Stein Obesity

In untreated women, the main risk factors for endometrial carcinoma are age, obesity, nulliparity, late menopause (and possibly early menarche), the Stein-Leventhal syndrome, exposure to exogenous estrogens, radiation, and certain systemic diseases, including diabetes mellitus, hypertension, hypothyroidism, and arthritis (SED-14, 1451) (88). Certain of these risk factors indicate that an altered endocrine state with increased estrogen stimulation is a predisposing cause, and one might thus in theory expect estrogen treatment (and notably hormonal replacement therapy) to increase the risk (SEDA-22, 466). 

Ravelli GP, Stein ZA, Susser MW (1976) Obesity in young men after famine exposure in utero and early infancy. N Engl J Med, 295(7) 349-353. 

Nauck MA, Meininger G, Sheng D, Terranella L, Stein P. Efficacy and safety of the dipeptidyl peptidase-4 inhibitor, sitagliptin, compared to the sulfonylurea, glipizide, in patients with type 2 diabetes inadequately controlled on metformin alone A randomized, double-blind, non-inferiority trial. Diabetes Obesity Metab 2007 9 194-205. 

Although most notable in Stein-Leventhal syndrome, which comprises the classical findings of amenorrhea, hirsutism, obesity, and sclerotic ovaries, a wide range of clinical presentations exist. Only one-quarter to one-half of the patients present the classical signs. Usually, infertility is the leading clinical problem of patients with PCOS. Recently, ultrasonographic studies reported a prevalence of polycystic ovaries in young women of at least 20%. However, there seems to be an overlap of polycystic ovaries and normal ovaries [62]. 

PrentM, M. Corkey, B.E. (1996) Diabetes, 45, 273-283. Are the p-ceU signahng molecules malonyl-CoA and cytosolic long-chain acyl-CoA implicated in multiple tissue defects of obesity and NIDDM Stein, D.T., Esser, V, Stevenson, B.E., Lane, K.E., Whiteside, J.H., Daniels, M.B., Chen, S. McGarry, J.D. (1996) J. Clin. Invest, 97, 2728-2735. Essentiality of Circulating Fatty Acids for Glucose-stimulated Insulin Secretion in the Fasted Rat. 

In polycystic ovarian disease, both of the generally enlarged ovaries contain many small follicular cysts (2-6 mm), but larger cysts may also be present. Polycystic ovarian syndrome (Stein-Leventhal syndrome) is characterized by the association of polycystic ovaries with irregular menses, prolonged uterine bleeding, amenorrhea, anovulation, and often hirsutism and obesity. The clinical manifestation of this syndrome begins at or shortly after puberty. 

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