Resistência insulínica e perfil metabólico em pacientes com síndrome dos ovários policísticos de peso normal e sobrepeso/obesidade

Serum fibrinogen-like protein 1 as a novel biomarker in polycystic ovary syndrome: a case-control study

PURPOSE

To investigate the relationship between fibrinogen-like protein 1 (FGL-1) concentrations and various metabolic characteristics in patients with polycystic ovary syndrome (PCOS) and explore whether FGL-1 could be a predictive biomarker for PCOS.

METHODS

This case-control study included 136 patients with PCOS and 34 normal controls recruited in the Department of Endocrinology and Metabolism, Shanghai Tenth People's Hospital between May 2017 and June 2021. Anthropometric characteristics, metabolic parameters, and reproductive hormones were collected. Serum FGL-1 measurement was conducted using enzyme-linked immunosorbent assay (ELISA) kits.

RESULTS

Serum FGL-1 concentrations were higher in patients with PCOS than in control subjects in body mass index (BMI) subgroups, insulin resistance (IR) subgroups, and hepatic function subgroups, respectively. Serum FGL-1 concentrations were significantly associated with BMI, glycosylated hemoglobin A1c (HbA1c), fasting plasma glucose (FPG), homeostasis model assessment of insulin resistance (HOMA-IR), alanine aminotransferase (ALT), aspartate aminotransferase (AST), high-density lipoprotein cholesterol (HDL-c), and serum uric acid (SUA) in all individuals. The receiver operating characteristic (ROC) curve analysis revealed that the best cutoff value for FGL-1 levels to predict PCOS was 21.02 ng/ml with a sensitivity of 74.3% and a specificity of 70.6%. Both univariate and multiple logistic regressions indicated that the odds ratio (OR) for PCOS significantly increased in the subjects with high levels of FGL-1.

CONCLUSION

In our study, FGL-1 was associated with serum aminotransferase and various metabolic indexes. Moreover, the high risk of PCOS was independently associated with the increased FGL-1 levels, which suggested that FGL-1 could be a predictive biomarker for PCOS.

Prevalência de sobrepeso e obesidade e fatores associados em mulheres de São Leopoldo, Rio Grande do Sul: um estudo de base populacional

Resumo Introdução O sobrepeso e a obesidade são multicausais, porém seus determinantes ainda não foram completamente estudados. Objetivo Estimar a prevalência de sobrepeso e de obesidade e os fatores associados. Método Estudo transversal de base populacional com 981 mulheres (20 a 60 anos) de São Leopoldo/RS. O peso e a altura foram aferidos para o cálculo do Índice de Massa Corporal (IMC). Mulheres com IMC entre 25,0 e 29,9 kg/m2 e IMC ≥ 30,0 kg/m2 foram classificadas com sobrepeso e obesidade, respectivamente. As razões de prevalência e os intervalos de confiança de 95% foram estimados por meio de regressão de Poisson. Resultados A prevalência de sobrepeso foi de 33% (IC95%: 30,1-36,0) e de obesidade foi de 31,2% (IC95%: 28,3-34,1). Após ajuste, maiores probabilidades de sobrepeso ocorreram em mulheres mais velhas, pertencentes às classes econômicas mais baixas, casadas ou em união, com histórico de obesidade materna e com uma ou mais gestações. As maiores probabilidades de obesidade ocorreram em mulheres mais velhas, de baixa renda, com histórico de obesidade materna e paterna e com três ou quatro gestações. Menarca acima de 12 anos e prática de atividade física de lazer foram fatores de proteção para a obesidade. Conclusão Esses resultados evidenciam a necessidade de ações de prevenção de longo prazo, algumas delas envolvendo ações transgeracionais.

The impact of testosterone administration to female-to-male transsexuals on insulin resistance and lipid parameters compared with women with polycystic ovary syndrome

OBJECTIVE

To evaluate the impact of testosterone (T) administration to female-to-male transsexuals (FtMs) on insulin resistance and lipid parameters and to compare the effects with women with polycystic ovary syndrome (PCOS).

DESIGN

Cohort analysis.

SETTING

University hospital.

PATIENT(S)

Twenty-nine FtMs and 240 women with PCOS.

INTERVENTION(S)

Screening panel, ultrasound of the ovaries, hormone, lipid, and glucose and insulin measurements.

MAIN OUTCOME MEASURE(S)

Endocrine, metabolic parameters, and insulin resistance.

RESULT(S)

The PCOS women had significantly higher fasting, 1-h, and 2-h insulin levels and a significantly lower insulin sensitivity index compared with FtMs before and after their T treatment. There were higher triglyceride levels and lower high-density lipoprotein cholesterol levels upon T treatment in FtMs compared with the PCOS women. Women with PCOS had higher body mass index (BMI) values. Positive correlations between insulin resistance indices and BMI were found only in women with PCOS.

CONCLUSION(S)

Testosterone administration by itself showed little detrimental influence on insulin resistance indices, but it had significant effects on lipid profiles. Compared with T, BMI had a greater impact on insulin resistance in women with PCOS.