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Due to prolonged life expectancy, people's requirements for quality of life are also increasing. As a protein anabolic hormone, testosterone not only improves muscle and bone health, but also improves energy and sexual function. It is widely used in middle-aged and elderly people, especially in patients with delayed-onset hypogonadism( LOH). However, as several clinical studies have found that testosterone supplementation increases cardiovascular risk, the use of testosterone decreased sharply, and some patients who require testosterone therapy thus do not receive treatment timely. This article summarizes the current clinical research results and analyzes the dilemma of testosterone supplementation therapy.
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Objective To investigate serum lipid profiles in newly diagnosed patients with polycystic ovary syndrome (PCOS) using lipidomics and correlate these features with hyperinsulinemia and hyperandrogenism associated with PCOS and obesity. Methods 32 newly-diagnosed PCOS women and 34 controls were enrolled and divided into obese and lean subgroups according to the body mass index (BMI). Anthropometric, biochemical, and hormonal parameters were collected. Serum lipid profiles including phospholipids, free fatty acids (FFAs), and bioactive lipids were analyzed using GC-MS and LC-MS. Results PCOS patients, in particular, the obese ones with fatty liver, have abnormal phosphatidylcholine (PC)/lysophospholipid (LPC) metabolism. PC was increased (16∶0, 18∶0, 18∶1, 18∶2, and 20∶4), while LPC was decreased (16∶0, 18∶0, and 18∶1; all P<0.05). Serum polyunsaturated fatty acids (PUFAs), were decreased significantly, and the long chain saturated fatty acid was increased. We also found that insulin stimulated the metabolism of PUFAs, but the androgen inhibits the metabolism of PUFAs by measuring their metabolites. Conclusion PCOS patients have metabolic disorders of phospholipids and PUFAs. Insulin stimulated while androgen inhibited PUFAs metabolism.
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Polycystic ovary syndrome ( PCOS) is a complex syndrome with clinical manifestations of both endocrine and metabolic disorders. The etiology and pathogenesis are complex. PCOS seriously affects reproductive function, and also significantly increases the risk of metabolic and cardiovascular diseases, which often requires long-term intervention, with uncertain efficacy. Proteomics and lipidomics/metabolomics are efficient methods to determine the metabolic disorders using liquid/gas chromatography-tandem mass spectrometry ( LC/GC-MS/MS ) . A deeper understanding of the metabolic characteristics presented in different subtypes of PCOS may, in future, be able to find new biomarkers and to guide some novel precise interventions.
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Objective To investigate the clinical effects of fluoxetine combined with small doses of aripiprazole in treatment of post -stroke depression and the influence on the recovery of neurological function. Methods 74 patients with post stroke depression were randomly divided into the two groups,all patients were given routine comprehensive treatment,the control group treated with fluoxetine,while the observation group was treated with fluoxetine combined with small doses of aripiprazole,clinical curative effect,neurological deficits and activities of daily living of the two groups were compared.Results The total effective rate of the observation group was 94.59%,which was significantly higher than 78.38% of the control group (χ2 =9.78,P0.05).Conclusion Fluoxetine combined with small dose of aripiprazole has an ex-act effect in the treatment of post stroke depression,with high security.
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Objective To investigate the relationship between the serum dehydroepiandrosterone sulfate ( DHEAS) level and bone mineral density ( BMD) in aged women. Methods Two hundred and seven elderly women aged 60-84 years were enrolled in the study. Acquisition histories, including age, body mass index, and blood pressure were recorded. Serum steroid hormones ( DHEAS, testosterone, estradiol, and cortisol) and bone metabolic markers:β-C-terminal telopeptide of type Ⅰ collagen (β-CTx ) , osteocalcin, and total procollagen type Ⅰ N propeptide ( TPINP) were determined. The BMD was also determined. The enrolled subjects were divided into 3 groups according to T values(T>-1. 0 s、-2. 5 s
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Objective To determine whether the single nucleotide polymorphisms (SNPs) rs231775 and rs3087243 of the cytotoxic T lymphocyte antigen 4 (CTLA-4) gene are associated with susceptibility to Graves' disease (GD) in Chinese Han population.Methods Patients were enrolled from outpatient department and wards.Blood samples from each subject were collected to extract DNA,and the genotypes were determined by TagMan-MGB probe.Results The frequencies of allele G (OR =1.244,95％ CI 1.124-1.377,P＜0.01) and genotype GG (55.3 ％ vs 49.1％,OR =1.279,95 ％ CI 1.126-1.454,P＜0.01) of rs231775 in GD group were higher than those in control group.The frequencies of allele G (OR =1.303,95％ CI 1.166-1.457,P＜0.01) and genotype GG (76.8％ vs 71.8％,OR=1.302,95％ CI 1.143-1.484,P＜0.01) of rs3087243 in GD group were also higher.Conclusion GG genotypes in rs231775 and rs3087243 of CTLA-4 gene are related to the high risk of GD.
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Objective To explore the prevalence of polycystic ovary syndrome (PCOS) in nurse of reproductive age and compare the characteristics of four phenotypic subgroups.Methods A cross-sectional survey was carried out in nurses aged 18-45 years in Renji Hospital in 2011.Questionnaire and anthropometric and biochemical assessments were made.Pelvic ultrasound evaluations were made and blood androgen levels were determined.Diagnosis of PCOS was based on Rotterdam 2003 criteria,consisting of anovulation/oligo-ovulation (ANOVU),clinical and/or biochemical hyperandrogenism (HA) and polycystic ovaries (PCO).Results There were 520 participants and finally 486 individuals finished questionnaire and androgen level determination.283 subjects were totally normal,48 suffered from PCO,129 HA,and 89 ANOVU.54 out of 486 women were diagnosed as PCOS,a prevalence of 11.1％.A significant difference exited only in age among four phenotypic subgroups (P＜0.05).There was no statistic difference in other parameters.Conclusion Establishing an explicit definition of each condition in PCOS criteria has important investigational implications and increase the comparability of published researches.Application of Rotterdam criteria is feasible for earlier diagnosis and timely intervention in order to prevent serious complications.
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Objective To investigate the relationship between serum uric acid level and body fat depots as well as the possible influencing factors of the relationship in type 2 diabetic patients.Methods Five hundred and thirty two patients hospitalized for type 2 diabetes were recruited in this study.According to serum uric acid,the subjects were classified into normal uric acid group (group NUA,n =426) and high uric acid group ( group HUA,n =106 ).Anthropometry ( BMI,waist circumference,hip circumference and WHR),serum uric acid level,blood glucose,renal function and lipid levels were compared between the two groups.Results Serum uric acid level was closely related to body fat distribution:(1) in group HUA,WHR,BMI,BUN,SCr and TG were significantly higher than that of group NUA ( [ 0.94 ± 0.07 ] vs.[ 0.91 ± 0.07 ],[ 26.91 ± 3.90 ]kg/m2 vs.[23.84 ±3.80] kg/m2,[8.66 ±5.94] mmol/L vs.[6.29 ±3.64] mmol/L,[93.9 ± 67.6 ] μmol/Lvs.[63.9 ± 20.6 ] μmol/L,[ 2.65 ± 1.92 ] mmol/L vs.[ 1.86 ± 1.46 ] mmol/L,respectively; all P ＜ 0.05 ] ;while HDL-C was lower in Group HUA than in group NUA ( [ 1.09 ± 0.32 ] mmol/L vs.[ 1.24 ± 0.45 ] mmol/L,P ＜0.05).(2) Multiple regression analysis revealed that the serum uric acid levels were positively correlated with BMI,SCr,and TG ( b =0.201,0.500,0.153,respectively,P ＜ 0.05 ),but negatively correlated with HbA(1)c and HDL-C ( b =- 0.168 and - 0.121,P ＜ 0.05 ).Conclusion In patients with type 2 diabetes,serum uric acid levels are closely related with the BMI and Glucose/lipid metabolism,which suggests that body weight control is as important as the uric acid lowering treatment in patients with type 2 diabetes to cut the risks of cardiac and vascular diseases.
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To study the function of lipoprotein lipase (LPL)with Asn291 Ser and Lys312insC compound mutation in LPL gene knockout heterozygous (LPL~(+/-)) mice. The results showed that triglycerides, free fatty acids, blood glucose and weight of LPL~(+/-) mice were higher than those of c57 mice(P<0. 05). The expressions of LPL Mrna and LPL protein of LPL~(+/-) group were lower than those of c57 group(P<0.05). The injection of Asn291Ser +Lys312insC protein caused little change of the lipid mass and LPL activity,but the injection of normal LPL protein induced obvious decrease of lipid mass and increase of the LPL activity.
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PPARγ2 gene C1431T polymorphism was assayed by PCR-RFLP in 200 polycystic ovary syndrome( PCOS)patients and 150 normal subjects. Serum adiponectin and leptin levels were determined by ELISA method. Polymorphism of the site might be associated with serum leptin and adiponectin concentrations and thiazolidinedione treatment in women with PCOS ( P<0.05 or P<0.01).
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Diabetic rat model was induced by high fat diet combined with streptozotocin (STZ). After the model was established, blood samples were taken from jugular veins to examine plasma adrenocorticotropic hormone (ACTH) and corticosterone, and hypothalamus and pituitary were removed for real-time PCR. There were no significant differences in basal plasma ACTH and corticosterone level among control, obese, and obese diabetic rats (P=0.07). The corticosterone rhythm in obese and obese diabetic rats was impaired. Hypothalamus glucocorticoid receptors (GR) mRNA expressions yielded similar results in the groups, but 11β-HSD1 mRNA expression in obese diabetic rats was up-regulated ( vs control rats, P<0.05 ). The expressions of GR and 11β-HSD1 in pituitary of obese diabetic and obese rats were significantly down-regulated (both P<0.05). In the obese diabetic rats, the impaired glucocorticoid negative feedback was partly due to down-regulation of 11 β-HSD1 and GR expressions in pituitary.
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The plasma level and the regulation of cortisol in type 2 diabetic patients were invesligated.Plasma and urinary cortisol levels were measured, and dexamethasonc suppression test and oral cortisone test in vivo were performed. Compared with controls, diabetic patients had higher urinary cortisol level. The activity of hepatic 11 β-hydroxy-steroid dehydrogenase-1 (11β-HSD1) in type 2 diabetic patients was decreased, suggesting that the elevated basal cortisol in type 2 diabetic patiens may due to impaired hepatic degradation of cortisol.
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Objective To investigate the function of the hypothalamic-pituitary-adrenal (HPA) axis in postmenopausal women with type 2 diabetes and visceral obesity. Methods Subjects were divided into three groups:control group(group C),type 2 diabetes mellitus with non-obesity group (group DM) and type 2 diabetes mellitus with visceral obesity group (group DM + OB). General clinical characteristics, morning blood cortisol concentrations and 24 h urine free cortisol of three groups were compared. Serum cortisol levels were also compared after 0.25 mg dexamethasone suppression test and followed by oral intake of 25 mg cortisone acetate. Results (1) There were no significant differences in basal cortisol levels, but after inhibition with dexamethasone the group DM + OB showed significantly higher cortisol level than that in the control group (P < 0.01). (2) Conversion of oral cortisone to plasma cortisol differed significantly between the group C (lower) and group DM + OB (P < 0.05). (3) Plasma LH and FSH concerntrations were significantly lower in group DM + OB compared with group C (P < 0.01). Conclusion In the postmenopausal women with type 2 diabetes mellitus, the negative feedback mechanism and hepatic 11β-HSD-1 activity were impaired, especially in those with visceral obesity.
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Objective To prepare rabbit antibody against mouse AD-004 by AD-004 expressed in the prokaryotic expression system and to identify its distribution in the testis and adrenal. Methods The full-length cDNA of mouse AD-004 was cloned into PET28 plasmid, and the protein was induced in E. coli BL21 bacteria by adding IPTC and then purified by Ni2+ -NTA column. The purified protein was used as an immunogen to prepare polyclonal antibody ( pAb) of AD-004. The specificity of the antibody was detected by Western blotting. Immunohistochemical staining was performed in the mouse adrenal and testis via pAb of AD-004. Results Hisfused AD-004 was expressed efficiently in the prokaryotic system. Western blot analysis showed that the polyclonal antibody was duly bound to purified AD-004 with high specificity and sensitivity. AD-004 could be abundantly identified in the adrenal medulla and mainly expressed in the Leydig cells of testis. Conclusion The mouse protein of AD-004 is obtained from the prokaryotic expression system. The rabbit anti-AD-004 antibody has been prepared successfully. AD-004 protein is mainly localized in the interstitium of testis, suggesting that AD-004 may play a role in the synthesis of sex-steroid hormone.