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Angelo Maria Patti Department of Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy

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Kalliopi Pafili Diabetes Centre, Second Department of Internal Medicine, Democritus University of Thrace, University Hospital of Alexandroupolis, Alexandroupolis, Greece

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Nikolaos Papanas Diabetes Centre, Second Department of Internal Medicine, Democritus University of Thrace, University Hospital of Alexandroupolis, Alexandroupolis, Greece

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Manfredi Rizzo Department of Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy

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fibrinogen, together with lower HDL-C levels ( 9 ). Insulin resistance and central adiposity are of crucial importance in the development of MetS, and they appear to correlate with cardiovascular (CV) risk factors, including hypertension, atherogenic

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Patricia Iozzo Institute of Clinical Physiology, National Research Council (CNR), Pisa, Italy

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Maria Angela Guzzardi Institute of Clinical Physiology, National Research Council (CNR), Pisa, Italy

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exerted by obesity on cognitive dysfunction and vice versa. Both have been associated with morphological reductions in brain volume, relating to systemic dysmetabolism and insulin resistance and/or to the degree of cognitive impairment ( 21 , 22 , 23

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Anouar Aznou Department of Internal Medicine, Amsterdam University Medical Centers, MB Amsterdam, the Netherlands

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Rick Meijer Department of Internal Medicine, Amsterdam University Medical Centers, MB Amsterdam, the Netherlands

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Daniel van Raalte Department of Internal Medicine, Amsterdam University Medical Centers, MB Amsterdam, the Netherlands

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Martin den Heijer Department of Internal Medicine, Amsterdam University Medical Centers, MB Amsterdam, the Netherlands

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Annemieke Heijboer Endocrine Laboratory, Department of Clinical Chemistry, Amsterdam University Medical Centers, MB Amsterdam, the Netherlands

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Renate de Jongh Department of Internal Medicine, Amsterdam University Medical Centers, MB Amsterdam, the Netherlands

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Introduction The exact mechanisms underlying the development of peripheral insulin resistance, a hallmark of type 2 diabetes mellitus (T2DM), are complex and not yet fully understood. Many metabolic and endocrine factors are involved in the

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Leanne Hodson Oxford Centre for Diabetes, Endocrinology and Metabolism, Radcliffe Department of Medicine, University of Oxford and National Institute for Health Research (NIHR) Oxford Biomedical Research Centre (BRC), Oxford University Hospital Trusts, Oxford, UK

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Fredrik Karpe Oxford Centre for Diabetes, Endocrinology and Metabolism, Radcliffe Department of Medicine, University of Oxford and National Institute for Health Research (NIHR) Oxford Biomedical Research Centre (BRC), Oxford University Hospital Trusts, Oxford, UK

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hyperinsulinaemia are often said to have ‘insulin resistance’ ( 4 , 5 ). Here we discuss the direct and indirect effects of insulin on intrahepatic processes (e.g. fatty acid synthesis) and systemic processes (e.g. the regulation of fatty acid flux from adipose

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Clarissa Souza Barthem Laboratório de Adaptações Metabólicas, Programa de Bioquímica e Biofísica Celular, Instituto de Bioquímica Médica Leopoldo de Meis, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil

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Camila Lüdke Rossetti Laboratório de Adaptações Metabólicas, Programa de Bioquímica e Biofísica Celular, Instituto de Bioquímica Médica Leopoldo de Meis, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
Laboratório de Fisiologia Endócrina Doris Rosenthal, Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil

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Denise P Carvalho Laboratório de Fisiologia Endócrina Doris Rosenthal, Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil

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Wagner Seixas da-Silva Laboratório de Adaptações Metabólicas, Programa de Bioquímica e Biofísica Celular, Instituto de Bioquímica Médica Leopoldo de Meis, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil

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against fatty liver and may improve pathway-selective insulin resistance . Diabetes 2013 424 – 434 . ( https://doi.org/10.2337/db11-1718 ) 14 Park SB Lee YJ Chung CK . Bone mineral density changes after ovariectomy in rats as an osteopenic

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Annieke C G van Baar Department of Gastroenterology and Hepatology, Academic Medical Center, Amsterdam, the Netherlands

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Andrei Prodan Department of Vascular Medicine, Academic Medical Center, Amsterdam, the Netherlands

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Camilla D Wahlgren Center for Diabetes Research, Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark

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Steen S Poulsen Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

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Filip K Knop Center for Diabetes Research, Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

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Albert K Groen Department of Vascular Medicine, Academic Medical Center, Amsterdam, the Netherlands
Department of Laboratory Medicine, University of Groningen, University Medical Center, Groningen, the Netherlands

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Jacques J Bergman Department of Gastroenterology and Hepatology, Academic Medical Center, Amsterdam, the Netherlands

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Max Nieuwdorp Department of Vascular Medicine, Academic Medical Center, Amsterdam, the Netherlands
Department of Internal Medicine, VUMC Free University, Amsterdam, the Netherlands
Wallenberg Laboratory, Sahlgrenska Hospital, University of Gothenburg, Gothenburg, Sweden

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Evgeni Levin Department of Vascular Medicine, Academic Medical Center, Amsterdam, the Netherlands
Horaizon BV, Delft, the Netherlands

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/L) 1.45 0.65 1.25 0.69 HOMA-IR 4.53 1.95 4.36 2.18 BMI, body mass index; HbA1c, glycated hemoglobin A1c; HDL, high-density lipoprotein; HOMA-IR, homeostatic model assessment-insulin resistance; LDL, low

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Nannan Bian Department of Endocrinology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China

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Xiaomeng Sun Department of Endocrinology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China

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Biao Zhou Departments of General Surgery and Obesity and Metabolic Disease Center, China-Japan Friendship Hospital, Beijing, China

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Lin Zhang Department of Endocrinology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China

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Qiu Wang Department of Endocrinology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China

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Yu An Department of Endocrinology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China

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Xiaohui Li Department of Endocrinology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China

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Yinhui Li Department of Endocrinology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China

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Jia Liu Department of Endocrinology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China

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Hua Meng Departments of General Surgery and Obesity and Metabolic Disease Center, China-Japan Friendship Hospital, Beijing, China

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Guang Wang Department of Endocrinology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China

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5.5% for men ( 2 ). Obesity is an independent risk factor for insulin resistance (IR), metabolic syndrome and type 2 diabetes (T2D). For morbidly obese patients, lifestyle interventions and medication fail to reduce body weight durably, however

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Signe Frøssing Department of Internal Medicine, Center of Endocrinology and Metabolism, Herlev Gentofte Hospital, Copenhagen, Denmark
Faculty of Health and Medical Sciences, Copenhagen University, Copenhagen, Denmark

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Malin Nylander Faculty of Health and Medical Sciences, Copenhagen University, Copenhagen, Denmark
Department of Obstetrics & Gynecology, Herlev Gentofte Hospital, Copenhagen, Denmark

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Caroline Kistorp Department of Internal Medicine, Center of Endocrinology and Metabolism, Herlev Gentofte Hospital, Copenhagen, Denmark
Faculty of Health and Medical Sciences, Copenhagen University, Copenhagen, Denmark

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Sven O Skouby Faculty of Health and Medical Sciences, Copenhagen University, Copenhagen, Denmark
Department of Obstetrics & Gynecology, Herlev Gentofte Hospital, Copenhagen, Denmark

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Jens Faber Department of Internal Medicine, Center of Endocrinology and Metabolism, Herlev Gentofte Hospital, Copenhagen, Denmark
Faculty of Health and Medical Sciences, Copenhagen University, Copenhagen, Denmark

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Introduction Women with polycystic ovary syndrome (PCOS) are challenged with a metabolic aspect of the syndrome as they have increased prevalence of overweight with central obesity and insulin resistance. They present with an accumulation of

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Yao Chen Hangzhou Fuyang Women and Children Hospital, Hangzhou, China

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Shu-ying Fang Hangzhou Fuyang Women and Children Hospital, Hangzhou, China

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, insulin resistance, ovulatory dysfunction and polycystic ovaries. The prevalence of PCOS may be as high as 15–20% of women of reproductive age ( 3 ). Although it was first reported in 1935 by Stein et al ., its etiology is still unclear. PCOS has a

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Chenyu Jiang Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China

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Mi Zhou Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China

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Huai Bai Laboratory of Genetic Disease and Perinatal Medicine, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China

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Meng Chen Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China

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Chunyi Yang Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China

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Kaifeng Hu Laboratory of Genetic Disease and Perinatal Medicine, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China

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Yujie Wu Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China

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Qingqing Liu Laboratory of Genetic Disease and Perinatal Medicine, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China

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Yangyu Zhao Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China

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Xinghui Liu Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China

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Ping Fan Laboratory of Genetic Disease and Perinatal Medicine, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China

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expressed as the ratio of TOS to TAC ( 5 , 23 ). The homeostatic model assessment of insulin resistance (HOMA-IR) was assessed as previously described ( 31 ). For all determinations, the intra-assay variations were less than 5% and the inter

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