Endocrine Abstracts

The USMBDPCP is unique that it is the first study to consider the whole US- Mexico Border as one epidemiological unit. The project goal is to reduce the burden of diabetes among persons with type 2 diabetes living in the U.S.-Mexico border region. I Development of a Prevalence Study and identification of risk factors. II Implementation an intervention pilot study for diabetes prevention and control.Phase IThe diabetes prevalence su...

Objective: The objective of this study was to determine the efficacy of combination therapy with pioglitazone and losartan in delaying the progression of chronic renal failure in subjects with type 2 diabetic nephropathy.Methods: A randomized, controlled trial was conducted in 60 patients with type 2 diabetic nephropathy. 30 patients received the combination treatment with pioglitazone 30 mg daily and losartan 100 mg daily, and 30 patients received losar...

Objective: Gestational diabetes mellitus occurs in 2–9 percent of all pregnancies. It is associated with substantial maternal and perinatal complications which can all be reduced if it is diagnosed. In UK 65% of pregnant complicated by diabetes involve gestational diabetes. Professional bodies disagree about whether to recommend routine screening, selective screening or no screening of gestational diabetes. The NICE guidelines are in progress and are expected by end of 20...

Background, subjects & methods: Dexamethasone increases visfatin synthesis in vitro, but it is not clear, whether it is reflected in the changes of serum levels of this cytokine. We have therefore assessed fasting serum concentrations of visfatin, glucose, insulin and cortisol in 20 subjects (4 males, 5 subjects with type 2 diabetes) age (mean±S.D.) 42.1±17.2 years, BMI 36,7±8.38 kg/m2 before and after 48 hours of administrat...

Background, subjects & methods: Visfatin, also known as pre-B cell colony enhancing factor (PBEF), is a cytokine that is highly expressed in visceral fat, and exerts insulin-mimicking effects in rodents through activation of an insulin receptor, though in a manner distinct from insulin. Visfatin levels do not change in response to acute hyperinsulinaemia in mice, but it is not clear whether this also applies to humans. In order to investigate this we measured serum visfati...

Background: It is well established that diabetes-related complications are greatest in patients with a high HbA1c and in those who do not attend primary or secondary care clinics. For an equivalent reduction in HbA1c greater benefits are achieved in those with a high baseline.Aim: To determine if a simple action plan implemented by the Diabetes and Practice Nurse in primary care could improve glycaemic control.Methods: A primary ca...

Vascular calcification, occurring in organs such as heart and kidneys, is associated with increased risk of cardiovascular mortality. The underlying molecular mechanisms remain unknown. To elucidate these, we investigated C3H mice, an inbred strain susceptible to vascular, myocardial and renal calcification. Myocardial calcification in C3H mice involves 4 genetic loci, Dyscalc1-4, that map to chromosomes 7, 4, 12 and 14, respectively. Dyscalc1 contributes to myoc...

Kisspeptins, peptide products of the KiSS-1 gene, are pleiotropic hormones best recognized as novel regulators of puberty onset and the reproductive system. Thus, the hypothalamus expresses both KiSS-1 and its receptor, GPR54. Hypothalamic KiSS-1 is attenuated by food restriction (72 h fast),and this provides a plausible link between negative energy balance and the disruption of reproductive function. Hypothalamic KiSS-1 mRNA levels are also reduced...

Background: Apolipoprotein B (APOB) is an integral part of the LDL, VLDL, IDL, Lp(a) and chylomicron lipoprotein particles. The APOB pre-mRNA consists of 29 constitutively-spliced exons. APOB exists as two natural isoforms: the full-length APOB100 isoform, assembled into LDL, VLDL, IDL and Lp(a) and secreted by the liver in humans; and the C-terminal truncation APOB48, assembled into chylomicrons and secreted by the intestine in humans. Down-regulation of ...

We have previously shown impaired neuroendocrine responses to ghrelin in patients with AN. The aim of this study was to investigate the metabolic responses during infusions of active ghrelin in severly malnourished patients with AN and compare them with responses of amenorrhoic AN patients who recovered body weight (PRAN) and constitutionally thin subjects (CTS) with regular menstrual cycles and without history of eating disorder and recent weight loss. Study was approved by t...

Skeletal muscle infarction is an uncommon manifestation of poor diabetic control. This report describes a gentleman who presented with two weeks of thigh pain and swelling, and had been referred to hospital for exclusion of deep vein thrombosis (DVT). His right thigh was markedly swollen, but soft. There was marked tenderness at the medial aspect. Right thigh circumference was 61 cm, while the left was 48.5 cm. There was no warmth or erythema. He had a full range of movements ...

Background: Hyperuricemia is often associated with chronic kidney diseases (CKD) and is considered as an independent risk factor of cardiovascular and renal diseases. Urate transporter 1 (URAT1), organic anion transporter 1 (OAT1) and OAT3 are believed to play pivotal roles on urate excretion in kidneys. Activation of RAAS in the kidney plays a key role in the pathophysiology of CKD. Thus, we hypothesized that RAAS may be involved in hyperuricemia in patients with CKD by effec...

A pre-diabetes state, Impaired Glucose Tolerance (IGT), is recognised as a natural stage in the development of diabetes with blood glucose levels gradually rising over time until levels consistent with diabetes are reached. In addition, people with IGT have a 2–3 times greater risk of macrovascular disease than euglycaemic subjects. Three recent studies demonstrate benefits of intensive lifestyle modification in people with IGT in preventing diabetes. Hence, education of ...

Aims/hypothesis: Adiponectin is an adipocyte-derived secretory factor that is highly specifically expressed in adipocytes. It exerts effects on energy homeostasis via peripheral and central mechanisms. However, it is not clear whether adiponectin is crossing the blood brain barrier in humans. In serum, adiponectin circulates in several different complexes, each of which has distinct functions. Here, we wanted to test whether adiponectin can be found in human cerebrospinal flui...

Aim: To evaluate whether a prospective randomised controlled trial of intensive lifestyle intervention delivered on a monthly out-patient basis can result in reduced cardiovascular risk, and improved quality of life in obese patients with type 2 diabetes.Patients and Methods: Patients were recruited from diabetes out-patient clinics. All subjects underwent a treadmill exercise test to assess eligibility before randomization. Subjects with a negative exer...

Inbred laboratory mice are widely used to generate, by homologous recombination, transgenic and chemical mutagenesis routes, genetic models of human disease. However, physiological studies of such models are hampered by the lack of normal ranges for serum and urinary biochemistry, particularly in relation to acclimatisation following placement in metabolic cages. To establish such values, we investigated urinary and serum parameters in forty, 24–30 week-old C3H/HeH, BALB/...

Many evidences have shown that the beneficial effect of statins on the cardiovascular disease may be not only due to their cholesterol-lowering, but also may result from their non-lipid related effects, such as the improvement of endothelial function, the inhibition of smooth muscle proliferation, etc\. Here we investigated the effect of fluvastatin on H2O2-induced oxidative cell damage and the underlying mechanism in human umbilical vein endothelial cell...

Background and Objective: CB1 antagonism may have potential benefits in the metabolic syndrome, with effects mediated through central orexigenic mechanisms and peripheral action on adipose tissue. We have previously described the effects of CB1 activation/inactivation on murine white preadipocyte 3T3-L1 proliferation; we now extend these studies to human tissue.Method: Ethical approval was obtained for this study. Human preadipocytes were isolated from w...

SOM230 is one of the long-acting somatostatin analogues, which has been developed for the treatment of neuroendocrine tumours. Recently we found that SOM230 inhibits the proliferation of human umbilical vein endothelial cells (HUVECs). The aim of this study is to further investigate its antiproliferative effect using adult human aortic endothelial cells (HAECs) and human dermal microvessel endothelial cells (HDMECs). The expression of SSTRs and the potential mechanism were obs...

Objective: Fetal hyperinsulinemia correlated with large birth weight and impaired glucose tolerance test and obesity in second decades of life. In study we compared the correlation between Fetal Insulin production (as estimated by amniotic fluid (AF) C-peptide concentration) and AF Insulin with macrosomia (as estimated by neonatal birth weight >4000 gr).Methods: Thirty eight neonates was studied: Ten infants were macrosomia and twenty eight was norma...

Objective: To evaluate the relation between C-peptide and insulin in amniotic fluid with macrosomia.Methods and materials: We enrolled ten newborns with more than 4000 gr weight as the case-group and 28 newborns with less than 4000 gr as the control group. During delivery (C/S or NVD) about 10cc of amniotic fluid was taken and we took samples from umbilical cord or venous blood of newborn and venous blood of mothers for evaluation of insulin and C-peptid...

Background: Women with epilepsy may be at risk of developing PCOS, but it is unclear whether this is due to the disease or sodium valproate (VPA) therapy. We sought to determine androgenic status and cardiometabolic risk in women taking VPA monotherapy and compared these with subjects taking lamotrigine and healthy controls.Methods: Patients with epilepsy (age 18–43) with no known vascular risk were divided into 3 groups: VPA monotherapy (n=1...

Introduction: Latent Autoimmune Diabetes of Adult (LADA) is a form of adult onset type1diabetes. It usually presents after age 30 years and has many demonstrable antibodies, Glutamic Acid Decarboxylase (GAD) being one of them. Detection of LADA has definite prognostic and treatment implications as 10% of adults with diabetes in UKPDS had LADA and majority of them required insulin within 6 years of diagnosis. Screening by using GAD antibody has been said to be a superior method...

Background: A number of reports have associated non-alcoholic steatohepatitis (NASH) with aspects of the metabolic syndrome, such as insulin resistance, dyslipidaemia, type 2 diabetes and obesity. NASH can progress to cirrhosis and hepato-cellular carcinoma, as well as acting as a marker for insulin resistance in patients with type 2 diabetes mellitus.Aims: The purpose of this study was to determine the prevalence of abnormal liver function in a populati...

Introduction: There are two isoforms of the insulin receptor (IR), generated by the alternative splicing of exon 11 to give IR-A (exon 11-) and IR-B (exon 11+) isoforms. The differing distribution and function of the isoforms has been postulated to play a role in the pathogenesis of diabetes mellitus, myotonic dystrophy and thyroid carcinoma. Previous work investigating IR alternative splicing has identified hormonal factors, splicing elements and factors which modulate the re...

There is a significant body of research that demonstrates an association between central (visceral) obesity, insulin resistance, endothelial dysfunction and accelerated atherosclerosis, but the molecular mechanisms underlying this link are incompletely understood. In cultured human aortic endothelial cell (HAEC) models, insulin stimulates an intracellular signalling cascade resulting in activating phosphorylation of Insulin Receptor Substrate-1, Protein kinase B (PKB/Akt) and ...

The metabolic syndrome, which encompasses features of obesity, insulin resistance, dyslipidaemia and hypertension, has been associated with excessive glucocorticoid (GC) exposure. The pancreas is a target of the adverse affects of GC action, resulting in β-cell damage and reduced glucose-stimulated insulin secretion (GSIS). 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1) catalyses the in vivo conversion of inactive to active glucocorticoids (cortisone E/11-de...

Low testosterone levels are a common in men with coronary artery disease and Type 2 diabetes (DM2). Testosterone replacement therapy improves insulin sensitivity and glycaemic control in men with diabetes and improves numerous other cardiovascular risk factors. Interest in testosterone as a potential treatment for cardiovascular disease continues to grow. Low HDL cholesterol (HDL-C) levels are recognised as an independent cardiovascular risk factor and comprise part of the met...

The nuclear receptor co-factor RIP140 has an essential role in metabolic regulation. Genetically manipulated mice lacking RIP140 show reduced fat accumulation, increased energy expenditure and increased insulin sensitivity. They gain less weight on high fat feeding than wild type littermates, and are protected from both age and high fat diet induced insulin resistance.RIP140 is a repressor of transcription and in its absence metabolic gene networks are u...

The insulin gene is expressed almost exclusively in the β cells of the islets of Langerhans, where transcriptional control is conferred by cis-acting regulatory sequences located within 300–400 base pairs from the transcription start site. These elements bind β-cell restricted (e.g. PDX-1) and ubiquitous (E47) transcription factors. In non-β cells the insulin gene is localised within tightly packed (hetero) chromatin structures. Developments in under...

Dehydroepiandrosterone (DHEA) and its sulphate ester DHEAS, have been shown to oppose the effects of glucocorticoids in vivo, thus producing beneficial effects on insulin sensitivity in rodent models of diabetes and obesity as well as in hypoadrenal patients. Glucocorticoids play a key role in regulating fat metabolism and distribution and are reactivated locally by 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1) oxoreductase activity, which increases with ...

Bone marrow stem cells (BMSCs) are able to differentiate along multiple lineages including adipogenic and osteogenic lineages. The adenosine A1 receptor (A1R) modulates adipose tissue function causing an inhibition of lipolysis. We therefore studied A1R expression in BMSCs induced to differentiate along the adipogenic lineage.BMSCs were isolated from rat femur (10 wk male Wistar), cultured in control medium (alphaMEM 10% FCS) and then plated into adipocy...

This abstract was printed as a duplication of abstract P291 and corrected onlineBackground: Excess glucocorticoids result in Cushing’s syndrome (CS) which is characterised by increased food intake, central obesity, dyslipidaemia and insulin resistance, leading to the metabolic syndrome. AMPK is a regulator of energy homeostasis and plays an important role in the regulation of appetite, glucose uptake, lipogenesis and gluconeogenesis. We hypothesised...

7-Oxysterols modulate lipid transport and promote oxidative stress and apoptosis in the vascular wall. 7-Ketocholesterol (7KC) and 7β-hydroxycholesterol (7βOHC) are inter-converted by 11β-hydroxysteroid dehydrogenase-1 (11βHSD1), better known for metabolising glucocorticoids. Pharmacological inhibition of 11βHSD1 protects against atherosclerosis and these beneficial effects may be mediated through changes in glucocorticoids or oxysterols. To establish ...

Aim: We aimed to evaluate the usefulness of the Body Image Assessment in Obesity (BIA-O) scale in a UK obesity clinic population by assessing its performance in individuals with a Body Mass Index (BMI) above 50 Kg/m2, evaluating whether obese subjects selected achievable ‘reasonable’ body sizes, and comparing the relationship between body dissatisfaction on the Eating Disorder Inventory-2 (EDI-2) and BIA-O.Methods: Subjects attending...

The rate limiting steps of hepatic glucocorticoid clearance are via A-ring reduction by 5α- and 5β-reductases. Our recent in vitro studies suggested that products of 5α-reduction (eg 5α-tetrahydrocorticosterone) can activate glucocorticoid receptors and hence may contribute to glucocorticoid action in liver. Here we compared the effects of administering 5α-tetrahydrocorticosterone (5αTHB) in vivo with those of corticosterone (B)....

A 46-year-old lady presented with a short history of thirst and polyuria. She had a past history of hypertension. Diabetes mellitus was ruled out as she had normal blood glucose levels. She was found to be normocalcaemic but hypokalaemic. In view of the latter finding and her hypertension, her plasma renin activity and aldosterone was measured, and found to be 45 pmol/ml/hr and 410 pmol/l respectively (aldosterone:PRA ratio of 9.1). The diagnosis of secondary hyperaldosteronis...

Background: Non-alcoholic fatty liver disease (NAFLD) is recognized as common liver disorder that represents the hepatic manifestation of the metabolic syndrome including visceral obesity, type 2 diabetes, insulin resistance and hyperlipidemia. Non-alcoholic steatohepatitis (NASH) is the progressive form of liver injury with the risk for progressive fibrosis, cirrhosis and end-stage liver disease. The pathophysiology that leads to NAFLD and NASH is not well understood. We hypo...

A 64 old year old obese (BMI 31 kg/m2) Caucasian male was admitted to our hospital with general malaise, nausea, vomiting and dehydration. He gave no preceding history of polyuria, polydipsia or weight loss. He had been receiving oral corticosteroids for established ulcerative colitis. He was found to have random plasma glucose of 70.7 mmol/l, positive serum and urine ketones, and metabolic acidosis with PH 7.27, bicarbonate 13 mmol/l and base excess −12.4. Th...

The endocrine pancreas develops from cells of the endoderm which in response to extracellular signals express the transcription factor PDX1 that subsequently induces formation of the pancreas. At a later stage neurogenin 3 (ngn3) is activated in a sub-set of cells that are then destined to become endocrine cells. The final stage of differentiation to the various cell types of the islets of Langerhans is controlled by a number of transcription factors including PAX4 and PDX1 (i...

Objective: Orexin-A and orexin-B and their G-protein coupled receptors (orexin receptor-1 & -2: OX1R, OX2R) have divergent effects on physiological behaviour, cardiovascular regulation, glucocorticoid and insulin release. Furthermore, orexins have been shown to affect both brown adipose tissue energy expenditure and thermogenesis through stimulation of sympathetic nerve activity. Despite in vivo studies demonstrating a role for orexins acting centrally on adipose ti...

Accelerated medial calcification is a major cause of premature cardiovascular mortality in people with chronic kidney disease. Evidence suggests that the concentration of extracellular Ca2+ and vascular smooth muscle cells play a pivotal role in the pathogenesis of vascular calcification. Extracellular Ca2+ is detected by the calcium-sensing receptor (CaSR). The CaSR is a G protein-coupled receptor that is expressed in a range of tissues, but characteriza...

South Asian people have a lower threshold for obesity related complications than Caucasians and as a result have a higher risk of type 2 diabetes (T2DM) and cardiovascular disease (CVD) for a given BMI. Premature biological ageing, assessed by reduction in telomere length (TL), may be mediated by factors resulting from altered metabolic profiles associated with obesity and insulin resistance. We therefore hypothesised that IR is associated with altered metabolic profiles and t...

Orexins, acting via their receptors, are involved in the control of feeding, sleep-wakefulness, arousal, neuroendocrine homeostasis and autonomic regulation. However, the 5′ structure and regulation of human orexin type 2 receptor (OX2R) gene remains is not known. We present original findings regarding the 5′ structural organization of the human OX2R gene and identify four OX2R mRNA transcripts that differ in their 5′-untranslated region (UTR). The four trans...

In humans, glucocorticoids (GC) are implicated in the pathogenesis of obesity and insulin resistance. In adipose tissue, GCs are regulated at the prereceptor level by oxo-reductase activity of 11beta-hydroxysteroid dehydrogenases type 1 (11β-HSD1). The hexose-6-phosphate dehydrogenase null mouse (H6PDH/KO) has shown that H6PDH is required for generating NADPH within the endoplasmic reticulum which determines the direction of 11β-HSD1 enzyme. We have shown that mRNA f...

Glucocorticoids (GC) have potent actions upon human adipose tissue, promoting adipocyte differentiation, inhibiting preadipocyte proliferation and inducing lipolysis to generate free fatty acids (FFA) and glycerol through a putative action upon hormone sensitive lipase (HSL). FFA have been strongly implicated in the pathogenesis of insulin resistance, yet the molecular mechanisms that cause GC induced lipolysis are not clear. Recently, several novel lipases have been identifie...

Objectives: The syndrome of CAIS is the result of loss of function mutations of the androgen receptor. Women with CAIS present with primary amenorrhea, absent uterus and 46XY karyotype. Little is known about the long term natural history of this condition, in particular the risk of heart disease in adults. Here we report on biochemical risk markers in a group of women with CAIS compared to a control group with ovarian failure who were matched for their use of exogenous oestrog...

Glucocorticoid (GC) excess is characterized by central obesity, insulin resistance and in some cases, type 2 diabetes mellitus. Whilst it is accepted that GCs cause insulin resistance, both insulin and GCs act synergistically to promote adipocyte differentiation. We have previously shown that GCs cause tissue specific changes in insulin sensitivity, enhancing insulin signalling in human adipose tissue in contrast to muscle.TRB3, a mammalian homolog of <i...

Critical clinical changes of pulmonary function and weight occur in patients with cystic fibrosis (CF) antecedent to the development of frank Diabetes Mellitus (DM). Impaired glucose tolerance (IGT) signifies diminished Insulin secretion and increased peripheral insulin resistance, correlating with worse clinical status, under nutrition and impaired pulmonary function. Insulin therapy has been associated with improvement in anthropometric data and an arrest in decline in force...

Central obesity is strongly associated with sub-clinical inflammation, insulin resistance (IR) and type 2 diabetes mellitus (T2DM), but the intracellular mechanisms involved in the pathogenesis of central obesity remain unclear. Recent studies have implicated NFκB and c-jun N terminal kinase (JNK) as central molecules linking insulin action and inflammation in mice. As such we examined (1) the inflammatory intracellular signaling pathways involving NFκB, JNK as a pot...

Diabetes Mellitus (DM) and Impaired Glucose Tolerance (IGT) in patients with cystic fibrosis(CF) signifies a six fold rise in mortality and is associated with declining pulmonary function. The pathophysiology is multifactorial but largely due to Insulinopenia which is due to global islet cell fibrosis and accompanied by loss of islet alpha cells. Insulin treatment improves weight, the bacterial milieu, and lung function but is associated with hypoglycaemia. These patients may ...

Background: Recent data suggest a direct impact of ghrelin and leptin on the immune system. Ghrelin appears to antagonize these effects. The role of ghrelin and leptin in the context of ANCA-associated vasculitis (AV) has not been reported.Methods: Fasting serum ghrelin, free and bound leptin levels were measured in 44 patients with active AV and 25 in matched healthy controls. Follow-up under immunosuppressive therapy was available in 25 patients (1, 3,...

Mitochondrial dysfunction has been implicated in the pathogenesis of obesity and Type 2 Diabetes Mellitus (T2DM). Recent research has investigated the role of mitochondria in skeletal muscle and suggesting mitochondrial dysregulation may be linked to T2DM. To date few studies have focused on the role of human adipose tissue (AT) in energy homoeostasis. Therefore we investigated a number of mitochondrial genes including PPARγ co-activator1 (PGC1α, mitochondrial biogen...

Aim: To determine the prevalence of vitamin D insufficiency in Asian patients with type 2 diabetes and to determine the most appropriate screening investigations.Introduction: The high prevalence of vitamin D deficiency and type 2 diabetes in the Asian community is well recognised. Vitamin D insufficiency (levels < 50 nmol/l) is associated with impaired insulin secretion and increased insulin resistance. The prevalence of Vitamin D insufficiency in p...

Introduction: The presence of Metabolic Syndrome (MetS) may be associated with increased cardiovascular risk. The International Diabetes Foundation (IDF) has recently published new diagnostic criteria for MetS. Thus, we sought to compare IDF-defined MetS, the previously defined Cholesterol Education Program Adult Treatment Panel III (ATPIII) and the European SCORE risk stratification model as predictors of the presence of Ischaemic Heart Disease (IHD) within an asymptomatic po...

Objective: The objective was to assess the impact of polycystic ovary syndrome (PCOS) on the quality of life of in women attending a patient-centred, nurse-led endocrine clinic.Method: An audit was conducted of quality of life data for N=152 women attending the clinic for management of PCOS. While one important focus of the clinic is weight management, not all these patients were overweight or obese (weight range 44.7–159.6 kg, mean weight 89...

Objective: The objective was to assess the impact of polycystic ovary syndrome (PCOS) on the quality of life of women attending a patient-centred, nurse-led endocrine clinic, and to investigate changes in quality of life over time.Method: Women attending the clinic, for management of PCOS, completed the PCOSQ (Cronin et al. 1998) at their first appointment. The PCOSQ is the only validated quality of life measure specifically focused on PCOS. It as...

We investigated ACTH-induced hypertension in mice by studying renal function in vivo and by analysing renal gene expression by microarray and RT PCR methods. During two weeks sc infusion with Synacthen, mean blood pressure in adult male mice increased (89±5 vs 110±2 mmHg), and plasma corticosterone, adrenal weights and drinking rate increased by 5, 2 and 2.5-fold respectively (P<0.01); renal mass was unaffected. Greater mineralocorticoid activity wa...

Fasting blood glucose is key to diagnosing diabetes, whilst the Oral Glucose Tolerance Test (OGTT) is a valuable adjunct when diagnosis is borderline or inconclusive. The OGTT is often used to detect early changes in glucose tolerance and predict a likely path to overt Diabetes Mellitus for example in gestational diabetes.A 42 year old female, referred to the Endocrine services for episodes of symptomatic hypoglycaemia. Past medical history included pylo...

Objective: The incidence of childhood obesity and type 2 diabetes has reached epidemic proportions. Glucocorticoid excess causes central obesity and diabetes mellitus as seen in Cushing’s syndrome. The 11beta-hydroxysteroid dehydrogenase type 1 enzyme (11beta-HSD1), which is predominantly expressed in liver and adipose tissue, regenerates active cortisol from inactive cortisone. Altered 11beta-HSD1 may cause tissue-specific Cushing syndrome with central obesity and impair...

Hirsutism affects 8% of women and forms an important reason for referral to the endocrine services in patients with polycystic ovarian syndrome (PCOS). Although antiandrogens are the mainstay in treatment, one needs to bear in mind that they are not without undesirable side effects.We present the case of a 37-year old woman, diagnosed with PCOS based on menstrual irregularities and typical ultrasound appearances of her ovaries. Her main concerns were hir...

Apolipoprotein (Apo)-B is a strong predictor of coronary risk in the general population. Whether it contributes to coronary disease in patients with reduced kidney function is unclear. We examined the prevalence and relationship of Apo-B with physician-diagnosed myocardial infarction among 7,404 adults age >20 years with reduced glomerular filtration rate (GFR) in the U.S. population. GFR was estimated Modification of Diet in Renal Disease Study (MDRD) equation and calibra...

Background: Despite scarce information on the implications of diabetes for pulmonary function, existing evidence suggests that the respiratory system might also be affected by diabetes. We therefore conducted a cross-sectional study of pulmonary function in our male diabetics using spirometric indices.Study design: This was a cross-sectional study of pulmonary function in diabetics. Seventy-six male diabetics aged 27–80 years, mean 55.4±12.6 we...