International Journal of Endocrinology and Metabolism
Volume:11 Issue: 2, Mar 2013

Estrogen deficiency due to natural menopause or surgical menopause has been suggested to have an adverse effect on insulin resistance. Testosterone and sex hormone–binding globulin (SHBG) as well as estrogen are also associated with insulin resistance in women. However, to date, the associations of estradiol, testosterone and SHBG with insulin resistance according to estrogen level have not been clarified.. We examined the associations of estradiol, testosterone and SHBG with insulin resistance in pre- and in postmenopausal women and postmenopausal women who had received hormone therapy to clarify whether the associations differ depending on the estrogen status..Patients and Twenty premenopausal women and thirty-two postmenopausal women were enrolled in this study. Fifteen postmenopausal women received oral conjugated equine estrogen (CEE) (0.625 mg) everyday for 12 months. Serum levels of estradiol, testosterone, SHBG and insulin and plasma levels of glucose were measured.. Serum estradiol levels tended to have a negative correlation with homeostasis model assessment of insulin resistance (HOMA-IR) in premenopausal women but not in postmenopausal women. On the other hand, free testosterone levels tended to have a positive correlation with HOMA-IR in postmenopausal women but not in premenopausal women. Serum SHBG levels showed significant negative correlations with HOMA-IR in both pre- and postmenopausal women. SHBG level was significantly increased, free testosterone level was significantly decreased and HOMA-IR was significantly decreased at 12 months after CEE administration. However, there were no significant correlations of changes between estradiol, SHBG or free testosterone and HOMA-IR.. The associations of sex steroid hormones with insulin resistance are different depending on the estrogen status..

Age at menarche is a significant indicator of growth and sexual maturation in girls. During adolescence, anthropometry provides a tool for monitoring and evaluating the hormone-mediated changes in growth and reproductive maturation.. We aimed to examine the anthropometric status of pre- and post-menarcheal Nigerian adolescent girls attending senior secondary schools.. In this school-based cross-sectional survey, a pre-tested structured self-administered questionnaire was set for obtaining the socio-demographic data (age at menarche, number of siblings, occupation and educational attainment of their parents, etc.), while the anthropometric status data was obtained by direct measurement of weight and height. The body mass index (BMI) and the ponderal index (PI) of each participant were computed from their respective weight and height values. The study was designed to include all the students in the two schools that were randomly selected. The anthropometric indices of pre- and post-menarcheal girls were compared.. Out of a total population of 2,166 students, 2,159 (99.7%) participated but 9 questionnaires were incompletely filled and were rejected, leaving 2,150 (510 were pre-menarcheal and 1,640 were post- menarcheal) for further analysis. The mean menarcheal age was 13.44 ± 1.32 years (95% Confidence Interval (CI) = 13.38-13.5). Girls from families with high socio-economic status (SES) attained menarche 8.0 and 9.0 months earlier than their counterparts from families with middle and low SES respectively. Girls from small-size families had a significantly lower menarcheal age than their counterparts from large-size families. A comparison of the anthropometric indices of pre- and post-menarcheal girls showed: weight, 41.1 ± 6.3 kg (95% CI = 40.6-41.6) vs 47.6 ± 7.2 kg (95% CI = 47.3-47.9), P < 0.001; height, 146.2± 5.5 cm (95% CI = 145.7-146.7) vs 153.6 ± 9.9 cm (95% CI=153.1-154.1), P < 0.001; BMI, 16.4 ± 1.9 (95% CI = 16.2-16.6) vs 18.8 ± 1.6 (95% CI = 18.7-18.9), P <0.001; and PI, 45.1 ± 1.7 (95% CI = 45.0-45.2) vs 44.6 ± 1.4 (95% CI = 44.5-44.7), P <0.01.. Post-menarcheal girls were significantly taller and heavier with a higher BMI than their pre-menarcheal counterparts, but the pre-menarcheal girls possessed a better linear body as reflected by the PI..

Early obesity and its transfer to the adulthood, increases likelihood incidence of coronary artery disease (CAD). ATP-binding cassette transporter (ABCA1) as a member of the ABC transporters family plays a crucial role in reverse cholesterol transport and CAD prevention.. The current study aimed to investigate ABCA1 expression in lymphocytes, plasma apolipoprotein A-I and HDL-C in response to eight-week interval endurance rope training in overweight and obese boy adolescents..Patients and Thirty students (17.3 ± 1.1yr, 85.73 ± 11.68 kg and 28.41 ± 2.36 kg / m²) volunteered and were randomly assigned into training (n = 15) and control (n = 15) groups. Exercise protocol was interval endurance rope training (8 wk, 4 d/wk and 40 min/d). Cell hemolysis and sensitive Elisa method was used for Lymphocyte ABAC1 protein expression.t-test was employed.. The independent-samples T-Test results showed that after 8 weeks IERT, the levels of lymphocyte ABCA1 expression(P = 0/001) and VO2max(P = 0/001) significantly increased and plasma levels of TG(P = 0.017), TC(P = 0.001), LDL-c/HDL-c(P = 0.026),TC/HDL-c(P = 0.002) and measures of BF%(P = 0/015)and BMI(P = 0.042) as anthropometric indicators significantly decreased. Changes of other variables such as increase in ApoA-I, HDL-c and decrease in LDL-c, body weight, were not significant.. The findings of this study proved that eight-week interval endurance rope training can have positive effects on lymphocyte ABCA1 protein expression (as gatekeeper of reverse cholesterol process) and lipid profiles among overweight and obese boy adolescents..

Childhood obesity has grown very fast over recent decades and now it represents a serious public health problem. The number of adipocytes is set in childhood and adolescence and then, an effective understanding of the development of adipose tissue during these periods will help in the prevention of this pathology.. The current study aimed to determine which adipose tissue characteristics are related to a high weight Z-score in childhood..Patients and The current study included 82 children aged 5-130 months who underwent inguinal hernia surgery. Anthropometric variables were measured, and a nutritional and physical activity questionnaire was completed. Subcutaneous adipose tissue samples, taken during the operation, were analyzed for preadipocyte number, adipocyte volume, fatty acid composition (gas chromatography of FAME), and relative gene expression of various genes (real time PCR).. The results showed that children with a higher weight Z-score spend more time in sedentary activities and less time running or involved in active games. SCD-1 activity index, arachidonic/linoleic index, and adipocyte volume were significantly higher in children with a weight Z-score greater than 0. The preadipocyte number and the genetic expression of the studied genes did not differ between the groups. A multiple regression analysis was done to determine which variables were related to the weight Z-score. R2 values indicated that the model which included adipocyte volume, SREBP-1c, SCD-1 expression, and activity index, predicted 59% of the variability in the weight Z-score among the children. The main variables associated with adipocyte volume were PPARγ, Adiponectin, CB1R expressions, as well as the SCD-1 activity and normalized weight.. It was concluded that in childhood, the weight Z-score is related to adipocyte volume and adipose tissue gene expression..

So far, there have been a few and incoherent results about the effects of physical activities. Fasting in Ramadan has an effect on the level of osmolarity and the concentration of serum electrolytes both in active and inactive females.. The aim of this study was to observe the changes of serum electrolytes and osmolarity levels according to regular exercise during fasting..Patients and Twenty two healthy females who were elected by convenience sampling method were divided into two groups: 1) fasting + exercise (FE; n = 11) and 2) fasting + non exercise (FNE; n = 15). The FE group participated in aerobic training for four sessions per week during the fasting. All measurements were done once before the first day, on the second week, on the fourth week and two weeks after fasting month and these measures were used to analyze test results.. The mean differences were as follows: significant weight loss, BMI, WHR, in two groups at the end of Ramadan (P < 0.05). The mean of weight, BMI, WHR, body fat, protein, mineral and total water showed no difference between groups (P > 0.05). Potassium, creatinine, urea and uric acid had been decreased significantly in both groups (P < 0.05). Variance between groups was significant only in variable urea (P < 0.05). Variations within group had been changed in FBS; sodium, phosphorus and osmolarity levels were not changed significantly.. According to this result, regular exercise in case of fasting in Ramadan led to some changes in serum osmolarity index, electrolytes and water. Therefore, it is important for female athletes to consider applying a suitable nutritious diet and sufficient water consumption during Ramadan.

Nesfatin-1 is a protein derived from a precursor molecule of the nucleobindin-2 gene, and acts as an anorexigenic peptide on food intake behavior, and its level isinfluenced by nutritional status, food composition [fat and carbohydrate (CHO)], and physical exercise.. The aim of this study was to investigate the effects of 6 weeks of treadmill running (at high intensity) program with and without zizyphus jujuba (high carbohydrate content) crud extraction on liver nesfatin-1, ATP, glycogen, and its plasma concentrations in female rats.. Twenty-eight Wistar female rats (6-8 weeks old100-120 g of weight) were randomly assigned to saline-control (SC), saline-training (ST), zizyphus jujuba-control (ZJC), and zizyphus jujuba-training (ZJT) groups. Rats ran on a motor-driven treadmill at 35 m/min, 60 min/day, 5 days/week for 6 weeks. Animals received ZJ extraction and saline at the dose of 1.25mL/100g of body weight. Seventy-two hours after the last training session rats were killed, a portion of liver excited, and plasma was collected for nesfatin-1, ATP, and glycogen measurements. A one-way ANOVA method, and Pearson correlation were employed. P<0.05 was considered as significant.. A higher and significant liver nesfatin-1 level was found in ZJ groups (p < 0.005), but plasma nesfatin-1 responded differently. Changes in liver nesfatin-1 were accompanied with an increase in liver glycogen,but not ATP contents.. The Findings indicate that higher liver nesfatin-1 and glycogen content by ZJ extraction might be due to the ZJ high CHO content, and it could be consideredas an anti-appetite herb..

Context: Maternal serum human Chorionic Gonadotropin (hCG) and Alpha Fetal Protein (AFP) were originally introduced to detect trisomy 21 and neural tube defects. However, in the absence of aneuploidy or neural tube defects, mid-trimester maternal serum hCG and/or maternal serum AFP associated with adverse pregnancy outcomes. Pregnancies with unexplained mid-trimester elevation in maternal serum hCG and/or maternal serum AFP, are at increased risk for pregnancy complications resulting from placental insufficiency..Evidence Acquisition: Mid-trimester maternal serum hCG>2.5 MoM associated with an increased risk for pregnancy complications including: late fetal loss, gestational hypertension, preeclampsia, intrauterine growth restriction (IUGR), preterm delivery and intrauterine fetal death(IUFD). Mid-trimester maternal serum AFP levels >2.5 MoM are thought to reflect a defect in placentation and associated with an increased risk for pregnancy complications including: late fetal loss, gestational hypertension, preeclampsia, IUGR, preterm delivery and IUFD.. Combined mid-trimester elevation in maternal serum hCG and AFP levels suggest a more complex type of placental pathology. They have stronger association with pregnancy complications including: late fetal loss, gestational hypertension, preeclampsia, IUGR, preterm delivery and IUFD.. Mid-trimester maternal serum hCG or AFP levels alone cannot detect all pregnant women with increased risk to develop pregnancy complications. Multiparameter testing of placental function in mid-trimester (maternal serum hCG and AFP screening, uterine artery Doppler and placental morphology) may allow us to identify women with increased risk to develop severe placental insufficiency and pregnancy complications. However, future prospective studies are needed to confirm the prognostic significance of multiparameter testing of placental function in mid-trimester..

The GnRH analogue (agonist and antagonist GnRH) changed ovarian stimulation. On the one hand, it improved chances of pregnancy to obtain more oocytes and better embryos. This leads to an ovarian hyper-response, which can be complicated by the ovarian hyperstimulation syndrome (OHSS). On the other hand, the GnRH analogue can prevent the incidence of OHSS: GnRH antagonist protocols, GnRH agonist for triggering final oocyte maturation, either together or separately, coasting, and the GnRH analogue may prove useful for avoiding OHSS in high-risk patients. We review these topics in this article..

Cardiac involvement infrequently occurs in hypopituitarism, and lethal cardiac arrhythmias are rarely reported. We present a middle age female who died as a consequence of refractory ventricular arrhythmia whose medical history and previous laboratory investigation were consistent with hypopituitarism. We conclude that hypopituitarism may lead to electrocardiographic changes and malignant ventricular arrhythmia and should be included in laboratory investigation and differential diagnosis of patients presenting with long QT syndrome.

Carcinoid tumor is a slow-growing type of neuroendocrine tumor, originating in the enterochromaffin cells and secreting mainly serotonin. The diagnosis is based on clinical symptoms, hormone levels, radiological and nuclear imaging, and histological confirmation. The clinical symptoms are characterized by flushing, diarrhea, abdominal pain, telangiectasia and/or bronchoconstriction. However, most patients have metastatic disease at diagnosis because the clinic goes unnoticed or are ascribed to other abdominal conditions. We report the clinical symptoms, hormone levels, radiological and nuclear imaging, histological diagnosis, treatment and evaluation of a 44-year-old female patient with congestive heart failure secondary to carcinoid heart disease in the context of liver metastases of an ileum carcinoid tumor..

Non-Insulin Dependent Diabetes Mellitus (NIDDM) is a common disease entity in patients with Coronary Artery Disease (CAD). Diabetic Ketoacidosis (DKA) is not only one of the major complications of Diabetes Mellitus but also a significant challenging clinical entity for the patients undergoing any elective or emergency surgery. Coronary Artery Bypass Grafting (CABG) being done in a patient with DKA has not been reported. We are presenting a rare case with DKA in whom CABG was carried out in a hospital devoted exclusively to cardiac cases. Insulin was given in very large doses as a part of therapeutic regimen and the outcome was favorable. This report concludes that if a patient undergoing urgent cardiac surgery incidentally develops DKA after induction of anesthesia, then the operation can be carried out provided DKA is managed aggressively. Also, major stress factors like cardio pulmonary bypass (CPB) and hypothermia should be avoided and care should be taken to avoid cerebral edema..