Clinical, Psycho-Social and Metabolic Profile of Women with Hirsutism in Yaounde

Background: Hirsutism is a clinical situation in Cameroon which is poorly elucidated due to a paucity of clinical and biological data;hence our interest in this study. The aim of this work was to describe the clinical, psycho-social and metabolic profile of women with hirsutism in Yaoundé. Materials and Methods: This was a descriptive cross-sectional study carried out from May 2013 to December 2013. Participants were recruited by announcement through social media. Our study included women at least 18 years old, not in menopausal, not pregnant, not breastfeeding, with hirsutism regardless of severity. They were assessed through an interrogation, anthropometric parameters, a physical examination using the modified Ferriman and Gallwey score, the measurement of fasting capillary blood glucose and a lipid profile. The psycho-social assessment was carried out using a pre-designed questionnaire on the participant’s perception and daily experience with hirsutism. The metabolic syndrome was established according to the criteria of the International Diabetes Federation of 2005 and the National Cholesterol Education Program-third adult treatment panel of 2001. Results: We recruited 60 women aged 27.6 ± 7.0 years. The median Ferriman and Gallwey score was 12. The mean duration of evolution was 9 years. A family history of hirsutism was found in 88.8% of the participants, especially in the mother. Signs of virilization were found in 3.3% of the participants. Association was found between menstrual cycle abnormalities and severity of hirsutism (p = 0.023). Psycho-socially, 58.8% of women found hirsutism normal. The metabolic syndrome was found in 21.7% and 18.3% according to the IDF and NCEP-ATP III, respectively. Conclusion: Hirsutism in our context seems normal to most of our participants. It is, however, associated with menstrual irregularities, signs of virilization and metabolic syndrome. As a result, hirsutism merits further study on a large-scale with emphasis on etiology.

Metabolic regulation by protein tyrosine phosphatases

Obesity and the metabolic syndrome and their associated morbidities are major public health issues, whose prevalence will continue to increase in the foreseeable future. Aberrant signaling by the receptors for leptin and insulin plays a pivotal role in development of the metabolic syndrome. More complete molecular-level understanding of how both of these key signaling pathways are regulated is essential for full characterization of obesity, the metabolic syndrome, and type lI diabetes, and for developing novel treatments for these diseases. Phosphorylation of proteins on tyrosine residues plays a key role in mediating the effects of leptin and insulin on their target cells. Here, we discuss the molecular methods by which protein tyrosine phosphatases, which are key physiological regulators of protein phosphorylation in vivo, affect signaling by the leptin and insulin receptors in their major target tissues.

Hepatitis C and insulin action:An intimate relationship

Chronic hepatitis C virus(HCV) infection has been shown to be linked to a higher prevalence of type 2 diabetes compared with the general population or with patients with chronic hepatitis B infection and diabetes is the most common extra-hepatic manifestation of HCV. The HCV-diabetes association is due to insulin resistance(IR) that occurs early in the course of the disease even in patients without or with minimal fibrosis. The mechanisms for HCV-induced IR are only partly understood and include a direct inhibitory effect of HCV on insulin signaling pathway. IR in chronic HCV results in an increased progression rate of hepatic fibrosis, cirrhosis and hepatocellular carcinoma. Some but not all studies found that IR reduces the response rate to interferon/ribavirin therapy. Whether IR affects the response to the new direct-acting antiviral treatments is still unknown.