多囊卵巢综合征伴胰岛素抵抗的研究进展

多囊卵巢综合征（polycystic ovary syndrome,PCOS）是国内外研究者、医患人员非常关心的育龄期妇女常见的内分泌代谢疾病,其主要表现为闭经、月经量减少、肥胖、不孕、体多毛等。多数伴有胰岛素抵抗（insulin resistance,IR）的发生,胰岛素抵抗（insulin resistance,IR）是指正常水平的胰岛素促进葡萄糖摄取及利用能力下降,机体各组织、器官代偿性分泌胰岛素以维持机体血糖稳定的一种代谢状态。近年来的研究不断证实PCOS患者2型糖尿病、血脂代谢紊乱及代谢综合征（metabolicsyndrome,MS）等并发症的发病率明显增高。运动能够改善2型糖尿病患者胰岛素抵抗的说法已经得到了共识,其分子机制也逐渐分明。PCOS患者胰岛素抵抗的研究目前仍处于进一步探讨阶段,但是经过近几年的努力已经有了新的进展,若在PCOS胰岛素抵抗患者的治疗过程中给予一定的运动干预,相信一定能够有新的突破。本文就PCOS患者胰岛素抵抗研究的机制、诊断及治疗方法的新进展简单做一综述。     

Serum Level of Zinc and Copper in Sudanese Women with Polycystic Ovarian Syndrome

The paper’s objective was to estimate weekly Hg intake from fish meals based on intervention research. Total Hg (THg) concentrations in blood and hair samples collected from men (n = 67) from an intervention study as well as muscular tissues of fresh and after heat-treating fish were determined using the thermal decomposition amalgamation atomic absorption spectrometry method (TDA-AAS) using direct mercury analyzer (DMA-80). The mean of the estimated weekly intake (EWI) was estimated at 0.62 μg/kg bw/week in the range 0.36–0.96 μg/kg body weight (bw) /week through the consumption of 4 edible marine fish species every day (for 10 days) by the participants from the intervention research in Lodz, Poland. The Hg intake in the volunteers in our intervention study accounted for 38.6% of the provisional tolerable weekly intake (PTWI) (1.6 μg/kg bw, weekly) value. The average Hg concentration in the analyzed fish ranged from 0.018 ± 0.006 mg/kg wet weight (Gadus chalcogrammus) to 0.105 ± 0.015 mg/kg wet weight (Macruronus magellanicus). The results for the average consumers were within PTWI of methylmercury (MeHg). Moreover, the average concentration of Hg in the selected fish after heat treatment did not exceed the maximum permitted concentrations for MeHg (MPCs = 0.5 mg/kg wet weight) in food set by the European Commission Regulation (EC/1881/2006). Hence, the risk of adverse effects of MeHg for the participants is substantially low.     

Assessing Impaired Glucose Tolerance and Insulin Resistance in Polycystic Ovarian Syndrome with A Muffin Test: An Alternative to the Glucose Tolerance Test

ObjectiveTo determine the sensitivity of a high-glucose load in a meal as an alternative to the standard oral glucose tolerance test (OGTT) in detecting impaired glucose tolerance and insulin resistance in women with polycystic ovarian syndrome (PCOS) and the relationship of body composition to insulin resistance in the PCOS cohort.MethodsIn this prospective, single-center study, women with PCOS who were being followed up as outpatients were recruited. The study was performed between November 2007 and March 2008. All participants underwent OGTT before study enrollment. Participants were given a meal including carbohydrates, fat, and protein. Glucose and insulin levels were measured every 30 minutes for 2 hours after completing the meal. Body composition was measured by dual-energy x-ray absorptiometry.ResultsThirteen of the 15 participants completed the meal tolerance test and the body composition study. Four of 13 participants (31%) had abnormal glucose tolerance with the meal test compared with 2 of 8 participants (25%) who completed the OGTT. Those who had insulin resistance on OGTT were detected with the meal test. The 2-hour insulin levels following the meal were 38% higher than with the OGTT. Of 10 participants with insulin resistance, 9 had a total body fat mass greater than the 90th percentile, whereas 1 of 3 participants (33%) with normal body composition was insulin resistant.ConclusionAdministration of oral glucose load via a meal is an effective alternative to the OGTT in diagnosing impaired glucose tolerance and insulin resistance and may be more sensitive, without the adverse effects of the oral glucose load in the OGTT. PCOS is an independent risk factor for impaired glucose tolerance and insulin resistance, regardless of body composition. (Endocr Pract. 2010;16:810-817)     

罗格列酮结合二甲双胍对多囊卵巢综合征患者胰岛素抵抗指数的影响及临床疗效

目的:探讨罗格列酮与二甲双胍联合给药对多囊卵巢综合征(PCOS)患者胰岛素抵抗指数(HOMA-IR)的变化影响与临床效果的评价。方法:回顾性选取我院收治的PCOS患者127例列为研究样本,按照用药方案差异分为两组,对照组62例采用二甲双胍进行治疗;研究组65例采用罗格列酮联合二甲双胍治疗。观察并比较两组患者治疗前后HOMA-IR、血清性激素水平、排卵率及副反应发生情况。结果:治疗后,研究组HOMA-IR低于对照组,排卵率高于对照组(P0.05);研究组患者血清E2及T水平低于对照组,而FSH及SHBG水平高于对照组(P0.05);两组患者副反应发生率比较,差异无统计学意义(P0.05)。结论:罗格列酮辅助二甲双胍治疗PCOS可显著改善患者HOMA-IR,对性激素平衡有良好作用,副作用较小。     

Role of Insulin Sensitizers on Cardiovascular Risk Factors in Polycystic Ovarian Syndrome: A Meta-Analysis

Objective: Polycystic ovarian syndrome (PCOS) is associated with an increase in cardiovascular (CV) risk factors such as insulin resistance, with accompanying hyperinsulinemia and hyperlipidemia, which are predisposing factors for type 2 diabetes mellitus and CV disease. The aim of this meta-analysis is to examine the effect of insulin sensitizers on clinical and biochemical features of PCOS and risk factors for CV disease.Methods: A systematic literature review was conducted, and randomized controlled clinical trials were identified by a search of bibliographic databases: Medline database (from 1966 forward), EMBASE (January 1985 forward), and Cochrane Central Register of Controlled Trials. Reviews of reference lists further identified candidate trials. Data was independently abstracted in duplicate by 2 investigators using a standardized data-collection form. Articles without a comparison group and randomization allocation were excluded. Reviewers worked independently and in duplicate to determine the methodological quality of trials, then collected data on patient characteristics, interventions, and outcomes.Results: Of 455 studies, 44 trials were eligible. A random effects model was used. Significant unadjusted results favoring treatment with insulin sensitizers were obtained for body mass index (BMI) (effect size [ES] of 0.58), waist to hip ratio (WHR) (ES of 0.02), low-density-lipoprotein cholesterol (LDL-C) (ES of 0.11), fasting insulin (ES of 2.82), fasting glucose (ES of 0.10), free testosterone (ES of 1.88), and androstenedione level (ES of 0.76).Conclusion: Treatment with insulin sensitizers in women with PCOS results in improvement in CV factors such as BMI, WHR, LDL-C, fasting insulin, glucose, free testosterone, and androstenedione.Abbreviations: BMI = body mass index CI = confidence interval CVD = cardiovascular disease DM = diabetes mellitus EE = ethinyl estradiol ES = effect size FSH = follicle-stimulating hormone GnRH = gonadotropin-releasing hormone HDL = high-density lipoprotein HDL-C = high-density-lipoprotein cholesterol HR = hazard ratio IR = insulin resistance LDL = low-density-lipoprotein LDL-C = low-density-lipoprotein cholesterol LH = luteinizing hormone PCOS = polycystic ovarian syndrome TGs = triglycerides TZD = thiazolidinedione WHR = waist to hip ratio     

Contribution of Zinc Deficiency to Insulin Resistance in Patients with Primary Biliary Cirrhosis

The relationship between metabolic abnormalities of trace elements and insulin resistance has been established. Recent studies have revealed that insulin resistance is associated with autoimmune responses. The purpose of this study was to examine the correlation between zinc or copper metabolism and insulin resistance in patients with primary biliary cirrhosis (PBC). Sixteen patients with PBC were divided into two groups: early and advanced stage disease. The overall value of the homeostasis model assessment of insulin resistance (HOMA-IR) in patients with advanced stage PBC was significantly higher than that in patients with early stage PBC, although the mean value in advanced stage PBC was significantly lower than that in hepatitis C virus (HCV)-related liver cirrhosis. There was an inverse correlation between serum zinc concentrations and HOMA-IR values in patients with PBC, while we found no correlation between serum copper levels and HOMA-IR values. HOMA-IR values were inversely associated with peripheral platelet counts, indicating the relationship between insulin resistance and hepatic fibrosis. These results suggest that zinc deficiency plays important roles of insulin resistance and subsequent hepatic fibrosis in patients with PBC, although insulin resistance in advanced stage PBC was significantly milder than that in HCV-related liver cirrhosis.     

The Relationship Between Insulin Resistance and CpG Island Methylation of LMNA Gene in Polycystic Ovary Syndrome

We sought to investigate the relationship between the changes of CpG island methylation status of LMNA gene and insulin resistance in polycystic ovary syndrome (PCOS) patients. The genome-wide methylation microarray screening was done in three PCOS cases of insulin resistance and one case of a normal woman. The PCOS insulin resistance-related genes were identified as indicated by the results of gene chip screening. Then, 24 cases of insulin-resistant PCOS patients and 24 cases of normal individuals were studied to identify the effects of the candidate genes using genome-wide study of DNA from the peripheral blood analyzed by MassARRAY^®EpiTYPER? DNA methylation analysis technique. We found that the methylation status of CpG island in the promoter area of LMNA gene was changed. The 20 CG sites in CpG island of LMNA gene were examined using case control experiment among which 12 CpG sites differed significantly (P < 0.05) between two groups while the remaining eight CpG sites differed non-significantly. We, therefore, concluded that the changes in the hypermethylation status of CpG island of LMNA gene were related to the insulin resistance in PCOS patients, indicating that this gene may be involved in the regulation of PCOS-associated insulin resistance.     

二甲双胍对多囊卵巢不孕症患者卵巢功能、雌激素水平及胰岛素抵抗的影响

目的:探讨二甲双胍对多囊卵巢不孕患者卵巢功能、雌激素水平及胰岛素抵抗的影响。方法:选取我院收治的多囊卵巢不孕症患者72例,根据用药不同分为对照组与实验组,每组36例。对照组患者给予来曲唑促排卵治疗,实验组患者在对照组基础上予以二甲双胍治疗。观察并比较治疗前后两组患者的卵巢功能、雌激素水平、胰岛素抵抗及受孕情况。结果:与治疗前比较,两组患者治疗后卵巢功能、雌激素水平、胰岛素抵抗及受孕情况均得到改善,差异具有统计学意义(P0.05);与对照组比较,实验组患者治疗后卵巢功能显著改善,雌激素水平显著提高,胰岛素抵抗情况明显好转,受孕情况显著改善,差异均具有统计学意义(P0.05)。结论:二甲双胍能够调节多囊卵巢不孕症患者的卵巢功能,提高雌激素水平,改善胰岛素抵抗,提高受孕率,值得临床推广应用。     

Homocysteine Levels in Patients with Schizophrenia on Clozapine Monotherapy

We tested the hypothesis that homocysteine levels are higher in blood of schizophrenic subjects on clozapine monotherapy than in healthy controls and they correlate with anthropometric measurements, laboratory tests and results of bioimpedance analysis of body composition. Data for 24 subjects with schizophrenia treated with clozapine and 24 age- and sex-matched healthy volunteers was analyzed. Regarding the whole group, homocysteine levels were significantly higher in men (17.0 ± 3.4 vs. 12.1 ± 4.0 μmol/L, p = 0.009). Homocysteine levels correlated with waist circumference (R = 0.58, p = 0.003), waist-to-hip ratio (R = 0.57, p = 0.003), basal metabolic rate (R = 0.48, p = 0.01), lean body mass [kg] (R = 0.53, p = 0.008), body water [L] (R = 0.53, p = 0.008) and triglycerides (R = 0.57, p = 0.003). There were no significant differences of homocysteine levels for impaired fasting glucose, abdominal obesity, obesity/overweight, and dyslipidemia. Homocysteine levels did not correlate with age, treatment duration, clozapine dose, weight, body mass index, abdominal circumference, blood pressure, total body fat, cholesterol, high density lipoproteins, low density lipoproteins, uric acid, calcium, glucose, insulin, homoeostasis model assessment of insulin resistance 1, and homoeostasis model assessment of insulin resistance 2. We did not find significant differences in blood homocysteine levels between subjects with schizophrenia and controls. Association with waist circumference may support homocysteine role as an important cardiovascular risk factor. Association with lean weight may explain why men have higher levels of homocysteine than women.     

Regional Brain Glucose Hypometabolism in Young Women with Polycystic Ovary Syndrome: Possible Link to Mild Insulin Resistance

Objective

To investigate whether cerebral metabolic rate of glucose (CMR_glu) is altered in normal weight young women with polycystic ovary syndrome (PCOS) who exhibit mild insulin resistance.

Materials and methods

Seven women with PCOS were compared to eleven healthy female controls of similar age, education and body mass index. Regional brain glucose uptake was quantified using FDG with dynamic positron emission tomography and magnetic resonance imaging, and its potential relationship with insulin resistance assessed using the updated homeostasis model assessment (HOMA2-IR). A battery of cognitive tests was administered to evaluate working memory, attention and executive function.

Results

The PCOS group had 10% higher fasting glucose and 40% higher HOMA2-IR (p ≤ 0.035) compared to the Controls. The PCOS group had 9–14% lower CMR_glu in specific regions of the frontal, parietal and temporal cortices (p ≤ 0.018). A significant negative relation was found between the CMR_glu and HOMA2-IR mainly in the frontal, parietal and temporal cortices as well as in the hippocampus and the amygdala (p ≤ 0.05). Globally, cognitive performance was normal in both groups but scores on the PASAT test of working memory tended to be low in the PCOS group.

Conclusions

The PCOS group exhibited a pattern of low regional CMR_glu that correlated inversely with HOMA2-IR in several brain regions and which resembled the pattern seen in aging and early Alzheimer’s disease. These results suggest that a direct association between mild insulin resistance and brain glucose hypometabolism independent of overweight or obesity can exist in young adults in their 20s. Further investigation of the influence of insulin resistance on brain glucose metabolism and cognition in younger and middle-aged adults is warranted.     

Novel Clinical Evidence of an Association between Homocysteine and Insulin Resistance in Patients with Hypothyroidism or Subclinical Hypothyroidism

ObjectiveHypothyroidism (HO) can induce significant metabolic dysfunction and increase cardiovascular disease risk. In the present study, we investigated the relationship between homocysteine (Hcy) and insulin resistance (IR) in patients with HO or subclinical hypothyroidism (SHO).MethodsA total of 270 subjects were enrolled. All subjects were divided into the following three groups: HO, SHO and control. Plasma levels of Hcy were measured, and each patient’s homeostatic index of insulin resistance (HOMA-IR) was calculated. Statistical analyses were carried out to evaluate the correlations among groups and to determine the predictors of IR in patients with HO or SHO.ResultsThe HOMA-IR value was significantly higher in the HO group than in the SHO and control groups. Plasma levels of Hcy were markedly increased in the HO group compared with those of the SHO group and controls. In addition, plasma levels of Hcy were positively correlated with the HOMA-IR values in both the HO and SHO groups. Multiple linear regression models showed that plasma levels of Hcy and free thyroxine (FT4) were the only predictors of HOMA-IR in patients with HO or SHO.ConclusionsPlasma levels of Hcy and HOMA-IR were increased in patients with HO or SHO. Our results suggest that HO and SHO may increase the risk for atherogenesis and cardiovascular disease by increased IR. The increased IR induced by hyperhomocysteinemia in patients with HO or SHO may partially explain this adverse effect.     

钙网质蛋白在多囊卵巢综合征大鼠子宫内膜的表达及意义

目的:研究钙网质蛋白(CRT)在PCOS大鼠子宫内膜中的表达及生物学意义。方法:60只雌性SD大鼠随机分为PCOS组和对照组,每组各30只。给模型组24日龄大鼠皮下埋植左旋甲基炔诺酮硅胶棒3 mm/只,3 d后BID皮下注射人绒毛膜促性腺激素1.5 IU。给对照组皮下注射等体积生理盐水。注射9 d后观察大鼠卵巢形态学(HE染色),化学发光法测定性激素水平。结果:模型组大鼠卵巢重量和体积均显著高于对照组(P<0.01)。模型组大鼠卵巢出现类多囊卵巢综合征的改变。模型组卵巢各级发育期卵泡及黄体少见,卵泡多呈囊性扩张。模型组大鼠血清孕激素、睾酮、空腹胰岛素、空腹血糖水平均显著高于对照组(P<0.05);卵泡刺激素(FSH)水平显著低于对照组(P<0.05)。LH/FSH比值显著高于对照组(P<0.05)。采用免疫组织化学方法及灰度值测定,定量分析CRT在PCOS组和对照组的子宫内膜中表达。CRT在两组中的子宫内膜中均有表达。PCOS组子宫内膜上皮CRT表达显著低于对照组(P<0.01)。结论:避孕硅胶棒联合hCG诱导SD大鼠多囊卵巢综合征模型是较好的PCOS模型。CRT与PCOS的发病密切相关。     

钙网质蛋白在多囊卵巢综合征大鼠子宫内膜的表达及意义

目的：研究钙网质蛋白（CRT）在PCOS大鼠子宫内膜中的表达及生物学意义。方法：60只雌性SD大鼠随机分为PCOS组和对照组,每组各30只。给模型组24日龄大鼠皮下埋植左旋甲基炔诺酮硅胶棒3mm／只,3d后BID皮下注射人绒毛膜促性腺激素1．5IU。给对照组皮下注射等体积生理盐水。注射9d后观察大鼠卵巢形态学（HE染色）,化学发光法测定性激素水平。结果：模型组大鼠卵巢重量和体积均显著高于对照组（P〈0．01）。模型组大鼠卵巢出现类多囊卵巢综合征的改变。模型组卵巢各级发育期卵泡及黄体少见,卵泡多呈囊性扩张。模型组大鼠血清孕激素、睾酮、空腹胰岛素、空腹血糖水平均显著高于对照组（P〈0．05）;卵泡刺激素（FSH）水平显著低于对照组（P〈0．05）。LH／FSH比值显著高于对照组（P〈0．05）。采用免疫组织化学方法及灰度值测定,定量分析CRT在PCOS组和对照组的子宫内膜中表达。CRT在两组中的子宫内膜中均有表达。PCOS组子宫内膜上皮CRT表达显著低于对照组（P〈0．01）。结论：避孕硅胶棒联合hCG诱导SD大鼠多囊卵巢综合征模型是较好的PCOS模型。CRT与PCOS的发病密切相关．     

Commentary on the Role of Insulin Sensitizers on Cardiovascular Risk Factors in Polycystic Ovarian Syndrome: A Meta-Analysis

Abbreviations: CIMT = carotid intima media thickness CVD = cardiovascular disease LDL = low-density lipoprotein PCOM = polycystic ovarian morphology PCOS = polycystic ovary syndrome TZDs = thiazolidenediones     

RETRACTED ARTICLE: Serum Zinc and Adiponectin Levels in Patients with Polycystic Ovary Syndrome,Adjusted for Anthropometric,Biochemical, Dietary Intake,and Physical Activity Measures

Biological Trace Element Research -     

Annexin I在PCOS大鼠颗粒细胞中的表达及意义

目的：探讨膜联蛋白I（AnnexinI）在多囊卵巢综合征（PCOS）大鼠卵泡颗粒细胞的表达及生物学意义。方法：采用免疫组织化学方法及灰度值测定AnnexinI在PCOS组和对照组的卵泡颗粒细胞中的表达。结果：AnnexinI在两组中的各级卵泡颗粒细胞中均有表达,PCOS组AnnexinI在窦状卵泡中表达显著高于对照组（P〈0．05）。结论：PCOS组AnnexinI在窦状卵泡颗粒细胞的表达上调,且PCOS中窦状卵泡颗粒细胞的凋亡增加,说明AnnexinI参与了卵巢颗粒细胞的凋亡过程,并且发挥了重要作用。     

Serum Zinc Concentration Is Inversely Associated with Insulin Resistance but Not Related with Metabolic Syndrome in Nondiabetic Korean Adults

Although zinc was known to be associated with insulin metabolism and diabetes, the relationship of serum zinc concentration with insulin resistance (IR) and metabolic syndrome (MetS) was not well investigated in general population. The aim of this study is to evaluate the relationships of serum zinc concentration with IR and MetS in a nondiabetic adult population. This cross-sectional study included 656 men and 825 women who were nondiabetic adults from the fifth Korea National Health and Nutrition Examination Survey conducted in 2010. Serum zinc concentration and metabolic parameters were measured. IR was estimated by homeostatic model assessment (HOMA2). MetS was defined according to the National Cholesterol Education Program Adult Treatment Panel III criteria. Serum zinc concentration was negatively correlated with homeostasis model assessment for insulin resistance (HOMA2-IR) in men (r?=??0.104, P?=?0.008), but not in women. After adjusting for conventional cardiovascular risk factors, the inverse correlation was significant in both men and women (B?=??0.262, SE?=?0.060 for men, and B?=??0.129, SE?=?0.052 for women). However, serum zinc concentration was not different between the groups with and without MetS (P?=?0.752 for men and P?=?0.371 for women). In conclusion, serum zinc concentration was inversely associated with IR but not related to MetS in nondiabetic adult population.     

血清OC、TSP-1、ANGPTL2与多囊卵巢综合征患者胰岛素抵抗、性激素和卵巢间质血流的关系研究

摘要 目的：分析血清骨钙素（OC）、血小板反应蛋白-1（TSP-1）、血管生成素样蛋白2（ANGPTL2）与多囊卵巢综合征（PCOS）患者胰岛素抵抗（IR）、性激素和卵巢间质血流的关系。方法：选取2020年1月～2022年4月内蒙古自治区人民医院收治的125例PCOS患者（PCOS组）,根据稳态模型评估（HOMA）-IR分为IR组68例和非IR组57例,另选取同期67例体检健康成年女性（对照组）。收集研究对象HOMA-IR和性激素、卵巢间质血流指标,采用酶联免疫吸附法检测血清OC、TSP-1、ANGPTL2水平。比较PCOS组与对照组、IR组与非IR组之间性激素、卵巢间质血流指标、血清OC、TSP-1、ANGPTL2水平的差异。采用Pearson/Spearman相关性分析法分析PCOS患者血清OC、TSP-1、ANGPTL2水平与HOMA-IR、性激素和卵巢间质血流指标的相关性。结果：PCOS组HOMA-IR、黄体生成素（LH）、LH/促卵泡生成素（FSH）、睾酮（T）、收缩期峰值速度（PSV）、ANGPTL2水平高于对照组,搏动指数（PI）和阻力指数（RI）、OC、TSP-1水平低于对照组（P＜0.05）。IR组LH、LH/FSH、T、PSV、ANGPTL2水平高于非IR组,PI、RI、OC、TSP-1水平低于非IR组（P＜0.05）。Pearson/Spearman相关性分析显示,PCOS患者血清OC、TSP-1水平与HOMA-IR、LH、LH/FSH、T、PSV呈负相关,与PI、RI呈正相关（P＜0.05）;血清ANGPTL2水平与PCOS患者HOMA-IR、LH、LH/FSH、T、PSV呈正相关,与PI、RI呈负相关（P＜0.05）。结论：血清OC、TSP-1在PCOS患者血清中低表达,ANGPTL2在PCOS患者血清中高表达,三者与PCOS患者IR、性激素和卵巢间质血流密切相关。     

Adipokines,Ghrelin and Obesity‐Associated Insulin Resistance in Nondiabetic Patients with Acute Coronary Syndrome

Altered glucose metabolism negatively modulates outcome in acute coronary syndromes (ACS). Insulin resistance is commonly associated with increasing BMI in the general population and these associations may involve obesity‐related changes in circulating ghrelin and adipokines. We aimed at investigating interactions between BMI, insulin resistance and ACS and their associations with plasma ghrelin and adipokine concentrations. Homeostasis model assessment of insulin resistance (HOMA_IR)‐insulin resistance index, plasma adiponectin, leptin, total (T‐Ghrelin), acylated (Acyl‐Ghrelin), and desacylated ghrelin (Desacyl‐Ghrelin) were measured in 60 nondiabetic ACS patients and 44 subjects without ACS matched for age, sex, and BMI. Compared with non‐ACS, ACS patients had similar HOMA_IR and plasma adipokines, but lower T‐ and Desacyl‐Ghrelin and higher Acyl‐Ghrelin. Obesity (BMI > 30) was associated with higher HOMA_IR, lower adiponectin, and higher leptin (P < 0.05) similarly in ACS and non‐ACS subjects. In ACS (n = 60) HOMA_IR remained associated negatively with adiponectin and positively with leptin independently of BMI and c‐reactive protein (CRP) (P < 0.05). On the other hand, low T‐ and Desacyl‐Ghrelin with high Acyl‐Ghrelin characterized both obese and non‐obese ACS patients and were not associated with HOMA_IR. In conclusion, in ACS patients, obesity and obesity‐related changes in plasma leptin and adiponectin are associated with and likely contribute to negatively modulate insulin resistance. ACS per se does not however enhance the negative impact of obesity on insulin sensitivity. High acylated and low desacylated ghrelin characterize ACS patients independently of obesity, but are not associated with insulin sensitivity.     

Serum Copper and Zinc Levels in Patients with Endometrial Cancer

Biological Trace Element Research - The aim of the present study was to evaluate serum concentrations of copper (Cu) and zinc (Zn), in relation with metabolic profile and clinicopathologic features...