- Email: [email protected]
MS207 IMPORTANCE OF INSULIN RESISTANCE AND GLUCOSE INTOLERANCE IN PREMENOPAUSAL WOMEN WITH POLYCYSTIC OVARIES AND POLYCYSTIC OVARIAN SYNDROME (PCOS)
78th EAS Congress
Atherosclerosis Supplements 11, no. 2 (2010) 109–222
allocated to the intervention group, performing 3 to 5 times per week eccentric endurance exercise by hiking downhill a path in the Austrian alps covering a difference in altitude of 540 meters; for the upward way a cable car was used, where compliance was recorded electronically. The control group included 25 subjects who remained sedentary. An oral glucose tolerance test (OGTT) was obtained at baseline and after 8 weeks of eccentric exercise. Results: Fasting plasma glucose decreased significantly in the intervention group (from 97±15 at baseline to 94±9 mg/dl after 8 weeks of eccentric endurance exercise; p = 0.025), but not in the control group (p = 0.265). Further, glucose tolerance (quantified as the incremental area under the glucose curve) was significantly improved in the intervention group (by 8.1%; p < 0.001), but not in the control group (p = 0.231). Conclusion: We conclude that eccentric endurance exercise even in nondiabetic individuals significantly improves fasting glucose and glucose tolerance. Because elevated fasting and postchallenge glucose values indicate an increased diabetes risk, eccentric endurance exercise may help to prevent diabetes. MS205 A RANDOMIZED OPEN TRIAL OF VARENICLINE VERSUS NICOTINE PATCH IN ADULT SMOKERS: EFFICACY, SAFETY AND WITHDRAWAL SYMPTOMS (THE VN-SEESAW STUDY) H. Tsukahara, K. Noda, Y. Uehara, K. Saku. Cardiology, Fukuoka University School of Medicine, Fukuoka, Japan We conducted a randomized controlled trial of varenicline versus nicotine patch in adult smokers, and compared efficacy, safety and withdrawal symptoms. Thirty-two adult smokers were randomly divided into a varenicline group (VG, n = 16, varenicline, 0.5−2 mg daily) and a nicotine patch group (NG, n = 16, 52.5−7 mg nicotine daily) for 12 weeks and 8 weeks, respectively. The primary endpoints were the 12- and 24-week smoking-abstinence rates, withdrawal symptoms and safety. No significant difference in abstinence rates was observed between the two groups over weeks 9−12, and weeks 9−24. The total withdrawal symptom score in VG was higher than that in NG at 2 weeks (14.8±3.5 vs. 12.2±2.4, p = 0.083): in detail, the frequencies of an inability to concentrate at 2, 4, and 8 weeks (P = 0.034, 0.070, 0.10, respectively), wakeful nights at 2 weeks (p = 0.003), and a lack of self-composure at 4 weeks (p = 0.146) were higher in VG than in NG. Adverse side effects associated with a gastro-intestinal disorder were observed in 14 cases and 1 case, and skin allergy was seen in 0 and 9 cases, respectively. BW and BMI were increased after 12 weeks in both groups, while systolic blood pressure tended to decrease in NP and LDL-C and HDL-C did not change after 12 weeks. Urinary 8-OHdG and 8-isoprostane decreased in NG group. We concluded that the selection of treatment should depend on the patient’s request based on the desired acuteness of cessation of smoking, gastro-intestinal problems, and skin allergy. MS206 IMPAIRED GLUCOSE TOLERANCE, INFLAMMATION AND MALNUTRITION SYNDROME IN OLDER PATIENTS WITH A SUBCLINICAL FORM OF PRIMARY HYPOTHYREOIDISM L. Majnaric1 , B. Vitale2 . 1 University “J.J. Strossmayer” Osijek, Health Center Osijek, Croatia, Osijek, 2 Ruder Boˇskovi´c Institute Zagreb, Zagreb, Croatia Background and Aims: Primary hypothyreoidism (PH) is known disease which may add to the cardiovascular (CV) risk profile. We investigated whether a subclinical form of PH, more frequently distributed in population than a clinically developed disease, can also be detrimental to the CV disease development. Methods: Increased TSH hormone levels and situations with TSH hormone values within the upper half and fT4 hormone values within the lower half of the reference range were used as criteria for definition of a subclinical form of PH. We tested 70 patients, aged 55−74 years (median 68), without diabetes mellitus, on fT4 and TSH hormone levels and divided them in two groups according to these criteria. Differences in many clinical parameters were than tested between these two groups of patients, including: BMI, weist/hipp ratio, cognitive impairment, anxiety/depression, OGTT, HbA1c , insulin, lipids, serum total proteins, acute phase proteins, folic acid, vitamin B12 , homocystein, prolactin and cortisol (median and 25−75% range and Mann–Whitney U test, p < 0.05). Results: We found a high proportion of 25.7% subjects with a subclinical form of PH. They were characterized with lower insulin levels, 14.95 (13.10–21.80) vs.19.30 (15.90–26.55) mIU/ml, p = 0.039, higher OGTT 2h glucose levels, 6.30 (5.40–7.10) vs. 5.20 (4.10–6.30) mmol/L, p = 0.043, decreased serum albumin, 45.10 (41.70–46.50) vs. 46.80 (44.80–48.15) g/L, p = 0.042, decreased vitamin B12 , 222.0 (198.0–297.0) vs. 237.0 (194.0–319.5), p = 0.048, and increased cortisol, 404, 65 (335.90–457.60) vs.337.50 (253.90–415.35), p = 0.038, in comparison with the controls. Conclusions: Impaired glucose tolerance, inflammation, malnutrition and neuroendocrine stress axis hyperactivity syndrome characterizes a subclinical form of PH.
151
MS207 IMPORTANCE OF INSULIN RESISTANCE AND GLUCOSE INTOLERANCE IN PREMENOPAUSAL WOMEN WITH POLYCYSTIC OVARIES AND POLYCYSTIC OVARIAN SYNDROME (PCOS) D. Paul1 , I. Pantea1,2 , L. Nedelcu1,2 , A. Stoicescu3,4 , C. Scarneciu1,2 . 1 Internal Medicine, County Emergency Hospital of Brasov, 2 Internal Medicine, 3 Endocrinology, Faculty of Medicine, University of ‘Transilvania’, 4 Endocrinology, County Emergency Hospital of Brasov, Brasov, Romania Objective: The aim of this study was to assess whether insulin resistance and glucose intolerance in women with polycystic ovaries and PCOS contribute to an additional risk for metabolic syndrome and coronary artery disease. Methods: The study included 78 premenopausal women (aged 20−48 years old) diagnosed with polycystic ovaries and/or PCOS. All patients underwent complex clinical examination including anthropometric measurements (BMI, waist circumference) and lower abdominal echography. Biological tests were done: TSH, prolactin levels, 17-hydroxyprogesterone, progesterone levels, DHEAS, LH, FSH, impared glucose, OGTT, insulin, lipid profile. We also considered lifestyle risk factors like smoking. Results: The lot was divided into 2 groups. Group 1 consisted of 36 patients that presented either glucose intolerance, insulin resistance or diabetes from whom 19 (52.78%) patients were obese (IMC>30, waist circumference >0.85) and 17 (47.22%) were overweight (IMC 25−30, waist circumference >0.80). First group consisted of 26 (72.22%) smokers. Group 2 consisted of 42 women without insulin resistance from whom 18 (42.85%) were obese (IMC>30, waist circumference>0.85), 11 (26.2%) were overweight (IMC 25−30, waist circumference>0.80) and 13 (30.95%) patients had normal weight. The second group presented 18 (42.85%) smokers. We also studied the prevalence of metabolic symptoms for polycystic ovary and PCOS: chronic anovulation without hirsutism (38.46% cases), amenorrhea with normal prolactin level (29.48% cases), hirsutism with regular cycles (10.25% cases) and polycystic ovaries (21.79% cases). Conclusion: Most women with PCOS are obese or overweight and developed insulin resistance and glucose intolerance. Obesity per se is a cause of insulin Syndrome X. Moreover, smoking seems to contribute to insulin resistance and glucose intolerance mechanisms. Therefore, measures to decrease this condition may have to be considered earlier to decrease the potential risks of developing diabetes mellitus and coronary artery disease at later ages of life in both overweight and normal weight women who have PCOS. MS208 URIC ACID, ENDOTHELIAL FUNCTION AND CARDIOVASCULAR RISK E.E. Babes, V.V. Babes, A. Ardelean, M.I. Popescu. Faculty of Medicine, Oradea, Romania Background: Previous studies have raised the possibility that UA might be an independent, causal risk factor for cardiovascular disease. The aim of the study was to evaluate the relationship between UA and endothelial function in patients with hypertension. Methods: A total of 106 newly diagnosed never treated patients with uncomplicated essential hypertension (56 men, mean age 49.6±6.8 y) were studied. Classical risk factors, UA, creatinine and C reactive protein (CRP) were determined. Endothelial function was estimated by flow-mediated dilatation (FMD) of the brachial artery. Patients were distributed in two groups: high UA 5 mg/dl (n = 49) and low UA < 5 mg/dl (n = 57). Results: Patients with high UA were older (p = 0.002), had higher systolic blood pressure (SBP) (p < 0.001), higher creatinine (p < 0.01) and higher CRP (p = 0.05). There were no differences between groups regarding BMI, lipid profile, diastolic BP, percentage of smokers. FMD was markedly lower in patients with high UA (5.77±1.55%) vs (7.57±1.23%) (p < 0.0001). In multiple regression analysis independent predictors for FMD were: creatinine (r = −0.67, p < 0.0001), serum UA − second correlate of FMD (r = −0.64, p = 0.0002) and SBP (r = −0.56, p = 0.0015) (R2 = 0.73). Conclusions: Hyperuricemia in patients with essential hypertension is associated with endothelial dysfunction. This association is independent of classical risk factors and CRP and may contribute to cardiovascular morbidity. Serum UA represents a possible new target for the reduction of morbidity and mortality associated with hypertension and cardiovascular disease. MS209 NEW EVENT OF MYOCARDIAL INFARCTION (MI) IN PATIENTS WITH PAST MI: AGE, SEX AND TREATMENT DIFFERENCES A. Ioannidis, K. Oikonomou, M. Ntalapascha, E. Karapatsoudi, I. Karantoumanis, K. Karali, P. Makridis. Department of Cardiology, General State Hospital of Edessa, Edessa, Greece Background: Limited data exists concernimg the pre- and post- admission medications of patients with history of MI suffering from a new event of MI. Aim: We studied the differences between the sexes regarding the pre- and post- admission medication, the type of in-hospital treatment, the type of MI, along with routine clinical and laboratory features.
Atherosclerosis Supplements 11, no. 2 (2010) 109–222
allocated to the intervention group, performing 3 to 5 times per week eccentric endurance exercise by hiking downhill a path in the Austrian alps covering a difference in altitude of 540 meters; for the upward way a cable car was used, where compliance was recorded electronically. The control group included 25 subjects who remained sedentary. An oral glucose tolerance test (OGTT) was obtained at baseline and after 8 weeks of eccentric exercise. Results: Fasting plasma glucose decreased significantly in the intervention group (from 97±15 at baseline to 94±9 mg/dl after 8 weeks of eccentric endurance exercise; p = 0.025), but not in the control group (p = 0.265). Further, glucose tolerance (quantified as the incremental area under the glucose curve) was significantly improved in the intervention group (by 8.1%; p < 0.001), but not in the control group (p = 0.231). Conclusion: We conclude that eccentric endurance exercise even in nondiabetic individuals significantly improves fasting glucose and glucose tolerance. Because elevated fasting and postchallenge glucose values indicate an increased diabetes risk, eccentric endurance exercise may help to prevent diabetes. MS205 A RANDOMIZED OPEN TRIAL OF VARENICLINE VERSUS NICOTINE PATCH IN ADULT SMOKERS: EFFICACY, SAFETY AND WITHDRAWAL SYMPTOMS (THE VN-SEESAW STUDY) H. Tsukahara, K. Noda, Y. Uehara, K. Saku. Cardiology, Fukuoka University School of Medicine, Fukuoka, Japan We conducted a randomized controlled trial of varenicline versus nicotine patch in adult smokers, and compared efficacy, safety and withdrawal symptoms. Thirty-two adult smokers were randomly divided into a varenicline group (VG, n = 16, varenicline, 0.5−2 mg daily) and a nicotine patch group (NG, n = 16, 52.5−7 mg nicotine daily) for 12 weeks and 8 weeks, respectively. The primary endpoints were the 12- and 24-week smoking-abstinence rates, withdrawal symptoms and safety. No significant difference in abstinence rates was observed between the two groups over weeks 9−12, and weeks 9−24. The total withdrawal symptom score in VG was higher than that in NG at 2 weeks (14.8±3.5 vs. 12.2±2.4, p = 0.083): in detail, the frequencies of an inability to concentrate at 2, 4, and 8 weeks (P = 0.034, 0.070, 0.10, respectively), wakeful nights at 2 weeks (p = 0.003), and a lack of self-composure at 4 weeks (p = 0.146) were higher in VG than in NG. Adverse side effects associated with a gastro-intestinal disorder were observed in 14 cases and 1 case, and skin allergy was seen in 0 and 9 cases, respectively. BW and BMI were increased after 12 weeks in both groups, while systolic blood pressure tended to decrease in NP and LDL-C and HDL-C did not change after 12 weeks. Urinary 8-OHdG and 8-isoprostane decreased in NG group. We concluded that the selection of treatment should depend on the patient’s request based on the desired acuteness of cessation of smoking, gastro-intestinal problems, and skin allergy. MS206 IMPAIRED GLUCOSE TOLERANCE, INFLAMMATION AND MALNUTRITION SYNDROME IN OLDER PATIENTS WITH A SUBCLINICAL FORM OF PRIMARY HYPOTHYREOIDISM L. Majnaric1 , B. Vitale2 . 1 University “J.J. Strossmayer” Osijek, Health Center Osijek, Croatia, Osijek, 2 Ruder Boˇskovi´c Institute Zagreb, Zagreb, Croatia Background and Aims: Primary hypothyreoidism (PH) is known disease which may add to the cardiovascular (CV) risk profile. We investigated whether a subclinical form of PH, more frequently distributed in population than a clinically developed disease, can also be detrimental to the CV disease development. Methods: Increased TSH hormone levels and situations with TSH hormone values within the upper half and fT4 hormone values within the lower half of the reference range were used as criteria for definition of a subclinical form of PH. We tested 70 patients, aged 55−74 years (median 68), without diabetes mellitus, on fT4 and TSH hormone levels and divided them in two groups according to these criteria. Differences in many clinical parameters were than tested between these two groups of patients, including: BMI, weist/hipp ratio, cognitive impairment, anxiety/depression, OGTT, HbA1c , insulin, lipids, serum total proteins, acute phase proteins, folic acid, vitamin B12 , homocystein, prolactin and cortisol (median and 25−75% range and Mann–Whitney U test, p < 0.05). Results: We found a high proportion of 25.7% subjects with a subclinical form of PH. They were characterized with lower insulin levels, 14.95 (13.10–21.80) vs.19.30 (15.90–26.55) mIU/ml, p = 0.039, higher OGTT 2h glucose levels, 6.30 (5.40–7.10) vs. 5.20 (4.10–6.30) mmol/L, p = 0.043, decreased serum albumin, 45.10 (41.70–46.50) vs. 46.80 (44.80–48.15) g/L, p = 0.042, decreased vitamin B12 , 222.0 (198.0–297.0) vs. 237.0 (194.0–319.5), p = 0.048, and increased cortisol, 404, 65 (335.90–457.60) vs.337.50 (253.90–415.35), p = 0.038, in comparison with the controls. Conclusions: Impaired glucose tolerance, inflammation, malnutrition and neuroendocrine stress axis hyperactivity syndrome characterizes a subclinical form of PH.
151
MS207 IMPORTANCE OF INSULIN RESISTANCE AND GLUCOSE INTOLERANCE IN PREMENOPAUSAL WOMEN WITH POLYCYSTIC OVARIES AND POLYCYSTIC OVARIAN SYNDROME (PCOS) D. Paul1 , I. Pantea1,2 , L. Nedelcu1,2 , A. Stoicescu3,4 , C. Scarneciu1,2 . 1 Internal Medicine, County Emergency Hospital of Brasov, 2 Internal Medicine, 3 Endocrinology, Faculty of Medicine, University of ‘Transilvania’, 4 Endocrinology, County Emergency Hospital of Brasov, Brasov, Romania Objective: The aim of this study was to assess whether insulin resistance and glucose intolerance in women with polycystic ovaries and PCOS contribute to an additional risk for metabolic syndrome and coronary artery disease. Methods: The study included 78 premenopausal women (aged 20−48 years old) diagnosed with polycystic ovaries and/or PCOS. All patients underwent complex clinical examination including anthropometric measurements (BMI, waist circumference) and lower abdominal echography. Biological tests were done: TSH, prolactin levels, 17-hydroxyprogesterone, progesterone levels, DHEAS, LH, FSH, impared glucose, OGTT, insulin, lipid profile. We also considered lifestyle risk factors like smoking. Results: The lot was divided into 2 groups. Group 1 consisted of 36 patients that presented either glucose intolerance, insulin resistance or diabetes from whom 19 (52.78%) patients were obese (IMC>30, waist circumference >0.85) and 17 (47.22%) were overweight (IMC 25−30, waist circumference >0.80). First group consisted of 26 (72.22%) smokers. Group 2 consisted of 42 women without insulin resistance from whom 18 (42.85%) were obese (IMC>30, waist circumference>0.85), 11 (26.2%) were overweight (IMC 25−30, waist circumference>0.80) and 13 (30.95%) patients had normal weight. The second group presented 18 (42.85%) smokers. We also studied the prevalence of metabolic symptoms for polycystic ovary and PCOS: chronic anovulation without hirsutism (38.46% cases), amenorrhea with normal prolactin level (29.48% cases), hirsutism with regular cycles (10.25% cases) and polycystic ovaries (21.79% cases). Conclusion: Most women with PCOS are obese or overweight and developed insulin resistance and glucose intolerance. Obesity per se is a cause of insulin Syndrome X. Moreover, smoking seems to contribute to insulin resistance and glucose intolerance mechanisms. Therefore, measures to decrease this condition may have to be considered earlier to decrease the potential risks of developing diabetes mellitus and coronary artery disease at later ages of life in both overweight and normal weight women who have PCOS. MS208 URIC ACID, ENDOTHELIAL FUNCTION AND CARDIOVASCULAR RISK E.E. Babes, V.V. Babes, A. Ardelean, M.I. Popescu. Faculty of Medicine, Oradea, Romania Background: Previous studies have raised the possibility that UA might be an independent, causal risk factor for cardiovascular disease. The aim of the study was to evaluate the relationship between UA and endothelial function in patients with hypertension. Methods: A total of 106 newly diagnosed never treated patients with uncomplicated essential hypertension (56 men, mean age 49.6±6.8 y) were studied. Classical risk factors, UA, creatinine and C reactive protein (CRP) were determined. Endothelial function was estimated by flow-mediated dilatation (FMD) of the brachial artery. Patients were distributed in two groups: high UA 5 mg/dl (n = 49) and low UA < 5 mg/dl (n = 57). Results: Patients with high UA were older (p = 0.002), had higher systolic blood pressure (SBP) (p < 0.001), higher creatinine (p < 0.01) and higher CRP (p = 0.05). There were no differences between groups regarding BMI, lipid profile, diastolic BP, percentage of smokers. FMD was markedly lower in patients with high UA (5.77±1.55%) vs (7.57±1.23%) (p < 0.0001). In multiple regression analysis independent predictors for FMD were: creatinine (r = −0.67, p < 0.0001), serum UA − second correlate of FMD (r = −0.64, p = 0.0002) and SBP (r = −0.56, p = 0.0015) (R2 = 0.73). Conclusions: Hyperuricemia in patients with essential hypertension is associated with endothelial dysfunction. This association is independent of classical risk factors and CRP and may contribute to cardiovascular morbidity. Serum UA represents a possible new target for the reduction of morbidity and mortality associated with hypertension and cardiovascular disease. MS209 NEW EVENT OF MYOCARDIAL INFARCTION (MI) IN PATIENTS WITH PAST MI: AGE, SEX AND TREATMENT DIFFERENCES A. Ioannidis, K. Oikonomou, M. Ntalapascha, E. Karapatsoudi, I. Karantoumanis, K. Karali, P. Makridis. Department of Cardiology, General State Hospital of Edessa, Edessa, Greece Background: Limited data exists concernimg the pre- and post- admission medications of patients with history of MI suffering from a new event of MI. Aim: We studied the differences between the sexes regarding the pre- and post- admission medication, the type of in-hospital treatment, the type of MI, along with routine clinical and laboratory features.