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Metabolic Profile and Insulin Resistance in Different Phenotypes of Polycystic Ovary Syndrome Attending in a Tertiary Care Hospital of Bangladesh
Mohammad Afjal Hossain,
Milton Barua,
Mirza Sharifuzzaman,
Farzana Amin,
Lutful Kabir,
Nusrat Mahmud,
Faria Afsana,
Faruque Pathan,
Mahmudul Kabir,
Mahmudul Islam Talukder,
Amanat Ullah
Issue:
Volume 6, Issue 3, September 2021
Pages:
88-94
Received:
11 April 2021
Accepted:
15 June 2021
Published:
30 June 2021
Abstract: Background: Polycystic ovary syndrome (PCOS) is a common endocrine disorder associated with various phenotypic expressions. Aims: This study was conducted to observe and compare various metabolic components in different phenotypes of PCOS and to find out the frequency of insulin resistance (IR) among them. Materials and Methods: Eighty (80) patients diagnosed as case of PCOS as per inclusion and exclusion criteria were recruited in this cross sectional observational study. Patients were categorized in 4 different phenotypes based on the presence of oligo/anovulation (O), hyperandrogenism (H) and polycystic ovarian morphology (P): (i) Phenotype A (O+H+P), Phenotype B (O+H), (iii) Phenotype C (H+P) and (iv) Phenotype D (O+P). Demographic, anthropometric, biochemical and metabolic parameters were recorded and compared by ANOVA & Chi Square test using SPSS software version 22.0. Results: Most prevalent phenotype was phenotype A (55%) followed by phenotype D (22.5%), phenotype B (15%) & phenotype C (7.5%). Phenotype A & B had higher mean body mass index (BMI), waist circumference (WC), waist hip ratio (WHR), total testosterone (TT), fasting insulin, triglycerides (TG) & lower HDL-cholesterol in comparison to phenotype C & D (P value 0.001, 0.000, 0.000, 0.003, 0.000, 0.005 & 0.046 respectively). Fasting plasma glucose (FPG), plasma glucose 2 hours after 75 grams oral glucose load (AG), total cholesterol & LDL-cholesterol were comparable among the phenotypes (P value 0.636, 0.829, 0.143 & 0.201 respectively). Overall frequency of IR as defined by HOMA-IR≥3.8 was 61.25%. Highest frequency of IR was found in phenotype B followed by phenotype A and least in phenotype D (IR in A, B, C & D were 72.73%, 83.33%, 33.33% & 27.28%, P 0.002). Conclusion: Phenotype A & B had higher degree of deranged metabolic parameters than other phenotypes. Insulin resistance is mostly associated with phenotype A & B and least in normoandrogenic phenotype (phenotype D).
Abstract: Background: Polycystic ovary syndrome (PCOS) is a common endocrine disorder associated with various phenotypic expressions. Aims: This study was conducted to observe and compare various metabolic components in different phenotypes of PCOS and to find out the frequency of insulin resistance (IR) among them. Materials and Methods: Eighty (80) patient...
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Top-cited Articles in Primary Aldosteronism: A Bibliometric Analysis
Qiang-Hong Pu,
Qiu-Ju Lyu
Issue:
Volume 6, Issue 3, September 2021
Pages:
95-104
Received:
7 July 2021
Accepted:
26 July 2021
Published:
4 August 2021
Abstract: Background: The objective of this study was to identify the top 100 cited articles in primary aldosteronism, and examine their characteristics. Methods: Science Citation Index Expanded database was utilized to search for the top 100 cited articles published since 1900. Articles were evaluated for several characteristics, including the number of citations, authorship, country and institution of origin, publication year, journal, and study design. Results: The top 100 articles were cited between 88 and 762 times, with a median of 130. The articles were published between 1955 and 2012, with the majority of the primary aldosteronism publications (n=35) being published between 2000 and 2009. The biggest number of the top 100 cited articles (n=19) were published in the Journal of Clinical Endocrinology Metabolism, followed by Hypertension (n=9), Annals of Internal Medicine (n=6), and Archives of Internal Medicine (n=6). The United States and Italy had the most publications, whereas University of Michigan and University of Padua were the top two institutions. Observational studies were the most popular article type, followed by reviews and basic science. The impact factor of a journal was not correlated with the number of top-cited articles it published. Furthermore there was no correlation between the number of citations and the number of years since publication, authors, participating institutions, or countries involved. Conclusion: These findings will assist researchers in quickly identifying the most significant advances in the field of primary aldosteronism, as well as deciphering the characteristics of top-cited articles in this subject, and laying a basis for further research.
Abstract: Background: The objective of this study was to identify the top 100 cited articles in primary aldosteronism, and examine their characteristics. Methods: Science Citation Index Expanded database was utilized to search for the top 100 cited articles published since 1900. Articles were evaluated for several characteristics, including the number of cit...
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Active Vitamin D3 Protects Against Diabetic Kidney Disease by Regulating the JNK Signaling Pathway in Rats
Xiaoju Fan,
Linlin Liu,
Wenzhuo Zhu,
Yumei Zhao,
Haowei Zhang,
Yang Wu,
Jia Fu,
Hongmin Liang,
Rui Han
Issue:
Volume 6, Issue 3, September 2021
Pages:
105-113
Received:
27 July 2021
Accepted:
9 August 2021
Published:
13 August 2021
Abstract: Diabetic kidney disease (DKD) is an inflammatory disease caused by metabolic disorder. As an important signaling pathway in the inflammatory response, the JNK signaling pathway plays an crucial role in kidney injury in DKD. Vitamin D3 can reduce the inflammatory reaction and delay or even reverse DKD progression. Unfortunately, the mechanism by which vitamin D3 regulates DKD pathogenesis is unclear. This research established a DKD rat model and vitamin D3 and irbesartan were used as interventions. Then, urine and blood biochemistry; and inflammatory cytokine (IL-1 and IL-6), phosphorylated JNK pathway protein (MEK-4 and JNK1/2/3) and downstream factor (AP-1 and ATF-2) expression were assessed. We found that the DKD group showed body weight and insulin secretion were significantly decreased; significantly increased FPG, HOMA-IR and blood lipids; and significantly increased 24-h urinary protein (UPro) compared with normal group. Additionally, the levels of IL-1 and IL-6 and phosphorylated JNK pathway proteins were significantly elevated. These changes were improved by vitamin D3, especially at a low dosage. These results suggest that active vitamin D3 protects against DKD in rats by reducing IL-6 and IL-1 release, downregulating the JNK inflammatory signaling pathway, and inhibiting downstream transcription factor AP-1- and ATF-2-mediated kidney damage. This research provides a new theoretical support for vitamin D3 treatment of diabetic nephropathy.
Abstract: Diabetic kidney disease (DKD) is an inflammatory disease caused by metabolic disorder. As an important signaling pathway in the inflammatory response, the JNK signaling pathway plays an crucial role in kidney injury in DKD. Vitamin D3 can reduce the inflammatory reaction and delay or even reverse DKD progression. Unfortunately, the mechanism by whi...
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Diabetes and Hypothyroidism Alone and Simultaneously in Bulgarian Pregnant Women - Frequency and Features of Various Risk Factors
Anna-Maria Borissovа,
Boyana Trifonova,
Lilia Dakovska,
Eugenia Michaylova,
Mircho Vukov
Issue:
Volume 6, Issue 3, September 2021
Pages:
114-124
Received:
24 August 2021
Accepted:
16 September 2021
Published:
27 September 2021
Abstract: Gestational hypothyroidism affects the maturation and function of the beta cell, which can influence glucose metabolism. The aim of the study is to investigate the relationship between Hypothyroidism and Hyperglycemia in Bulgarian pregnant women and to look for the influence of various factors on the manifestation of each of these diseases separately, as well as their role in cases of simultaneous combination of the two diseases. Маterial: We studied 547 pregnant women, mean 30±5 years. The cross-sectional population-based multicenter study was conducted in 84 Bulgarian towns and villages. Pregnant women were divided into 4 groups according to the presence or absence of Diabetes (Diab) resp. Hypothyroidism (Thyr): Group 0 – 62.7% (n-343) – without Thyr or Diab; Group 1 – 22.9% (n-125) – Thyr; Group 2 – 11% (n-60) – Diab; Group 3 – 3.5% (n-19) – with Thyr and Diab. Methods: Fasting morning venous blood (TSH, FT4 - determined by ECLIA method) and fresh morning urine sample (to determine urine iodine concentration - UIC) was taken. A two-hour, 75 g oral glucose tolerance test (OGTT) was performed. The peripheral levels of 25(OH)D were tested using a standard assay in a central laboratory on the day of the sampling. The statistical analysis was conducted using standard SPSS 13.0 for Windows. Results: Group 2 were the oldest and Group 1 - the youngest, P<0.001. Group 2 as well as Group 3 had significantly higher BMI compared to Group 0 and Group 1, P<0.0001 / P<0.016. In Group 1 thyroid pathology had manifested itself earlier in the course of pregnancy, while in Group 2 dysglycemia occurred later, P<0.029 as well as for group 3, P<0.004. There was a significant negative correlation between 25(OH)D with level of fasting plasma glycemia - P<0.004, and at 120 minute of OGTT, P<0.003. In the group of pregnant women with Hyperglycaemia (n-79), deficiency of UIC (<150 µg / L) was reported in 45.6%, and twice more frequently artificial excess in the UIC level (>500 µg / L), compared with the Group with Normoglycemia (n-368). Conclusion: All international guidelines specifically emphasize the main risk factors when pregnant women should be screened for early detection of major endocrine diseases. However, the role of some additional factors, such as deficiency of 25(OH)D and iodine, should not be underestimated.
Abstract: Gestational hypothyroidism affects the maturation and function of the beta cell, which can influence glucose metabolism. The aim of the study is to investigate the relationship between Hypothyroidism and Hyperglycemia in Bulgarian pregnant women and to look for the influence of various factors on the manifestation of each of these diseases separate...
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