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Objective: To compare androgens and sex hormone-binding globulin (SHBG) levels, and indices of insulin sensitivity (the response of plasma insulin and C-peptide in OGTT, insulin resistance and beta-cell activity estimated with the homeostasis assessment model (HOMA model) in healthy obese premenopausal women with different body fat distributions., Patients and Methods: Free testosterone, androstenedione, SHBG levels and responses of plasma glucose, insulin and C-peptide in OGTT were examined in 74 healthy premenopausal women (19 with lower-body obesity (WHR < 0.80), 20 with pure abdominal obesity (WHR > 0.85), 19 with predominant abdominal obesity (WHR 0.81-0.85) and 18 normal-weight women). Insulin resistance and beta-cell function were estimated with the HOMA model., Results: Both fasting and glucose-induced insulin levels were higher in women with pure abdominal obesity than in the controls (p < 0.001) and in those with lower-body obesity (P < 0.01). Insulin resistance was also higher in women with pure abdominal obesity than in the controls (p < 0.01) and those with lower-body obesity (p < 0.05). Free testosterone (p < 0.01) was higher and SHBG (p < 0.001) was lower in women with abdominal obesity than in the control group and those with lower-body obesity. Insulin significantly correlated with SHBG, and this correlation was independent of androgens, obesity and obesity type. Beta-cell function positively correlated with free testosterone, whereas insulin resistance negatively correlated with SHBG, and was independent of obesity and obesity type., Conclusions: In healthy premenopausal women, increased BMI and more pronounced abdominal fat accumulation was associated with increased androgenic activity (higher free testosterone and lower SHBG levels) and with insulin resistance estimated using the HOMA model, as well as with increasing basal and glucose-induced insulin levels. SHBG levels correlated with insulin and insulin resistance independently of the degree of obesity, obesity type and androgens, whereas beta-cell function correlated only with free testosterone.

Sixty-four diabetic patients, 35 with diarrhea, 15 with constipation and 14 without stool problems, and forty healthy subjects, were subjected to rectosigmoidoscopy. During rectosigmoidoscopy, rectal biopsy specimens for histological and histochemical analysis were obtained. Histological findings of nonspecific colitis in 25 out of 64 diabetic patients were uniformly distributed among the three groups (p = 0.959). However, the finding was slightly more common in diabetic patients than in controls (eight out of 40 control subjects, p = 0.043). A positive PAS reaction was observed in 30 out of 64 diabetic patients and was also uniformly distributed among the three groups (p = 0.508), but was significantly more common among diabetic patients than controls (three out of 40, p < 0.001). A positive reaction to cholesterol was found in 46 out of 64 diabetic patients, also uniformly distributed among the three groups (p = 0.773). It was significantly more common in diabetic patients than in controls (nine out of 40, p < 0.001). Reactions of the rectal mucosa histological specimens to glycogen and triglycerides were negative, both in diabetic patients and in controls. In conclusion, it appears that stool problems among our diabetic patients were not related to the positivity of PAS or to the positive cholesterol reaction in the rectal mucosa histological specimens. Since positive findings of both reactions were more common in specimens taken from diabetic patients than in controls, positive reactions might be related to metabolic disturbances in diabetic patients.