RESUMEN
PURPOSE: Polycystic ovary syndrome (PCOS), considered a lifelong condition, manifests mainly as a cluster of hyperandrogenic symptoms during the early reproductive years, with the affected woman gradually developing an adverse cardiometabolic profile over the years. However, some data point to the possibility of differences in the evolution of PCOS according to a woman's weight. The aim of the present study was to evaluate the metabolic and hormonal profiles of women with PCOS over time. METHODS: A total of 763 lean women with PCOS (BMI 20-25 kg/m2) and 376 controls were included. The study group was further divided into three age groups representing women post-adolescence, of reproductive age, and of late reproductive age. All subjects were assessed clinically, biochemically, and hormonally. RESULTS: Waist circumference, lipids, androgens, and insulin resistance index (homeostasis model assessment of IR index (HOMA-IR)) were significantly higher in the PCOS group compared with controls. Age subgroup analysis showed a progressive decrease of HOMA-IR and waist circumference, and lipid levels were comparable between PCOS and controls in all age groups. Androgens remained significantly higher in PCOS, but they gradually decreased through time. A significant negative association of age with waist circumference, androgens, insulin, and HOMA-IR was revealed. Univariate and multivariate regression analysis disclosed a strong correlation of HOMA-IR with age (p = 0.014, ß - 0.19, SE coefficient 0.008) as a single parameter or in combination with total cholesterol (TC) (p < 0.001, age: ß - 0.023, SE 0.10; TC: ß 0.084, SE 0.027). CONCLUSION: Insulin resistance, androgens, and lipids are gradually improved in an age-dependent manner in lean PCOS women. We hypothesize that if these women do not gain weight with the passage of time, there is a high probability that their cardiometabolic risk will be attenuated.
Asunto(s)
Andrógenos/sangre , Colesterol/sangre , Resistencia a la Insulina , Insulina/sangre , Síndrome del Ovario Poliquístico/sangre , Delgadez/sangre , Adulto , Factores de Edad , Índice de Masa Corporal , Estudios de Cohortes , Femenino , Humanos , Circunferencia de la Cintura/fisiología , Población Blanca , Adulto JovenRESUMEN
Metabolism is controlled through homeostatic system consisting of central centers, gut hormones, hormones from adipose tissue and the other hormonal axes. This cooperation is based on cross-talk between central and peripheral signals. Among them the hypothalamus plays a crucial role, with interconnected nuclei forming neuronal circuits. Other regions in the brain, such as the brain stem, the endocannabinoid system, the vagal afferents, are also involved in energy balance. The second component is peripheral source of signals--the gastrointestinal tract hormones. Additionally, adipokines from adipose tissue, thyrotropic, gonadotropic and somatotropic axes play a role in energy homeostasis. Knowledge about all components of this neuroendocrine circuit will be helpful in developing novel therapeutic approaches against the metabolic syndrome and its components.
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Metabolismo Energético/fisiología , Sistemas Neurosecretores/fisiología , Animales , Regulación del Apetito/genética , Regulación del Apetito/fisiología , Tronco Encefálico/metabolismo , Tronco Encefálico/fisiología , Metabolismo Energético/genética , Hormonas Gastrointestinales/metabolismo , Hormonas Gastrointestinales/fisiología , Humanos , Hipotálamo/metabolismo , Hipotálamo/fisiología , Sistemas Neurosecretores/metabolismo , RecompensaAsunto(s)
Polimorfismo Genético , Receptores Androgénicos/genética , Adulto , Humanos , Masculino , Persona de Mediana EdadRESUMEN
AIM: Androgens influence human behavior. They affect sport performance, physical activity and emotional responses. CAG repeat polymorphism of androgen receptor (AR) gene is associated with transcriptional activity of AR. Decreased number of CAG repeats leads to increased androgen sensitivity. The purpose of this study was to investigate associations between AR CAG polymorphism and physical activity phenotype. METHODS: Within the framework of the HALS Study we randomly selected 900 adult Caucasian males from one administrative region of Poland (Lower Silesia). Eventually, AR CAG repeat was genotyped by a PCR based assay in 360 male subjects. International Physical Activity Questionnaire (IPAQ) was used to determine the level of physical activity of studied subjects. It was expressed as multiples of resting metabolic rate by minutes of performance during a week (METs-minute/week). RESULTS: No association between AR CAG repeat polymorphism and physical activity (P=0.2, ANOVA) was observed. Men with short CAG presented the lowest level of physical activity reaching 3.44 log (METs-minute/week) (SE 0.053; 95% CI, 3.34-3.54), while in men with medium and long CAG it was respectively 3.58 (SE 0.063; 95% CI, 3.46-3.71) and 3.52 (SE 0.039; 95% CI, 3.44-3.60) log (METs-minute/week). CONCLUSIONS: There is no association between AR CAG repeat polymorphism and the level of physical activity in healthy men.
Asunto(s)
Andrógenos/genética , Actividad Motora , Polimorfismo Genético , Receptores Androgénicos/genética , Receptores Citoplasmáticos y Nucleares/genética , Adulto , Anciano , Análisis de Varianza , Intervalos de Confianza , Variación Genética , Genotipo , Humanos , Estilo de Vida , Masculino , Persona de Mediana Edad , Polonia , Encuestas y Cuestionarios , Adulto JovenRESUMEN
BACKGROUND: Myocardial fibrosis is one of the mechanisms underlying left ventricular (LV) dysfunction in obese patients and may result from dysregulation of extracellular matrix (ECM) turnover. Matrix metalloproteinases (MMPs) and their tissue inhibitors (TIMPs) represent a regulatory system playing a crucial role in ECM metabolism. OBJECTIVES: We sought to assess plasma levels of MMP-2, MMP-9, TIMP-1 and TIMP-2 in obese young women and to evaluate the association between MMP/TIMP system components and LV function in this population. DESIGN: Prospective, cross-sectional study. SETTING: University hospital. PATIENTS: Seventy-one women aged < 35 years with body mass index > 30 kg m(-2) and 30 healthy slim female controls. MAIN OUTCOME MEASURES: Plasma MMP-2, MMP-9, TIMP-1 and TIMP-2 measurements and echocardiographic studies, including LV strain/strain rate evaluation. RESULTS: We demonstrated increased levels of MMP-9 and TIMP-1 and decreased MMP-2 in the obese population. LV dysfunction shown in patients with obesity was characterized by significantly lower values of strain/strain rate parameters. Plasma MMP-2 correlated positively and TIMP-1 negatively with systolic strain (r = 0.39, P < 0.001 and r = -0.40, P < 0.001, respectively), peak systolic strain rate (r = 0.38, P < 0.001 and r = -0.27, P < 0.03, respectively) and peak early diastolic strain rate (r = 0.40, P < 0.001 and r = -0.24, P < 0.05, respectively). Plasma MMP-2, fasting insulin and body mass index proved the only independent determinants of strain/strain rate parameters of LV systolic and diastolic performance in obese subjects. CONCLUSIONS: In premenopausal obese women (1) plasma MMP/TIMP profile is altered, (2) abnormalities of LV function are related to the changes in the MMP/TIMP system that might promote attenuated ECM degradation, mainly to the downregulation of MMP-2.