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Preliminary data on the relationship between circulating levels of Sirtuin 4, anthropometric and metabolic parameters in obese subjects according to growth hormone/insulin-like growth factor-1 status.
No full textBACKGROUND:
The main components of GH/insulin-like growth factor (IGF)-1 axis and Sirtuin 4 (Sirt4), highly expressed in liver and skeletal muscle mitochondria, serve as active regulators of mitochondrial oxidative capacity with opposite functions. In obesity both GH/IGF-1 status and serum Sirt4 levels, likely mirroring its reduced mitochondrial expression, might be altered.
OBJECTIVE:
To evaluate the association between circulating levels of Sirt4, body composition, metabolic parameters and cardio-metabolic risk profile in obese patients according to their different GH/IGF-1 status.
DESIGN:
Cross-sectional study with measurement of serum Sirt4, GH after GH releasing hormone (GHRH)+Arginine test, IGF-1 and assessment of body composition, glucose and lipid metabolism in 50 class II-III obese subjects (BMI 35.6 to 62.1kg/m(2)) and 15 normal weight subjects. Low GH secretion and IGF-1 were defined using pre-determined cutoff-points. The Homeostatic Metabolic Assessment of insulin resistance index and Visceral adiposity index were also calculated. The association of Sirt4 with peak stimulated GH and IGF-1, body composition, metabolic parameters and cardio-metabolic risk profile was assessed.
RESULTS:
Serum Sirt4 was inversely related to anthropometric and metabolic parameters and positively related to peak GH and IGF-1. After adjusting for peak GH and IGF-1, the relationships between Sirt4 and BMI became not significant. At multiple regression analysis IGF-1 (p<0.001) was the independent predictor for Sirt4.
CONCLUSION:
There was a close relationship between low IGF-1 and low serum Sirt4. This observation suggested that in obese patients, low GH/IGF-1 status was likely associated with a major compensatory decrease in circulating levels of Sirt4 to oppose to its negative regulator effect on mitochondrial oxidative capacity
Lipid profile in nonobese pregnant women with polycystic ovary syndrome: a prospective controlled clinical study.
No full textAlterations in lipid pattern and increased risk for obstetric/neonatal complications have been observed in 34
patients with polycystic ovary syndrome (PCOS). Pregnancy leads to physiologic changes in lipoprotein 35
metabolism, and alterations in lipid profile have been related with adverse pregnancy outcomes. Based 36
on these considerations, the aim of the present prospective controlled clinical study was to test the 37
hypothesis that the changes in the lipid profile in patients with PCOS during pregnancy are characteristic 38
and potentially related to the increased risk of obstetric/neonatal complications. One hundred and fifty 39
nonobese PCOS women and 150 age- and body mass index (BMI)-matched healthy controls were 40
enrolled. Serum lipids, glucose, insulin, and androgens levels were serially assayed in all subjects before 41
and throughout pregnancy. Serum low-density lipoprotein (LDL) and triglyceride (TG) concentrations 42
were significantly (P < 0.05) higher in PCOS group than in healthy controls at each assessment. Through- 43
out pregnancy, serum LDL and TG levels increased significantly (P < 0.05) in both groups, although the 44
change from pre-pregnancy values was significantly (P < 0.05) greater in PCOS patients than in healthy 45
controls. A significant (P < 0.05) relationship was observed between serum LDL and TG changes and 46
changes in both insulin sensitivity indexes and androgen levels in PCOS patients alone. After adjusting 47
for maternal age, pre-pregnancy BMI and lipid levels, body weight gain, and insulin-resistance markers, 48
serum TG concentrations during pregnancy were directly and independently associated with obstetric 49
complications in both groups, whereas serum LDL levels only in PCOS patients. We can conclude that 50
nonobese PCOS patients had specific changes in lipid profile during pregnancy, and that the lipid pattern 51
typical of PCOS may account for the more frequent adverse pregnancy outcomes. PCOS-related hormonal 52
and metabolic features, such as insulin resistance and high androgen levels, may mediate this 53
phenomenon
Low-Grade Chronic Inflammation in Pregnant Women With Polycystic Ovary Syndrome: A Prospective Controlled Clinical Study
No full textContext: Polycystic ovary syndrome (PCOS) and pregnancy are conditions characterized by an
increased low-grade chronic inflammation state. A higher incidence of pregnancy complications
has been detected in pregnant PCOS women.
Objective: The objective of the study was to test the hypothesis that the low-grade chronic inflammation
state typical of PCOS patients persists during gestation and is exacerbated by pregnancy
and contributes to the increased risk of obstetric/neonatal complications.
Design: This was a prospective controlled clinical study.
Setting: The study was conducted at the Academic Department of Obstetrics and Gynecology of
the “Pugliese-Ciaccio” Hospital of Catanzaro (Catanzaro, Italy).
Patients: One hundred fifty pregnant PCOS women and 150 age- and body mass index-matched
healthy pregnant controls participated in the study.
Interventions: Interventions included serial clinical, biochemical, and ultrasonographic assessments
before and throughout pregnancy.
Main Outcome Measures: Serum levels of white blood cell count (WBC), C-reactive protein (CRP),
and ferritin were measured.
Results: Pregnant women with PCOS had higher WBC, CRP, and ferritin levels at study entry and
at all gestational ages than controls. Changes in serum WBC and ferritin levels were significantly
higher in PCOS than in controls starting from the 12thweekof gestation whereas those in CRP from
the 20th week of gestation. By multivariable Cox proportional hazard analysis, in the PCOS group,
a significant association with the risk of adverse obstetric/neonatal outcomes was found for WBC
[hazard risk (HR) 1.52, 95% confidence interval (CI) 1.31–1.64; P .010], CRP (HR 1.19, 95% CI
1.06–1.34; P .019), and ferritin levels (HR 1.12, 95% CI 1.03–1.26; P .011).
Conclusions: In PCOS patients, the low-grade chronic inflammation persists during gestation and
is exacerbated by pregnancy, and it is associated with adverse pregnancy outcomes
Endocrinopathies after allogeneic and autologous transplantation of hematopoietic stem cells.
No full textEarly and late endocrine disorders are among the most common complications in survivors after hematopoietic allogeneic- (allo-) and autologous- (auto-) stem cell transplant (HSCT). This review summarizes main endocrine disorders reported in literature and observed in our center as consequence of auto- and allo-HSCT and outlines current options for their management. Gonadal impairment has been found early in approximately two-thirds of auto- and allo-HSCT patients: 90-99% of women and 60-90% of men. Dysfunctions of the hypothalamus-pituitary-growth hormone/insulin growth factor-I axis, hypothalamus-pituitary-thyroid axis, and hypothalamus-pituitary-adrenal axis were documented as later complicances, occurring in about 10, 30, and 40-50% of transplanted patients, respectively. Moreover, overt or subclinical thyroid complications (including persistent low-T3 syndrome, chronic thyroiditis, subclinical hypo- or hyperthyroidism, and thyroid carcinoma), gonadal failure, and adrenal insufficiency may persist many years after HSCT. Our analysis further provides evidence that main recognized risk factors for endocrine complications after HSCT are the underlying disease, previous pretransplant therapies, the age at HSCT, gender, total body irradiation, posttransplant derangement of immune system, and in the allogeneic setting, the presence of graft-versus-host disease requiring prolonged steroid treatment. Early identification of endocrine complications can greatly improve the quality of life of long-term survivors after HSCT
I disordini del ciclo mestruale e la sindrome dell'ovaio policistico: ruolo dell'esercizio fisico
No full text
Beneficial effects of a three-month structured exercise training program on cardiopulmonary functional capacity in young women with polycystic ovary syndrome.
No full textCONTEXT:
Polycystic ovary syndrome (PCOS) is an endocrine disease closely related to several risk factors for cardiovascular disease. An impaired cardiopulmonary functional capacity was previously demonstrated in PCOS women. No data regarding the effects of a structured exercise training (ET) program on cardiopulmonary functional capacity in PCOS women are available.
OBJECTIVE:
Our objective was to evaluate the effects of a 3-month ET program on cardiopulmonary functional capacity in young PCOS women.
DESIGN AND SETTING:
A prospective baseline-randomized clinical study was conducted at the University "Federico II" of Naples, School of Medicine (Italy).
PATIENTS:
Ninety young overweight PCOS women were enrolled.
MEAN OUTCOME MEASURES:
Ninety young PCOS women were randomly subdivided into two groups, each composed of 45 subjects. The PCOS-T (trained) group underwent a 3-month structured ET program, whereas the PCOS-UnT (untrained) group did not. Hormonal and metabolic profiles and cardiopulmonary and exercise parameters were evaluated.
RESULTS:
After 3-month ET, PCOS-T showed a significant improvement in peak oxygen consumption (+35.4%; P<0.001) and in maximal workload (+37.2%; P<0.001). In PCOS-T we also observed a significant reduction in body mass index (-4.5%; P<0.001) and in C-reactive protein (-10%; P<0.001), and a significant (P<0.001) improvement in insulin sensitivity indexes. After 3 months, no changes were observed in PCOS-UnT.
CONCLUSIONS:
A 3-month structured ET program improves cardiopulmonary functional capacity in young PCOS women
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