Endocrine Metabolic Disorders Research Articles

Exercise and Metformin-Flutamide Therapy Improve Cardiometabolic and Endocrine-Reproductive Outcomes in a Rodent Model of PCOS and Metabolic Syndrome

Polycystic ovary syndrome (PCOS) is one of the most common endocrine-metabolic disorders in women of reproductive age. PCOS is commonly associated with the metabolic syndrome (MetS), inclusive of insulin resistance, obesity and dyslipidemia. The PCOS-MetS phenotype is at increased cardiometabolic risk, particularly dyslipidemia, and has been observed to be resistant to therapies including lifestyle and pharmacological interventions. Clinically, exercise has been used to target weight-loss, metformin is used to improve insulin sensitivity and flutamide has been used to treat androgen excess and dyslipidemia. The aim of this study was to target these multiple risk factors, weight-loss, insulin sensitivity and dyslipidemia, and to determine potential mechanisms of action in a rodent model of PCOS and MetS.

ROLE OF ADIPOSE DERIVED MESENCHYMAL STEM CELLS IN IMPROVING STREPTOZOTOCIN-INDUCED DIABETES MELLITUS IN RATS

Background: Diabetes mellitus (DM) is one of the most recognizable endocrine metabolic disorders characterized by chronic hyperglycemia.Mesenchymalstem cells (MSCs) are promising toolto treatDM type I (DM 1). They can be isolated from many sources including adipose tissue because of its easy availability. Objective: Evaluation of the effect of adipose derived MSCs (ADMSCs) on streptozotocin (STZ)-induced DM in rats. Materials and Methods: Forty eight adult male albino rats were included and divided into 4 equal groups. Group I: control untreated, group II: diabetic group, group III: insulin-treated group, and group IV: ADMSCs-treated group. After 21 days from treatment, animals were sacrificed and pancreas was obtained for histological assessments. Stem cell homing was detected by polymerase chain reaction for human specific Alu gene. Results: ADMSCs caused lowering of blood glucose levels starting at the 14th day of treatment and increased blood insulin levels accompanied by reversal of the histopathological changes that were found in the diabetic group and increase insulin secreting cells. Conclusion: ADMSCs improved blood glucose levels and reversed the histopathological changes of the pancreas in experimentally induced DM I.

Cardiometabolic and reproductive benefits of early dietary energy restriction and voluntary exercise in an obese PCOS-prone rodent model.

Polycystic ovary syndrome (PCOS) is one of the most common endocrine-metabolic disorders in women of reproductive age characterized by ovulatory dysfunction, hyperandrogenism and cardiometabolic risk. The overweight-obese PCOS phenotype appears to have exacerbated reproductive dysfunction and cardiometabolic risk. In overweight-obese adult women with PCOS, exercise and energy restricted diets have shown limited and inconsistent effects on both cardiometabolic indices and reproductive outcomes. We hypothesized that an early lifestyle intervention involving exercise and dietary energy restriction to prevent or reduce the propensity for adiposity would modulate reproductive indices and cardiometabolic risk in an obese PCOS-prone rodent model. Weanling obese PCOS-prone and Lean-Control JCR:LA-cp rodents were given a chow diet ad libitum or an energy-restricted diet combined with or without voluntary exercise (4 h/day) for 8 weeks. Dietary energy restriction and exercise lowered total body weight gain and body fat mass by 30% compared to free-fed sedentary or exercising obese PCOS-prone animals (P<0.01). Energy restriction induced an increase in exercise intensity compared to free-feeding plus exercise conditions. Energy restriction and exercise decreased fasting plasma triglycerides and apoB48 concentrations in obese PCOS-prone animals compared to free-fed and exercise or sedentary groups. The energy restriction and exercise combination in obese PCOS-prone animals significantly increased plasma sex-hormone binding globulin, hypothalamic cocaine-and amphetamine-regulated transcript (CART) and Kisspeptin mRNA expression to levels of the Lean-Control group, and this was further associated with improvements in estrous cyclicity. The combination of exercise and dietary energy restriction when initiated in early life exerts beneficial effects on cardiometabolic and reproductive indices in an obese PCOS-prone rodent model, and this may be associated with normalization of the hypothalamic neuropeptides, Kisspeptin and CART.

Association Study between Polycystic Ovarian Syndrome and the Susceptibility Genes Polymorphisms in Hui Chinese Women.

IntroductionPolycystic ovary syndrome (PCOS) is one of the most common endocrine-metabolic disorders. Evidence of familial aggregation analysis and different clinical traits among different regions and ethnicities indicated that the pathogenesis of PCOS is associated with multiple genetic and environmental factors. Our previous research had identified three susceptibility loci (rs2479106, DENND1A; rs13405728, LHCGR; rs13429458, THADA) for PCOS in Han Chinese women. The overall aim of this study was to investigate the relationship between three susceptibility gene polymorphisms and PCOS in Hui ethnic women.Methods151 patients with PCOS (case group) and 99 healthy women (control group) were recruited from the Reproductive Medicine Center of the General Hospital of Ningxia Medical University. Clinical data and serum hormone characteristics of case and control groups were collected and analyzed. The three susceptibility single-nucleotide polymorphisms have been replicated in both case and control groups. Gene polymorphisms were detected by direct sequencing after polymerase chain reaction.ResultsThe Body Mass Index, LH, LH/FSH ratio and total testosterone were significantly elevated in PCOS patients compared to control group (P<0.05). The frequencies of genotype and allele in rs13405728 were significantly different between the PCOS and the control groups (P<0.05). Of the SNP rs13405728, the PCOS cases with TT genotype stayed at a higher level of total testosterone, TG and LDL than those with the CC and CT genotypes. In contrary, there was no statistical difference between the two groups for SNP rs13429458 and rs2479106 (P>0.05).ConclusionThe present study suggested that the SNP rs13405728 in the LHCGR gene was associated with PCOS in Hui ethnic women, and its TT genotype characterized with higher level of TT, TG and LDL.

English

Diabetes mellitus (DM) is a common endocrine metabolic disorder and a leading cause of death worldwide. Dyslipidemia is a well-recognized manifestation of uncontrolled DM, because insulin has important regulatory effects on lipid metabolism. This study was conducted to determine the frequency and pattern of dyslipidaemia in diabetic patients. Cross-sectional study was conducted on a total of two hundred ninety five diabetic patients attending diabetic follow-up clinic of Hawassa University Referral Hospital from March to November, 2014. For each selected subject, structured questionnaire about socio-demographic characteristics and diabetic related information was filled; overnight fasting blood samples were analyzed for fasting blood sugar (FBS) and lipid profiles, namely, total cholesterol (TC), triglyceride (TG), high density lipoprotein (HDL) and low density lipoprotein (LDL). Dyslipidemia was assessed according to the United State National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP-III) model guideline. SPSS version 20 was used as tool for data analysis. P-value of <0.05 was used as statistical significance. The mean (± standard deviation, SD) values of TC, TG, HDL, LDL were 186.03 (± 37.40), 194.33 (± 93.38), 49.66 (± 10.34), 119.15 (± 42.33) mg/dl, respectively. Among all of the diabetic patients, 34.9% had high serum LDL, 34.6% had hypercholesterolemia, 29.8% had hypertriglyceridemia and 12.2% had low HDL. Significantly higher mean serum levels of TC (p = 0.002) and LDL (p = 0.008) were noted in type 2 DM than type 1 DM. Females had significantly higher TC and LDL levels than males; whereas males had significantly lower HDL levels as compared to females (48.04 ± 9.13 versus 51.93 ± 11.49 mg/dl; p < 0.001). The mean (± SD) FBS level was 178.18(± 85.39) mg/dl and patients with type 1 DM had significantly higher FBS than those with type 2 DM (p < 0.001). Our study showed the presence of dyslipidaemia in Ethiopians with DM. The most common dyslipidemia in this study was high level of serum LDL followed by hypercholesterolemia and hypertriglyceridemia. The optimal care for diabetic patients should also include routine monitoring of serum lipid profile. Key words: Diabetes, lipid profile, dyslipidemia.

Correlative analysis of blood pressure and other biochemical parameters with type 2 DM subjects

Objective : To determine the association of blood pressure and other biochemical parameters with type 2 DM subjects.Methodology : This was an observational study with case control design was conducted in the Biomedical Research Group, Research Division, Bangladesh Institute of Research and Rehabilitation in Diabetes ,Endocrine Metabolic Disorders (BIRDEM), Dhaka Bangladesh, during the period of July 2008 to June 2009. A total of 153 subjects were included in study of which 63 belonged to T2 Diabetes Mellitus group and 90 were healthy Controls. Insulin glucose ratio were assayed in patients and controls and identified the association, using standardized assay methods. We also assessed the type – 2 diabetic patients who had significantly raised Fasting blood sugar, insulin HOMA-B %= B cell function assessed by homeostasis model assessment to compared with the healthy controls. Correlation analysis of HOMA-B % with biochemical parameters, blood pressure, fasting and post prandial glucose also analysed.Results : Age of Control and type 2 DM subjects ( Mean±SD),P-value] were (46 ± 8.31) and (47 ±7.58), (P=0.326) respectively and BMI, among subject and control (kg/m2), (Mean ± SD), (24 ± 3.96, 25 ± 2.72 p=0.754). WHR [cm, (Mean±SD), p=&lt;0.001], showed significant difference between T2 DM and healthy subjects. The median (range) of the glucose and insulin ratio of the study group, there was significant difference between Control vs. T2DM (p&lt;0.001). Systolic blood pressure[S-BP, mean±SD] &amp; Diastolic blood pressure [D-BP, mean±SD] were significant in T2DM as compared to control subjects {( p= 0.008) ( p= 0.003)} respectively ; Fasting plasma glucose levels [mmol/l, (Mean± SD)] , post prandial plasma glucose level [mmol/l, (Mean± SD)]and the HOMA%B level median (range) among subject and control of the study group[(8.27±2.19) , (11.79 ± 2.69), {71 ( 4.90 - 391.30)}] were a significant difference in between Control vs type2 DM {(p &lt;0.001), (p &lt;0.001)and. (p &lt;0.001)} respectively.Conclusion : In this study, boty systolic and diastolic blood pressure, blood glucose level and insulin status and WHR were found the significant parameters for maintaining type to DM under control condition. Development of hypertension cardio vascular disease and other complication can be prevented on keeping these parameters in normal level.Northern International Medical College Journal Vol.5(1) 2013: 306-308

Aortic Intima-Media Thickness and Mean Platelet Volume in Children With Type 1 Diabetes Mellitus

Background:Diabetes mellitus type 1 is the most common endocrine metabolic disorder occurring in childhood and adolescence due to the autoimmune destruction of pancreatic beta cells as a result of various environmental factors interacting with an underlying genetic predisposition. Diabetes is a risk factor for early onset atherosclerosis, and the high mortality rate seen in these patients is partially related to cardiovascular diseases.Objectives:This study was conducted to compare mean platelet volume as a marker of early atherosclerosis with aortic intima-media thickness in children with type 1 diabetes and to identify its correlation with known cardiovascular risk factors.Patients and Methods:The study included 27 patients between age range of 6 and 17 years that were diagnosed with type 1 diabetes and 30 healthy children of the same age range who did not have any chronic disease. In both groups, we used the color Doppler ultrasound to measure children’s aortic intima-media thickness and identify their mean platelet volumes.Results:There was no significant difference between the groups regarding gender distribution, age, High-Density Lipoprotein (HDL) and Low-Density Lipoprotein (LDL) cholesterol levels (P > 0.05). Also no significant difference could be documented between the patient and control groups regarding the aortic intima-media thickness and mean platelet volume (P > 0.05). However, there was a significant correlation between aortic intima-media thickness and mean platelet volume (r = 0.351; P < 0.05).Conclusions:In the present study, there was no evidence of early atherosclerosis in children with type 1 diabetes. However, mean platelet volume having a significant correlation with aortic intima-media thickness may be useful as an early marker of atherosclerosis.

FGF-21 alleviates diabetes-associated vascular complications: Inhibiting NF-κB/NLRP3 inflammasome-mediated inflammation?

Diabetes mellitus is a metabolic endocrine disorder. It is mainly characterized by hyperglycemia and is associated with the imbalance in carbohydrate, protein and lipid metabolisms [1]. The number of patients with diabetes has been increasing worldwide in the past two decade, and these patients are at a greater risk of developing complications of the vascular system [2]. Accumulating evidence indicates that inflammation is an important pathogenic factor in diabetes-associated vascular complications.

54G/C polymorphism of SREBF-1 gene is associated with polycystic ovary syndrome

ObjectiveA sterol regulatory element-binding protein (SREBF-1) transcription factor is a major regulator of lipid metabolism, carbohydrate, and plays a key role in energy homeostasis. The 54(G/C) polymorphism of SREBF-1 gene was reported that it is related with metabolic diseases including obesity, type 2 diabetes, and dyslipidemia. Among these, polycystic ovary syndrome (PCOS) is known as a common metabolic-endocrine disorder of women in reproductive ages. Study designHere, we performed a comparative study of 54(G/C) polymorphism of SREBF-1 gene with PCOS. The 54(G/C) polymorphism of SREBF-1 gene was analyzed by polymerase chain reaction restriction fragment length polymorphism (PCR-RFLP) of total 286 PCOS patients and 149 matched controls of healthy women. Statistical analysis was performed using HapAnalyzer. A p-value under 0.05 was considered statistically significant. ResultsThere was a strong association between the 54(G/C) polymorphism of SREBF-1 gene and PCOS (OR: 0.65, 95% CI: 0.46–0.90, p: 0.0129). The genotype and allelic frequencies were in Hardy–Weinberg equilibrium (HWE). ConclusionThis is the first study on the genetic variation of SREBF-1 gene and PCOS. We concluded that 54(G/C) polymorphism of SREBF-1 gene is associated with PCOS. Therefore, our results suggest that SREBF-1 gene may play a role in genetic predisposition to PCOS, which is helpful in understanding the etiology of PCOS.

Predictors of incidence of clinically significant depressive symptoms in the elderly: 10-year follow-up study of the Bambui cohort study of aging

We aim to evaluate the incidence rate and predictors of clinically significant depressive symptoms (CSDS) over 10 years of follow-up from a population-based cohort study (the Bambui Cohort Study of Aging). We calculated the predictors of incidence of CSDS over 10 years of follow-up by the Cox proportional regression analysis. Depressive symptoms were evaluated by GHQ-12 and scores of five or higher indicated CSDS. The annualized incidence rate of clinically significant depressive symptoms was 46 per 1000 person-year. In the multivariate analysis, the main predictors of CSDS were cognitive impairment (HR = 1,69 CI95% [1,20 - 2.37], p = 0.002), diabetes (HR = 1.59 CI95% [1.14 - 2.20], p = 0.006), use of 2 to 4 (HR = 1,95 CI95% [1.21 - 3.15], p = 0.006) and of 5 or more medications in the last 90 days (HR = 2.19 CI95% [1.31 - 3.66], p = 0.003) and higher baseline depressive symptoms (HR = 2.12 CI95% [1.61 - 2.78], p < 0.001). These results highlight the importance of higher depressive symptoms, cognitive impairment and endocrine-metabolic disorders to the development of depressive symptoms in older adults. These findings provide a framework for the development of interventions to prevent the emergence of clinically significant depressive symptoms in the elderly.

Study of thyroid function in type 2 diabetic and non-diabetic population

Background: Diabetes mellitus (DM) is a common endocrine metabolic disorder and is one of the leading causes of death worldwide. Thyroid disorders are also very common in the general population and are second only to diabetes as the most common condition to affect the endocrine system. As a result, it is common for an individual to be affected by both thyroid diseases and diabetes. Objective: To compare the prevalence of thyroid dysfunction in type 2 diabetic patients and healthy controls. Methods and Methods: This study comprises 200 subjects including 100 type 2 diabetic patients and 100 controls, in whom serum-fasting glucose, serum triiodothyronine (T3), thyroxine (T4), and thyroid-stimulating hormone (TSH) were measured. Result: Among the 100 type 2 diabetic patients studied, 32% of the patients had abnormal thyroid hormone levels and 68% had normal thyroid hormone levels. Among the 32% of diabetic patients with abnormal thyroid hormone levels, 22% of them had hypothyroidism (8% clinical hypothyroidism and 14% subclinical hypothyroidism) and 10% had hyperthyroidism (4% clinical hyperthyroidism and 6% subclinical hyperthyroidism). All the controls were found to have normal thyroid hormone levels. Conclusion: There is high prevalence of thyroid dysfunction in type 2 diabetic patients as compared to healthy controls. Hypothyroidism was found more common than hyperthyroidism. Therefore, detection of abnormal thyroid hormone levels in the early stage of DM may help patients improve the quality of life and reduce the morbidity rate.

Estimation of thyroid profile in patients with diabetes mellitus in New Civil Hospital, Surat

Background: Diabetes mellitus (DM) and thyroid diseases are the two common endocrinopathies seen commonly in the population. There is inter-dependence between insulin and thyroid hormones for normal cellular metabolism so that DM and thyroid diseases can mutually influence the other disease process. The excess or deficit of one hormone may result in functional derangement of other. Diabetes being a most common endocrine metabolic disorder, the variety of thyroid abnormalities may co-exist and interact with DM. Early detection of thyroid dysfunction and its treatment can delay the long-term complications of DM. The present study was planned to determine prevalence of thyroid dysfunction in DM patients and therefore to provide the appropriate guidelines. Methods: The study was cross-sectional. 100 patients were enrolled for the study. Among them 50 were control (non-diabetic) and 50 were cases (diabetic). They were enrolled in the study from medicine outpatient department’s and inpatient department’s according to inclusion and exclusion criteria. Their thyroid profile (free T3, T4 and thyroid stimulating hormone) was done by chemiluminescence assay method. Results: Results were analyzed by unpaired- t -test. Prevalence of thyroid dysfunction was found significantly high in DM patients. p<0.05 value considered as statistically significant. Conclusions: Screening for thyroid disease among patients with diabetes mellitus should be routinely performed for early detection and treatment of thyroid dysfunction to delay the complications of diabetes.

Troubles affectifs et comorbidités endocrino-métaboliques

Links between affective and endocrine-metabolic disorders are numerous and complex. In this review, we explore most frequent endocrine-metabolic comorbidities. On the one hand, these comorbidities imply numerous iatrogenic effects from antipsychotics (metabolic side-effects) or from lithium (endocrine side-effects). On the other hand, these comorbidities are also associated with affective disorders independently from medication. We will successively examine metabolic syndrome, glycemic disturbances, obesity and thyroid disorders among patients with affective disorders. Endocrinemetabolic comorbidities can be individually encountered, but can also be associated. Therefore, they substantially impact morbidity and mortality by increasing cardiovascular risk factors. Two distinct approaches give an account of processes involved in these comorbidities: common environmental factors (iatrogenic effects, lifestyle), and/or shared physiological vulnerabilities. In conclusion, we provide a synthesis of important results and recommendations related to endocrine-metabolic comorbidities in affective disorders : heavy influence on morbidity and mortality, undertreatment of somatic diseases, importance of endocrine and metabolic side effects from main mood stabilizers, impact from sex and age on the prevalence of comorbidities, influence from previous depressive episodes in bipolar disorders, and relevance of systematic screening for subclinical (biological) disturbances.

Follicular fluid lipid fingerprinting from women with PCOS and hyper response during IVF treatment.

Polycystic ovary syndrome (PCOS) is an endocrine-metabolic disorder that leads to lower natural reproductive potential and presents a challenge for assisted reproductive medicine because patients may exhibit immature oocyte retrieval and a higher risk of ovarian hyper stimulation syndrome during in vitro fertilization (IVF) treatment. This study aimed to identify potential lipid biomarkers for women with PCOS and a hyper response to controlled ovarian stimulation. Follicular fluid samples were collected from patients who underwent IVF, including normal responder women who became pregnant (control group, n = 11), women with PCOS and a hyper response to gonadotropins (PCOS group, n = 7) and women with only hyper response to gonadotropins (HR group, n = 7). A lipidomic analysis was performed by electrospray ionization mass spectrometry, and candidate biomarkers were analyzed by tandem mass spectrometry experiment. The lipid profiles indicated particularities related to differences in phosphatidylcholine (PCOS and HR), phosphatidylserine, phosphatydilinositol and phosphatidylglycerol (control), sphingolipids (PCOS) and phosphatidylethanolamine (control and HR). These findings contribute to the understanding of the molecular mechanisms associated with lipid metabolism in the PCOS-related hyper response, and strongly suggest that these lipids may be useful as biomarkers, leading to the development of more individualized treatment for pregnancy outcome.

Exploring the potential association between brominated diphenyl ethers, polychlorinated biphenyls, organochlorine pesticides, perfluorinated compounds, phthalates, and bisphenol A in polycystic ovary syndrome: a case-control study.

BackgroundPolycystic Ovary Syndrome (PCOS) is an endocrine-metabolic disorder that affects approximately 6-10% of women of child-bearing age. Although preliminary studies suggest that certain pollutants may act as endocrine disruptors in animals, little is known about their potential association with PCOS. The objective of this case-control pilot study is to determine whether women with PCOS have higher concentrations of specific environmental contaminants compared to women who have not developed PCOS.MethodsFifty-two PCOS case-patients (diagnosed using the National Institutes of Health 1990 definition) and 50 controls were recruited in 2007–2008, from an urban academic medical center in Los Angeles, CA. Brominated diphenyl ethers, polychlorinated biphenyls (PCBs), organochlorine pesticides, and perfluorinated compounds (PFCs) were measured in serum, and phthalates metabolites and bisphenol A (BPA) in urine.ResultsPCOS case-patients had significantly higher geometric mean (GM) serum concentrations of two PFCs: perfluorooctanoate (PFOA) (GMcases = 4.1 μg/L, GMcontrols = 2.3 μg/L; p = 0.001) and perfluorooctane sulfonate (PFOS) (GMcases = 8.2 μg/L, GMcontrols = 4.9 μg/L; p = 0.01), and lower urinary concentrations of monobenzyl phthalate (mBzP) (GMcases = 7.5 μg/g creatinine, GMcontrols = 11.7 μg/g creatinine; p = 0.02). Logistic regression, controlling for body mass index, age and race, identified an increased likelihood of PCOS in subjects with higher serum concentrations of PFOA and PFOS (adjusted-ORs = 5.8–6.9, p < 0.05), and with lower urine concentrations of mBzP and mono-n-butyl phthalate (mBP) (aORs = 0.14–0.25, p < 0.05).ConclusionsOur data suggest that PCOS case-patients may differ from controls in their environmental contaminant profile. PCOS subjects had higher serum concentrations of two PFCs, PFOA and PFOS, and lower urine concentrations of mBP and mBzP. Future studies are needed to confirm these preliminary findings and determine if these chemicals or their precursors may have a role in the pathogenesis of PCOS.Electronic supplementary materialThe online version of this article (doi:10.1186/1472-6823-14-86) contains supplementary material, which is available to authorized users.

Spine bone texture assessed by trabecular bone score (TBS) to evaluate bone health in thalassemia major.

Due to the increasing survival of thalassemic patients, osteopathy is a mounting clinical problem. Low bone mass alone cannot account for the high fracture risk described; impaired bone quality has been speculated but so far it cannot be demonstrated noninvasively. We studied bone quality in thalassemia major using trabecular bone score (TBS), a novel texture measurement extracted from spine dual-energy X-ray absorptiometry (DXA), proposed in postmenopausal and secondary osteoporosis as an indirect index of microarchitecture. TBS was evaluated in 124 adult thalassemics (age range 19-56 years), followed-up with optimal transfusional and therapeutical regimens, and in 65 non-thalassemic patients (22-52 years) undergoing DXA for different bone diseases. TBS was lower in thalassemic patients (1.04 ± 0.12 [range 0.80-1.30]) versus controls (1.34 ± 0.11 [1.06-1.52]) (p < 0.001), and correlated with BMD. TBS and BMD values correlated with age, indicating that thalassemia negatively affects both bone quality and quantity, especially as the patient gets older. TBS was 1.02 ± 0.11 [0.80-1.28] in the osteoporotic thalassemic patients, 1.08 ± 0.12 [0.82-1.30] in the osteopenic ones and 1.15 ± 0.10 [0.96-1.26] in those with normal BMD. No gender differences were found (males: 1.02 ± 0.13 [0.80-1.30], females 1.05 ± 0.11 [0.80-1.30]), nor between patients with and without endocrine-metabolic disorders affecting bone metabolism. Our findings from a large population with thalassemia major show that TBS is a valuable tool to assess noninvasively bone quality, and it may be related to fragility fracture risk in thalassemic osteopathy.

Spanish consensus on the physical health of patients with depressive disorders

Comorbidity between depression and physical illnesses is very common and has a significant impact on the health and management of the patient. With the support of the Sociedades Españolas de Psiquiatría y Psiquiatría Biológica and Sociedad Española de Médicos de Atención Primaria (SEMERGEN) a consensus was prepared on physical health in patients with depression and it is summarised in the present work. The literature review highlighted the high frequency of cardiovascular and endocrine–metabolic disorders in patients with depression such as diabetes and obesity, thus making the primary and secondary prevention recommendations for patients with cardiovascular or metabolic risk applicable to patients with depression. Comorbidity between depression and chronic pain is also frequent, and requires an integrated therapeutic approach. The presence of physical illness in patients with depression may condition, but not preclude, the pharmacological treatment; drug selection should take into account potential side effect and drug–drug interactions. On the other hand, psychotherapy may contribute to the patient's recovery. Overall, coordination between the primary care physician, the psychiatrist and other health professionals involved is essential for the management of patients with depression and concomitant physical illness.

EPA-1543 - Prevalence endocrine-metabolic disorders in patients with mood disorders

Background Mood Diisorders (MD) is an independent risk factor for Endocrine-Metabolic (E-M) disorders and metabolic syndrome. Biological processes relating to the pathophysiology of MD and metabolic syndrome have common characteristics. Aim To study the frequency and types E-M disorders in patients with the MD. Method Research included 27 patients with Bipolar Affectiv Disorder (BAD) and 65 patients with a Depressive Disorder (DD) (ICD-10 diagnostic criteria), hospitalized during one year. Results Among patients with BAD there were 11 men (40.7%) and 16 (59.2%) women. Comorbidity was registered in 8 (72.7%) men, with an average age of 47 years, and 10 (62.5%) women, with an average age of 51.3 years. Patients with DD were 24 men (36.92%) and 41 women (63.07%). Somatic comorbidity was observed in 31 women (75.61%), average age 51.2 years, and 17 men (70.83%), average age 52.8 years. The relationship between age and gender and prevalence of somatic comorbidity was analysed (statistical analysis by x2 and t-test). Analysis of somatic illnesses showed that E-M disorder had the highest prevalence, 11 patients (40.7% with BAD) and 36 patients (55.38% with DD). Dyslipidemia, DM and disorder of the Thyroid gland were the most frequent. There was no statistically significant discrepancy in the prevalence of E-M disorders and MD depending on gender (p=0,64 BAD), (p=0,29 DD) and age (p=0,18 BAD), (p=0,25 DD). Conclusion MD are accompanied by E-M disordersat a high rate (51%), but there is no statistically significant difference depending on gender and age.

Exfoliative cytology of buccal squames: A quantitative cytomorphometric analysis of patients with diabetes.

Background:Diabetes is a third leading cause of mortality and morbidity in the world. Diabetes is one of the most common endocrine metabolic disorders and its prevalence has been increasing worldwide. Oral exfoliative cytology may be a more appropriate adjunctive diagnostic tool in conditions like diabetes mellitus, where the invasive techniques lose viability.Aims:The purpose of this study is to analyze the cytomorphometric changes in the exfoliated cells of the oral mucosa, as an adjunct to the diagnosis of diabetes.Materials and Methods:Smears were taken from the buccal mucosa of 30 diabetes patients (study group) and 30 healthy individuals (control group). All the smears were stained with rapid Papanicolaou stain (PAP). In the PAP smears, the nuclear area (NA), cytoplasmic area (CA), and cytoplasmic-to-nuclear ratio (CNR) were evaluated for 50 cells in each smear, using the Image Analysis Software (Magnus Pro™) and research microscope (Lawrence and Mayo™).Results:The results showed that the mean NA was significantly higher (P < 0.001) in the study group, whereas, the mean CA did not exhibit a statistically significant difference (P > 0.001). The mean CNR was significantly lower in the study group (P < 0.001).Interpretation and Conclusion:The results associated with the clinical observations suggest that diabetes can produce morphological and functional alterations in the oral epithelial cells, detectable by microscopic and cytomorphometric analysis using exfoliative cytology, which can be used in the diagnosis of the disease.

Polycystic ovary syndrome, insulin resistance, and obesity: navigating the pathophysiologic labyrinth.

Polycystic ovary syndrome (PCOS) is a highly prevalent endocrine-metabolic disorder that implies various severe consequences to female health, including alarming rates of infertility. Although its exact etiology remains elusive, it is known to feature several hormonal disturbances, including hyperandrogenemia, insulin resistance (IR), and hyperinsulinemia. Insulin appears to disrupt all components of the hypothalamus-hypophysis-ovary axis, and ovarian tissue insulin resistance results in impaired metabolic signaling but intact mitogenic and steroidogenic activity, favoring hyperandrogenemia, which appears to be the main culprit of the clinical picture in PCOS. In turn, androgens may lead back to IR by increasing levels of free fatty acids and modifying muscle tissue composition and functionality, perpetuating this IR-hyperinsulinemia-hyperandrogenemia cycle. Nonobese women with PCOS showcase several differential features, with unique biochemical and hormonal profiles. Nevertheless, lean and obese patients have chronic inflammation mediating the long term cardiometabolic complications and comorbidities observed in women with PCOS, including dyslipidemia, metabolic syndrome, type 2 diabetes mellitus, and cardiovascular disease. Given these severe implications, it is important to thoroughly understand the pathophysiologic interconnections underlying PCOS, in order to provide superior therapeutic strategies and warrant improved quality of life to women with this syndrome.