Amenorrhea: an approach to diagnosis and management.

Although amenorrhea may result from a number of different conditions, a systematic evaluation including a detailed history, physical examination, and laboratory assessment of selected serum hormone levels can usually identify the underlying cause. Primary amenorrhea, which by definition is failure to reach menarche, is often the result of chromosomal irregularities leading to primary ovarian insufficiency (e.g.

Age-related decline in salivary dehydroepiandrosterone sulfate and associated health risks among African Americans.

Objectives: Dehydroepiandrosterone sulfate (DHEAS) declines with age and low endogenous DHEAS concentrations have been associated with obesity. In addition, DHEAS has been studied for its role in mood and wellbeing. However, limited data are available on salivary DHEAS concentrations in African Americans.

Self-reported sleep impairment and the metabolic syndrome among African Americans.

Objectives: African Americans (AA) experience a high mortality from cardiovascular disease (CVD), even without an increase in the prevalence of the metabolic syndrome (MetS). The potential role of sleep impairment in this phenomenon has not been studied. The current study examined the relationship between self-reported sleep and MetS components among AAs.

Allostatic load and health status of African Americans and whites.

Objectives: To compare health risks in 84 healthy African American and 45 white men and women after calculating allostatic load (AL) from biologic, psychosocial, and behavioral measures.

Methods: Participants (18-45 years) ranging in weight from normal to obese and without hypertension or diabetes. Fitness, body fat, CRP, mood, social support, blood pressure, sleep and exercise habits, coping, and insulin responses were dichotomized as low/high risk and summed for AL.

Total and acylated ghrelin levels in children with poor growth.

Ghrelin, an enteric hormone with potent appetite stimulating effects, also stimulates growth hormone release. We hypothesized that altered levels of total ghrelin (TG) or acylated ghrelin (AG) could affect growth by altering growth hormone secretion, subsequently affecting insulin-like growth factor-1 (IGF-1) generation or by altering appetite and food intake. After institutional review board approval, 52 children presenting for evaluation of chronic gastrointestinal symptoms (group 1), poor weight gain (group 2), or poor linear growth (group 3) were evaluated for fasting TG and AG levels in addition to their regular evaluation.

Plasma Proteomic Signature in Overweight Girls Closely Correlates with Homeostasis Model Assessment (HOMA), an Objective Measure of Insulin Resistance.

Obesity is known to be associated with a large number of long-term morbidities, and while in some cases the relationship of obesity and the consequences is clear (for example, excess weight and lower extremity orthopedic problems) in others the mechanism is not as clear. One common system of categorizing overweight in terms of the likelihood of negative consequences involves using the concept of "metabolic syndrome". We hypothesized that the development of a plasma protein profile of overweight adolescents with and without the metabolic syndrome might give a more precise and informative picture of the disease process than the current clinical categorization and permit early targeted intervention.

Cardiovascular fitness and risk factors of healthy African Americans and Caucasians.

Background: African Americans have a higher prevalence of and mortality rates from cardiovascular disease than Caucasians. One important risk factor for cardiovascular disease is poor cardiovascular fitness. We quantified associations between fitness and related primary risk factors for cardiovascular disease in healthy African Americans and Caucasians.

Diagnostic criteria for metabolic syndrome: caucasians versus African-Americans.

Background: Metabolic syndrome is a constellation of risk factors used to identify individuals at greatest risk for developing cardiovascular disease (CVD). Early diagnosis of CVD would benefit African-Americans (AA), who have a higher prevalence of and mortality rate from CVD compared to Caucasians (CA). Two definitions for metabolic syndrome were used to classify healthy CA and AA, and evaluate how other CVD risk factors [C-reactive protein (CRP), percent body fat, fitness level, insulin resistance, and non-high-density lipoprotein cholesterol (HDL-C)] changed metabolic syndrome classification.

Should triglycerides and the triglycerides to high-density lipoprotein cholesterol ratio be used as surrogates for insulin resistance?

The aims of the present study were to examine whether triglycerides (TG) and the triglyceride to high-density lipoprotein cholesterol ratio (TG/HDL-C) could predict insulin resistance in healthy African Americans and whites. This cross-sectional study included 99 African American and 50 white men and women between 18 and 45 years of age with body mass indexes between 18.5 and 38.

Psychological and physiological correlates of insulin resistance at fasting and in response to a meal in African Americans and Whites.

Background: African Americans are more insulin resistant than are Whites. The purpose of this study was to characterize physiologic and psychological (stress coping style) correlates of insulin resistance in African Americans and Whites.

Methods: We examined African American (n = 67) and White (n = 41) men and women aged 18-45 years with body mass index 18-35 kg/m2.

The prevalence of overweight in participants in high school extramural sports.

This study examines the body mass index (BMI) percentiles for age of 3970 male high school athletes. Overall, boys participating in sports had BMI percentiles similar to the general population. However, the prevalence of overweight in boys playing certain sports, particularly football, but also wrestling and crew, was higher than the general population.

Effects of dehydroepiandrosterone and alprazolam on hypothalamic-pituitary responses to exercise.

Context: The hypothalamic-pituitary-adrenal axis (HPA) is restrained by activation of gamma-amino-butyric acid receptors. Alprazolam (APZ) and dehydroepiandrosterone (DHEA) are purported to be gamma-amino-butyric acid agonists and antagonists, respectively.

Objective: Our objective was to examine the effects of APZ and DHEA alone and in combination on HPA axis activity.

Inadequacy of in-school support for diabetic children.

The level of blood glucose control needed to minimize complications in children with diabetes requires frequent blood sugar monitoring and appropriate responses to the information obtained. It is our impression that optimal support for good control is not available in all of the schools our patients attend. The objective of this study was to identify and quantify barriers to good control of diabetes in the school setting, and then use this information to target interventions to improve in-school support for children with diabetes.