1.  Title: Maternal mid-pregnancy serum triglyceride levels and neonatal birth weight. Author: Kushtagi P; Arvapally S Source: International Journal of Gynaecology and Obstetrics. 2009 Mar 25; Abstract: Although disturbances in maternal glucose metabolism and resultant fetal hyperinsulinemia are known to significantly impact fetal overgrowth, it has been suggested that other fuels such as lipids and amino acids may be the determinants of fetal growth in nondiabetics. Maternal serum lipid levels increase in mid to late pregnancy; and in women with gestational diabetes, elevated triglycerides were significantly associated with birth weight corrected for gestational age. Although the role of maternal hyperlipidemia in fetal growth is not known, maternal fasting serum triglyceride levels at 24 to 32 weeks of pregnancy were shown to be significantly and positively associated with neonatal weight at term, independent of maternal prepregnancy obesity, weight gain during pregnancy, or mid-pregnancy plasma glucose levels (either fasting or postprandial) in Japanese and white women. The aim of the present study was to determine the relationship between maternal mid-pregnancy serum lipid levels and neonatal birth weight in our region. (excerpt) Language: English Keywords: INDIA | RESEARCH REPORT | CLINICAL RESEARCH | WOMEN IN DEVELOPMENT | PREGNANT WOMEN | INFANT | BIRTH WEIGHT | PREGNANCY, SECOND TRIMESTER | LIPIDS | LIPID METABOLIC EFFECTS | MATERNAL NUTRITION | CHOLESTEROL | GLUCOSE METABOLISM EFFECTS | BODY WEIGHT | Asia, Southern | Asia | Developing Countries | Research Methodology | Economic Development | Economic Factors | Population Characteristics | Demographic Factors | Population | Youth | Age Factors | Physiology | Biology | Pregnancy | Reproduction | Nutrition | Health | Carbohydrate Metabolic Effects | Metabolic Effects Document Number: 341469 |
| 2. Title: HIV-related lipodystrophy in Africa and Asia. Author: Womack J Source: AIDS Reader. 2009 Apr;19(4):131-9, 148-52. Abstract: This article reviews the medical literature for information about lipodystrophy in Africa and Asia. These 2 regions were selected because both are of particular interest to the declaration for universal access. Africa represents the epidemic's epicenter. Asia, especially India and China, will soon have HIV / AIDS prevalence rates that will outstrip those seen in the rest of the world combined. The methodology is summarized first: how articles were selected, the inclusion and exclusion criteria used, and how information was synthesized. The results and discussion focus on 3 specific areas: how lipodystrophy is defined and measured, the study populations, and the persons excluded from these studies. A summary of what is and what is not yet known about lipodystrophy in Africa and Asia is also included. Language: English Keywords: AFRICA | ASIA | LITERATURE REVIEW | UNAIDS | PERSONS LIVING WITH HIV/AIDS | LIPID METABOLIC EFFECTS | GLUCOSE METABOLISM EFFECTS | DIABETES | HEART DISEASES | RISK FACTORS | PREVENTION AND CONTROL | QUALITY OF LIFE | TREATMENT | OBSTACLES | Developing Countries | UN | International Agencies | Organizations | Political Factors | Sociocultural Factors | HIV Infections | Viral Diseases | Diseases | Lipids | Physiology | Biology | Carbohydrate Metabolic Effects | Metabolic Effects | Health | Social Welfare | Economic Factors | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Organization and Administration Document Number: 341055 |
| 3. Title: Sex differences in the control of glucose homeostasis. Author: Blaak E Source: Current Opinion In Clinical Nutrition and Metabolic Care. 2008 Jul;11(4):500-4. Abstract: PURPOSE OF REVIEW: A markedly higher prevalence of impaired glucose tolerance has been reported in women than in men, whereas the opposite was seen for impaired fasting glucose. The present review focuses on the underlying mechanisms. RECENT FINDINGS: An increased meal glucose appearance and disturbances in postprandial glucose disposal may contribute to higher glucose concentrations in women. An increased, similar or reduced insulin sensitivity has been reported in women than in men, which makes it unclear to what extent a disturbed insulin-mediated glucose disposal may contribute to increased postprandial glucose concentrations in women. This discrepancy may be explained by differences in the phase of menstrual cycle during the study, the use of oral contraceptives and different degrees of physical fitness. Nevertheless, there are consistent data indicating that women are protected against fatty acid-induced insulin resistance. Furthermore, both disturbances in endogenous glucose output and metabolic clearance of glucose may contribute to the reduced fasting glucose concentrations in women. SUMMARY: There is an urgent need for studies that test whether sex-related disturbances in glucose metabolism may be involved in the pathogenesis of type 2 diabetes and the metabolic syndrome, taking age, menstrual cycle, the use of oral contraceptives and physical activity into account. Language: English Keywords: NETHERLANDS | LITERATURE REVIEW | CLINICAL RESEARCH | ADULTS | WOMEN | PREVALENCE | SEX FACTORS | GLUCOSE METABOLISM EFFECTS | TIME FACTORS | DIABETES | AGE FACTORS | MENSTRUAL CYCLE | ORAL CONTRACEPTIVES, SIDE EFFECTS | FITNESS | Developed Countries | Europe, Western | Europe | Research Methodology | Population Characteristics | Demographic Factors | Population | Measurement | Carbohydrate Metabolic Effects | Metabolic Effects | Physiology | Biology | Population Dynamics | Diseases | Menstruation | Reproduction | Contraceptive Safety | Safety | Public Health | Health Document Number: 328649 |
| 4. Title: Prevalence of polycystic ovary syndrome in unselected women from southern China. Author: Chen X; Yang D; Mo Y; Li L; Chen Y Source: European Journal of Obstetrics, Gynecology and Reproductive Biology. 2008 Jul;139(1):59-64. Abstract: The objective was to determine the prevalence and metabolic parameters of polycystic ovary syndrome (PCOS) in southern China. The study was observational with a parallel study. Participants were studied in a medical examination center. A population of 915 women of reproductive age was investigated at the time of their annual physical examination to determine the prevalence of PCOS in unselected women from southern China. Our results demonstrated a 2.2% (20/915) prevalence of PCOS. Women with PCOS had higher levels of luteinizing hormone and higher luteinizing hormone/follicle-stimulating hormone ratios than those in the other groups. Women with PCOS had higher fasting insulin levels and lower fasting glucose/fasting insulin ratios than women in any of the other groups. Some clinical and biochemical characteristics were apparent in PCOS patients in our population, and ethnic differences may be considered when studying the clinical and metabolic features of PCOS in China. (author's) Language: English Keywords: CHINA | RESEARCH REPORT | CLINICAL RESEARCH | WOMEN | OVARIAN EFFECTS | PREVALENCE | LUTEINIZING HORMONE | GLUCOSE METABOLISM EFFECTS | Asia, Eastern | Asia | Developing Countries | Research Methodology | Demographic Factors | Population | Ovary | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Measurement | Gonadotropins, Pituitary | Gonadotropins | Hormones | Endocrine System | Carbohydrate Metabolic Effects | Metabolic Effects Document Number: 327515 |
5.  Peer Reviewed Title: Use of metformin in polycistic ovary syndrome: A meta-analysis. Author: Creanga AA; Bradley HM; McCormick C; Witkop CT Source: Obstetrics and Gynecology. 2008 Apr;111(4):959-968. Abstract: The objective was to update the state of evidence on the efficacy of metformin, used either alone or in combination with clomiphene citrate in women with polycystic ovary syndrome, by examining three outcomes: ovulation, pregnancy, and live birth. Sources of heterogeneity among the published randomized controlled trials are systematically assessed. An electronic literature search was performed using MEDLINE, EMBASE, SCOPUS, CENTRAL, Cochrane, and U.S. Food and Drug Administration databases, restricted to studies conducted on humans and published in English. Of the 406 potentially relevant articles identified, 17 met criteria for inclusion in the meta-analysis, rendering a total sample of 1,639 women. Study quality was examined in terms of randomization scheme, masking process, adequacy of allocation concealment, statistical power, and loss to follow-up; publication bias was also assessed. Meta-analytic procedures were used to compare metformin with placebo, and metformin plus clomiphene with clomiphene alone, for all study outcomes. Exploratory analyses were conducted to assess differences in treatment effects between clomiphene-resistant and nonresistant patients, obese and nonobese patients, and trials with long and short durations of follow-up. Metformin improved the odds of ovulation in women with polycystic ovary syndrome when compared with placebo (odds ratio [OR] 2.94; 95% confidence interval [CI] 1.43-6.02; number-needed-to-treat 4.0) and appears more effective for non-clomiphene-resistant women. Metformin and clomiphene increased the likelihood of ovulation (OR 4.39; 95% CI 1.94 -9.96; number-needed-to-treat 3.7) and pregnancy (OR 2.67; 95% CI 1.45-4.94; number-needed-to-treat 4.6) when compared with clomiphene alone, especially in clomiphene-resistant and obese women with polycystic ovary syndrome. These treatment effects were greater for trials with shorter follow-up. Using all available evidence, this metaanalysis suggests that metformin increases the likelihood of ovulation and, in combination with clomiphene, increases the odds of both ovulation and pregnancy in women with polycystic ovary syndrome. (author's) Language: English Keywords: GLOBAL | RESEARCH REPORT | LITERATURE REVIEW | WOMEN | OVARIAN EFFECTS | GLUCOSE METABOLISM EFFECTS | DRUGS | DRUG RESISTANCE | DRUG INTERACTIONS | INFERTILITY | OVULATION | PREGNANCY | PREGNANCY OUTCOMES | Demographic Factors | Population | Ovary | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Carbohydrate Metabolic Effects | Metabolic Effects | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Reproduction Document Number: 325771 |
| 6. Title: Infertility and polycystic ovarian syndrome: A study of association between body mass index and intrafamily marriages. Author: Haq F; Rizvi J Source: Gynecologic and Obstetric Investigation. 2008;65(4):269-274. Abstract: Polycystic ovarian syndrome (PCOS) is a common endocrine disorder which causes anovulatory infertility. Obesity is one of the factors which directly modifies the clinical, biochemical and metabolic expression of this syndrome. Recently a genetic association of PCOS with intrafamily marriages has been postulated. This study investigates the association of environmental factors such as BMI and intrafamily marriages with the clinical, biochemical and hormonal features of this syndrome. The objective was to determine the relationship of different clinical, biochemical parameters and hormonal assay with the BMI of women who are known to have PCOS, and to compare these demographic features with intrafamily marriages. From January 2005 until December 2006, patients attending the infertility clinic at Aga Khan University Hospital, Karachi, were evaluated for their clinical features. Couples were divided into 2 groups: group A had a history of first-degree intrafamily marriages, and group B had none. Complete biochemical evaluation was performed by day-2 serum FSH, LH, prolactin, testosterone and fasting serum insulin levels. The results were recorded on a data collection form. Ultrasonic evaluation was performed with transvaginal ultrasound to check the morphological appearance of the ovaries. A modified glucose tolerance test with 75 g glucose was performed and the results were recorded as normal, impaired and abnormal. Insulin resistance was calculated using the HOMA index method. During this period 203 patients were evaluated for demographic and biochemical features of PCOS. The prevalence of obesity was 70% with 59.3% women found to have hyperinsulinemia while 52.3% of patients had insulin resistance according to the HOMA index method. Univariate and multivariate analyses were used to compare the 2 groups. A linear relationship between oligomenorrhea, family history of diabetes, tonic LH, high fasting serum insulin levels, insulin resistance and an abnormal glucose tolerance test was revealed, keeping intrafamily marriage and BMI as dependent variables. In this population 48% of couples were in first-degree intrafamily marriages, suggesting the possibility of a high genetic predisposition for abnormal metabolic features beside ethnic predisposition. A linear relationship of high BMI and family marriages has been seen with insulin resistance, oligomenorrhea and impaired glycemic control. The number of obese women and the high rate of intrafamily marriages make our population genetically susceptible to metabolic complications. (author's) Language: English Keywords: PAKISTAN | RESEARCH REPORT | WOMEN | COUPLES | OBESITY | BODY WEIGHT | OVARIAN CANCER | OVARIAN CYSTS | INFERTILITY | DRUG RESISTANCE | GLUCOSE METABOLISM EFFECTS | TESTING | TREATMENT | Developing Countries | Asia, Southern | Asia | Demographic Factors | Population | Family Characteristics | Family and Household | Sociocultural Factors | Physiology | Biology | Cancer | Neoplasms | Diseases | Reproduction | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Carbohydrate Metabolic Effects | Metabolic Effects | Measurement | Research Methodology Document Number: 326619 |
| 7. Peer Reviewed Title: Prevalence of dyslipidemia and dysglycaemia in HIV infected patients. Author: Manuthu EM; Lule GN; Karari E Source: East African Medical Journal. 2008 Jan;85(1):10-17. Abstract: Highly active antiretroviral therapy (HAART) has dramatically reduced AIDS morbidity and mortality; however long-term metabolic consequences including dysglycaemia and dyslipidemia have raised concern regarding accelerated cardiovascular disease risk. Objective: To determine the period prevalence of dyslipidemia and dysglycaemia in HIV-infected patients. Design: Cross-sectional comparative group study. Setting: Kenyatta National Hospital, a tertiary HIV dedicated out-patient facility. Subjects: Consecutive HIV- positive adult patients. Main outcome measures: Dyslipidemia: presence of raised total or LDL cholesterol or low HDL cholesterol, or raised triglycerides. Dysglycaemia: presence of impaired fasting glucose or impaired glucose tolerance, or diabetes mellitus. Results: Between January and April 2006, out of 342 screened patients, 295 were recruited and 58% were females. One hundred and thirty four (45%) were on HAART, 82% of whom were on stavudine, lamivudine and either nevirapine or efavirenz. Overall prevalence of dyslipidemia was 63.1% and dysglycaemia was 20.7%. High total cholesterol occurred in 39.2% of HAART and 10.0% HAART naive patients (p<0.0001, OR 5.18, CI 3.11-10.86), whereas high LDL cholesterol occurred in 40.8% and in 11.2% respectively (p<0.0001, OR 5.43, CI 2.973-9.917). HDL levels were low in 14.6% and 51.3% among HAART and HAART naive patients, respectively, (p<0.0001, OR 0.16, CI 0.091-0.29) while high triglycerides occurred in 25.6% and 22.5% respectively (p=0.541 OR 1.184 C1 0.688-2.037). Among patients on HAART compared to HAART naive patients, diabetes was found in 1.5% against 1.2% (p=0.85), impaired fasting in 2.2% against 0.6% (p=0.30) and impaired glucose tolerance in 16.4% against 21.1% (p=0.221, respectively. Conclusions: HIV-infected patients demonstrated a high prevalence of dyslipidemia. HAART use was associated with high levels of total, and LDL cholesterol and high triglyceride levels, an established athrogenic lipid profile. However, HAART was not associated with low HDL cholesterol and had no significant effect on dysglycaemia. Language: English Keywords: KENYA | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | CLINICAL RESEARCH | CROSS SECTIONAL ANALYSIS | CASE CONTROL STUDIES | PERSONS LIVING WITH HIV/AIDS | CARDIOVASCULAR EFFECTS | HIV INFECTIONS | ANTIRETROVIRAL THERAPY | SIDE EFFECTS | CHOLESTEROL | DIABETES | PREVALENCE | GLUCOSE METABOLISM EFFECTS | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Research Methodology | Studies | Persons Living With HIV/AIDS | Viral Diseases | Diseases | Physiology | Biology | HIV | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Lipids | Measurement | Carbohydrate Metabolic Effects | Metabolic Effects Document Number: 326585 |
| 8. Peer Reviewed Title: Risk factors for pre-eclampsia in pregnant Chinese women with abnormal glucose metabolism. Author: Sun Y; Yang H; Sun WJ Source: International Journal of Gynecology and Obstetrics. 2008 Apr;101(1):74-76. Abstract: The objectives were to investigate the incidence and risk factors for pre-eclampsia in pregnant Chinese women with abnormal glucose metabolism. A retrospective cohort study was performed on 1499 pregnant women with abnormal glucose metabolism at Peking University First Hospital from January 1995 to December 2004. The overall prevalence of preeclampsia in women with abnormal glucose metabolism was 9.4% (141/1499). The prevalence of pre-eclampsia in women diagnosed with diabetes mellitus prior to pregnancy was higher than that of gestational diabetes mellitus and gestational impaired glucose tolerance patients (29.1% vs 8.7% and 7.8%, P less than 0.01). Pre-pregnancy body mass index was significantly higher in women with pre-eclampsia than in those without. A higher rate of pre-eclampsia was found in women with chronic hypertension and those with poor glucose control. The independent risk factors for pre-eclampsia were chronic hypertension and elevated pre-pregnancy body mass index. The type of diabetes, chronic hypertension, and elevated pre-pregnancy body mass index are high risk factors for pre-eclampsia in pregnant women with abnormal glucose metabolism. (author's) Language: English Keywords: CHINA | RESEARCH REPORT | COHORT ANALYSIS | RETROSPECTIVE STUDIES | PREGNANT WOMEN | PREECLAMPSIA | INCIDENCE | RISK FACTORS | GLUCOSE METABOLISM EFFECTS | DIABETES | HYPERTENSION | BODY WEIGHT | BODY HEIGHT | Asia, Eastern | Asia | Developing Countries | Research Methodology | Studies | Population Characteristics | Demographic Factors | Population | Pregnancy Complications | Diseases | Measurement | Biology | Carbohydrate Metabolic Effects | Metabolic Effects | Physiology | Vascular Diseases Document Number: 325435 |
| 9. Title: Hormonal contraception in HIV-positive women. Author: Womack J; Williams A Source: AIDS Reader. 2008 Jul;18(7):372-7, 381. Abstract: In September 2006, the CDC recommended that the interpretation of 'general consent' for medical care include HIV screening, which eliminated the need for a separate, written consent. Routine baseline prenatal screening should include an HIV test, with re-screening in the third trimester for women at high risk for HIV infection, including women with symptoms of acute HIV infection or women residing in a community with a high incidence of HIV infection among women of childbearing age (17 or more cases of HIV infection per 100,00 person-years). The goal of this recommendation is to increase identification of unrecognized HIV infection so as to expand the delivery and benefit of antiretroviral therapy and to decrease mother-to-child transmission. Because of these recommendations, providers can anticipate seeing an increased number of know HIV-positive persons in their practices. Furthermore, because women constitute the majority of persons younger than 25 years who are infected with HIV and because the number of HIV infections in women is increasing, it is likely that many of these patients will be young women. Control of fertility and the option of effective, reversible birth control will become more significant issues as these women choose to have families and to space rather than avoid pregnancies. Health care providers thus need to be well versed in the contraceptive options available to women and the clinical issues related to their use. Hormonal contraceptive methods are of particular interest to women of reproductive age because of their effectiveness. (excerpt) Language: English Keywords: UNITED STATES OF AMERICA | RECOMMENDATIONS | CRITIQUE | CLINICAL RESEARCH | WOMEN | PERSONS LIVING WITH HIV/AIDS | CONTRACEPTIVE AGENTS, FEMALE | HIV INFECTIONS | HIV TRANSMISSION | ANTIRETROVIRAL THERAPY | DRUG INTERACTIONS | GLUCOSE METABOLISM EFFECTS | CONTRACEPTIVE AGENTS, SIDE EFFECTS | METABOLIC EFFECTS | LIPID METABOLIC EFFECTS | Developed Countries | North America | Americas | Research Methodology | Demographic Factors | Population | Viral Diseases | Diseases | Contraceptive Agents | Contraception | Family Planning | HIV | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Carbohydrate Metabolic Effects | Physiology | Biology | Lipids Document Number: 328422 |
| 10. Title: The correlation of plasma homocysteine with insulin resistance in polycystic ovary syndrome. Author: Yilmaz N; Pektas M; Tonguc E; Kilic S; Gulerman C Source: Journal of Obstetrics and Gynaecology Research. 2008 Jun;34(3):384–391. Abstract: Aim: This study aims to investigate the existence of any relationship between homocysteine levels and insulin resistance in Turkish women with polycystic ovary syndrome. Methods: A case-controlled, cross-sectional, observational study was undertaken in a total of 94 infertile Turkish women who required professional help in the Department of Infertility of Dr Zekai Tahir Burak Women's Health Research and Education Hospital. The correlation between serum homocysteine with age, body mass index, hormone profile, fasting insulin and glucose concentrations and insulin resistance were examined in patients with polycystic ovary syndrome and the results were compared to those of women with normal ovaries, who served as a control group. Results: The mean serum fasting glucose and insulin levels, thus insulin resistance index of women with polycystic ovary syndrome, were significantly higher than those of the control subjects. The mean serum homocysteine levels were significantly higher in women with polycystic ovary syndrome than those in the control group. A positive correlation was detected between the mean homocysteine, the insulin resistance index determined by homeostasis model assessment and the fasting insulin levels in polycystic ovary syndrome patients. Conclusions: Serum homocysteine levels are elevated in women with polycystic ovary syndrome, and this elevation is associated with the serum insulin level rather than androgen excess. The intense treatment of hyperhomocysteinemia in women with polycystic ovary syndrome might improve reproductive outcome and contribute to protection from cardiovascular risks. (author's) Language: English Keywords: TURKEY | RESEARCH REPORT | CLINICAL RESEARCH | CROSS SECTIONAL ANALYSIS | CASE CONTROL STUDIES | WOMEN IN DEVELOPMENT | OVARIAN CYSTS | INFERTILITY | AGE FACTORS | BODY WEIGHT | HORMONES | DRUG RESISTANCE | GLUCOSE METABOLISM EFFECTS | Developing Countries | Europe, Southeastern | Europe | Research Methodology | Studies | Economic Development | Economic Factors | Diseases | Reproduction | Population Characteristics | Demographic Factors | Population | Physiology | Biology | Endocrine System | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Carbohydrate Metabolic Effects | Metabolic Effects Document Number: 327384 |
| 11. Peer Reviewed Title: Very young children with uncomplicated falciparum malaria have higher risk of hypoglycaemia: A study from Suriname. Author: Zijlmans WC; van Kempen AA; Ackermans MT; de Metz J; Kager PA Source: Tropical Medicine and International Health. 2008 May;13(5):626-634. Abstract: The objective was to measure glucose kinetics and the influence of age, nutritional status and fasting duration in children with uncomplicated falciparum malaria (UFM) under the age of 5 years. Plasma glucose concentration, endogenous glucose production (EGP) and gluconeogenesis (GNG) were measured using [6,6-/2H/2] glucose and 2/H2O in 17 very young (less than 3 years) and 7 older (3-5 years) Surinamese children with UFM admitted to the Distrikt Hospital Stoelmanseiland and Diakonessen Hospital Paramaribo over 17 months. Plasma glucose concentration was lower in the group of very young children than in the older children (P = 0.028). There were no differences in EGP and GNG between the groups. Overall GNG contributed 56% (median, range 17-87%) to EGP, with no differences between the groups (P = 0.240). Glucose clearance was lower in the older children (P = 0.026). Glucose concentration did not differ between children with weight for length/height less than -1.3 SD and children with weight for length / height greater than -1.3 SD (P = 0.266). Plasma glucose concentration was not predicted by fasting duration (P = 0.762). Our data suggest a higher risk of hypoglycaemia in very young children with uncomplicated malaria as plasma glucose concentration was lower in this study group. Since this could not be attributed to an impaired EGP, and because glucose clearance was lower in the older children, we presume that older children were better capable of reducing glucose utilization during fasting. Studies on glucose kinetics are feasible in very young children with malaria and give more insight in the pathophysiology of hypoglycaemia. (author's) Language: English Keywords: NETHERLANDS | RESEARCH REPORT | NUTRITION INDEXES | CHILD | GLUCOSE METABOLISM EFFECTS | MALARIA | Developed Countries | Europe, Western | Europe | Nutrition | Health | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Carbohydrate Metabolic Effects | Metabolic Effects | Physiology | Biology | Parasitic Diseases | Diseases Document Number: 325930 |
| 12. Title: Prevalence of metabolic syndrome during menopausal transition Tehranian women: Tehran Lipid and Glucose Study (TLGS). Author: Ainy E; Mirmiran P; Zahedi Asl S; Azizi F Source: Maturitas. 2007 Oct;58(2):150-155. Abstract: This study was conducted to assess the prevalence of metabolic syndrome (MetS) in Tehranian women during menopausal transition. In this cross sectional study 2182 subjects, pre-menopausal (pre-M) n = 537, menopausal (M) n = 311 and postmenopausal (post-M) n = 1334 were selected from 15005 participants of the TLGS and assessed for MetS risk factors. All MetS components were evaluated following age adjustment according to the ATPIII criteria. The mean ages of post-M, M and pre-M women were 61.0+or-4.3, 53.0+or-4.0 and 47.0+or-1.9 years, respectively. The prevalence of MetS in subjects was 63% (53%, 54% and 69%) in pre-M, M and post-M women respectively. HDL-c levels was significantly higher in post-M women in comparison to pre-M women (p < 0.001). TG levels, FPG and waist circumference was significantly higher in post-M women in comparison to pre-M women (p < 0.05). The most frequent markers of MetS were low HDL-c and high diastolic blood pressure in post-M women. It is concluded that the frequency of MetS is significantly higher in post-M women as compared to pre-M women; low HDL-c and high diastolic blood pressure is the most frequent feature in comparison to other factors. (author's) Language: English Keywords: IRAN | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | CLINICAL RESEARCH | WOMEN IN DEVELOPMENT | MENOPAUSE | GLUCOSE METABOLISM EFFECTS | LIPID METABOLIC EFFECTS | PREVALENCE | AGE FACTORS | ANTHROPOMETRY | HYPERTENSION | Developing Countries | Middle East | Research Methodology | Economic Development | Economic Factors | Reproduction | Carbohydrate Metabolic Effects | Metabolic Effects | Physiology | Biology | Lipids | Measurement | Population Characteristics | Demographic Factors | Population | Vascular Diseases | Diseases Document Number: 321347 |
| 13. Title: [Insulinotherapy, maternal glycemic control and perinatal prognosis-- difference between clinical and gestational diabetes] Insulinoterapia, controle glicemico materno e prognostico perinatal – diferenca entre o diabetes gestacional e o clinico. Author: Basso NA; Costa RA; Magalhaes CG; Rudge MV; Calderon ID Source: Revista Brasileira de Ginecologia e Obstetricia. 2007 May;29(5):253-259. Abstract: Purpose: to evaluate the insulin therapy protocol and its maternal and perinatal outcome in patients with clinical or gestational diabetes in a high risk reference service. Methods: descriptive and prospective study including 103 pregnant women with gestational or clinical diabetes treated with insulin and attended by the reference service from October 2003 to December 2005. Gemellarity, miscarriages, unfinished prenatal care and deliveries not attended by the service were excluded. The gestational age at the beginning of the treatment, dosage, doses/day, increment of insulin (UI/kg), glycemic index (GI) and perinatal outcomes were compared. ANOVA, Fisher's exact test and Goodman's test considering p<0.05 were used. Results: multiparity (92 versus 67.9%), pre-gestational body mass index (BMI) >25 kg/m2 (88 versus 58.5%), weight gain (WG) <8 kg (36 versus 17%) and a high increment of insulin characterized the gestational diabetes. For the patients with clinical diabetes, despite the highest GI (120 mg/dL (39.2 versus 24%)) at the end of the gestational period, insulin therapy started earlier (47.2 versus 4%), lasted longer (56.6 versus 6%) and higher doses of insulin (92 versus 43 UI/day) were administered up to three times a day (54.7 versus 16%). Macrosomia was higher among newborns from the cohort of patients with gestational diabetes (16 versus 3.8%), being the only significant neonatal outcome. There were no neonatal deaths, except for one fetal death in the cohort of patients with clinical diabetes. There were no differences in the other neonatal complications in both cohorts, and most of the newborns were discharged from hospital up to seven days after delivery (46% versus 55.8%). Conclusions: the analysis of these two cohorts has shown differences in the insulin therapy protocol in quantity (UI/day), dosage (UI/kg weight) and number of doses/day, higher for the clinical diabetes cohort, and in the increment of insulin, higher for the gestational diabetes cohort. Indirectly, the quality of maternal glycemic control and the satisfactory perinatal outcome have proven that the treatment protocol was adequate and did not depend on the type of diabetes. Language: Portuguese Keywords: RESEARCH REPORT | EPIDEMIOLOGIC METHODS | CLINICAL RESEARCH | PROSPECTIVE STUDIES | INFANT | PREGNANT WOMEN | PREVALENCE | GLUCOSE METABOLISM EFFECTS | PREGNANCY COMPLICATIONS | ABORTION, SPONTANEOUS | MULTIPARITY | RISK FACTORS | BODY WEIGHT | DIABETES | NEONATAL DISEASES AND ABNORMALITIES | Research Methodology | Studies | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Measurement | Carbohydrate Metabolic Effects | Metabolic Effects | Physiology | Biology | Diseases | Parity | Fertility Measurements | Fertility | Population Dynamics Document Number: 324630 |
| 14. Peer Reviewed Title: Clinical update: Adverse effects of antiretroviral therapy. Author: Calmy A; Hirschel B; Cooper DA; Carr A Source: Lancet. 2007 Jul 7;370(9581):12-14. Abstract: The adverse effects of antiretroviral therapy (ART) cause substantial morbidity and compromise adherence, which can lead to drug resistance. Treatment guidelines recommend against universal immediate ART, partly because of toxicities (table). The webtable lists licensed ARTs. HIV lipodystrophy is characterised by peripheral subcutaneous lipoatrophy, relative central fat accumulation, lipomatosis, dyslipidaemia, insulin resistance, and hyperlactataemia. Over the first 6 months of ART, limb and visceral fat increase, often followed by a progressive and selective loss of limb fat. Zidovudine and stavudine are the drugs most associated with lipoatrophy. About 30% of patients receiving stavudine for 2 years developed lipoatrophy compared with 6% of tenofovir recipients. Abacavir, emtricitabine, lamivudine, and tenofovir do not seem to induce much lipoatrophy; the protease inhibitor nelfinavir accelerated lipoatrophy, but another such drug, lopinavir, might prevent it. Lipoatrophy can be largely prevented by avoidance of stavudine and zidovudine. Switching stavudine or zidovudine to tenofovir or abacavir improves lipoatrophy, but normalisation can take years. Cessation of protease inhibitor therapy may improve visceral adiposity. (excerpt) Language: English Keywords: UNITED STATES OF AMERICA | CRITIQUE | RECOMMENDATIONS | CLINICAL RESEARCH | PERSONS LIVING WITH HIV/AIDS | ANTIRETROVIRAL THERAPY | USER COMPLIANCE | TOXICITY | SIDE EFFECTS | ADMINISTRATION AND DOSAGE | TIME FACTORS | CARDIOVASCULAR EFFECTS | GLUCOSE METABOLISM EFFECTS | RENAL EFFECTS | Developed Countries | North America | Americas | Research Methodology | HIV Infections | Viral Diseases | Diseases | HIV | Behavior | Physiology | Biology | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Drugs | Population Dynamics | Demographic Factors | Population | Carbohydrate Metabolic Effects | Metabolic Effects | Urogenital Effects | Urogenital System Document Number: 318348 |
| 15. Title: Agreement among insulin sensitivity indexes on the diagnosis of insulin resistance in polycystic ovary syndrome and ovulatory women. Author: de Paula Martins W; Santana LF; Nastri CO; Ferriani FA; de Sa MF Source: European Journal of Obstetrics, Gynecology and Reproductive Biology. 2007 Aug;133(2):203-207. Abstract: The objective was to compare agreement on the diagnosis of insulin resistance (IR) among insulin sensitivity indexes in both ovulatory women and those with polycystic ovary syndrome (PCOS). In an observational study, the 75-g oral glucose tolerance test was performed in 105 women with PCOS and 51 ovulatory women. The insulin sensitivity indexes used were insulin quantitative sensitivity check index (QUICKI), 1/homeostasis model assessment-insulin resistance (1/HOMA-IR), area under curve for insulin (AUC-I), and the Matsuda insulin sensitivity index (COMP). For the IR diagnosis we used cut-off values described in recent publications (insulin >12 µI/ml, 1/HOMA-IR < 0.47, QUICKI /= 7000 µI/ml 120 min, and COMP < 4.75. Excellent agreement was assessed among insulin, QUICKI, and 1/HOMA-IR. However, the rate of IR detected by these indexes in the PCOS group (44.8-51.4%) was lower than expected. New cut-offs were then determined based on COMP results. Using these values, 1/ HOMA-IR and QUICKI showed excellent agreement (k = 0.83) with COMP. The observed agreements among insulin, QUICKI and 1/HOMA-IR were higher than 93%. Therefore, clinicians may choose any of those obtaining similar results. For clinicians who prefer COMP, but are looking for a simpler test to detect IR in PCOS women, the use of QUICKI and 1/HOMA-IR with the new cut-offs seems reasonable. (author's) Language: English Keywords: BRAZIL | RESEARCH REPORT | CORRELATION STUDIES | COMPARATIVE STUDIES | QUANTITATIVE RESEARCH | WOMEN | OVARIAN EFFECTS | ENDOCRINE EFFECTS | GLUCOSE METABOLISM EFFECTS | GLUCOSE TOLERANCE TEST | TESTING | South America, Eastern | South America | Latin America | Americas | Developing Countries | Statistical Studies | Studies | Research Methodology | Demographic Factors | Population | Ovary | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Endocrine System | Carbohydrate Metabolic Effects | Metabolic Effects | Laboratory Procedures | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Measurement Document Number: 318802 |
| 16. Peer Reviewed Title: Hypoglycaemia in under-five children with diarrhoea. Author: Huq S; Hossain MI; Malek MA; Faruque AS; Salam MA Source: Journal of Tropical Pediatrics. 2007 Jun;53(3):197-201. Abstract: The present study aimed to observe the clinical features of hypoglycaemia, and identify predictors of hypoglycaemia in under-five diarrhoeal children requiring hospitalization for close observation and support. Such information could be useful to the clinicians and policy makers in developing appropriate management protocols both for identification of such children and optimizing their management. We performed a prospective study in 782 under-five children who presented with diarrhoeal illnesses. Blood glucose was determined when hypoglycaemia was suspected in 598 (62%), and 65 (11%) of them were hypoglycaemic (study group). From the other 533 non-hypoglycaemic children, 195 were randomly selected as comparison group. Bacteraemia was significantly (P = 0.026) often detected in 17 out of 260 (7%) children as opposed to 3 out of 184 (2%) children who did not have a rapid glucose test performed. Among hypoglycaemic children, 7 (11%) were bacteraemic and among non-hypoglycaemic children 10 (5%) had bacteraemia. In univariate analysis, history of shorter (< 72 h) pre-admission duration of diarrhoea (75 vs. 58%, P = 0.01), documented convulsion (28 vs. 11%, P < 0.001), shorter (<72 h) hospitalization (52 vs. 33%, P = 0.01), higher case fatality rate (28 vs. 14%, P = 0.02) were associated with hypoglycaemia. In logistic regression, bacteraemic children (with clinical sepsis) were 4 times more likely to develop hypoglycaemia (OR = 4.2, 95% CI = 1.4-12.9, P = 0.012). Therefore, in a diarrhoeal disease health care service with limited resources, a rapid bedside glucose test may be considered as an inexpensive alternative in the management decisions of diagnosing bacteraemia and initiating empiric antibiotic treatment. (author's) Language: English Keywords: BANGLADESH | RESEARCH REPORT | RESEARCH METHODOLOGY | CHILD | DIARRHEA | ANTIBIOTICS | GLUCOSE METABOLISM EFFECTS | TESTING | COST BENEFIT ANALYSIS | TREATMENT | Developing Countries | Asia, Southern | Asia | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Diseases | Drugs | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Carbohydrate Metabolic Effects | Metabolic Effects | Physiology | Biology | Measurement | Quantitative Evaluation | Evaluation Document Number: 316984 |
| 17. Peer Reviewed Title: Intrapartum maternal glucose infusion and fetal acid -- base status. Author: Jamal A; Choobak N; Tabassomi F Source: International Journal of Gynecology and Obstetrics. 2007 Jun;97(3):187-189. Abstract: The objective was to compare the effects of an intrapartum infusion of a lactated Ringer solution or a glucose-boosted saline solution on the acid-base status of umbilical arterial blood. In a prospective clinical trial 178 women in labor were randomized to receive intravenously either a lactated Ringer solution or a saline solution boosted with 5% glucose. Umbilical arterial blood was then assessed for acid-base status. There were significant differences between the lactated Ringer group and the glucose group in umbilical artery pH values (7.25 ± 0.07 vs. 7.28 ± 0.06; P = 0.008), pCO/2 values (44.8 ± 5.6 mm Hg vs. 41.6 ± 4.1 mm Hg; P = 0.001), and base excess (-7.3 ± 2.1 mEq/L vs. -6.6 ± 1.8 mEq/L; P = 0.02). Intrapartum intravenous fluid containing a 5% glucose solution reduces umbilical cord acidemia and hypercarbia. (author's) Language: English Keywords: IRAN | RESEARCH REPORT | CLINICAL TRIALS | COMPARATIVE STUDIES | FETUS | MATERNAL-FETAL EXCHANGE | GLUCOSE METABOLISM EFFECTS | HUMAN MILK | Developing Countries | Middle East | Clinical Research | Research Methodology | Studies | Pregnancy | Reproduction | Carbohydrate Metabolic Effects | Metabolic Effects | Physiology | Biology | Lactation | Maternal Physiology Document Number: 316676 |
| 18. Peer Reviewed Title: Positive influence of Centchroman on cardiovascular system and tissue lipid peroxidation in rats. Author: Jatwa R; Kar A Source: Contraception. 2007 Nov;76(5):408-412. Abstract: Centchroman, a nonsteroidal oral contraceptive, was evaluated for its hitherto unstudied effect on cardiovascular system, thyroid function and tissue lipid peroxidation in rats. Wistar sperm-positive female rats were treated with Centchroman (1.5 mg/kg per day, po) for 10 days and the alterations in serum concentration of thyroid hormones [triiodothyronine (T3) and thyroxine (T4)], insulin, glucose, total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), very low-density lipoprotein cholesterol (VLDL-C), triglycerides (TG), aspartate aminotransferase (AST), alanine aminotransferase (ALT) and alkaline phospahatase (ALP) activity, hepatic type-1 iodothyronine 5'-monodeiodinase (5'D) enzyme activity and hepatic, renal, cardiac and serum lipid peroxidation (LPO) were studied. Simultaneously, alterations in endogenous antioxidants [superoxide dismutase (SOD); catalase (CAT) and reduced glutathione (GSH)], relative risk ratio (RR), atherogenic index (AI) and daily rate of food and water consumption were also investigated as supportive parameters. Centchroman administration resulted in the complete inhibition of pregnancy. It increased serum T4 marginally and HDL-C levels, hepatic SOD, CAT and GSH; cardiac SOD and GSH and renal SOD and CAT activity significantly. However, it reduced LPO in all tissues; concentrations of other serum lipids; AI; RR and activity of ALP. As Centchroman administration did not alter the concentrations of most active thyroid hormone, T3, serum insulin and glucose, it appears that the drug has no side effect on thyroid function and glucose metabolism. Rather, it possesses cardiovascular and antiperoxidative benefits. (author's) Language: English Keywords: INDIA | RESEARCH REPORT | LABORATORY PROCEDURES | LABORATORY ANIMALS | INHIBITION OF FERTILIZATION | CONTRACEPTION RESEARCH | THYROID EFFECTS | HORMONES | CARBOHYDRATE METABOLIC EFFECTS | LIPIDS | CARDIOVASCULAR EFFECTS | GLUCOSE METABOLISM EFFECTS | Developing Countries | Asia, Southern | Asia | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Clinical Research | Research Methodology | Contraceptive Mode of Action | Contraception | Family Planning | Endocrine Effects | Endocrine System | Physiology | Biology | Metabolic Effects Document Number: 321776 |
| 19. Title: The long-term effect of different combination therapies on glucose metabolism in HIV / AIDS subjects in Cameroon. Author: Judith LN; Mbouobda HD; Martin F; Nouemsi AP; Julius O Source: Journal of Medical Sciences. 2007;7(4):609-614. Abstract: The use of antiretroviral drugs is associated with an increase of metabolic abnormalities such as impaired glucose metabolism and insulin resistance. This study was designed to investigate the long-term effect of antiretroviral combinations therapy on glucose metabolism in HIV/AIDS patients in Cameroon. A descriptive and prospective study was carried out on 58 patients on HAART and 80 pre-HAART patients. The various drugs regimens comprised Lamivudin-Zidovudin associated with Efavirenz (Therapy I, n = 9) of Nevirapin (Therapy II, n =13) and Stavudin-Lamivudin associated with Nevirapin (Therapy III, n =30) of Efavirenz (Therapy IV, n =16). All patients were monitored at baseline and then 12 months later. Blood glucose levels increased significantly in both pre-HAART (34.08 +or- 9.93%) and HAART patients (45.56 +or- 7.86%). The mean blood glucose levels increased by 78.19% (p < 0.001), 61.50% (p < 0.0001), 69.96% (p < 0.0001) and 16.92% (p < 0.01) with therapy I, II, IV, and III, respectively. The increase was associated with efavirenz or zidovudine use. It is possible that efavirenz or zidovudine use in a combination therapy may exaggerate an underlying tendency to develop mitochondrial toxicity or insulin resistance. (author's) Language: English Keywords: CAMEROON | RESEARCH REPORT | PROSPECTIVE STUDIES | PERSONS LIVING WITH HIV/AIDS | HIV | ANTIRETROVIRAL THERAPY | GLUCOSE METABOLISM EFFECTS | ANTIRETROVIRAL DRUGS | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Studies | Research Methodology | Persons Living With HIV/AIDS | HIV Infections | Viral Diseases | Diseases | Carbohydrate Metabolic Effects | Metabolic Effects | Physiology | Biology | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 320869 |
| 20. Peer Reviewed Title: Comparison of ethinyl-estradiol plus cyproterone acetate versus metformin effects on classic metabolic cardiovascular risk factors in women with the polycystic ovary syndrome. Author: Luque-Ramirez M; Alvarez-Blasco F; Botella-Carretero JI; Martinez-Bermejo E; Lasuncion MA Source: Journal of Clinical Endocrinology and Metabolism. 2007;92(7):2453-2461. Abstract: Oral contraceptives may worsen the metabolic profile of patients with polycystic ovary syndrome (PCOS), favoring the use of insulin sensitizers in these patients. The aim of the study was to compare the effects of a contraceptive pill on metabolic classic cardiovascular risk factors with those of the insulin sensitizer metformin. We conducted a randomized, parallel, open-label clinical trial. The study was conducted at an academic hospital. Thirty-four consecutive PCOS patients were studied. Patients were randomized to oral treatment with metformin (850 mg twice daily) or with the Diane Diario pill (35 µg of ethinyl-estradiol plus 2 mg of cyproterone acetate) for 24 wk. Hyperandrogenism, lipid profiles, and indexes of glucose tolerance and insulin sensitivity were measured at baseline and after 12 and 24 wk of treatment. Diane Diario resulted in higher reductions in hirsutism score and serum androgen levels compared with metformin. Menstrual regularity was restored in all the patients treated withDiane Diario compared with only 50% of those receiving metformin. Plasma apolipoprotein A-I and HDL-phospholipid levels increased with Diane Diario, whereas metformin did not induce any change in the lipid profile. On the contrary, the insulin sensitivity index increased with metformin but did not change with Diane Diario. No differences in the frequencies of abnormalities of glucose tolerance and dyslipidemia were found between both treatments. Diane Diario appears to be superior to metformin for the control of hyperandrogenism and for the restoration of menstrual regularity in PCOS patients, and it is not associated with any clinically relevant worsening in the classic metabolic cardiovascular risk profile of these women. (author's) Language: English Keywords: SPAIN | RESEARCH REPORT | CLINICAL TRIALS | WOMEN | ETHINYL ESTRADIOL | RISK FACTORS | ORAL CONTRACEPTIVES, SIDE EFFECTS | CARDIOVASCULAR EFFECTS | OVARIAN CYSTS | GLUCOSE METABOLISM EFFECTS | CONTRACEPTIVE SAFETY | SERUM PROTEIN EFFECTS | ANDROGENS | LIPID METABOLIC EFFECTS | Europe, Southwestern | Europe | Developed Countries | Clinical Research | Research Methodology | Demographic Factors | Population | Contraceptive Agents, Estrogen | Contraceptive Agents, Female | Contraceptive Agents | Contraception | Family Planning | Biology | Safety | Public Health | Health | Physiology | Diseases | Carbohydrate Metabolic Effects | Metabolic Effects | Hematological Effects | Hemic System | Hormones | Endocrine System | Lipids Document Number: 320673 |
| 21. Title: Measuring the energy spent by parturient women in fasting and in ingesting caloric replacement (Honey). Author: Maganha e Melo CR; Peracoli JC Source: Revista Latino-Americana de Enfermagem. 2007 Jul-Aug;15(4):612-617. Abstract: This research aims to measure the energy spending in parturient women of low gestation risk. Participants were selected randomly and submitted to fasting (n=15; Group I) or honey ingestion (n=15; Group II). Data were collected by means of capillary blood values and heart frequency monitoring. The paired t-test with a 5% significance level and Tukey's method were used in statistical analysis. The results showed that honey ingestion did not promote an overload in the mother's glucose; the lactate response demonstrated that the substrate offered was well used; the cardiorespiratory rate demonstrated "good performance" for both groups; the total energy spent during labor demonstrated that carbohydrate ingestion exerts significant influence, improving maternal anaerobic performance; the group which remained in fasting presented, immediately after labor, higher levels of lactate, showing the organism's efforts to compensate for the energy spent. (author's) Language: English Keywords: BRAZIL | RESEARCH REPORT | PROSPECTIVE STUDIES | PREGNANT WOMEN | BODY WEIGHT | GESTATIONAL AGE | CHILDBIRTH | TIME FACTORS | DIET | CALORIC INTAKE | MEASUREMENT | GLUCOSE METABOLISM EFFECTS | South America, Eastern | South America | Latin America | Americas | Developing Countries | Studies | Research Methodology | Population Characteristics | Demographic Factors | Population | Physiology | Biology | Fetus | Pregnancy | Reproduction | Pregnancy Outcomes | Population Dynamics | Nutrition | Health | Carbohydrate Metabolic Effects | Metabolic Effects Document Number: 324098 |
| 22. Title: Effect of maternal fasting on uterine arterial blood flow. Author: Mirghani HM; Salem M; Weerasinghe SD Source: Journal of Obstetrics and Gynaecology Research. 2007 Apr;33(2):151-154. Abstract: The aim was to determine the effect maternal diet pattern on the uterine artery Doppler flow velocimetry. This is a cross-sectional observational study. The uterine artery Doppler flow velocimetry was measured between 20 and 24 weeks' gestation in healthy pregnant women observing Ramadan. For each fasting mother, a non-fasting healthy pregnant woman was recruited as a control. Maternal blood glucose level was measured. A total of 106 pregnant women were studied. The mean hours since last oral intake were significantly longer, and the maternal glucose level was significantly lower in the study group than in the control group. The Mean (95% CI) of the uterine artery pulsatility index, resistance index, peak systolic velocity, end diastolic velocity and systolic/diastolic ratio was similar in both groups. Maternal fasting is not associated with significant changes in the uterine artery Doppler flow velocimetry. (author's) Language: English Keywords: UNITED ARAB EMIRATES | RESEARCH REPORT | CLINICAL RESEARCH | CASE CONTROL STUDIES | EVALUATION INDEXES | PREGNANT WOMEN | WOMEN IN DEVELOPMENT | DIET | MATERNAL NUTRITION | UTERUS | PHYSICAL EXAMINATIONS AND DIAGNOSES | PREGNANCY, SECOND TRIMESTER | GLUCOSE METABOLISM EFFECTS | HEALTH STATUS INDEXES | BLOOD DONORS | Developed Countries | Middle East | Research Methodology | Studies | Quantitative Evaluation | Evaluation | Population Characteristics | Demographic Factors | Population | Economic Development | Economic Factors | Nutrition | Health | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Pregnancy | Reproduction | Carbohydrate Metabolic Effects | Metabolic Effects | Blood Supply | Equipment and Supplies Document Number: 315379 |
| 23. Peer Reviewed Title: Metabolic function and the prevalence of lipodystrophy in a population of HIV-infected African subjects receiving highly active antiretroviral therapy. Author: Mutimura E; Stewart A; Rheeder P; Crowther NJ Source: JAIDS. Journal of Acquired Immune Deficiency Syndromes. 2007 Dec 1;46(4):451-455. Abstract: This study measured the prevalence of lipodystrophy and the metabolic effects of highly active antiretroviral therapy (HAART) in HIV-infected African subjects. Prevalence was measured in 571 Rwandans receiving HAART for $6 months. Metabolic variables were measured in 100 HIV-positive adults with lipodystrophy, 50 HIV-positive nonlipodystrophic adults, and 50 HIV-negative controls. A HAART regimen of stavudine, lamivudine, and nevirapine was used by 81.6% of subjects; none received protease inhibitors. Lipodystrophy was observed in 34% (48.5% in urban groups and 17.3% in rural groups) of subjects, with a prevalence of 69.6% in those receiving HAART for .72 weeks. Peripheral lipoatrophy combined with abdominal lipohypertrophy was observed in 72% of lipodystrophic subjects. HIV-positive adults with lipodystrophy had a significantly higher waist-to-hip ratio (WHR; 0.99 +or- 0.05 vs. 0.84 +or- 0.03: P < 0.0005) than HIV-positive nonlipodystrophic adults. Total cholesterol concentrations (median [interquartile range], mmol/L) were significantly higher in the HIV-positive adults with lipodystrophy (3.60 [1.38]) than in HIV-positive nonlipodystrophic adults (3.19 [0.65]; P < 0.005) and control (3.13 [0.70]; P < 0.0005) groups. Impaired fasting glucose was observed in 18% of HIV-positive adults with lipodystrophy, 16% of HIV-positive nonlipodystrophic adults, and 2% of controls, but insulin levels did not differ. African subjects with lipodystrophy have increased WHR, glucose, and cholesterol levels. Glucose concentrations are also elevated in nonlipodystrophic HIV-positive subjects. Therefore, factors other than body fat redistribution contribute to the glucose intolerance. (author's) Language: English Keywords: AFRICA | RWANDA | RESEARCH REPORT | PROSPECTIVE STUDIES | PERSONS LIVING WITH HIV/AIDS | HUMAN VOLUNTEERS | ANTIRETROVIRAL THERAPY | LIPID METABOLIC EFFECTS | PREVALENCE | BODY WEIGHT | CHOLESTEROL | GLUCOSE METABOLISM EFFECTS | Developing Countries | Africa, Central | Africa, Sub Saharan | Studies | Research Methodology | Persons Living With HIV/AIDS | HIV Infections | Viral Diseases | Diseases | Clinical Research | HIV | Lipids | Physiology | Biology | Measurement | Carbohydrate Metabolic Effects | Metabolic Effects Document Number: 322160 |
| 24. Title: [Fetal breathing movements in pregnancies complicated by pregestational diabetes mellitus] Movimentos respiratorios fetais em gestacoes com diabetes mellitus pre-gestacional. Author: Nomura RM; Martins AN; Teshma LK; Miyadahira S; Zugaib M Source: Revista Brasileira de Ginecologia e Obstetricia. 2007 Jul;29(7):354-357. Abstract: Purpose: to analyze the pattern of fetal breathing movements (FBM) in diabetic pregnant women in the third trimester of pregnancy. Methods: sixteen pregestational diabetic and 16 nondiabetic (control group) pregnant subjects were included fulfilling the following criteria: singleton, between 36-40 weeks of gestation, absence of other maternal diseases and absence of fetal anomalies. The fetal biophysical profile (FBP) was performed to evaluate the following parameters: fetal heart rate, FBM, fetal body movements, fetal tone and amniotic fluid index. The FBM was evaluated for 30 minutes, period when the examination was integrally recorded in VHS video for posterior analysis of the number of FBM episodes, the duration of each episode and the fetal breathing movements index (BMI). The BMI was calculated by the formula: (interval of time with FBM/total time of observation) x 100. At the beginning and in the end of the FBP maternal glucose levels were checked. The results were analyzed by the Mann-Whitney U-test and the Fisher exact test, adopting a level of significance of 5%. Results: the glucose levels demonstrated significantly superior average in the diabetic group (113.3+or-35.3 g/dL) in relation to the normal group (78.2+or-14.8 g/dL, p<0.001). The average of the amniotic fluid index was higher in the group of the diabetic cases (15.5+or-6.4 cm) when compared with controls (10.6+or-2.0 cm; p=0.01). The average of the number of FBM episodes was superior in the diabetic ones (22.6+or-4.4) in relation to controls (14.8+or-2.3; p<0.0001). The average of the BMI in the diabetic patients (54.6+or-14.8%) was significantly higher than that in the control group (30.5+or-7.4%, p<0.0001). Conclusions: the elevated blood glucose levels can be associated with a different pattern in the FBM of diabetic mothers. The use of this parameter of the FBP, in the obstetric practice, must be considered with concern in diabetic pregnancies. Language: Portuguese Keywords: RESEARCH REPORT | CLINICAL RESEARCH | CASE CONTROL STUDIES | EVALUATION INDEXES | PREGNANT WOMEN | FETUS | DIABETES | PREGNANCY COMPLICATIONS | FETAL VIABILITY | RESPIRATORY INSUFFICIENCY | PREGNANCY, THIRD TRIMESTER | HEALTH STATUS INDEXES | GLUCOSE METABOLISM EFFECTS | Research Methodology | Studies | Quantitative Evaluation | Evaluation | Population Characteristics | Demographic Factors | Population | Pregnancy | Reproduction | Diseases | Pulmonary Effects | Physiology | Biology | Health | Carbohydrate Metabolic Effects | Metabolic Effects Document Number: 324641 |
| 25. Peer Reviewed Title: Comparative study of two insulin regimes in pregnancy complicated by diabetes mellitus. Author: Nor Azlin MI; Nor NA; Sufian SS; Mustafa N; Jamil MA Source: Acta Obstetrica et Gynecologica Scandinavica. 2007;86(4):407-408. Abstract: Diabetes mellitus complicates 5% of pregnancies and attempts to normalize blood sugar concentration have been proven to be the cornerstone of treatment. The variety of insulins available and patient commitment in self-monitoring of blood sugar have revolutionized the care of these women with diabetes in pregnancy. The use of short-acting insulin (SAI) to control postprandial glucose level together with intermediate-acting insulin (IAI) to control basal glucose level is well recognized. However this requires cooperation from patients and understanding of the disease process and would affect the pregnancy if control is inadequate. By using single type insulin it is hoped that patients' compliance will be improved. This trial was designed to compare the outcomes of pregnancy in using SAI versus IAI alone in pregnant diabetic patients. (excerpt) Language: English Keywords: MALAYSIA | RESEARCH REPORT | COMPARATIVE STUDIES | PREGNANT WOMEN | INFANT | LABORATORY PROCEDURES | LABORATORY EXAMINATIONS AND DIAGNOSES | DIET | GLUCOSE METABOLISM EFFECTS | DIABETES | Developing Countries | Asia, Southeastern | Asia | Studies | Research Methodology | Population Characteristics | Demographic Factors | Population | Youth | Age Factors | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Nutrition | Carbohydrate Metabolic Effects | Metabolic Effects | Physiology | Biology | Diseases Document Number: 317071 |
| 26. Title: Is the polycystic ovary syndrome associated with chronic inflammation per se? Author: Olszanecka-Glinianowicz M; Banas M; Zahorska-Markiewicz B; Janowska J; Kocelak P Source: European Journal of Obstetrics, Gynecology and Reproductive Biology. 2007 Aug;133(2):197-202. Abstract: The aim of the present study was to evaluate serum concentrations of tumor necrosis factor-a (TNF-a), TNF-soluble receptors, and IL-6 in obese women without additional diseases and obese women with polycystic ovary syndrome (PCOS). The study group consisted of 39 obese women with PCOS and 34 age-matched obese women without additional disease were included as controls. Blood glucose, total cholesterol, HDL-cholesterol, and triglycerides were measured by the enzymatic procedure. Plasma insulin, follicle-stimulating hormone (FSH), luteinizing hormone (LH), dehydroepiandrosterone sulfate (DHEAS), androstenedione, total and free testosterone, cortisol, progesterone, 17OH-progesterone, estradiol, and sex hormone binding globulin (SHBG) were measured by a commercial radioimmunoassay (RIA). Tumor necrosis factor-alpha (TNF-a), soluble TNF receptors (sTNFRs), and IL-6 were determined by an ELISA. We did not observe any differences in serum concentrations of TNF-a between obese women with and without PCOS. Serum concentrations of sTNFR1 and sTNFR2 were significantly higher in PCOS patients compared with controls; however, serum concentrations of IL-6 were significantly lower in PCOS patients. Our findings suggest that PCOS is not associated with chronic inflammation. (author's) Language: English Keywords: POLAND | RESEARCH REPORT | CORRELATION STUDIES | CASE CONTROL STUDIES | QUANTITATIVE RESEARCH | WOMEN | OBESITY | OVARIAN EFFECTS | ENDOCRINE EFFECTS | GLUCOSE METABOLISM EFFECTS | Developing Countries | Europe, Central | Europe | Statistical Studies | Studies | Research Methodology | Demographic Factors | Population | Body Weight | Physiology | Biology | Ovary | Genitalia, Female | Genitalia | Urogenital System | Endocrine System | Carbohydrate Metabolic Effects | Metabolic Effects Document Number: 318801 |
| 27. Peer Reviewed Title: Increasing burden of childhood severe malaria in a Nigerian tertiary hospital: Implication for control. Author: Orimadegun AE; Fawole O; Okereke JO; Akinbami FO; Sodeinde O Source: Journal of Tropical Pediatrics. 2007 Jun;53(3):185-189. Abstract: Malaria remains an important public heath concern in Nigeria because of its impact on child and maternal health, but the contribution of severe malaria to morbidity among Nigerian children was scantly reported. This study was undertaking to document the hospital-burden of severe malaria among children in Ibadan in order to reflect on the impacts and health implications of the current malaria control strategies. A review of 6-year case records of all children admitted to the emergency ward of the University College Hospital Ibadan was carried out. Cases of severe malaria were defined as those children in whom parasitaemia were confirmed with blood film microscopy and any of the WHO case definitions for severe malaria was documented. Severe malaria cases constituted 11.3% of 16 031 admissions (2000-05) with 89.1% being children less than 5 years old. Cerebral malaria accounted for about one-fifth (19.7%) of all severe malaria cases. The yearly proportional morbidity rate from severe malaria ranged from 8.7% to 13.2% with significant increase from 2000 to 2004 (X/2 = 48.49; df = 5; P less than 0.001). Severe malaria accounted for 12.4% of all paediatric deaths with an estimated overall case fatality rate of 9.6%. Deaths from malaria were significantly associated with wasting (Z-score for weight-for-height less than or equal to 2.0), age less than 2 years, hypoglycaemia and respiratory distress. Our data demonstrated an increased trend in morbidity from severe malaria over the study period. Severe malarial anaemia was a more common complication of Plasmodium falciparum malaria than cerebral malaria in hospitalized Nigerian children and it was associated with a high number of deaths. The consequences of high rate of severe malaria may be beyond health as it also affects the economy and the developmental prospects of the country. There may therefore a need to review the current strategies for malaria control in Nigeria. (author's) Language: English Keywords: NIGERIA | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | CLINICAL RESEARCH | CHILDREN | HOSPITALS | MALARIA | CEREBROVASCULAR EFFECTS | PREVALENCE | CAUSES OF DEATH | CHILD MORTALITY | BODY WEIGHT | RESPIRATORY INSUFFICIENCY | GLUCOSE METABOLISM EFFECTS | Africa, Western | Africa, Sub Saharan | Africa | Developing Countries | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Health Facilities | Delivery of Health Care | Health | Parasitic Diseases | Diseases | Physiology | Biology | Measurement | Mortality | Population Dynamics | Pulmonary Effects | Carbohydrate Metabolic Effects | Metabolic Effects Document Number: 313545 |
| 28. Peer Reviewed Title: Efficacy of an oral contraceptive containing drospirenone in the treatment of women with polycystic ovary syndrome. Author: Pehlivanov B; Mitkov M Source: European Journal of Contraception and Reproductive Health Care. 2007 Mar;12(1):30-35. Abstract: Objective: To investigate the efficacy of a combined oral contraceptive containing 30 ethinyloestradiol and 3 mg drospirenone in the treatment of hyperandrogenism affecting women with the polycystic ovary syndrome (PCOS). Methods: Prospective open study of 20 women for six cycles. At the beginning and at the end of the study the following values were determined: the Ferriman-Gallwey (F-G) score, body mass index, waist/hip ratio, serum levels of testosterone, SHBG, immune reactive insulin (IRI), glucose, the free androgenic index, and insulin resistance (HOMA-IR). Results: All 20 women completed six cycles of therapy. The medication was well tolerated. At the end of the study there was a significant improvement of hirsutism, expressed in the decrease of the F-G score, accompanied by a decrease of testosterone and an increase SHBG values. The carbohydrate metabolism was not affected significantly. Conclusion: The combined oral contraceptive containing 30 mg ethinyloestradiol and 3 mg drospirenoneis an effective drug in the treatment of hyperandrogenism in women with PCOS; it elicits few side effects and does not significantly influence insulin resistance. (author's) Language: English Keywords: BULGARIA | RESEARCH REPORT | CLINICAL RESEARCH | PROSPECTIVE STUDIES | WOMEN IN DEVELOPMENT | ORAL CONTRACEPTIVES | CONTRACEPTIVE EFFECTIVENESS | OVARIAN CYSTS | ANTHROPOMETRY | TESTOSTERONE | HEMATOLOGICAL EFFECTS | GLUCOSE METABOLISM EFFECTS | IMMUNOLOGICAL EFFECTS | ANDROGENS | CARBOHYDRATE METABOLIC EFFECTS | Europe, Southeastern | Europe | Developing Countries | Research Methodology | Studies | Economic Development | Economic Factors | Contraceptive Methods | Contraception | Family Planning | Diseases | Measurement | Hormones | Endocrine System | Physiology | Biology | Hemic System | Metabolic Effects | Immunity | Immune System Document Number: 313271 |
| 29. Title: Assessment of insulin resistance in the idiopathic hirsutism. Author: Sarac F; Saygili F; Ozgen G; Tuzun M; Yilmaz C; Kabalak T Source: Gynecologic and Obstetric Investigation. 2007 Apr;63(3):126-131. Abstract: Idiopathic hirsutism (IH) is the second most common cause of hirsutism, after polycystic ovary syndrome and occurs in about 15% of hirsute women. There are not many studies showing whether patients with IH also have insulin resistance. In the present study, we aimed to investigate the insulin sensivity in IH with non-obese and changing hormone levels during the hyperinsulinemic-euglycemic clamp. Twenty (20) non-obese women with IH (Group I) ranging in age from 20 to 30 (mean 25 ± 5) years were studied. Hirsutism in women with normal testosterone (T) levels and regular menstrual cycles is as defined IH. Twenty (20) healthy women (mean age 23 ± 2 years) (Group II) were included in this study as the control group. Insulin sensitivity was assessed with modified euglycemic insulin clamp technique. Samples of prolactin, luteinizing hormone (LH), follicle-stimulating hormone, adrenocorticotropic hormone (ACTH), dehydroepiandrosterone sulfate, cortisol, estradiol, progesterone, 17-OH progesterone (17-OHP), total T, and free T (FT) were obtained at baseline and at 2nd hour during clamp. Steady-state (120 min) glucose disposal rates were higher in Group II than Group I (7.51 ± 0.83 vs. 5.76 ± 1.89 mg/kg/min). Mean FT, ACTH, cortisol, LH, prolactin and 17-OHP levels were found to have decreased statistically significantly (p < 0.05) in Group I. Mean FT, ACTH, and prolactin levels were found to have decreased statistically significantly (p < 0.05) in Group II during the clamp. Mean baseline levels of FT, LH and prolactin were greater in women with hirsutism than in the control subjects (p < 0.05). Insulin mediated glucose disposal was lower in the normal weight women with IH than in those without hirsutism. Mean FT, 17-OHP and dehydroepiandrosterone sulfate levels decreased during euglcemic-hyperinsulinemic clamp in IH. (author's) Language: English Keywords: TURKEY | RESEARCH REPORT | WOMEN | HIRSUTISM | TESTOSTERONE | MENSTRUAL CYCLE | PROLACTIN | FOLLICLE STIMULATING HORMONE | LUTEINIZING HORMONE | MEASUREMENT | EXAMINATIONS AND DIAGNOSES | GLUCOSE METABOLISM EFFECTS | Developing Countries | Europe, Southeastern | Europe | Demographic Factors | Population | Signs and Symptoms | Diseases | Androgens | Hormones | Endocrine System | Physiology | Biology | Menstruation | Reproduction | Pituitary Hormones | Gonadotropins, Pituitary | Gonadotropins | Research Methodology | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Carbohydrate Metabolic Effects | Metabolic Effects Document Number: 315877 |
| 30. Title: Effect of a new oral contraceptive with drospirenone on vital signs, complete blood count, glucose, electrolytes, renal, and liver function. Author: Taneepanichskul S; Jaisamrarn U; Phupong V Source: Journal of the Medical Association of Thailand. 2007 Mar;90(3):426-431. Abstract: The objective was to evaluate the effect of a new oral contraception formulation with drospirenone (Yasmin) on vital signs, complete blood count, glucose, electrolytes, and renal and liver function. An open-label non-comparative clinical trial was conducted. One hundred women who were planning to use oral contraception for at least six months were recruited. The subjects received a blister pack which contained 21 tablets of 3 mg drospirenone/30 µg ethinyl estradiol for the first four cycles (1 cycle = 28 days). Cycle 5 and 6 blister packs were dispensed during the visit in cycle 4. Heart rate and blood pressure of each subject were checked at baseline and each visit. Serum from each subject was collected and sent for complete blood count, glucose, electrolytes, and renal and liver function tests at baseline and at cycle 6. Mean differences in these tests at cycle 6 compared to baseline were assessed. Ninety-two of the 100 subjects (92%) completed the present study. There was no significant change in heart rate, blood pressure, complete blood count, glucose, electrolytes, and renal and liver function tests at cycle 6 when compared to baseline. Oral contraception formulation with drospirenone (Yasmin) is well tolerated and has good contraceptive efficacy. It is safe, as it has no effect on heart rate, blood pressure, complete blood count, glucose, electrolytes, and renal and liver function. (author's) Language: English Keywords: THAILAND | RESEARCH REPORT | CLINICAL TRIALS | WOMEN | ORAL CONTRACEPTIVES | ETHINYL ESTRADIOL | ADMINISTRATION AND DOSAGE | CARDIOVASCULAR EFFECTS | BLOOD PRESSURE | GLUCOSE METABOLISM EFFECTS | HEPATIC EFFECTS | RENAL EFFECTS | |