Objective-Adipocyte fatty acid-binding protein (A-FABP) has been shown to be an important player in atherosclerosis in animal models. However, the clinical relevance of these findings is still unknown. This study aims to examine the relationship between serum A-FABP level and carotid intima-media thickness (IMT), an indicator of atherosclerosis in humans. Methods and Results-The study cohort included 479 Chinese subjects who underwent carotid IMT measurement.Serum A-FABP levels were determined by enzyme-linked immunosorbent assays. Serum A-FABP levels positively correlated with carotid IMT in both men (rϭ0.211, Pϭ0.001) and women (rϭ0.435, PϽ0.001). In women, but not in men, the presence of plaques was associated with significantly higher serum A-FABP levels (PϽ0.001 versus women without plaques). Stepwise multiple regression analysis showed that serum A-FABP level was independently associated with carotid IMT in women (Pϭ0.034), together with age and hypertension (both PϽ0.001). Conclusions-A-FABP is an independent determinant of carotid atherosclerosis in Chinese women, but not in men.This gender difference may be attributed to the lower serum A-FABP levels in men, and the effect of other risk factors, such as smoking, among our male participants. 2 Earlier animal studies showed that A-FABPnull mice were partially protected from developing hyperinsulinemia, hyperglycemia, and insulin resistance when challenged with dietary and genetic obesity. 3,4 In apolipoprotein E (apoE)-deficient mice, whether on a low-fat or high-fat diet, ablation of the A-FABP gene provided almost complete protection against atherosclerosis, independent of its effects on glucose and lipid metabolism. 5,6 Remarkably, after a high-fat atherogenic Western diet for 1 year, the survival rates of apoE Ϫ/Ϫ mice null for both A-FABP and mal1 were 67% higher than those of apoE Ϫ/Ϫ control mice, primarily because of the increased stability of atherosclerotic plaques. 7 These results suggest that A-FABP is a major mediator of atherosclerotic lesion formation in mice. In humans, A-FABP is expressed in monocytes on PPAR␥ activation, 8 and oxidized LDL has been shown to induce A-FABP expression in human THP-1 macrophage cell lines. 9 Furthermore, a genetic variant associated with increased A-FABP mRNA expression in adipose tissues predicted coronary artery disease in homozygous subjects. 10 These findings suggest that A-FABP may also play a role in the development of atherosclerotic diseases in humans.Although A-FABP was traditionally thought to be an intracellular protein, we have demonstrated that a small portion of A-FABP is released from mature adipocytes into the human blood stream, 11 with the serum concentrations being Ϸ8 to 60 ng/mL. In a cross-sectional study we observed a strong positive association between serum A-FABP levels and parameters of adiposity. In addition, serum A-FABP levels correlated closely with several key features of the metabolic syndrome, an aggregate of cardiometabolic risk factors associated with accelerated atheroscl...

Epidemiology data have revealed a higher prevalence of nodular goiters in women than men in both iodine-sufficient and iodine-deficient areas. Increased prevalence of thyroid nodules has also been reported in women with higher gravidity. However, the association between pregnancy and thyroid nodule formation has never been studied. The aim of our study was to evaluate the incidence of thyroid nodules during pregnancy and determine whether pregnancy will induce thyroid nodule formation. Two hundred twenty-one healthy southern Chinese women in the first trimester of their pregnancy were studied prospectively. Thyroid ultrasonography, thyroid function tests, and urinary iodine excretion were measured at first, second, and third trimesters of pregnancy as well as 6 wk and 3 months postpartum. Thyroid nodules (>2 mm in any dimension on ultrasonography) were detected in 34 (15.3%) subjects at first trimester, with 12 (5.4%) subjects having more than one nodule. Eight subjects had clinically palpable nodules. Women with thyroid nodules were older (P < 0.01) and had higher gravidity (P < 0.02) than those women without thyroid nodules. The volume of the single/dominant nodules increased from 60 (14--344) mm(3), median (interquartile range) at first trimester to 65 (26-472) mm(3) at third trimester (P < 0.02). These nodules remained enlarged at 103 (25-461) mm(3) 6 wk postpartum (P < 0.005) and 73 (22-344) mm(3) at 3 months postpartum (P < 0.05). Patients with thyroid nodules had lower serum TSH values (P < 0.03) and higher Tg levels (P < 0.05) throughout pregnancy. Appearance of new nodules was detected in 25 (11.3%) women as pregnancy advanced so that by 3 months postpartum, the incidence of thyroid nodular disease was 24.4% (P < 0.02 vs. first trimester). Compared with those with no detectable nodules throughout pregnancy, subjects with new nodule formation had higher urinary iodine excretion from second trimester onward (P all < 0.05). However, no difference could be detected in their TSH and Tg levels throughout pregnancy. Fine-needle aspiration on nodules greater than 5 mm in any dimension after delivery (n = 21) confirmed the majority having histological features consistent with nodular hyperplasia. No thyroid malignancy was detected. In conclusion, pregnancy is associated with an increase in the size of preexisting thyroid nodules as well as new thyroid nodule formation. This may predispose to multinodular goiter in later life.

In a borderline iodine sufficient area, pregnancy posed an important stress resulting in higher rates of maternal goitrogenesis as well as neonatal hypothyroxinaemia and hyperthyro- trophinaemia. An adequate iodization program is necessary to eliminate iodine deficiency disorders during pregnancy.

Our data suggest that our women who attended the PDC clinic had an open attitude towards TOP for fetal abnormalities in general.