RESUMO
Insulin resistance (IR) is one of the common features of the polycystic ovary syndrome (PCOS), and recent studies indicate the possible role of vitamin D in the pathogenesis of IR and glucose metabolism. Aim of this study was aimed to determine the effect of vitamin D replacement therapy on glucose metabolism, insulin, and androgen levels in obese, insulin-resistant women with PCOS. Eleven women with PCOS were included in the study. Mean age of the patients was 23.6+/-5.7 yr, body mass index 33.9+/-5.1 kg/m(2). Six patients (54.5%) had acantosis nigricans and 10 (90.9%) oligoamenorrhea. The mean Ferriman Gallwey score was 14.1+/-4.6. Only 2 women were within the normal limits of vitamin D levels as >20 ng/ml. Three weeks after the administration of the single dose of 300,000 units of vitamin D3 orally, 25-hydroxyvitamin D3 significantly increased from 16.9+/-16 ng/ml to 37.1+/-14.6 ng/ml (p: 0.027) and only 2 women were detected to have vitamin D3 levels <20 ng/ml. Although glucose and insulin levels were decreased non-significantly, homeostasis model assessment (HOMA)-IR significantly decreased from 4.41+/-1.38 to 3.67+/-1.48 (p: 0.043). No significant alterations were witnessed at the levels of DHEAS, total and free testosterone, androstenedione. No correlation was found between vitamin D with HOMA and other hormonal parameters. In conclusion, women with PCOS have mostly insufficient vitamin D levels, and vitamin D replacement therapy may have a beneficial effect on IR in obese women with PCOS.
Assuntos
Androgênios/sangue , Resistência à Insulina/fisiologia , Síndrome do Ovário Policístico/sangue , Síndrome do Ovário Policístico/tratamento farmacológico , Vitamina D/uso terapêutico , Adolescente , Adulto , Animais , Glicemia/metabolismo , Feminino , Humanos , Insulina/metabolismo , Obesidade/metabolismo , Vitaminas/uso terapêutico , Adulto JovemRESUMO
Combinations of insulin and oral antidiabetic drugs (OAD) are often prescribed instead of insulin alone. In this study, the effects of insulin glargine (IG) in combination with repaglinide or acarbose on glycemic parameters were investigated. Obese Type 2 diabetic patients with fasting blood glucose (FBG) levels >or= 7.7 mmol/l [corrected] and hemoglobin glycated (A1C) >or=9% under maximal OAD combination therapy were enrolled. Previous therapies were discontinued, and patients were randomized into 2 groups. The combinations of IG and repaglinide were administered to group 1, and of IG and acarbose to group 2 for 13 weeks. Twenty patients in group 1 and 18 patients in group 2 completed the study. A1C levels were significantly decreased from 10.9+/-1.4% to 7.7+/-1.1% in group 1 and 11.0+/-1.4% to 8.1+/-1.4% in group 2. FBG levels were significantly decreased from 11.9+/-2.7 to 7.1+/-2.3 mmol/l in group 1 and 11.1+/-2.5 to 6.8+/-1.4 mmol/l in group 2. Post-prandial glucose levels were significantly decreased from 15.3+/-3.8 to 10.3+/-3.0 mmol/l in group 1 and 14.0+/-3.1 to 8.9+/-2.2 mmol/l in group 2. Intergroup comparisons indicated no significant differences. More weight gain was detected in group 1, compared to the baseline. Symptomatic hypoglycemia incidence was similar in both groups. Severe hypoglycemic attacks were seen in two patients in group 1. Flatulence incidence was higher in acarbose group. Conclusively, repaglinide and acarbose were equally effective when combined with IG for obese Type 2 diabetic patients controlled inadequately with OAD alone. Furthermore, acarbose seems to have advantages over repaglinide concerning weight gain and severe hypoglycemic attacks.
Assuntos
Acarbose/uso terapêutico , Glicemia/metabolismo , Carbamatos/uso terapêutico , Diabetes Mellitus Tipo 2/tratamento farmacológico , Hipoglicemiantes/uso terapêutico , Insulina/análogos & derivados , Piperidinas/uso terapêutico , Acarbose/administração & dosagem , Carbamatos/administração & dosagem , Carbamatos/efeitos adversos , Diabetes Mellitus Tipo 2/complicações , Quimioterapia Combinada , Feminino , Hemoglobinas Glicadas/metabolismo , Humanos , Hipoglicemia , Insulina/administração & dosagem , Insulina/uso terapêutico , Insulina Glargina , Insulina de Ação Prolongada , Masculino , Pessoa de Meia-Idade , Obesidade/complicações , Obesidade/tratamento farmacológico , Piperidinas/administração & dosagem , Piperidinas/efeitos adversos , Aumento de Peso/efeitos dos fármacosRESUMO
Many pharmacological agents were investigated for the prevention of renal ischemic reperfusion (IR) injury as well as the phosphodiesterase (PDE) inhibitors. The aim of the study was to examine the possible renoprotective effect of enoximone as a member of this family on IR injury. Thirty-six Wistar-Albino rats were allocated to six groups. Sham (S) and control groups (E1, E2) only received 0.09% NaCl, 5 mg/kg and 10 mg/kg enoximone via caudal caval vein, respectively. In ischemia (I) and treatment groups (IE1, IE2), the rats were subjected to bilateral renal artery occlusion and were given 0.09% NaCl, 5 mg/kg and 10 mg/kg enoximone in the same route, respectively. Bilateral kidneys were removed at the sixth hour of laparotomy for histopathological and biochemical analysis, such as superoxide dismutase, myeloperoxidase, malonyldialdehyde, and nitric oxide end products. Blood samples were taken in order to evaluate renal function tests. The data were analyzed by using one-way analysis of variance, and p < .05 was considered to be statistically significant. The worst results were achieved in ischemia group (p < .05). Treatments groups showed nearly similar findings with this group (p < .05). There was no significant difference between control and sham groups. In this study, we found that apart from the other members of the PDE inhibitors' family, enoximone did not contribute to the attenuation of IR injury of kidney.
Assuntos
Enoximona/uso terapêutico , Nefropatias/prevenção & controle , Inibidores de Fosfodiesterase/uso terapêutico , Traumatismo por Reperfusão/prevenção & controle , Animais , Enoximona/farmacologia , Masculino , Inibidores da Fosfodiesterase 3 , Inibidores de Fosfodiesterase/farmacologia , Ratos , Ratos WistarRESUMO
Hyperglycemia increases reactive oxygen species (ROS) and the resulting oxidative stress contributes to the development of diabetic complications. Dexpanthenol (Dxp) is the biological active form of pantothenic acid. We investigated whether Dxp administration could decrease oxidative stress as a way to treat renal complications of diabetes mellitus (DM). Thirty-two male Wistar albino rats were divided into four groups: control, Dxp, DM and DM + Dxp. Experimental diabetes was induced by a single dose of streptozotocin (STZ). After administration of STZ, the DM + Dxp group was administered 500 mg/kg Dxp intraperitoneally every day for 6 weeks. At the end of the study, blood glucose levels were measured and rats were sacrificed. Kidneys were embedded in paraffin, sectioned and stained with hematoxylin and eosin, and periodic acid-Schiff. The mean malondialdehyde levels, glutathione peroxidase, superoxide dismutase and catalase activities, and total antioxidant and total oxidant status also were measured. The control group was normal in histological appearance. We observed congestion, inflammation, glomerulosclerosis, tubular desquamation, loss of villi and hydropic degeneration in tubule cells in the DM group. Indicators of oxidative stress were elevated and antioxidant activity was reduced in the DM group compared to controls. In the DM + Dxp group, oxidative stress was decreased, antioxidant activity was increased and histopathological changes were reduced compared to the DM group. We found that Dxp exhibited ameliorative effects on STZ induced diabetic nephropathy by increasing antioxidant activity.
Assuntos
Nefropatias Diabéticas/tratamento farmacológico , Rim/efeitos dos fármacos , Estresse Oxidativo/efeitos dos fármacos , Ácido Pantotênico/análogos & derivados , Animais , Antioxidantes/farmacologia , Diabetes Mellitus Experimental/metabolismo , Nefropatias Diabéticas/patologia , Modelos Animais de Doenças , Glutationa/metabolismo , Glutationa Peroxidase/metabolismo , Inflamação/tratamento farmacológico , Inflamação/metabolismo , Masculino , Malondialdeído/farmacologia , Ácido Pantotênico/farmacologia , Ratos Wistar , Espécies Reativas de Oxigênio/metabolismoRESUMO
AIM: Autoimmune disorders are considered to be associated with a Th1 immune response whereas allergic diseases with a Th2 response. Studies mainly performed on children revealed conflicting results regarding the association of atopy/allergic disease and autoimmune disorders. Therefore, we aimed to investigate the prevalence of allergic diseases in adult Type 1 diabetic patients. METHODS: Eighty-nine Type 1 diabetic patients and 64 controls were enrolled into the study. Skin-prick test and European Community Respiratory Health Survey questionnaire were performed on all cases. Patients who gave at least one positive answer to questions about asthma in the questionnaire underwent pulmonary function test and methacholine challenge test. RESULTS: Patients' mean age were similar in diabetic patients and controls (28.2+/-8.9 and 28.1+/-5.2 yr; respectively). In skin-prick test, the rate of positive response to at least one allergen was not significantly different in diabetes (29.2%) and in the control group (31.3%). In European Community Respiratory Health Survey questionnaire, diabetic patients waked up by an attack of cough more than controls did. The rate of physician-diagnosed asthma was similar in both groups. There was no difference between the 2 groups based on the answers of other questions about asthma and other allergic diseases such as allergic rhinitis, eczema, and drug allergy. CONCLUSION: We found that atopy frequencies were similar in an adult population of Type 1 diabetic patients and controls. Although asthmatic symptom prevalence is increased in diabetic patients, the incidence of current asthma was similar in both groups.
Assuntos
Diabetes Mellitus Tipo 1/complicações , Hipersensibilidade Imediata/epidemiologia , Hipersensibilidade/epidemiologia , Adulto , Asma/complicações , Asma/diagnóstico , Asma/epidemiologia , Feminino , Humanos , Hipersensibilidade/complicações , Hipersensibilidade Imediata/complicações , Masculino , Cloreto de Metacolina , Testes de Função Respiratória , Testes Cutâneos , Inquéritos e Questionários , Turquia/epidemiologiaRESUMO
OBJECTIVE: To investigate the importance of transvaginal color Doppler ultrasonography of uterine and intraovarian arteries in the clinical diagnosis of polycystic ovary syndrome (PCOS). MATERIAL & METHOD: This study was planned as a cohort, controlled, prospective study. A total of 80 participants (40 with PCOS and 40 as a control group) were enrolled in the study. A Doppler system with a 6.0 MHz transvaginal probe was used when performing ultrasonography (USG) and Doppler examinations. Ovarian size and volume, number of follicles and stromal echogenity were evaluated by USG. Doppler flow studies were targeted to uterine and intraovarian arteries and the pulsatility index (PI) was assessed. The concentrations of luteinizing hormone (LH), follicle stimulating hormone (FSH), total testosterone (T) and dihydroepiandrostenedione sulphate (DHEAS) were measured by immunometric methods. RESULTS: The mean values of the number of follicles and the ovarian volume of both the right and left ovaries were higher in the group with PCOS than the control group (p < 0.05). The mean PI values of the right and left ovaries, respectively, were 0.84 +/- 0.23 and 1.09 +/- 1.17 in the group with PCOS, and 0.88 +/- 0.14 and 0.92 +/- 0.15 in the control group. The mean PI values of the right and left uterine arteries, respectively, were 3.25 +/- 0.98 and 3.33 +/- 1.12 in the group with PCOS, and 3.17 +/- 0.93 and 3.2 +/- 1.38 in the control group (p > 0.05). The correlation analysis of the ovarian volume, the number of follicles and Doppler parameters revealed that there was a positive correlation and statistically significant difference between the right ovarian volume and right uterine artery PI in the group with PCOS and the left ovarian volume and left uterine artery PI in the control group (p > 0.05). The mean stromal PI of the ovarian and uterine arteries were 0.96 +/- 0.61 and 3.29 +/- 1.02 in the group with PCOS and 0.9 +/- 0.12 and 3.19 +/- 1.14 in the control group, respectively (p > 0.05). In the group with PCOS, the mean ovarian volume and the mean number of follicles were 11.46 +/- 4.43 and 13.91 +/- 4.11, respectively, whereas they were 7.63 +/- 2.44 and 5.55 +/- 2.34 in the control group (p < 0.05). CONCLUSION: It is not beneficial to use color Doppler transvaginal ultrasonography in the clinical diagnosis of patients with PCOS.
Assuntos
Síndrome do Ovário Policístico/diagnóstico por imagem , Síndrome do Ovário Policístico/fisiopatologia , Adulto , Artérias/fisiologia , Estudos de Casos e Controles , Estudos de Coortes , Feminino , Humanos , Ovário/irrigação sanguínea , Síndrome do Ovário Policístico/sangue , Valor Preditivo dos Testes , Estudos Prospectivos , Fluxo Pulsátil , Ultrassonografia Doppler em Cores , Útero/irrigação sanguínea , VaginaAssuntos
Doença Hepática Induzida por Substâncias e Drogas/etiologia , Glucose/toxicidade , Hipoglicemiantes/toxicidade , Insulina/toxicidade , Tentativa de Suicídio , Adulto , Alanina Transaminase/sangue , Aspartato Aminotransferases/sangue , Doença Hepática Induzida por Substâncias e Drogas/sangue , Humanos , MasculinoRESUMO
AIM: The aim of this study was to evaluate the data of our patients who had been treated for second branchial anomalies in the last 10 years. Here we report our clinical experience in second branchial anomalies with a review of the literature. PATIENTS AND METHODS: We evaluated retrospectively the data of 14 patients, who had been operated on between 1994 and 2004 for second branchial anomalies, in relation to age, sex, complaint at application, diagnostic test, surgical procedures and histopathologic findings. RESULTS: The mean age of the patients (8 female, 6 male) was 5.3 years (range = 1.5-16). The anomalies were usually located on the left side of the neck (n = 6). There were only 3 cases with bilateral anomalies. The majority of the lesions were sinuses (93%). The most frequent clinical feature was the presence of persistent discharge from an external (cutaneous) orifice. All lesions were excised by performing a second step ladder incision. Eight of the lesions were removed under the guidance of 3/0 polypropylene suture. No postoperative complication or recurrence was observed during the follow-up period. CONCLUSIONS: Second branchial arches anomalies are the most common branchial anomalies. Sinuses are more frequently encountered in children. Definitive treatment for these lesions is surgical excision. A polypropylene suture can be inserted into the tract as a guide to prevent incomplete excision.