SummaryThe activities of hepatic and lipoprotein lipase and the levels of lipo-and apoproteins were compared in two groups of normoglycaemic men representing the highest (n = 18) and lowest (n = 15) fasting insulin quintiles of first degree male relatives of non-insulin-dependent diabetic patients. The high insulin group representing insulin-resistant individuals had significantly lower post-heparin plasma lipoprotein lipase activity than the low insulin group (14.2 + 4.0 vs 20 + 5.8 ~mol NEFA-m1-1 9 h -1, p < 0.001); hepatic lipase activity did not differ between the two groups (24.2 + 11 vs 18.0 _+ 5.3 ~mol NEFA-ml -~ . h -1, NS). The lipoprotein lipase/hepatic lipase ratio in the high insulin group was decreased by 66 % as compared to the low insulin group (0.75 + 0.57 vs 1.25 +_ 0.65, p < 0.01). In the high insulin group both total and VLDL triglycerides were higher than in the low insulin group (1.61 + 0.57 vs 0.86 + 0.26 mmol/1, p < 0.001 and 1.00 + 0.47 vs 0.36 + 0.16 mmol/1, p < 0.001, respectively) whereas HDL cholesterol and HDL 2 cholesterol were lower (1.20 + 0.30 vs 1.43 + 0.22 mmol/1, p<0.05 and 0.49+0.21 vs 0.71+0.17mmol/1, p < 0.05, respectively). Total cholesterol, LDL cholesterol or HDL 3 cholesterol did not differ between the two groups. The mean particle size of LDL was smaller in the high insulin group than in the low insulin group (258 + 7 vs 265 + 6 A, p < 0.05). We propose that the changes of lipoprotein lipase and lipoprotein lipase/hepatic lipase ratio cluster with insulin resistance and provide a possible mechanism to explain the lowering of HDL cholesterol and elevation of triglyceride concentrations observed in insulin-resistant subjects. [Diabetologia (1995) rides and lowering of HDL-cholesterol, is an inherent feature in this cluster of metabolic abnormalities which also include insulin resistance, hyperinsulinism, central obesity, impaired glucose tolerance or non-insulin-dependent diabetes mellitus (NIDDM) and hypertension. Recently, the preponderance of small dense LDL has been linked with this constellation [4,5]. The lipoprotein pattern has been termed as the atherogenic lipoprotein phenotype and it is associated with excess risk of coronary heart disease [6, 7].A major challenge is to define the causal sequence between dyslipidaemia and insulin resistance. Several studies have demonstrated that fasting insulin is related to high trigtyceride levels [8][9][10][11]. Substantial evidence indicates that hypertriglyceridaemia is indeed

IntroductionTo investigate the safety of balloon catheter for cervical ripening in women with term pre‐labor rupture of membranes (PROM) and to compare the incidence of maternal and neonatal infections in women with PROM and women with intact membranes undergoing cervical ripening with a balloon catheter.Material and methodsThis retrospective cohort study of 1923 women with term singleton pregnancy and an unfavorable cervix undergoing cervical ripening with a balloon catheter was conducted in Helsinki University Hospital between January 2014 and December 2018. For each case of PROM, two controls were assigned. The main outcome measures were the rates of maternal and neonatal infections. Statistical analyses were performed by SPSS.ResultsIn all, 641 (33.3%) women following PROM and 1282 (66.6%) women with intact amniotic membranes underwent labor induction. The rates of intrapartum infection (3.7% vs 7.7%; P = .001) and neonatal infection (1.7% vs 3.8%; P = .01) were not increased in women induced by balloon catheter following PROM. Intrapartum infections were associated with nulliparity (odds ratio [OR] 3.3, 95% confidence interval [CI] 1.6‐6.5), history of previous cesarean section (OR 2.8, 95% CI 1.2‐6.4), extended gestational age ≥41 weeks (OR 1.9, 95% CI 1.2‐3.0) and an induction to delivery interval of 48 hours or more (OR 2.0, 95% CI 1.2‐3.3). The risk of neonatal infection was associated with nulliparity (OR 3.3, 95% CI 1.4‐8.0), gestational age ≥41 weeks (OR 1.9, 95% CI 1.09‐3.36) and induction to delivery interval of 48 hours or more (OR 3.4, 95% CI 1.9‐6.0).ConclusionsUse of balloon catheter in women with term PROM appears safe and was not associated with increased maternal or neonatal infectious morbidity.