Tak Kim

Postmenopausal status according to years since menopause as an independent risk factor for the metabolic syndrome

Objective: Features of the metabolic syndrome such as abdominal adiposity, insulin resistance, and dyslipidemia develop with the transition from pre- to postmenopausal status in women. We investigated the effects of postmenopausal status on the prevalence of the metabolic syndrome according to years since menopause. Design: We studied 1,002 women, 618 premenopausal and 384 postmenopausal, who participated in annual health examinations at Anam Hospital in Seoul, Korea. Results: Using multivariate logistic regression analysis, we determined that postmenopausal status was an independent risk factor for the metabolic syndrome. Moreover, after controlling for age and body mass index, postmenopausal women had an increased risk of the metabolic syndrome (odds ratio, 2.93; 95% CI, 1.62-5.33) and the abnormalities of its individual components. The risk for the metabolic syndrome increased up to 14 years since menopause, then decreased. For its individual components, postmenopausal women with 5 to 9 years since menopause had the highest risk of high blood pressure; postmenopausal women with less than 5 years since menopause had an increased risk of abdominal obesity and high glucose. With 10 to 14 years since menopause, postmenopausal women had an increased risk of high triglycerides. Conclusions: Postmenopausal status is an independent risk factor for the metabolic syndrome and all of its individual components. The risk for the metabolic syndrome increased up to 14 years since menopause. In addition, postmenopausal status has effects during different periods since menopause for each of these components.

Detection of Microrna as Novel Biomarkers of Epithelial Ovarian Cancer From the Serum of Ovarian Cancer Patient

Objective MicroRNA (miRNA) is an abundant class of small noncoding RNAs that act as gene regulators. Recent studies have suggested that miRNA deregulation is associated with the initiation and progression of human cancer. However, information about cancer-related miRNA is mostly limited to tissue miRNA. The aim of this study was to find specific profiles of serum-derived miRNAs of ovarian cancer based on a comparative study using a miRNA microarray of serum, tissue, and ascites. Methods From 2 ovarian cancer patients and a healthy control, total RNA was isolated from their serum, tissue, and ascites, respectively, and analyzed by a microarray. Under the comparative study of each miRNA microarray, we sorted out several miRNAs showing a consistent regulation tendency throughout all 3 specimens and the greatest range of alteration in serum as potential biomarkers. The availability of biomarkers was confirmed by qRT-PCR of 18 patients and 12 controls. Results Out of 2222 kinds of total miRNAs that were identified in the microarray analysis, 95 miRNAs were down-regulated and 88 miRNAs were up-regulated, in the serum, tissue, and ascites of cancer patients. Among the miRNAs that showed a consistent regulation tendency through all specimens and showed more than a 2-fold difference in serum, 5 miRNAs (miR-132, miR-26a, let-7b, miR-145, and miR-143) were determined as the 5 most markedly down-regulated miRNAs in the serum from ovarian cancer patients with respect to those of controls. Four miRNAs (miR-132, miR-26a, let-7b, and miR-145) out of 5 selected miRNAs were significantly underexpressed in the serum of ovarian cancer patients in qRT-PCR. Conclusions Serum miR-132, miR-26a, let-7b, and miR-145 could be considered as potential candidates as novel biomarkers in serous ovarian cancer. Also, serum miRNAs is a promising and useful tool for discriminating between controls and patients with serous ovarian cancer.

Correlation between estrogens and serum adipocytokines in premenopausal and postmenopausal women.

Objective:The purpose of this study was to investigate the association between serum adipocytokines (adiponectin, resistin, leptin, and tumor necrosis factor &agr; [TNF-&agr;]) and endogenous estrogen (estrone and estradiol) levels in healthy premenopausal and postmenopausal women. Design:This study included 53 healthy premenopausal women, 45 healthy postmenopausal women, and 10 postmenopausal women with the metabolic syndrome who were participating in general health examinations. A secondary analysis was performed on levels of adiponectin, resistin, leptin, TNF-&agr;, estrone (E1), and estradiol (E2). Results:After accounting for body mass index, TNF-&agr; was significantly increased (1.5 ± 0.1 vs 2.0 ± 0.1 pg/mL, P < 0.05) in healthy postmenopausal women as compared with healthy premenopausal women, whereas leptin was decreased (5.6 ± 1.1 vs 4.0 ± 1.1 ng/mL). Estrogen (E1 and E2) was positively correlated with leptin in only healthy premenopausal women, whereas estrogen did not correlate with any adipocytokine in healthy postmenopausal women. In the multiple regression analysis, only leptin significantly contributed to insulin resistance. Combining healthy premenopausal and postmenopausal women, E1 correlated negatively with TNF-&agr; (r = −0.23, P < 0.05) and positively with leptin (r = 0.35, P < 0.01) and did not correlate with resistin. E2 correlated negatively with TNF-&agr; (r = −0.24, P < 0.05) and positively with leptin (r = 0.34, P < 0.01); it did not correlate with adiponectin or resistin. Leptin might stimulate the increase of plasma gonadotropin-releasing hormone levels, which could result in a positive correlation with estrogen in premenopausal women but not in postmenopausal women. Conclusions:Estrogen deficiency resulted in increased TNF-&agr; levels. Serum leptin levels correlated positively with estrogen levels in premenopausal women. However, the increase in obesity in postmenopausal women increased leptin, which increases insulin resistance.

Thyroid stimulating hormone is associated with metabolic syndrome in euthyroid postmenopausal women

OBJECTIVES The aim of this study was to investigate the relationship between thyroid stimulating hormone (TSH) and metabolic syndrome (MetS) in euthyroid postmenopausal women. METHODS We conducted a cross-sectional study of 2205 Korean postmenopausal women. Subjects who were not euthyroid were excluded. Fasting TSH, free thyroxine (FT4), insulin, glucose, and the level of insulin resistance, estimated by the homeostasis model assessment for insulin resistance (HOMA-IR) were measured. MetS was defined according to the National Cholesterol Education Program Adult Treatment Panel III criteria. RESULTS TSH levels were associated with total cholesterol, LDL-cholesterol, triglycerides and diastolic blood pressure. Using a multiple linear regression analysis, LDL-cholesterol, and triglycerides levels were identified as independently associated with TSH. Multivariate logistic regression analysis determined that TSH levels strongly contributed to MetS. Compared with the lower most quartile (TSH, 0.3-1.44 mIU/L), the adjusted odds ratio for MetS was 1.95 in the upper most quartile (TSH, 2.48-4.00 mIU/L). The prevalence of MetS increased as the TSH quartile showed a gradual increase. CONCLUSION We found a close relationship between TSH and MetS in euthyroid postmenopausal women. Therefore, more attention should be focused on postmenopausal women with high normal TSH levels for the management of cardiovascular disease.

Association of insulin resistance with anti‐Mullerian hormone levels in women without polycystic ovary syndrome (PCOS)

Objective  To explore the relationship of insulin resistance (IR) and adipokines (leptin, adiponectin, RBP4) to anti‐Mullerian hormone (AMH) levels in women without polycystic ovary syndrome (PCOS).

Role of Estrogen Receptor-α and -β) in Regulating Leptin Expression in 3T3-L1 Adipocytes

We investigated the effects of the estrogen receptor‐α (ERα) and ‐β (ERβ) in the regulation of leptin, resistin, and adiponectin expression in 3T3‐L1 adipocytes. Mature adipocytes were exposed to estradiol (E2), ERα agonist (PPT (4,4′,4″‐(4‐propyl‐[1H]‐pyrazole‐1,3,5‐triyl)trisphenol)), ERβ agonist (DPN (2,3‐bis(4‐Hydroxyphenyl)‐propionitrile)), E2 with ERα antagonist (MPP (1,3‐Bis(4‐hydroxyphenyl)‐4‐methyl‐5‐[4‐(2‐piperidinylethoxy)phenol]‐1H‐pyrazole dihydrochloride)), and E2 with ERβ antagonist (R, R‐THC ((R, R)‐5,11‐diethyl‐5,6,11,12‐tetrahydro‐2,8‐chrysenediol)) at different concentrations. To clarify the expression and regulation of adipokines by ER subtypes, total RNA was extracted from cells and measured using quantitative PCR. Western blot analysis was performed to evaluate the protein expression of adipokines, ERα, and ERβ. The leptin expression was significantly increased in the cells treated with high concentrations (10−5 and 10−6 mol/l) of the PPT (P < 0.01, P < 0.05). By contrast, the leptin expression decreased in a dose‐dependent manner in the MPP‐treated groups (P < 0.05). High concentrations (10−5 mol/l) of R, R‐THC with E2 (10−7 mol/l) caused a significant increase of the leptin expression (P < 0.01). The leptin mRNA levels were positively correlated with the ERα mRNA levels (r = 0.584, P < 0.01) and negatively correlated with the ERβ mRNA levels (r = −0.236, P = 0.03) in the adipocytes. The ratio of the ERα to ERβ mRNA levels in the adipocytes was significantly associated with leptin mRNA levels (r = 0.454, P < 0.01). ERα induced leptin expression and ERβ inhibited its expression in 3T3‐L1 adipocytes. The ratio of the ERα‐to‐ERβ expression in 3T3‐L1 adipocytes may be an important potential regulatory factor in leptin expression.

Effectiveness of nasal surgery alone on sleep quality, architecture, position, and sleep-disordered breathing in obstructive sleep apnea syndrome with nasal obstruction.

Background The goal of this study was to evaluate the effect of nasal surgery alone on sleep quality, architecture, position, and sleep-disordered breathing (SDB) (including obstructive apnea and snoring) in adult patients with obstructive sleep apnea syndrome (OSAS) and nasal obstruction. Methods A total of 22 consecutive male patients (mean age, 41.3 ± 10.9 years) with OSAS and nasal obstruction, who underwent nasal surgery alone, were enrolled in the study. We compared polysomnographic data related with sleep quality (sleep efficiency [SE] and arousal index [ArI]), sleep architecture (stages N [nonrapid eye movement], 1, 2, and 3, and R [rapid eye movement]), the distribution of sleep positions, and SDB (apnea–hypopnea index [AHI], apnea index [AI], minimum arterial oxygen saturation [SaO 2 ], and snoring) before and after nasal surgery. Results SE (from 86.6 ± 6.3% to 89.7 ± 7.1%; p = 0.039), stage R (from 15.3 ± 4.8% to 18.6 ± 5.4%; p = 0.016) and snoring (from 32.2 ± 16.4% to 25.8 ± 18.6%; p = 0.045) significantly changed after nasal surgery. However, there were no significant changes in ArI, other sleep stages, the proportion of sleep time spent in the supine position, AHI, AI, and minimum SaO 2 after nasal surgery. Conclusion Nasal surgery alone was partially effective in improving sleep quality, architecture, and snoring, but it had no effect on the change of the distribution of sleep positions and obstructive apnea in patients with OSAS and nasal obstruction.

High‐risk human papillomavirus testing for monitoring patients treated for high‐grade cervical intraepithelial neoplasia

Aim:  The aim of the present study was to examine the accuracy of high‐risk human papillomavirus (HR‐HPV) DNA detection as a predictor of residual or recurrent cervical intraepithelial neoplasia (CIN) after treatment of high‐grade CIN.

The relationship between fat depot‐specific preadipocyte differentiation and metabolic syndrome in obese women

Objective  Obesity is strongly associated with metabolic syndrome, but not all obese individuals display a clustering of metabolic risk factors. Recent studies have shown that in vitro subcutaneous (SC)‐preadipocyte differentiation is negatively associated with obesity. These results suggest that impaired adipogenesis is an important factor linking obesity to metabolic disorders. We examined whether in vitro preadipocyte differentiation is associated with metabolic syndrome, independent of obesity.

Association of body mass index with severity of endometriosis in Korean women

To investigate the relationship between endometriosis severity and body mass index (BMI).