ABSTRACT
Background & objectives: Insulin resistance (IR) is a major confounding factor in polycystic ovarian syndrome (PCOS) irrespective of obesity. Its exact mechanism remains elusive till now. C/T polymorphism in the -34 promoter region of the CYP17 gene is inconsistently attributed to elucidate the mechanism of IR and its link to hyperandrogenemia in obese PCOS patients. In the present study we aimed to evaluate any association of this polymorphism with IR in non-obese women with PCOS. Methods: Polymorphism study was performed by restriction fragment length polymorphism (RFLP) analysis of the Msp A1 digest of the PCR product of the target gene in 75 PCOS cases against 73 age and BMI matched control women. Serum testosterone, BMI and HOMA-IR (homeostatic model of assessment-insulin resistance) were analyzed by standard techniques. A realistic cut-off value for the HOMA-IR was obtained through receiver operating characteristic (ROC) curve for exploring any possible link between IR and T/C polymorphism in the case group. Results: Significant increases in serum testosterone and HOMA-IR values were observed among the case group (P<0.001) without any significant elevation in BMI and FBG compared to controls. Cut-off value for IR in the PCOS patients was 1.40 against a maximum sensitivity of 0.83 and a minimum false positivity of 0.13. The analysis revealed an inconclusive link between the C/T polymorphic distribution and insulin resistant case subjects. Interpretation & conclusions: The results showed that CYP17A1 gene was not conclusively linked to either IR or its associated increased androgen secretion in non-obese women with PCOS. We propose that an increased sensitivity of insulin on the ovarian cells may be the predominant reason for the clinical effects and symptoms of androgen excess observed in non-obese PCOS patients in our region.
ABSTRACT
Thyroid hormone deficiency (hypothyroidism) leads to many serious conditions in body. Oxidative stress (OS), a state of excess free radicals and reactive metabolites formation which ultimately leads to an imbalance between the production of oxidants and their elimination by antioxidative systems in the body. Researchers all around the globe are in search of the link between this oxidative stress by estimating its different markers and hypothyroidism. In this present study oxidative stress is evaluated in hypothyroidism by estimating serum ischaemia modified albumin (IMA) and malondialdehyde (MDA). Settings and Design: 56 patients attending different Out-Patient Department (OPD) who have fulfilled inclusion criteria were included as cases and 43 apparently healthy persons were selected as control. Serum fT4 and TSH level measured by immunoassay and serum IMA and MDA level measured by well standardised validated methods. Results: By undertaking independent sample‘t’ test it is found that mean and standard deviation (SD) of IMA (t=4.149, p<0.001) and MDA (t=19.171, p<0.001) are significantly increased in case group than the control group. In case group it was found that serum IMA & MDA are significantly correlated with fT4 {r= -0.835 (IMA) & -0.765(MDA)} & TSH {(r= +0.859(IMA) & +0.672(MDA)}.
ABSTRACT
Cerebrovascular accident or stroke is defined by an abrupt onset of neurological deficit that is attributable to a focal vascular cause. Stroke is a major cause of morbidity and mortality worldwide. This may result from brain infarction or hemorrhage. Carotid atherosclerosis is a reasonable risk factor for cerebral ischemic stroke. Deranged lipid metabolism due to various modifiable and non-modifiable risk factors leads to the pathogenesis of atherosclerosis. This study is intended to find out any association between altered lipid metabolism (Cholesterol, Triglycerides, LDL : HDL ratio) and development of cerebral ischemia. An observational case control study was conducted with 50 cases of cerebral ischemia and 50 age & sex matched healthy controls within age group 50-70 years. After inclusion of cases and controls and taking informed consent they underwent history taking, proper clinical examination &biochemical investigations (lipid profile). Then data were collected and results were statistically analyzed using Chi-square test & Independent Sample “Ttest”. The study showed altered lipid profile is associated with cerebral ischemia by increasing carotid intima media thickness (IMT). There was significant (p<0.001) dyslipidemia (NCEP ATP III guidelines) in cases as compared to controls. Hence early diagnosis and monitoring of dyslipidemia and treatment of the high risk group with anti hyperlipidemic drugs will help to prevent the incidence of cerebral ischemic stroke thereby reducing morbidity and mortality.