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Background Type 1 diabetes mellitus (T1DM) has shown a steady increase in prevalence in most parts of the world. Polycystic ovary syndrome (PCOS) frequently occurs in 15-20% of women in their reproductive age. It is associated with subfertility, ovulatory dysfunction, dysregulated androgen biosynthesis, and increased risk of insulin resistance. This study aims to assess the prevalence, phenotypic distribution, and clinical characteristics of PCOS in a sample of Egyptian women with T1DM. Patients and methods A total of 100 Egyptian women in their reproductive age (18-42 years old) previously diagnosed as having T1DM were recruited in the study. They were screened for symptoms and signs of PCOS by clinical, laboratory, and radiological investigations. Results Overall, 28% of our women with T1DM had PCOS and 61% had metabolic syndrome. Frank PCOS was the most common PCOS phenotype (47%). When women with T1DM with and without PCOS were compared, BMI, waist circumference, systolic blood pressure, and fasting blood sugar were statistically higher in the PCOS group, whereas high-density lipoprotein cholesterol was statistically lower (P < 0.05). Follicular-stimulating hormone (FSH) and sex hormone-binding globulin were also statistically lower and luteinizing hormone (LH), LH/FSH ratio, and total testosterone (TT) were statistically higher (P < 0.01) in the PCOS than in the non-PCOS group. In women with T1DM, LH, LH/FSH ratio, and TT were positively correlated with BMI and waist circumference, whereas LH/FSH ratio and TT were negatively correlated with high-density lipoprotein cholesterol. Conclusion The prevalence of PCOS among women with T1DM in our sample of Egyptian patients revealed that PCOS and its associated traits are common findings. Thus, current T1DM management guidelines should include screening tests for PCOS and androgen excess as these patients have a high incidence of metabolic syndrome. [ABSTRACT FROM AUTHOR]

Background Chronic kidney disease (CKD) arises from many heterogeneous disease pathways that alter the function and structure of the kidney irreversibly, over months or years. The diagnosis of CKD rests on establishing a chronic reduction in kidney function and structural kidney damage, which presents with varied clinical manifestations. CKD may be associated with elevation of serum prolactin (PRL) levels. In addition to sexual dysfunction, PRL may have several biologic actions that participate in the atherosclerotic process and lead to insulin resistance. It may also be associated with endothelial dysfunction and lipid profile abnormalities. Objective The objective of this work was to evaluate serum PRL level in male patients with CKD. Patients and methods This study was conducted on 90 male participants, aged 30–60 years old. They were divided into two groups: group 1 comprised 60 male participants diagnosed with CKD, and group 2 included 30 age-matched healthy individuals as a control group. CKD group was subdivided into compensated CKD and CKD on hemodialysis. Results Among 60 patients with CKD, 48 (80%) patients had elevated serum PRL compared with normal serum PRL in group 2. A significant positive correlation was found between PRL and serum creatinine (r=0.259, P<0.05) and a negative correlation was observed between PRL and estimated glomerular filtration rate (r=−0.259, P>0.05). Patients with CKD on hemodialysis had higher PRL level compared with patients with compensated CKD (P<0.05). Conclusion CKD is associated with hyperprolactinemia which was found in most patients. [ABSTRACT FROM AUTHOR]

Background Irisin is an adipo-myokine, which has broad implications for metabolism and energy homeostasis. However, evidence about its association with diabetic nephropathy (DN) is limited. Aim To evaluate serum irisin level and its relation to DN in patients with type 2 diabetes. Patients and methods This case–control study was conducted on 60 patients with type 2 diabetes and 30 healthy age-matched and sex-matched individuals. Patients were divided into three groups according to urinary albumin–creatinine ratio (ACR), namely, normoalbuminuric group, which included 15 patients; microalbuminuric group, which included 30 patients; and macroalbuminuric group, which included 15 patients. Detailed history, clinical examination, and anthropometric measurements were assessed for all participants. Fasting blood glucose and 2-h postprandial blood glucose, total cholesterol, triglycerides, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, urea, creatinine, uric acid, estimated glomerular filtration rate, and irisin were measured for all participants. Glycosylated hemoglobin and urinary ACR were measured for patients only. Results Irisin was significantly lower in diabetic groups compared with controls. Irisin was positively correlated with estimated glomerular filtration rate but negatively correlated with fasting blood glucose, creatinine, and ACR. Multivariable regression analysis revealed that lower irisin level was considered as an independent predictor for DN. Conclusion Serum irisin is significantly related to diabetic kidney disease, and it might be progressively decreasing with development of the different stages of DN. [ABSTRACT FROM AUTHOR]

Background Diabetic retinopathy (DR) is a major microvascular complication of diabetes. Aim of the work To study the association between serum apolipoprotein B (Apo-B) and DR in type 2 diabetes. Patients and methods This comparative study was conductedon75patients with type2diabetes recruited from the Endocrinology and Ophthalmology Departments of Al-Zahraa University Hospital. They were divided into three groups according to DR grading: group A included 31 patients without DR, group B included 27 patients with nonproliferativeDR, and group C included 17 patients with proliferative DR. Detailed history, clinical examination, and anthropometric measurementswere assessed for all selected patients. Fasting and 2-h postprandial blood glucose levels, glycosylated hemoglobin, total cholesterol (CHO), triglycerides (TG), lowdensity lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and Apo-B were measured. Fundus examination was done for all participants. Results CHO, TGs, LDL-C, and Apo-B were statistically significantly higher in group C followed by group B and then group A. However, HDL-C was statistically significantly lower in group C followed by group B and then group A. A significant positive correlation was found between DR on one hand and age, diabetes duration, systolic blood pressure, diastolic blood pressure, glycosylated hemoglobin, CHO, TGs, LDL-C, and Apo-B on the other hand. DR correlated negatively with HDL-C. Conclusion Serum Apo-B levels may be a strong biomarker for DR than traditional lipids. [ABSTRACT FROM AUTHOR]

Objectives: We sought to evaluate the mid-term outcome of hospital survivors with extracardiac Fontan circulation. Background: Few data exist about the mid-term and long-term results of the extracardiac Fontan operation. Methods: From November 1988 to November 2003, 221 patients underwent an extracardiac Fontan procedure as primary (9 patients) or secondary (212 patients) palliation, at a mean age of 72.2 months (range 13.1 to 131.3 months). A total of 165 of 193 early survivors underwent programmed noninvasive follow-up evaluations and at least one cardiac catheterization. Results: The overall survival, including operative deaths, was 85% at 15 years. Freedom from late failure among hospital survivors is 92% at 15 years. A total of 127 of 165 survivors (77%) were in New York Heart Association functional class I. The incidence of late major problems was 24% (42 major problems in 36 of 165 patients): 19 patients had arrhythmias (11%), 5 patients had obstruction of the extracardiac conduit (3%) and 6 of the left pulmonary artery (3.5%), and 5 patients experienced ventricular failure (3%), leading to heart transplantation in 3 patients. Protein-losing enteropathy was found in two patients (1%). The incidence of late re-interventions was 12.7% (21 of 165 patients, including 15 epicardial pacemaker implantations). Four patients died (2.3%), two after heart transplantation. Conclusions: After 15 years of follow-up, the overall survival, the functional status, and the cardiopulmonary performance of survivors of the extracardiac Fontan procedure compare favorably with other series of patients who underwent the lateral tunnel approach. The incidence of late deaths, obstructions of the cavopulmonary pathway, re-interventions, and arrhythmias is lower than that reported late after other Fontan-type operations. [Copyright &y& Elsevier]