Lucas Fornari Laurindo, Giulia Minniti , Ricardo José Tofano , Karina Quesada , Eduardo Federighi Baisi Chagas, Sandra Maria Barbalho
Detection of Metabolic Syndrome Using Insulin Resistance Indexes: A Cross-Sectional Observational Cohort Study
Endocrines 2023, 4(2), 257-268
Insulin resistance (IR) is considered cardinal to the pathophysiology of metabolic syndrome (MetS). Previously, several simple indexes of IR calculated from biochemical and anthropometric variables have been proposed. However, these indexes are population-dependent; therefore, further studies on a global scale are necessary. The present study assessed the diagnostic accuracy of eight IR indicators, namely, METS-IR, TG-HDL-c, TyG, TyG-BMI, TyG-NC, TyG-NHtR, TyG-WC, and TyG-WHtR, in indicating MetS among a Brazilian population. For this, 268 patients (152 men and 116 women, 53–59 years of age) were included in the study, out of which 111 were diagnosed with MetS according to the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III). All indexes achieved significant accuracy, with TyG-WC (0.849 (0.800–0.889)), TyG (0.837 (0.787–0.879)), and TG-HDL-c (0.817 (0.765–0.861)) having the highest area under the curve (AUC). Further, the most heightened diagnostic sensitivities were observed for TG-HDL-c (90.99%), TyG-WC (89.19%), and TyG-NC (84.68%), whereas the highest diagnostic specificities were noted for TyG (73.89%), TyG-WHtR (72.61%), and TyG-WC (66.88%). Thus, TyG-WC, TyG, and TG-HDL-c reached the greatest AUC values in our analyses, making them useful diagnostic indicators of MetS, and crucial for patients’ clinical management.
Jinlin Xie, Na Li, Haiyan Bai, Juanzi Shi, He Cai
Overweight and obesity affect the efficacy of vaginal vs. intramuscular progesterone for luteal-phase support in vitrified-warmed blastocyst transfer Fertility and Sterility 2023, 119: 605-615
Objective: To compare the difference in the live birth rates (LBRs) between vaginal progesterone and intramuscular progesterone as luteal-phase support in programmed vitrified-warmed blastocyst transfer cycles and determine whether the association was moderated by overweight/obesity.
Design: Retrospective cohort study. Setting: Tertiary reproductive medicine center. Patient(s): Patients who underwent transfer of single vitrified-warmed blastocyst in a programmed cycle between January 2018 and June 2021.
Intervention(s): Vaginal or intramuscular progesterone as luteal-phase support. Analysis was performed using the generalized estimating equation framework and multivariate regression models. Interaction testing was used to determine whether overweight/obesity (body mass index of R25 kg/m2 ) moderated the association between progesterone replacement and LBRs.
Main Outcome Measure(s): The primary outcome was live birth. The secondary outcomes were biochemical pregnancy, clinical pregnancy, miscarriage, and total pregnancy loss.
Result(s): A total of 6,905 programmed cycles (4,616 with vaginal progesterone and 2,289 with intramuscular progesterone) were included in the analysis. In the general cohort who underwent cryopreserved blastocyst transfer, the LBRs were 46.23% and 48.62% in the vaginal and intramuscular progesterone groups, respectively (odds ratio [OR], 0.91; 95% confidence interval [CI], 0.82–1.01; adjusted OR [aOR], 0.89; 95% CI, 0.81–0.98), with a significantly increased rate of pregnancy losses in the vaginal progesterone group compared with that in the intramuscular progesterone group (22.22% vs. 18.90%; OR, 1.23; 95% CI, 1.08–1.39; aOR, 1.23; 95% CI, 1.08– 1.40). Among normal-weight women, the LBR in the vaginal progesterone group was lower than that in the intramuscular progesterone group (aOR, 0.84; 95% CI, 0.75–0.95). On the other hand, among women with overweight/obesity, the LBRs were similar between the 2 groups of progesterone replacement (aOR, 1.06; 95% CI, 0.86–1.33). Interaction testing of the routes of progesterone administration and overweight/obesity was significant.
Conclusion(s): Luteal-phase support with vaginal progesterone was associated with reduced LBRs compared with intramuscular progesterone for vitrified-warmed blastocyst transfer, and the association was modified by maternal overweight/obesity. Further research is needed to better understand the mechanisms behind the association. (Fertil Steril 2023;119:606-15. 2022 by American Society for Reproductive Medicine.)
Alexis Roditis, Marie Florin, Pascal Rousset, Cyril Touboul, Sofiane Bendifallah, Marc Bazot, Isabelle Thomassin-Naggara
Accuracy of combined physical examination, transvaginal ultrasonography, and magnetic resonance imaging to diagnose deep endometriosisFertility and Sterility 2023, 119: 634-643
Objectives: To assess the ability of physical examination (PE), transvaginal ultrasonography (TVUS), and magnetic resonance imaging (MRI) alone and combined to diagnose deep infiltrating endometriosis (DIE).
Design: We retrospectively queried our pelvic MRI database to identify women who underwent PE, TVUS, and pelvic MRI for DIE up to 12 months before surgery between January 1, 2016 and August 31, 2020. The presence of uterosacral ligaments (USL), vaginal, rectosigmoid (RS), parametrial, or sacrorectogenital septum (lateral) DIE shown by PE, TVUS, and MRI were correlated with surgical and histological findings.
Setting: Academic hospital. Patient(s): We included 178 patients.
Intervention(s): Clinical and imaging evaluation of women who were diagnosed at surgery with deep pelvic endometriosis.
Main Outcome Measure(s): The sensitivity, specificity, positive and negative predictive values, and accuracy of each technique sepa-rately and combined were assessed for each location. When the 3 techniques were combined, 2 models were tested as follows: all 3 techniques positive and concordant; and R2 techniques positive and concordant.
Result(s): The prevalence of USL, vaginal, RS, and lateral DIE were 94.4%, 20.2%, 34.3%, and 32.6%, respectively. In addition, MRI was more sensitive than PE, TVUS or any combination to detect DIE. Moreover, MRI and model B were the most accurate for detecting USL and RS locations with an accuracy of 90.4% and 82.6%, a sensitivity of 91.1% and 50%, and a specificity of 77.8% and 90.9%, respectively. Model B was the most accurate for the vaginal location with an accuracy, sensitivity, and specificity of 82.6%, 50%, and 90.9%, respectively. Finally, MRI was more accurate than any combination for identifying a lateral location with an accuracy, sensitivity, and specificity of 75.1%, 36%, and 93.8%, respectively.
Conclusion(s): A combination of PE, TVUS, and MRI was more accurate than each technique separately to diagnose DIE because of the equally high sensitivity of each, as well as the high specificity of PE and TVUS.
Sophia Von Stockuma, anja Bauerfeinda, Kerstin Beckera, christian Frankea, Franca Fruzzettib, Joaquim calafc, christoph Keckd, Klaas heinemann
NOMAC-E2 shows a better contraceptive effectiveness than LNG combined oral contraceptives in women under 25: real-world PRO-E2 studyGynecological Endocrinology 2023, Vol. 39, no. 1, 2162036
Objective: to investigate unintended pregnancy and changes in mood, acne, and weight in NOMac-e2 vs levonorgestrel-containing cOc (cOclNG) users under 25 years.
Methods: in this large, observational study, new users (first-ever users of an eligible cOc or restarting with the same or a new eligible cOc after a break of at least 2 months) of NOMac-e2 and cOclNG were recruited in 12 countries in europe, australia, and latin america and followed up via questionnaires for up to 2 years. Unintended pregnancy was expressed by the Pearl index (Pi; contraceptive failures/100 women-years). crude (hRcrude) and adjusted hazard ratios (hRadj) were calculated. Mood and acne changes were defined as change of score from baseline. Weight change was defined as percent change of body weight.
Results: Overall, 12,829 NOMac-e2 users and 17,095 cOclNG users under 25 were followed-up. the risk of unintended pregnancy was statistically significantly lower in the NOMac-e2 cohort; confirmed events: 30 NOMac-e2 (Pi 0.24; 95% ci, 0.16–0.35) vs 94 cOclNG (Pi 0.51; 95% ci, 0.41–0.62). the hRcrude for unintended pregnancy comparing NOMac-e2 to cOclNG was 0.47 (95% ci, 0.31–0.71) and the hRadj was 0.52 (95% ci, 0.34–0.78). No differential effect on acne, mood, and weight was observed between cohorts.
Conclusions: NOMac-e2 shows a significantly better contraceptive effectiveness in young women and has no differential effect on acne, mood, and weight compared to cOclNG
Jessica M. V. Pino , Vitoria F. Silva , Marcos Monico-Neto , Danielle C. Seva , Melissa Y. Kato , July N. Alves , Gabriela C. Pereira , Hanna Karen M. Antunes, Thales D. Galvao, Lia R. A. Bitterncourt, Sergio Tufk, Lysien I. Zambrano , Ana R. Damaso, Lila M. Oyama, David Thivel, Raquel M. S. Campos , Kil S. Lee
Severe Obesity in Women Can Lead to Worse Memory Function and Iron Dyshomeostasis Compared to Lower Grade Obesity
International Journal of Endocrinology Volume 2023, Article ID 7625720
Objective. Obesity is one of the modifable risk factors for dementia. Insulin resistance, the abundance of advanced glycated endproducts, and infammation are some of the mechanisms associated with the lower cognitive performance observed in obesity. This study aims to evaluate the cognitive function of subjects with distinct degrees of obesity, comparing class I and II obesity (OBI/II) to class III obesity (OBIII), and to investigate metabolic markers that can distinguish OBIII from OBI/II.
Study Design. This is a cross-sectional study, in which 45 females with BMI varying from 32.8 to 51.9 kg/m2 completed a set of 4 cognitive tests (verbal paired-associate test, stroop color, digit span, and Toulouse–Pieron cancellation test) and their plasma metabolites, enzymes, and hormones related to glycemia, dyslipidemia, and liver function, as well as the biomarkers of iron status, were concomitantly analyzed.
Results. OBIII showed lower scores in the verbal paired-associate test compared to OBI/II. In other cognitive tests, both groups showed similar performance. OBIII presented a lower iron status compared to OBI/II based on total iron binding capacity, degree of transferrin saturation, hemoglobin, mean corpuscular volume, and mean corpuscular hemoglobin. Te levels of indicators for glycemia, liver function, and lipid metabolism were similar in both groups. Analysis of plasma metabolites showed that OBIII had lower levels of pyroglutamic acid, myoinositol, and aspartic acid and higher levels of D-ribose than OBI/II.
Conclusion. Iron is an essential micronutrient for several metabolic pathways. Thus, iron dyshomeostasis observed in severe obesity may aggravate the cognitive impairment by altering metabolic homeostasis and enhancing oxidative stress. These fndings can contribute to searching for biomarkers that indicate cognitive performance in the population with obesity
Guqiao Nie, Jing jing Wan, Lei Jiang, Shu kai Hou, Wen Peng
Correlation Analysis between Uric Acid and Metabolic Syndrome in the Chinese Elderly Population: A CrossSectional Study
International Journal of Endocrinology Volume 2023, Article ID 8080578
Background. Currently, both metabolic syndrome and hyperuricaemia have attracted extensive attention in public health. Te correlation between uric acid and metabolic syndrome is controversial. Research on the relationship between uric acid and metabolic syndrome in community-dwelling elderly people is relatively lacking. The purpose of this study is to explore the relationship between uric acid and metabolic syndrome in the community-dwelling elderly people.
Design. Cross-sectional study.
Methods. We collected the physical examination data of 1,267 elderly people in Gutian community in Wuhan and used SPSS IBM 25.0 for data analysis. Correlation and logistic regression analyses were performed, and ROC curves were drawn.
Results. The uric acid level of the nonmetabolic syndrome group was lower than that of the metabolic syndrome group (337.31 vs. 381.91 µmol/L; P < 0.05). Uric acid was positively correlated with systolic blood pressure (r = 0.177, P < 0.001), diastolic blood pressure (r = 0.135, P < 0.001), body mass index (r =0.234,P < 0.001), waist circumference (r = 0.283, P < 0.001), and triglycerides (r = 0.217, P < 0.05). High-density lipoprotein cholesterol (r = −0.268, P < 0.001) showed the opposite trend. Logistic regression analysis results suggested that uric acid is a risk factor for metabolic syndrome. The result is described as exp (B) and 95% CI (1.003 [1.001, 1.005]). Based on the receiver operating characteristic curve, we found that the area under the curve of uric acid to diagnose metabolic syndrome was 0.64 (sensitivity: 79.3%, specifcity: 45.1%).
Conclusion. We observed an association between uric acid levels and metabolic syndrome in the elderly Chinese population. Te best threshold value for uric acid in predicting metabolic syndrome diagnosis was 314.5 μmol/l.
ConghuiHu , Yinxia Su, XiaoyuanHu, Kun Luo, Alimire Abudireyimu, Yuanyuan Li, Hua Yao
The Effect of the Interaction between Abnormal Body Mass Index and Hypertension on the Risk of Type 2 DiabetesInternational Journal of Endocrinology Volume 2023, Article ID 6009414
Objective. Many patients with type 2 diabetes have an abnormal body mass index (BMI) and hypertension together, but few studies on the interaction of the two on the risk of T2DM are reported. We aim to explore the efect of the interaction between abnormal BMI and hypertension on the risk of type 2 diabetes mellitus (T2DM) in Uyghur residents.
Methods and Results. Based on the physical examination data of 27,4819 Uygur residents in Moyu County, a logistic regression model was used to analyze the correlation between BMI abnormality, hypertension, and T2DM disease, and then, the efect of their interaction on the risk of T2DM was evaluated by an additive model and a multiplicative model. Te results showed that the detectable rate of T2DM was 5.58%, the proportion of abnormal BMI was 59.49%, and the proportion of hypertension was 25.14%. Te risk of T2DM in people with an abnormal BMI and hypertension was higher than that in people with a normal weight and without hypertension, and the diference was statistically signifcant (P < 0.05). Te additive model showed that after adjusting for confounding factors such as gender, age, family history of diabetes, abdominal obesity, and alcohol consumption, abnormal BMI and hypertension had a synergistic efect on the risk of T2DM and the evaluation indicators RERI, AP, and S were 0.90 (0.32∼1.49), 0.20 (0.11∼0.30), and 1.36 (1.17∼1.57), respectively. But there was no multiplicative interaction between the two (OR = 0.97, (95% CI: 0.89∼1.06). 3).
Conclusion. Te interaction between abnormal BMI and hypertension can increase the risk of T2DM, and improving BMI and controlling blood pressure within the normal range can efectively reduce the risk of T2DM.