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Query: UMLS:C0028754 (obesity)
 124,988 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Fifteen patients with idiopathic hirsutism, who had no attenuated adrenal hyperplasia, obesity, enlarged ovaries, or amenorrhea, were studied. Excessive androgen secretion by adrenal tissue was suggested by the finding of increased levels of dehydroepiandrosterone sulfate, which decreased after dexamethasone administration but did not change after human chorionic gonadotropin (hCG) injection. Excessive androgen secretion by ovarian tissue was suggested by the finding that testosterone and androstenedione levels were elevated, correlated significantly with the levels of luteinizing hormone, decreased with administration of estrogen-progestagen, and increased after hCG injection. Notably, free testosterone levels, which were significantly increased, were only partially suppressed during dexamethasone or estrogen-progestagen administration. These results provide further evidence that both the adrenals and the ovaries secrete androgens excessively in patients with idiopathic hirsutism.
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PMID:Evidence of excessive androgen secretion by both the ovary and the adrenal in patients with idiopathic hirsutism. 680 96

The effects of various parameters on age at menopause have been investigated in five ethnic groups in Israel comprising East European, West European, North African, Israeli and other Middle Eastern (Mediterranean) women, respectively. The data were acquired by means of anonymous questionnaires and were programmed for 1770 women. Correlation coefficients between various variables and age at menopause revealed three variables which have a straight correlation, vis. obesity index, number of children, and years of amenorrhoea (during the reproductive years). The years-of-smoking variable has an inverse correlation with age at menopause. East Europeans have the highest age at menarche. Two-way analysis of variance has shown that the obesity index, years of amenorrhoea, number of children and years-of-smoking parameters are individually more important than ethnic origin. The finding that the age at menopause is highest in the North African group is explained by the higher incidence in this group of high parity, a greater number of amenorrhoea, obesity, and low cigarette consumption. Since many habits (such as smoking, diet, use of contraceptive pills, multiple partners and marital obligations) are subject to frequent change in the modern world, it is of the utmost importance to repeat such a study every few years.
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PMID:Menopausal age in various ethnic groups in Israel. 716 66

Hypocycloidal tomograms of the sella turcica and serum prolactin concentrations were obtained in 146 women with amenorrhea, galactorrhea, or both to diagnose prolactin-secreting pituitary adenomas. Findings suggesting an adenoma, ie, abnormal tomogram and elevated serum prolactin concentration, were found in 24.6% (16/65) of previously unscreened patients and 59.2% (48/81) of prescreened patients. The combination of an abnormal tomogram and elevated prolactin level was relatively specific for an adenoma, as 91% (42/46) of women with these findings who underwent surgery had histologically confirmed tumors. Tumors occurred in women from 15 to 45 years of age, with amenorrhea or galactorrhea ranging from less than six months to more than 20 years in duration. Some women in this series also had obesity, rapid weight loss, polycystic ovarian syndrome, amenorrhea following discontinuance of oral contraceptive use, or emotional stress.
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PMID:Prolactin-secreting pituitary adenomas. III. Frequency and diagnosis in amenorrhea-galactorrhea. 719 Oct 13

A case of adrenocortical carcinoma, a 18-year-old female with Cushing's syndrome and later hypoglycemia, was reported. Cushing's syndrome was corroborated by clinical signs of moon face, obesity, hirsutism and amenorrhea as well as by elevated urinary steroid levels. A huge tumor in the right adrenal region weighing 171 g was removed and histologically diagnosed as adrenocortical carcinoma. Shortly after the surgery, urinary levels of steroid excretion became within normal ranges. However, hypoglycemia with elevated levels of urinary steroid appeared in 6 months postoperatively. She died of massive hemorrhage from gastric ulcer. Autopsy revealed a huge tumor in the right hypochondrial region pressing the liver and right kidney. Tumor cells of autopsy material showed much more anaplastic feature than those of surgical one. Several possible mechanisms for hypoglycemia were discussed.
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PMID:Hypoglycemia by adrenocortical carcinoma with Cushing's syndrome. 720 68

Contraception by progestational agents only can be a very effective method when estroprogestational contraception or the IUD are contraindicated. Progestational agents affect the physiochemistry of the cervical mucus, spermatozoa capacitation, the endometrium, and the secretory process of the tubes. Progestins can be administered intramuscularly at a dose of 250 mg every 3 months, or of 450 mg every 6 months; they can also be administered in microdoses of 0.5 mg per os per day. Method of administration can be continuous, every day, discontinuous, from the 5th to the 25th day of the cycle, or mixed, i.e. one agent on a continuous basis every day, and another progestational agent for 5-10 days only. Progestational agents are usually well tolerated; they do, however, cause a series of menstruation disorders, including spotting, amenorrhea, and irregularities of the cycle. Reversibility is very good. Contraindicatoins to this type of contraception are diabetes, obesity, lipid metabolic problems, any cardiovascular pathology, any uterine and breast pathology when it is hormonodependant. Sequential contraception would be better indicated than progestational contraception for premenopausal women.
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PMID:[Isolated progestational contraception. Advantages and disadvantages]. 723 18

Primary empty sella syndrome (ESS) is an anatomo-radiological picture characterized by the presence of an arachnoid herniation filled with liquor that compresses the pituitary against the sellar wall. ESS occurs particularly in obese, hypertensive, cephalalgic women. It is often asymptomatic but may be associated with ophthalmologic, neurologic and non-characterizing endocrine disorders. We report here 43 cases of primary ESS observed and assessed in our Departments of Internal Medicine from June 1983 to May 1993. The following endocrinological diagnostic procedures were carried out: hormonal (RIA) basal profile: FT3, FT4, TSH, PRL, ACTH, FSH, LH, 8.00 a.m. and p.m., blood cortisol, aldo, PRA, DHEA-S, FTe, E2, P, PTH, CT, and calcemia and phosphoremia; provocative tests: TRH, GnRH, etc.; inhibition tests: high dose dexamethasone. Clinical, neurologic (skull radiographs, sellar stratigraphy, computed tomography scan and magnetic resonance), and ophthalmologic (fundus, visual fields) assessments were also made. Our findings fit with the data in the literature concerning common symptoms of ESS, associated endocrinopathies and other illness. We found obesity (62.7%), oligo-amenorrhea (16.6%), galactorrhea (14.6%), hyperPRL (11.6%), hypopituitarism (9.3%), hypogonadism (4.6%), diabetes insipidus (2.3%), (micro-)polycystic ovary syndrome (19%), hyperACTH (2.3%). In 9.3% of the cases, endocrinopathy referred to pituitary adenomas. Moreover, we noted a high frequency of psychological disorders, to our knowledge not previously reported in the literature, including anxiety or dysthymic disorders with altered behavior (chiefly oral compulsion). We also make the hypothesis that obesity (occurring in 62.7% of our patients) and hypertension (62.7%) may be related to hypothalamic alterations.
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PMID:[43 cases of primary empty sella syndrome: a case series]. 761 55

Cushing syndrome in pregnancy is rare. This is explained by the syndrome's association with amenorrhoea, oligomenorrhoea, infertility and abortions. Cushing syndrome commonly presents with hypertension, weight gain, diabetes, striae or truncal obesity, all of which can be consistent with pregnancy in women without Cushing syndrome. We describe a case of Cushing syndrome in pregnancy secondary to an adrenal cortical tumour which was discovered after an abnormal glucose tolerance test. The woman developed classical features of Cushing syndrome including gestational diabetes and hypertension and was managed successfully to term after a unilateral adrenalectomy at 23 weeks. The case is reported not only because of its rarity but also because the diagnosis was made after a routine screening test for gestational diabetes. Early diagnosis and treatment of adrenal adenoma causing Cushing syndrome in pregnancy reduces maternal and fetal morbidity and mortality.
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PMID:Cushing syndrome in pregnancy secondary to an adrenal cortical adenoma. 767 97

Glucose and lipid metabolism were studied in 30 patients with polycystic ovary syndrome (PCOS), divided into obese (n = 17) and non-obese (n = 13) groups according to BMI > 27 or < 24. Another 30 healthy controls were also divided into obese (n = 14) and nonobese (n = 16) normal groups on the same index. Cubital venous blood was drawn from each participant for oral glucose tolerance test (OGTT), insulin and lipid profile determination, for PCOS groups at the end of 3 months amenorrhea and control groups within the first 10 days of the menstrual cycle. The results showed: (1) the PCOS groups had much higher insulin level before and after OGTT than the normal groups. There was a significant positive correlation between fasting insulin level and testosterone concentration; (2) in lipid profile, the triglyceride levels in both obese groups were significantly higher than that in the non-obese groups, in whom a strong positive correlation between triglyceride and BMI was found. It is concluded that the obese and non-obese PCOS were correlated with insulin alteration, and the changed serum lipid in obese PCOS patients might be the effect of obesity but not PCOS.
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PMID:[Glucose and lipid metabolism in patients with polycystic ovary syndrome]. 783 28

The polycystic ovary (PCO) syndrome is frequently associated with obesity. That subset of women reportedly shows a much higher incidence of hirsutism and menstrual irregularities than do nonobese women with PCO syndrome. We evaluated the clinical features and hormonal profiles of 56 women with PCO syndrome and correlated them with the presence or absence of obesity. Thirty-eight (67.8%) of these women were obese (body mass index > or = 25 kg/m2). While presenting with the classic manifestations of PCO, they did not differ significantly from the manifestations of nonobese women with PCO syndrome. Although obese women with PCO had a lower incidence of oligomenorrhea as compared to nonobese women with PCO (57.9% vs. 83.3%, respectively) and amenorrhea was more frequent in the former group (42.1% vs. 16.6%, respectively), these findings are not statistically significant. The incidences of hirsutism and anovulatory infertility in the obese group as compared to the nonobese group were 81.6% vs. 77.8% and 28.9% vs. 27.8%, respectively (not statistically significantly different). The mean (+/- SE) serum levels of luteinizing hormone (LH), follicle stimulating hormone (FSH), LH/FSH ratios, prolactin and testosterone were not statistically significantly different among the two groups. The present study found that obesity is common in PCO syndrome but that there are no significant differences in the clinical and hormonal characteristics of obese and nonobese women with it. Further studies are warranted to clarify the impact of obesity on clinical, metabolic and hormonal changes in PCO syndrome.
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PMID:Effect of obesity on the clinical and hormonal characteristics of the polycystic ovary syndrome. 783 28

Ethinyl estradiol is the only estrogen form used in low-dose oral contraceptive (OC) pills. Progestogenic compounds used in OCs include norethindrone, norethindrone acetate, ethynodiol diacetate, norgestrel, levonorgestrel, and norethynodrel. The newest third generation progestins are desogestrel and norgestimate. The most important benefits associated with OC use are a decrease in benign breast disease, less incidence of ovarian and endometrial cancers, and a decrease in the incidence of pelvic inflammatory disease. The most serious risks to OC users who are over age 35 and smoke are deep vein thrombosis, pulmonary embolus, retinal thrombosis, or cardiovascular disease. Other risk factors for cardiovascular disease include obesity, diabetes, hypertension, increased serum cholesterol, and a family history of premature myocardial infarction. All users should have blood pressure checks 3 and 6 months after commencing pill use. OC preparations cause an increase in total cholesterol, triglycerides, low density lipoprotein (LDL), very low density lipoprotein (VLDL), and a decrease in high density lipoprotein (HDL), but norgestimate may actually increase HDL levels. Preparations with levonorgestrel may produce the greatest decrease in glucose tolerance, while those with 35 mcg of ethinyl estradiol and 0.5 mg of norethindrone have the least effect. OCs do not increase the risk of developing breast cancer, but can stimulate the growth of breast cancer once it has occurred. The incidence of gallbladder disease is increased slightly in OC using women who are predisposed. Hepatocellular adenomas are associated with combined OC use. Underweight women are more prone to side effects and need a very low potency preparation. A common problem encountered by patients on OCs is amenorrhea. This usually resolves after 3 cycles. Breakthrough bleeding is also very common. Post-pill amenorrhea is frequently found after stopping OCs. Combined oral contraceptives are a safe and effective contraceptive method for most women throughout their reproductive years.
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PMID:Combined oral contraceptive pills: a brief review. 783 35


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