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The aim of the study was to investigate the relation between thyroid autoimmunity (TAI), reflected as the presence of thyroid peroxidase antibodies (TPOAb), and parameters of ovarian reserve in women with type 1 diabetes (T1DM) and polycystic ovary syndrome (PCOS). We studied 83 euthyroid women with T1DM (age - 26 ± 5 years, BMI - 24 ± 3 kg/m2) - 12 with PCOS and positive TPOAb (PCOS + TPOAb), 29 with PCOS with negative TPOAb (PCOS + noTPOAb), 18 without PCOS with positive TPOAb (noPCOS + TPOAb), 24 without PCOS with negative TPOAb (noPCOS + noTPOAb). Serum concentrations of anti-Müllerian hormone (AMH), sex hormones, TSH, thyroid hormones and TPOAb were assessed. The prevalence of TAI was comparable between PCOS and noPCOS. We did not observe differences in hormonal profile or AMH concentration between two PCOS groups-PCOS + TPOAb and PCOS + noTPOAb (p > 0.05). Women with PCOS + TPOAb had lower FSH concentration and higher LH/FSH index than noPCOS + noTPOAb (p = 0.027; p = 0.019, respectively). Moreover, PCOS + TPOAb had lower oestradiol level than noPCOS + TPOAb (p = 0.041). AMH concentration was higher in both groups with PCOS, independent of TPOAb presence, than in noPCOS + noTPOAb (both p < 0.001). The presence of positive TPOAb titre was not related to the studied parameters of ovarian reserve - AMH and ovarian follicle number. In multiple linear regression analysis, the only significant predictor of AMH in the whole studied group with T1DM was total daily insulin dose U/kg (ß = - 0.264; p = 0.022). The presence of TAI did not affect the hormonal profile or ovarian reserve in women with T1DM with and without PCOS.
Sujet(s)
Autoanticorps , Auto-immunité , Diabète de type 1 , Réserve ovarienne , Syndrome des ovaires polykystiques , Glande thyroide , Humains , Femelle , Diabète de type 1/sang , Diabète de type 1/immunologie , Diabète de type 1/complications , Diabète de type 1/physiopathologie , Syndrome des ovaires polykystiques/sang , Syndrome des ovaires polykystiques/immunologie , Syndrome des ovaires polykystiques/physiopathologie , Adulte , Glande thyroide/physiopathologie , Glande thyroide/immunologie , Glande thyroide/métabolisme , Autoanticorps/sang , Autoanticorps/immunologie , Jeune adulte , Hormone antimullérienne/sang , Iodide peroxidase/immunologieRÉSUMÉ
Summary: We report a case of a 59-year-old woman with Cushing's disease who developed hyperthyroidism following treatment of hypercortisolaemia. The patient with a history of recurrent hospitalisations caused by multi-sited soft tissue abscesses was admitted with sepsis. Both her medical history and physical examination suggested Cushing's syndrome. The initial hormonal diagnostic process, conducted after sepsis treatment, brought forth conflicting results. However, hormonal assessment repeated 3 months later indicated pituitary hypercortisolaemia, which was confirmed through bilateral inferior petrosal sinus sampling and was successfully treated with transsphenoidal pituitary surgery. Three months after the surgery, the patient was readmitted to our epartment with symptoms of hyperthyroidism, which was confirmed by laboratory tests. Thyroid scintiscans indicated Graves' disease. However, the absence of anti-thyroid stimulating hormone antibodies suggested other etiologies of hyperthyroidism. Eventually, the patient underwent radioiodine therapy. Currently, her condition is improving and she has had no recurrence of abscesses, severe infections, or hyperthyroidism. In conclusion, while clinical manifestation of hypercortisolaemia might be non-specific, its treatment may trigger the development of autoimmune diseases. Learning points: The presence of recurrent severe infections should prompt physicians to consider the possibility of hypercortisolaemia. Chronic hypercortisolism is debilitating and can lead to significant disability. Dexamethasone suppression testing in patients with active or recent severe inflammatory or infectious illnesses may produce misleading or confusing results. Clinicians should be aware of the potential development of autoimmune diseases following successful treatment of hypercortisolaemia.
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The kynurenine pathway (KP) of tryptophan degradation includes several compounds that reveal immunomodulatory properties. The present study aimed to investigate the alteration in KP metabolites in young women with autoimmune thyroiditis (AIT) and their associations with thyroid function. The thyroid function tests, antithyroid antibodies measurement and ultrasonography of the thyroid gland have been performed in 57 young women with AIT and 38 age-matched healthy controls. The serum levels of tryptophan, kynurenine (KYN) and its metabolites were determined, and the activity of KP enzymes was calculated indirectly as product-to-substrate ratios. KP was activated and dysregulated in AIT, along with significantly elevated levels of KYN and anthranilic acid (AA), at the expense of the reduction of kynurenic acid (KYNA), which was reflected by the increase in the AA/KYNA ratio (p < 0.001). In univariate and multiple regression analyses, peripheral deiodinase (SPINA-GD) activity in AIT was positively associated with KYNA, AA, and quinolinic acid (QA). The merger of AA, AA/KYNA ratio, QA and SPINA-GD exhibited the highest sensitivity and specificity to predict AIT (p < 0.001) in receiver operating characteristic (ROC) analysis. In conclusion, the serum KYN metabolite profile is dysregulated in young women with AIT and could serve as a new predictor of AIT risk.
Sujet(s)
Cynurénine , Thyroïdite auto-immune , Humains , Femelle , Cynurénine/métabolisme , Tryptophane/métabolisme , Acide quinolinique , Acide kynurénique/métabolismeRÉSUMÉ
INTRODUCTION: Polycystic ovary syndrome (PCOS) is associated with metabolic disturbances, such as insulin resistance and prediabetes, and the risk for their occurrence is especially increased in hyperandrogenic (HA) phenotypes of PCOS. Circulating microRNAs (miRNAs) may be involved in PCOS pathogenesis and regulation of metabolic processes. OBJECTIVES: The aim of the study was to assess expression levels of selected circulating miRNAs in women with PCOS and to investigate the relationship of these miRNAs with glucose metabolism. PATIENTS AND METHODS: The study included 95 patients with HAPCOS and 76 healthy women similar to the study group in age and body mass index. Measurements of sex hormone concentrations, oral glucose tolerance test (OGTT), and transvaginal ultrasonography were performed. Serum levels of selected miRNAs (miR27a, miR34a, miR106b, miR193b, miR181a, miR181b, and miR320) were assessed with realtime polymerase chain reaction, and their association with PCOS and glucose metabolism parameters was studied. RESULTS: Serum levels of all studied miRNAs, except for miR34a, differed between the patients with HAPCOS and healthy women (all P <0.05). In HAPCOS, miR27a and miR320 levels correlated with fasting glucose (R = 0.33; P = 0.001 and R = -0.35; P <0.001, respectively) and insulin concentrations (R = 0.26; P = 0.01 and R = -0.23; P = 0.03, respectively). Additionally, the level of miR27a correlated with mean glucose concentration during OGTT (R = 0.26; P = 0.01). No such correlations were observed in the healthy women. In linear regression analyses, both miR27a and miR320 were associated with fasting glucose concentrations after adjustment for potentially confounding factors in the HAPCOS group only. CONCLUSIONS: The expression profile of circulating miRNAs is altered in patients with HAPCOS. Circulating miR27a and miR320 could serve as potential biomarkers of glucose metabolism disturbances in PCOS.
Sujet(s)
Insulinorésistance , microARN , Syndrome des ovaires polykystiques , Humains , Femelle , microARN/génétique , Marqueurs biologiques , Insulinorésistance/génétique , GlucoseRÉSUMÉ
BACKGROUND: The relationship between brain natriuretic peptides and depression was studied in patients with cardiovascular diseases (CVD), but the data in people without CVD are limited. Metabolic disturbances can be associated with natriuretic peptides' levels. The study aimed to assess serum N-terminal pro-brain natriuretic peptide (NT-proBNP) level in women with depressive symptoms and its relationship with metabolic disturbances. METHODS: The analysis included 347 women (20-60 years old) from Bialystok PLUS cohort study: 98 with depressive symptoms and 249 controls. Clinical examination, oral glucose tolerance test (OGTT) and assessment of lipid, sex hormone binding globulin (SHBG) and NT-proBNP concentrations in the blood were performed. The participants completed Beck Depression Inventory questionnaire. RESULTS: Metabolic syndrome was more frequent in the group of women with depressive symptoms compared to women without depressive symptoms. Women with depressive symptoms had lower NT-proBNP level than the control group - 45.88 (27.80-67.04) vs 56.49 (32.42-94.25) pg/mL, p = 0.027. Multiple linear regression analysis of all women showed that NT-proBNP level was reversely associated with the presence of depressive symptoms, waist circumference and heart rate and positively connected with age. In the group of women with depressive symptoms, we observed negative correlations between NT-proBNP level and insulin concentration at 60 min of OGTT, diastolic blood pressure and a positive correlation with SHBG. CONCLUSIONS: NT-proBNP level is decreased in women with depressive symptoms, which might be connected with metabolic disturbances in this group.
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Maladies cardiovasculaires , Dépression , Humains , Femelle , Jeune adulte , Adulte , Adulte d'âge moyen , Études de cohortes , Peptide natriurétique cérébral , Fragments peptidiques , Peptides natriurétiquesRÉSUMÉ
A number of studies have been conducted on multimorbidity; however, there are different patterns in various countries, ethnicities and social groups. The aim of this study is to estimate the prevalence of multimorbidity (physical diseases) in the urban population in Poland. In this population-based study, we examined multimorbidity stratified by sex, age, educational attainment and professional activity. Sixty-seven conditions were identified based on self-reported history (known conditions) and completed examinations (unknown conditions). Among the overall individuals aged 20-80 years, 1422 (88.2%) of the total 1612 individuals, 787 (88.9%) of 885 women and 635 (87.3%) of 727 men were diagnosed with at least two chronic conditions. On average, 5.25 ± 3.5 conditions occurred in the study population. The number of diagnosed conditions per individual increased with age and decreased with higher educational levels, with differing pathways in women and men. Women showed a higher number of conditions than men in the same age groups and educational levels. Only among students, the level of multimorbidity was lower in women than in men. In the other occupational activity categories, it was already higher in women. The level of multimorbidity in employed and unemployed individuals in a particular sex cluster was similar. We identified a high prevalence of multimorbidity in the urban population in Poland varying by age, sex, education attainment and professional activity. Our work may help in the selection of appropriate screening tests based on age, sex and educational attainment in order to recognise multimorbidity based on both known and unknown conditions. Ultimately, it may impact clinical practice, service delivery and study design.
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BACKGROUND With the expanding understanding of conditions contributing to heightened cardiovascular risk, emerging pathologies like nonalcoholic fatty liver disease (NAFLD) and polycystic ovary syndrome (PCOS) are being recognized as hepatic and ovarian manifestations of metabolic syndrome, respectively. This study aims to elucidate the recent advancements in our comprehension of the link between these conditions in the pediatric demographic, focusing on pathogenesis, incidence, diagnostic methods, and effective therapeutic strategies. MATERIAL AND METHODS A systematic review was conducted following the PRISMA 2020 guidelines, with a search of the PubMed database for eligible studies published in the ten years leading up to January 2023. RESULTS Out of 23 reports based on 16 original studies, we found a significantly higher prevalence of NAFLD in adolescents with PCOS compared to healthy controls. Factors such as increased de novo lipogenesis, alterations in gut microbiota, and a deficiency in growth differentiation factor-15 have been implicated in their pathogenesis. Additionally, novel biomarker S100A4, a clinical prediction score for hepatic steatosis in PCOS, and pharmacotherapy involving low-dose spironolactone, pioglitazone, and metformin have been proposed to enhance the management of these conditions. CONCLUSIONS A meticulous approach to the prevention, detection, and treatment of NAFLD in adolescents with PCOS is paramount to mitigate further complications. The study underlines the need for ongoing research to refine our understanding and management of these interconnected metabolic disorders.
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Insulinorésistance , Stéatose hépatique non alcoolique , Syndrome des ovaires polykystiques , Femelle , Adolescent , Humains , Enfant , Syndrome des ovaires polykystiques/complications , Syndrome des ovaires polykystiques/épidémiologie , Stéatose hépatique non alcoolique/métabolisme , PrévalenceRÉSUMÉ
Adipocyte fatty acid-binding protein (A-FABP) is mainly expressed in adipocytes. The risk of abdominal obesity and autoimmune thyroid disease is increased in women with polycystic ovary syndrome (PCOS). The objective of this study was to explore the relationship of serum concentration of A-FABP with parameters of obesity, e.g., waist to hip ratio (WHR) and the amount of adipose tissue assessed by bioelectrical impedance analysis (BIA), and thyroid hormone homeostasis in women with PCOS. We examined 66 women with PCOS and 67 healthy women. Serum concentrations of A-FABP and thyroid hormones were measured; the FT3/FT4 ratio, thyroid-stimulating hormone index (TSHI), thyrotrope thyroxine resistance index (TT4RI) and thyroid feedback quantile-based index (TFQI) were calculated. In the PCOS group, serum concentrations of A-FABP, FT3 and the FT3/FT4 ratio were significantly higher in comparison to the control group (all p < 0.05). A correlation of A-FABP with WHR (r = 0.26, p = 0.04) and the percentage of adipose tissue (r = 0.33, p = 0.01) has been found only in women with PCOS. We observed no correlation between serum levels of A-FABP and TSHI, TT4RI or TFQI in women with PCOS (all p > 0.05). Our results indicate that A-FABP is an adipokine that may be connected with abdominal obesity independently of thyroid hormone homeostasis in PCOS patients.
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INTRODUCTION: Diabetes remains one of the top public health care priorities. Over 6% of the world's population is affected by type 2 diabetes; however, a similar number of individuals may be unaware of this diagnosis. OBJECTIVES: Our populationbasedstudy aimed to investigate the true prevalence of diabetes and prediabetes in the general population of a mediumsized city in Poland. PATIENTS AND METHODS: The analysis included 1051 participants of the Bialystok PLUS populationbased cohort study. In those who did not report a history of diabetes, the oral glucose tolerance test (OGTT) was performed. Medical history data were gathered using standardized questionnaires, and anthropometric as well as body composition measurements were performed. RESULTS: According to the medical history data, a total of 75 participants had diabetes (7.14%). Prediabetes (impaired fasting glycemia [IFG] or impaired glucose tolerance [IGT]) was identified in 410 individuals, including 241 participants with IFG (22.9%) and 169 patients with IGT (16.1%). Moreover, there were 71 individuals (6.75%) who were newly diagnosed with diabetes based on OGTT results. Overall, 146 patients with diabetes (13.8%) were identified. The ratio of lean mass to fat mass differed significantly between the patients with newly diagnosed diabetes and those without impaired glucose metabolism. CONCLUSIONS: Our cohort study demonstrated a high prevalence of undiagnosed diabetes in the Bialystok population. In addition, we showed that a large group of patients still remains undiagnosed for other hyperglycemic disorders. Abdominal obesity as well as imbalance between the fat and lean mass may predispose to diabetes.
Sujet(s)
Diabète de type 2 , Intolérance au glucose , État prédiabétique , Humains , État prédiabétique/épidémiologie , État prédiabétique/diagnostic , Diabète de type 2/épidémiologie , Diabète de type 2/diagnostic , Études de cohortes , Prévalence , Glycémie/métabolisme , Intolérance au glucose/diagnostic , Intolérance au glucose/épidémiologieRÉSUMÉ
Polycystic ovary syndrome (PCOS) is a common endocrine disorder of unknown etiology that occurs in women of reproductive age. Despite being considered to affect up to one-fifth of women in this cohort, the condition lacks generally accepted diagnostic biomarkers and options for targeted therapy. Hereby, we analyzed the diagnostic, therapeutic, and functional potential of a recently discovered miR-335-5p that was observed to be reduced in the follicular fluid (FF) of PCOS patients as compared with healthy women. We found miR-335-5p to be significantly decreased in the serum and FF samples of PCOS patients (n = 40) vs healthy women (n = 30), as well as in primary human granulosa cells (hGCs), and in 3 different hormonally induced PCOS-like murine models vs. wild-type (WT) mice. The level of circulating miR-335-5p was found to significantly correlate with the impaired endocrine and clinical features associated with PCOS in human patients. Ovarian intrabursal injection of the miR-335-5p antagomir in WT mice ovaries induced a PCOS-like reproductive phenotype. Treatment with the miR-335-5p agomir rescued the dihydrotestosterone-induced PCOS-phenotype in mice, thereby providing a functional link between miR-335-5p and PCOS. We identified SP1 as a miR-335-5p target gene by using the dual-luciferase reporter assay. Both the luciferase reporter assay and chromatin immunoprecipitation assay showed that SP1 bound to the promoter region of human CYP19A1 and inhibited its transcription. miR-335-5p increased the production of estradiol via the SP1/CYP19A1 axis in hGCs, thereby suggesting its mechanistic pathway of action. In conclusion, these results provide evidence that miR-335-5p may function as a mediator in the etiopathogenesis of PCOS, as well as has the potential as both a novel diagnostic biomarker and therapeutic target for PCOS.
Sujet(s)
microARN , Syndrome des ovaires polykystiques , Humains , Femelle , Animaux , Souris , Syndrome des ovaires polykystiques/génétique , microARN/métabolisme , Cellules de la granulosa/métabolisme , Oestradiol , Luciferases/métabolismeRÉSUMÉ
INTRODUCTION: Clinically overt depression is associated with an increased risk for insulin resistance. Data regarding the impact of subclinical depressive symptoms on the risk of diabetes are limited. OBJECTIVES: The study aimed to assess the relationship of subclinical depressive symptoms with body fat distribution and diabetes risk in women. PATIENTS AND METHODS: The analysis included 250 women, 68 with subclinical depressive symptoms and 182 controls. A clinical examination, oral glucose tolerance test, and lipid and liver enzyme level assessments were performed. Body composition was estimated by dualenergy Xray absorptiometry. The participants completed the Beck Depression Inventory (BDI) questionnaire. RESULTS: The women with subclinical depressive symptoms had higher visceral adipose tissue (VAT) mass than the control group. The groups did not differ in the body mass index, waist circumference, total fat, fatfree, android, and gynoid fat mass. Homeostatic Model Assessment for Insulin Resistance (HOMAIR) and alanine aminotransferase (ALT) activity were higher in the women with subclinical depressive symptoms than in the control group. In the women with subclinical depressive symptoms, we observed a positive correlation between the severity of somaticvegetative symptoms reported in the BDI and VAT mass, HOMAIR, and gamma glutamyltransferase (GGT) activity. Dysglycemia occurred more frequently in the women with subclinical depressive symptoms. In a subgroup analysis of postmenopausal women, the individuals with subclinical depressive symptoms had higher HOMAIR, GGT, ALT, and triglyceride / highdensity lipoprotein cholesterol ratios than the control group. CONCLUSIONS: Subclinical depressive symptoms in women might predispose to dysglycemia.
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Insulinorésistance , Indice de masse corporelle , Dépression , Femelle , Humains , Graisse intra-abdominale/métabolisme , Obésité/complicationsRÉSUMÉ
BACKGROUND: Insulin resistance is a risk factor for cardiovascular disease. Recently, we have developed a novel index, FLAIS (Fasting Laboratory Assessment of Insulin Sensitivity), which accurately reflects insulin sensitivity, measured with hyperinsulinemic-euglycemic clamp, in different groups of subjects. The aim of the present study was to assess the relationship of FLAIS with cardiovascular risk factors in a population-based study. METHODS: The study group comprised 339 individuals from the ongoing Bialystok Plus study, without previously known diabetes. Clinical examination, oral glucose tolerance test and the measurement of blood laboratory parameters were performed. RESULTS: Prediabetes (impaired fasting glucose and/or impaired glucose tolerance) was diagnosed in 165 individuals whereas type 2 diabetes was diagnosed in 19 subjects. FLAIS was lower in individuals with prediabetes and diabetes in comparison with individuals with normal glucose tolerance. FLAIS was significantly related to waist circumference, systolic and diastolic blood pressure, triglycerides, HDL-cholesterol and LDL-cholesterol in the entire study group and in the subgroups with normal glucose tolerance and with prediabetes/diabetes. HOMA-IR, QUICKI and Matsuda index were not related to blood pressure and LDL-cholesterol in individuals with normal glucose tolerance. Majority of the adjusted models with FLAIS were characterized by better fit with the data in comparison with other indices for all cardiovascular risk factors except waist circumference. CONCLUSIONS: FLAIS represents useful index to assess the cluster of insulin resistance-associated cardiovascular risk factors in general population.
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Maladies cardiovasculaires , Diabète de type 2 , Insulinorésistance , État prédiabétique , Glycémie , Indice de masse corporelle , Maladies cardiovasculaires/diagnostic , Maladies cardiovasculaires/épidémiologie , Cholestérol HDL , Cholestérol LDL , Diabète de type 2/diagnostic , Diabète de type 2/épidémiologie , Facteurs de risque de maladie cardiaque , Humains , Insuline , Insulinorésistance/physiologie , État prédiabétique/diagnostic , État prédiabétique/épidémiologie , Facteurs de risqueRÉSUMÉ
Body composition, especially an increased amount of fat mass and decreased lean body mass, is connected with metabolic complications. Thyroid hormones can influence body composition pattern. To date, scarce data defining the relationships between thyroid hormones and parameters of body composition using dual-energy X-ray absorptiometry (DXA), especially in cohort studies, are available. Therefore, the aim of the present study was to investigate the relationships among serum concentrations of (thyroid-stimulating hormone (TSH), thyroid hormones, and distribution of fat tissue assessed using the DXA method in a euthyroid cohort from the Bialystok PLUS study. We examined 582 euthyroid subjects who were divided into lean (body mass index (BMI) < 25 kg/m2) and overweight/obese (BMI ≥ 25 kg/m2) (84 lean men, 182 overweight/obese men, 160 lean women, and 156 overweight/obese women). Serum concentrations of TSH, free T3 (fT3), and free T4 (fT4) were assessed, and DXA was performed. We observed lower serum levels of fT4 (p = 0.03) and higher serum levels of fT3 (p = 0.04) in overweight/obese vs. lean men, whereas serum levels of TSH did not differ between these groups (p = 0.38). In lean men, we only observed a relationship between serum levels of TSH and visceral adipose tissue (VAT) (r = −0.24, p = 0.02). In overweight/obese men, we found that serum levels of fT3 were positively connected with total fat mass (r = 0.16, p = 0.02), android fat mass (r = 0.15, p = 0.03), and gynoid fat mass (r = 0.17, p = 0.01), but not with VAT (r = 0.03, p = 0.63). We did not observe differences in serum levels of TSH, fT3, and fT4 between lean and overweight/obese women. Additionally, we did not notice relationships between serum levels of thyroid hormones and fat in different regions estimated by DXA in lean and overweight/obese women (all p > 0.05). We concluded that the serum concentration of TSH is connected with VAT in lean men, whereas, in overweight/obese men, higher fT3 is connected with an increased fat amount. These associations are absent in women.
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The subject of vocal changes accompanying pathological conditions, although still not well explored, seems to be promising. The discovery of laryngeal receptors for sex hormones and thyroid hormones can strongly support the hypothesis of changes in voice due to various endocrinopathies. On the other hand, the impairment of the proper function of the vocal apparatus can also be caused in the process of the microvasculature complications of diabetes mellitus. This review was a comprehensive summary of the accessible literature concerning the influence of selected endocrinopathies on subjective and objective voice parameters. We analysed a total number of 16 English-language research papers from the PubMed database, released between 2008 and 2021, describing vocal changes in reproductive disorders such as polycystic ovary syndrome and congenital adrenal hyperplasia, thyroid disorders in shape of hypo- or hyperthyroidism and type 2 diabetes mellitus. The vast majority of the analysed articles proved some changes in voice in all mentioned conditions, although the detailed affected vocal parameters frequently differed between research. We assume that the main cause of the observed conflicting results might stem from non-homogeneous methodology designs of the analysed studies.
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Chronic low-grade inflammation has been proposed as a linking mechanism between obesity and the development of inflammation-related conditions such as insulin resistance and cardiovascular disease. Despite major advances in the last 2 decades, the complex relationship between inflammation and obesity remains poorly understood. Therefore, we aimed to identify novel inflammation-related proteins associated with adiposity. We investigated the association between BMI and waist circumference and 72 circulating inflammation-related proteins, measured using the Proximity Extension Assay (Olink Proteomics), in 3,308 participants of four independent European population-based studies (KORA-Fit, BVSII, ESTHER, and Bialystok PLUS). In addition, we used body fat mass measurements obtained by Dual-energy X-ray absorptiometry (DXA) in the Bialystok PLUS study to further validate our results and to explore the relationship between inflammation-related proteins and body fat distribution. We found 14 proteins associated with at least one measure of adiposity across all four studies, including four proteins for which the association is novel: DNER, SLAMF1, RANKL, and CSF-1. We confirmed previously reported associations with CCL19, CCL28, FGF-21, HGF, IL-10RB, IL-18, IL-18R1, IL-6, SCF, and VEGF-A. The majority of the identified inflammation-related proteins were associated with visceral fat as well as with the accumulation of adipose tissue in the abdomen and the trunk. In conclusion, our study provides new insights into the immune dysregulation observed in obesity that might help uncover pathophysiological mechanisms of disease development.
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Adiposité , Protéomique , Absorptiométrie photonique , Indice de masse corporelle , Humains , Inflammation , ObésitéRÉSUMÉ
Polycystic ovary syndrome (PCOS) is the most common endocrinopathy affecting reproductive-age women. Important factors in its pathogenesis are hyperinsulinaemia and insulin resistance, which lead to higher risk of metabolic syndrome (MetS) and its complications. With the implementation of the Rotterdam diagnostic criteria in 2003, the group of PCOS patients became highly heterogeneous, with varying metabolic risk reported for different phenotypes of the syndrome. The aim of the present review is to assess the prevalence and severity of MetS and its components in patients with the four phenotypes of PCOS. A comprehensive search of Pubmed database was performed to identify studies comparing metabolic characteristics between PCOS patients with different phenotypes of the syndrome. The results of 60 studies published between 2004 and 2020 were retrieved and analysed. More adverse metabolic profile was observed in PCOS patients with hyperandrogenic phenotypes in comparison to normoandrogenic patients, as well as in classic phenotypes, defined by National Institutes of Health criteria, in comparison to newer phenotypes introduced by the Rotterdam criteria. In the majority of observations, normoandrogenic PCOS patients did not differ significantly from controls in terms of metabolic characteristics, although some East Asian studies reported more adverse metabolic profile in normoandrogenic phenotype in comparison to healthy women. In conclusion, metabolic abnormalities in PCOS seem to be associated with joint effects of hyperandrogenism, insulin resistance and visceral obesity. The differences observed between the four phenotypes of PCOS underline the need for individualised diagnostic and therapeutic approach.