多囊卵巢综合征患者肥胖和高雄激素血症与胰岛素抵抗的相关性

收集多囊卵巢综合征(PCOS)患者101例,招募30名正常健康志愿者。根据血清雄激素水平及稳态模型评估的胰岛素抵抗指数(HOMA-IR)水平分层分析肥胖、高雄激素和胰岛素抵抗的关系。结果显示,101例PCOS患者中39.8％患者体重正常,24.5％超重,35.7％肥胖。将PCOS患者分为正常雄激素组(睾酮＜0.51 μg/L)和高雄激素组(睾酮≥0.51 μg/L),两组体重指数(BMI)、空腹血糖(FPG)、甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)及HOMA-IR均无统计学差异。将PCOS患者分为非胰岛素抵抗组(HOMA-IR＜2.29)和胰岛素抵抗组(HOMA-IR≥2.29),两组血清睾酮水平无统计学差异,胰岛素抵抗组的BMI、FPG、TG、TC、LDL-C明显高于非胰岛素抵抗组(P＜0.05或P＜0.01),HDL-C明显低于非胰岛素抵抗组(P＜0.01)。HOMA-IR与BMI显著相关(P＜0.01),而与血清睾酮水平无显著相关性,提示PCOS患者体重增加与HOMA-IR的相关性独立于血清睾酮水平。     

新诊断2型糖尿病患者血清铁蛋白与糖、脂代谢及胰岛功能的关系

目的 比较不同血清铁蛋白(SF)水平的新诊断2型糖尿病(T2DM)患者糖、脂代谢及胰岛功能,分析其与SF的关系.方法 以新诊断T2DM患者115例为观察对象,按SF浓度分为高SF组40例(SF≥274.66 μg/L)与正常SF组75例(21.80 μg/L≤SF< 274.66 μg/L).测量两组患者的身高、体重、腰围、臀围,检测空腹血糖、餐后2h血糖(2 hPG)、HbA1c、空腹胰岛素(FINS)、总胆固醇、甘油三酯、高密度脂蛋白-胆固醇(HDL-C)、低密度脂蛋白-胆固醇(LDL-C),计算体重指数、腰臀比、稳态模型评估-胰岛素抵抗指数(HOMA-IR)、稳态模型评估-胰岛β细胞功能指数(HOMA-β)、定量胰岛素敏感性指数(QUICKI)和处置指数,并进行Spearman相关性及多元线性回归分析.结果 高SF组体重指数、FINS、甘油三酯、HOMA-IR高于正常SF组(t=2.470、2.631、2.316、2.879,P均<0.05),HDL-C、QUICKI低于正常SF组(t=-2.030、-2.623,P均<0.05);SF水平与体重指数、腰臀比、空腹血糖、2 hPG、HOMA-IR、甘油三酯均呈正相关(r=0.191 ～0.303,P均<0.05),与HDL-C、QUICKI、处置指数呈负相关(r=-0.221、-0.261、-0.293,P均<0.05);多元线性回归分析显示体重指数、处置指数和甘油三酯是SF的独立相关因素(β=0.041、-0.443、0.270,P均<0.05).结论 高SF水平的新诊断T2DM患者其糖、脂代谢紊乱及胰岛素抵抗程度较正常SF的T2DM患者更严重,SF可能通过增加胰岛素抵抗,促进T2DM的发生和发展.     

吡格列酮对糖尿病前期患者血清抵抗素水平的影响

目的探讨吡格列酮对糖尿病前期患者血浆抵抗素水平及胰岛素抵抗的影响。方法将80例糖尿病前期患者分为治疗组和对照组。对照组给予饮食控制及运动等生活方式干预,治疗组在生活方式干预的基础上给予吡格列酮30mg/d,疗程3个月。干预前后分别测量身高、体重、腰围、臀围,计算体重指数(BMI)及腰臀比(WHR),测量血压,计算平均动脉压;空腹抽血测定空腹血糖(FPG)、餐后2h血糖(2hPG)、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、空腹胰岛素(FINS)、抵抗素;计算胰岛素敏感指数(HOMA-IR)和胰岛素抵抗指数(ISI)。结果干预后治疗组抵抗素、FPG、2hPG、血脂、FINS、HOMA-IR均明显低于对照组(P<0.05),而ISI显著高于对照组。结论吡格列酮具有降低抵抗素和增加胰岛素敏感性的作用。     

社区非糖尿病人群颈围和胰岛素抵抗的相关性分析

目的 分析和探索中国社区人群健康成人的颈围和胰岛素抵抗的相关性.方法 选择常住江苏徐州地区的社Ⅸ健康人群2 31 8名为研究对象,检测受试者颈围、身高、腰围、臀围、体重和甘油三酯、总胆固醇、高密度脂蛋白胆固醇(H DL-C)、低密度脂蛋白胆固醇(LDL-C)、空腹血糖和餐后2 h血糖等相关生化指标.胰岛素抵抗以稳态模型评估的胰岛素抵抗指数(HOMA-IR)来评价.结果 颈围和年龄、体重指数(BMI)、腰围、臀围、腰臀比、收缩压、舒张压、甘油三酯、总胆固醇、LDL-C、尿酸正相关,与HDL-C负相关.校正年龄和其他心血管代谢危险因素后,无论男性和女性,颈围和HOMA-IR的增加趋势显著相关,进一步校正BMI和腰围后,这种相关性并没有明显变化.颈围和BMI或腰围对HOMA-IR有显著的叠加作用(P＜0.01);在较大BMI和较大腰围的个体,颈围和HOMA-IR的相关性更明显.结论 在中国健康成人中,颈围和胰岛素抵抗、心血管代谢危险因素独立相关,并且和BMI、腰围有交互作用.     

原发性高血压患者胰岛素抵抗与非高密度脂蛋白胆固醇的关系

目的探讨壮族原发性高血压患者胰岛素抵抗(IR)与非HDL-C的关系,为壮族高血压综合治疗提供参考。方法选取壮族高血压患者200例,以是否合并糖尿病分为合并组80例和未合并组120例;另选健康体检者60例为对照组。各组均测定TC、TG、LDL-C、HDL-C、空腹血糖和空腹胰岛素,计算IR指数(HOMA-IR)和非HDL-C,分析非HDL-C与IR等指标的关系。以非HDL-C水平进行四分位,分为上四分位组51例和下四分位组48例,并分析HOMA IR等指标间的关系。结果与对照组比较,合并组和未合并组患者空腹血糖、空腹胰岛素、TC、TG、IDL C、非HDL C和HOMA IR明显升高,HDLC明显降低(P<0.05,P<0.01);与未合并组比较,合并组患者空腹胰岛素、非HDL-C和HOMA IR明显升高,HDLC明显降低(P<0.05)。与下四分位组比较,上四分位组患者收缩压、舒张压、空腹血糖、TC、TG、LDL-C和HOMA-IR明显升高,HDL-C明显降低(P<0.05,P<0.01)。结论不同糖代谢状态下壮族高血压患者均存在脂代谢紊乱和IR。非HDL-C与IR密切相关,是临床上评估糖、脂代谢异常的良好指标。     

血尿酸和细胞间黏附分子1对2型糖尿病颈动脉内膜中层厚度的影响

目的探讨2型糖尿病合并颈动脉粥样硬化(CA)患者血尿酸、细胞间黏附分子1(ICAM-1)与颈动脉内膜中层厚度(IMT)的关系。方法选择2型糖尿病患者80例,根据诊断分为糖尿病合并颈动脉粥样硬化组(CA组)40例和单纯糖尿病组(对照组)40例,检测分析2组患者血尿酸、ICAM-1、收缩压、舒张压、空腹血糖、空腹胰岛素、糖化血红蛋白、餐后2 h血糖、餐后2 h胰岛素、HDL-C、LDL-C、TC、TG等糖、脂代谢指标及颈动脉IMT的水平差异。同时计算体重指数、胰岛素抵抗指数(HOMA-IR)。结果 CA组颈动脉IMT、血尿酸、ICAM-1、收缩压、体重指数、TG、TC、LDL-C、糖化血红蛋白、空腹血糖、餐后2 h血糖、空腹胰岛素、餐后2 h胰岛素、HOMA-IR均明显高于对照组(P<0.05,P<0.01)。血尿酸、ICAM-1与颈动脉IMT密切相关(P<0.01),作为CA的主要独立影响因素最先进入多元逐步回归方程。结论 2型糖尿病合并CA患者较无CA的糖尿病患者存在更明显的代谢紊乱、胰岛素抵抗、血管内皮功能障碍及炎性反应,早期联合检测血尿酸、ICAM-1有助于对糖尿病人群发生血管病变进行预测。     

非酒精性脂肪肝患者视黄醇结合蛋白4与胰岛素抵抗的关系

目的探讨非酒精性脂肪肝(NAFLD)患者血清视黄醇结合蛋白4(RBP-4)与胰岛素抵抗(IR)的关系。方法选择NAFLD患者150例,年龄、性别相匹配的健康对照150例,检测血清RBP-4、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、空腹血糖(FPG)、空腹胰岛素(FINS),以及身高、体重,计算体重指数(BMI)、稳态模型胰岛素抵抗指数(HOMA-IR)。结果 NAFLD组血清RBP-4水平〔(20.30±10.50)ng/ml〕明显低于对照组〔(25.14±11.44)ng/ml,P<0.01〕;血清RBP-4水平与BMI、FPG、FINS和HOMA-IR呈负相关(r分别为-0.171、-0.152、-0.180、-0.193,均P<0.01),与HDL-C呈正相关(r=0.147,P<0.05)。回归分析示,HOMA-IR是血清RBP-4的独立的影响因素(β=-1.561,P<0.01)。结论 NAFLD患者血清RBP-4水平降低,且与IR密切相关。     

肥胖相关性肾病患者胰岛素抵抗状态评估指标的分析

目的:以胰岛素抵抗指数(HOMA-IR)作为标准评价肥胖相关性肾病(ORG)患者胰岛素抵抗(IR)状态,并探讨血脂评估ORG患者个体IR的价值。方法:选取经临床和肾脏病理证实的ORG患者36例,健康体检的正常人266例作为对照(空腹血糖<6·1mmol/L,且BMI<25kg/m2),测定两组人群的空腹血糖、胰岛素、总胆固醇(Chol)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)水平,计算HOMA-IR以评价ORG患者的IR状态。分析ORG人群的Chol、TG、HDL-C、LDL-C、TG/HDL-C比值与HOMA-IR的相关关系。结果:ORG患者的HOMA-IR平均值为6·32±4·11,显著高于对照组(1·98±0·89,P<0·001)。ORG的Chol、TG、TG/HDL-C比值较对照组显著升高,HDL-C显著降低(P<0·01),LDL-C升高(P<0·05)。其中以TG、TG/HDL-C比值升高更明显。Chol、TG、HDL-C、LDL-C、TG/HDL-C比值与HOMA-IR相关系数分别为0·195、0·122、-0·045、-0·019、0·143,均无统计学差异(P>0·05)。结论:HOMA-IR作为评估IR的指标同样适用于ORG患者。虽然血脂水平也被用于IR的评估,但对于ORG患者并不是理想指标。     

男性老年人胰岛素抵抗指数与胰岛素分泌曲线的对照分析

目的对比研究男性老年人胰岛素抵抗指数与胰岛素分泌曲线，探讨其在反映胰岛素抵抗的运用价值。方法根据体重指数将体检患者分为肥胖组与非肥胖组，测空腹血糖（FBG）、甘油三脂（TG）、胆固醇（TC）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C），并进行葡萄糖耐量试验（OGTT）、胰岛素释放试验（IRT）；计算胰岛素抵抗指数（HOMA-IR）。结果两组间的年龄、FBG、FINS、HOMA-IR、TC等指标以及两组间OGTT血糖变化曲线无显著性差异（P〉0.05）；肥胖组TG、LDL-C高于非肥胖组，HDL-C低于非肥胖组；肥胖组餐后1小时、2小时的胰岛素水平明显高于非肥胖组（P〈0.01）。结论高胰岛素血症首先出现在餐后，餐后高胰岛素血症比胰岛素抵抗指数更为敏感地反映胰岛素抵抗。     

2型糖尿病患者血清铁蛋白与血脂、体重指数等相关性分析

目的探讨血清铁蛋白(SF)与2型糖尿病(T2DM)的关系。方法以2型糖尿病患者220例为观察对象,按其SF浓度分别分为高SF组(150例,SF≥300 ng/m L)与正常SF组(70例,SF300 ng/m L),检测分析两组患者的身高、体重、血清铁蛋白(SF)、总胆固醇(TC)、三酯甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、糖化血红蛋白(Hb A1c)、空腹血糖(FBG)、空腹胰岛素(FINS)、体重指数(BMI)、胰岛素抵抗指数(HOMR-IR)和胰岛β细胞功能(HOMA-β)。结果 2型糖尿病患者的SF水平与BMI、FBG、FINS、HOMR-IR、Hb A1c、TG、LDL-C均呈正相关(P均0.05),与HDL-C呈负相关(P0.05),与TC、LDL-C、HOMA-β无相关性(P0.05);2型糖尿病高SF组患者FBG、Hb A1c、FINS、HOMR-IR显著高于正常SF组患者(P0.05)。结论血清SF水平升高可能影响糖尿病患者的糖脂代谢;SF可能通过胰岛素抵抗来介导糖尿病的早期发展。     

多囊卵巢综合征患者非酒精性脂肪性肝病的发病情况及特点分析

目的探讨多囊卵巢综合征（PCOS）患者非酒精性脂肪性肝病（NAFLD）的发生情况和临床特点。方法对306例PCOS患者行基础内分泌、口服糖耐量试验及胰岛素释放试验、肝功、血脂、肝脏超声等检查。分析NAFLD的发病情况及特点。结果 NAFLD发生率为30.7%（94/306）;NAFLD发病率随体质量指数（BMI）和年龄的增加而升高。PCOS合并NAFLD者空腹血糖、空腹胰岛素、口服葡萄糖2h后血糖及胰岛素水平、稳态模型评估（HOMA-IR）、谷丙转氨酶（ALT）、谷草转氨酶（AST）、TC、TG、LDL-C、BMI、腰围、腰臀比,均显著高于不合并NAFLD者（P均〈0.05）;而量化胰岛素敏感指数（QUICK）、HDL-C则显著低于不合并NAFLD者（P均〈0.05）。PCOS合并NAFLD者胰岛素抵抗、腹型肥胖、糖耐量异常、糖尿病、肝功异常、血脂异常、高血压病及代谢综合征的患病率显著高于不合并NAFLD者（P〈0.05）。结论 PCOS伴NAFLD发病率较高;其发病率与BMI和年龄呈正相关;PCOS伴NAFLD多存在胰岛素抵抗、代谢异常;超重及腹型肥胖是PCOS患者NAFLD的主要危险因素。     

男性冠心病患者血清性激素结合球蛋白水平变化的临床观察

目的探讨性激素结合球蛋白(SHBG)在男性冠心病(CHD)患者中的变化及其临床意义。方法选择住院并接受冠状动脉造影检查的男性患者,并根据冠脉造影结果分为冠脉造影正常组(对照组)33例;冠脉造影异常组(CHD组)52例,同时测定两组患者血清SHBG、睾酮(TT)、血脂、血糖、胰岛素等水平的变化,计算体质指数(BMI)。结果 CHD组和对照组相比hs-CRP、TC、GLU、空腹胰岛素显著增高(P<0.05),HDL-C、SHBG、TT、胰岛素敏感指数显著减低(P<0.05),BMI、LDL-C、TG差异无统计学意义。相关分析显示SHBG与BMI、LDL-C及空腹血糖呈负相关(r=-0.25～0.87,P<0.05),与胰岛素敏感指数呈正相关(r=0.45,P<0.05),但是其与TC、TG、HDL-C及hs-CRP间未见显著的相关关系(r=-0.19～0.02,P>0.05)。结论男性冠心病患者血清SHBG含量降低可能是导致男性冠心病发病率显著升高的重要因素。     

Glucose-to-insulin ratio rather than sex hormone-binding globulin and adiponectin levels is the best predictor of insulin resistance in nonobese women with polycystic ovary syndrome

Polycystic ovary syndrome (PCOS), the main androgen disorder in women, has been suggested to be associated with a high risk of developing cardiovascular disease and type 2 diabetes. In many PCOS patients, overweight or central obesity is generally associated with increases in fasting insulin levels, insulin resistance, and glucose intolerance, and has been identified as a target for new therapeutic strategy, including early change in lifestyle. Early biochemical marker(s) for identifying at-risk patients will be useful for prevention studies. The main goal of the present study was to search for such tool(s). We investigated 16 nonobese PCOS women by performing euglycemic hyperinsulinemic clamp and measuring insulin levels during fasting and oral glucose tolerance test, as well as the serum concentrations of SHBG, leptin, and adiponectin, the newly identified adipose factors. Eight of the 16 patients had a steady-state glucose disposal rate less than 8.5 mg/kg.min, the lowest normal value for nonobese control women. These insulin-resistant patients had significant higher body mass index (BMI) and waist-to-hip ratio (WHR), and lower high-density lipoprotein cholesterol and SHBG levels. As expected, glucose disposal correlated negatively with BMI (P = 0.01), WHR (P = 0.01), and fasting insulin level (P = 0.003). On stepwise regression analysis, however, the glucose-to-insulin ratio (GIR) emerged as the strongest independent parameter to appraise insulin resistance (R(2) = 0.61). SHBG level correlated positively with GIR (P < 0.001) and negatively with BMI (P = 0.003) but did not correlate with either insulin response during the glucose tolerance test or plasma leptin and/or adiponectin levels. In contrast, BMI was the only independent predictive parameter of SHBG (P = 0.003, R(2) = 0.73). Interestingly, plasma adiponectin levels were positively associated with glucose disposal rate (P = 0.043) and negatively with WHR (P = 0.024), waist circumference being the best predictor of adiponectin level (P < 0.01). Leptin level correlated only with BMI (r = 0.62, P = 0.01). This study confirmed that insulin resistance, despite the lack of obesity as such, is clearly present in many PCOS women, and demonstrated that GIR is the best predictor for insulin resistance. It was also shown that adiponectin level is a good indicator of abdominal fat mass and is associated to insulin resistance. Finally, low SHBG levels in PCOS are intimately associated with BMI, suggesting that some signal(s) from the adipose tissue, independent of adiponectin and leptin, may regulate liver production of SHBG.     

Adiponectin is independently associated with apolipoprotein B to A-1 ratio in Koreans

Apolipoprotein B to A-1 (apo B/A-1) ratio is reportedly a better predictor of atherosclerotic vascular disease than low-density lipoprotein cholesterol (LDL-C). The aim of this study was to assess the association of serum apo B/A-1 ratio with insulin resistance and adiponectin in patients with different grades of glucose intolerance. Patients were divided according to glucose tolerance into 3 groups: normal glucose tolerance without metabolic syndrome (n = 229), impaired fasting glucose (subjects with fasting plasma glucose level between 100 and 125 mg/dL, n = 658), and type 2 diabetes mellitus (n = 381). Serum concentrations of apo B, apo A-1, glucose, total cholesterol (TC), triglycerides, and high-density lipoprotein cholesterol (HDL-C) and adiponectin were measured. Insulin resistance was estimated by the homeostasis model assessment of insulin resistance index (HOMA-IR). There were significant differences in metabolic parameters among the groups, including waist circumference, insulin, HOMA-IR, and apo B/A-1 ratio, which increased sequentially with glucose intolerance, whereas adiponectin level decreased with increasing severity of glucose intolerance. The apo B/A-1 ratio was significantly correlated with TC, triglycerides, LDL-C, HDL-C, adiponectin, and HOMA-IR in normal glucose tolerance, impaired fasting glucose, and type 2 diabetes mellitus. Multiple regression analysis showed that apo B/A-1 ratio was significantly associated with TC, LDL-C, HDL-C, and adiponectin. In conclusion, apo B/A-1 ratio was significantly associated with insulin resistance according to glucose intolerance; and serum adiponectin was an important independent factor associated with apo B/A-1 ratio in Koreans.     

2型糖尿病合并高尿酸血症患者动脉粥样硬化的影响因素

目的研究2型糖尿病合并高尿酸血症(HUADM)患者颈动脉内膜中层厚度(IMT)与脂联素、C反应蛋白(CRP)的关系。方法选择2型糖尿病患者85例,按血尿酸水平分为:HUADM组43例、血尿酸正常糖尿病(NUADM)组42例,分析2组空腹血糖(FPG)、空腹胰岛素(FINS)、脂联素、CRP、糖化血红蛋白(HbA1c)及餐后2h血糖、餐后2h胰岛素,IMT,计算胰岛素抵抗指数(HOMA-IR),并且进行多元逐步回归分析。结果与NUADM组比较,HUADM组患者FPG、餐后2h血糖、FINS、餐后2h胰岛素、HbA1c、IMT、尿酸和lgHOMA-IR均明显升高,脂联素明显降低(P0.05,P0.01)。HUADM组患者IMT与HOMA-IR、TG、LDL-C和CRP呈正相关,与脂联素呈负相关。结论 HUADM患者存在更明显的代谢紊乱和胰岛素抵抗,且血清脂联素水平降低,CRP水平升高,提示更容易发生动脉粥样硬化。     

Decreased plasma adiponectin is associated with insulin resistance and HDL cholesterol in overweight subjects

The purpose of this study was to investigate plasma adiponectin concentration and its relation with metabolic parameters in overweight and normal weight subjects. The study was carried out in 46 overweight subjects (20 male, 26 female; mean age 39.4 +/- 10.2 years) and 48 (19 male, 29 female; mean age 36.1 +/- 10.6 years) sex- and age-matched normal weight subjects. Anthropometric measurements were recorded and adiponectin, glucose, insulin, lipid profile, total homocysteine (tHcy) and fibrinogen levels were measured. The insulin resistance index was assessed by homeostasis model assessment for insulin resistance (HOMA-IR). Plasma mean adiponectin concentrations of the overweight subjects were significantly lower than those of normal weight subjects (15.0 +/- 4.2 vs 17.3 +/- 5.6 ng/ml) (P<0.05). In overweight subjects, adiponectin levels negatively correlated with body weight (r = -0.35, P<0.001), body mass index (BMI) (r = -0.28, P<0.006), systolic blood pressure (r = -0.21, P<0.04), fasting insulin (r = -0.19, P<0.01) and HOMA-IR (r = -0.20, P<0.01) and positively with high-density lipoprotein cholesterol (HDL-C) (r = 0.27, P<0.009). Overweight subjects with low HDL-C levels had significantly decreased plasma adiponectin levels compared to those with high HDL-C levels (P<0.05). Multiple regression analysis revealed that BMI, HOMA-IR and HDL-C explained 12%, 20% and 15% variance of the adiponectin concentrations. These findings may suggest that circulating adiponectin is associated with insulin resistance and HDL-C levels independent from BMI in overweight subjects.     

Association of serum retinol binding protein 4 and insulin resistance in apparently healthy adolescents

Insulin resistance constitutes a pathophysiologic link between obesity, atherosclerosis, and/or cardiovascular complications. Retinol binding protein 4 (RBP4) is a newly discovered adipocyte product that modulates glucose metabolism and consequently induces insulin resistance. We investigated the association between serum RBP4 levels and insulin resistance in obese and nonobese adolescents. A total of 87 nonobese (60 males and 27 females) and 85 obese (62 males and 23 females) apparently healthy adolescents, 12 to 18 years old, were included in this study. A questionnaire was used to obtain participant medical history and lifestyle information, such as smoking and alcohol ingestion habits. Subjects' anthropometric measurements were taken to calculate for body mass index and waist-to-hip ratio. Serum RBP4 levels were measured by an enzyme immunoassay kit. High-sensitivity C-reactive protein, fasting glucose, total cholesterol, triglycerides, high-density lipoprotein cholesterol, and fasting insulin were measured. Low-density lipoprotein cholesterol level and homeostatic model assessment of insulin resistance (HOMA-IR) were calculated. Males had significantly higher RBP4 levels than females. Serum RBP4 levels were significantly higher in the obese group compared with the nonobese group. In all subjects, RBP4 was positively correlated with adiposity index (body mass index, waist circumference, waist-to-hip ratio), systolic and diastolic blood pressures, glucose tolerance index (fasting glucose, insulin, HOMA-IR), lipid profile (total cholesterol, triglycerides), and inflammatory indices (high-sensitivity C-reactive protein, white blood cell count). In multiple linear regression analysis, RBP4 was independently associated with age, HOMA-IR, and triglyceride levels in the nonobese group and with sex and triglyceride levels in the obese group. These results suggest that serum RBP4 might have clinical implications for lipid metabolism and insulin action in adolescents.     

Vitamin D deficiency is common and associated with metabolic risk factors in patients with polycystic ovary syndrome

Both vitamin D deficiency and polycystic ovary syndrome (PCOS) are associated with aspects of metabolic syndrome, but it is unclear whether vitamin D deficiency contributes to the metabolic disturbances commonly found in women with PCOS. This study sought to investigate (1) the prevalence of vitamin D deficiency in PCOS women in Scotland and (2) the relationship between vitamin D status and metabolic risk factors. This was an observational study on 52 women (25 in PCOS group and 27 in control group). Serum 25-hydroxyvitamin D concentrations less than 25 nmol/L were classified as severe vitamin D deficiency and were found in 44.0% and 11.2% of subjects in the PCOS and control groups, respectively (P = .047). Among the PCOS subjects, 25-hydroxyvitamin D concentrations were negatively correlated with body mass index (P = .033), C-reactive protein (P = .027), and free androgen index (P = .025) and positively correlated with quantitative insulin sensitivity check index (P = .035), high-density lipoprotein cholesterol (HDL-C) (P = .033), and sex hormone binding globulin (P = .038). Associations of vitamin D deficiency with quantitative insulin sensitivity check index and HDL-C were independent of body mass index and waist-to-hip ratio. Vitamin D deficiency is highly prevalent in PCOS women in Scotland, and a larger proportion of PCOS patients than control women were found to be vitamin D deficient. We also demonstrate correlations of vitamin D status with insulin sensitivity, HDL-C, and C-reactive protein in PCOS patients, which support the increasing evidence that vitamin D deficiency is associated with multiple metabolic risk factors in PCOS women.