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Early carotid atherosclerosis in normotensive severe obese premenopausal women with low DHEA(S)

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An Erratum to this article was published on 01 May 2003

Abstract

The aim of this study was to investigate the direct involvement of hyperinsulinaemia, DHEA and DHEA-S [DHEA(S)] in severe obesity in early carotid atherosclerosis, measured as intima-media thickness (IMT). Seventeen normotensive premenopausal women with very high BMI (43.5±1.6 kg/m2) were recruited for the study. Six women were also evaluated 12 months after laparoscopic adjustable silicone gastric banding (LASGB). Dietary intake, fasting plasma lipid profile, glycemic and insulinemic response to the OGTT, adrenal secretion, at baseline and after ACTH stimulation test, were measured. IMT, common carotid diameter (CD) and left ventricular mass index (LVMi) were measured by B-mode echotomography. All obese subjects showed higher fasting and stimulated insulin levels, but lower DHEA(S) levels than controls, showing a negative correlation between both fasting and stimulated insulin and DHEA(S), either at baseline or after ACTH testing. IMT was higher (p<0.05) than controls, with a positive correlation with stimulated insulin (p<0.05) and a strong negative correlation with DHEA(S) (p<0.001). In a multiple linear regression analysis, insulin response to OGTT maintained an association with DHEA(S) independent of fasting insulin, while DHEA maintained the association with IMT independent of stimulated insulin (p<0.0001). In the six patients evaluated 12 months after LASGB, fasting insulin levels decreased, while DHEA(S) levels increased (p<0.05). In conclusion, an early cardiovascular involvement was detected in this group of severe obese with hyperinsulinaemia and low DHEA(S), even in the absence of other well known CVD risk factors.

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Authors and Affiliations

  1. Department of Molecular and Clinical Endocrinology and Oncology, University “Federico II” Medical School, Via A. Manzoni 71, 80123, Naples, Italy

    Silvia Savastano, F. Orio Jr, G. Lupoli & G. Lombardi

  2. CEOS-CNR, Department of Cellular and Molecular Biology and Pathology, University “Federico II” Medical School, Naples, Italy

    R. Valentino

  3. Department of Neurosciences, Unit of Physiology, University “Federico II” Medical School, Naples, Italy

    A. Belfiore, A. M. Villani & C. Falcone

  4. Department of Clinical Medicine and Cardiovascular Science, University “Federico II” Medical School, Naples, Italy

    N. De Luca

  5. Department of Gynaecology and Obstetrics, “S.M. delle Grazie” Hospital, ASL NA2, Pozzuoli (Naples), Italy

    A. de Alteriis

  6. Department of Obstetrics and Gynaecology, University “Magna Grecia”, Catanzaro, Italy

    S. Palomba

Authors
  1. Silvia Savastano
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  2. R. Valentino
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  3. A. Belfiore
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  4. N. De Luca
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  5. A. de Alteriis
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  6. F. Orio Jr
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  8. A. M. Villani
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  9. C. Falcone
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  10. G. Lupoli
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  11. G. Lombardi
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Correspondence to Silvia Savastano.

Additional information

An erratum to this article is available at http://dx.doi.org/10.1007/BF03345190.

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Savastano, S., Valentino, R., Belfiore, A. et al. Early carotid atherosclerosis in normotensive severe obese premenopausal women with low DHEA(S). J Endocrinol Invest 26, 236–243 (2003). https://doi.org/10.1007/BF03345163

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  • DOI: https://doi.org/10.1007/BF03345163

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