Very high frequency of the polymorphism for the insulin receptor substrate 1 (IRS-1) at codon 972 (glycine972arginine) in Southern Italian women with polycystic ovary syndrome.

A major component of the polycystic ovary syndrome (PCOS) is the insulin resistance. Only a few studies have evaluated the IRS-1 polymorphism at codon 972, sometimes in the absence of a control group, and with great variability in frequency (0-23% in PCOS vs. 0-17% in controls), and with no unequivocal relationships between the polymorphism and clinical or biochemical indexes. The aim of the work was to evaluate the frequency of the IRS-1 polymorphism at codon 972 in PCOS, and correlate it to clinical and biochemical indexes. We assessed the rs 1801278 polymorphic variant in the IRS-1 gene (Gly972Gly=wild-type; Gly972Arg=heterozygosity; Arg972Arg=homozygosity) in genomic DNA by restriction fragment length polymorphism. The study was conducted at an academic medical center with the participation of 65 women with PCOS and 27 age-matched healthy women (controls). Compared to controls, Gly972Arg was very frequent in PCOS (77% vs. 18%, p<0.0001); one PCOS woman was homozygous. Compared to wild-type PCOS, heterozygous PCOS women had only three significantly different indexes: higher fasting insulin, insulin resistance index, and lower 120 min OGTT glucose. Moreover, in the correlation analysis between any two clinical or biochemical variables, the Pearson's correlation coefficients were frequently of different magnitude in heterozygous PCOS versus wild-type PCOS. Overall, heterozygous PCOS had a greater number of statistically significant relationships between different clinical, metabolic and hormonal indexes: 44 direct and 9 inverse versus 6 and 3, respectively. The IRS-1 Gly972Arg has the highest frequency reported world-wide for PCOS women. This variant is associated with insulin resistance and higher fasting insulin in PCOS women.

Screening for gestational diabetes in Sicily.

OBJECTIVE: To establish the prevalence of gestational diabetes in a universally screened population living in Messina, Sicily, as the first step in evaluating the cost: benefit ratio of screening for carbohydrate intolerance in pregnancy. STUDY DESIGN: Between October 1989 and March 1995, 1,000 pregnant women underwent screening for gestational diabetes with a 50-g, one-hour glucose challenge test. All the risk factors were registered. RESULTS: Two hundred sixty subjects had a value of > or = 135 mg/dL and underwent a full three-hour oral glucose tolerance test. Of them, 46 (4.6%) met the Carpenter-Coustan diagnostic criteria for gestational diabetes. CONCLUSION: The apparent incidence of gestational diabetes (1.2%) prior to screening was only 25% of the incidence determined with the protocol of universal screening (4.6%). If we assume that timely diagnosis and treatment of gestational diabetes provides an important opportunity to improve obstetric outcome and reduce perinatal morbidity, and since women with gestational diabetes are at increased risk of developing diabetes later, the knowledge that the true prevalence is almost four times that previously reported is a determinant of a future evaluation of the cost:benefit ratio of screening universally for gestational diabetes.

Behaviour of HPL and GH plasmatic rate in pregnant women at different times of their pregnancy during dynamic tests.

The authors have studied the effects of an oral or intravenous glucose load, of insulinic hypoglycemia, of arginine and the effects of the 2-deoxi-glucose on the plasmatic concentration of HPL and GH on pregnant women at different times during their pregnancy. None of the used tests seemed able to modify in any way the plasmatic concentration of the placental lactogen hormone; the somatotropinic response to the different stimuli happens to be lower than that found in non pregnant women of the same age. We and by asserting that unlike what happens with the GH, there does not exist a direct "feedback" between the modifications of plasmatic concentration of the main underlayers and HPL.