***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Purpose To assess whether there are changes on anthropometric and biochemical measures of adiposity in pre- and postmenopausal women and in the latter before and after 6 months treatment with 17β-estradiol plus drospirenone . Methods Twenty postmenopausal and 20 premenopausal women were enrolled in a prospect i ve comparative study . Postmenopausal women received 1 mg 17β-estradiol plus 2 mg drospirenone daily for 6 months . Measurements of body mass index ( BMI ) , waist/hip ratio and plasmatic levels of insulin , glucose , high-density lipoprotein ( HDL ) , low-density lipoprotein ( LDL ) , triglyceride , leptin , adiponectin , orexin-A , glucagon-like peptide-1 ( GLP-1 ) and ghrelin were performed in premenopausal ( group 1 ) and postmenopausal women and in the latter before ( group 2a ) and after ( group 2b ) 6 months treatment with 17β-estradiol plus drospirenone . Results No significant changes in BMI s , insulin and glucose were observed between group 1 and 2a ; and group 2a and 2b . GLP-1 levels were significantly increased in group 1 compared to group 2a ( p = 0.035 ) . Leptin levels were significantly increased ( p = 0.001 ) and GLP-1 levels were significantly decreased ( p = 0.021 ) in group 2b compared to group 2a . HDL was significantly decreased while LDL and triglyceride levels were significantly increased in group 2a compared to group 1 . ( p = 0.030 , p = 0.001 , p = 0.020 ; respectively ) LDL was significantly decreased ( p = 0.010 ) in group 2b compared to group 2a . GLP-1 had a positive correlation with orexin-A ( p < 0.001 , r = 0.520 ) and negative correlation with leptin ( p = 0.008 , r = −0.345 ) . Conclusion Leptin was significantly higher and GLP-1 was significantly lower in women receiving 17β-estradiol plus drospirenone treatment . GLP-1 levels were significantly lower after the menopause compared to premenopausal levels . Orexin-A and GLP-1 were positively correlated Hypocretin ( orexin ) peptides are involved in the regulation of energy balance and pituitary hormone release . Narcolepsy is a sleep disorder characterized by disruption of hypocretin neurotransmission . Pituitary LH secretion is diminished in hypocretin-deficient animal models , and intracerebroventricular administration of hypocretin-1 activates the hypothalamo-pituitary-gonadal axis in rats . We evaluated whether hypocretin deficiency affects gonadotropin release in humans . To this end , we deconvolved 24-h serum concentrations of LH and FSH in seven hypocretin-deficient narcoleptic males ( N ) and seven controls ( C ) matched for age , body mass index , and sex .  Basal plasma concentrations of testosterone , estradiol , and sex hormone-binding globulin were similar in both groups . Mean 24-h LH concentration was significantly lower in narcolepsy patients [ 3.0 + /- 0.4 ( N ) vs. 4.2 + /- 0.3 ( C ) U/l , P = 0.01 ] , which was primarily due to a reduction of pulsatile LH secretion [ 23.5 + /- 1.6 ( N ) vs. 34.3 + /- 4.9 ( C ) U.l(-1).24 h(-1 ) , P = 0.02 ] . The orderliness of LH and FSH secretion , quantitated by the approximate entropy statistic , was greater in patients than in controls . In contrast , all other features of FSH release were similar in narcoleptic and control groups . Also , LH and FSH secretions in response to intravenous administration of 100 microg of GnRH were similar in patients and controls . These data indicate that endogenous hypocretins are involved in the regulation of the hypothalamo-pituitary-gonadal axis activity in humans . In particular , reduced LH release in the face of normal pituitary responsivity to GnRH stimulation in narcoleptic men suggests that hypocretins promote endogenous GnRH secretion Abstract Aim : In the current study , we aim ed to investigate whether serum orexin-A ( OXA ) levels are different in polycystic ovary syndrome ( PCOS ) subjects . Material s and methods : Thirty-six women with PCOS and 40 healthy , age and body mass index-matched controls were included in the prospect i ve cross-sectional study . All subjects underwent venous blood draws during the early follicular phase after overnight fasting .  Serum OXA levels were measured with an enzyme immunoassay ( EIA ) . The relationships between the serum OXA levels and the anthropometric and metabolic parameters were also assessed . Results : The serum OXA levels were lower in the women with PCOS compared to the control group . The serum OXA levels were correlated negatively with systolic blood pressure , the Ferriman-Gallway score and LH and free testosterone levels . Conclusion : Our results indicate that serum OXA levels decrease in the serum of women with PCOS STUDY OBJECTIVES Obesity is a common feature of narcolepsy . In addition , an increased occurrence of non-insulin dependent diabetes has been reported . So far , it is not known whether glucose metabolism in narcolepsy is disturbed due to , or independently of obesity . DESIGN Case-control study . SETTING Sleep medicine clinic at a research institute . PATIENTS We studied 17 patients with narcolepsy/cataplexy compared to 17 healthy controls matched for age , sex , and body mass index ( BMI ) . INTERVENTIONS A 75-g oral glucose tolerance test was performed . MEASUREMENTS Glucose tolerance was determined by computing plasma glucose curve following oral glucose challenge for 240 minutes ; insulin sensitivity and insulin secretion by homeostasis model assessment and minimal model analysis . RESULTS St and ard outcome measures and indices of the oral glucose tolerance test did not differ between the patient group and the group of control subjects . CONCLUSIONS In this study , no clinical ly relevant pathologic findings in the glucose metabolism of narcoleptic patients compared to weight matched controls were found . Thus , narcolepsy is unlikely to be a risk factor per se for impaired glucose tolerance or diabetes OBJECTIVE Alterations in sleep quality and metabolism during menopause are improved by menopausal hormone therapy ( MHT ) . The mechanisms mediating these effects remain unclear . Orexin A ( OxA ) is a neuro-peptide that regulates sleep/wakefulness , food intake and metabolism . This study examined changes in plasma OxA levels during and after treatment in women from the Kronos Early Estrogen Prevention Study ( KEEPS ) . METHODS KEEPS r and omized women within three years of menopause to : oral conjugated equine estrogen ( o-CEE , 0.45mg/day ) , transdermal 17β estradiol ( t-E2 , 50μg/day ) , or placebo pills and patches for four years  . Plasma OxA levels were measured by enzyme immunoassays in fasting blood sample s collected annually from KEEPS participants at Mayo Clinic during and three years after MHT .  Changes in menopausal symptoms and plasma OxA levels were assessed for treatment differences . RESULTS During treatment , OxA levels increased more in women r and omized to o-CEE compared with the other groups . Women r and omized to either form of MHT demonstrated smaller increases in BMI than those on placebo . Insomnia severity decreased similarly among treatment groups . However , neither changes in sleep nor changes in BMI correlated with changes in plasma OxA levels . Changes in waist circumference correlated positively with changes in plasma OxA levels three years after discontinuation of study treatments . CONCLUSIONS Although OxA levels increased only in women r and omized to o-CEE , these changes did not correlate with changes in sleep quality or BMI . The modest correlation of OxA levels with waist circumference once study treatments were discontinued suggests that OxA may be modulated through multiple intermediary pathways affected by metabolites of 17β-estradiol . Clinical Trial Registration for KEEPS : NCT00154180 AIMS To investigate the association between serum orexin concentrations and insulin resistance/sensitivity in a sample of patients with type 2 diabetes mellitus , and to study the effects of anti-hyperglycemic treatment on orexin concentrations over three months . METHODS This study was design ed as a r and omized , open-label , clinical trial . Before allocation , sixty medication-naïve , newly-diagnosed , type 2 diabetes patients underwent a 75 g oral glucose tolerance test ( OGTT ) . Afterwards , using a r and omized trial design ( I RCT 201102275917N1 ) patients were allocated to either the metformin ( 1000 mg daily ) or pioglitazone ( 30 mg daily ) arm , and were reexamined after three months . Serum insulin , plasma glucose , and orexin concentrations were measured at baseline , during OGTT , and after three months . RESULTS Orexin concentrations significantly decreased after OGTT ( 0 vs. 120 min : 0.63 ± 0.07 vs. 0.31 ± 0.03 ng/ml , p < 0.001 ) . Insulin resistance determined by homeostasis model assessment of insulin resistance ( HOMA-IR ) was significantly and negatively correlated with orexin ( r = -0.301 , p = 0.024 ) . Furthermore , orexin concentrations were significantly and positively correlated with the insulin sensitivity index derived from OGTT ( r = 0.326 , p = 0.014 ) . Three-month treatment with metformin and pioglitazone significantly improved insulin sensitivity and increased orexin concentrations by 26 % ( p = 0.025 ) and 14 % ( p = 0.076 ) , respectively . Between-group analysis showed that changes in orexin concentrations  with metformin and pioglitazone were not significantly different ( p = 0.742 ) . CONCLUSIONS There was a negative association between peripheral orexin concentrations and insulin resistance in type 2 diabetes patients . Three-month anti-hyperglycemic treatment with proportionate doses of metformin or pioglitazone  increased orexin concentrations via amelioration of insulin resistance and improvement of glycemic control BACKGROUND Sleep-disordered breathing ( SDB ) is linked to adverse pregnancy outcomes . However , little is known about the association of SDB with timing of delivery . We examined the association of snoring frequency , a key SDB marker , and snoring intensity , a correlate of SDB severity , with time-to-delivery among a cohort of pregnant women . METHODS In this prospect i ve cohort study , 1483 third trimester pregnant women were recruited from the University of Michigan prenatal clinics . Women completed a question naire about their sleep , and demographic and pregnancy information was abstract ed from medical charts . After exclusion of those with hypertension or diabetes , 954 women were classified into two groups by their snoring onset timing , chronic or pregnancy-onset . Within each of these groups , women were divided into four groups based on their snoring frequency and intensity : non-snorers ; infrequent-quiet ; frequent-quiet ; or frequent-loud snorers . Cox proportional hazard regression models were used to investigate the association between snoring frequency and intensity and time-to-delivery , adjusting for maternal characteristics . RESULTS Chronic snoring was reported by half of the pregnant women , and of those , 7 % were frequent-loud snorers . Deliveries before 38 weeks ' gestation are completed occurred among 25 % of women with chronic , frequent-loud snoring . Compared with pre-pregnancy non-snorers , women with chronic frequent-loud snoring had an increased hazard ratio for delivery ( adjusted hazard ratio 1.60 , 95 % confidence interval 1.04 , 2.45 ) . CONCLUSIONS Snoring frequency and intensity is associated with time-to-delivery in women absent of hypertension or diabetes . Frequent-loud snoring may have a clinical utility to identify otherwise low-risk women who are likely to deliver earlier 
    Output:
    
Associations between HCRT1 , metabolic and reproductive function are inconsistent .