Prevalence and predictors of metabolic syndrome with comparison of myoinositol and metformin in PCOS women

Background: The objective is to determine the prevalence of metabolic syndrome (MBS) and the effects of insulin sensitizers to improve the clinical and hormonal milieu for better reproductive outcome in PCOS women.Methods: This prospective cross-sectional study was conducted on 50 PCOS women and 50 age matched control to determine the prevalence of the MBS in two tertiary hospitals over one year. Diagnosis of PCOS was based on at least two of ESHRE/ASRM criteria and diagnosis of MBS was based on at least three of NCEPATPIII criteria. Patients already diagnosed as PCOS were treated with insulin sensitizers myoionositol and metformin which were compared.Results: The study revealed that the prevalence of MBS was 40 % (20/50) nearly 4-fold higher than that of control groups. Among PCOS women, the most prevalent MBS factors were high BMI (52%) and low serum HDL-C (42%). The least prevalent factor was high fasting serum glucose level (16%). The resumption of spontaneous regular menstrual cycle and pregnancy rate in infertile groups of PCOS patients with myoionositol and metformin were 61% vs. 26% and 50% vs.91% respectively. The myoionositol group did not require any extra ovulating agents for pregnancy, while 7 out of 11 patients in metfromin group needed clomiphen citrate for ovulation induction to achieve pregnancy. With myoinositol there is significant reduction of weight, BMI, LH/FSH ratio and fasting insulin level; whereas metformin shows decrement of weight and BMI only.Conclusions: The prevalence of MBS in PCOS is nearly 4 times in present study and there is significant improvement of symptom profile, weight, BMI and change of hormonal pattern in myoinositol group.

Results of adding metformin and orlistat to complex treatment of stable angina associated with metabolic syndrome

Aim. To evaluate the complex therapy with the addition of metformin and orlistat in treatment of II-III functional class stable angina associated with metabolic syndrome. Methods. The study included 143 patients with stable angina at the age of 36 to 70 years (mean age 54.2±3.6). Of these, 59 patients (control group) received standard treatment (isosorbide 5-mononitrate 40 mg/day, amlodipine 5 mg/day, acetylsalicylic acid 100 mg/day, carvedilol 25 mg/day, atorvastatin 20 mg/day, eprosartan 600 mg/day), and 84 patients (study group) were additionally administered metformin 1000 mg/day and orlistat 360 mg/day. Clinical and laboratory examinations (serum glucose and lipid level measurements) as well as instrumental examinations (electrocardiography, Doppler echocardiography, 24-hour electrocardiography and blood pressure monitoring) were performed before the treatment, 3, 6 and 12 months after the treatment start. Results. After 12 months of treatment mean systolic blood pressure in patients of the main group reduced by 24.5%, diastolic - by 18.8%, fasting serum glucose level - by 14.3% compared to the baseline level. Cholesterol level reduced by 13.8%, triglycerides - by 14.7%, low density lipoproteins - by 14.0%, blood level of high density lipoproteins increased by 11.6%. Body weight index reduced by 10.3%. Conclusion. Adding of 1000 mg of metformin and 360 mg of orlistat daily decreased the fasting serum glucose level by 14.3%, body weight index by 10.3%, and reduced the number of angina episodes by 19.6%, of painless myocardial ischemia by 36.3%, as well as increased physical ability tolerance by 26.5%.

Impact of Prediagnosis Smoking, Alcohol, Obesity, and Insulin Resistance on Survival in Male Cancer Patients: National Health Insurance Corporation Study

PurposeAlthough many studies have demonstrated that smoking, alcohol, obesity, and insulin resistance are risk factors for cancer, the role of those factors on cancer survival has been less studied.Patients and MethodsThe study participants were 14,578 men with a first cancer derived from a cohort of 901,979 male government employees and teachers who participated in a national health examination program in 1996. We obtained mortality data for those years from the Korean Statistical Office. We used a standard Poisson regression model to estimate the hazard ratio (HR) for survival in relation to smoking, alcohol, obesity, and insulin resistance before diagnosis.ResultsPoor survival of all cancer combined (HR, 1.24; 95% CI, 1.16 to 1.33), cancer of the lung (HR, 1.45; 95% CI, 1.15 to 1.82), and cancer of the liver (HR, 1.36; 95% CI, 1.21 to 1.53) were significantly associated with smoking. Compared with the nondrinker, heavy drinkers had worse outcomes for head and neck (HR, 1.85; 95% CI, 1.23 to 2.79) and liver (HR, 1.25; 95% CI, 1.11 to 1.41) cancer, with dose-dependent relationships. Patients with a fasting serum glucose level above 126 mg/dL had a higher mortality rate for stomach (HR, 1.52; 95% CI, 1.25 to 1.84) and lung (HR, 1.48; 95% CI, 1.18 to 1.87) cancer. Higher body mass index was significantly associated with longer survival in head and neck (HR, 0.54; 95% CI, 0.39 to 0.74) and esophagus (HR, 0.44; 95% CI, 0.28 to 0.68) cancer.ConclusionPrediagnosis risk factors for cancer development (smoking, alcohol consumption, obesity, and insulin resistance) had a statistically significant effect on survival among male cancer patients.