Menopausal status influences the relationship between serum ghrelin levels and fat mass in healthy women.

OBJECTIVE: To examine the relationships of fasting serum ghrelin levels to bone mass index (BMI) and body fat mass, focusing on the effects of menopausal status and changes in fat distribution in women after menopause. DESIGN: An observational study. PATIENTS: Fifty-nine pre-menopausal and 31 post-menopausal healthy Japanese women volunteers were enrolled in the present study. MEASUREMENTS: Total and regional body fat mass weight was measured by dual energy x-ray absorptiometry. Serum ghrelin was measured. Relationships of serum ghrelin levels to weight, BMI, total body and regional fat mass weight were separately examined in post-menopausal and pre-menopausal women. RESULTS: Serum ghrelin levels were significantly inversely correlated with weight (r = -0.377, p < 0.05, Pearson's correlation test), right arm fat mass (r = -0.408, p < 0.05), left arm fat mass (r = -0.386, p < 0.05), trunk fat mass (r = -0.361, p < 0.05) and total body fat mass (r = -0.383, p < 0.05) in the post-menopausal women but not in pre-menopausal women. CONCLUSIONS: Menopausal status may influence the relationship between serum ghrelin levels and fat mass in healthy women.

Perioperative changes in circulating leptin levels in women undergoing total abdominal hysterectomy.

To investigate the effects of total abdominal hysterectomy on circulating leptin levels, 16 pre- and 8 postmenopausal patients with uterine leiomyoma or carcinoma in situ of the uterine cervix were enrolled. Serum levels of leptin and fasting blood sugar (FBS) were determined before (day -7) and after surgery (day +1 and +7). Body mass index (BMI) was recorded at day -7 and +7. Anesthesia duration, surgical duration, hematology, and blood loss during surgery were recorded. Relations of these variables to serum leptin levels were investigated. Serum leptin levels rose from 7.3+/-4.7 ng/mL to 9.3+/-5.8 ng/mL at day +1 (P < 0.01), then decreased to 4.9+/-3.0 ng/mL at day +7 (P < 0.05 vs. values at day -7 and +1). FBS levels also rose from 89.4+/-7.5 mg/dL to 119.3+/-24.0 mg/dL (P < 0.01), then returned to normal at day +7 (96.2+/-9.0 mg/dL). However, there was no significant correlation observed between FBS and leptin levels at each time point (r < or = 0.22). BMI decreased from 22.7+/-3.0 kg/m2 to 21.7+/-2.9 kg/m2 at day +7 (P < 0.001). At day -7 and +7, leptin levels were positively correlatd with BMI (r = 0.79, P < 0.001 and r = 0.71, P < 0.001, respectively). Circulating leptin levels were increased on day one after total abdominal hysterectomy.

Waist to hip circumference ratio as a significant predictor of preeclampsia, irrespective of overall adiposity.

OBJECTIVE: To investigate whether abnormal body fat distribution is a significant predictor of the development of preeclampsia, irrespective of overall adiposity. METHODS: Twenty-six women with preeclampsia and 198 control women were enrolled. Waist to hip circumference ratio (WHR), body weight (BW), and body mass index (BMI, wt/ht2) were measured early in pregnancy (< 9 weeks of gestational age). Age, height, parity, tobacco usage, education period, gestational duration, and weight gain during pregnancy were also recorded for each subject. RESULTS: WHR, BMI, and BW early in pregnancy were significantly higher in the preeclampsia group (p < 0.0001). WHR, BMI, and BW positively correlated with the development of preeclampsia on univariate regression analysis (Standardized regression coefficient = 0.410, 0.387, and 0.363, respectively, p < 0.0001). On stepwise multiple regression analysis, WHR still correlated with the development of preeclampsia irrespective of BMI and BW. When the WHR predictive of the development of preeclampsia was set at 0.9, the sensitivity was 46.2% (12/26), which was significantly better than that of 25 of BMI (19.2%, 5/26; p < 0.05). CONCLUSION: Higher WHR is a significant predictor of the development of preeclampsia. This relation is irrespective of overall adiposity.

Relationships among serum testosterone levels, body fat and muscle mass distribution in women with polycystic ovary syndrome.

We investigated the relationships among serum testosterone levels, body fat and muscle mass distribution in women with polycystic ovary syndrome (PCOS). Subjects were 67 women with PCOS (mean age +/- standard deviation, 28.8 +/- 6.6 years). Baseline characteristics included age and height. Trunk-leg fat ratio and trunk-leg muscle ratio were assessed with dual-energy x-ray absorptiometry. Serum testosterone and dehydroepiandrosterone sulfate levels were measured with radioimmunoassays. Relationships among serum testosterone levels, body fat and muscle mass distribution were investigated using Pearson and partial correlation tests. Serum testosterone levels were positively correlated with trunk-leg fat ratio (r = 0.398, P < 0.01), but were inversely correlated with trunk-leg muscle ratio (r = -0.332, P < 0.05). Trunk-leg muscle ratio was inversely correlated with trunk-leg fat ratio (r = -0.360, P < 0.01). Serum testosterone levels were still correlated with trunk-leg fat ratio (r = 0.500, P < 0.001) and trunk-leg muscle ratio (r = -0.286, P < 0.05), after adjusting for age and height. Trunk-leg fat ratio was still correlated with trunk-leg muscle ratio, after adjusting for age, height, and serum testosterone levels. Based on these results, we concluded that higher serum testosterone levels may contribute to the upper body fat distribution and peripheral muscle mass distribution. In addition, peripheral muscle mass distribution may also contribute to the upper body fat distribution.

Differences in umbilical venous and arterial leptin levels by mode of delivery.

OBJECTIVE: To investigate the differences in umbilical venous and arterial leptin levels by mode of delivery. METHODS: Subjects were 30 mothers who had elective cesarean deliveries and 34 mothers who had vaginal deliveries. Umbilical venous and arterial leptin levels were measured immediately after delivery. Maternal age, neonatal gender, neonatal birth weight, placental weight, and gestational duration were recorded. Inter- and intragroup comparisons were made in umbilical venous and arterial leptin levels and obstetric variables. Significant determinants of differences in umbilical venous and arterial leptin levels were investigated. RESULTS: Umbilical venous and arterial leptin levels were higher in the vaginal delivery group (n = 34) than in the cesarean group (n = 30) (P <.01). In the vaginal delivery group, umbilical venous leptin levels were significantly higher than arterial leptin levels (P <.001). These differences were still significant after adjustment for neonatal gender, neonatal birth weight, and placental weight. However, in the cesarean group, leptin levels did not differ between umbilical vein and artery. CONCLUSION: Placental leptin release is augumented during advanced labor.

Body fat distribution as a risk factor of endometrial cancer.

OBJECTIVE: To investigate the relative contributions of upper body fat distribution and overall adiposity to endometrial cancer risk. METHODS: Subjects were 63 postmenopausal women with endometrial cancer aged less than 70 years and 201 age-matched controls. Age, age at menopause, years since menopause, height, weight, and body mass index were recorded at the time of admission. The trunk-leg fat ratio, body fat mass, trunk fat mass, and the percentage of body fat were measured by dual-energy X-ray absorptiometry. RESULTS: Trunk-leg fat ratio was higher in endometrial cancer patients than in controls (1.40 +/- 0.59 vs 1.23 +/- 0.39, p < 0.05). Whereas, other variables including age at menopause, percentage of body fat, body fat mass, and body mass index did not differ between the 2 groups. On stepwise multiple regression analysis, the trunk-leg fat ratio was still correlated with the presence of endometrial cancer (p < 0.05). CONCLUSIONS: Upper body fat distribution rather than overall adiposity is associated with endometrial cancer risk.

Differences in umbilical cord serum lipid levels with mode of delivery.

OBJECTIVE: To investigate whether umbilical cord serum lipid levels differ with mode of delivery. DESIGN: Retrospective observation study. POPULATION: Two hundred and ninety mothers aged 29.1 years (SD 4.7) who had vaginal delivery, and 44 mothers aged 30.4 years (SD 4.7) who had elective caesarean section were enrolled. MAIN OUTCOME MEASURES: Maternal and umbilical cord blood were obtained immediately after delivery. Serum lipid levels including total cholesterol, high density lipoprotein cholesterol, saturated fatty acid, mono-unsaturated fatty acid and polyunsaturated fatty acid were measured. Obstetric variables and serum lipid levels were compared between the two groups. In each group the correlations of fetal serum lipid levels with maternal serum lipid levels were investigated. RESULTS: There were no significant differences in maternal age, neonatal weight, gestational duration, placental weight and neonatal gender distribution between the two groups. Only the two fetal serum lipid levels (including total cholesterol and non-high density lipoprotein cholesterol) showed a correlation with maternal fetal lipid levels with correlation coefficients > 0.3 in the caesarean section group. However, saturated fatty acid, mono-unsaturated fatty acid and total fatty acid levels in the non-high density lipoprotein low density lipoprotein, very low density lipoprotein, intermediate density lipoprotein and free fatty acid fraction in the umbilical cord serum were significantly higher in the vaginal delivery cases (P < 0.01). CONCLUSIONS: Umbilical cord serum levels of saturated and mono-unsaturated fatty acids increase during vaginal delivery.

The sex differences in cord-blood cholesterol and fatty-acid levels among Japanese fetuses.

We examined serum cholesterol and fatty-acid levels of cord blood and maternal blood samples collected from 193 Japanese fetuses and their mothers. Our study, which is the largest study of this kind ever conducted in Japan, is the first Japanese study reporting that total, high density lipoprotein (HDL) and non-HDL cholesterol levels in females were statistically significantly higher than those in males; the sex differences of total, HDL and non-HDL cholesterol levels were 8.5 mg/dl (P = 0.002), 4.5 mg/dl (P = 0.004) and 4.1 mg/dl (P = 0.045), respectively. The sex difference of total cholesterol was attributable to both HDL and non-HDL cholesterol. The sex of fetuses didn't show evident differences in cholesterol levels in maternal sera. Fatty-acid levels in cord blood were also higher in female fetuses than in male fetuses. However, none of the differences except for monoene fatty acids were statistically significant. Further investigations seem warranted to elucidate the mechanisms involved in our results.

Sarcoidosis with tumorous hepatic and bone lesions mimicking disseminated malignancy: a case report.

An asymptomatic 49-year-old woman with a diffuse abnormal shadow detected on a routine chest rentogenogram was referred for evaluation. Ultrasonography, computed tomography (CT) and magnetic resonance imaging (MRI) revealed space-occupying lesions in the liver and spleen. Lymphadenopathy was observed in the mediastinum and abdomen on CT, and multiple lesions of low signal intensity were observed in the spine on MRI. Furthermore, the presence of multiple tumorous nodules in the liver suggesting metastatic hepatic cancer was demonstrated on laparoscopy. Biopsy of the liver tumors revealed sarcoidosis; transbronchial biopsy specimens showed identical histological features. After administration of prednisolone for one month, the space-occupying lesions in the liver, spleen and spine improved. This case of sarcoidosis exhibited hepatic tumorous nodules and space-occupying lesions in the spleen and the spine which mimicked the presence of metastatic hepatic cancer.