Positive and Negative Syndrome Scale were used to evaluate subjective sexual dysfunction and psychopathology, respectively. Levels of prolactin and metabolic parameters were also measured. In total, 279 participants with schizophrenia were recruited. The overall incidences of hyperprolactinemia, sexual dysfunction, and metabolic syndrome were 51.6, 53.8, and 43.7%, respectively. Higher ASEX scores, higher insulin levels, female sex, and younger age were associated with hyperprolactinemia. Prolactin level was significantly correlated with ASEX score. Elevated prolactin levels, concomitant antidepressant, increased insulin resistance, longer illness duration, and female sex were associated with sexual dysfunction. Female participants recorded higher levels of sexual dysfunction than their male counterparts did, whereas male participants had comparatively lower prolactin levels and lower rates of spousal partnership. Hyperprolactinemia, metabolic syndrome, and sexual dysfunction are prevalent in patients with schizophrenia treated with olanzapine. Clinicians should maintain awareness of these problems and monitor them regularly with their patients.
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Affiliation(s)
- Tzu-Hua Wu
- Department of Clinical Pharmacy, School of Pharmacy, College of Pharmacy, Taipei Medical University, Taipei, Taiwan.,Psychiatric Research Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Chieh-Hsin Lin
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan.,Graduate Institute of Biomedical Sciences, China Medical University, Taichung, Taiwan.,School of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Kah Kheng Goh
- Psychiatric Research Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.,Department of Psychiatry, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Cynthia Yi-An Chen
- Psychiatric Research Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.,Department of Psychiatry, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Chun-Hsin Chen
- Psychiatric Research Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.,Department of Psychiatry, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.,Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Hsien-Yuan Lane
- Graduate Institute of Biomedical Sciences, China Medical University, Taichung, Taiwan.,Department of Psychiatry and Brain Disease Research Center, China Medical University Hospital, Taichung, Taiwan
| | - Mong-Liang Lu
- Psychiatric Research Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.,Department of Psychiatry, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.,Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
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48
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Low sex hormone binding globulin: a potential predictor of future glucose dysregulation in women. Cardiovasc Endocrinol Metab 2021; 10:191-192. [PMID: 34386722 PMCID: PMC8352627 DOI: 10.1097/xce.0000000000000252] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 06/14/2021] [Indexed: 11/26/2022]
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49
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Motoki AH, Buttros DAB, Gaspar AL, Almeida-Filho BS, Carvalho-Pessoa E, Vespoli HDL, Nahas-Neto J, Nahas EAP. Association Between Metabolic Syndrome and Immunohistochemical Profile at Breast Cancer Diagnosis in Postmenopausal Women. Clin Breast Cancer 2021; 22:e253-e261. [PMID: 34465534 DOI: 10.1016/j.clbc.2021.07.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 06/11/2021] [Accepted: 07/19/2021] [Indexed: 12/26/2022]
Abstract
BACKGROUND The aim of this study was to evaluate the association between metabolic syndrome (MetS) and the immunohistochemical profile of breast cancer (BC) in postmenopausal women. METHODS This cross-sectional cohort study included 189 women, aged 45 to 75years and amenorrhea >12 months, with newly diagnosed BC and no previous cancer treatment. Clinical, anthropometric and biochemical data were collected, as well as data on BC hormone status (estrogen receptor, ER; progesterone receptor, PR; human epidermal growth factor receptor-2, HER-2), and epithelial proliferative activity (Ki-67). Tumors were divided into 5 subtypes:luminal A, luminal B HER-2 negative, luminal B HER-2 positive, non-luminal HER-2, and triple negative. Women with three or more of the following criteria were diagnosed with MetS: waist circumference ≥88cm; triglycerides ≥150mg/dL; HDL-cholesterol <50mg/dL; blood pressure ≥130/85mmHg; glucose ≥100mg/dL. RESULTS Sixty-three (33.3%) of the 189 patients had MetS at the time of diagnosis. Women with MetS had a higher frequency of tumors ≤ 2cm than women without MetS (49.2% vs. 31.8%) (P = .038). There were no differences in histological grade, staging, or axillary lymph node metastasis (P > .05). The proportion of PR-positive (P = .006), HER-2-negative (P = .034), and luminal B HER-2-negative (P = .038) tumors was higher among patients with MetS compared to women without MetS (79.4% vs. 61.8%, 89.9% vs. 78.6% and 44.5% vs. 27.8%, respectively). Multivariate analysis adjusted for age, time since menopause and BMI showed a higher risk for luminal B HER-2-negative tumors among women with MetS (OR 2.00, 95% CI 1.03-3.89), obese patients (OR 2.03, 95% CI 1.06-3.90), and women with abdominal obesity (OR 1.96, 95% CI 1.01-4.03). CONCLUSION In postmenopausal women with newly diagnosed BC, the presence of MetS was associated with smaller tumor size, PR-positive and HER-2-negative status, and the luminal B tumor subtype.
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Affiliation(s)
- Andre H Motoki
- Graduate Program in Tocogynecology, Botucatu Medical School, Sao Paulo State University - UNESP, Botucatu, Sao Paulo, Brazil
| | - Daniel A B Buttros
- Graduate Program in Tocogynecology, Botucatu Medical School, Sao Paulo State University - UNESP, Botucatu, Sao Paulo, Brazil; Claretian School of Medicine - Rio Claro University Center, Rio Claro, Sao Paulo, Brazil
| | - Ana Luisa Gaspar
- Graduate Program in Tocogynecology, Botucatu Medical School, Sao Paulo State University - UNESP, Botucatu, Sao Paulo, Brazil
| | - Benedito S Almeida-Filho
- Graduate Program in Tocogynecology, Botucatu Medical School, Sao Paulo State University - UNESP, Botucatu, Sao Paulo, Brazil; Department of Gynecology and Obstetrics, Botucatu Medical School, Sao Paulo State University - UNESP, Botucatu, Sao Paulo, Brazil
| | - Eduardo Carvalho-Pessoa
- Department of Gynecology and Obstetrics, Botucatu Medical School, Sao Paulo State University - UNESP, Botucatu, Sao Paulo, Brazil
| | - Heloisa D L Vespoli
- Department of Gynecology and Obstetrics, Botucatu Medical School, Sao Paulo State University - UNESP, Botucatu, Sao Paulo, Brazil
| | - Jorge Nahas-Neto
- Department of Gynecology and Obstetrics, Botucatu Medical School, Sao Paulo State University - UNESP, Botucatu, Sao Paulo, Brazil
| | - Eliana A P Nahas
- Graduate Program in Tocogynecology, Botucatu Medical School, Sao Paulo State University - UNESP, Botucatu, Sao Paulo, Brazil; Department of Gynecology and Obstetrics, Botucatu Medical School, Sao Paulo State University - UNESP, Botucatu, Sao Paulo, Brazil.
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Fabian CJ, Befort CA, Phillips TA, Nydegger JL, Kreutzjans AL, Powers KR, Metheny T, Klemp JR, Carlson SE, Sullivan DK, Zalles CM, Giles ED, Hursting SD, Hu J, Kimler BF. Change in Blood and Benign Breast Biomarkers in Women Undergoing a Weight-Loss Intervention Randomized to High-Dose ω-3 Fatty Acids versus Placebo. Cancer Prev Res (Phila) 2021; 14:893-904. [PMID: 34244155 DOI: 10.1158/1940-6207.capr-20-0656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 05/04/2021] [Accepted: 06/29/2021] [Indexed: 11/16/2022]
Abstract
The inflammation-resolving and insulin-sensitizing properties of eicosapentaenoic (EPA) and docosahexaenoic (DHA) fatty acids have potential to augment effects of weight loss on breast cancer risk. In a feasibility study, 46 peri/postmenopausal women at increased risk for breast cancer with a body mass index (BMI) of 28 kg/m2 or greater were randomized to 3.25 g/day combined EPA and DHA (ω-3-FA) or placebo concomitantly with initiation of a weight-loss intervention. Forty-five women started the intervention. Study discontinuation for women randomized to ω-3-FA and initiating the weight-loss intervention was 9% at 6 months and thus satisfied our main endpoint, which was feasibility. Between baseline and 6 months significant change (P < 0.05) was observed in 12 of 25 serum metabolic markers associated with breast cancer risk for women randomized to ω-3-FA, but only four for those randomized to placebo. Weight loss (median of 10% for trial initiators and 12% for the 42 completing 6 months) had a significant impact on biomarker modulation. Median loss was similar for placebo (-11%) and ω-3-FA (-13%). No significant change between ω-3-FA and placebo was observed for individual biomarkers, likely due to sample size and effect of weight loss. Women randomized to ω-3-FA exhibiting more than 10% weight loss at 6 months showed greatest biomarker improvement including 6- and 12-month serum adiponectin, insulin, omentin, and C-reactive protein (CRP), and 12-month tissue adiponectin. Given the importance of a favorable adipokine profile in countering the prooncogenic effects of obesity, further evaluation of high-dose ω-3-FA during a weight-loss intervention in obese high-risk women should be considered. PREVENTION RELEVANCE: This study examines biomarkers of response that may be modulated by omega-3 fatty acids when combined with a weight-loss intervention. While focused on obese, postmenopausal women at high risk for development of breast cancer, the findings are applicable to other cancers studied in clinical prevention trials.
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Affiliation(s)
- Carol J Fabian
- Department of Internal Medicine, University of Kansas Medical Center, Kansas City, Kansas.
| | - Christie A Befort
- Department of Population Health, University of Kansas Medical Center, Kansas City, Kansas
| | - Teresa A Phillips
- Department of Internal Medicine, University of Kansas Medical Center, Kansas City, Kansas
| | - Jennifer L Nydegger
- Department of Internal Medicine, University of Kansas Medical Center, Kansas City, Kansas
| | - Amy L Kreutzjans
- Department of Internal Medicine, University of Kansas Medical Center, Kansas City, Kansas
| | - Kandy R Powers
- Department of Internal Medicine, University of Kansas Medical Center, Kansas City, Kansas
| | - Trina Metheny
- Department of Internal Medicine, University of Kansas Medical Center, Kansas City, Kansas
| | - Jennifer R Klemp
- Department of Internal Medicine, University of Kansas Medical Center, Kansas City, Kansas
| | - Susan E Carlson
- Department of Dietetics and Nutrition, University of Kansas Medical Center, Kansas City, Kansas
| | - Debra K Sullivan
- Department of Dietetics and Nutrition, University of Kansas Medical Center, Kansas City, Kansas
| | - Carola M Zalles
- Department of Pathology, Boca Raton Regional Hospital, Boca Raton, Florida
| | - Erin D Giles
- Department of Nutrition, Agriculture and Life Sciences, Texas A&M University, College Station, Texas
| | - Stephen D Hursting
- Department of Nutrition and Nutrition Research Institute, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Jinxiang Hu
- Department of Biostatistics and Data Science, University of Kansas Medical Center, Kansas City, Kansas
| | - Bruce F Kimler
- Department of Radiation Oncology, University of Kansas Medical Center, Kansas City, Kansas
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