Endocrine Abstracts

Background. Hypopituitarism is associated with increased VLDL and LDL apoB concentrations, which may be attributable to GHD. Studies examining the effects of GHR on VLDL apoB kinetics have been conflicting, possibly due to differences in the duration of GHR. As yet, the effects of GHR on LDL apoB kinetics are unknown. Aim. To examine the effect of GHR on VLDL and LDL apoB kinetics, and to explore the hypothesis that these effects are dependent on the duration of therapy. Metho...

Background. Abnormal lipoprotein composition associated with growth hormone deficiency (GHD) may contribute to increased mortality observed in conventionally replaced hypopituitarism. Aim. To examine the effects of forty weeks of growth hormone replacement (GHR) on lipoprotein composition and LDL size in sixteen GHD hypopituitary subjects. In eight patients, VLDL and LDL composition were additionally assessed after eight weeks. Methods. VLDL and LDL were separated by different...

Aims: Increasing evidence supports the role of glycated insulin in the insulin resistant state of type 2 diabetes. We measured 24-hour profiles of plasma glycated insulin, using a novel radioimmunoassay, to evaluate the effects of meal stimulated insulin secretion and the fasting state on production of plasma glycated insulin in type 2 diabetes. Methods: Patients (n=6, HbA1c 7.2±0.6%, fasting plasma glucose 7.4±0.7 mmol l-1, BMI 35.7±3.5 kg m<su...

Plasma homocysteine is now regarded as a graded risk factor for vascular disease comparable to smoking, high cholesterol and raised blood pressure. In diabetes homocysteine values have correlated with microalbuminuria and are thought to contribute to vascular damage. Folic acid is an essential co-factor for homocysteine metabolism and folic acid supplementation has been shown to reduce plasma homocysteine by about 30%.In this study patients with Type II ...

OBJECTIVE. Previous studies of relatives of patients with type 2 diabetes had given valuable information necessary for the current attempts towards primary prevention of diabetes. Thus, we aimed to assess the changes in anthropometric, metabolic and insulin resistance indices in a previously studied group of offspring of type 2 diabetic patients.METHOD: Twenty-three (23) previously studied offspring of patients with type 2 diabetes participated for re-assessment of diabetic ri...

OBJECTIVE: There are reports suggesting that currently available drugs used in the management of Type 2 diabetes do not sustain metabolic control on long term basis. We therefore assessed metabolic control and insulin resistance indices in Type 2 diabetic patients commonly treated with sulphonylurea drugs at primary care setting.METHOD: One hundred and seventy-nine (117 females, 62 males) randomly selected Type 2 diabetic patients attending primary care...

Background Polycystic ovary syndrome (PCOS) affects between 5-10% of premenopausal women and is characterised by insulin resistance. PCOS also carries with it an increased lifetime risk of diabetes, hypertension and possibly coronary heart disease. The underlying mechanisms are unknown but we have proposed that metabolic insulin resistance may be associated with endothelial dysfunction, leading to increased vascular stiffness, abnormalities of fibrinolysis and increased platel...

Objective To evaluate the prevalence of insulin resistance and metabolic syndrome, to define its components and to reveal their relationships in obese children. Patients and methods A total of 147 obese (BMI higher than 95 centile for age and gender) Caucasian children aged 9-16 years, mean age 13,67±2,43 (75 boys and 72 girls) were examined. Waist and hip circumferences were measured with WHR calculation, arterial blood pressure was registered. Standard 2-h OGTT was pe...

Aim: To investigate total homocysteine (Hcy), cysteine (Cys), glutathione (GSH), lipid and steroid sulfate levels in women with polycystic ovary syndrome (PCOS).Methods: The blood levels of Hcy, Cys, GSH (determined by HPLC), total and HDL-cholesterol, insulin (IRMA),DHEA and DHEAS, cortisol, pregnenolone, 17-hydroxy-pregnenolone and pregnenolone-sulphate (all RIA) were examined in 44 women with PCOS (age 24+/-7yrs) and 12 healthy controls (34+/-5yrs) in...

Objectives: To estimate the prevalence of acanthosis nigricans (AN) in a cohort of obese subjects and to assess the validity of AN as an indicator of insulin resistanceMethods: 88 healthy obese subjects were assessed clinically for severity of AN scored according to Burke's Scale1. Neck and axilla severity scores (NASS) were discriminative, easy to access in a clinical setting and hence used in the analysis. Insulin resistance was assessed by Homeostasi...

ACE inhibitor, lizinopril, reduced cerebrovascular death, myocardial infarction and stroke. It also reduced diabetic nephropathy and increased sensitivity of insulin in people with diabetes.The aim of this study was to determine the effects of lizinopril on cerebrovascular death, myocardial infarction, stroke, nephropathy and insulin sensitivity. Sixty patients with diabetes mellitus type 2, mean age 58.6 plus/minus 5.6 years, with similar BMI, were div...

Much controversy exists surrounding, the screening, diagnosis, treatment and even existence of gestational diabetes mellitus (GDM). This study aims to compare sensitivity and cost of two screening strategy of GDM.2416 pregnant women referred to five university hospital clinics were followed up until delivery. The universal screening performed. Obstetric and family histories were taken followed by a complete physical examination. Retrospectively were conc...

A case - control study was conducted on 2416 pregnant women referred to five university hospital clinics. The universal screening was performed with a 50g 1-hour glucose challenge test and those with plasma glucose level >= 130mg/dl, were diagnosed as having GDM if they had an impaired 100g 3-hour glucose tolerance test based on Carpenter and Coustan criteria. Overall 114 GDM patients were identified who were matched to 220 normoglycemic pregnancies in view of age, BMI, pa...

Members of a hospital staff (n=332) were invited to complete a survey outlining dietary and lifestyle behaviour, and indicate if they were interested in a weight management programme. Height and weight were measured and body mass index (BMI) was calculated, in all respondents.Two hundred and sixty (78%) staff members responded, 60 males (23.1%) and 200 females (76.9%). The mean age of respondents was 36.5 yrs (35.8yrs males, 36.7yrs female). The mean bo...

Resistin, a novel signalling molecule isolated in mice, has been suggested to be the putative hormone thought to link obesity with type 2 diabetes. As central obesity is associated with a higher risk of diabetes, we compared resistin mRNA expression in abdominal fat depots to thigh and breast adipose tissue. Mononuclear cells are also known to expression resistin, therefore, CD45 expression (a marker of mononuclear blood cells), was also analysed. RNA was extracted from 32 hum...

Adiponectin (acrp30) is an adipocyte derived-hormone, associated with insulin sensitivity and lower risk of atherosclerosis. Plasma adiponectin concentrations are decreased in obese and type 2 diabetic subjects with insulin resistance. As central rather than gluteo-fermoral fat is known to increase the risk of type 2 diabetes and cardiovascular disease we investigated the expression of adiponectin in human adipose tissue depots. We examined expression of adiponectin mRNA level...

ATP-evoked signalling events are known to promote release of insulin from pancreatic beta-cells in a Ca2+-dependent manner. In rodent beta-cells and insulin-secreting cell lines, this is mediated by purinergic receptors and there is evidence for the involvement of both P2X and P2Y subtypes. Here,we have used human insulin-secreting cells to examine the expression of purinoceptors in control and disease tissue. Intact islets and isolated beta-cells were obtained from...

A gender-related bias in survival rates has been demonstrated in rodent models of critical illness. Sex steroids have differential effects on metabolic, immune and cardiovascular end points which may underlie these observations. The hypothalamo-pituitary-gonadal (HPG) axis response to critical illness in humans is poorly characterised. We have conducted a prospective study to characterise this response in the context of heterogeneous disease severity and disturbances in overal...

The Diabetes Control and Complications Study, United States, and the United Kingdom Prospective Diabetes Study both reported increasing weight gain in all groups of patients with diabetes. The present study was designed to examine retrospectively if this was the experience in a clinic with an emphasis on weight loss as a central component of the treatment offered, facilitated by frequent clinic visits, the attendance of a dietitian at all clinics, a relatively low rate of insu...

The influence of the hypothyroidism (H) on the glucose metabolism (GM) has not been studied by modern methods till now. We described the changes in the effect of insulin on GM in patients in artificial H and after the thyroid hormone therapy (T).Materials and Methods: We have investigated 15 female patients (age 32.8 plus/minus 8.1 years) in H (ssTSH 84.45 plus/minus 19.69 milli international units per litre; fT4 1.68 plus/minus 0.77 picomoles per litre;...

OBJECTIVE Recent studies have shown the benefits of insulin sensitising agents such as Metformin in the treatment of infertility and hirsuitism in PCOS. However not all women with PCOS are insulin resistant. Within a clinic population of women referred for treatment of hirsuitism, we examined the utility of fasting insulin/glucose measurement in identifying which women were insulin resistant.DESIGN We evaluated an outpatient clinic group of 25 PCOS pati...

Introduction: Reduced sex hormone binding globulin (SHBG) is seen in patients with polycystic ovarian syndrome (PCOS) and is considered a surrogate marker of hyperinsulinaemia in these patients. Little data currently exists on the biological variability of SHBG for an individual with PCOS and this information is crucial to establish its clinical utility. Method: 12 PCOS patients (median age 28 yrs, range 18-31) and 11 weight matched, control women having regular menses and wit...

Islet amyloid deposition is a characteristic feature of Type 2 diabetes. Accumulation of IAPP by abnormal intracellular peptide degradation in beta-cell could promote fibril formation. IAPP is present in high concentrations in beta-cell lysosomes. To determine if fibrils form in lysosomes and the pathway for the accumulation human islets were cultured under conditions of elevated production of insulin (11mM glucose) and inhibition of secretion (0.6mM diazoxide) and/or lysosoma...

Background and aims: Cardiovascular (CVS) disease accounts for the majority of morbidity and mortality in diabetes. We audited lipid management in a hospital diabetes clinic.Patients: CVS disease risk factors were assessed in 241 consecutive patients with diabetes (type1 15%, type2 85%, male 53%, female 47%, mean age 59±13 years, mean duration of diabetes 10±9 years). 86(36%) had symptomatic atherosclerotic vascular disease (secondary prev...

In addition to its original growth hormone-releasing function,ghrelin has been shown to exert a variety of effects on metabolism,specifically in terms of the regulation of body habitus and fat. Itincrease food intake and body weight, and regulates energyhomeostasis: it also increases glucose levels, reduces insulinsecretion and regulates downstream insulin signa...

Most children with diabetes are insulin deficient (type 1). We have reported type 2 diabetes in children, defined by evidence of insulin resistance, but the prevalence and characteristics in UK children is unknown. We aimed to characterise and determine the prevalence of non-type 1 diabetes in the UK. The British Society for Paediatric Endocrinology and Diabetes Clinical Trials unit undertook a cross-sectional questionnaire survey of all paediatric diabetes centres during 2000...

Previous studies have demonstrated that POMC peptides are present in islets of Langerhans and suggested that ACTH-related peptides may act as paracrine modulators of insulin secretion. In order to shed light on the cellular mechanisms involved in these responses, we have carried out experiments using the MIN6 mouse insulinoma cell-line and synthetic ACTH 1-24. Following the detection of mouse ACTH receptor (MC-2) receptor mRNA by PCR amplification of MIN6 cDNA, perifusion expe...

For realisation of Sent-Vinsent declaration we organised the group of diabetic pregnant women for observation. 32 patients were examined. Besides common clinical and biochemical examination we conducted measurement of plasma circulation immune complexes (CIC) levels. The control group comprised 10 normal pregnant women. Normal pregnant state: CIC level was 169,64 ±2,93 u.o.s.In diabetic pregnant state with decompensation stage CIC level was 450,7...

The factors affecting counterregulatory (CR) responses to hypoglycaemia in T2DM remain uncertain. Previous studies have suggested an effect of glycaemic control on CR responses in T2DM. Little data exists on the effect of treatment with metformin (MET) vs. Sulphonylurea (SUL) on the CR responses to hypoglycaemia in T2DM.To date, we have performed stepped hypoglycaemic hyperinsulinaemic clamp studies (2-4 mU/kg/min) on 5 subjects treated with MET (Age 50....

Diabetes contributes to 80% mortality in coronary heart disease (CHD). Hyperglycaemia antedates diabetes and is a late stage in the series of events leading to diabetes.Stress hyperglycaemia on admission with acute myocardial infarction (AMI) has been reported to have an increased risk of in-hospital mortality/morbidity.We conducted a retrospective study of all AMI admissions to coronary care unit over a six-month period to see th...

Changed lipid and apoprotein composition of serum lipoproteins is commonly found in chronic liver diseases. In this study we evaluated the serum total cholesterol (TC), triglyceride (TG), HDL-cholesterol (HDL-c), LDL-cholesterol (LDL-c), apolipoprotein-A (Apo-A), apolipoprotein-B (Apo-B), and Lp(a) levels in age, BMI, and sex matched patients with liver cirrhosis (LC) (n: 50), chronic hepatitis (CH) (n: 31) and compared with control subjects (n: 69). The increasing severity of...

Advanced glycation end products modify protein structure and function in type I diabetes. Glycoproteins may be potentially modified through other mechanisms, particularly changes to insulin-dependent oligosaccharide components. We have assessed the use of immobilised lectins, characterising the oligosaccharides of a serum glycoprotein, human chorionic gonadotrophin (hCG). We wish to test the hypothesis that glycoprotein glycosylation may be modified in type I diabetes.<p ...

Objectives-Aim: Oxidized low-density lipoprotein (LDL) seems to play an important role in the etiology of atherosclerosis. They stumulate atherosclerosis. Glucocorticoids decrease LDL degradation and expression of LDL receptor. Morever insulin resistance in glucocorticoid excess state may contribute to LDL oxidation changes. The aim of this study was to investigate, the LDL oxidation in glucocorticoid excess state and the effect of atorvastatin on LDL oxidation.<p class="...

Aim: To determine whether metformin has beneficial effects on hirsutism in patientswithout diabetes mellitus.Methods: This was a randomised placebo controlled double blind parallel study of six months Metformin (1500milligrams per day)/placebo. The primary outcomes were change in hair growth rate on hirsutography and by Ferriman-Galwey score. Secondary endpoints were changes in biochemical parameters related to androgens and ins...

Objective: To establish the prevalence of Syndrome X in women with Polycystic Ovary Syndrome (PCOS) and determine which sonographic features of PCO best predict syndrome X.Background: Recently, the third report of the USA national cholesterol education program expert-panel on the detection, evaluation and treatment of high blood cholesterol in adults specifically identified syndrome X, a combination of insulin resistance and compensatory hyperinsulinaemi...