Lean Women Research Articles

The Influence of FAM13A and PPAR-γ2 Gene Polymorphisms on the Metabolic State of Postmenopausal Women

Recently, we have observed two significant pandemics caused by communicable (COVID-19) and non-communicable factors (obesity). Obesity is related to a specific genetic background and characterized by immunogenetic features, such as low-grade systemic inflammation. The specific genetic variants include the presence of polymorphism of the Peroxisome Proliferator-Activated Receptors gene (PPAR-γ2; Pro12Ala, rs1801282, and C1431T, rs3856806 polymorphisms), β-adrenergic receptor gene (3β-AR; Trp64Arg, rs4994), and Family With Sequence Similarity 13 Member A gene (FAM13A; rs1903003, rs7671167, rs2869967). This study aimed to analyze the genetic background, body fat distribution, and hypertension risk in obese metabolically healthy postmenopausal women (n = 229, including 105 lean and 124 obese subjects). Each patient underwent anthropometric and genetic evaluations. The study has shown that the highest value of BMI was associated with visceral fat distribution. The analysis of particular genotypes has revealed no differences between lean and obese women except for FAM13A rs1903003 (CC), which was more prevalent in lean patients. The co-existence of the PPAR-γ2 C1431C variant with other FAM13A gene polymorphisms [rs1903003(TT) or rs7671167(TT), or rs2869967(CC)] was related to higher BMI values and visceral fat distribution (WHR > 0.85). The co-association of FAM13A rs1903003 (CC) and 3β-AR Trp64Arg was associated with higher values of systolic (SBP) and diastolic blood pressure (DBP). We conclude that the co-existence of FAM13A variants with C1413C polymorphism of the PPAR-γ2 gene is responsible for body fat amount and distribution.

Does Obesity Affect Neuromuscular and Cardiovascular Adaptations after a 3-Month Combined Exercise Program in Untrained Premenopausal Middle-Aged Women?

Previous studies indicated different acute adaptations between obese and lean individuals, while there is limited information with conflicting results regarding long-term adaptations. The aim of this study was to compare the efficacy of a 3-month integrated combined training between obese and lean middle-aged untrained premenopausal women. In total, 72 women (36 obese/36 lean) were divided into four groups: (a) obese exercise (OB-EG), (b) obese control (OB-CG), (c) lean exercise (L-EG), and (d) lean control (L-CG). The exercise groups followed a 3-month (3 times/week) integrated combined aerobic and strength training program. Health indices (body composition, body circumferences, blood pressure, respiratory function), functional capacity (flexibility, balance), and physical fitness (strength, aerobic capacity) were measured before and after the 3-month time period. Participants' enjoyment was also assessed following the program. OB-EG and L-EG significantly improved (p < 0.05) similarly across all functional capacity and physical fitness indices (10-76%; depending on the evaluation index), except balance and strength indices of the non-preferred limb where OB-EG showed greater improvement (reducing the existing pre-training strength/balance asymmetries) than L-EG. Furthermore, both obese and lean individuals showed similarly high levels of enjoyment. This program could be effectively used in fitness settings causing similar neuromuscular and cardiovascular adaptations in obese and lean women.

Abstract 6470: Coffee and tea consumption, coffee-related metabolites, and breast cancer risk in US Women

Abstract Background: Coffee intake may protect against breast cancer; however, previous studies have been inconsistent and potential underlying mechanisms remain unclear. We aimed to 1) examine the association between total coffee, tea, and caffeine intake and breast cancer risk and 2) identify plasma metabolites associated with coffee intake and examine these metabolites in relation to breast cancer risk. Methods: Data on breast cancer risk factors were collected from questionnaires administered biennially and at the time of blood collections (Nurses’ Health study, NHS, distant collection: 1989-1990, recent collection: 2000-2002; NHSII, 1996-1999). We evaluated the association between total coffee (caffeinated and decaffeinated), tea consumption and caffeine intake and breast cancer risk in the full cohort using Cox regression models. Leveraging dietary and metabolomic data, we identified and validated plasma metabolites associated with coffee intake in 2,033 women from the NHSII breast cancer sub-study. We then evaluated the prospective association of all prior (PMID: 32788283) and new coffee-related metabolites with breast cancer risk in a nested case-control study using conditional logistic regression models. Results: We documented 10,060 cases of invasive breast cancer during 3,901,211 person-years of follow-up. In pooled, multivariable-adjusted models, compared to never consumers (0 cups/d), women consuming ≥6 cups/d of total coffee were at lower risk of invasive breast cancer (HR, 0.91; 95% CI, 0.82, 1.00; P-trend&amp;lt;0.01). Stratified analysis showed a significant effect modification by BMI (P-interaction=0.03). Compared to never consumers, drinking ≥6 cups of coffee per day was inversely associated with risk of invasive breast cancer among lean women (HR, 0.83; 95% CI, 0.72, 0.97) but not among overweight or obese women. Moreover, a lower risk of ER-negative breast cancer was observed with total coffee (HR ≥6 cups/d vs. 0 cups/day 0.75; 95% CI, 0.59, 0.95; P-trend=0.01) and decaffeinated coffee consumption (HR ≥4 cups/d vs. o cups/day 0.66; 95% CI, 0.45, 0.95; P-trend=0.01). Among the 31 studied metabolites, no single metabolite was associated with breast cancer risk. Associations were generally consistent between ER-positive and ER-negative breast cancer, although trigonelline seemed to be suggestively stronger for ER-negative (OR, 95% CI, 0.87, 0.75-1.01; P-value=0.061). Furthermore, 1,7-dimethyluric acid, some cholesterol esters (C18:1 CE, C18:2 CE and C20:4 CE) and trigonelline, all positively associated with coffee, were indicative of an inverse association with breast cancer risk among lean women. Conclusions: Coffee consumption was associated with lower breast cancer risk, particularly among lean women and ER-negative breast cancer. Some metabolites that might explain some of the observed inverse associations. Nonetheless, these results merit further exploration. Citation Format: Andrea Romanos-Nanclares, Oana A. Zeleznik, Mingyang Song, Walter C. Willett, Rulla M. Tamimi, Wendy Y. Chen, Michelle D. Holmes, Jae Hee Kang, A. Heather Eliassen. Coffee and tea consumption, coffee-related metabolites, and breast cancer risk in US Women [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 6470.

ASSESSMENT OF CARDIOVASCULAR RISK IN WOMEN WITH PCOS: A NARRATIVE REVIEW

Polycystic ovarian syndrome (PCOS) is one of the commonest endocrinopathy of women of reproductive age globally. This clinical condition not only dysregulates the reproductive axis, but also a risk factor for hyperinsulinemia, insulin resistance, dyslipidaemia, T2DM. All these metabolic states aggravate the cardiovascular risk in women with PCOS. The aim of this review is to provide an overview of evidences of subclinical cardiovascular risk in PCOS women and synthesize the result. To attain this aim, the published research articles were reviewed using the databases PubMed, Google scholar and EMBASE employing key words PCOS, cardiovascular risk, arterial stiffness, endothelial function to obtain relevant information. Total 162 articles were searched and after applying eligibility criteria, 12 articles have been included for qualitative synthesis of the information. Most of the studies are cross-sectional, case-control study conducted on pre-, peri and menopausal, obese, lean women with PCOS. The study participants were mostly diagnosed on the basis of Rotterdam criteria. But, other criteria such as National Institutes of Health criteria (NIH), Androgen Excess Society criteria (AES) were also used to diagnose the condition. Mostly these studies recorded arterial stiffness as assessed by pulse wave velocity (PWV), augmentation index (AIx) and endothelial dysfunction as assessed by brachial artery ow mediated vasodilatation (FMD). The ndings of few cardinal systematic review and metaanalysis were also reported. These studies mainly analysed the data obtained for subclinical cardiovascular status of women with PCOS as assessed by carotid intima media thickness (cIMT), carotid artery calcium (CAC) score and FMD. Majority of the studies concluded that women with PCOS display enhanced arterial stiffness and endothelial dysfunction in comparison to age and BMI-matched healthy control group, though controversy exists is the literature. In this regard, the existing traditional cardiovascular risk factors in PCOS women, make them more prone to cardiovascular disease. It needs further prospective study with hard cardiovascular outcome to prove this point undoubtedly. It must be emphasized that regular cardiovascular screening might be advocated for this vulnerable population to prevent any major cardiovascular eventuality.

Serum Phoenixin-14 levels of women with polycystic ovary syndrome increase proportionally with BMI.

This study aimed to compare serum PNX-14 values of women with PCOS classified as lean or overweight according to the BMI values. Fifty lean or overweight women diagnosed with PCOS according to the revised Rotterdam criteria were included in the study. They were divided into two groups according to their BMI values. Thirty patients with BMI values of 18.5-24.9 kg/m2 constituted the normal-weight PCOS group. Twenty patients with BMI values of 25-29.9 kg/m2 formed the overweight PCOS group. Thirty patients with regular menstrual cycles who did not exhibit clinical and laboratory findings of PCOS were selected as the control group. The patients in the control group were also divided into two different groups as normal weight (n=17) and overweight (n=13). In anovulatory PCOS group, blood samples were collected on the third day of progesterone withdrawal bleeding. Both in ovulatory PCOS and control groups, blood samples were collected on the third day of spontaneous menstrual cycle. In addition to basal hormonal parameters, serum phoenixin-14 concentrations were measured by enzyme-linked immunosorbent assay. LH values of the overweight or lean PCOS group were significantly higher than the overweight or lean non-PCOS group (p<0.01). The LH/FSH ratios of the lean and obese PCOS groups were significantly higher than the non-PCOS control group (p<0.01). Testosterone levels of both lean and obese PCOS groups were significantly higher than non-PCOS groups (p<0.02). The HOMA-IR value of the obese PCOS group was significantly higher than the lean PCOS group (p<0.03). The HOMA-IR values of the patients in the PCOS group were significantly higher than the non-PCOS controls. Phoenixin-14 levels of the obese PCOS group were approximately three times higher than the lean PCOS group (p<0.01). Phoenixin-14 levels of the obese non-PCOS group were also three times higher than the lean non-PCOS group (p<0.01). Serum Phoenixin-14 levels of patients in the lean PCOS group were significantly higher than in the lean non-PCOS group (9.11±2.09 pg/mL vs. 2.04±0.11 pg/mL, p<0.01). Serum Phoenixin-14 levels of the patients in the obese PCOS group were significantly higher than in the obese non-PCOS group (27.4±3.04 pg/mL vs. 6.44±1.09 pg/mL, p<0.01). A positive and significant correlation was found between serum PNX-14 levels and BMI, HOMA-IR, LH, and testosterone levels in both lean and obese PCOS patients. This study showed for the first time that serum PNX-14 levels are significantly increased in lean and obese PCOS patients. The increase in PNX-14 showed a proportional trend with BMI levels. Serum PNX-14 levels were correlated positively with serum LH, testosterone, and HOMA-IR.

Study of some physiological and hematological parameters in obese women with arthritis

Introduction and Aim: Obesity and overweight refers to excessive buildup of fat in the body. Arthritis is a group of medical disorders associated with obesity and being overweight. Obesity associated with rheumatoid arthritis is more pronounced in women. In this study, we aimed to evaluate some physiological and hematological parameters in obese women with arthritis. Materials and Methods: This study included 90 women aged between 18 and 68 years. The women were divided into three groups based on their BMI as Obese (n=30), Obese+RA (n=30) and normal lean women as controls (n=30). Blood drawn from each participant was tested for their complete blood tests, lipid profiles, C-reactive protein reaction and presence of rheumatoid factor. Data was subjected to statistical analysis. Results: Our study revealed the mean +SE for age, WHR and BMI to be elevated in women in the obese as well as Obese+RA groups and to be significantly higher in comparison to women in the control group. Except for HDL, all the other lipid parameters were seen elevated in the obese and Obese+RA group and showed significant difference from the control group. Similarly, among the complete blood count indices only ESR, WBC and PLT were found to be significantly elevated in obese and Obese+RA groups. The prevalence percentage for CRP and RF was seen to be highest in individuals belonging to the Obese+RA group. Conclusion: Obese women as well as obese women with RA have elevated hematological and physiological parameters when compared to lean women.

Portion control tableware differentially impacts eating behaviour in women with and without overweight

Portion control tableware has been described as a potentially effective approach for weight management, however the mechanisms by which these tools work remain unknown. We explored the processes by which a portion control (calibrated) plate with visual stimuli for starch, protein and vegetable amounts modulates food intake, satiety and meal eating behaviour. Sixty-five women (34 with overweight/obesity) participated in a counterbalanced cross-over trial in the laboratory, where they self-served and ate a hot meal including rice, meatballs and vegetables, once with a calibrated plate and once with a conventional (control) plate. A sub-sample of 31 women provided blood samples to measure the cephalic phase response to the meal. Effects of plate type were tested through linear mixed-effect models. Meal portion sizes (mean ± SD) were smaller for the calibrated compared with the control plate (served: 296 ± 69 vs 317 ± 78 g; consumed: 287 ± 71 vs 309 ± 79 g respectively), especially consumed rice (69 ± 24 vs 88 ± 30 g) (p < 0.05 for all comparisons). The calibrated plate significantly reduced bite size (3.4 ± 1.0 vs 3.7 ± 1.0 g; p < 0.01) in all women and eating rate (32.9 ± 9.5 vs 33.7 ± 9.2 g/min; p < 0.05), in lean women. Despite this, some women compensated for the reduced intake over the 8 h following the meal. Pancreatic polypeptide and ghrelin levels increased post-prandially with the calibrated plate but changes were not robust. Plate type had no influence on insulin, glucose levels, or memory for portion size. Meal size was reduced by a portion control plate with visual stimuli for appropriate amounts of starch, protein and vegetables, potentially because of the reduced self-served portion size and the resulting reduced bite size. Sustained effects may require the continued use of the plate for long-term impact.

Don't sugar coat it: The independent and synergistic impacts of obesity and gestational diabetes on placental parameters.

Don't sugar coat it: The independent and synergistic impacts of obesity and gestational diabetes on placental parameters.

Metformin Impacts Human Syncytiotrophoblast Mitochondrial Function from Pregnancies Complicated by Obesity and Gestational Diabetes Mellitus in a Sexually Dimorphic Manner.

Maternal obesity and gestational diabetes mellitus (GDM) are associated with placental dysfunction, small for gestational age (SGA) offspring, and programming of adult-onset disease. We examine how metformin, commonly used to treat type A2 GDM, affects placental metabolism as well as mitochondrial content and function. Syncytiotrophoblasts (STBs) were prepared from placentas of male and female fetuses collected at term cesarean section from lean (pre-pregnancy BMI < 25), obese (BMI > 30), and obese A2GDM women. Metformin treatment (0.001-10 mM) of STB caused no change in non-mitochondrial respiration but significant concentration-dependent (1 and 10 mM) decreases in basal, maximal, and ATP-linked respiration and spare capacity. Respiration linked to proton leak was significantly increased in STB of male A2GDM placentas at low metformin concentrations. Metformin concentrations ≥1 mM increased glycolysis in STB from placentas from lean women, but only improved glycolytic capacity in female STB. Whereas metformin had little effect on superoxide generation from male STB of any group, it gave a concentration-dependent decrease in superoxide generation from female STB of lean and obese women. Fewer mitochondria were observed in STB from obese women and male STB from lean women with increasing metformin concentration. Metformin affects STB mitochondrial function in a sexually dimorphic manner but at concentrations above those reported in maternal circulation (approximately 0.01 mM) in women treated with metformin for GDM.

Effects of androgen excess and body mass index on endothelial function in women with polycystic ovary syndrome.

Polycystic ovary syndrome (PCOS) is associated with endothelial dysfunction; whether this is attributable to comorbid hyperandrogenism and/or obesity remains to be established. Therefore, we 1) compared endothelial function between lean and overweight/obese (OW/OB) women with and without androgen excess (AE)-PCOS and 2) examined androgens as potential modulators of endothelial function in these women. The flow-mediated dilation (FMD) test was applied in 14 women with AE-PCOS (lean: n = 7; OW/OB: n = 7) and 14 controls (CTRL; lean: n = 7, OW/OB: n = 7) at baseline (BSL) and following 7 days of ethinyl estradiol supplementation (EE; 30 µg/day) to assess the effect of a vasodilatory therapeutic on endothelial function; at each time point we assessed peak increases in diameter during reactive hyperemia (%FMD), shear rate, and low flow-mediated constriction (%LFMC). BSL %FMD was attenuated in lean AE-PCOS versus both lean CTRL (5.2 ± 1.5 vs. 10.3 ± 2.6%, P < 0.01) and OW/OB AE-PCOS (5.2 ± 1.5 vs. 6.6 ± 0.9%, P = 0.048). A negative correlation between BSL %FMD and free testosterone was observed in lean AE-PCOS only (R2 = 0.68, P = 0.02). EE increased %FMD in both OW/OB groups (CTRL: 7.6 ± 0.6 vs. 10.4 ± 2.5%, AE-PCOS: 6.6 ± 0.9 vs. 9.6 ± 1.7%, P < 0.01), had no impact on %FMD in lean AE-PCOS (5.17 ± 1.5 vs. 5.17 ± 1.1%, P = 0.99), and reduced %FMD in lean CTRL (10.3 ± 2.6 vs. 7.6 ± 1.2%, P = 0.03). Collectively, these data indicate that lean women with AE-PCOS exhibit more severe endothelial dysfunction than their OW/OB counterparts. Furthermore, endothelial dysfunction appears to be mediated by circulating androgens in lean but not in OW/OB AE-PCOS, suggesting a difference in the endothelial pathophysiology of AE-PCOS between these phenotypes.NEW & NOTEWORTHY We present evidence for marked endothelial dysfunction in lean women with androgen excess polycystic ovary syndrome (AE-PCOS) that is 1) associated with free testosterone levels, 2) impaired relative to overweight/obese women with AE-PCOS, and 3) unchanged following short-term ethinyl estradiol supplementation. These data indicate an important direct effect of androgens on the vascular system in women with AE-PCOS. Our data also suggest that the relationship between androgens and vascular health differs between phenotypes of AE-PCOS.

Severe Hemoperitoneum due to Ovarian Bleeding after Transvaginal Oocyte Retrieval with Surgical Management: A Retrospective Analysis and Comprehensive Review of the Literature.

Background and Objectives: Severe hemoperitoneum of ovarian bleeding origin is a rare but potentially life-threatening complication of transvaginal oocyte retrieval (TVOR) procedure. The study aimed to present a case series of surgically managed patients from our clinic with hemoperitoneum caused by ovarian bleeding after TVOR, as well as to perform a comprehensive literature review in order to summarize and analyze all published cases with this condition and their management. Materials and Methods: The data of 2939 patients, who underwent TVOR procedures for IVF/ICSI (in vitro fertilization, intracytoplasmic sperm injection) in our clinic between 2010 and 2021 were reviewed. Moreover, a systemic literature search was performed. Main outcome measures from the pooled analysis were incidence and risk factors, type of surgery, intraoperative finding and intervention leading to hemostasis. Results: In our Clinic 4 (0.136%), cases of hemoperitoneum due to ovarian bleeding were surgically managed. Moreover, 39 cases from 18 studies reported in the literature were identified. No risk factors besides lean women with PCOS were identified. In the pooled analysis, the bleeding symptoms appeared in 58.1% of patients within eight hours after TVOR and cumulatively in 81.4% cases during the 24 h after TVOR. The average time from TVOR to surgery was 27.19 ± 53.25 h. Hemostasis was mostly established using electrocoagulation, although few cases of ovariectomy were also reported. Embryo transfer at 60% of cases was postponed and embryos cryopreserved. Conclusions: Severe hemoperitoneum due to ovarian bleeding after TVOR is a rare event that should be treated by techniques of minimally invasive surgery whenever possible. Protocols should be developed to enable optimal management strategies for infertility patients. Embryos obtained should be cryopreserved.

Are Women with Normal-Weight Obesity at Higher Risk for Cardiometabolic Disorders?

This study aimed to evaluate the cardiometabolic abnormalities in women with normal-weight obesity (NWO) in comparison with lean, overweight, and obese women. This cross-sectional study evaluated the assessment of cardiometabolic abnormalities of women with NWO compared to lean, overweight, and obese women. NWO was defined as a BMI < 25 kg.m-2 and a BFP higher than 30%. Anthropometric variables, cardiometabolic abnormality markers (fasting blood glucose (FBG), blood pressure (BP), lipid profile, insulin resistance, and high-sensitivity C-reactive protein (hs-CRP)), and liver enzymes were also examined. Significant differences were observed in HDL concentrations between NWO, lean, and obese participants (p < 0.05). There were no significant differences in FBG, insulin resistance, liver enzymes, or cholesterol between groups (p > 0.05). The prevalence of the abnormal metabolic phenotype was higher in NWO compared to the lean group (4.0% and 24.1%, respectively; p < 0.05). Women with type 2 and 3 obesity had abnormal metabolic profiles (60.9% and 73.9%, respectively) compared to NWO participants (p < 0.01). The NWO group had a significantly higher incidence of cardiometabolic abnormalities compared to the lean participants (p < 0.05), while the type 2 and 3 obese individuals had significantly higher incidences compared to the NWO group (p < 0.001 and p < 0.001, respectively). Individuals with NWO had a significantly higher incidence of cardiometabolic abnormalities when compared to lean participants. These abnormalities strongly relate to BFP and waist circumferences.

Diagnostic Performance of Ovarian Morphology on Ultrasonography across Anovulatory Conditions-Impact of Body Mass Index.

The study objectives were to determine whether ovarian morphology can distinguish between women with regular menstrual cycles, normo-androgenic anovulation (NA-Anov), and PCOS and whether body mass index (BMI)-specific thresholds improved diagnostic potential. Women with PCOS (biochemical and/or clinical hyperandrogenism and irregular cycles; N = 66), NA-Anov (irregular cycles without clinical and/or biochemical hyperandrogenism; N = 64), or regular cycles (controls; cycles every 21-35 days in the absence of clinical or biochemical hyperandrogenism; N = 51) were evaluated. Participants underwent a reproductive history, physical exam, transvaginal ultrasound, and a fasting blood sample. Linear regression analyses were used to assess the impact of BMI on ovarian morphology across groups. The diagnostic performance of ovarian morphology for anovulatory conditions, and by BMI (lean: <25 kg/m2; overweight: ≥25 kg/m2), was tested using Receiver Operating Characteristic (ROC) curves. Follicle number per ovary (FNPO) and ovarian volume (OV), but not follicle number per cross-section (FNPS), increased across controls, NA-Anov, and PCOS. Overall, FNPO had the best diagnostic performance for PCOS versus controls (AUCROC = 0.815) and NA-Anov and controls (AUCROC = 0.704), and OV to differentiate between PCOS and NA-Anov (AUCROC = 0.698). In lean women, FNPO best differentiated between PCOS and controls (AUCROC = 0.843) and PCOS versus NA-Anov (AUCROC = 0.710). FNPS better distinguished between NA-Anov and controls (AUCROC = 0.687), although diagnostic performance was lower than when thresholds were generated using all participants. In women with overweight and obesity, OV persisted as the best diagnostic feature across all analyses (PCOS versus control, AUCROC = 0.885; PCOS versus NA-Anov, AUCROC = 0.673; NA-Anov versus controls, AUCROC = 0.754). Ovarian morphology holds diagnostic potential to distinguish between NA-Anov and PCOS, with marginal differences in diagnostic potential when participants were stratified by BMI suggesting that follicle number may provide better diagnostic performance in lean women and ovarian size in those with overweight.

Weight-for-age z-scores of Japanese children using the World Health Organization Child Growth Standards.

Weight-for-age z-scores of Japanese children using the World Health Organization Child Growth Standards.

The Efficacy of Metformin Treatment on Insulin Resistance and Hyperandrogenism in Lean Women with Polycystic Ovary Syndrome: A Literature Review

Background: Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in premenopausal women, characterized by insulin resistance and hyperandrogenism. Previous studies have investigated the use of metformin, a well-known insulin sensitizer, on lean PCOS patients, but it remains unclear as to how effective the treatment is. This literature review was carried out to better assess the effects of metformin on lean PCOS patients. Methods: Related literature was fully searched using MEDLINE, EMBASE, Web of Science, and COCHRANE for metformin therapy on lean women with PCOS (last updated May 2022). A review was performed to evaluate the effects of continued metformin treatment on relevant hormonal and metabolic indicators in these women. Results: A total of fourteen studies among 300 related articles were included in the review. Significant changes in total testosterone, sex hormone binding globulin (SHBG), blood insulin, and Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) were reported in majority of the studies. Several studies observed significant changes in Body Mass Index (BMI), luteinizing hormone (LH), and blood glucose. Nearly none of the studies assessed reported significant changes in follicle-stimulating hormone (FSH) and androstenedione. Discussion: Current literature around the efficacy of metformin treatment on lean PCOS patients remains unclear and uncertain. The majority of studies reviewed indicate that metformin treatment significantly ameliorated total testosterone, SHBG levels, and insulin resistance in lean patients with PCOS. However, the mechanisms and effects of metformin on other treatment outcomes in lean PCOS women is unclear. Conclusion: Metformin may be a putative treatment for lean PCOS women with significant insulin resistance and/or hyperandrogenism. More research involving larger sample sizes and a greater number of clinical outcomes is required.

Bilirubin Levels Are Negatively Correlated with Adiposity in Obese Men and Women, and Its Catabolized Product, Urobilin, Is Positively Associated with Insulin Resistance.

Bilirubin levels in obese humans and rodents have been shown to be lower than in their lean counterparts. Some studies have proposed that the glucuronyl UGT1A1 enzyme that clears bilirubin from the blood increases in the liver with obesity. UGT1A1 clearance of bilirubin allows more conjugated bilirubin to enter the intestine, where it is catabolized into urobilin, which can be then absorbed via the hepatic portal vein. We hypothesized that when bilirubin levels are decreased, the urobilin increases in the plasma of obese humans, as compared to lean humans. To test this, we measured plasma levels of bilirubin and urobilin, body mass index (BMI), adiposity, blood glucose and insulin, and HOMA IR in a small cohort of obese and lean men and women. We found that bilirubin levels negatively correlated with BMI and adiposity in obese men and women, as compared to their lean counterparts. Contrarily, urobilin levels were positively associated with adiposity and BMI. Only obese women were found to be insulin resistant based on significantly higher HOMA IR, as compared to lean women. The urobilin levels were positively associated with HOMA IR in both groups, but women had a stronger linear correlation. These studies indicate that plasma urobilin levels are associated with obesity and its comorbidities, such as insulin resistance.

Soluble CD40 ligand (sCD40L) may be a predictive marker of vascular endothelial damage in lean and obese women with PCOS

Soluble CD40 ligand (sCD40L) may be a predictive marker of vascular endothelial damage in lean and obese women with PCOS

Analysis of the phenotypic variants of polycystic ovarian syndrome in women of reproductive age group

Aims: To identify the different phenotypic variant of PCOS in women of reproductive age group and to assess the hormonal and metabolic profile of women with PCOS. Methods: This Prospective descriptive study was conducted in the Department of Obstetrics and Gynecology, BPKIHS, Dharan for a period of one year from July 2020 to June 2021. All Women presenting to Gynecology OPD with complaints of menstrual irregularity and clinical features of hyperandrogenism were assessed and evaluated for polycystic ovarian syndrome. BMI was calculated. Hormonal Profile (serum LH, FSH and testosterone) and metabolic parameters (fasting blood sugar and lipid profile) were studied; and then further categorized into different phenotypic variants. All data were stored in Microsoft excel format and analyzed using SPSS version 11.5. using descriptive statistics. Results: Total of 80 cases of PCOS were enrolled during the study period. The most common phenotypic variant was Type B (60%) followed by Type D (30%). The mean BMI was 22.4± 4.2kg/m2 . All PCOS cases presented with menstrual irregularity as the primary complaint. Conclusions: Anovulatory PCOS was the most common phenotypic variant in our study population. This study did not find obese PCOS hence emphasizing the need of evaluation in lean women with or without hyperandrogenism presenting with menstrual irregularities.

Placental F4-Neuroprostanes and F2-Isoprostanes are altered in gestational diabetes mellitus and maternal obesity

We investigated whether gestational diabetes mellitus (GDM) associated with maternal obesity modifies the placental profile of F4-Neuroprostanes and F2-Isoprostanes, metabolites of non-enzymatic oxidation of docosahexaenoic acid (DHA) and arachidonic acid (AA), respectively. Twenty-five placental samples were divided into lean (n=11), obesity (n=7) and overweight/obesity+GDM (n=7) groups. F4-Neuroprostanes and F2-Isoprostanes were higher in obesity compared to lean controls, but reduced to levels similar to lean women when obesity is further complicated with GDM. Lower content of F2-Isoprostanes suggests adaptive placental responses in GDM attenuating oxidative stress. However, low levels of placental F4-Neuroprostanes may indicate impaired DHA metabolism in GDM, affecting fetal development and offspring health. These results were not related to differences in placental content of DHA, AA and polyunsaturated fatty acids status nor to maternal diet or gestational weight gain. Placental DHA and AA metabolism differs in obesity and GDM, highlighting the importance of investigating the signalling roles of F4-Neuroprostanes and F2-Isoprostanes in the human term placenta.

Breast adipose tissue attenuation as a novel imaging biomarker for cardiometabolic risk.

Certain adipose tissue depots infer higher cardiometabolic risk than body mass index (BMI). To assess breast adipose tissue (BrAT) attenuation as a novel imaging biomarker for cardiometabolic risk. We studied 151 women (mean age = 56 ± 1 years) across the weight spectrum. BrAT attenuation, abdominal adipose tissue cross-sectional areas (CSA), and attenuation were quantified using non-contrast computed tomography (CT) scans. Cardiometabolic risk factors were assessed from medical records. BrAT attenuation was lower in obese women compared to lean women. BrAT attenuation was inversely associated with BMI, waist circumference, abdominal fat CSA, fasting glucose, and triglycerides (P ≤ 0.02), and positively associated with abdominal adipose tissue attenuation (P < 0.001). BrAT attenuation had a sensitivity of 90% but a specificity of only 35% in detecting the metabolic syndrome (area under the curve = 0.63). BrAT attenuation is associated with cardiometabolic risk markers and could serve as an imaging biomarker for opportunistic risk assessment in patients undergoing CT examination of the chest.