BACKGROUND & AIMS: :We examined the effect of exercise on postprandial lipemia (PPL) and insulin resistance in individuals with metabolic syndrome. Subjects were 10 hypertriglyceridemia (HTG) males with insulin resistance [age = 40.1 +/- 2.2 years, body weight = 96.3 +/- 3.3 kg, fasting triglyceride (TG) = 263 +/- 25 mg/dl, VO(2)max = 37 +/- 1.1 ml/kg/min, and Homeostatic Model Assessment (HOMA-IR, an index of insulin resistance) = 3.05 +/- 0.40]. Each subject performed a control trial (Ctr, no exercise), and three exercise trials at 40% (40%T), 60% (60%T), and 70% (70%T) of their VO(2)max. The order of trials was randomized and there were 1-2 weeks wash-out period between the trials. All subjects had a fat-meal in each trial. In the exercise trials, subjects jogged on a treadmill for 1 h at a designated intensity 12 h prior to a fat-meal ingestion. Blood samples were taken at 0 h (before the meal), and 2, 4, 6, and 8 h after the meal. The plasma TG, area score under TG concentration curve for over an 8 h-period (TG AUC) after the meal, and HOMA-IR were analyzed. The TG AUC score in 40%T was 30% lower (P = 0.003), 60%T was 31% lower (P = 0.02), and 70%T was 39% lower (P = 0.02) than Ctr. There were no significant differences in the TG AUC scores among the exercise trials (P > 0.05). The insulin concentrations in both 60 and 70%T were lower than Ctr (P < 0.01) which did not differ from 40%T. HOMA-IR in both 60%T (P = 0.041) and 70%T (P = 0.002) were lower than Ctr, but not different from 40%T (HOMA-IR: Ctr = 3.05 +/- 0.40, 40%T = 2.67 +/- 0.35, 60%T = 2.49 +/- 0.31, 70%T = 2.21 +/- 0.27). The results suggest that for physically inactive individuals with metabolic syndrome, exercising at low to moderate intensity may be sufficient to attenuate PPL and increase insulin sensitivity, whereas higher intensity exercise may be needed to normalize blood glucose.

背景与目标： : 我们研究了运动对代谢综合征患者餐后脂血症 (PPL) 和胰岛素抵抗的影响。研究对象为胰岛素抵抗男性高甘油三酯血症 (HTG) 10例 [年龄 = 40.1 +/- 2.2岁，体重 = 96.3 +/-3.3千克，空腹甘油三酯 (TG) = 263 +/- 25 mg/dl，VO(2)max = 37 +/-1.1毫升/kg/min，稳态模型评估 (homa-ir，胰岛素抵抗指数) = 3.05 +/- 0.40]。每个受试者在其VO(2) 最大值的40% (40% T) 、60% (60% T) 和70% (70% T) 下进行对照试验 (Ctr，无运动) 和三个运动试验。试验顺序是随机的，试验之间有1-2周的冲洗期。在每个试验中，所有受试者都吃了一顿脂肪餐。在运动试验中，受试者在摄入脂肪餐之前以指定的强度在跑步机上慢跑1小时。在餐前0小时，餐后2、4、6和8小时采集血样。分析了餐后8小时内的血浆TG，TG浓度曲线下的面积评分 (TG AUC) 和homa-ir。40% T的TG AUC评分30% 低于Ctr (P = 0.003)，60% T 31% 低于Ctr (P = 0.02)，70% T 39% 低于Ctr (P = 0.02)。运动试验之间的TG AUC评分无显着差异 (P> 0.05)。60% 和70% T中的胰岛素浓度均低于Ctr (P <0.01)，这与40% T没有差异。60% T (P = 0.041) 和70% T (P = 0.002) 的homa-ir均低于Ctr，但与40% T (homa-ir: Ctr = 3.05/- 0.40，40% T = 2.67/- 0.35，60% T = 2.49 +/- 0.31，70% T = 2.21 +/- 0.27)。结果表明，对于代谢综合征的身体不活跃的个体，低至中等强度的运动可能足以减弱PPL并增加胰岛素敏感性，而可能需要高强度的运动才能使血糖正常化。

BACKGROUND & AIMS: :Japanese people in both Japan and in Hawaii have a lower incidence of hip fractures than white people in Hawaii or on the mainland of the United States. Hip fractures usually occur after a fall, and differing incidence rates of falls might contribute to the observed differences in hip fracture rates. To investigate this possibility we undertook a prospective study of falls among elderly Japanese men and women living in Hawaii using intensive surveillance methods similar to those used in studies of predominantly white populations. For our Japanese participants, the incidence rates of total falls were 139 per 1000 person years for men and 276 per 1000 person years for women. Age adjusted rate ratios of falls for predominantly white populations compared with our Japanese participants ranged from 1.8 to 2.3 for women and from 2.6 to 4.7 for men. The risk of injuries when they did fall, however, was not lower for our Japanese participants than reported for white participants. For our Japanese population, past falls, female gender, and daytime hours were associated with an increased incidence of falls.

背景与目标： : 日本和夏威夷的日本人髋部骨折的发生率都比夏威夷或美国本土的白人低。髋部骨折通常发生在跌倒后，不同的跌倒发生率可能会导致观察到的髋部骨折发生率差异。为了调查这种可能性，我们使用了类似于以白人为主的研究中使用的强化监测方法，对居住在夏威夷的日本老年男性和女性的跌倒进行了前瞻性研究。对于我们的日本参与者，男性的总跌倒发生率为139/1000人年，女性为276/1000人年。与我们的日本参与者相比，以白人为主的年龄调整后的跌倒率比率为女性的1.8至2.3，男性的2.6至4.7。但是，我们的日本参与者跌倒时受伤的风险并不比白人参与者低。对于我们的日本人口，过去的跌倒，女性性别和白天的时间与跌倒的发生率增加有关。

BACKGROUND & AIMS: STUDY OBJECTIVE:To examine the prevalence, symptomatology, risk factors, and other infections associated with urogenital chlamydial infection in pregnant teenagers. DESIGN:Retrospective case-control study by medical record review. SETTING:Prenatal care clinic for adolescents at University of Tennessee Medical Center, Knoxville, Tennessee. PARTICIPANTS:Pregnant adolescents younger than 19 years of age who were diagnosed with chlamydial infection on the first prenatal visit from 1988 to 1994 were studied. Pregnant adolescents of similar age and socioeconomic background who came in the same day for the first prenatal visit, but were not infected, made up the control group. INTERVENTION:Routine prenatal questionnaires regarding personal and medical histories, and routine prenatal screening, including pelvic examination with Papanicolaou (PAP) smear and laboratory investigations for common genital infections and sexual transmitted disease (STDs), were obtained. MAIN OUTCOME MEASURES:Analyzed the prevalence of chlamydial infection and compared the infected group to the control group with regard to race, behavioral factors, symptoms, prenatal screening results, other concurrent genital infections, and histories of STDs. RESULTS:Of a total population of 596 pregnant teenagers, 67 (11.24%) were infected with Chlamydia trachomatis. In multivariate analysis, black race (odds ratio [OR] = 4.01; 95% confidence interval [CI] = 1.74-9.23; p = 0.001) and greater gestational age at first prenatal visit (OR = 1.11; 95% CI = 1.04-1.18; p = 0.001) were independently associated with chlamydial infection. Age, marital status, number of pregnancies, smoking, alcohol abuse, drug abuse, age at first intercourse, and multiple sex partners were not associated with the infection. Likewise, the symptom of vaginal discharge (a complaint of > 70% in each group), other genital co-infections (found > 50% in each group, mainly candidiasis and bacterial vaginosis), abnormal PAP smears (found > 60% in each group) and histories of STDs or previous chlamydial infection were not significantly different between case and control groups. Human papillomavirus infection, trichomonal infection, and dysplasia or atypia were found more often in patients infected with chlamydia, but were not statistically significant. CONCLUSION:Pregnant adolescents in east Tennessee were at risk for chlamydial infection as well as for other genital infections and abnormal PAP smears. Routine prenatal chlamydial screening is warranted because of a lack of specific symptoms.

背景与目标：

BACKGROUND & AIMS: OBJECTIVE:To measure chlamydia testing and positivity rates among 16-39 year olds attending Aboriginal Community Controlled Health Services (ACCHSs). METHODS:Retrospective non-identifiable computerised records containing consultation and chlamydia testing data were collected for patients (16-39 years) attending eight ACCHSs during 2008-09 in urban, regional and remote settings for the Australian Collaboration for Chlamydia Enhanced Sentinel Surveillance (ACCESS) system. Annual chlamydia testing and positivity rates were estimated. RESULTS:Over two years, 13,809 patients aged 16-39 years (57.8% female, 82.3% Aboriginal or Torres Strait Islander) attended. The annual overall chlamydia testing rate was 13.0% (2008) and 16.0% (2009). Testing rates were higher among females (p<0.001) and among patients aged 16-29 than 30-39 years (males: p=0.01; females: p<0.001). Chlamydia positivity was 8.5% overall; similar in females (8.7%) and males (7.8%) (p=0.46); highest among 16-19 years (females: 17.4%; males: 13.0%), declining to 1.5% among females 35-39 years (p<0.001) and 4.8% among males 30-34 years (p<0.001). CONCLUSIONS:Chlamydia testing at these ACCHSs approached recommended levels among some patient groups, however, it should increase. High positivity among younger people highlights they should be targeted. IMPLICATIONS:Young people should be targeted for sexual health interventions. ACCHSs are well placed to provide enhanced sexual health services if appropriately resourced.

背景与目标：

BACKGROUND & AIMS: :The possible combined effects of caffeine and exercise on blood pressure (BP) regulation were examined in 34 healthy, normotensive (BP less than 135/85 mm Hg) young men (mean age 27 +/- 3 years) in a placebo-controlled, double-blind crossover design. Each subject performed submaximal and symptom-limited maximal supine bicycle exercise 1 hour apart after ingestion of placebo or caffeine (3.3 mg/kg). Heart rate, BP, cardiac output and peripheral vascular resistance were compared for placebo and caffeine days. Postdrug baseline showed that caffeine increased systolic and diastolic BP and peripheral vascular resistance (p less than 0.001 for each) and decreased heart rate (p less than 0.01) but did not change stroke volume or cardiac output. BP and vascular resistance effects of caffeine remained during submaximal exercise resulting in an additive increase in BP while negative chronotropic effects of caffeine disappeared. At maximal exercise substantially more subjects (15 on caffeine vs 7 on placebo, p less than 0.02) had systolic BP greater than or equal to 230 mm Hg and/or greater than or equal to 100 mm Hg for diastolic BP. Plasma norepinephrine levels were not significantly different across days, but epinephrine was higher at maximal exercise and cortisol was increased post-drug and throughout maximal exercise on caffeine days. Data indicate that caffeine increases BP additively during submaximal exercise and may cause excessive BP responses at maximal exercise for some individuals. The pressor effects of caffeine appear to be due to increasing vascular resistance rather than cardiac output.

背景与目标： : 在安慰剂对照中，在34名健康，血压正常 (血压低于135/85mm Hg) 的年轻男性 (平均年龄27/- 3岁) 中检查了咖啡因和运动对血压 (BP) 调节的可能综合作用，双盲交叉设计。每个受试者在摄入安慰剂或咖啡因 (3.3 mg/kg) 后1小时间隔进行次最大和症状受限的最大仰卧自行车运动。比较安慰剂和咖啡因天数的心率，血压，心输出量和外周血管阻力。药物后基线显示，咖啡因增加收缩压和舒张压以及周围血管阻力 (每个p小于0.001) 和降低心率 (p小于0.01)，但不改变中风量或心输出量。在次最大运动期间，咖啡因的BP和血管阻力效应仍然存在，导致BP的累加性增加，而咖啡因的负变时性效应消失了。在最大运动时，明显更多的受试者 (咖啡因组15例，安慰剂组7例，p小于0.02) 的收缩压大于或等于230毫米Hg和/或舒张压大于或等于100毫米Hg。血浆去甲肾上腺素水平在不同的日子没有显着差异，但肾上腺素在最大运动时较高，皮质醇在服药后和咖啡因的整个最大运动中增加。数据表明，咖啡因在次最大运动期间会增加BP，并可能导致某些人在最大运动时产生过多的BP反应。咖啡因的升压作用似乎是由于血管阻力增加而不是心输出量增加所致。

BACKGROUND & AIMS: :Obesity, diabetes, hypertension, and hyperlipidemia constitute risk factors for morbidity and premature mortality. Based on animal and in vitro studies, resveratrol reverts these risk factors via stimulation of silent mating type information regulation 2 homolog 1 (SIRT1), but data in human subjects are scarce. The objective of this study was to examine the metabolic effects of high-dose resveratrol in obese human subjects. In a randomized, placebo-controlled, double-blinded, and parallel-group design, 24 obese but otherwise healthy men were randomly assigned to 4 weeks of resveratrol or placebo treatment. Extensive metabolic examinations including assessment of glucose turnover and insulin sensitivity (hyperinsulinemic euglycemic clamp) were performed before and after the treatment. Insulin sensitivity, the primary outcome measure, deteriorated insignificantly in both groups. Endogenous glucose production and the turnover and oxidation rates of glucose remained unchanged. Resveratrol supplementation also had no effect on blood pressure; resting energy expenditure; oxidation rates of lipid; ectopic or visceral fat content; or inflammatory and metabolic biomarkers. The lack of effect disagrees with persuasive data obtained from rodent models and raises doubt about the justification of resveratrol as a human nutritional supplement in metabolic disorders.

背景与目标： : 肥胖、糖尿病、高血压和高脂血症是发病和过早死亡的危险因素。基于动物和体外研究，白藜芦醇通过刺激沉默交配型信息调节2同源物1 (SIRT1) 来恢复这些危险因素，但人类受试者的数据很少。这项研究的目的是检查高剂量白藜芦醇在肥胖人类受试者中的代谢作用。在随机，安慰剂对照，双盲和平行组设计中，将24名肥胖但健康的男性随机分配到4周的白藜芦醇或安慰剂治疗中。在治疗前后进行了广泛的代谢检查，包括评估葡萄糖周转和胰岛素敏感性 (高胰岛素性正常血糖钳夹)。主要结局指标胰岛素敏感性在两组中均无明显恶化。内源性葡萄糖的产生以及葡萄糖的周转率和氧化速率保持不变。补充白藜芦醇对血压也没有影响; 静息能量消耗; 脂质的氧化率; 异位或内脏脂肪含量; 或炎症和代谢生物标志物。缺乏效果与从啮齿动物模型获得的有说服力的数据不一致，并且引起了人们对白藜芦醇作为代谢紊乱人体营养补充剂的合理性的怀疑。

BACKGROUND & AIMS: :sigma(28) RNA polymerase is an alternative RNA polymerase that has been proposed to have a role in late developmental gene regulation in Chlamydia, but only a single target gene has been identified. To discover additional sigma(28)-dependent genes in the Chlamydia trachomatis genome, we applied bioinformatic methods using a probability weight matrix based on known sigma(28) promoters in other bacteria and a second matrix based on a functional analysis of the sigma(28) promoter. We tested 16 candidate sigma(28) promoters predicted with these algorithms and found that 5 were active in a chlamydial sigma(28) in vitro transcription assay. hctB, the known sigma(28)-regulated gene, is only expressed late in the chlamydial developmental cycle only, and two of the newly identified sigma(28) target genes (tsp and tlyC_1) also have late expression profiles, providing support for sigma(28) as a regulator of late gene expression. One of the other novel sigma(28)-regulated genes is dnaK, a known heat shock-responsive gene, suggesting that sigma(28) RNA polymerase may be involved in the response to cellular stress. Our sigma(28) prediction algorithm can be applied to other bacteria, and by performing a similar analysis on the Escherichia coli genome, we have predicted and functionally identified five previously unknown sigma(28)-regulated genes in E. coli.

背景与目标： : sigma(28) RNA聚合酶是一种替代的RNA聚合酶，已被提议在衣原体的晚期发育基因调控中起作用，但仅鉴定出单个靶基因。为了在沙眼衣原体基因组中发现其他依赖sigma(28) 的基因，我们使用生物信息学方法，使用基于其他细菌中已知sigma(28) 启动子的概率权重矩阵和基于sigma(28) 启动子的功能分析的第二个矩阵。28) 启动子。我们测试了用这些算法预测的16个候选sigma(28) 启动子，发现5个在衣原体sigma(28) 体外转录测定中具有活性。已知的sigma(28) 调控基因hctB仅在衣原体发育周期的晚期表达，新鉴定的sigma(28) 靶基因 (tsp和tlyC_1) 中的两个也具有晚期表达谱，为sigma(28) 作为晚期基因表达的调节剂提供支持。另一个新的sigma(28) 调控基因是dnaK，这是一种已知的热休克反应基因，表明sigma(28) RNA聚合酶可能参与了对细胞应激的反应。我们的sigma(28) 预测算法可以应用于其他细菌，并且通过对大肠杆菌基因组进行类似的分析，我们已经预测并在功能上鉴定了大肠杆菌中五个以前未知的sigma(28) 调控基因。

BACKGROUND & AIMS: -2

背景与目标： -2

BACKGROUND & AIMS: :The effect of body mass index (BMI) and obesity on apolipoprotein (apo) A-I levels and kinetics was examined by gender. Apo A-I kinetics were determined with a primed, constant infusion of deuterated leucine in the fed state in 19 men and 13 postmenopausal women. Compared with nonobese men, nonobese women had a higher level of high-density lipoprotein cholesterol (HDL-C) and apo A-I due to a 48% higher apo A-I production rate (PR) (P = .05). Obesity had no significant effects on apo A-I kinetics in women. In contrast, compared with nonobese men, obese men had a 9% lower apo A-I level due to a 64% higher fractional catabolic rate (FCR) partially offset by a 47% higher PR. Obese women had a 52% higher HDL-C than obese men (50 vs 33 mg/dL, respectively; P = .012), a finding related to the faster apo A-I FCR in obese men. BMI was directly correlated with apo A-I FCR (r = 0.84, P < .001) and PR (r = 0.79, P < .001) in men but not in women. Sixty-two percent of the variability in PR and 71% of the variability in FCR were due to BMI in men and only 3% and 23%, respectively, in women. In conclusion, BMI has a significant effect on apo A-I PR and FCR in men but not in women.

背景与目标： : 通过性别检查了体重指数 (BMI) 和肥胖对载脂蛋白 (apo) A-I水平和动力学的影响。在19名男性和13名绝经后女性中，通过在进食状态下持续不断地输注氘代亮氨酸来确定Apo A-I动力学。与非肥胖男性相比，非肥胖女性的高密度脂蛋白胆固醇 (hdl-c) 和apo a-I水平较高，原因是apo A-I的生产率 (PR) 48% 较高 (P = .05)。肥胖对女性的apo A-I动力学没有显着影响。相反，与非肥胖男性相比，肥胖男性的apo a-I水平9% 较低，这是由于64% 较高的分解代谢率 (FCR) 部分被47% 较高的PR抵消。肥胖女性的hdl-c比肥胖男性高52% (分别为50 vs 33 mg/dL; P = .012)，这一发现与肥胖男性的apo a-I FCR更快有关。BMI与男性的apo A-I FCR (r = 0.84，P <.001) 和PR (r = 0.79，P <.001) 直接相关，而女性则不相关。PR变异性的60 2% 和FCR变异性的71% 是由于男性的BMI，而女性分别只有3% 和23%。总之，BMI对男性的apo a-I PR和FCR有显着影响，而女性则没有。

BACKGROUND & AIMS: :The antigenicity of the major outer membrane protein of Chlamydia trachomatis serovar C was assessed by using overlapping hexapeptide homologs of serovar C major outer membrane protein and rabbit antisera in a peptide enzyme-linked immunosorbent assay. Five immunogenic sites were found distributed within variable sequences of the protein: four were immunodominant and three were surface exposed on native elementary bodies of serovar C. None was surface exposed on serovars H, I, and J.

背景与目标： : 通过在肽酶联免疫吸附试验中使用血清C主要外膜蛋白和兔抗血清的重叠六肽同源物评估沙眼衣原体血清型C主要外膜蛋白的抗原性。在蛋白质的可变序列中发现了五个免疫原性位点: 四个是免疫优势，三个表面暴露在血清型C的天然基本体上。没有一个表面暴露在血清型H，I和J上。

BACKGROUND & AIMS: :The relationship and degree of association between the percentage of sperm swelling (HOS-test) and conventional semen variables was investigated in 263 consecutive ejaculates. The semen samples were exclusively obtained from men suspected of primary infertility. It was found that the correlation coefficients (Spearman's rho) followed the order: percentage of progressive motility at 3 h greater than count/ml greater than percentage of total motility at 3 h greater than percentage of normal spermatozoa. Of the three morphology sub-classes considered (sperm head, mid-piece and tail abnormalities), only mid-piece abnormalities correlated with the outcome of the HOS-test (rho = -0.409). Linear relationships between HOS-test results and sperm motility and morphology, but not sperm count, were indicated by LOWESS-smoothing. However, a linear relationship between the HOS-test, sperm count and a 'functional index' combining the conventional semen variables could be demonstrated after normalization of the data. Our findings suggest that the HOS-test may be of value in assessing the functional integrity and viability of spermatozoa; however, its prognostic power for fertility is probably not different from that of conventional semen variables.

背景与目标： : 在263连续射精中研究了精子肿胀百分比 (HOS检验) 与常规精液变量之间的关系和关联程度。精液样本仅来自怀疑原发性不育的男性。发现相关系数 (Spearman's rho) 遵循以下顺序: 3 h时的进行性运动百分比大于计数/ml大于3 h时的总运动百分比大于正常精子的百分比。在考虑的三个形态亚类 (精子头部，中段和尾部异常) 中，只有中段异常与HOS测试的结果相关 (rho = -0.409)。低度平滑显示了HOS测试结果与精子活力和形态之间的线性关系，而不是精子数量之间的线性关系。但是，在数据归一化后，可以证明HOS测试，精子数量和结合常规精液变量的 “功能指标” 之间存在线性关系。我们的发现表明，HOS测试可能在评估精子的功能完整性和生存能力方面具有价值; 但是，其对生育能力的预后能力可能与常规精液变量没有什么不同。

BACKGROUND & AIMS: PURPOSE:Glycine-arginine-alpha-ketoisocaproic acid (GAKIC) is a relatively new supplement that athletes and fitness enthusiasts ingest to enhance performance during anaerobic exercise. Therefore, the purpose of this study was to investigate the potential ergogenic effects of GAKIC ingestion during multiple bouts of resistance exercise. METHOD:Seven resistance-trained men participated in a randomized, counterbalanced, double-blind study. Participants were randomly assigned to placebo or GAKIC (10.2 g) and performed 5 sets of 75% of 1-repetition maximum leg press to failure. Total load volume was calculated by multiplying the 75% of 1-repetition maximum mass lifted by the sum of repetitions to failure. One week later, participants ingested the other supplement (placebo or GAKIC) and the same exercise protocol was performed (i.e., crossover). Blood lactate, glucose, and heart rate were determined preexercise and immediately postexercise. RESULTS:GAKIC supplementation significantly increased leg-press total load volume (GAKIC = 31,564 +/- 9,132 kg; placebo = 25,763 +/- 6,595 kg, p < .05). Heart rate and blood lactate were significantly increased (p < .05) postexercise compared with preexercise but were not significantly different between GAKIC and placebo. No significant changes (p > .05) were detected for one-repetition maximum and blood glucose. CONCLUSIONS:These novel findings suggest that GAKIC increases total work performed during repeated bouts of lower-body resistance exercise. Thus, our data suggest that GAKIC ingestion before weight training may increase the training volume of athletes and resistance-trained individuals.

背景与目标：

BACKGROUND & AIMS: BACKGROUND:There have been a number of studies of treatment for men with intellectual disabilities and sexually abusive behaviour but few follow-up studies. Our aim was to follow up men with intellectual disabilities who had attended group cognitive behavioural treatment (CBT) for sexually abusive behaviour. METHOD:Thirty-four men (from seven treatment sites) were followed up. All had attended SOTSEC-ID groups. The mean length of follow-up, since the end of the treatment group, was 44 months (SD 28.7, range 15-106 months). RESULTS:The statistically significant improvements in sexual knowledge, empathy and cognitive distortions that occurred during treatment were maintained at follow-up. In all, 11 of the 34 (32%) men showed further sexually abusive behaviour, but only two of these men received convictions. Analyses of the variables associated with further sexually abusive behaviour indicated that a diagnosis of autism was associated with a higher likelihood of further sexually abusive behaviour. CONCLUSIONS:This study provides some evidence of the longer-term effectiveness of group CBT for men with intellectual disabilities and sexually abusive behaviour.

背景与目标：

BACKGROUND & AIMS: :Osteoporosis maintains a special position in today's medicine, regarding both its growing incidence and its clinical and social consequences--fractures, leading to the loss of self-dependence, disabilities and higher mortality rates. It was thought for many years that osteoporosis affected mainly women after menopause. At present, it is known that the problem concerns men, as well. In the present review, similarities and differences between osteoporosis in either sex are discussed, concentrating on epidemiological and pathogenetic aspects, as well as on therapeutic differences.

背景与目标： : 骨质疏松症在当今医学中保持着特殊的地位，无论是其发病率的增长还是其临床和社会后果-骨折，导致丧失自我依赖性，残疾和更高的死亡率。多年来，人们一直认为骨质疏松症主要影响更年期后的妇女。目前，众所周知，这个问题也涉及男性。在本综述中，讨论了两种性别的骨质疏松症之间的异同，重点是流行病学和致病方面以及治疗上的差异。

BACKGROUND & AIMS: AIMS/HYPOTHESIS:Impaired regulation of lipolysis and accumulation of lipid intermediates may contribute to obesity-related insulin resistance and type 2 diabetes mellitus. We investigated insulin-mediated suppression of lipolysis in abdominal subcutaneous adipose tissue (AT) and skeletal muscle (SM) of obese men with normal glucose tolerance (NGT) and obese type 2 diabetic men. METHODS:Eleven NGT men and nine long-term diagnosed type 2 diabetic men (7 ± 1 years), matched for age (58 ± 2 vs 62 ± 2 years), BMI (31.4 ± 0.6 vs 30.5 ± 0.6 kg/m(2)) and [Formula: see text] (28.9 ± 1.5 vs 29.5 ± 2.4 ml kg(-1) min(-1)) participated in this study. Interstitial glycerol concentrations in AT and SM were assessed using microdialysis during a 1 h basal period and a 6 h stepwise hyperinsulinaemic-euglycaemic clamp (8, 20 and 40 mU m(-2) min(-1)). AT and SM biopsies were collected to investigate underlying mechanisms. RESULTS:Hyperinsulinaemia suppressed interstitial SM glycerol concentrations less in men with type 2 diabetes (-7 ± 6%, -13 ± 9% and -27 ± 9%) compared with men with NGT (-21 ± 7%, -38 ± 8% and -53 ± 8%) (p = 0.014). This was accompanied by increased circulating fatty acid and glycerol concentrations, a lower glucose infusion rate (21.8 ± 3.1 vs 30.5 ± 2.0 μmol kg body weight(-1) min(-1); p < 0.05), higher hormone-sensitive lipase (HSL) serine 660 phosphorylation, increased saturated diacylglycerol (DAG) lipid species in the muscle membrane and increased protein kinase C (PKC) activation in type 2 diabetic men vs men with NGT. No significant differences in insulin-mediated reduction in AT interstitial glycerol were observed between groups. CONCLUSIONS/INTERPRETATION:Our results suggest that a blunted insulin-mediated suppression of SM lipolysis may promote the accumulation of membrane saturated DAG, aggravating insulin resistance, at least partly mediated by PKC. This may represent an important mechanism involved in the progression of insulin resistance towards type 2 diabetes. TRIAL REGISTRATION:ClinicalTrials.gov NCT01680133.

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