BMI-matched Controls Research Articles

Postural adjustments in adolescent idiopathic thoracic scoliosis during walking

IntroductionAdolescent idiopathic scoliosis (AIS) is the most common type of three-dimensional spinal deformity. Identifying the postural adjustments or changes for different phases and events is needed for developing programs to improve the AIS gait, but such information has been limited. The current study aimed to fill the gap via three-dimensional motion analysis of quiet standing and level walking in patients with severe thoracic AIS. Materials and MethodsSixteen female adolescents with AIS (Lenke 1 or 2, age: 14.9 ± 1.7 years, height: 154.7 ± 5.0 cm, mass: 41.7 ± 7.2 kg) and sixteen sex-, age- and BMI-matched healthy controls (age: 14.8 ± 2.7 years, height: 154.9 ± 5.6 cm, mass: 44.7 ± 6.3 kg) participated in the current study with informed written consent. The kinematic and kinetic changes between the trunk, pelvis, and lower limb segments, and at the lumbosacral level at different gait events were measured during quiet standing and level walking. ResultsThe homogeneity of the current patient group helped reduce the effects of the level and severity of spinal deformity on inter-subject variability that has been associated with controversies over reported gait variables in AIS. The current results support the hypothesis that postural adjustments involving the trunk, pelvis and lower limb segments were needed in severe thoracic AIS during both quiet standing and level walking, and differed between concave and convex sides at different key gait events during level walking. ConclusionsAlthough scoliotic spinal deformity occurred mainly in the frontal plane, postural adjustments in all three planes were present at key events during level walking with associated joint loading changes in patients with severe thoracic AIS. Monitoring of such adjustments and the associated joint kinetic changes will be helpful for assessing the disease and treatment outcomes.

Enhanced food-related responses in the ventral medial prefrontal cortex in narcolepsy type 1

Narcolepsy type 1 is a chronic sleep disorder caused by a deficiency of the orexin (hypocretin) neuropeptides. In addition to sleep regulation, orexin is important for motivated control processes. Weight gain and obesity are common in narcolepsy. However, the neurocognitive processes associated with food-related control and overeating in narcolepsy are unknown. We explored the neural correlates of general and food-related attentional control in narcolepsy-type-1 patients (n = 23) and healthy BMI-matched controls (n = 20). We measured attentional bias to food words with a Food Stroop task and general executive control with a Classic Stroop task during fMRI. Moreover, using multiple linear regression, we assessed the relative contribution of neural responses during Food Stroop and Classic Stroop to spontaneous snack intake. Relative to healthy controls, narcolepsy patients showed enhanced ventral medial prefrontal cortex responses and connectivity with motor cortex during the Food Stroop task, but attenuated dorsal medial prefrontal cortex responses during the Classic Stroop task. Moreover, the former activity but not the latter, was a significant predictor of spontaneous snack intake. These findings demonstrate that narcolepsy, characterized by orexin deficiency, is associated with decreased dorsal medial prefrontal cortex responses during general executive control and enhanced ventral medial prefrontal cortex responses during food-driven attention.

Identification of the metabolic fingerprints in women with polycystic ovary syndrome using the multiplatform metabolomics technique

In addition to chronic anovulation and clinical signs of hyperandrogenism women with polycystic ovary syndrome (PCOS) are insulin resistant and therefore, develop central obesity with its long term consequences such as dyslipidaemia, hypertension, atherosclerosis and type 2 diabetes mellitus (T2DM), which all lead to the development of cardiovascular disease (CVD). Due to the polysymptomatic nature of this syndrome and lack of consensus on its diagnostic criteria there is a strong need of finding a reliable biochemical or molecular marker, which would facilitate making the accurate diagnosis of PCOS. Therefore, the aim of our study was to perform a metabolomics analysis with the use of two complementary techniques: gas chromatography and liquid chromatography coupled with mass spectrometry, of the serum samples from women with PCOS (n = 30) and to compare them with healthy age and BMI matched controls (n = 30). Obtained results were subjected to one-dimensional statistical analysis (student’s t-test or its non-parametric equivalent U Mann-Whitney test) and multivariate statistical analysis (the principal component analysis [PCA], variable importance into projection [VIP] and selectivity ratio [SR]). The results of our study showed that women with PCOS are characterised by metabolic disorders of the amino acids, carbohydrates, steroid hormones, lipids and purines. Compared to control subjects, women with PCOS had increased serum levels of phospholipids, aromatic amino acids, organic acids, hormones and sphinganine and decreased total cholesterol. Among the identified compounds, total cholesterol, phenylalanine and dehydroepiandrosterone sulfate, uric and lactic acid were the compounds with the strongest discriminating power.

Intrauterine Fetal Growth Delay During Late Pregnancy After Maternal Gastric Bypass Surgery.

To investigate intrauterine fetal growth development and birth anthropometry of fetuses conceived after maternal gastric bypass surgery. Longitudinal cohort study describing longitudinal growth estimated by ultrasound on 43 singleton pregnancies after gastric bypass compared to 43 BMI-matched controls. In fetuses after maternal gastric bypass surgery, growth percentiles decreased markedly from the beginning of the second trimester until the end of the third trimester (decrease of 3.1 fetal abdomen circumference percentiles (95 %CI 0.9-5.3, p = 0.007) per four gestational weeks). While in the second trimester, fetal anthropometric measures did not differ between the groups, the mean abdomen circumference percentiles appeared significantly smaller during the third trimester in offspring of mothers after gastric bypass (mean difference 25.1 percentiles, p < 0.001). Similar tendencies have been observed in estimated fetal weight resulting in significantly more SGA offspring at delivery in the gastric bypass group. In children born after maternal gastric bypass surgery, weight percentiles (32.12th vs. 55.86th percentile, p < 0.001) as well as placental weight (525.2 g vs. 635.7 g, p < 0.001) were significantly reduced compared to controls. In fetuses conceived after maternal gastric bypass, intrauterine fetal growth distinctively declined in the second and third trimester, most prominently observed in fetal abdomen circumferences. Birth weight and placental weight at birth was significantly lower compared to BMI-matched controls, possibly due to altered maternal metabolic factors and comparable to mothers experiencing chronic hunger episodes.

Serum Preptin and Amylin Levels with Respect to Body Mass Index in Polycystic Ovary Syndrome Patients.

BackgroundPreptin and amylin are pancreatic hormones which participate in glucose homeostasis. This study aimed to evaluate how serum preptin and amylin levels are altered in polycystic ovary syndrome (PCOS) patients and healthy women based on BMI groups (<25 kg/m2 and ≥25 kg/m2).Material/MethodsThis was a prospective randomized control study of 40 PCOS patients and 40 healthy women who were matched with respect to BMI (<25 kg/m2 and ≥25 kg/m2).ResultsWhen compared to the healthy women, PCOS patients had significantly higher ovarian volumes, Ferriman-Gallwey scores, and free and total testosterone levels, but significantly lower amylin concentrations (p=0.001, p=0.001, p=0.049, p=0.021, and p<0.001, respectively). Both the normal-weight and overweight PCOS patients had significantly lower amylin levels than the normal-weight and overweight controls (p<0.001, p=0.009, p=0.001, and p=0.001, respectively). Amylin levels were negatively and significantly correlated with the Ferriman-Gallwey scores (r=−0.272, p=0.001) and ovarian volume (r=−0.206, p=0.007). Serum preptin levels were not elevated in either group.ConclusionsSerum preptin levels are statistically similar in PCOS patients and BMI-matched healthy controls. Serum amylin levels are significantly higher in healthy controls than PCOS patients whether they are slim or overweight. These findings suggest the presence of mechanisms that can prevent the elevation in serum amylin concentrations that can occur in response to the impaired glucose metabolism in PCOS patients.

Risk of Suicide and Self-harm Is Increased After Bariatric Surgery-a Systematic Review and Meta-analysis.

Bariatric surgery is endorsed by multiple societies as the most effective treatment for obesity. Psychosocial functioning has also been noted to improve for most patients after bariatric surgery. However, some studies have shown an increase in post-operative suiciderisk. The aim of this study was to review the published literature and evaluate the association of bariatric surgery with suicide events and suicide/self-harm attempts in patients who have undergone weight loss surgery. MEDLINE and Embase were searched from inception through January 2018 for retrospective or prospective studies reporting mortality outcomes and self-harm or suicide rates after bariatric procedures. The primary outcome was the pooled event rate with 95% confidence interval (95% CI) for suicide. Secondary outcomes were suicide/self-harm attempts after bariatric surgery compared to same population prior to surgery and to matched control subjects, with the respective calculated odds ratios (OR) and 95% CI. From 227 citations, 32 studies with 148,643 subjects were eligible for inclusion. The patients were predominantly females (76.9%). Roux-en-Y gastric bypass (RYGB) was the most commonly performed procedure (58.9%). The post-bariatric suicide event rate was 2.7/1000 patients (95% CI 0.0019-0.0038), while the suicide/self-harm attempt event rate was 17/1000 patients (95% CI 0.01-0.03). The self-harm/suicide attempt risk was higher after bariatric surgery within the same population with OR of 1.9 (95% CI 1.23-2.95), and compared to matched control subjects, OR 3.8 (95% CI, 2.19-6.59). Post-bariatric surgery patients had higher self-harm/suicide attempt risk compared to age-, sex-, and BMI-matched controls. Various pre- and post-surgical psychosocial, pharmacokinetic, physiologic, and medical factors may be involved.

The Relationship Between Bone Mineral Density and Type 2 Diabetes in Obese Children and Adolescents at the Time of Initial Diagnosis.

Long-term effects of type 2 diabetes mellitus (T2D) on bone health remain unclear. The objective of this study was to assess the possible association of bone mineral density (BMD) at multiple sites with T2D after correcting for several potential confounders such as age, sex, Tanner stage, and BMI known to affect BMD in adolescents with newly developed T2D. In this cross-sectional study, 17 children and adolescents with T2D and 59 age, sex, and BMI-matched controls were included. All subjects underwent dual-energy X-ray absorptiometry to measure regional and whole-body composition with Lunar Prodigy at the time of initial diagnosis. A BMD Z-score was calculated using data from healthy Korean children and adolescents after adjusting for height-for-age. The mean age of all subjects was 12.9±2.4 years (range, 8.3-18.3 years). BMDht Z-scores for lumbar spine and total body after adjusted for age, sex, BMI SDS, and Tanner stage were not significantly different between patients and controls. However, BMDht Z-scores for femur neck and bone mineral apparent density (BMAD) Z-scores of lumbar spine were significantly lower in T2D patients than those in healthy controls. HOMA-IR or HbA1c was not associated with BMDht Z-scores at multiple sites. BMDht Z-scores at multiple sites except femur neck in adolescents with newly developed T2D were similar to those in obese controls after adjustment for potential confounders.

Increased frequency of impaired fasting glucose and isolated systolic hypertension in Paget's disease of bone.

Scanty data about glucose metabolism and hypertension have been reported in Paget's disease of bone (PDB) to be related with increased cardiovascular mortality. The aim of the present study was to evaluate glucose and blood pressure levels in PDB, looking for their association with disease severity. We performed an observational cross-sectional study in 54 patients with PDB and 54 age, sex and BMI-matched controls. Glucose and blood pressure levels and parameters of bone and mineral metabolism were assessed. Patients with PDB showed increased glucose levels (6.3 ± 1.7 vs 5.3 ± 1.4 mmol/l, p < 0.001) and prevalence of impaired fasting glucose (14.8%, 5.3-24.3 vs 1.9%, 0-5.4, p < 0.02) as well as enhanced systolic blood pressure (145.9 ± 21.3 vs 132.9 ± 18.9 mmHg, p < 0.005), pulse pressure (69.6 ± 20.0 vs 56.0 ± 16.9 mmHg, p < 0.01) and prevalence of isolated systolic hypertension (46.3%, 33.0-59.6 vs 16.7%, 6.7-26.6, p < 0.003) in comparison to controls. Moreover, we found a positive association of (1) glucose levels with ionized calcium and bone alkaline phosphatase; (2) both systolic and pulse pressure with total and bone alkaline phosphatase (p < 0.05). By multiple linear regression analysis (R2 = 0.26; p < 0.05) serum ionized calcium correlated with glucose levels (β = 0.44; p < 0.04), after adjusting for age and BMI. Our study shows increased fasting glucose, systolic and pulse pressure levels as well as enhanced prevalence of impaired fasting glucose and isolated systolic hypertension in PDB, potentially accounting for increased cardiovascular mortality. Furthermore, our findings suggest high serum calcium and/or increased bone alkaline phosphatase as a link between PDB and cardio-metabolic disorders.

Circulating microRNAs -192 and -194 are associated with the presence and incidence of diabetes mellitus

We sought to identify circulating microRNAs as biomarkers of prevalent or incident diabetes. In a pilot study of 18 sex- and age-matched patients with metabolic syndrome, nine of whom developed diabetes during 6 years of follow-up, an array of 372 microRNAs discovered significantly elevated serum levels of microRNAs -122, -192, -194, and -215 in patients who developed diabetes mellitus type 2 (T2DM). In two cross-sectional validation studies, one encompassing sex- and age-matched groups of patients with T2DM, impaired fasting glucose (IFG) and euglycemic controls (n = 43 each) and the other 53 patients with type 1 diabetes and 54 age- and BMI-matched euglycemic controls, serum levels of miR-192, miR-194, and mi215 were significantly higher in diabetic subjects than in probands with euglycemia or IFG. In a longitudinal study of 213 initially diabetes-free patients of whom 35 developed diabetes during 6 years of follow-up, elevated serum levels of microRNAs 192 and 194 were associated with incident T2DM, independently of fasting glucose, HbA1c and other risk factors. Serum levels of miR-192 and miR-194 were also elevated in diabetic Akt2 knockout mice compared to wild type mice. In conclusion, circulating microRNAs -192 and -194 are potential biomarkers for risk of diabetes.

Omentin-1 and NAMPT serum concentrations are higher and CK-18 levels are lower in children and adolescents with type 1 diabetes when compared to healthy age, sex and BMI matched controls.

Background Adipokines were shown to affect glucose homeostasis and β-cell function in patients with pancreatic dysfunction which is associated with changes in the adipose tissue secretory profile. However, information about adipokines associated with β-cell dysfunction is lacking in pediatric patients with type 1 diabetes. Methods (1) We compared serum concentrations of nicotinamide phosphoribosyltransferase (NAMPT), omentin-1 and caspase-cleaved cytokeratin 18 fragment M30 (CK-18) in pediatric type 1 diabetes patients (n=245) and healthy age, sex and body mass index standard deviation score (BMI-SDS) matched controls (n=243). (2) We investigated the influence of insulin treatment on serum concentrations of NAMPT, omentin-1 and CK-18 in groups of patients with type 1 diabetes stratified according to the duration of their disease: at onset (n=50), ≥6 months and <5 years (n=185), ≥5 and <10 years (n=98), and ≥10 years (n=52). Results Patients at onset compared with healthy controls demonstrated no significant differences in NAMPT levels (p=0.129), whereas omentin-1 levels were elevated (p<0.001) and CK-18 levels were lowered (p=0.034). In contrast, NAMPT and omentin-1 were elevated and CK-18 serum levels were lower in longstanding patients compared to healthy controls (p<0.001). NAMPT serum levels did not change significantly during the duration of type 1 diabetes (p=0.546). At onset, omentin-1 and CK-18 levels were higher than in any group of longstanding type 1 diabetes (p<0.025). Conclusions Altered serum levels of NAMPT, omentin-1 and CK-18 in pediatric type 1 diabetes patients indicate metabolic changes caused by adipose tissue dysregulation which do not normalize during insulin therapy.

Circulating SCUBE1 levels in women with polycystic ovary syndrome.

Objective:Polycystic ovary syndrome (PCOS) is thought to represent an early manifestation of metabolic syndrome, which is associated with cardiovascular disease. Signal peptide-CUB (complement C1r/C1s, Uegf, and Bmp1)-epidermal growth factor domain-containing protein 1 (SCUBE1) is a platelet activation marker that plays important roles in vascular biology and has been closely linked to cardiovascular events. In the present study, we investigated SCUBE1 levels in lean glucose-tolerant women with PCOS and assessed the possible association between SCUBE1 levels and hormonal and metabolic features of women with PCOS.Materials and Methods:The study population consisted of 90 lean [body mass index (BMI) <25 kg/m2] women who were diagnosed as having PCOS using the Rotterdam criteria and 100 age- and BMI-matched healthy controls with no clinical or biochemical feature of hyperandrogenism. Glucose tolerance was evaluated in all subjects before recruitment using the 2 h 75 g oral glucose tolerance test, and only those exhibiting normal glucose tolerance were enrolled. Hormonal and metabolic parameters, and serum SCUBE1 levels were evaluated.Results:Circulating SCUBE1 levels were significantly higher in women with PCOS than in controls (5.9±3.9 vs. 4.2±1.4 ng/mL, p=0.022). No association between SCUBE1 level and clinical or biochemical parameters was found in the control or PCOS group.Conclusion:SCUBE1 levels are elevated in women with PCOS compared with those in healthy controls; thus, this protein may be an early biomarker of cardiovascular disease later in life.

The influence of subclinical hypothyroidism on serum lipid profile, PCSK9 levels and CD36 expression on monocytes

BackgroundProprotein convertase subtilisin/kexin type 9 (PCSK9) is a serine protease and a secreted protein which increases cholesterol levels in plasma via inducing degradation of low-density lipoprotein receptor (LDLR). Cluster of differentiation 36 (CD36) is a member of a family of cell surface proteins in many cells. CD36 is known as fatty acid translocase (FAT) because it imports fatty acids inside cells and participate in triglyceride storage. It has been suggested that PCSK9 regulates CD36 in some tissues. MethodsData and serum levels of TSH, FT4, lipid profile and PCSK9 and the expression of CD36 on monocytes from 40 new untreated patients with subclinical hypothyroidism (SH) and 40 age- sex- and BMI-matched euthyroid controls were analyzed in a cross-sectional study. Then the relationships between these parameters were examined. ResultsPatients with SH had higher TSH, FT4, total cholesterol (TC) and triglyceride (TG) Low-density lipoprotein (LDL) and PCSK9 levels than controls. There were significant and positive correlations between serum TSH levels and lipid parameters except HDL-C. PCSK9 had a significant and negative correlation with FT4. No significant correlation could be found in relation to PCSK9 and CD36. ConclusionsPCSK9 inhibitors are used to reduce blood cholesterol levels as drugs. If it will be proven that PCSK9 can induce CD36 degradation, taking these drugs may have unwanted side effects. This study showed that serum PCSK9 and lipid profile levels increase in patients with subclinical hypothyroidism and there is no relationship between PCSK9 and CD36 in these patients.

Body composition, resting metabolic rate, and respiratory quotient in patients with narcolepsy vs BMI-matched controls

Body composition, resting metabolic rate, and respiratory quotient in patients with narcolepsy vs BMI-matched controls

Significant effect of group education in patients with diabetes type 1

Type 1 diabetes mellitus (T1DM) constitutes a real challenge in everyday practice for both physicians and patients. Due to the complexity of the disease and its unpredictable nature, structured education and training programs are nowadays implemented that ensure active patient involvement and self-care behaviors to achieve adequate glycemic control, prevent diabetic complications, and improve the quality of life of patients. These programs provide patients with the necessary knowledge and skills to self-monitor and self-manage the disease and its associated metabolic conditions. The aim of the study was to evaluate the effect of a structured 12-month education program that motivated patients to follow a healthy Mediterranean diet and exercise regularly as well as to adjust carbohydrate intake and insulin dose according to their needs. The education group (EG) was comprised of 62 patients (45 males) with type 1 DM, mean age 36 ± 4.2years and BMI 24.2 ± 3.1kg/m2. An age- and BMI-matched control group (CG, n = 25, mean age 41 ± 6.4years, BMI 25.7 ± 4.2kg/m2) was composed of patients referred but not enrolled in the project. At the end of this program, HbA1C levels were significantly decreased (8.5 ± 2.1% vs. 7.08 ± 0.79%, p < 0.0001) as was also the incidence of hypoglycemic episodes (p < 0.05). Regarding daily glucose fluctuations, significant improvement (p < 0.05) was observed, as reflected in low, high, and daily median glucose values. On the other hand, the above parameters remained stable in the CG. These results strongly support the need for long-lasting structured education group courses for adult diabetic patients keen to change their habits in order to achieve self-management of the disease.

Association between circulating irisin levels and epicardial fat in patients with treatment-naïve overt hyperthyroidism

Background: Hyperthyroidism is associated with increased metabolic activity and thermogenesis. Irisin is a key molecule in thermogenesis and energy expenditure via adipose tissue browning. Epicardial fat was previously defined as brown-like fat. Thus, here we aimed to evaluate the association between serum irisin level and epicardial fat thickness (EFT) in patients with hyperthyroidism.Methods: A total of 25 hyperthyroid patients and 24 age-, sex- and BMI-matched healthy controls were enrolled. Serum irisin levels, thyroid hormone levels, and body compositions were compared. EFT was measured via transthoracic echocardiography.Results: Serum irisin level and EFT were significantly higher in the hyperthyroid group (p < 0.001 and p = 0.001, respectively). The distributions of fat-free mass, muscle mass and fat mass were similar between the study groups. Serum irisin level was negatively correlated with TSH (p < 0.001) and positively correlated with fT3 (p < 0.001), fT4 (p < 0.001) and TSH receptor antibody (p = 0.002) levels and EFT (p = 0.001). In multivariate linear regression analysis, TSH (β = −0.475, p < 0.001) and EFT (β = 0.290, p = 0.023) levels were significantly associated with serum irisin levels.Conclusions: An increased serum irisin level associated with EFT might contribute to metabolic derangement in hyperthyroidism. Further studies are needed to elucidate whether irisin levels and EFT are affected by hyperthyroidism or vice versa.

Perfluorinated alkyl acids in the serum and follicular fluid of UK women with and without polycystic ovarian syndrome undergoing fertility treatment and associations with hormonal and metabolic parameters.

Women with polycystic ovarian syndrome (PCOS) undergoing treatment for infertility could be a sensitive subpopulation for endocrine effects of exposure to perfluorinated alkyl acids (PFAAs), persistent organic pollutants with potential endocrine activity. Women with, PCOS (n = 30) and age- and BMI-matched controls (n = 29) were recruited from a UK fertility clinic in 2015. Paired serum and follicular fluid samples were collected and analysed for 13 PFAAs. Sex steroid and thyroid hormones, and metabolic markers were measured and assessed for associations with serum PFAAs. Four PFAAs were detected in all serum and follicular fluid samples and concentrations in the two matrices were highly correlated (R2 > 0.95): perfluorooctane sulfonate (PFOS), perfluorooctanoic acid (PFOA), perfluorohexane sulfonate (PFHxS), and perfluorononanoic acid (PFNA). Serum PFOS was positively associated with age (1 ng/mL per yr, p < 0.05) and was higher in PCOS cases than controls (geometric mean [GM] 3.9 vs. 3.1 ng/mL, p < 0.05) and in women with irregular vs. regular menstrual cycles (GM 3.9 vs. 3.0 ng/mL, p = 0.01). After adjustment for confounders, serum testosterone was significantly associated with PFOA, PFHxS, PFNA, and the molar sum of the four frequently detected serum PFAAs (approximately 50 percent increase per ln-unit) among controls but not PCOS cases. HbA1c in PCOS cases was inversely associated with serum PFOA, PFHxs, and sum of PFAAs (2-3 mmol/mol per ln-unit). In controls, fasting glucose was positively associated with serum PFOA and sum of PFAAs (0.25 nmol/L per ln-unit increase in PFAAs). Few other associations were observed. The analyses and findings here should be considered exploratory in light of the relatively small sample sizes and large number of statistical comparisons conducted. However, the data do not suggest increased sensitivity to potential endocrine effects of PFAAs in PCOS patients.

Difference of Sagittal Alignment between Adolescents with Symptomatic Lumbar Isthmic Spondylolisthesis and the General Population

This case-control study aimed to investigate differences in the sagittal spinal parameters between the symptomatic spondylolisthesis patients and the general population. Twenty-nine adolescent patients with symptomatic lumbar isthmic spondylolisthesis were included. For each patient, two age-matched, gender-matched and BMI-matched controls were enrolled. Comparison analyses detected higher values in the case group for the following parameters: CL (−22.06 ± 7.552° versus −20.36 ± 7.016°, P < 0.001), T1 Slope (19.84 ± 8.708° versus 13.99 ± 6.537°, P = 0.001), PT (21.54 ± 9.082° versus 8.87 ± 7.863°, P < 0.001), PI (64.45 ± 13.957° versus 43.60 ± 9.669°, P < 0.001), SS (42.90 ± 9.183° versus 34.73 ± 8.265°, P < 0.001), LL (−50.82 ± 21.596° versus −43.78 ± 10.356°, P = 0.042), SVA (16.99 ± 14.625 mm versus 0.32 ± 31.824 mm, P = 0.009), L5 Slope (33.95 ± 13.567° versus 19.03 ± 6.809°, P < 0.001), and L5I (8.90 ± 6.556° versus 1.29 ± 6.726°, P < 0.001). Conversely, TS-CL (6.56 ± 6.716° versus 11.04 ± 7.085°, P = 0.006), cSVA (11.31 ± 6.867 mm versus 17.92 ± 11.832 mm, P = 0.007), and TLK (−2.66 ± 10.101° versus 2.71 ± 7.708°, P = 0.007) were smaller in the case group. Slippage percentage was most correlated with PI (r = 0.530, P = 0.003), followed by PT (r = 0.465, P = 0.011) and L5I (r = 0.433, P = 0.019). Results of binary logistic regression showed that the main risk factor of isthmic spondylolisthesis was PI (OR = 1.145, 95%CI = 1.083–1.210, P < 0.001). Further subgroup analysis also showed that PI was the main risk factor of isthmic spondylolisthesis in the female adolescents (OR = 1.237, 95%CI = 1.086–1.493, P = 0.003) and in the male adolescents (OR = 1.523, 95%CI = 1.093–2.123, P = 0.013). PI was the main risk factor for adolescent symptomatic isthmic spondylolisthesis in the Chinese Han adolescents. The greater PI indicated the higher the progressive risk of spondylolisthesis. In these isthmic spondylolisthesis adolescents, the body always inclined forward and lumbar and cervical lordosis increased.

High Serum Fractalkine is Associated with Lower Trabecular Bone Score in Premenopausal Women with Graves' Disease.

Chemokine CX3CL1 (fractalkine) may be an important factor linking thyroid status and bone remodeling, through tetrac, a derivative of thyroxine. This study explores the relationship between serum fractalkine levels and parameters of thyroid status and bone in premenopausal women with Graves' disease (GD) in comparison to healthy controls. This cross-sectional study included three premenopausal female groups: active GD; cured GD, and healthy age-, gender-, and BMI-matched controls. Measurement of serum fractalkine levels (Quantikine® ELISA), total amino-terminal peptide of procollagen type 1 (P1NP), CTx, thyroid hormones, BMD and trabecular bone score (TBS) were performed in all study subjects. Sixty women (21, 16, and 23 in active GD, cured GD, and healthy control groups, respectively) were included. Serum fractalkine levels were higher (p<0.05) in active and cured GD subjects compared to healthy controls (mean 0.7±0.14; 0.93±0.15, and 0.48±0.13 ng/ml, respectively). Lumbar spine BMD was lowest in the cured GD group in comparison to active GD and control group subjects (0.926±0.03; 1.016±0.03; 1.051±0.03 g/cm2; p<0.05, respectively). TBS was lower (p<0.05) in both GD groups than controls being lowest in those with active GD (1.395±0.02; 1.402±0.02, 1.469±0.02, respectively). Serum fractalkine concentration was positively correlated with fT4, and negatively correlated with TBS values. GD in pre-menopausal females is associated with increased serum fractalkine concentration and decreased TBS. Fractalkine may be a currently unappreciated link between hyperthyroidism and bone; further research into this possibility is needed.

Circulating insulin-like peptide 5 levels and its association with metabolic and hormonal parameters in women with polycystic ovary syndrome.

Insulin-like peptide 5 (INSL5) is a gut peptide hormone that is a member of relaxin/insulin superfamily. Growing evidence implicates the crucial role of the peptide in some metabolisms including food intake, glucose homeostasis and reproductive system. Polycystic ovary syndrome (PCOS) is involved in both reproductive and metabolic issues. The aim of the study was determination of circulating levels of INSL5 alteration in women with PCOS and evaluation of the relationship between INSL5 and hormonal-metabolic parameters as well as carotid intima media thickness (cIMT). A total of 164 subjects were recruited in this cross-sectional study (82 women with PCOS and 82 age- and BMI-matched controls). Circulating INSL5 levels were assessed via ELISA method. High-resolution B-mode ultrasound was used to measure cIMT. The hormonal and metabolic parameters of the recruited subjects were determined. Circulating INSL5 levels were significantly elevated in women with PCOS compared to controls (27.63 ± 7.74 vs. 19.90 ± 5.85ng/ml, P < 0.001). The mean values of INSL5 were significantly higher in overweight subjects compared to lean weight subjects in both groups. The women with PCOS having insulin resistance have increased INSL5 compared to those of PCOS subjects without insulin resistance. INSL5 is associated with insulin resistance, BMI, luteinizing hormone and free androgen index. Multivariate logistic regression analyses revealed that the odds ratio for having PCOS in the highest tertile of INSL5 was higher than in the lowest tertile. PCOS subjects exhibited an elevation in circulating INSL5 levels along with a link between INSL5 level induction and metabolic-hormonal parameters.

Impact of Type 1 Diabetes on 24-Hour Energy Expenditure and Metabolic Flexibility

Type 1 diabetes (T1D) is associated with an increase in resting metabolic rate, but the impact of T1D on other components of 24-hour energy expenditure (EE) and metabolic flexibility (MF) is not known. We measured 24-hour EE, its components and substrate oxidation rates in 11 patients with T1D and 12 nondiabetic, age and BMI matched controls (HC) using whole room calorimetry. MF was defined as the respiratory quotient (RQ) kinetic response after ingesting a standard high CHO breakfast. Briefly, the kinetics between the lowest RQ pre-breakfast and the highest RQ after breakfast were analyzed by a simple linear regression between time (1-minute resolution) and RQ units (RQUnits). Subjects with T1D had marginally higher 24-hour EE and higher 24-hour non-exercise EE, but sleeping EE and basal EE were not significantly different (Table 1). There were no differences in 24-h respiratory quotient (RQ) or sleeping RQ, but MF during the breakfast meal was significantly lower in T1D vs. HC (p=0.042). Among patients with T1D, MF was related to the glycemic response to breakfast. These data suggest that T1D is characterized by alterations in EE and MF. These results have implications for glycemic and weight management among patients with T1D. Disclosure E.A. Carnero: None. K.D. Corbin: None. C.P. Bock: None. S.R. Smith: None. R.E. Pratley: Other Relationship; Self; AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Eisai Inc., GlaxoSmithKline plc., Janssen Pharmaceuticals, Inc., Lexicon Pharmaceuticals, Inc., Ligand Pharmaceuticals, Inc., Eli Lilly and Company, Merck &amp; Co., Inc., Novo Nordisk Inc., Pfizer Inc., Sanofi-Aventis, Takeda Development Center Americas, Inc..