The resistance to insulin-mediate glucose disposal is characteristic of patients with type 2 diabetes mellitus. This review article studies different aspects of this syndrome including risk factors, associated conditions such as yperinsulinemia, impaired glucose tolerance, hypertension, hypertriglyceridemia, decrease of HDL-cholesterol and truncal obesity and their management.

Background: Turner syndrome occurs in nearly one in every 2000-5000 female births. This syndrome is a genetic problem in the female phenotype and the most common sex chromosome anomaly. It is diagnosed based on clinical manifestations and cytogenetic examinations. The classic syndrome (i. e., monosomy X) makes up 50% of the cases while other forms contain X chromosome variants, which do not typically manifest as the classic X phenotype. Case Presentation: This study, presents a rare variant of Turner syndrome reported in a 20-year-old woman presenting with primary amenorrhea, hypothyroidism, and short stature who had hypergonadotropic hypogonadism with hypoplastic ovaries while without the clinical manifestations of the classic Turner syndrome. The karyotype was determined as X isochromosome-X syndrome [46 XXi (Xq)]. Conclusion: This rare syndrome occurs in approximately 7% of the cases of Turner syndrome. Rare variants of the syndrome should also be considered in female patients without the classic manifestations of Turner syndrome.

A role of adenosine in pathogenesis of syndrome X has recently been postulated. Previous studies suggest that aminophylline (an adenosine receptor blocker) improves exercise tolerance in this disorder. Present study was performed to examine the efficacy of theophylline in syndrome X and to determine the incidence of cardiovascular risk factors clinical, ECG and Angiographic findings in these patients. 31 patients were studied. The first 16 patients received theophylline. Other 15 cases received placebo. Exercise tolerance test was repeated after 1-2 weeks.Patients who received theophylline had increase in Rate-pressure product at peak exercise and decrease in symptoms during exercise, but stage of st depression, global and peak st depression, exercise tolerance and persistence of st depression more than 3 minutes in recovery and symptoms of patients in general were not significantly different. Theophylline has a favorable effect on exercise, reduces chest pain and Rate-Pressure product at peak exercise in patients with syndrome X, but not on other variables of exercise test.

Background: All the patients with Angina pectoris have not stenotic coronary artery. Syndrome x consists of patients with Angina pectoris and positive Exercise test along with normal coronary angiography. Syndrome x includes 25-30 percent of those who undergo diagnostic coronary arteriography at the different centers. In our study it was attempted to know the prevalence and characteristics of this special group in Afshar cath-lab.Materials and Methods: In a prospective cross sectional descriptive study 200 patients who were admitted for coronary angiography evaluated in terms of Risk factors: HTN, Family history Hyperlipidemia, DM, Cigarette smoking , clinical symptoms , response to TNG, different symptoms, ECG and Exercise test. data in two subgroups with normal and abnormal Coronary angioghraphy were compared. Six patients were excluded because of ambiguous Coronary angiography.Results: Among 194 patients 51 patients (26.3% )had normal coronary artery. 38.9% of female and 21.4% of males showed normal coronary angioghraphy (P = 0.013). The prevalence of risk factors among those with syndrome x and abnormal coronary Artery were as follow. HTN 37% vs 42% , Hyperlipidemia 50% vs 51% , smoking 25% vs 37% , DM 12% vs 28% , obesity 45% vs 47% Positive family history for CAD = 21.5% vs 47% respectively. Angina relieved suitably with TNG in 24% of those with syndrome x compared to 76% suitable response in those with abnormal coronary arteries.(P Value = 0.49 ). Regarding to functional class , 87% of patients with normal coronary artery belonged to class I and II. also 26% had atypical pain 50% had normal rest ECG and 51% achieved stage III or IV of Bruce protocol during Exercise test.Conclusion: Syndrome x was more prevalent among women ,also angina was less typical and less responsive to TNG. Most patients had not positive familial history for CAD. normal ECG was more prevalent among those with syndrome x .

Introduction: Cardiac syndrome X includes chest pain and positive exercise and/or radionuclide test and normal coronary angiography. There is no obvious etiology for this syndrome. Some mechanisms such as endothelial dysfunction and estrogen deficiency have been explained. In this study, we studied correlation between helicobacter pylori infection and cardiac syndrome X. Materials and Methods: 23 patients (17 female and 6 male) with cardiac syndrome X between 30-65 years old (mean 42±4) matched with control group (16 female and 7 male) between 31-64 years old (mean 41±4). Helicobacter pylori infection detected by urease breathe test (UBT). Patients with dyspepsia and coronary spasm were excluded.Results: UBT showed that 91% of cases in patient group and 48% in control group were positive for helicobacter pylori infection, and this difference was significant (P<0.001).Conclusion: Due to high prevalence of infection with helicobacter pylori in cardiac syndrome X patients (91%) in comparison with its prevalence in control group (48%), possibility of relationship between infection with helicobacter pylori and cardiac syndrome X is suggested

Background and aim: There is no obvious etiology for cardiac syndrome X (CSX). Some mechanisms, such as endothelial dysfunction and estrogen deficiency have been involved. In this study, we tried to find the association between Helicobacter pylori (HP) infection and cardiac syndrome X. Methods: In this case control study in year 2007, 54 cardiac syndrome X-affected patients and 168 referred patients to the Taleghani hospital for elective surgery were included. Data were collected by interview physical examination, laboratory and angiographic findings. Then, Serum anti-Helicobacter pylori antibody (IgG) was determined by enzyme-linked immunosorbent assay (ELISA). Statistical analysis was performed using Chi-square, and Mantel- Hanzel tests with SPSS software. Result: According to the results of this study, 54 patients were considered as case group and meeting diagnostic criteria for cardiac syndrome X. The mean age of subjects was 54.54±8.99 years (range=38 to 72 years). From the total 54 case group patients, 44 patients (81.5%) were positive for helicobacter pylori and from 168 control patients, 95 patients (56.5%) were positive (P<0.001). There was no significant difference between history of diabetes and blood pressure in H.pylori-positive cardiac syndrome X-affected patients. Conclusion: According to the results of this study, a probable role for HP infection seems to be involved in the pathogenesis of CSX.

Background: Xp22. 3 region is characterized by low frequency of interspersed repeats and low GC content. Several clinically important genes including ANOS1 (KAL1) reside in this region. This gene was first identified due to translocation between chromosomes X and Y in a patient with Kallmann syndrome. Case Presentation: A 20 year old male presented with complaints of delayed secondary sexual characteristics, impaired sense of smell, and poor scholastic performance. On examination, he had short stature (151 cm; <3rd centile). His sexual maturity corresponded to Tanner stage 3. Stretched penile length was 3. 6 cm (<3rd centile). Right testis was undescended with low left testicular volume (12 ml). There was mild ichthyosis over abdomen and back. He had hyposmia, hoarse voice, and synkinesia. Investigations were suggestive of hypogonadotrophic hypogonadism. Karyotype revealed an extra chromosomal material on p arm of chromosome X (46, Xp+, Y). On cytogenetic microarray, deletion of 8. 3 Mb on Xp22. 33 region and duplication of 12. 8 Mb on Yq11. 22 region were identified. The breakpoint on X chromosome resulted in deletion of exons 7-14 of ANOS1 gene and complete STS, NLGN4X, ARSL (ARSE), SHOX, and VCX genes. Conclusion: Patients diagnosed with Kallmann syndrome should receive careful clinical evaluation to detect presence of a contiguous gene syndrome.