The Experts below are selected from a list of 186 Experts worldwide ranked by ideXlab platform
Yuhei Kawano - One of the best experts on this subject based on the ideXlab platform.
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decreases in serum uric acid by amelioration of Insulin resistance in overweight hypertensive patients effect of a low energy diet and an Insulin Sensitizing Agent
American Journal of Hypertension, 2002Co-Authors: Sei Tsunoda, Junichi Minami, Kei Kamide, Yuhei KawanoAbstract:Abstract Background Hyperuricemia and hyperInsulinemia/Insulin resistance are commonly seen in obese subjects and hypertensive patients. To clarify whether the Insulin resistance plays a role in hyperuricemia, we investigated alterations in serum uric acid (UA) concentrations during treatment with a low-energy diet or an Insulin-Sensitizing Agent in overweight hypertensive patients. Methods Twenty-eight overweight hypertensive patients (14 men and 14 women, mean age 61 ± 2 years) were assigned to a weight reduction program with a low-energy diet (3360 kJ/day for 3 weeks, n = 14) and to treatment with troglitazone (200 mg twice daily for 8 weeks, n = 14). Measurements of body weight, blood pressure (BP), serum UA, and a 75-g oral glucose tolerance test were performed at baseline and the end of the intervention periods. Results Body weight and BP decreased significantly in the diet group but not in the troglitazone group at the end of the intervention periods. Levels of blood glucose, plasma Insulin, and homeostasis model assessment–Insulin resistance index (HOMA-R) improved similarly in the two groups. Serum UA concentration decreased by treatment both in the diet (0.4 ± 0.2 mg/dL, P Conclusions The amelioration of Insulin resistance by either a low-energy diet or troglitazone decreased the serum UA level in overweight hypertensive patients. Insulin resistance or hyperInsulinemia, independent of body weight and BP, may play an important role in UA metabolism in multiple risk factor syndrome.
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effects of a low energy diet and an Insulin Sensitizing Agent on ambulatory blood pressure in overweight hypertensive patients
Journal of Hypertension, 2000Co-Authors: Yuhei Kawano, Naoki Okuda, Junichi Minami, Shuichi Takishita, Teruo OmaeAbstract:Objective To clarify the role of Insulin resistance and hyperInsulinaemia in the pathogenesis of obesity-related hypertension. Design An open study comparing the effects of weight reduction by low-energy diet and treatment with troglitazone, an Insulin-Sensitizing Agent. Setting A tertiary teaching hospital. Patients Thirty overweight hypertensive patients (15 men and 15 women, mean age 61 years, mean body mass index 29.1 kg/m2). Interventions Fifteen patients were assigned to a weight-reduction programme by low-energy diet (3360 kJ/day) for 3 weeks; the remaining 15 patients were treated with troglitazone (400 mg/day) for 8 weeks. Main outcome measures Casual and ambulatory blood pressures, glucose and lipid metabolism, and Insulin sensitivity. Results The baseline values of body mass index, fasting and post-glucose plasma Insulin, and casual and ambulatory blood pressures were comparable between the two groups. Weight reduction (4.1 ± 0.3 kg, mean ± SEM) was associated with significant decreases in plasma Insulin, blood glucose, homeostasis model assessment (HOMA) Insulin resistance index, serum triglyceride, casual blood pressure (7.7 ± 2.3/3.9 ± 1.4 mmHg) and 24 h blood pressure (8.3 6 1.9/ 4.3 ± 1.1 mmHg). Treatment with troglitazone caused comparable decreases in the metabolic parameters and HOMA index, but did not change casual or 24 h blood pressure (0.8 ± 3.4/0.8 ± 2.1 and 1.5 ± 2.4/1.0 ± 1.9 mmHg, respectively). Conclusions Insulin resistance/hyperInsulinaemia may not have an important role in the pathogenesis of obesity-related hypertension. The antihypertensive effect of weight reduction seems to be mediated mainly by other mechanisms.
Randall W. Whitcomb - One of the best experts on this subject based on the ideXlab platform.
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Troglitazone improves ovulation and hirsutism in the polycystic ovary syndrome: A multicenter, double blind, placebo-controlled trial
Journal of Clinical Endocrinology and Metabolism, 2001Co-Authors: Ricardo Azziz, David Ehrmann, Richard S. Legro, Rochelle Hanley, Mary O'keefe, Randall W. Whitcomb, Anita Gmerek Fereshetian, Mahmoud N. GhazziAbstract:We hypothesized that the administration of troglitazone, an Insulin-Sensitizing Agent of the thiazolidinedione class, would improve the ovulatory dysfunction, hirsutism, hyperandrogenemia, and hyperInsulinemia of polycystic ovary syndrome (PCOS) patients. Four hundred and ten premenopausal women with PCOS in a multicenter, double blind trial were randomly assigned to 44 weeks of treatment with placebo (PBO) or troglitazone [150 mg/day (TGZ-150), 300 mg/day (TGZ-300), or 600 mg/day (TGZ-600)]. We compared changes in ovulatory function (by monitoring the urinary level of pregnanediol-3-glucuronide daily), hirsutism (by a modified Ferriman-Gallwey scoring method), hormonal levels (total and free testosterone, androstenedione, sex hormone-binding globulin, LH, FSH, and the LH/FSH ratio), and measures of glycemic parameters (fasting levels of glucose, Insulin, hemoglobin A(1c), and the glucose and Insulin areas under the curve during an oral glucose challenge) among study groups. Of the 410 patients recruited, 305 (74.4%) met evaluability criteria and were included in the analyses. The patients' baseline characteristics were similar across all treatment arms. Ovulatory rates were significantly greater for patients receiving TGZ-300 and TGZ-600 than for those receiving PBO (0.42 and 0.58 vs. 0.32; P < 0.05 and 0.0001, respectively). Of PCOS patients treated with TGZ-600, 57% ovulated over 50% of the time compared with 12% of placebo-treated patients. There was a significant decrease in the Ferriman-Gallwey score with TGZ-600 compared with PBO (0.22 +/- 0.53 vs. -2.21 +/- 0.49; P < 0.05, respectively). Free testosterone decreased and sex hormone-binding globulin increased in a dose-related fashion with troglitazone treatment, and all three troglitazone treatment groups were significantly different from placebo. Nearly all glycemic parameters showed dose-related decreases with troglitazone treatment. The total number and severity of adverse events (including elevations in liver enzymes) and the proportion of patients withdrawn from the study due to the development of adverse effects were similar between treatment groups. Troglitazone improves the ovulatory dysfunction, hirsutism, hyperandrogenemia, and Insulin resistance of PCOS in a dose-related fashion, with a minimum of adverse effects.
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the Insulin Sensitizing Agent troglitazone improves metabolic and reproductive abnormalities in the polycystic ovary syndrome
The Journal of Clinical Endocrinology and Metabolism, 1996Co-Authors: Andrea Dunaif, Denise Scott, Diane T Finegood, Benjamin Quintana, Randall W. WhitcombAbstract:We performed this study to investigate the hypothesis that Insulin resistance plays a role in the pathogenesis of reproductive abnormalities in women with the polycystic ovary syndrome (PCOS). Twenty-five women with PCOS were enrolled in a double-blind randomized 3-month trial of two doses of the Insulin-Sensitizing Agent, troglitazone, 21 of whom completed the study: 200 mg, n = 10; 400 mg, n = 11. Baseline hormonal parameters and glucose tolerance were compared with 12 age- and weight-matched ovulatory control women. There were no significant changes in body mass index during the study. Fasting (P < 0.01) and 2-h post-75-g glucose load Insulin levels (P < 0.05), as well as integrated Insulin responses to the glucose load, decreased (P < 0.05), and Insulin sensitivity assessed by a frequently sampled iv glucose tolerance test increased significantly (P < 0.001) during troglitazone treatment. This was accompanied by significant decreases in the levels of nonsex hormone-binding globulin-bound testosterone ...
Junichi Minami - One of the best experts on this subject based on the ideXlab platform.
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decreases in serum uric acid by amelioration of Insulin resistance in overweight hypertensive patients effect of a low energy diet and an Insulin Sensitizing Agent
American Journal of Hypertension, 2002Co-Authors: Sei Tsunoda, Junichi Minami, Kei Kamide, Yuhei KawanoAbstract:Abstract Background Hyperuricemia and hyperInsulinemia/Insulin resistance are commonly seen in obese subjects and hypertensive patients. To clarify whether the Insulin resistance plays a role in hyperuricemia, we investigated alterations in serum uric acid (UA) concentrations during treatment with a low-energy diet or an Insulin-Sensitizing Agent in overweight hypertensive patients. Methods Twenty-eight overweight hypertensive patients (14 men and 14 women, mean age 61 ± 2 years) were assigned to a weight reduction program with a low-energy diet (3360 kJ/day for 3 weeks, n = 14) and to treatment with troglitazone (200 mg twice daily for 8 weeks, n = 14). Measurements of body weight, blood pressure (BP), serum UA, and a 75-g oral glucose tolerance test were performed at baseline and the end of the intervention periods. Results Body weight and BP decreased significantly in the diet group but not in the troglitazone group at the end of the intervention periods. Levels of blood glucose, plasma Insulin, and homeostasis model assessment–Insulin resistance index (HOMA-R) improved similarly in the two groups. Serum UA concentration decreased by treatment both in the diet (0.4 ± 0.2 mg/dL, P Conclusions The amelioration of Insulin resistance by either a low-energy diet or troglitazone decreased the serum UA level in overweight hypertensive patients. Insulin resistance or hyperInsulinemia, independent of body weight and BP, may play an important role in UA metabolism in multiple risk factor syndrome.
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effects of a low energy diet and an Insulin Sensitizing Agent on ambulatory blood pressure in overweight hypertensive patients
Journal of Hypertension, 2000Co-Authors: Yuhei Kawano, Naoki Okuda, Junichi Minami, Shuichi Takishita, Teruo OmaeAbstract:Objective To clarify the role of Insulin resistance and hyperInsulinaemia in the pathogenesis of obesity-related hypertension. Design An open study comparing the effects of weight reduction by low-energy diet and treatment with troglitazone, an Insulin-Sensitizing Agent. Setting A tertiary teaching hospital. Patients Thirty overweight hypertensive patients (15 men and 15 women, mean age 61 years, mean body mass index 29.1 kg/m2). Interventions Fifteen patients were assigned to a weight-reduction programme by low-energy diet (3360 kJ/day) for 3 weeks; the remaining 15 patients were treated with troglitazone (400 mg/day) for 8 weeks. Main outcome measures Casual and ambulatory blood pressures, glucose and lipid metabolism, and Insulin sensitivity. Results The baseline values of body mass index, fasting and post-glucose plasma Insulin, and casual and ambulatory blood pressures were comparable between the two groups. Weight reduction (4.1 ± 0.3 kg, mean ± SEM) was associated with significant decreases in plasma Insulin, blood glucose, homeostasis model assessment (HOMA) Insulin resistance index, serum triglyceride, casual blood pressure (7.7 ± 2.3/3.9 ± 1.4 mmHg) and 24 h blood pressure (8.3 6 1.9/ 4.3 ± 1.1 mmHg). Treatment with troglitazone caused comparable decreases in the metabolic parameters and HOMA index, but did not change casual or 24 h blood pressure (0.8 ± 3.4/0.8 ± 2.1 and 1.5 ± 2.4/1.0 ± 1.9 mmHg, respectively). Conclusions Insulin resistance/hyperInsulinaemia may not have an important role in the pathogenesis of obesity-related hypertension. The antihypertensive effect of weight reduction seems to be mediated mainly by other mechanisms.
Stephen Franks - One of the best experts on this subject based on the ideXlab platform.
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when should an Insulin Sensitizing Agent be used in the treatment of polycystic ovary syndrome
Clinical Endocrinology, 2011Co-Authors: Stephen FranksAbstract:Polycystic ovary syndrome (PCOS) is associated with Insulin resistance and an increased risk of developing type 2 diabetes mellitus. The attendant hyperInsulinaemia is also thought to contribute to the mechanism of anovulation in PCOS. Both metabolic and reproductive abnormalities are amplified by obesity and the treatment of first choice for overweight or obese women with PCOS is modification of diet and lifestyle. Nevertheless, changes in diet and exercise are, for many subjects, not easy to sustain and there seems an obvious place for Insulin Sensitizing Agents in management of both reproductive and metabolic disturbances. Of the available Agents affecting Insulin sensitivity, metformin has been the most widely used but despite an enormous literature reporting beneficial effects on reproductive, cutaneous and metabolic manifestations of PCOS, its efficacy is unproven apart from in those subjects with impaired glucose tolerance or frank diabetes. Metformin at least has an assured safety record whereas both efficacy and safety of other Insulin Sensitizing Agents in women of reproductive age, such as thiazolidinediones and glucagon-like peptide analogues, remains to be established.
Teruo Omae - One of the best experts on this subject based on the ideXlab platform.
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effects of a low energy diet and an Insulin Sensitizing Agent on ambulatory blood pressure in overweight hypertensive patients
Journal of Hypertension, 2000Co-Authors: Yuhei Kawano, Naoki Okuda, Junichi Minami, Shuichi Takishita, Teruo OmaeAbstract:Objective To clarify the role of Insulin resistance and hyperInsulinaemia in the pathogenesis of obesity-related hypertension. Design An open study comparing the effects of weight reduction by low-energy diet and treatment with troglitazone, an Insulin-Sensitizing Agent. Setting A tertiary teaching hospital. Patients Thirty overweight hypertensive patients (15 men and 15 women, mean age 61 years, mean body mass index 29.1 kg/m2). Interventions Fifteen patients were assigned to a weight-reduction programme by low-energy diet (3360 kJ/day) for 3 weeks; the remaining 15 patients were treated with troglitazone (400 mg/day) for 8 weeks. Main outcome measures Casual and ambulatory blood pressures, glucose and lipid metabolism, and Insulin sensitivity. Results The baseline values of body mass index, fasting and post-glucose plasma Insulin, and casual and ambulatory blood pressures were comparable between the two groups. Weight reduction (4.1 ± 0.3 kg, mean ± SEM) was associated with significant decreases in plasma Insulin, blood glucose, homeostasis model assessment (HOMA) Insulin resistance index, serum triglyceride, casual blood pressure (7.7 ± 2.3/3.9 ± 1.4 mmHg) and 24 h blood pressure (8.3 6 1.9/ 4.3 ± 1.1 mmHg). Treatment with troglitazone caused comparable decreases in the metabolic parameters and HOMA index, but did not change casual or 24 h blood pressure (0.8 ± 3.4/0.8 ± 2.1 and 1.5 ± 2.4/1.0 ± 1.9 mmHg, respectively). Conclusions Insulin resistance/hyperInsulinaemia may not have an important role in the pathogenesis of obesity-related hypertension. The antihypertensive effect of weight reduction seems to be mediated mainly by other mechanisms.