Estrogen impacts insulin action and cardiac metabolism, and menopause dramatically increases cardiometabolic risk in women. However, the mechanism(s) of cardiometabolic protection by estrogen remain incompletely understood. Here, we tested the effects of selective activation of E2 receptor alpha (ER α) on systemic metabolism, insulin action, and cardiac mitochondrial function in a mouse model of metabolic dysfunction (ovariectomy [OVX], insulin resistance, hyperlipidemia, and advanced age). Middle‐aged (12‐month‐old) female low‐density lipoprotein receptor (Ldlr)−/− mice were subjected to OVX or sham surgery and fed “western” high‐fat diet (WHFD) for 3 months. Selective ER α activation with 4,4′,4″‐(4‐Propyl‐[1H]‐pyrazole‐1,3,5‐triyl) (PPT), prevented weight gain, improved insulin action, and reduced visceral fat accumulation in WHFD‐fed OVX mice. PPT treatment also elevated systemic metabolism, increasing oxygen consumption and core body temperature, induced expression of several metabolic genes such as peroxisome proliferator‐activated receptor gamma, coactivator 1 alpha, and nuclear respiratory factor 1 in heart, liver, skeletal muscle, and adipose tissue, and increased cardiac mitochondrial function. Taken together, selective activation of ER α with PPT enhances metabolic effects including insulin resistance, whole body energy metabolism, and mitochondrial function in OVX mice with metabolic syndrome.
Background: Congenital as well as acquired heart diseases remain one of the important factors complicating pregnancy and remains a significant cause of maternal as well as perinatal morbidity and mortality. Pregnant women with cardiac diseases need a comprehensive management strategy to minimize the adverse effect of cardiac conditions on pregnancy and its outcome.Methods: This was an observational study conducted in a tertiary care hospital located in an urban area. Pregnant patients diagnosed to be having congenital or acquired heart diseases and admitted either in ward, labour room or intensive care unit were included in this study on the basis of a predefined inclusion and exclusion criteria. Detailed history was taken and clinical examination was done in all the cases. Patients were classified according to New York Heart Association. Maternal and perinatal Outcome was studied in cases.Results: The incidence of cardiac disease amongst pregnant patients during study period was found to be 0.58%. The mean age of studied cases was found to be 23.16±5.06 years. Most of the patients were primigravida (85.71%) and 6 patients (14.29%) were multigravida. The majority of the patients (76.19%) belonged to NYHA grade I whereas 8 (19.05%) patients belonged to NYHA class II. 1 patient belonged to NYHA Class III and Class IV respectively. Isolated mitral stenosis secondary to rheumatic valvular involvement was the single most common lesion seen in studied cases and was seen in 8 (19.05%) patients. Ventricular septal defect was most common congenital heart disease (14.28%). 26 (61.90 %) delivered by normal vaginal delivery whereas emergency and elective LSCS was done in 9 (21.43%) and 6 (14.29%) patients respectively. nature of cardiac disease was common factor for elective cesarean section which was done in 5 cases (11.90%). Postpartum cardiac failure (14.29%) and postpartum hemorrhage (9.52%) were common maternal complications. 24 (57.14%) neonates required admission in neonatal intensive care unit. The most common indication for NICU admission was found to be low birth weight (23.81%) followed by birth asphyxia (19.05%).Conclusions: Cardiac disease in pregnancy is associated with increased risk of maternal as well as perinatal morbidity and mortality. Early diagnosis and management during pregnancy is essential to reduce maternal as well as perinatal outcome in these cases.
Background: Systemic lupus erythematosus (SLE) is an autoimmune disorder predominantly affecting women of child bearing age group and is known to require significant lifestyle modifications. The manifestations of SLE are myriad and it may virtually affect every system of affected individual. We Undertook this study to know the clinical profile of young female patients having SLE. The aim of the study was to study clinical features and medical therapy of young female patients having SLE.Methods: This was a prospective study in which 60 female patients diagnosed to be having lupus were included on the basis of a predefined inclusion and exclusion criteria. Investigations relevant to the diagnosis such as Antinuclear antibodies, Antiphospholipid Antibodies, Anti B2GP1 IgG, Anti-dsDNA antibody, Anti Smith Antibody and complement (C3 and C4) levels were done in all the cases. Other investigations such as imaging studies were done in selected cases. Clinical features and medical management being taken by these patients were analyzed. SSPS 21.0 software was used for statistical purpose.Results: The mean duration of the disease in studied cases was found to be 6.96±4.51 years. Malar rash was the commonest type of rash seen in these patients and was present in 53 (88.33%). Arthralgia with or without arthritis was seen in 54 (90%) of the cases. Anemia was the most common hematological abnormality and was seen in 17 (28.33%) patients. Renal involvement in the form of proteinuria was seen in 25 (41.67%) cases. The most common form of pulmonary involvement was pleural effusion which was seen in 4 (6.67%) patients. Cardiovascular manifestations were seen in 11 patients (18.33%).Conclusions: SLE usually affect women of child bearing age group and have a myriad clinical presentation. A thorough knowledge of various clinical presentations and a high index of suspicion is necessary to diagnose SLE particularly in its early stages.
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