Klinefelter syndrome, insulin resistance, metabolic syndrome, and diabetes: review of literature and clinical perspectives

Klinefelter syndrome (KS), the most frequent chromosomic abnormality in males, is associated with hypergonadotropic hypogonadism and an increased risk of cardiovascular diseases (CVD). The mechanisms involved in increasing risk of cardiovascular morbidity and mortality are not completely understood. Insulin resistance, metabolic syndrome, and type 2 diabetes are more frequently diagnosed in KS than in the general population; however, the contribution of hypogonadism to metabolic derangement is highly controversial. Whether this dangerous combination of risk factors fully explains the CVD burden of KS patients remains unclear. In addition, testosterone replacement therapy only exerts a marginal action on the CVD system. This review summaries the current understandings of the complex relationship between KS, metabolic syndrome and cardiovascular risk in order to plan future studies and improve current strategies to reduce mortality in this high-risk population. Since fat accumulation and distribution seem to play a relevant role in triggering metabolic abnormalities, an early diagnosis and a tailored intervention strategy with drugs aimed at targeting excessive visceral fat deposition appear necessary in patients with KS

Homepage of the DMD portal.

<p>The ‘Database' section allow the user to access database tables to consult (by system’s public access) or add, edit, and delete epidemiological data (by system’s authorized access).</p

A Web Geographic Information System to share data and explorative analysis tools: The application to West Nile disease in the Mediterranean basin - Fig 1

<p><b>Datasets displayed by the web GIS</b>–<b>(A)</b> WNV distribution and outbreaks since 1994 (points for outbreaks and polygons for disease distributions), <b>(B)</b> Phylogenetic tree of selected WNV strains, <b>(C)</b> MODIS Day Land Surface Temperature (DLST) January 2011, and <b>(D)</b> Geographical distribution of the Countries. (The MODIS image derives from open data downloaded from NASA EOSDIS Land Processes DAAC, USGS Earth Resources Observation and Science (EROS) Center at <a href="http://eros.usgs.gov/#" target="_blank">http://eros.usgs.gov/#</a> (<a href="https://lpdaac.usgs.gov/" target="_blank">https://lpdaac.usgs.gov</a>). The shapefile related to admistrative units of the countries is downloaded from Natural Earth at <a href="http://www.naturalearthdata.com/" target="_blank">http://www.naturalearthdata.com/</a>).</p

Number of WNV outbreaks and strains stored in the DMD database since 1994.

<p>Number of WNV outbreaks and strains stored in the DMD database since 1994.</p

PhyloWN section interface for 95 selected West Nile strains.

<p>Left side: map with the selected strains; right, the phylogenetic tree (rectangular mode). (The shapefile related to admistrative units of the countries is downloaded from Natural Earth at <a href="http://www.naturalearthdata.com/" target="_blank">http://www.naturalearthdata.com/</a>).</p

Database structure and table relationship.

<p>The DMD database contains a set of support tables to facilitate the database updating (i.e. the decoding tables of diseases, species, diagnosis and vectors), and tables containing epidemiological information and environmental and climatic data.</p

Preliminary environmental and climatic analysis.

<p>Values for the 6 months preceding the start date of the outbreak are displayed in tab (DLST) and graph format (Chart tab). (The MODIS image derives from open data downloaded from NASA EOSDIS Land Processes DAAC, USGS Earth Resources Observation and Science (EROS) Center at <a href="http://eros.usgs.gov/#" target="_blank">http://eros.usgs.gov/#</a> (<a href="https://lpdaac.usgs.gov/" target="_blank">https://lpdaac.usgs.gov</a>)).</p

DMD system architecture.

<p>DMD system architecture.</p

‘DOWNLOAD’ tab to download the list of selected outbreaks and the related environmental and climatic data as excel spreadsheet format.

<p>‘LEGEND’ panel to properly interpret the symbols and colours in the disease map.</p

Disease section interface.

<p>(The MODIS image derives from open data downloaded from NASA EOSDIS Land Processes DAAC, USGS Earth Resources Observation and Science (EROS) Center at <a href="http://eros.usgs.gov/#" target="_blank">http://eros.usgs.gov/#</a> (<a href="https://lpdaac.usgs.gov/" target="_blank">https://lpdaac.usgs.gov</a>)).</p