We report a case of a 30-year-old man with insulin-dependent diabetes (type 1 diabetes) since he was 12 years old, who was admitted to our hospital with history of a sudden onset of generalized abdominal pain worst in the epigastrium which radiated to the back. The pain was described as severe, sharp and intermittent and was exacerbated by movement. He had two episodes of vomiting without any bloody content and denied fever or changes in bowel habit previously. Computed tomography scan showed the presence of intussusception, which was treated surgically. In this case report, we also provide an up-to-date discussion for the association between diabetes and intussusception. J Endocrinol Metab. 2021;11(2):49-51 doi: https://doi.org/10.14740/jem732
{"title":"Is There Any Association Between Diabetes and Intussusception in Adults? A Case Report","authors":"A. Mahmood, Mohamed H. Ahmed, K. Canna","doi":"10.14740/JEM.V11I2.732","DOIUrl":"https://doi.org/10.14740/JEM.V11I2.732","url":null,"abstract":"We report a case of a 30-year-old man with insulin-dependent diabetes (type 1 diabetes) since he was 12 years old, who was admitted to our hospital with history of a sudden onset of generalized abdominal pain worst in the epigastrium which radiated to the back. The pain was described as severe, sharp and intermittent and was exacerbated by movement. He had two episodes of vomiting without any bloody content and denied fever or changes in bowel habit previously. Computed tomography scan showed the presence of intussusception, which was treated surgically. In this case report, we also provide an up-to-date discussion for the association between diabetes and intussusception. J Endocrinol Metab. 2021;11(2):49-51 doi: https://doi.org/10.14740/jem732","PeriodicalId":15712,"journal":{"name":"Journal of Endocrinology and Metabolism","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2021-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45952984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ana Maria Zarante Bahamon, J. Rivera, J. Rojas, V. G. Lopez, V. Vargas, M. Arevalo
Hypophosphatasia (HPP) is a rare inherited disorder characterized by low serum alkaline phosphatase. It affects bone and tooth mineralization, although extra-skeletal manifestations are frequent. HPP is caused by loss-of-function mutations in the ALPL gene, encoding the protein tissue-nonspecific alkaline phosphatase. The phenotype is broadly variable, from a subtype with exclusive odontological compromise (odontohypophosphatasia) to five subtypes with systemic involvement, classified according to the age of onset at first symptoms. We present seven cases of HPP, in order to perform the clinical, biochemistry and radiological description of these Colombian patients, as well as to show the clinical variability of the disease in patients who present the same mutation or genetic defect. J Endocrinol Metab. 2021;11(2):56-64 doi: https://doi.org/10.14740/jem711
{"title":"Clinical Variability of Hypophosphatasia in Colombian Patients: Case Reports","authors":"Ana Maria Zarante Bahamon, J. Rivera, J. Rojas, V. G. Lopez, V. Vargas, M. Arevalo","doi":"10.14740/JEM.V11I2.711","DOIUrl":"https://doi.org/10.14740/JEM.V11I2.711","url":null,"abstract":"Hypophosphatasia (HPP) is a rare inherited disorder characterized by low serum alkaline phosphatase. It affects bone and tooth mineralization, although extra-skeletal manifestations are frequent. HPP is caused by loss-of-function mutations in the ALPL gene, encoding the protein tissue-nonspecific alkaline phosphatase. The phenotype is broadly variable, from a subtype with exclusive odontological compromise (odontohypophosphatasia) to five subtypes with systemic involvement, classified according to the age of onset at first symptoms. We present seven cases of HPP, in order to perform the clinical, biochemistry and radiological description of these Colombian patients, as well as to show the clinical variability of the disease in patients who present the same mutation or genetic defect. J Endocrinol Metab. 2021;11(2):56-64 doi: https://doi.org/10.14740/jem711","PeriodicalId":15712,"journal":{"name":"Journal of Endocrinology and Metabolism","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2021-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43662211","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Obesity is a chronic disease of pandemic proportions. Obesity reduces life expectancy, because it is associated with hypertension, dyslipidemia, type 2 diabetes, cardiovascular disease, and certain types of cancer. Additionally, it is associated with a severe course of coronavirus disease 2019 (COVID-19), although it is unclear to what extent that association is causal [1]. Obesity is also strongly associated with blaming (by the lay public and, alas, also by health care professionals), stigma, and reduced quality of life [1]. Thus, effective prevention and treatment of obesity are of paramount importance. Lifestyle interventions focused on diet and exercise remain the cornerstone of treatment. However, a meta-analysis of behavior-based randomized controlled trials (67 studies, 22,065 participants) showed, on average, only modest weight loss after 12 to 18 months (2.4 kg, 95% confidence interval (CI), 1.9 to 2.9) [2]. Additionally, weight loss, once achieved, is extremely difficult to maintain. A meta-analysis of behavior-based randomized controlled trials (25 studies, 2,949 participants who had achieved an initial weight loss of 5 to 10 kg) showed a residual weight loss at 12 months of only 1.6 kg (95% CI, 0.9 to 2.3) [3]. This should not come as a surprise, because the biological adaptations to weight loss with regard to energy expenditure, satiety, appetite and nutrient absorption are such that weight regain is strongly favored above maintenance of weight loss [4]. Although clearly some individuals can successfully maintain weight loss over the long term, variables that strongly predict such success have not been identified. Lifestyle interventions alone therefore are unsuccessful in many obese individuals. Additionally, adjunctive pharmacotherapy (with orlistat, phentermine-topiramate, or naltrexone-bupropion), over the past decades, has been shown to be at most modestly effective [5, 6]. Moreover, some drugs have been withdrawn from the market because of safety concerns; among these are amphetamines (addiction), fenfluramine (cardiac toxicity) and lorcaserin (cancer risk) [6]. Although bariatric surgery can be an effective treatment of obesity, the procedure is invasive, costs of this treatment are high and availability on a global scale is limited. In this context, glucagon-like peptide-1 (GLP-1) agonists appear to be a promising development. Liraglutide and semaglutide are GLP-1 agonists that have been approved for the treatment of type 2 diabetes in adults and for reducing the risk of cardiovascular events in people with type 2 diabetes and cardiovascular disease. These GLP-1 agonists are also associated with weight loss, presumably because they decrease appetite and thus energy intake. Semaglutide, in particular, has been shown to induce weight loss in people with type 2 diabetes and in adults with obesity in a phase 2 trial [7]. Recently, the results of the STEP-1 trial have been published, which evaluated semaglutide (2.4 mg subcutaneo
{"title":"Treating Obesity: Lifestyle, New Options in Pharmacotherapy, and the Obesogenic Environment","authors":"C. Stehouwer","doi":"10.14740/JEM.V11I2.737","DOIUrl":"https://doi.org/10.14740/JEM.V11I2.737","url":null,"abstract":"Obesity is a chronic disease of pandemic proportions. Obesity reduces life expectancy, because it is associated with hypertension, dyslipidemia, type 2 diabetes, cardiovascular disease, and certain types of cancer. Additionally, it is associated with a severe course of coronavirus disease 2019 (COVID-19), although it is unclear to what extent that association is causal [1]. Obesity is also strongly associated with blaming (by the lay public and, alas, also by health care professionals), stigma, and reduced quality of life [1]. Thus, effective prevention and treatment of obesity are of paramount importance. Lifestyle interventions focused on diet and exercise remain the cornerstone of treatment. However, a meta-analysis of behavior-based randomized controlled trials (67 studies, 22,065 participants) showed, on average, only modest weight loss after 12 to 18 months (2.4 kg, 95% confidence interval (CI), 1.9 to 2.9) [2]. Additionally, weight loss, once achieved, is extremely difficult to maintain. A meta-analysis of behavior-based randomized controlled trials (25 studies, 2,949 participants who had achieved an initial weight loss of 5 to 10 kg) showed a residual weight loss at 12 months of only 1.6 kg (95% CI, 0.9 to 2.3) [3]. This should not come as a surprise, because the biological adaptations to weight loss with regard to energy expenditure, satiety, appetite and nutrient absorption are such that weight regain is strongly favored above maintenance of weight loss [4]. Although clearly some individuals can successfully maintain weight loss over the long term, variables that strongly predict such success have not been identified. Lifestyle interventions alone therefore are unsuccessful in many obese individuals. Additionally, adjunctive pharmacotherapy (with orlistat, phentermine-topiramate, or naltrexone-bupropion), over the past decades, has been shown to be at most modestly effective [5, 6]. Moreover, some drugs have been withdrawn from the market because of safety concerns; among these are amphetamines (addiction), fenfluramine (cardiac toxicity) and lorcaserin (cancer risk) [6]. Although bariatric surgery can be an effective treatment of obesity, the procedure is invasive, costs of this treatment are high and availability on a global scale is limited. In this context, glucagon-like peptide-1 (GLP-1) agonists appear to be a promising development. Liraglutide and semaglutide are GLP-1 agonists that have been approved for the treatment of type 2 diabetes in adults and for reducing the risk of cardiovascular events in people with type 2 diabetes and cardiovascular disease. These GLP-1 agonists are also associated with weight loss, presumably because they decrease appetite and thus energy intake. Semaglutide, in particular, has been shown to induce weight loss in people with type 2 diabetes and in adults with obesity in a phase 2 trial [7]. Recently, the results of the STEP-1 trial have been published, which evaluated semaglutide (2.4 mg subcutaneo","PeriodicalId":15712,"journal":{"name":"Journal of Endocrinology and Metabolism","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2021-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47528633","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
T. Yanagawa, H. Matsuda, M. Sugawara, M. Fukuda, Takashi Sasaki
Background: Sodium-glucose cotransporter 2 (SGLT-2) inhibitors have been reported to more effectively suppress cardiovascular events (CVEs) in patients with type 2 diabetes. The underlying mechanism, however, remains unknown. SGLT-2 inhibitors have the unique beneficial effect of ameliorating hypomagnesemia, which is a well-known independent risk factor for CVE. However, the mechanism by which SGLT-2 inhibitors increase the serum magnesium (Mg) levels also remains unknown. We hypothesized that SGLT-2 inhibitor-induced visceral fat loss might also be correlated with the serum Mg levels. Methods: We conducted a sub-analysis of the data of 31 patients with type 2 diabetes who were treated with luseogliflozin in the LIGHT study. The correlations between changes in the serum Mg concentration (Delta Mg) and the baseline patient characteristics/changes in the values of clinical parameters at 24 weeks were analyzed by multiple regression analysis. Results: The Delta Mg was significantly associated with the baseline serum Mg concentration (beta = -0.47, 95% confidence interval (CI): -0.84 - -0.13; P = 0.01) and Delta visceral fat volume (VFV) (beta = -0.33, -0.59 - -0.09; P = 0.03). Conclusions: We found that elevation of serum Mg concentrations after SGLT-2 inhibitor treatment was associated with two factors; low serum Mg concentrations before the start of treatment and decrease in the VFV after treatment. J Endocrinol Metab. 2021;11(2):35-41 doi: https://doi.org/10.14740/jem738
{"title":"Correlation Between Changes in the Serum Magnesium Concentration and Visceral Fat Volume in Patients With Type 2 Diabetes Receiving Luseogliflozin: A Sub-Analysis of Data From the LIGHT Study","authors":"T. Yanagawa, H. Matsuda, M. Sugawara, M. Fukuda, Takashi Sasaki","doi":"10.14740/JEM.V11I2.738","DOIUrl":"https://doi.org/10.14740/JEM.V11I2.738","url":null,"abstract":"Background: Sodium-glucose cotransporter 2 (SGLT-2) inhibitors have been reported to more effectively suppress cardiovascular events (CVEs) in patients with type 2 diabetes. The underlying mechanism, however, remains unknown. SGLT-2 inhibitors have the unique beneficial effect of ameliorating hypomagnesemia, which is a well-known independent risk factor for CVE. However, the mechanism by which SGLT-2 inhibitors increase the serum magnesium (Mg) levels also remains unknown. We hypothesized that SGLT-2 inhibitor-induced visceral fat loss might also be correlated with the serum Mg levels. Methods: We conducted a sub-analysis of the data of 31 patients with type 2 diabetes who were treated with luseogliflozin in the LIGHT study. The correlations between changes in the serum Mg concentration (Delta Mg) and the baseline patient characteristics/changes in the values of clinical parameters at 24 weeks were analyzed by multiple regression analysis. Results: The Delta Mg was significantly associated with the baseline serum Mg concentration (beta = -0.47, 95% confidence interval (CI): -0.84 - -0.13; P = 0.01) and Delta visceral fat volume (VFV) (beta = -0.33, -0.59 - -0.09; P = 0.03). Conclusions: We found that elevation of serum Mg concentrations after SGLT-2 inhibitor treatment was associated with two factors; low serum Mg concentrations before the start of treatment and decrease in the VFV after treatment. J Endocrinol Metab. 2021;11(2):35-41 doi: https://doi.org/10.14740/jem738","PeriodicalId":15712,"journal":{"name":"Journal of Endocrinology and Metabolism","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2021-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49230105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
B. P. Kundaktepe, S. Durmuş, M. Cengiz, Fatih Orkun Kundaktepe, V. Sozer, Ç. Papila, R. Gelişgen, H. Uzun
Background: The relationship between insulin resistance (IR) and prognostic factors in breast cancer (BC) in premenopausal (pre-M) and postmenopausal (post-M) women is still controversial. We evaluated the potential association between hemoglobin A1c (HbA1c), fasting blood glucose (FBG), fasting insulin levels (FILs), the homeostasis model assessment index (HOMA), and the prognostic factors of BC in nondiabetic patients with pre-M and post-M breast tumors. Methods: We compared 80 nondiabetic patients with pre-M and post-M breast tumors to 60 women with normal mammography as a control. Results: Age, body mass index (BMI), FBG, and HbA1c did not differ between the groups. FIL (P < 0.001) and HOMA-IR (P < 0.001) of the BC group were significantly higher than in the control group. FIL (P < 0.001) and HOMA-IR (P < 0.001) of the BC group were significantly higher than in the control group, for both pre- and post-M patients. FIL and HOMA-IR values were found to be significantly higher in the patients with stage IV BC than in other stages of BC. FIL and HOMA-IR are highly specific and sensitive parameters in their ability to diagnose BC. Conclusions: FIL and HOMA-IR are associated with BC risk in nondiabetic patients with pre-M and post-M breast tumors. When BC risk was evaluated according to the stage of menopause, no difference was observed; only the disease stage was significant. FIL and IR may function as potential biomarkers and therapeutic targets for human cancers. J Endocrinol Metab. 2021;11(2):42-48 doi: https://doi.org/10.14740/jem729
{"title":"The Significance of Insulin Resistance in Nondiabetic Breast Cancer Patients","authors":"B. P. Kundaktepe, S. Durmuş, M. Cengiz, Fatih Orkun Kundaktepe, V. Sozer, Ç. Papila, R. Gelişgen, H. Uzun","doi":"10.14740/JEM729","DOIUrl":"https://doi.org/10.14740/JEM729","url":null,"abstract":"Background: The relationship between insulin resistance (IR) and prognostic factors in breast cancer (BC) in premenopausal (pre-M) and postmenopausal (post-M) women is still controversial. We evaluated the potential association between hemoglobin A1c (HbA1c), fasting blood glucose (FBG), fasting insulin levels (FILs), the homeostasis model assessment index (HOMA), and the prognostic factors of BC in nondiabetic patients with pre-M and post-M breast tumors. Methods: We compared 80 nondiabetic patients with pre-M and post-M breast tumors to 60 women with normal mammography as a control. Results: Age, body mass index (BMI), FBG, and HbA1c did not differ between the groups. FIL (P < 0.001) and HOMA-IR (P < 0.001) of the BC group were significantly higher than in the control group. FIL (P < 0.001) and HOMA-IR (P < 0.001) of the BC group were significantly higher than in the control group, for both pre- and post-M patients. FIL and HOMA-IR values were found to be significantly higher in the patients with stage IV BC than in other stages of BC. FIL and HOMA-IR are highly specific and sensitive parameters in their ability to diagnose BC. Conclusions: FIL and HOMA-IR are associated with BC risk in nondiabetic patients with pre-M and post-M breast tumors. When BC risk was evaluated according to the stage of menopause, no difference was observed; only the disease stage was significant. FIL and IR may function as potential biomarkers and therapeutic targets for human cancers. J Endocrinol Metab. 2021;11(2):42-48 doi: https://doi.org/10.14740/jem729","PeriodicalId":15712,"journal":{"name":"Journal of Endocrinology and Metabolism","volume":"11 1","pages":"42-48"},"PeriodicalIF":0.4,"publicationDate":"2021-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43825981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Moumen, S. Chakdoufi, Hamza El jadi, O. Zammani, Cherif Abad El Asri, G. Belmejdoub
Dopamine agonist (DA) treatment is the first choice treatment of prolactinomas. Optic chiasm prolapse with secondary visual deterioration is an unusual and rare complication of DA treatment. A 40-year-old man with giant prolactinoma was successfully treated by cabergoline. After 14 months, he presented with a visual impairment with no ophthalmologic anomalies that could explain this worsening. The pituitary magnetic resonance imaging (MRI) revealed an important shrinkage of prolactinoma with a prolapse and a central atrophy of optic chiasm secondary to the adenoma shrinkage. This case highlights the need of regular assessment of visual field all along cabergoline treatment of macroprolactinomas despite initial improvement or even normalization of visual field, to promptly identify an optic chiasm prolapse and avoid the optic chiasm atrophy. J Endocrinol Metab. 2021;11(2):52-55 doi: https://doi.org/10.14740/jem730
{"title":"An Unusual Complication of Cabergoline Treatment of Macroprolactinomas","authors":"A. Moumen, S. Chakdoufi, Hamza El jadi, O. Zammani, Cherif Abad El Asri, G. Belmejdoub","doi":"10.14740/JEM.V11I2.730","DOIUrl":"https://doi.org/10.14740/JEM.V11I2.730","url":null,"abstract":"Dopamine agonist (DA) treatment is the first choice treatment of prolactinomas. Optic chiasm prolapse with secondary visual deterioration is an unusual and rare complication of DA treatment. A 40-year-old man with giant prolactinoma was successfully treated by cabergoline. After 14 months, he presented with a visual impairment with no ophthalmologic anomalies that could explain this worsening. The pituitary magnetic resonance imaging (MRI) revealed an important shrinkage of prolactinoma with a prolapse and a central atrophy of optic chiasm secondary to the adenoma shrinkage. This case highlights the need of regular assessment of visual field all along cabergoline treatment of macroprolactinomas despite initial improvement or even normalization of visual field, to promptly identify an optic chiasm prolapse and avoid the optic chiasm atrophy. J Endocrinol Metab. 2021;11(2):52-55 doi: https://doi.org/10.14740/jem730","PeriodicalId":15712,"journal":{"name":"Journal of Endocrinology and Metabolism","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2021-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48629884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Subclinical hyperthyroidism (SH, defined by low or undetectable serum thyroid stimulating hormone and normal thyroid hormones) is associated with increased cardiovascular risk (CVR) such as atrial fibrillation. Few studies also showed an increased risk of vascular disease and mortality in SH. Inflammation has been shown to play a significant role in the pathogenesis of cardiovascular disease. Increased levels of C-reactive protein (CRP), lipoprotein associated phospholipase A2 (Lp-PLA2, an inflammatory marker which plays a critical role in atherosclerosis), neutrophil to lymphocyte ratio (NLR) and monocyte to lymphocyte ratio (MLR) have been reported in conditions with increased cardiovascular risk. We aimed to ascertain whether abnormal CRP, Lp-PLA2, NLR and MLR contribute to an increased CVR in SH. Methods: CRP, Lp-PLA2, NLR and MLR in peripheral blood were measured in 30 SH subjects at baseline and after 6 months of treatment with either carbimazole or placebo in a randomized placebo-controlled design. Results: There was no significant difference in CRP, Lp-PLA2, NLR and MLR between carbimazole and placebo treated groups at 6 months. There was also no statistical difference in the above parameters if we compared the change or difference between two visits (visit 2 and visit 0 levels) in both groups. Conclusion: There is no evidence of chronic inflammation in our small cohort of SH subjects. Our finding needs to be confirmed in future studies with larger number of SH subjects. J Endocrinol Metab. 2021;11(1):28-32 doi: https://doi.org/10.14740/jem723
{"title":"The Role of Inflammation in Contributing to Vascular Risk in Subclinical Hyperthyroidism: Randomized Controlled Trial","authors":"S. Shakoor, Hong Jiao, A. Tan, Liew Huiling","doi":"10.14740/JEM.V11I1.723","DOIUrl":"https://doi.org/10.14740/JEM.V11I1.723","url":null,"abstract":"Background: Subclinical hyperthyroidism (SH, defined by low or undetectable serum thyroid stimulating hormone and normal thyroid hormones) is associated with increased cardiovascular risk (CVR) such as atrial fibrillation. Few studies also showed an increased risk of vascular disease and mortality in SH. Inflammation has been shown to play a significant role in the pathogenesis of cardiovascular disease. Increased levels of C-reactive protein (CRP), lipoprotein associated phospholipase A2 (Lp-PLA2, an inflammatory marker which plays a critical role in atherosclerosis), neutrophil to lymphocyte ratio (NLR) and monocyte to lymphocyte ratio (MLR) have been reported in conditions with increased cardiovascular risk. We aimed to ascertain whether abnormal CRP, Lp-PLA2, NLR and MLR contribute to an increased CVR in SH. Methods: CRP, Lp-PLA2, NLR and MLR in peripheral blood were measured in 30 SH subjects at baseline and after 6 months of treatment with either carbimazole or placebo in a randomized placebo-controlled design. Results: There was no significant difference in CRP, Lp-PLA2, NLR and MLR between carbimazole and placebo treated groups at 6 months. There was also no statistical difference in the above parameters if we compared the change or difference between two visits (visit 2 and visit 0 levels) in both groups. Conclusion: There is no evidence of chronic inflammation in our small cohort of SH subjects. Our finding needs to be confirmed in future studies with larger number of SH subjects. J Endocrinol Metab. 2021;11(1):28-32 doi: https://doi.org/10.14740/jem723","PeriodicalId":15712,"journal":{"name":"Journal of Endocrinology and Metabolism","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2021-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45770887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Md Shahed Morshed, Hurjahan Banu, N. Akhtar, T. Sultana, A. Begum, Moriom Zamilla, S. Tuqan, Sukanti Shah, A. Hossain, Shazia Afrine, E. Rashid, I. Jahan, M. Hasanat
Background: Altered luteinizing hormone to follicle-stimulating hormone (LH-FSH) ratio and hyperandrogenism are two important pathophysiological characteristics of polycystic ovary syndrome (PCOS). The aim of this study was to evaluate the relationship of LH-FSH ratio with androgen in women with PCOS. Methods: This cross-sectional study included 550 newly detected reproductive aged women with PCOS (mean ± standard deviation (SD): age 23.14 ± 4.80 years; body mass index (BMI) 27.64 ± 5.34 kg/m 2 ) according to revised Rotterdam criteria. Relevant clinical history, physical examination and ultrasonogram of ovaries were done for each participant. Fasting serum LH, FSH and total testosterone (TT) were measured by chemiluminescent microparticle immunoassay from blood collected during follicular phase of menstrual cycle. Results: More than two-thirds (n = 389, about 71%) had altered LH-FSH ratio (cut-off > 1.0) and about 43% (n = 234) had hyperandrogenemia (TT > 46 ng/dL). Frequency of none of the clinical variables or ovarian morphology differed statistically between the groups with or without altered LH-FSH ratio (NS for all). Serum TT and LH-FSH ratio were positively correlated (r = 0.139, P = 0.001). However, menstrual irregularity (P = 0.002), polycystic ovaries (P = 0.045), diabetes mellitus (P = 0.017), obesity (P = 0.009) and hirsutism (P < 0.001) were higher in frequency in the hyperandrogenic group. Serum TT had predictive association with altered LH-FSH ratio (odds ratio (OR) (95% confidence interval (CI)): 1.09 (1.02 - 1.16), P = 0.02) and LH-FSH had predictive association with hyperandrogenemia (OR (95% CI): 1.15 (1.03 - 1.28), P = 0.02) in women with PCOS. Conclusions: Serum LH-FSH ratio and androgenemia significantly correlate in women with PCOS. However, manifestations are more frequent with hyperandrogenemia rather than altered LH-FSH ratio. J Endocrinol Metab. 2021;11(1):14-21 doi: https://doi.org/10.14740/jem716
{"title":"Luteinizing Hormone to Follicle-Stimulating Hormone Ratio Significantly Correlates With Androgen Level and Manifestations Are More Frequent With Hyperandrogenemia in Women With Polycystic Ovary Syndrome","authors":"Md Shahed Morshed, Hurjahan Banu, N. Akhtar, T. Sultana, A. Begum, Moriom Zamilla, S. Tuqan, Sukanti Shah, A. Hossain, Shazia Afrine, E. Rashid, I. Jahan, M. Hasanat","doi":"10.14740/JEM.V0I0.716","DOIUrl":"https://doi.org/10.14740/JEM.V0I0.716","url":null,"abstract":"Background: Altered luteinizing hormone to follicle-stimulating hormone (LH-FSH) ratio and hyperandrogenism are two important pathophysiological characteristics of polycystic ovary syndrome (PCOS). The aim of this study was to evaluate the relationship of LH-FSH ratio with androgen in women with PCOS. Methods: This cross-sectional study included 550 newly detected reproductive aged women with PCOS (mean ± standard deviation (SD): age 23.14 ± 4.80 years; body mass index (BMI) 27.64 ± 5.34 kg/m 2 ) according to revised Rotterdam criteria. Relevant clinical history, physical examination and ultrasonogram of ovaries were done for each participant. Fasting serum LH, FSH and total testosterone (TT) were measured by chemiluminescent microparticle immunoassay from blood collected during follicular phase of menstrual cycle. Results: More than two-thirds (n = 389, about 71%) had altered LH-FSH ratio (cut-off > 1.0) and about 43% (n = 234) had hyperandrogenemia (TT > 46 ng/dL). Frequency of none of the clinical variables or ovarian morphology differed statistically between the groups with or without altered LH-FSH ratio (NS for all). Serum TT and LH-FSH ratio were positively correlated (r = 0.139, P = 0.001). However, menstrual irregularity (P = 0.002), polycystic ovaries (P = 0.045), diabetes mellitus (P = 0.017), obesity (P = 0.009) and hirsutism (P < 0.001) were higher in frequency in the hyperandrogenic group. Serum TT had predictive association with altered LH-FSH ratio (odds ratio (OR) (95% confidence interval (CI)): 1.09 (1.02 - 1.16), P = 0.02) and LH-FSH had predictive association with hyperandrogenemia (OR (95% CI): 1.15 (1.03 - 1.28), P = 0.02) in women with PCOS. Conclusions: Serum LH-FSH ratio and androgenemia significantly correlate in women with PCOS. However, manifestations are more frequent with hyperandrogenemia rather than altered LH-FSH ratio. J Endocrinol Metab. 2021;11(1):14-21 doi: https://doi.org/10.14740/jem716","PeriodicalId":15712,"journal":{"name":"Journal of Endocrinology and Metabolism","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2021-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43940216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Impaired glucose tolerance (IGT) is an independent risk factor of cardiovascular diseases. This increased risk can be partly explained by dyslipidemia traits, such as low levels of high-density lipoprotein-cholesterol (HDL-C) or high levels of triglyceride (TG). However, the sex-based association has been rarely reported. The study aimed to investigate the association between dietary factors and dyslipidemia traits in individuals with IGT. Methods: The cross-sectional study included 124 female and 121 male with IGT. Demographic and biochemical parameters including body mass index, serum TG, HDL-C, and insulin resistance index were measured. Dietary intake was assessed using a food frequency questionnaire, and dietary intake was assessed. Results: Male had significantly higher TG and lower HDL-C levels as well as higher carbohydrate intake and significantly higher daily alcohol intake than female. The multiple regression analyses showed that alcohol intake positively correlated to the TG level, although carbohydrate intake negatively correlated to the HDL-C level in male. In female, carbohydrate intake positively correlated to the TG level and alcohol intake positively correlated to the HDL-C level. The carbohydrate intake is a predictor of the HDL-C level in male and a possible predictor of the TG level in female, whereas alcohol intake is a predictor of the TG and HDL-C levels in both male and female, respectively. Conclusions: These findings may facilitate the development of a sex-specific dietary strategy to improve dyslipidemia traits among individuals with IGT. J Endocrinol Metab. 2021;11(1):22-27 doi: https://doi.org/10.14740/jem721
{"title":"Dietary Factors Associated With Dyslipidemia Traits in Individuals With Impaired Glucose Tolerance","authors":"N. Sakane, A. Suganuma, H. Kuzuya","doi":"10.14740/JEM.V0I0.721","DOIUrl":"https://doi.org/10.14740/JEM.V0I0.721","url":null,"abstract":"Background: Impaired glucose tolerance (IGT) is an independent risk factor of cardiovascular diseases. This increased risk can be partly explained by dyslipidemia traits, such as low levels of high-density lipoprotein-cholesterol (HDL-C) or high levels of triglyceride (TG). However, the sex-based association has been rarely reported. The study aimed to investigate the association between dietary factors and dyslipidemia traits in individuals with IGT. Methods: The cross-sectional study included 124 female and 121 male with IGT. Demographic and biochemical parameters including body mass index, serum TG, HDL-C, and insulin resistance index were measured. Dietary intake was assessed using a food frequency questionnaire, and dietary intake was assessed. Results: Male had significantly higher TG and lower HDL-C levels as well as higher carbohydrate intake and significantly higher daily alcohol intake than female. The multiple regression analyses showed that alcohol intake positively correlated to the TG level, although carbohydrate intake negatively correlated to the HDL-C level in male. In female, carbohydrate intake positively correlated to the TG level and alcohol intake positively correlated to the HDL-C level. The carbohydrate intake is a predictor of the HDL-C level in male and a possible predictor of the TG level in female, whereas alcohol intake is a predictor of the TG and HDL-C levels in both male and female, respectively. Conclusions: These findings may facilitate the development of a sex-specific dietary strategy to improve dyslipidemia traits among individuals with IGT. J Endocrinol Metab. 2021;11(1):22-27 doi: https://doi.org/10.14740/jem721","PeriodicalId":15712,"journal":{"name":"Journal of Endocrinology and Metabolism","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2021-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49501272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Diabetes is highly linked to the severity of coronavirus disease 2019 (COVID-19). My recent meta-analysis also suggested a higher prevalence of diabetes in severe COVID-19 as compared with non-severe COVID-19. Recent observational studies have shown that hyperglycemia was significantly associated with severity of COVID-19 in both diabetic and non-diabetic patients. To prevent worse outcome of COVID-19, more tight glucose control is required. I studied the association between hyperglycemia and worse outcome of COVID-19, the putative beneficial and harmful effects, and clinical outcomes of oral hypoglycemic drugs and insulin use in glycemic control among COVID-19 patients, by searching literatures. Although there were some negative studies, the meta-analysis reported that the treatment using metformin was associated with reduction in mortality due to COVID-19. One study showed that treatment with sitagliptin, one of dipeptidyl peptidase-4 (DPP4) inhibitors, during hospitalization was associated with reduction of mortality, with a clinical improvement as compared with patients on the standard care. There were no clinical studies showed effects of glucagon-like peptide-1 receptor agonists, pioglitazone and sulfonylurea on COVID-19 outcomes. Regarding sodium-glucose cotransporter 2 (SGLT2) inhibitors, a case of euglycemic diabetic ketoacidosis (DKA) associated with COVID-19 and a case of DKA that was difficult to distinguish from COVID-19 were reported. COVID-19 patients who need hospital care may deteriorate rapidly, an early and appropriate initiation of insulin therapy in hyperglycemic COVID-19 patients may be to be encouraged. J Endocrinol Metab. 2021;11(1):1-7 doi: https://doi.org/10.14740/jem718
{"title":"The Optimal Medical Therapy for Glycemic Control in COVID-19","authors":"H. Yanai","doi":"10.14740/JEM.V0I0.718","DOIUrl":"https://doi.org/10.14740/JEM.V0I0.718","url":null,"abstract":"Diabetes is highly linked to the severity of coronavirus disease 2019 (COVID-19). My recent meta-analysis also suggested a higher prevalence of diabetes in severe COVID-19 as compared with non-severe COVID-19. Recent observational studies have shown that hyperglycemia was significantly associated with severity of COVID-19 in both diabetic and non-diabetic patients. To prevent worse outcome of COVID-19, more tight glucose control is required. I studied the association between hyperglycemia and worse outcome of COVID-19, the putative beneficial and harmful effects, and clinical outcomes of oral hypoglycemic drugs and insulin use in glycemic control among COVID-19 patients, by searching literatures. Although there were some negative studies, the meta-analysis reported that the treatment using metformin was associated with reduction in mortality due to COVID-19. One study showed that treatment with sitagliptin, one of dipeptidyl peptidase-4 (DPP4) inhibitors, during hospitalization was associated with reduction of mortality, with a clinical improvement as compared with patients on the standard care. There were no clinical studies showed effects of glucagon-like peptide-1 receptor agonists, pioglitazone and sulfonylurea on COVID-19 outcomes. Regarding sodium-glucose cotransporter 2 (SGLT2) inhibitors, a case of euglycemic diabetic ketoacidosis (DKA) associated with COVID-19 and a case of DKA that was difficult to distinguish from COVID-19 were reported. COVID-19 patients who need hospital care may deteriorate rapidly, an early and appropriate initiation of insulin therapy in hyperglycemic COVID-19 patients may be to be encouraged. J Endocrinol Metab. 2021;11(1):1-7 doi: https://doi.org/10.14740/jem718","PeriodicalId":15712,"journal":{"name":"Journal of Endocrinology and Metabolism","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2021-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47113421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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