Heterogenous forms of dyslipidemiain women with polycystic ovary syndrome

Forms of dyslipidemia are very common in individuals affected by polycystic ovary syndrome (PCOS), but in addition to plasmatic lipids, it is necessary to evaluate the alterations in the atherogenic lipoproteins (Lp) and apolipoproteins (apo). In our study we measured the concentrations of apoB, Lp(a) and low density lipoproteins (LDL) in 42 patients with PCOS (age: 28 +/- 7 years, body mass index: 27 +/- 5 kg/m-) and 37 healthy women (of the same age and body mass index). Methods: values of Lp(a) >30 mg/dl were considered high, whereas for apoB, values >100 g/l were considered high. Results: the patients with PCOS showed an increase in triglycerides (p=0.0011) and low levels of high density lipoproteins (HDL) (p=0.0131), but the total cholesterol and the LDLs were not significantly different to those of the control group. High levels of Lp(a) were found in 24% of the individuals with PCOS, and a smaller number showed high levels of apoB (14%). This analysis shows that the concentrations of Lp(a) are only correlated to the HDL levels (r =0.378, p= 0.0431). 36% of the patients with PCOS with normal levels of plasmatic lipids show high levels of Lp(a) and apoB, and small and dense LDLs. Conclusions: alterations in the plasmatic lipids are present in 1/3 of the women affected by PCOS. More research is necessary to better understand the mechanisms responsible to reduce the risk of cardiovascular problems in young women with polycystic ovary syndrome

Bisphosphonate-associated femoral fracture: implication for management

Studies carried out on individuals being treated long term with bisphosphonates have provoked considerable interest and perplexity about the effect that these drugs have on bone turnover in the long run. In fact the experiences reported by numerous researchers tend to highlight how treatment with high doses of bisphosphonates over many years, of individuals with osteoporosis complicated by or secondary to neoplastic pathologies, causes a suppression of bone turnover that over time predisposes the bone to the accumulation of micro damage that can then result in complicated fractures, as in the case described here

Body composition of individuals with polycystic ovary syndrome

Polycystic ovary syndrome (PCOS) is one of the principle forms of hyperandrogenism that affects women of reproductive age. Few studies have evaluated the body composition of patients with PCOS being based mainly on an evaluation of the quantity and distribution of the fat mass. Objectives: to evaluate the body composition of patients affected by PCOS and to establish the hormonal factors that determine possible differences in body composition compared with healthy women. Methods: 110 Caucasian women affected by clinical hyperandrogenism and/or irregular menstrual periods were included in the study; the control group was made up of 90 healthy Caucasian women, of reproductive age, without hyperandrogenism. The control group and the patients were similar in age (23 ± 3 vs. 24.1 ± 6.4 years old) but not in body weight or body mass index (BMI). A hematic sample was taken from both groups, on the fifth day of the menstrual cycle, to measure the quantities of glycaemia, insulin, testosterone (T), SHBG and dehydroepiandrosterone sulphate (DHEAS). In the hyperandrogenic patients the quantities of serum 17-hydroxyprogesterone (on the 5th day of the menstrual cycle) and of progesterone (on the 22nd day of the menstrual cycle) were also measured. Moreover, the hyperandrogenic patients underwent a pelvic or intra-vaginal ultrasound scan to evaluate the ovarian morphology. Results: the patients with classic PCOS showed serum levels higher in testosterone, FAI and insulin than the patients with ovulatory PCOS and idiopathic hyperandrogenism; the patients with ovulatory PCOS had higher levels of testosterone, FAI and insulin (p<0.01) than the control group. The patients with Idiopathic Hyperandro-genism had higher levels of testosterone (p<0.01) and FAI (p<0.01) but similar levels of BMI and insulin, and similar waist circumference and body composition. Conclusions: the hyperandrogenic patients have a different body composition to normal women. The increase in the fat free mass seems to be primarily a consequence of hyperinsulinemia, as the fat free mass correlated significantly with the circulating insulin and the insulin resistance. Consequently, these alterations have an influence on the body composition and therefore both on the quantity and distribution of body fat and on the increase in muscle mass

Chemioterapia di II linea nel carcinoma epiteliale dell'ovaio. Studio di Fase II

Chemioterapia di II linea nel carcinoma epiteliale dell'ovaio. Studio di Fase II

Determinants of Left Atrial Compliance in the Metabolic Syndrome: Insights from the “Linosa Study”

The association between left atrial (LA) impairment and cardiovascular diseases (CVD) and between dyslipidaemia and CVD are well known. The present study aims to investigate the relationships between metabolic factors and LA dimensions and compliance, as well as test the hypothesis that metabolic factors influence LA function independent from hemodynamic mechanisms. Arterial blood pressure (BP), waist and hip circumference, metabolic indices, and a complete echocardiographic assessment were obtained from 148 selected inhabitants (M/F 89/59; age 20–86 years) of Linosa Island, who had no history of CVD. At enrollment, 27.7% of the subjects met the criteria for metabolic syndrome (MetS) and 15.5% for arterial hypertension (HTN). LA compliance was reduced in subjects with MetS compared to those without (53 ± 27% vs. 71 ± 29%, p = 0.04) and was even lower (32 ± 17%, p = 0.01) in those with MetS and HTN. At multiple regression analysis, the presence of MetS independently determined LA maximal area (r = 0.56, p p < 0.001). In an apparently healthy population with a high prevalence of MetS, dyslipidaemia seems to independently influence LA compliance. At a 5-year follow-up, LA compliance was reduced in both all-cause and CVD mortality groups, and markedly impaired in those who died of CVD. These findings may contribute to understanding the prognostic role of LA function in CVD and strengthen the need for early and accurate lipid control strategies

Effects of mud-pack treatment on plasma cytokine and soluble adhesion molecule levels in healthy volunteers

The suggested hypothesis of a direct anti-inflammatory property of mud-pack treatment has led us to speculate that its action on the cytokine network might counteract the heat-stress-related effects on platelet and endothelial cell function often reported following hot-spring baths. Therefore, the present study was designed to investigate the effects of a cycle of 12 daily mud-pack treatments on bio-humoral markers of inflammation, as well as on markers of in vivo platelet and/or endothelial cell activation, in plasma samples obtained from healthy volunteers. METHODS: Blood samples were obtained before (T(0)), at the end of the first treatment (T(1)) and after a cycle of 12 daily mud-pack treatments (T(2)). Plasma cytokines (TNF-alpha IL-1beta, and IL-6) and adhesion molecules (sP-selectin, sE-selectin and sVCAM) levels, as well as hematocrit and complete and differential blood cell counts were determined at every time point. RESULTS: Plasma sP-selectin levels were not modified during treatment, as were not sE-selectin or sVCAM. Similarly, IL-1beta and TNF-alpha levels were unchanged through a 12 daily mud-pack treatment. Conversely, plasma IL-6 levels were significantly lowered at the end of a 20-min 47 degrees C mud-pack treatment (p<0.01). CONCLUSIONS: The lack of effects on in vivo platelet and/or endothelial cell activation suggests that hot mud-pack treatment might be used as a relatively safe procedure in patients with atherothrombotic disorders

The role of OPG, RANK, RANKL in the bone metabolism, cardiovascular disease and immune system: Clinical and physiopathological implication

The bone remodelling process is characterized by alternate phases of production and resorption of the mineralized matrix, is possible by two types of cells: osteoblasts and osteoclasts. When these ones are subject to hormonal and cytokines stimulus, they express and produce a lot of proteic molecules that play an essential role in regulating the processes of activation and inhibition of osteoclastogenesis. Three molecules have been the subject of intense research in the field of bonebiochemistry: OPG, RANK and RANKL. OPG is a glycoprotein belonging to the TNFR superfamily. The importance of this molecule is confirmed by the presence of specific domains, that are essential for the osteoclastogenesis inhibition. OPG makes it by binding with RANKL. This event prevents the binding of RANKL to RANK, that is expressed in the osteoclasts, and inhibits the differentiation of pre-osteoclasts in mature osteoclast, RANKL is a peptide produced by osteoblasts cells. We review the physiopathologic implications of this molecules, and their implication in the immune and vascular system. Infact in the former it has been observed that RANKL expressed in the activated T cells, binds with RANK determining a inummomodulator final effect; in the latter it has been possible to observe that RANK and RANKL are expressed by endothelial cells, and regulate their survival