Serum adiponectin and resistin levels in patients with polycystic ovarian syndrome and their clinical implications

In this study, serum adiponectin and resistin levels were determined in 46 patients with polycystic ovarian syndrome (PCOS), and their correlation with serum sexual hormones and insulin resistance (IR) were examined.The subjects included 26 obese patients with body mass index (BMI)>25 and 20 non-obese patients with BMI≤25, with 25 obese and 25 non-obese healthy volunteers without PCOS serving as controls.Serum adiponectin and resistin levels in all subjects were measured, and endocrinal and metabolic indices were also analysed.Our results showed that the serum adiponectin levels in both obese and non-obese PCOS groups were significantly lower than their controls, while the serum resistin levels in obese and non-obese PCOS group were significantly higher than in their controls (P<0.001).The serum adiponectin level was significantly lower and serum resistin level significantly higher in the non-obese PCOS group as compared with the obese control group (P<0.05).Serum adiponectin level was negatively correlated with FIN, HOMA-IR, LH and LH/FSH (P<0.05), but serum resistin level was positively correlated with FIN, HOMA-IR, LH and LH/FSH (P<0.05).We are led to conclude that PCOS patients have obvious IR, low serum adiponectin and high serum resistin, and adiponectin and resistin might play important roles in the pathogenesis of IR in PCOS patients.     

Evaluation of Adiponectin, Resistin, IL-6, TNF-a in Obese and Non-obese Women with Polycystic Ovary Syndrome

Objective To evaluate possible clinical effects of adiponectin, resistin, IL-6, and TNF-α in obese and non-obese patients with polycystic ovary syndrome (PCOS). Methods Seventy selected PCOS patients were recruited for this study, and were divided into two groups based on their body mass index (BMI): 35 obese (BMI ≥ 25kg/m2 , group A), 35 non-obese (BMI<25kg/m2 , group B). In addition, 35 healthy non-obese women (BMI<25kg/m2 ) were enrolled as the control (group C). Serum levels of FSH, LH, T, glucose, insulin, adiponectin, resistin, IL-6, TNF-α were detected, and compared the differences of them among three groups. Results Blood glucose levels among three groups had no difference (P>0.05). Blood insulin level was significantly greater in group A than in group B or group C (P<0.05), and a significant difference existed between group B and group C (P<0.05). The ratio of glucose/insulin was significantly higher in group A than in group B or group C (P<0.05), and the ratio in group B was significantly higher than that in group C (P<0.05). Adiponectin level was significantly lower and resistin level was significantly higher in group A than in group B or group C (P<0.05). IL-6 level in group C was significantly lower than that in group A or group B (P<0.05), and significant difference was found between group A and group B (P<0.05). TNF-α level was a slight high in group B, whereas there was no statistical difference among three groups (P>0.05). Conclusion Disturbances of some metabolic and inflammatory adipokines could involve the pathogenesis of PCOS in both obese and non-obese women. Low-grade chronic inflammation might have negative effects on the development of PCOS in non-obese women.     

Effects of Metformin Combined with Cyproterone Acetate on Clinical Features, Endocrine and Metabolism of Non-obese Women with Polycystic Ovarian Syndrome

In order to explore the effects of metformin combined with cyproterone acetate (CPA) on the clinical features, endocrine and metabolism of the patients with polycystic ovarian syndrome (PCOS), 50 cases of non-obese PCOS were randomly subjected to CPA (CPA treatment group, n=25) and CPA metformin (n=25) treatment for 6 months. Before and after treatment the body mass index (BMI), waist:hip ratio (WHR), ovarian volume, serum gonadotrophin, and rogen andsex hormone-binding globulin (SHBG) levels, and fasting lipid, glucose and insulin levels were measured. The results showed that all of the parameters in two groups were similar before treatment. After treatment for 6 months in the CPA metformin group, BMI and WHR were significantly decreased, while insulin sensitivity was significantly decreased as compared with those before treatment. In CPA group, no significant changes were found before and after treatment. Combined use of CPA and metformin could result in the reduction of serum androstenedione and increases of serum SHBG levels as compared with the CPA treatment alone. It was concluded that combined use of CPA and metformin could improve the insulin sensitivity, and further suppress the hyperandrogenism in non-obese women with PCOS.     

Increased circulating myostatin in patients with type 2 diabetes mellitus

The changes of plasma myostatin levels in patients with type 2 diabetes mellitus(T2D) and their clinical correlation were investigated.We recruited 43 T2D patients and 20 age-matched healthy subjects.Plasma myostatin,lipid and glucose,and serum insulin were determined.T2D patients showed significantly higher fasting plasma glucose(FPG),serum insulin and triglyceride levels,and lower high-density lipoprotein levels than normal control subjects(P<0.01).Mean plasma myostatin level in T2D patients and health controls was(66.5±17.8) and(46.2±13.8) ng/mL,respectively.An unpaired t test showed that the increase of myostatin in the T2D patients was significant(P<0.001).In both healthy control and T2D groups,the female subjects showed higher myostatin levels than the male subjects.In the T2D patients,plasma level of myostatin was negatively correlated with body mass index(BMI,r=-0.42,P<0.01) and FPG(r=-0.51,P<0.01),but positively correlated with insulin resistance index(HOMA-IR,r=0.48,P<0.01).Up-regulation of plasma myostatin in the T2D patients and its correlation with BMI,FPG and blood insulin sensitivity suggests that plasma myostatin may be implicated in the pathogenesis of T2D and thus presented as a therapeutic target for treating the disease.Furthermore,circulating myostatin levels may be used as a biomarker for the disease.     

Effect of Metformin on Tyrosine Kinase Autophosphorylation of Erythrocyte Insulin Receptor from Women with Polycystic Ovary Syndrome

Objective To document the possible effect of tyrosine kinase autophosphorylation on erythrocyte insulin-receptor after 12 weeks of metformin administration from the women with polycystic ovary syndrome (PCOS). Methods Thirty non-obese (BMI<25 kg/m 2 ) healthy women with normal reproductive cycles were evaluated by conventional criteria as the control, 30 non-obese women with PCOS were categorized as nob-PCOS group, 40 obese women with PCOS (BMI ≥ 25 kg/m 2 ) were categorized as ob-PCOS group. Subjects with PCOS were given metformin 850 mg/d for 12 weeks. The autophosphorylation of insulin receptor pY1158, pY1162/1163 and insulin receptor-β subunit (IR-β) from the solubilised erythrocyte were detected by ELISA. Results 1) Only the autophosphorylation level of pY1158 in nob-PCOS and ob-PCOS groups was lower (P<0.05) than that in control group and it can be increased after insulin stimulation (P<0.05); no similar changes were found in pY1162/1163 (P>0.05), even insulin-stimulated insulin receptor (P>0.05) from both of PCOS groups. 2) After metformin administration, the pY1158, pY1162/pY1163 autophosphorylation levels were increased (P<0.01) and further increased after plus insulin stimulation in vitro (P<0.01). The pY1162/1163 autophosphorylation level was increased in nob-PCOS group (P<0.01) and ob-PCOS group (P<0.05). 3) No difference was found in concentration of IR-β between control group and both of PCOS groups following metformin administration (P>0.05). In summary, oral administration of metformin ledto an significant increase in tyrosine kinase activity in both groups of PCOS. Conclusion The impairment of tyrosine autophosphorylation at pY1158 may contribute to insulin resistance, the tyrosine kinase activity per receptor of solubilised erythrocytes were significantly increased by metformin administration and the effect of metformin on insulin-receptor tyrosine kinase activity appeared to be independent of either of these variables.     

Variation of serum monocyte chemoattractant protein-1 in patients with diabetes and metabolic syndrome

This study investigated the variation of serum monocyte chemoattractant protein-1(MCP-1) in patients with both diabetes mellitus(DM) and metabolic syndrome(MS).Based on the International Diabetes Federation(IDF) diagnostic criteria,93 patients enrolled in this study were divided into four groups:normal control(NC),simple DM,simple MS,and DM plus MS(DM-MS) groups.The main measures included height,weight,waist circumference(WC),hip circumference,blood pressure,fasting blood glucose,insulin resistance index(HOMA-IR),serum triglyceride(TG),HDL-ch,LDL-ch,and MCP-1.The results showed that the serum levels of MCP-1 in the DM-MS group were significantly increased as compared with those in the DM and MS groups(P<0.05),and the increase in the MCP-1 level in the DM group was much higher than in the MS group(P<0.05).The DM-MS group had the highest HOMA-IR levels,followed by MS,DM and NC groups(P<0.05).Correlation tests showed that the association of MCP-1 with age,HDL-ch,or LDL-ch was insignificant,whereas that of MCP-1 with body mass index(BMI),waist hip rate(WHR),WC,systolic blood pressure(SBP),diastolic blood pressure(DBP),TG,and HOMA-IR was significantly positive.It was concluded that circulating MCP-1 was substantially increased in patients with both DM and MS as compared with that in the patients with DM or MS alone,and the central obese state may contribute to a more vicious proinflammatory condition and insulin resistance in patients with diabetes.     

Secreted Frizzled-Related Protein 5 (SFRP5) in Patients with Obstructive Sleep Apnea

Objective Obstructive sleep apnea (OSA) is closely related to obesity, insulin resistance and inflammation. Secreted frizzled-related protein 5 (SFRP5) is a recently discovered adipokine. It is involved in insulin resistance and inflammation in obesity. This study aimed at evaluating the association between SFRP5 and sleeping characteristics as well as biochemical parameters of OSA patients. Methods This was a prospective case control study. Nondiabetic OSA patients and controls were consecutively recruited and divided into three groups: OSA group, apnea–hypopnea Index (AHI)≥5/h; healthy controls with normal body mass index (BMI); obese controls without OSA, and BMI > 24.0 kg/m2. All participants underwent polysomnography (PSG). Plasma SFRP5 was examined using enzyme-linked immunosorbent assay (ELISA). Blood biochemical examinations, including fasting blood glucose (FBG), lipid profile, hypersensitive C-reactive protein (hsCRP), were performed early in the morning after PSG. Patients with severe OSA were treated with nasal continuous positive airway pressure (nCPAP), and plasma SFRP5 was repeatedly measured for comparison. Results Sixty-eight subjects were enrolled in the study, including 38 patients of OSA, whose medium AHI was 58.70 /h (36.63, 71.15), 20 obese controls, and 10 healthy controls. The plasma SFRP5 level of OSA patients was not significantly different from that of healthy controls or obese controls. In OSA patients, SFRP5 level correlated positively with triglyceride level (r=0.447,P=0.005) and negatively with LDL-cholesterol level and HDL- cholesterol level (r=?0.472 andP=0.003;r=?0.478 andP=0.002; respectively). SFRP5 level was not found correlating with FBG, AHI, or any of nocturnal hypoxia parameters. After overnight nCPAP treatment, plasma SFRP5 levels of OSA patients did not change significantly (t=1.557, P = 0.148) compared to that of pretreatment. Conclusions In nondiabetic OSA patients, plasma SFRP5 is associated with the lipid profile. However, no correlation was observed between SFRP5 and FBG or sleep parameters. The SFRP5 level of OSA patients did not differ from that of non-OSA individuals in our study.     

Polymorphism of the leptin gene promoter in pedigrees of type 2 diabetes mellitus in Chongqing, China

Background It has been shown that the presence of leptin is associated with deabefes, glucose wefabolism and insulin metablism. In this research, we evaluated the presence of the leptin C^-2549→A polymorphism in the Chinese population in Chongqing and verified its association with plasma leptin levels and anthropometric, metabolic, and clinical parameters.Methods Two hundred and sixty-nine patients with diabetes, 135 non-diabetic first-degree relatives of the patients, and 85 healthy controls were screened for the presence of C^-2549→A polymorphism using a PCR-RFLP assay. Body mass index, fasting leptin, fasting insulin, fasting glucose and homeostatic model assessment for insulin resistance ( HOMA)-IR were also determined.Results In the type 2 diabetes group, AA genotype frequency (6.32%) and A allele frequency(34.94%) was higher than in normal controls (1.18% and 25.29%, respectively). Diabetic patients with the AA genotype had lower fasting leptin and insulin levels than those with other genotypes.Carriers with the AC genotype had decreased fasting leptin and insulin levels and longer duration of disease as compared with those with CC genotype. The HOMA-IR of patients with AA or AC genotypes was lower than those with the CC genotype. In non-diabetic relatives group, individuals with the AA genotype had a lower fasting leptin level than those with the AC genotype. The fasting insulin and HOMA-IR level of carriers of the AA or AC genotype were lower than those of the CC genotype.Conclusion The C^-2549→A polymorphism in the leptin gene is associated with fasting leptin in patients with type 2 diabetes. The distribution of the genotypes in diabetic subjects from diabetic pedigrees differs from those in normal controls. The A allele frequency in diabetic patients is higher than that in normal controls. The haplotypes defined by genotypes are different in the familial subjects.     

Study of Association between Polycystic Ovary Syndrome and Dietary Intake

Objective To compare dietary intake and composition of women with and without polycystic ovary syndrome (PCOS), and finally to figure out the relationship between dietary intake and PCOS. Methods Eighty-six women attending an outpatient gynecological endocrinology unit, underwent evaluation of anthropometry, dietary intakes by means of a food frequency questionnaire (FFQ), 47 women with PCOS and 39 age-matched control women were investigated. Dietary intake was assessed by 24 h recalls. Associations between nutrients, BMI, WHR and glycometabolic measurements of PCOS were analyzed using multiple linear correlation and multiple linear regression analysis. Results 1) Obesity PCOS patients (BMI≥25 kg/m2) took significantly more carbohydrates (P<0.05) and fat (P<0.01) of diet than the control women in 24 h before the first visit. There was significantly lower ratio of protein (P<0.01) and higher ratio of lipid (P<0.01) in obesity PCOS patients than those in the control. Obesity PCOS women took significantly more calories (P<0.05) and higher ratio of lipid (P<0.01) than non-obesity PCOS women (BMI<25 kg/m2). There were no significantly statistical differences between the non-obesity PCOS women and controls. 2) There were positive correlations between BMI and energy lipid intake, but negative correlations between BMI and the ratio of protein in the diet intake (P<0.05). In PCOS women, fasting insulin (FINS), area under curve of insulin (IAUC), and homeostasis model assessment of insulin resistance (HOMA-IR) were all positively related with BMI (all P<0.05). 3) Multiple stepwise regression analysis showed that BMI was positively associated with the amount of fat and negatively associated with the ratio of protein in diet in 24 h (both P<0.001). HOMA-IR was positively related with fat intake and negatively related with protein composition (both P<0.05). Conclusion The statistical differences exist in the nutritional composition of obesity PCOS patient’s diets, which may contribute to obesity PCOS development.     

麻疹的双相移位研究进展

近年新生儿、婴儿、成人麻疹患者逐年增加,临床表现一般仍较典型,成年人麻疹患者全身中毒症状较重。麻疹抗体检测结果阳性是主要的诊断依据。麻疹发病的双相移位的机理可能是,免疫保护力不足,婴儿出生时麻疹抗体力低。孕期母传胎的麻疹抗体减弱,母经乳汁传给婴儿的抗体减弱,成人麻疹抗体水平逐年下降。预防措施是怀孕前给予育龄妇女麻疹疫苗接种,鼓励母乳喂养,麻疹疫苗计划免疫适当提前,在成人追加麻疹疫苗的免疫,加强病毒变异的研究等。     

妊娠晚期重度妊高征的监测

重度妊高征表现为高血压、蛋白尿、浮肿等症状 ,严重可以导致母婴死亡。对妊娠足月的重度妊高征 ,可以根据其临产与否及宫颈条件 ,立即决定其为阴道分娩或是剖宫产术。对于妊娠晚期的重度妊高征 ,因其胎龄不足月 ,胎儿生长发育及胎肺成熟度情况需通过一定时间的治疗 ,根据其病情变化来决定其治疗方案或终止妊娠的时机[1,2 ] 。这就需要我们对这一阶段的治疗进行监测 ,防止母儿并发症的发生。现将 2 0 0 0年至今我院收治妊娠晚期重度妊高征 30例的监测结果回顾分析如下。1　资料和方法1.1　研究对象　选择孕 31～ 36周重度妊高征 30例 ,其中 …     

80例局限性银屑病误诊原因分析

本文报告80例局限于小腿或手或足的银屑病。均经皮肤组织病理检查确诊。因部位比较特殊。受多种理化因素影响,使皮疹形态发生轻重程度不同的变化,常看不到典型损害,因而误诊为神经性皮炎,湿疹,慢性皮炎及癣等。作者对误诊原因进行了分析后,提出了鉴别诊断方法。     

腰椎间盘突出症再次手术的原因分析

目的解决腰椎间盘突出症手术中神经压迫。方法对1980～1998年再手术资料进行统计分析,讨论分析再手术原因,再次手术前影像学检查,观察病理变化以确定再手术方法。结果对11例随访6个月～1年,优7例(68．4％),良3例(36．8％),差1例(2．8％)。结论初次手术前详细查体和分析X线片,术中用导尿管和神经剥离探查,尽量避免髓核遗留,手术范围不宜太大,尽量减少对软组织和脊柱结构的破坏,避免形成硬膜囊与神经根粘连而致单纯形疤痕。     

降钙素原变化率的测定对细菌性肺炎的评估价值

目的 探讨降钙素原变化率的测定对细菌性肺炎的评估价值.方法 选取住院治疗的细菌性肺炎患者72例,根据治疗效果分为治疗有效组(有效组)47例和治疗无效组(无效组)25例,对治疗有效组和无效组中的降钙素酶原变化及影响肺炎治疗效果的危险因素进行分析.结果 有效组治疗后3天及治疗后7天的降钙素酶原显著低于无效组的患者(P＜0.05);年龄＞65岁、心功能≥3级、COPD、糖尿病、肺部双侧受累(X线示)、菌血症、感染性休克和3天内降钙素酶原变化率＜30％是影响细菌性肺炎治疗效果的危险因素;感染性休克、肺部双侧受累、3天内降钙素酶原变化率＜30％及心功能≥3级是影响细菌性肺炎治疗效果的独立危险因素.结论 测定降钙素原变化率对细菌性肺炎的疗效评估具有重要临床意义,可在临床推广应用.     

人工全髋关节置换术的手术配合

目的：介绍人工全髋关节置换术的手术配合做法;方法：主要在手术配合的六个方面,解决防感染、防栓塞等问题。结果：30例人工全髋关节置换术均获成功,结论：手术配合是护士责任心和基本功的全面体现,对提高手术效果有至关重要的影响。     

正常增殖期子宫内膜细胞增生状态的定量观察

以＾３氢－胸腺嘧啶核苷放射自显影法及ＨＥ染色，观察并分别测定了１８例正常子宫内膜增殖中期，１５例增殖晚期的腺上皮细胞或间质细胞的标记指数、分裂指数。结果显示：子宫内膜增殖晚期腺上皮细胞或间质细胞之ＬＩ均明显高于增殖中期。同时，增殖晚间质细胞之ＭＩ也明显高于增殖中期，即此两种细胞在增殖晚期中增生明显，其增生状态初步获得了定位定量测定的正常值。