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- Eriksson, Maria A, 1965-, et al.
(författare)
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Sex-related differences in the associations between hyperleptinemia, insulin resistance and dysfibrinolysis
- 2008
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Ingår i: Blood Coagulation and Fibrinolysis. - : Lippincott Williams & Wilkins. - 1473-5733 .- 0957-5235. ; 19:7, s. 625-632
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Tidskriftsartikel (refereegranskat)abstract
- The adipocyte-derived hormone leptin is associated with insulin resistance and reduced fibrinolytic status - or dysfibrinolysis - in humans. As leptin associates differentially to the development of cardiovascular disease and diabetes in men and women, we hypothesized that leptin and insulin sensitivity are related to dysfibrinolysis in a sex-dependent manner. Thirty-two men and 40 women were recruited from the Monitoring of trends and determinants in Cardiovascular disease (MONICA) population sample, representing the highest and lowest quartiles of fasting insulin levels. Lipids, fibrinolytic status [plasminogen activator inhibitor 1 (PAI-1) activity, tissue plasminogen activator (tPA) mass and activity, and tPA-PAI complex], leptin, testosterone and sex-hormone-binding globulin were measured. Insulin sensitivity was estimated using the euglycaemic clamp technique. Body composition was determined by bioimpedance. Determinants for circulating levels of fibrinolytic factors were explored in a multivariate linear regression analysis. Levels of fibrinolytic variables and estimated insulin sensitivity did not differ between men and women. Leptin was independently associated with reduced fibrinolytic status high PAI-1 activity, low tPA activity, high tPA mass, and high tPA-PAI complex) in men (P<0.001-0.002). In women, fat mass and/or insulin sensitivity were related to these factors (P<0.001-0.03), and leptin only to reduced tPA activity (P = 0.002). Hyperleptinemia, dysfibrinolysis, insulin sensitivity and androgenicity associate differentially in men and women. Blood Coagul Fibrinolysis 19:625-632 (C) 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins.
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| 3. |
- Nybacka, Asa, et al.
(författare)
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Randomized comparison of the influence of dietary management and/or physical exercise on ovarian function and metabolic parameters in overweight women with polycystic ovary syndrome
- 2011
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Ingår i: Fertility and Sterility. - : Elsevier BV. - 0015-0282 .- 1556-5653. ; 96:6, s. 1508-1513
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To compare the influence of dietary management and/or physical exercise on ovarian function and metabolic variables in women with polycystic ovary syndrome (PCOS). Design: Randomized 4-month trial with three interventions and a long-term follow-up. Setting: Women's health clinical research unit at a university hospital. Patient(s): Fifty-seven overweight/obese women with PCOS. Intervention(s): Dietary management, physical exercise, or both, using programs individually adapted and supervised by a dietician and/or a physical therapist. Main Outcome Measure(s): Ovarian function, endocrinologic, and metabolic status and body composition. Result(s): On average, body mass index was reduced 6% by the dietary management, 3% by the exercise, and 5% by the combined interventions. Lower body fat and lean body mass were significantly decreased in the dietary groups, whereas upper body fat was lowered and lean body mass maintained by exercise alone. The menstrual pattern was significantly improved in 69% and ovulation confirmed in 34% of the patients, with no differences among the groups. The strongest predictor of resumed ovulation was a high serum level of insulin-like growth factor-binding protein 1 after the intervention. Follow-up of one-half of the patients for a median of 2.8 years revealed sustained weight reduction and improvement in menstrual pattern. Conclusion(s): Dietary management and exercise, alone or in combination, are equally effective in improving reproductive function in overweight/obese women with PCOS. The underlying mechanisms appear to involve enhanced insulin sensitivity. Supportive individualized programs for lifestyle change could exert long-term beneficial effects.
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| 4. |
- Nybacka, Asa, et al.
(författare)
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Serum antimullerian hormone in response to dietary management and/or physical exercise in overweight/obese women with polycystic ovary syndrome : secondary analysis of a randomized controlled trial
- 2013
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Ingår i: Fertility and Sterility. - : Elsevier BV. - 0015-0282 .- 1556-5653. ; 100:4, s. 1096-1102
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To investigate whether randomized diet and/or physical exercise influence serum levels of antimullerian hormone (AMH) in obese women with polycystic ovary syndrome (PCOS). Design: Randomized, 4-month trial with three interventions. Setting: Women's health clinical research unit at a university hospital. Patient(s): Fifty-seven overweight/obese women with PCOS. Intervention(s): Diet, physical exercise, or both, using programs individually adapted and supervised by a dietician and/or a physiotherapist. Main Outcome Measure(s): Serum AMH levels before and after the interventions and correlations to reproductive function, body composition, and endocrine and metabolic variables. Result(s): After intervention, serum levels of AMH were significantly decreased only in the diet group, and the levels were significantly lower than in the exercise group. The strongest predictor of decreased AMH was a decrease in free T, whereas weight loss had no significant influence. Normalized levels of AMH were associated with improvements in menstrual cyclicity and hyperandrogenism but not in metabolic variables. Conclusion(s): This randomized study supports that diet reduces serum AMH in association with decreased androgen levels in obese women with PCOS. Increased serum AMH may be used as a marker of ovulatory dysfunction and hyperandrogenism but not as a marker of insulin resistance.
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