OBJECTIVE -To compare the metabolic effects of fructose in healthy male and female subjects.RESEARCH DESIGN AND METHODS -Fasting metabolic profile and hepatic insulin sensitivity were assessed by means of a hyperglycemic clamp in 16 healthy young male and female subjects after a 6-day fructose overfeeding.RESULTS -Fructose overfeeding increased fasting triglyceride concentrations by 71 vs. 16% in male vs. female subjects, respectively (P Ͻ 0.05). Endogenous glucose production was increased by 12%, alanine aminotransferase concentration was increased by 38%, and fasting insulin concentrations were increased by 14% after fructose overfeeding in male subjects (all P Ͻ 0.05) but were not significantly altered in female subjects. Fasting plasma free fatty acids and lipid oxidation were inhibited by fructose in male but not in female subjects.CONCLUSIONS -Short-term fructose overfeeding produces hypertriglyceridemia and hepatic insulin resistance in men, but these effects are markedly blunted in healthy young women. Diabetes Care 31:1254-1256, 2008H igh fructose intake has been associated with adverse metabolic effects (1). Few studies have addressed whether the metabolic effects of fructose are sex dependent, however. In rats, several reports show that fructose has more pronounced adverse metabolic effects in males than in females (2,3); similarly, in humans, only men showed fructoseinduced hypertriglyceridemia (4,5). The aim of this study was to further assess whether the effects of short-term fructose overfeeding on fasting lipid metabolism and insulin sensitivity differ between men and women.RESEARCH DESIGN AND METHODS -Healthy, nonsmoking, Caucasian male (n ϭ 8, mean Ϯ SD age 22.5 Ϯ 0.93 years, BMI 22.5 Ϯ 1.4, and percent fat mass 14.2 Ϯ 3.1%) and female (n ϭ 8, age 22.9 Ϯ 0.62 years, BMI 21.0 Ϯ 1.4, and percent fat mass 24.6 Ϯ 2.5%) volunteers took part in the study. All subjects were in good health, and none were taking medications (except oral contraception for women).Each subject was studied on two occasions. On one occasion (control test), they were placed on a balanced, isoenergetic diet (100% energy requirements: 15% proteins, 35% lipids, 40% starch, and 10% mono-and disaccharides) for 6 days. On the other occasion, they were placed on the same isoenergetic diet supplemented with 3.5 g fructose ⅐ kg fat-free mass Ϫ1 ⅐ day Ϫ1 for 6 days (130% energy requirements: 11% proteins, 26% lipids, 30% starch, 8% glucose and disaccharides, and 25% fructose). The two dietary conditions were applied in a randomized order with a 4-week washout period. On the seventh day, subjects underwent a metabolic assessment including basal hormone and substrate concentrations, fasting endogenous glucose, and glucose metabolism during a two-step hyperglycemic clamp (6). Women who were not on oral contraceptive (n ϭ 2) were studied during the first 10 days of their menstrual cycle. Statistical analysisData are expressed as means Ϯ SEM. Comparisons between control diet and fructose supplementation were performed using the paired Wilco...

Background and aimsStudies in patients seeking medically assisted reproduction have shown that smoking reduces fertility, but little information is available in the general population. We assessed the associations between smoking and the number of children, childbearing planning and age at menopause in a representative sample of the population of Lausanne, Switzerland.MethodsData from 6711 participants (3530 women, age range 35–75 years) collected between 2003 and 2006 and again in 2009 and 2012. Smoking status, number of offsprings and age of menopause were assessed.ResultsWomen who currently smoke had significantly less children than former or never smokers: the number of children per women (average±SD) was 1.38±1.05, 1.45±1.07 and 1.576±1.16, respectively (p<0.001). Women who currently smoke had their first child at an earlier age than the others: 26.7±5.2, 27.4±5.4 and 26.9±5.2 years old for current, former and never smokers, respectively, (p=0.01). Similar findings were found for men: number of children per men 1.475±1.16, 1.67±1.13 and 1.55±1.22 for current, former and never smokers, respectively (p<0.001); no difference was found regarding age at the first child. The difference persisted after multivariate adjustment (adjusted for age, body mass index, Caucasian origins, alcohol consumption, caffeinated drinks consumption, educational level, receiving social help and women taking contraceptives) for the age at first child among women. No association was found between Heaviness of Smoking Index and the number of children among current smokers in both genders. Women who smoke had their menopause more than 1 year prior than never-smoking women (48.9±0.2 years compared with 47.8±0.3 years, respectively, p=0.002).ConclusionsSmoking is associated with an earlier age of having the first child and of menopause among women.

BackgroundAdrenal insufficiency is a rare and potentially lethal disease if untreated. Several clinical signs and biological markers are associated with glucocorticoid failure but the importance of these factors for diagnosing adrenal insufficiency is not known. In this study, we aimed to assess the prevalence of and the factors associated with adrenal insufficiency among patients admitted to an acute internal medicine ward.MethodsRetrospective, case-control study including all patients with high-dose (250 μg) ACTH-stimulation tests for suspected adrenal insufficiency performed between 2008 and 2010 in an acute internal medicine ward (n = 281). Cortisol values <550 nmol/l upon ACTH-stimulation test were considered diagnostic for adrenal insufficiency. Area under the ROC curve (AROC), sensitivity, specificity, negative and positive predictive values for adrenal insufficiency were assessed for thirteen symptoms, signs and biological variables.Results32 patients (11.4%) presented adrenal insufficiency; the others served as controls. Among all clinical and biological parameters studied, history of glucocorticoid withdrawal was the only independent factor significantly associated with patients with adrenal insufficiency (Odds Ratio: 6.71, 95% CI: 3.08 –14.62). Using a logistic regression, a model with four significant and independent variable was obtained, regrouping history of glucocorticoid withdrawal (OR 7.38, 95% CI [3.18 ; 17.11], p-value <0.001), nausea (OR 3.37, 95% CI [1.03 ; 11.00], p-value 0.044), eosinophilia (OR 17.6, 95% CI [1.02; 302.3], p-value 0.048) and hyperkalemia (OR 2.41, 95% CI [0.87; 6.69], p-value 0.092). The AROC (95% CI) was 0.75 (0.70; 0.80) for this model, with 6.3 (0.8 – 20.8) for sensitivity and 99.2 (97.1 – 99.9) for specificity.Conclusions11.4% of patients with suspected adrenal insufficient admitted to acute medical ward actually do present with adrenal insufficiency, defined by an abnormal response to high-dose (250 μg) ACTH-stimulation test. A history of glucocorticoid withdrawal was the strongest factor predicting the potential adrenal failure. The combination of a history of glucocorticoid withdrawal, nausea, eosinophilia and hyperkaliemia might be of interest to suspect adrenal insufficiency.

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