Endocrinology and Metabolism

Review Article

Obesity and Metabolism
An Update on Contraception in Polycystic Ovary Syndrome: Seda Hanife Oguz, Bulent Okan Yildiz; Endocrinol Metab. 2021;36(2):296-311. Published online April 15, 2021; DOI: https://doi.org/10.3803/EnM.2021.958

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Polycystic ovary syndrome (PCOS) is a common endocrine disorder in reproductive-aged women, characterized by hyperandrogenism, oligo/anovulation, and polycystic ovarian morphology. Combined oral contraceptives (COCs), along with lifestyle modifications, represent the first-line medical treatment for the long-term management of PCOS. Containing low doses of estrogen and different types of progestin, COCs restore menstrual cyclicity, improve hyperandrogenism, and provide additional benefits such as reducing the risk of endometrial cancer. However, potential cardiometabolic risk associated with these agents has been a concern. COCs increase the risk of venous thromboembolism (VTE), related both to the dose of estrogen and the type of progestin involved. Arterial thrombotic events related to COC use occur much less frequently, and usually not a concern for young patients. All patients diagnosed with PCOS should be carefully evaluated for cardiometabolic risk factors at baseline, before initiating a COC. Age, smoking, obesity, glucose intolerance or diabetes, hypertension, dyslipidemia, thrombophilia, and family history of VTE should be recorded. Patients should be re-assessed at consecutive visits, more closely if any baseline cardiometabolic risk factor is present. Individual risk assessment is the key in order to avoid unfavorable outcomes related to COC use in women with PCOS.

Citations

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Expert Opinion on Pharmacotherapy.2023; 24(1): 105. CrossRef
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Original Articles

Obesity and Metabolism
Associations between Dietary Acid-Base Load and Cardiometabolic Risk Factors in Adults: The Tehran Lipid and Glucose Study: Zahra Bahadoran, Parvin Mirmiran, Hadise Khosravi, Fereidoun Azizi; Endocrinol Metab. 2015;30(2):201-207. Published online June 30, 2015; DOI: https://doi.org/10.3803/EnM.2015.30.2.201

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Abstract PDF PubReader

Background

In this study we investigated the associations of dietary acid-base load, identified by potential renal acid load (PRAL) and protein to potassium (Pro:K) ratio, with cardiometabolic risk factors in Tehranian adults.

Methods

A cross-sectional study was conducted within the framework of the fourth phase of the Tehran Lipid and Glucose Study (2009 to 2011) on 5,620 men and women aged 19 to 70 years. Dietary data were collected by a trained dietitian using a validated, 147-food item, semi-quantitative food frequency questionnaire, and dietary PRAL and Pro:K ratio were calculated. Multiple linear regression models with adjustment for potential confounding variables were used to evaluate the associations of dietary acid-base load with anthropometric measures, blood pressure, serum triglycerides, high density lipoprotein cholesterol (HDL-C), serum creatinine, and fasting blood glucose.

Results

The mean±SD age of the participants was 39.8±12.8 years and 54% of participants were women. Mean±SD PRAL was -22.0±29.1; mean PRAL was -15.6 in men and -26.8 in women. Dietary PRAL was associated with weight (β=0.098, P<0.001), waist circumference (β=0.062, P<0.01), serum triglycerides (β=0.143, P<0.01), HDL-C (β=-0.11, P<0.01), diastolic blood pressure (β=0.062, P<0.01), and serum creatinine (β=0.142, P<0.001). Pro:K ratio was associated with weight (β=0.055, P<0.001), waist circumference (β=0.04, P<0.01), serum HDL-C (β=-0.06, P<0.01), serum triglycerides (β=0.03, P<0.05), diastolic blood pressure (β=0.026, P<0.05), and serum creatinine (β=0.07, P<0.01).

Conclusion

A more acidic dietary acid-base load may be a risk factor for the development of metabolic disorders.

Citations

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Obesity and Metabolism
Helicobacter pylori Stool Antigen Levels and Serological Biomarkers of Gastric Inflammation are Associated with Cardio-Metabolic Risk Factors in Type 2 Diabetic Patients: Zahra Bahadoran, Parvin Mirmiran, Maryam Zarif-yeaganeh, Homayoun Zojaji, Fereidoun Azizi; Endocrinol Metab. 2015;30(3):280-287. Published online May 18, 2015; DOI: https://doi.org/10.3803/EnM.2015.30.3.280

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30 Download
5 Web of Science
4 Crossref

Abstract PDF PubReader

Background

Helicobacter pylori infection and subsequent gastric inflammation have been proposed as risk factors for the development of insulin resistance and cardiovascular disease. In this study we assessed the possible association of H. pylori bacterial load, and serum biomarker of gastric inflammation with cardiometabolic risk factors in diabetic patients.

Methods

In this cross-sectional study, 84 H. pylori-infected type 2 diabetic patients were assessed for anthropometrics, biochemical and clinical measurements. Pearson correlation test, linear, and logarithmic regression curve estimation models were used to assess the association of H. pylori stool antigen (HpSAg) levels, and pepsinogen I (PGI) to pepsinogen II (PGII) ratio with fasting serum glucose, insulin, serum lipid and lipoprotein parameters, malondialdehyde, high-sensitive C-reactive protein (hs-CRP), systolic and diastolic blood pressure, body weight, waist circumference and lipid accumulation product (LAP) index.

Results

The mean age of participants was 54±10 years, and 44% were men. Mean HpSAg levels and PGI/PGII ratio were 0.24±0.23 µg/mL and 9.9±9.0, respectively. Higher HpSAg as well as lower PGI/PGII was correlated with higher anthropometric measures and LAP. A significant negative correlation between PGI/PGII ratio and blood pressure (r=-0.21 and r=-0.22, systolic and diastolic, respectively, P<0.05), serum insulin (r=-0.17, P=0.05), and hs-CRP (r=-0.17, P=0.05) was observed. A significant linear association between PGI/PGII ratio with serum triglycerides (β=-0.24, P<0.05), serum high density lipoprotein cholesterol (HDL-C; β=0.43, P<0.01), and triglycerides/HDL-C ratio (β=-0.28, P<0.05) were observed.

Conclusion

Higher H. pylori bacterial load and lower PGI/PGII ratio was associated with higher levels of cardiometabolic risk factors in H. pylori infected type 2 diabetic patients.

Citations

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Both diet and Helicobacter pylori infection contribute to atherosclerosis in pre- and postmenopausal cynomolgus monkeys
Traci L. Testerman, Cristina Semino-Mora, Jennifer A. Cann, Beidi Qiang, Edsel A. Peña, Hui Liu, Cara H. Olsen, Haiying Chen, Susan E. Appt, Jay R. Kaplan, Thomas C. Register, D. Scott Merrell, Andre Dubois, Xianwu Cheng
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