Endocrine Abstracts

Type II diabetic nephropathy (DN) has become the single most common cause of end-stage renal disease in the Western world. In previous studies we have shown a significant involvement of the GH-IGF-I axis in a mouse model of type I DM. The purpose of this study was to examine the endocrine and renal changes in GH-IGF-I axis key molecules in db/db mice, a model of type II DM lacking a functional leptin receptor. Obese (D) and lean (heterozygote) (C) animals were followed, beginn...

Objectives: To study the mechanism by which sodium bicarbonate act to enhance exercise.Methods: Fifteen healthy volunteers, different age groups varies between 20 to 32 years, body weight between 65 to 70 kg, male subjects, were put for exercise test under three conditions: following ingestion of 300 mg sodium bicarbonate per kg of body mass (i); following ingestion of a placebo (100 mg sodium chloride isotonic solution per kg of body mass) (ii); and fol...

Amylase is a digestive enzyme made primarily by the pancreas and salivary glands.Objectives: To determine other functions for the enzyme amylase.Design: In vitro tests combined with prospective study on one hundred and fifty healthy volunteers.Methods: Twenty five mls of Human Saliva alpha amylase were added to 5 mls of sucrose (table sugar) and 5 mls of flour (starch) in different samples. Twenty five...

High levels of GH and low levels of IGF-I are found in the serum of type 1 DM. GH binds to its receptor (GHR) and leads to a series of signal transduction reactions, involving phosphorylation of intracellular proteins, including IGF-I and angiotensin II receptor type I (AT1R). It has been previously shown that in type I DM mice there is a decrease in liver GHR levels and circulating IGF-? in spite of increased circulating GH, suggesting a state of GH resistance, although its e...

It is well known that there exists a correlative relationship between diabetes mellitus (DM) and sex hormone levels. However, it has not yet been found if it is caused either by hyperinsulinemia, or hyperglycemia or insulin resistance (IR). Eighty-one men with DM and 35 healthy men with normal glucose levels were examined. In each group the persons were divided into four age subgroups: 36–45 years old, 46–55, 56–65 and 66–75 years old. IR was estimated usin...

There is an association between high LDL-Ch levels and cardiovascular disease in T2DM patients. Clinical trials have shown that reduction of LDL-Ch with statins has a beneficial effect on macrovascular complications in patients with T2DM, but is this a relevant effect in clinical practice? LAF has a slower absorption, longer action time and less side effects than other statins.Objective: To assess in clinical practice, the effect of LAF on LDL-Ch and the...

Introduction: Undernutrition is common in haemodialysed diabetic patients. To estimate the nutritional status before and after dialysis, we followed up prospectively initially undialysed uremic diabetic patients.Methods: All 20 patients had initial body composition (Lean Body Mass, LBM, using DEXA) and serum albumin (SA) measurements. Ten patients underwent hemodialysis (HD) after 15 m (mean). They had a similar LBM & SA evaluation 6.5 m after starti...

Introduction: End-Stage Renal Disease is a common cause of undernutrition, with a high risk of morbidity and mortality in dialysis. To improve nutritional status before dialysis, we followed up 35 non-dialysed uremic diabetic patients in a prospective and cooperative study.Methods: We analysed glomerular filtration rate (GFR, using 51Cr-EDTA), glycemic control (HbA1c), and nutritional status: body composition (lean body mass, LBM, by DEXA), serum albumin...

Introduction: Patients with Parkinson’s disease on pharmacological treatment frequently loose weight but regain weight after subthalamic nucleus deep brain stimulation (SNBS). This is, at least in part, due to an increase in resting energy expenditure (Perlemoine et al., Br J Nutrition 2005; 93). As SNBS electrodes are located close to the hypothalamic centre regulating food intake, we investigated whether ghrelin levels would vary with SNBS and/or L-DOPA tr...

The aim of the study: An attempt to assess relative roles of common risk factors of coronary artery disease (CAD) and sex hormones in the pathogenesis of CAD in young menstruating women (W).Materials: CAD-W group: 52 W in the age of 38–48 years with angiographically proven critical changes in coronary arteries. 38 of them suffered from myocardial infarction. H-W group: 15 healthy W in the age of 35–45 years.Methods: In al...

Urinary N-Acytyl β-D glucoseaminidase EC: 3.2.1.31 is a lysosomal enzyme which is classified in hexosaminidases group. This enzyme is found in different tissues such as, kidney, liver and spleen, but the kidney has maximum level of enzyme.The first step was the standardization of colourimetry and flourimetry of enzyme assay. In colourimerty method para-nitrophenyl N-acetyl β-D-glucosamine is used as substrate and in flourimetry method the subst...

Introduction and objectives: Aim of this study is to evaluate the psycho-biological correlates of DM associated hypogonadism (DMAH).Methods: The Structured Interview SIEDY was employed along with several biochemical, psychological and instrumental investigations. We defined hypogonadal subjects (HY) those with a circulating total testosterone (T) below 10.4 nM.Results: We studied 1246 patients. More than 15% resulted affected by ty...

Aim: The aim of the study was a comparison of the selected parameters of the lipid metabolism (total cholesterol – TC, LDL cholesterol – LDL, HDL cholesterol – HDL and triglycerides – TG) in pregnant women with gestational diabetes mellitus (GDM) depending on the method of diabetes treatment.Material and methods: A group of 121 women with GDM was analyzed. There were 85 women treated with diet alone (G1) and 36 women treate...

The aim of the study was to estimate the parameters of lipid metabolism (total cholesterol – TC, LDL and HDL cholesterol and triglycerides – TG) in women with GDM. Material and method. The study was carried out in 121 GDM women being at the age of 30.5±5.7. The control group (CG) were 36 healthy women at the age of 25.3±4.4. Results. The parameters were analyzed while making diabetes mellitus diagnosis in GDM women at the end of the second gestational trime...

The aim of our study is to assess the efficacy of a lifestyle modification including altered diet composition and physical activity in preventing diabetes mellitus type 2 (DM 2) in individuals with impaired glucose tolerance and impaired fasting glucose (IGT/IFG).Materials and methods: The study included 327 patients (68 m 258 f) 25–65 years. Patients were divided into 2 groups matched by sex, age, weight, body mass index (BMI), waist-to-hip ratio (...

Background and aims: DM2 has been associated with altered levels of trace elements and a prothrombotic state. We investigated the effect of a 28-day Greek mediterranean diet (rich in fiber, mono- and polyunsaturated fatty acids and complex carbohydrates) on serum concentration of trace ele-ments and blood factors participating in coagulation and fibrinolysis in 58 patients with DM2.Materials and methods: Blood trace elements and blood coagulation fac-tor...

Introduction: Glargine is an analogue insulin with a flat pharmacokinetic profile and duration of action of 24 h providing stable ‘background’ insulin on which fast acting insulin can be added during meal times. Clinical trials have indicated that this leads to more satisfactory and stable glycaemic control with reduced frequency of hypoglycaemia. We carried out a prospective audit to see if these reported benefits are confirmed in routine clinical practice.<p cl...

Obesity and adipokines are associated with a state of chronic low grade inflammation (Trayhurn & Wood 2004).In view of our findings that the adipokines resistin and fiaf (fasting-induced adipose factor) are also expressed in mouse brain and pituitary gland (Wiesner et al 2004), we tested the hypothesis that these factors would be induced in brain tissue following cerebral hypoxia/ischemia (H/I). Neonatal H/I (postnatal day 8; unilateral common c...

The prevalence of cardiovascular diseases (CVD) has increased sharply in the developing countries and because Type 2 diabetic patients are at increased risk for CVD.Objective: To determine the prevalence of patients with past hystory of a myocardial infarction or cerebral strok in newly diagnosed type 2 diabetic patients in Georgia.Design: Cross-sectional study.Patients: Newly diagnosed type 2 diabetic patien...

Recently, several groups have described a subset of obese women, who despite having excessive total body fat, are insulin sensitive (ISO for Insulin Sensitive Obese), normotensive and present a favorable lipid profile. Adiponectin, ghrelin and leptin play important roles in the regulation of energy metabolism and food intake. Moreover, all three hormones have been reported to be closely linked to insulin resistance and regulated by insulin. Therefore, we propose to investigate...

Background/objectives: We have previously shown the existence of a pancreatic islet renin-angiotensin system and its key component AT1 receptor (AT1R) was upregulated in an obese Type 2 diabetes mellitus (T2DM) mouse model. Blockade of the AT1R was found to improve beta-cell function and glucose-stimulated insulin secretion in this T2DM model. However, the mechanism(s) remain equivocal. In this context, oxidative stress was suggested to be a critical regulator for t...

Objectives: We have recently identified an islet renin-angiotensin system in the pancreas which was subjected to upregulation in an obesity-induced mouse model of Type 2 diabetes mellitus (T2DM). Blockade of the AT1 receptor (AT1R) activation in this diabetic model improves islet function. It is well known that hyperglycemia plays a pivotal role in beta-cell dysfunction and T2DM. Nevertheless, glucotoxicity-induced AT1R activation and its consequence in oxidative st...

The renin-angiotensin system (RAS) has been implicated in the development of diabetic vascular complications and angiotensin converting enzyme (ACE) has a major role in this system. This study sought to examine the in vivo effect of aqueous extract of garlic (Allium sativum) on the level of ACE activity of serum from streptozotocin (STZ)-diabetic and non-diabetic rats. Serum ACE activity measured by Cushman and Cheung colorimetric assay in the beginning of diabetes indu...

Insulin resistance is an integral part of the metabolic syndrome. Insulin resistance and metabolic syndrome predisposes to chronic kidney disease. However, the determinants of insulin resistance (measured by the homeostasis model, HOMA-IR) and metabolic syndrome are not known in hemodialysis (HD) patients. Thus, we studied 157 HD patients.Results: The prevalence of metabolic syndrome was 46.5%. Patients with metabolic syndrome had higher HOMA-IR (5.6&#17...

Background: Metabolic disturbances could contribute to poor outcome after acute myocardial infarction (AIM) in type 2 diabetic patients.Objective: We examined the acid base disturbances that could contribute to poor prognosis after MI among type 2 diabetics suffering AMI.Methods: Parameters of acid base status and blood lactate level were compared (using one and two – way ANOVA) in 160 age-matched individuals. Forty of them we...

Traditional herbal medicine has been used for centuries to treat various chronic diseases – There have been some anecdotal evidence to suggest that the use of some of these herbal medicine may be both safe & efficacious in patients and laboratory animals with diabetes. Many patients with diabetes worldwide use some of these medicines without informing their caring physicians. PHS-E2 (Glucoherb) is a Chinese traditional herbal medicine, which is extracted from two medi...

Fasting of Holy month of Ramadan may be beneficial for patients with Type-2 diabetes but patient education and advice is of paramount importance to offset any effect from changing of dietary habits and treatment schedule. We conducted a questionnaire study few weeks before, during Ramadan and few weeks after Ramadan 1424 H/ 2004. A cross sectional random sample of patients with diabetes attending our services was analyzed. 50 patients mean age 65 yeas (20–83), (median, ra...

The effect of short-term (10 days) and long-term (28 days) intake of alcohol (6% ethanol in tap water) on insulin receptor properties in adipose tissue plasma membranes and adipokines expression in adipose tissue of ad libitum fed male Wistar rats was studied. Control animals (C) had free access to standard laboratory diet. After 10 days of alcohol intake lower body mass gain with no changes in size of both epididymal fat pads and adipocytes was observed. However, long-...

Background: Des-acyl ghrelin (Des-G) is an isoform of ghrelin without the n-octanoyl modification at Ser3 present in this peptide. It is mainly produced in endocrine cells located in the stomach, in the mucosal layer of the fundus, and it is secreted into bloodstream where it circulates in higher amounts than ghrelin (2:1).Although Des-G was previously thought of as a non-functional peptide, since it does not activate GHS-R1a, recent studies have shown t...

Adipokines such as resistin and FIAF (fasting-induced adipose factor) are predominantly, but not exclusively, expressed in adipose tissue and may modulate insulin sensitivity and lipid metabolism. We reported that resistin and fiaf mRNA, and resistin protein, are detectable in the mouse hypothalamus and pituitary gland (see eg. Wiesner et al. 2004). We are investigating the regulation of these genes in a novel hypothalamic neuronal cell line (n-1; Belsham ...

The silent myocardial ischemia is a serious diagnostic problem especially in patients with long-standing diabetes of type 1 (DM). Resting as well as exercise myocardial perfusion scintigraphy tests allow to recognize the silent myocardial ischemia in these groups of patients and to start the relevant treatment. The aim of the study was to establish the prevalence of myocardial ischemia in patients with type 1 DM, without clinical symptoms of ischemic heart disease (IHD) and wi...

Background and Aims: The aim of our investigation was to evaluate the relationship between parameters of the metabolic syndroma (MSDR; NCEP/ATPIII Panel) in randomly selected diabetic patients (DM) with peripheral arterial occlusive disease (PAOD).Materials and Methods: diabetics, male 680 (49.7%), age (mean+SD) 52.6+14.4yrs. (16–84), were propectively examined using doppler examination and neuropathy disability scoring (NDS). PAOD was confirmed in ...

In congenital hyperinsulinism (CHI), mutations have been found in 5 different genes, ABCC8, KCNJ11, GCK, GLUD1 and SCHAD. In approximately 50% of all cases, however, no genetic explanation can be found.A mature newborn girl presented macrosomic, birth weight 4378 g, and a blood glucose down to 1.3 mmol/l at day 1. Hyperinsulinism was documented. The child responded to diazoxide treatment, initially in combination with prednisolone, chlorothiazide and oct...

Aims: Waist circumference is a convenient measure of abdominal adipose tissue,it correlates closely with BMI and is strongly linked to obesity- related risk factors. The sex specific waist circumference currently proposed for European male is 94 centimetres and for females is 80 cm. Thus, there is a need to develop sex specific waist circumference cut-offs points appropriate for different population (W.H.O).The aims are to determine the appropriate waist...

Objective: To explore the relationship between body mass index (BMI) and smoking in a cross-sectional and longitudinal study.Methods: In the 4th and 5th Tromsø studies in 1994 and 2001, 27158 and 8130 subjects participated. Height and weight were measured and a questionnaire on life style factors filled in.Results: Complete datasets were available for 10920 men and 12092 women in the 4th Tromsø study. Among these subjects...

Introduction: Genes involved in common complex disorders such as obesity, type 2 diabetes mellitus (T2DM), dyslipidemia or hypertension are not disease specific, since clinically related disorders also share genetic components. These diseases cluster together in the Metabolic Syndrome, a generalized pathology with increased cardiovascular risk in which insulin resistance is considered a key feature. Cysteine protease Calpain-10 (CAPN10) has been associated with T2DM, polycysti...

Diabetes mellitus (DM) includes a group of carbohydrate metabolism disorders that is characterized by hyperglycemia and leads long-term macro- and microvascular complications. Also siblings of type 2 diabetic patients have increased relative risk of micro and macrovasculer outcome of DM even though their plasma glucose levels in normal range. Genetically determined hyperinsulinemia, insulin resistance and associated dyslipidemia have crucial role in the processes of vascular a...

Prior studies have demonstrated that diabetes as a cause of or contributing factor to end stage renal disease (ESRD) has a detrimental impact on survival. What is unclear is whether this effect varies by age and gender.Methods: The objective of this study was to evaluate mortality differences by age and gender among diabetic and non-diabetic ESRD patients in a national cohort. Data on all new ESRD patients (n=451,296) who were initiated on dialysi...

Aim: To assess possible changes in concentrations (conc) of hormones in men (M) suffering from metabolic syndrome (MS) which may be involved in pathogenesis of coronary artery disease (CAD).Materal: CAD-M group: 33 M with MS and CAD in the age 51,5±6,4 years with angiographically defined CAD. 14 of them were normoglycemic, 19 with impaired glucose tolerance or diabetes mellitus t. II. H-M group: 13 healthy M in the same age.Me...

Objective: The present study designed to assess the effect of Mg+Zn, vitamin C+E, and combination of these micronutrients on blood pressure in type 2 diabetic patients.Materials and methods: In a randomized, double-blind, placebo controlled clinical trial, 69 type 2 diabetic patients were randomly divided into four groups, each group receiving one of the following daily supplement for 3 months; group M: 200 mg and 30 mg Zn (n=16), group V: 200 mg...

Peroxisome proliferator-activated receptors (PPARs) regulate adipocyte differentiation and gene expression by an interplay with other transcription factors. They are the nuclear receptor that are mostly expressed in adipocytes and some nonadipose tissues like intestinal wall, muscles, liver and macrophages. The aim of the study was to assess the possible association between Pro12Ala PPAR-gamma2 receptor gene polymorphism and satiety factors, insulin resistance and androgen exc...

Among specific diabetes subtypes secondary to pancreatopathies, hereditary hemochromatosis is an inherited disorder of iron metabolism, resulting to excessive iron overload and tissue damage in various organs. We report here the case of a man with the young-onset form of the disease and we describe his glycaemic status, before and during venesection therapy. A 25-year-old man attended our clinic in Athens, Greece, with hypogonadotropic hypogonadism due to hereditary hemochroma...

The metabolism of glucocorticoids within adipose tissue, by the enzyme 11beta-hydroxysteroid dehydrogenase type 1 (11HSD1), is known to be altered in obesity and following high fat feeding. Until recently, little attention has been paid to the fat depots found directly adjacent to blood vessels. Emerging evidence suggests that perivascular adipose may play a key role in modulating vascular function. The presence of steroidogenic enzymes within perivascular adipose, and the eff...

Objective: In humans insulin-induced hypoglycaemia activates the autonomic nervous system and provokes counterregulatory hormonal responses, the magnitude of which is lower in healthy non-diabetic females and in women with type 1 diabetes compared to male counterparts, although the glycaemic thresholds at which these responses are triggered are similar in both sexes. The Edinburgh Hypoglycaemia Score (a validated method of symptom assessment) was used to examine symptoms to as...

Background and Aims: Early glycoregulation disorders, impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) are associated with metabolic syndrome (MS). The aim of this study is: (a) to analyze parameters of insulin sensitivity, glycoregulation, lipid status, microalbuminuria (MI) and homocysteine (HCY) in patients with obesity (I), IFG (II), IGT (III) and newly diagnosed DM type 2 (IV) patients; (b) to determine the percentage of metabolic syndrome at these pati...

Background: The impact of hyperglycemia on atherogenesis is regulated through the increase of the oxidative stress, increase of the rest of the glycosylated products of metabolism and development of the endothelium dysfunction.Aim: To compare the biochemical indexes and investigate their relationship with the development of cardiovascular disease in obese patients with and without type 2 diabetes.Materials and methods: 21 patients ...

Neonatal rats were treated with MSG (4G/Kg daily for 7 days). Glucose tolerance tests (GTT) were performed at 32, 65 and 70 weeks. After one year there was evidence of Type II diabetes, and the blood glucose levels were significantly greater than the controls for several points in the GTT; islet beta-cells were unchanged, cataracts were often present and there was central obesity.The amines in the heart, proximal tail artery, kidneys and adrenals were ex...

Background: The male preponderance among 15–30 yrs old patients with type 1 diabetes mellitus (T1DM) was repeatedly described. All-age gender distribution assessment was not done yet because of the difficulties in the type of DM recognition in insulin-treated (IT) patients diagnosed after 30 yrs of age. The possibility of such assessment has arisen from the use of population-based DM registers by patients stratification depending of their disease history.<p class="abs...

Background: Arm swing is a Chinese style of exercise. During the exercise, participants stand and simultaneously move their both arms forward and then backward for about 1 round per second.Abstract: The present study aims to investigate effects of arm exercise training on metabolic responses in type 2 diabetic Thai patients.Methods: Fourteen male and 47 female diabetic patients (aged 57.5±1.4 yrs) without cardiovascular diseas...

Hyperinsulinemia leading to insulin resistance is the major factor in the pathogenesis of type 2 diabetes mellitus. And also defect in glucose uptake is among the primary defects associated with peripheral insulin resistance. Interestingly, the result from our previous study indicated that the ethanolic extract of Combretum decandrum Roxb. (CD) had a hypoglycemic effect in type 1 diabetic rat model. Therefore this study examined the effect of CD extract on the glucose t...

Background: In-patients inadequate food intake can worsen the prevalence and degree of malnutrition.Patients and methods: A “one day” questionnaire was used in medicine (M-Dpts) geriatric (G-Dpts) and surgery (S-Dpts) departments of a university hospital to: i) evaluate nutritional status with the Detky score, ii) quantify food intake, iii) understand the reasons of non-consumption of in-patients (n 286, 46 & 104 in M-, G- & S-Dpts, res...

Introduction: There is no difference in blood pressure between boys and girls, but following puberty, blood pressure increases more in men than in women. The higher blood pressure and stronger progression of hypertension in men is associated with a higher risk and mortality for cardiovascular diseases than in women. Androgens are known to play an important role in renal tubular epithelial cell growth, hypertrophy and erythropoetin production and may be important determinants o...

Background: IRS consists of ≥3 of the following components: obesity (BMI >98th centile), abnormal insulin glucose homeostasis, hypertension, dyslipidaemia. Elevated serum alanine aminotransferase (ALT) is a marker of NAFLD.Objective: To define the prevalence of IRS and NAFLD in obese children referred to our centre.Methods: subjects: mean BMI-SDS +6 (+0.6 to +14), median age 13.4 years (3–19), female 66%, British Asi...

Ghrelin is gastric peptide with appetite stimulating and growth hormone (GH) releasing properties. Circulating ghrelin levels decrease after nutrient ingestion, oral and iv glucose challenge. It has been hypothesized that vagal system may have a major role in initiating this decrease.The aim of this study was to investigate circulating ghrelin levels during oral glucose challenge in gastrectomized (GASTRX)- vagotomized patients. The study was approved by...

We hypothesised that SNPs within oxidative stress genes influence vascular compliance in patients with coronary artery disease.A SNP within the gene encoding the eNOS (NOS3) which encodes a Glu298→Asp amino acid substitution has been associated with cardiovascular disorders in which NO bioactivity is impaired. The gene coding for p22phox, a critical component of the NADH/NAD(P)H oxidase enzyme system, a major source of vascular SO, is CYB...

A common NOS3 polymorphism (the gene which encodes endothelial nitric oxide synthase), a variable number of tandem repeats within Intron 4 has been associated with cardiovascular disorders in which nitric oxide bioactivity is impaired including myocardial infraction. Consistent characteristic changes in the pressure pulse wave shape have been associated with ageing, risk factors for cardiovascular disease and impaired NO bioactivity. Therefore pulse waveform analysis can be ut...

In humans, glucocorticoids (GC) are implicated in the pathogenesis of obesity and insulin resistance. GCs are regulated at the prereceptor level by 11beta-hydroxysteroid dehydrogenases (11β-HSD). 11β-HSD type 1 (11β-HSD1) predominantly displays oxo-reductase activity, converting cortisone in man, 11-dehydrocorticosterone in rodents, to cortisol and corticosterone respectively – a reaction requiring the cofactor NADPH. The generation of a hexose-6-phosphate ...

Background and aims: Earlier we reported, that GADA and ICA revealed more often in HBV and HCV infected type 2 diabetic patients, than in noninfected. The goal was to determine the role of HBV- and HCV-infections in insulin insufficiency mechanisms in type 2 diabetic patients.Materials and methods: 173 patients with type 2 DM (41 male, 132 female, middle age 57.5±0.8 year, average diabetes duration 8.55±0.53 years) were surveyed. Markers of a v...

Background and aims: High prevalence of diabetes mellitus (DM) in patients with viral hepatites is observed. Trigger role of HBV and HCV infection in development of autoimmune reactions in diabetic patients is discussed. The goal was to study influence of hepatotropic viruses (HBV and HCV) on development of autoimmune processes to pancreatic β-cells.Materials and methods: patients with type 2 DM (41 male, 132 female, middle age 57.5±0.8 year, a...

Adrenomedullin (AM) is a multifunctional peptide hormone which plays a significant role in vasodilation and angiogenesis, implicating it in hypertension as well as in carcinogenesis. AM exerts its effects via the Calcitonin Receptor-Like Receptor (CLR) complexed with either Receptor Activity Modifying Protein (RAMP) 2 or 3.The aim of the present study is to investigate the biological actions, functions and possible target genes of AM in immortalized Huma...

Activation of the melanocortin-4 receptor (MC4R) leads to a decrease of appetite and an elevation of sympathetic nerve activity (SNA). The sympathoexcitatory property of leptin is mediated by the melanocortin system and a functional MC4R is a prerequisite for the development of hypertension associated with obesity in animal model. To test the hypothesis that functional mutations of the MC4R lead to a diminished SNA in humans, ten carriers of MC4R mutations and a control group ...

Introduction: Insulin is widely used in Type 2 patients to control the blood sugar when the oral hypoglycaemic agents fail. This is a case report of a type 2 diabetes patient who developed Myocardial Infarction after factitious hypoglycaemia with insulin.Case report: A 64-year-old gentleman with known Ischaemic Heart Disease was treated with insulin (Mixtard 30) and metformin for his type 2 diabetes. He presented to diabetes Specialist nurse with persist...

Objective: Accumulating data suggests that post-prandial hypertriglyceridemia is important in the pathogenesis and progression of atherosclerosis, and thus cardiovascular diseases. We aimed to assess the acute effect of the orlistat vs placebo on post-prandial triglyceride (TG) level in diabetic and non-diabetic obese patients.Research Design and Methods: Study population consisted of 49 patients with obesity (25 non-diabetics, 24 diabetic). Patients wer...

We present a case of 55 years old obese man with type 2 diabetes of 13 years duration, seen in diabetes clinic. His HbA1c had been 8–10% for about 7 years despite being on maximum doses of sulphonylurea and metformin.It was decided to start him on 30/70 mixed insulin and Metformin was continued. His HbA1c did not improve despite aggressive insulin titration. His injections became painful as insulin doses increased and resistance was noted on injecti...

Central obesity is strongly associated with sub-clinical inflammation, insulin resistance (IR) and type 2 diabetes mellitus (T2DM), but the intracellular mechanisms involved in its pathogenesis remain unclear. Recent Murine studies have implicated C-jun N terminal kinase (JNK) as an important molecule linking insulin action and inflammation, therefore we investigated JNK in human abdominal adipose tissue (AT). JNK expression/activity was assessed in abdominal subcutaneous (Abd...

Polycystic ovary syndrome (PCOS) affects more than 5% of women in reproductive age and is characterized by a heterogeneous spectrum of oligoanovulation and biochemical or clinical evidence of hyperandrogenism. Insulin resistance and compensatory hyperinsulinaemia play a significant role in pathogenesis of PCOS.Chronic low level inflammation and an increased risk for cardiovascular disease and type2-diabetes are reported in women with PCOS.<p class="a...

Obesity is a risk factor for the metabolic syndrome and type 2 diabetes. Adiponectin, a 30 kDa peptide secreted from adipocytes has been shown to be anti-atherogenic, and anti-inflammatory, as well as affecting insulin resistance and pancreatic beta-cell function. This study investigated the levels of expression of the adiponectin receptor subtypes 1 and 2 (AdR-1 and AdR-2) and regulation of their expression in the pancreatic BRIN-BD11 beta-cells line. Cells were cultured in R...

The frequency of type 2 diabetes increases in all of the world. The risk for atherosclerosis vascular disease is greatest in type 2 diabetic patients who have other known risk factors such obesity, smoking, hypertension and dyslipidemia.The aim of our study is to determine the frequency of cardiovascular risk factors associated to diabetes and the frequency of macrovascular complications in type 2 diabetic patients.It is a retrospe...

Homozygous familial hypercholesterolemia (HoFH) represents a potentially fatal condition that is caused by low density lipoprotein (LDL) cholesterol receptor deficiency. Statins alone are not effective in HoFH. In recent years, semiselective or selective LDL cholesterol apheresis systems have been shown to prolong life. However, applying LDLC apheresis therapy, recent evidence also suggests that more intense LDL cholesterol reduction is associated with more clinical benefit. E...

C-reactive protein (CRP) is a non-specific but sensitive marker of underlying systemic inflammation. High CRP levels correlate with risk for future cardiovascular events. Statins can lower the circulating levels of CRP. In contrast, the evidence that fibrates lower CRP levels is very limited. This retrospective study evaluates the effect of micronised fenofibrate on plasma levels of CRP in patients with combined hyperlipidemia.Sixty-four patients with co...

Combined hyperlipidemia is characterized by elevated levels of total cholesterol, low density lipoprotein (LDL), triglyceride and mild decrease in high density lipoprotein (HDL) cholesterol. It is difficult to achieve desirable decreases of LDL cholesterol, triglycerides and increasing of HDL cholesterol with monotherapy in patients with mixed hyperlipoproteinemia. This retrospective study was carried out to assess the safety atorvastatin-fenofibrate combination therapy.<p...

Glargine is an analogue insulin which has a peakless action profile over approximately 24 hours. As a result it has been shown to reduce the frequency of hypoglycaemia thereby enabling achievement of tight glycaemic control. This is important during pregnancy in order to lower the risk of foetal malformations.Method: 17 women, mean age 28 years, with type 1 Diabetes Mellitus on a basal bolus regimen including Glargine became pregnant between January 2004...

Introduction: Serum ferritin concentration was found to be related with dyslipidemia, hypertension and abdominal adiposity. The aim of this study is to evaluate the correlations between serum ferritin concentrations and metabolic risk markers in obesity.Methods: Obese 534 women were enrolled into the study. The patients were divided into three tertiles according to the serum ferritin concentrations. The mean serum ferritin concentration was 9.96±4.1...

Introduction: Prevalence of diabetes mellitus (DM) in the UAE is around 20% amongst adults. Lifestyle including meal timings are different from the West and may necessitate different treatment schedules. We have used continuous glucose monitoring (CGMS) to look at glycemic patterns in patients with type 1 and type 2 diabetes in the UAE.Methods: Available CGMS data (using methods previously described) on forty-four patients (thirty-one with type 2 DM and ...

Introduction: The body fat distribution chances with menopause in women. The gluteo-femoral fat dominancy alters with central adiposity via menopause. The incidence of cardiovascular atherosclerosis increases with this period. Altered lipid profile and the increment in abdominal adipose tissue are suggested to be the influencing factors of this situation. The aim of this study was to evaluate the metabolic and anthropometric features of premenopausal and postmenopausal obese w...

Introduction: Metabolic syndrome (MS) is a clustering of risk factors. Endothelial dysfunction has been reported in patients with MS and even in healthy obese individuals with a normal metabolic profile. Sympathetic activity commonly is increased in obese hypertensives, and moxonidine, is found to be effective in lowering blood pressure and improving insulin sensitivity. The aim of this study is to evaluate the efficacy of moxonidine on endothelial dysfunction in insulin-resis...

Introduction: It was found that vitamin D could have a direct effect of on adipocyte differentiation and metabolism and might be involved in glucose regulation of insulin secretion, which may be speculated from finding of a nuclear localization of 1,25-(OH)2D3 in the pancreatic islets. In recent years several polymorphisms in VDR gene, which are potent to alter the activity of VDR protein, have been described. BsmI and FokI polymorphisms were described in...

Background and Aims: Insulin glargine is a long acting insulin analog that mimics normal basal insulin secretion without pronounced peaks. The aim of this study was to compare insulin glargine with NPH insulin for basal insulin supply in patients with type 1 diabetes.Materials and Methods: A total of 48 type 1 diabetics (mean age 27 yr, BMI 23,1 kg/m2) on long term intensive insulin therapy (IIT) were randomized into 3 different regimens of ba...

Objective: C-reactive protein (CRP) is a nontraditional risk factor that predicts cardiovascular disease but its relationship between diabetes and insulin resistance is not well documented. We evaluated the association of CRP levels and insulin resistance in a group of patients at high risk for diabetes.Materials and methods: In this study we evaluated 22 first degree relatives of type 2 diabetic patients with impaired glucose tolerance test (Group 1) an...

Objectives: Glucose insulin potassium (GIK) improves haemodynamic performance following coronary artery bypass graft surgery (CABG). We postulated that this might be secondary to beta-1 adrenergic receptor (ADRB1) up-regulation and changes in myocyte calcium handling.Methods: We performed a randomised double-blind placebo-controlled trial on patients undergoing first time elective/urgent on-pump CABG (LREC approval obtained). A cohort of 48 patients rand...

Objective: To analyse the effects of bariatric surgery on the global coronary risk profile two years after the surgical procedure.Methods: A total of 32 class III obese patients, 6 men and 26 women, mean age 34.3±8.5 years, were included. Total Cholesterol (TC), HDL, triglycerides, Blood Pressure (BP), presence of diabetes and smoking were evaluated before and two years after bariatric surgery. The 10 year Framingham coronary heart disease risk scor...

Impaired estrogen (E2) action is important for cardiovascular disease (CAD) in both men and women. Associations of CAD with estrogen receptor polymorphisms, which may influence sensitivity to E2 have been reported for men but have not been confirmed for women. The aim of the present study was to investigate the association of estrogen receptor common polymorphisms with the severity of coronary disease in women undergoing coronary angiography.Estrogen rec...

Adult progenitor cells exist in most adult tissues, their differentiation being primed by insult, repopulating damaged or dysfunctional tissue. Utilisation of resident progenitor cells has the potential to cure many diseases, including neurodegenerative disorders or diabetes which presently can only be managed. This potential is limited in the brain by constraints on endogenous progenitor cell mobilisation and by difficulties in progenitor cell harvesting for ex vivo ex...

Excessive glucocorticoid exposure has been implicated in the pathogenesis of obesity and the metabolic syndrome. The in vivo conversion of inactive to active glucocorticoids is catalysed by 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1), requiring NADPH as a cofactor. Hexose-6-phosphate dehydrogenase (H6PDH) is co-localised with 11β-HSD1 in the lumen of the endoplasmic reticulum and controls local NADPH availability. Thus H6PDH plays an important role...

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Introduction: Low endogenous testosterone levels are related to the metabolic syndrome /MS/ and diabetes type 2 in middle-aged and elderly men, but little is known about interrelations testosterone-insulin in younger hyperinsulinemic men. Recent studies have shown that the night melatonin in males with hypogonadotropic hypogonadism is significantly higher in comparison with the healthy men, while it is significantly reduced in patients with hypergonadotropic hypogonadism. Howe...

Material and methods: Data for 124 554 DM patients is contained in the DM register of Moscow region (MR) for 2004. Mortality is evaluated yearly.Results: Mortality as result of T1D was 1.92, and of T2D – 41.82 people for 100 thousand population. Mortality among men surpasses mortality among women for T1D (2.11 men/1.76 women), whereas the opposite was observed for T2D (58.79 women/21.81 men). Life expectancy after a diagnosis of sugar diabetes is ma...

Background and aims: Diabetic foot ulcers are a common problem and result in lower extremity amputations. Research on the prevalence of diabetic foot syndrome (DFS), food ulcers, and high amputations reflects the state of diabetic aid.Materials and methods: The data from the Moscow Region DM register on the detectability of DFS, the number of high amputations, the presence of late complications that enable the development of ulcer defects – diabetic...

Aim: To evaluate the relationship between insulin resistance and cutaneous vasomotor responses (endothelial-dependent vasodilatation and peripheral sympathetic failure: noradrenergic control of smooth muscle cells – vasoconstriction and neuropeptides induced vasodilatation) in patients with metabolic syndrome (MS).Methods and subjects: Patients with insulin resistance and MS (defined according to ‘The 2005 IDF definition of the metabolic syndro...

Background: Women with polycystic ovary syndrome (PCOS) appear at increased cardiovascular risk due in part to a dyslipidemia characterized by increased plasma triglyceride and reduced high density lipoprotein (HDL) cholesterol levels. Obesity, insulin resistance and hyperandrogenemia are features of PCOS and potentially affect lipid metabolism. On the other hand, obesity has an important influence on the lipid metabolism.Objectives: The aim of this stud...

Aging is associated with weight loss, appetite decline, reduced fat-free mass (FFM) and increased fat mass (FM). Dysregulation of the ghrelin and leptin systems could reduce hunger and promote early satiety in elderly subjects, leading to impairment of the nutritional status. To better clarify this issue, we evaluated the response of plasma ghrelin and leptin to a standardised oral mixed nutrient load (SOMNL) in elderly subjects with different body composition. The study popul...

Serotonergic transmission is involved in eating behaviour and body weight control. Comparison of SERT properties in blood platelets and serotonergic synaptosomes suggests that the human platelet can serve as an appropriate model for the transport, metabolism and release of serotonin by serotonergic neurons.Aim of this study was to evaluate SERT expression in platelets obtained from overweight or obese subjects (OB) as compared with normal weight healthy volunteers (C), and to ...

Introduction: There is indirect evidence of unfavorable effects of parathyroid hormone (PTH) on glucose metabolism. Teriparatide (recombinant human PTH 1-34 - TPTD) has been recently available for the treatment of osteoporosis.Aim: To evaluate the acute and chronic effect of TPTD on blood glucose and insulin levels in women with established osteoporosis.Patients and methods: Twenty-three postmenopausal women with established osteop...

The major glucocorticoids (cortisol in man and corticosterone in the rat) play an important role in obesity and its attendant hypertension. However, there is no consistent evidence of glucocorticoid excess in simple obesity, suggesting that its role in the regulation of adipose tissue mass results from a more complex mechanism than adrenal hypersecretion of glucocorticoid. Glucocorticoid biosynthesis is not limited to the adrenal cortex; mRNA and enzymatic activity of 11β...

In the light of recent data reporting a high rate of cardiovascular events in Primary Aldosteronism (PA) we investigated whether the Metabolic Syndrome (MS) represents a common feature in patients with PA. A cohort of 86 patients, mean age 51±12 yr was analysed: 59 patients (26 females and 39 males) with idiopathic hyperaldosteronism (IHA) and 27 patients (13 females and 14 males) with aldosterone producing adenoma (APA). Anthropometric parameters (height, weight, waist c...

Adiponectin, a recently discovered protein which is secreted by the adipose tissue, exerts anti-inflammatory and anti atherogenic properties, but also promotes glucose uptake by skeletal muscle and fatty acids oxidation. Patients with hypertension and obesity have reduced plasma levels of adiponectin so that they lack its beneficial metabolic effects. However no data are available in patients with primary aldosteronism (PA). In order to investigate the role of the adiponectin ...

Aims: The aim of our study was to evaluate the incidence of coronary artery disease (CAD) and heart failure (HF) in diabetic and nondiabetic patients admitted to a central hospital in the North of Portugal between 1989 and 2004.Materials and methods: Data from the Hospital Coding Centre were retrospectively analysed according to International Classification of Diseases (9th version) criteria. We have studied the distribution by age, sex, procedures, caus...

Testosterone (T) acts as a coronary vasodilator and reduces myocardial ischemia in men with coronary heart disease. We have previously demonstrated that T inhibits the pore forming alpha1c subunit of the cardiovascular L-type calcium channel in HEK293 cells. In this study we investigated the effects of T and 5β-dihydrotestosterone (5β-DHT) on extracellular calcium entry in A7r5 vascular smooth muscle cells (VSMCs). A7r5 cells grown on coverslips in 12-well plates in ...

Background and aims: Many obese patients with type 2 diabetes mellitus (T2DM) are not adequatly controlled with oral antidiabetic therapy (OAD), even with combination between metformin and sulfonylurea (SU). When OADs no longer maintain good glycaemic control in obese T2DM, it is necessary to add insulin therapy. The aim of this study is to compare the effect of adding premixed insulin aspart 30(BIAsp30) vs. premixed human insulin 30/70 (BHI30) to support metformin therapy in ...

Background and aims: Metformin is the drug of first choice in obese patients with type 2 diabetes (T2DM), but in some patients it is not possible to achieve good glycaemic control by using metformin only. Starting from a fact that T2DM is a heterogeneous disorder due to the interaction of impaired early insulin secretion and peripheral insulin resistance, the aim of the present study was to evaluate and compare the efficacy of repaglinide vs. glimepirid on glycaemic control of...

Background: The alpha2B adrenoceptor gene, a candidate gene for essential hypertension, harbours a functional insertion/deletion (I/D) polymorphism of three glutamate residues.Objectives: The aim of this study was to investigate whether the presence of the D allele is associated with hypertension in Greek patients with type 2 diabetes mellitus (T2DM).Patients-methods: One hundred and twenty-nine hypertensive (64 male, mean age: 66....

Insulin resistance is possibly playing an underlying pathogenic role in the polycystic ovary syndrome (PCOS) and although is not a part of its definition, it appears in 50-90% of PCOS women. Polycystic ovary syndrome is also frequently associated with obesity; women suffering of PCOS seem to be at a great risk of developing a metabolic syndrome.Objectives: The aim of our study was to determine the prevalence of the metabolic syndrome in a population of 4...

Background: Diabetic nephropathy is leading cause of end-stage renal disease (ESRD), which requires dialysis or a transplant. Progression of diabetic nephropathy (DN) leads to development of chronic renal failure (CRF).Material and methods: Data for 124 554 DM patients who live in Moscow region (MR) is in the MR DM register for 2004. The number of T1D- 8747, T2D patients is 115, 534. These registers only contain information about registered cases of DN.<...

NIPHS is a rare cause of adult onset hyperinsulinaemic hypoglycaemia with islet hypertrophy/nesidioblastosis, but without mutations in the ABBC8 and KCNJ11 genes coding for the beta cell KATP-channel subunits SUR1 and Kir6.2. NIPHS patients with GCK mutations have never been described.We report of a 42-y-old woman with asymptomatic hypoglycaemia down to 2.9 mmol/l with simultaneous p-insulin 208 pmol/l (12–77 pmol/l), p-C-peptide 1574 pmo...

Objective: Visfatin, a novel adipocytokine, is predominantly expressed in visceral fat and correlated with obesity. The pathophysiologic role of visfatin in metabolic syndrome (MS) is not clear. We aimed to investigate the relationship between plasma visfatin levels and components of MS, and also the effect of therapeutic lifestyle change (TLC) on these parameters.Design and methods: Nineteen patients (5 male, 14 female; mean age 51.0±9.3 years; bod...

Background: This study was carried out to assess the vasodilatory effect of oestrogen in the human pulmonary circulation. The influence of gender upon the response to oestrogen was also assessed.Method: Isolated human pulmonary arteries were studied by wire myography. Vessels were obtained from male (n=6, age 70±9 years) and female (n=6, age 59±9 years) patients. The study was approved by the local ethics committee. Vessels were p...

Objective: The pleiotropic functions of statins are crucial in reducing cardiovascular events. There is controversy about their effects on insulin resistance. The aim of this study was to investigate the effect of Fluvastatin treatment on plasma adiponectin and insulin levels in a group of dyslipidemic population who had no confounding factors for insulin resistance such as diabetes or hypertension.Design and methods: Forty nine (27 male, 22 female; mean...

Introduction: Besides of the neuroendocrine actions including the stimulatory effects on growth hormone, prolactin and adrenocorticotropin release, acylated ghrelin (AG) plays a role in the regulation of metabolic processes, resulting in the decrease of insulin secretion and increase of hepatic glucose release. Despite of many earlier studies, the mechanisms involved in AG secretion have not been established. The aim of study was to assess the influence of leptin on AG.<p ...

Leptin and adiponectin are cytokine-like hormones secreted by white adipose tissue. Plasma leptin correlates closely with total body fat mass, and its secretion is positively regulated by insulin in vivo and in vitro. Hypoleptinaemia is a key centrally-mediated orexigenic stimulus. Plasma adiponectin, in contrast, correlates negatively with whole body fat mass and insulin resistance in adults, and its expression is regulated negatively by insulin in vivo a...

Background: Women with PCOS carry cardiovascular (CV) risk factors, which may account for the increased CV risk. Oral contraception therapy using ethinyl-estradiol & cyproterone acetate (EE-CA) is administrated to normalize menstrual cycles and reduce serum androgen levels in women with PCOS. The aim of this study was to assess the effect of EE-CA on endothelial function in young, non-obese PCOS women.Methods: We studied 13 non-obese (body mass index...

Introduction: Trisomy 21 is often associated with congenital malformation and metabolic abnormalities such as glucose intolerance and an increased risk of developing diabetes mellitus.Aim: The aim of this study was to assess carbohydrate metabolism in children with Down syndrome.Material and methods: Thirty nine children with Down syndrome, aged between 2 months and 16 years (mean 6.5 years), took part in the study. Glycaemia befor...

Aim: To determine if the endogenous estrogen 17beta-estradiol protected against oxidative stress-induced endothelial cell damage and the mechanism of this potential effect.Methods: Human umbilical vein endothelial cells were isolated and cultured in phenol red free media with 2% charcoal-stripped serum. The following were undertaken (1) Cells were exposed to 0.1 to 1 nM 17beta-estradiol immediately prior to 100 μM hydrogen peroxide added for 24 hour...

Surgery is the most effective way of treating morbid obesity. The laparoscopic gastric bypass (Roux en-Y) is the preferred bariatric surgical procedure performed at our hospital. This combines restriction of intake with a profound sensation of early satiety.Ideally, multi-disciplinary team involvement (including psychological assessment), over a period of at least six months, is a prerequisite for bariatric surgery referral. The more psychotherapeutic wo...

Introduction: Androgenetic alopecia (AGA) is the most common cause of balding in men. AGA is the risk factor of cardiovascular diseases, glucose metabolism disorders and also the risk of benign prostethyperplasia and prostate carcinoma. Polycystic ovary syndrome (PCOS) and metabolic syndrome are the risk factors of insulin resistance, obesity and diabetes mellitus. The genetic autosomal trait of PCOS initiated a hypothesis about the existence of a male equivalent of PCOS. Prem...

Background: The polycystic ovary syndrome (PCOS) is a condition defined by hyperandrogenism and ovulatory dysfunction. It is also known to be associated with insulin resistance and has many features in common with the metabolic syndrome (MS) - a cluster of risk factors that have been shown to predict a greater risk of future cardiovascular events and type 2 diabetes. While there are studies confirming that the MS is more common in PCOS, none have systematically compared the re...

Context: Estrogens may have protective properties in the cardiovascular system, linked to the activation of estrogen receptor alpha (ERα), present in vascular smooth muscle cells (VSMCs) and endothelial cells (ECs). ERα-mediated signaling regulates vasodilatation and atherogenesis, and since hypertension and atherosclerosis are major mechanisms in stroke development, we hypothesized that genetic variations in the ERα gene (ESR1) were associated with strok...

The current PDA recommendations relating to the good metabolic control of diabetes are: self-controlled fasting blood glucose (FBG)70–90 mg%, HbA1c ≤6.1%, lipid profile (LP) TChol ≤175 mg%, LDL≤100 mg%, HDL ≥40 mg%, TG≤150 mg%.Objective: To evaluate the accomplishment of the proper metabolic control in diabetic outpatients with regard to the PDA guidelines.Material and Methods: a548 diabetics (249...

Childhood obesity and its later progression to Type 2 Diabetes (T2DM) are known to be associated with sub-clinical inflammation; although the underlying cause for this is unclear. However, studies suggest that bacterial endotoxin (LPS) derived from commensal bacteria in the human gastrointestinal tract may contribute directly to sub-clinical inflammation. Human adipose tissue expresses toll like receptors that induce an inflammatory cascade in the presence of endotoxin. Hence,...

Obesity is a major cause of chronic hypoventilation and/or obstructive sleep apnea syndrome (OSAS). Aim of this study was to evaluate the prevalence of pulmonary dysfunction and the relationship between OSAS and several clinical, functional and polysomnographics parameters in severely obese patients. 101 subjects (68 females and 33 males) aged 49.2±13.2 years (mean±S.D.), with BMI 46.8±6.5 Kg/m2 were enrolled. Sleep quality and daytime ...

Insulin resistance states are associated with endothelial dysfunction, but the molecular mechanisms underlying this association are incompletely understood. Impairment of insulin stimulated endothelial NO production is proposed to be a key mechanism in this process. In cultured human aortic endothelial cell (HAEC) models, insulin stimulates an intracellular signalling cascade resulting in activating phosphorylation of Insulin Receptor Substrate-1 (IRS-1), Protein kinase B (PKB...

Aim of the study: To examine the white blood cell count and the platelet count in type 2 diabetic patients vs. age-matched healthy controls, as well as to investigate if the abovementioned counts are associated with parameters of diabetes.Methods: This study included 337 subjects, divided into two groups. Group A comprised 190 type 2 diabetic patients (98 men, mean age 66.5±9.6 years, mean diabetes duration 11.7±8.6 years). Group B comprised 14...

Objective: To examine the ability of a multisensor armband (SenseWear Pro 2 Armband™, Body Media, Pittsburgh, PA) to estimate daily energy expenditure (EE).Patients and methods: Eighteen healthy women (mean age:29.4±5.8 yr and mean BMI:23.2) participated in the study. Daily EE was estimated by the Sensewear Armband and a physical activity record (PAL) during the same day. Appropriate MET factors were assigned to the different activity categorie...

The PROactive study recently demonstrated that pioglitazone, a thiazolidinedione class drug, reduces macrovascular morbidity and mortality in patients with type 2 diabetes. This class of drug has been reported to exert PPAR gamma receptor dependent as well as receptor independent effects, possibly via AMP kinase activation (AMPK) but the precise mode of action resulting in improved cardiovascular outcome remains uncertain.We studied the effects of rosigl...

Dehydroepiandrosterone (DHEA) and its sulfate derivative (DHEA-S) are major adrenal secretory products in humans, but their biological function is not still fully explained. Some studies reported negative correlation of DHEA(S) with BMI, fat distribution, and correlations with insulin sensitivity or lipid spectra, but the results are often controversial. Our objective was to assess the correlations of DHEA and DHEA-S levels in Czech non-diabetic population with anthropometric,...

Dyslipidemiαs should be managed from childhood for prevention of early atheromatic vascular lesions and premature cardiovascular disease in adult life.Aim: We examined the frequency of different types of dyslipidemiα in children and the results on blood lipids of lifestyle intervention (diet and exercise).Patients and methods: We studied retrospectively 136 children, 74 boys and 62 girls, mean chronological age 8.5±3...

The fusion of insulin-stimulated GLUT4-containing vesicles (GSV) with the plasma membrane (PM) of adipose or skeletal muscle cells is governed by regulated exocytosis. In all such membrane fusion events cognate t- and v-SNAREs interact in an ordered way to allow vesicles to first dock with, and then fuse with the plasmalemma. In neurons, the best-studied example of this well conserved process, the protein species responsible for directing the final (rate-limiting) fusion step ...

Background: Glucorticoids can affect blood pressure in humans, as demonstrated most strikingly in Cushing’s syndrome. We have previously reported that total cortisol metabolite excretion is raised in obese subjects, while other investigations have identified genetically determined changes in glucocorticoid receptor function as contributors to hypertension. Furthermore, in essential hypertension, vasoconstrictor sensitivity to glucocorticoids is increased. Such raised sens...

Glucose metabolism was investigated in 65 patients with Cushing’s syndrome (CS), 19 with cortisol-secreting adrenal adenoma (mean age 47.2±4.9), 40 with ACTH secreting pituitary adenoma (mean age 41.4±12.48), 4 with cortisol secreting adrenal cancer (mean age 63.0±8.4) and 2 patients with ectopic ACTH secretion (38.7±11.9).Eleven patients (17%) were diagnosed as diabetic after abnormal fasting glucose levels (>126 mg/dl). Whi...

Obesity is a well established risk factor for congestive heart failure. The existence of an ‘obese cardiomyopathy’ has been hypothesized, as the complex combination of the effects of both hemodynamic and metabolic alterations. Aim of this study was to analyze the effect of bariatric surgery on the early myocardial alterations detected in a group of severe obese patients by high frame rate integrated backscatter (IBS). Twenty severely obese patients (5 males, 15 femal...

Obesity has reached epidemic proportions worldwide. There are still major gaps in our understanding both of overall effective weight management strategies and physical activity alone as a weight management strategy. The aim of this study was to investigate the effect of an 18 week monthly group exercise education program on weight, physical activity, cardiovascular fitness, quality of life and attitudes to exercise in obese Irish females. Eighteen obese females were recruited ...

Cannabinoids and ghrelin exert hypothalamic orexigenic effects and independent peripheral effects have also been reported. We have recently reported that ghrelin and cannabinoids can stimulate hypothalamic and heart AMPK activity, and can inhibit liver and adipose tissue AMPK activity, in rats (Kola et al., JBC, 2005). These data are concordant with the known orexigenic, adipogenic and diabetogenic effects of these compounds as well as with their beneficial effects on t...

Tissue kallikrein is a serine protease involved in the generation of kinins in kidneys, colon, salivary glands, pancreas and blood vessels which have vasodilator roles and influence ion transport. Abnormal renal synthesis and urinary excretion of tissue kallikrein have been linked to diabetes and hypertension. This study’s objective was to produce mAbs against native forms of prokallikrein and active kallikrein in order to study the expression of tissue kallikrein in diff...

Obesity/Metabolic syndrome (insulin resistance, hypertension, cardiovascular disease) has reached epidemic levels in western societies. Aberrantly elevated glucocorticoid amplification by intracellular enzyme 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD-1) within adipose tissue might explain the striking similarities between idiopathic obesity/metabolic syndrome and Cushing’s syndrome, causes by plasma GC excess. A major contributor to obesity/metabol...

KCNJ11 as well as UCP2 genes are involved via modulation of ATP concentration in pancreatic beta-cells in control of insulin secretion. The aim of study was to compare genotypic distribution of E23K (KCNJ11) and G-866A (UCP2) polymorphisms between diabetics, their offspring and controls and to study the possible association of these polymorphisms with biochemical and anthropometric parameters.The study entered 302 diabetics, 165 offspring, 241 controls. ...

Obesity is associated with decreased hepatic reactivation of glucocorticoids (Gc) by 11β-hydroxysteroid dehydrogenase type 1 (11HSD) and increased metabolism of glucocorticoids by hepatic A-ring reductases, which may contribute to activation of the hypothalamic-pituitary-adrenal axis. Androgen action encourages central obesity and increased metabolic complications, possibly by altering Gc metabolism.This study investigates the role of gonadal androg...

Objective: The cardiac hormone brain natriuretic peptide (BNP), including the N-terminal fragment of the prohormone (NT-proBNP) have in cross-sectional studies been demonstrated to be inversely associated with BMI. Clearance of these peptides by adipocyt specific receptors have been suggested. We therefore investigated the impact of weight loss on plasma levels of NT-proBNP and adiponectin in obese individuals.Methods: A total of 20 obese women and 2 men...

Orexin-A (OR-A) and orexin-B (OR-B) play an important role in the regulation of energy balance and the control of sleep-wake cycle. They act via G-protein coupled receptors, namely orexin receptor-1 (OX1R) and orexin receptor-2 (OX2R). OX2R has equal affinity for both OR-A and OR-B, whilst OX1R has a 10-fold greater affinity for OR-A. Orexin-mediated functions have been extensively explored, however, the intracellular signalling pathways remain poorly understood. Using HEK-293...

The medical burden of deprived patients is high. In diabetes deprivation status is associated with poor metabolic control and more frequent complications. No data to date existed showing the association between individual deprivation in adults and anthropomorphic factors linked to abdominal obesity. We would determine whether individual index of deprivation were associated with anthropomorphometric dimensions, postures or body girths and metabolic parameters. We conducted a cr...

Obesity is linked to the development of insulin resistance, diabetes and an increased risk of cardiovascular disease and the metabolic syndrome. Adipose tissue-derived proteins so termed ‘adipokines’ have been implicated in cardiovascular disease and the metabolic syndrome although the molecular mechanisms are not fully understood. Adiponectin, unlike other adipokines, has been shown to have anti-inflammatory, anti-atherogenic, and insulin-sensitising effects. Import...

Type 2 diabetes mellitus is associated with increased prevalence of low serum testosterone levels in men [1]. Testosterone levels in men are known to be positively correlated with insulin sensitivity and negatively with visceral obesity. We performed a double blind placebo controlled crossover study to determine the effect of testosterone treatment on insulin resistance and glycaemic control in 24 hypogonadal men (10 patients treated with insulin) above age of 30 with Type 2 d...

The family of G-protein coupled receptors (GPCRs) are amongst the best-described regulators of cardiovascular pathophysiology. In rodents, intracerebroventricular administration of orexins increases mean arterial pressure and heart rate. However, important peripheral actions of orexins and their cognate receptors is now increasingly of interest.In this study we demonstrated that both receptors are present across the rat heart, at mRNA and protein level. ...

Besides playing a role in energy homeostasis, orexins have been reported to have divergent effects on physiological behaviour, cardiovascular regulation, glucocorticoid release, as well as playing a key role in the aetiopathogenesis of narcolepsy. Recent studies using rodent models suggest orexins may also be involved in the regulation of thermogenesis. For example, mice lacking the prepro-orexin gene are significantly hypophagic but have normal body weight suggesting differen...

The aim of this study was to compare metabolic profile in hypertensive obese and lean subjects. The study population consisted of 76 patients. We measured fasting glucose and insulin levels, triglycerides, total, LDL and HDL cholesterol. We also estimated the BMI, WHR, systolic (SBP) and diastolic blood pressure (DBP). We used WHO criteria for abdominal obesity (WHR>0.90 men, >0.85 women), and WHO criteria for diagnosing the metabolic syndrome (triglyceride>1.7 mmo...

The causal relationship between obesity and heart failure is broadly acknowledged; however, the pathophysiological mechanisms involved remain unclear. Besides hemodynamic changes, an alternative mechanism of cardiomyocytes apoptosis secondary to intracellular lipid accumulation has been proposed. However, this seems to be valid only for severe obesity but may not explain the increase in heart failure risk with mild-to-moderate overweight. Since adipocytes secrete a wide variet...

WNK1 (With-No-K, lysine) and WNK4 are serine/threonine kinases, mutated in Gordon syndrome (Pseudohypoaldosteronism Type II), a dominant, hypertensive, hyperkalaemic disorder; implicating this novel WNK pathway in normal regulation of blood pressure (BP) and electrolyte balance. Previous Xenopus oocyte work implicates WNK4 in regulation of K+ secretion via ROMK (renal outer medullary K+ channel) and Cl- transport pathways both paracellularly via tight junctions (claudin...

Visfatin, a novel adipocytokine preferentially expressed in omental (Om) adipose tissue (AT), has been shown to exert insulin-mimetic effects in mice and humans. Recent studies in Asian populations show elevated serum visfatin levels in subjects with Type 2 Diabetes Mellitus (T2DM), suggesting a potential role for visfatin in the pathogenesis of this disease. Whilst central adiposity is closely related to IR and T2DM, the role of AT in the development of these conditions remai...

Adrenal steroids and alterations in steroid metabolism are important factors in the development of obesity in Zucker rats. One might predict, therefore, that the function of the adrenal gland differs between lean and obese Zucker animals. Accordingly, we investigated adrenal gland morphology and function and have considered not only glucocorticoids and HPA activity but also the renin-angiotensin-aldosterone system. Plasma samples and adrenal glands were obtained from young 12 ...

Background: Atrial fibrillation occurs in 5–15% of hyperthyroid patients. On the other hand, amiodarone is a highly effective antiarrhythmic agent. Despite antiarrhythmic treatment, iodine-induced hyperthyroidism via amiodarone may be associated with recurrence of initial arrhythmias.Aims: To assess if amiodarone maintained it’s antiarrhythmic efficacy in the presence of amiodarone-induced hyperthyroidism (AIT).Patients a...

The aim of the study was to evaluate the effects of hyperthyroidia on glycemic control in patients with diabetes mellitus.Research design and methods: We retrospectively evaluated the patients with diabetes and hyperthyroidism. We analysed clinical data, thyroid ultrasound exploration, laboratory analyses (glycosylated hemoglobin, free thyroxin FT4, triiodothyronine T3, thyroid stimulating hormone TSH).Results: We evaluated 48 pati...

Acromegaly causes various cardiovascular dysfunctions, and cardiovascular complications are the main cause of increased mortality in non-cured acromegalic patients. The aim of the study was assessment of flow mediated dilatation (FMD) and the concentration of soluble vascular cell adhesive molecule (sVCAM) as the selected markers of endothelial dysfunction in patients suffering from acromegaly. The study was carried out in 40 patients with acromegaly in various stages of the d...

Low endogenous testosterone is associated with atherosclerosis in elderly men. The aim of this study was to examine the role of the androgen receptor (AR) in the development of atherosclerosis and determine whether an inactive AR coupled with testosterone deficiency, inherent to the testicular feminised (Tfm) mouse, is associated with atherosclerosis following cholesterol feeding compared to surgically-castrated male littermates with AR intact.Ten-week-o...

We have previously shown that Tfm mice which have a non-functional androgen receptor (AR) and low endogenous levels of testosterone exhibit increased fatty streak formation within the aortic root. The aim of the present study was to administer varying degrees of testosterone to these animals in comparison to littermate controls to determine the role of the AR in the anti-atherogenic action of testosterone.Eight-week-old Tfm mice (n=24) and XY litt...

Objectives: Insulin resistance (IR) and obesity are very common metabolic abnormalities, which are often associated with reduced GH secretion. GH reduces intraabdominal fat and its deficiency may contribute to the metabolic syndrome. IGF-1 improves IR but IGFBPs have a potential role in regulating its bioactivity although only little information exists. We postulate that the elevated insulin levels in IR may persistently suppress GH provided its regulation remains insulin sens...

The adrenal steroid dehydroepiandrosterone (DHEA) has been shown in vivo, to mimic the effects of peroxosome proliferator-activated receptor (PPAR) ligands and oppose those of glucocorticoids, thus producing beneficial effects on insulin sensitivity and adipogenesis in obese and diabetic rodents. Furthermore, DHEA treatment has recently been shown to reduce subcutaneous and visceral fat in humans in vivo. However, the mechanism by which DHEA produces these anti-a...

Skeletal muscle is the principal tissue responsible for insulin-stimulated glucose disposal and is thus the major site of peripheral insulin resistance. Urocortin 2 (Ucn2), a corticotropin releasing factor (CRF) family member and the type 2 CRF receptor (CRFR2) are highly expressed in skeletal muscle. To determine the physiological role of Ucn2, we generated mice deficient in this peptide. Using glucose and insulin tolerance tests and hyperinsulinemic euglycemic glucose clamp ...

Obesity is considered as a state of chronic, systemic low-grade inflammation. Likely causes include infectious factors, leptin, cigarette smoking, low serum HDL-cholesterol and high serum triglycerides. No definitive confirmation on the causative factor is available so far.The aim of the study was to evaluate serum levels of C-reactive protein (hs-CRP, sensitivity 0,085 ng/L), IL-6, IL-10, TNF-α and its soluble type 2 receptor (sTNF-αR-2) in vi...

Systemic lupus erythematosus (SLE) is a multifactorial multisystem autoimmune disorder. Although the survival of SLE patients has been improved with the administration of immunomodulatory therapy, patients seem to suffer from complications of the disease such as atherosclerosis. Lipoprotein Lp(a) is a known risk factor for the development of atherosclerosis.The aim was to evaluate lipoprotein Lp(a) and its relationship with disease activity in patients w...

Considering the high incidence of diabetes mellitus in society and related therapeutic problem, we investigated antihyperlipidemic effects of alcoholic extracts of Juglans regia septum on serum tryglycerids, cholesterol, LDL and HDL in streptozocin-induced diabetic adult male rats. In present study, alcoholic extract of septum of juglans regia linn. Was found to have potent antihyperlipidemic activity. supplementation of this alcoholic extract by gavage at dose o...

Pancreatic islet beta cells contain a substantial amount of chelatable zinc (Zn2+), where it acts as a structural component of insulin packaging and is also co-secreted with insulin. Zinc at concentrations found in the pancreas is potentially harmful, and like in the brain, its permeation into endocrine cells may trigger the destruction of the islet leading to the onset of diabetes. Despite the potential importance little is known about the permeation pathways of zi...

Epidemiological studies show increased mortality in patients with rheumatoid arthritis (RA). One of the causes of death in RA patients is cardiovascular disease. Lipoprotein Lp(a) appears to be an independent risk factor for the development of cardiovascular diseases. The aim of the study was to evaluate serum lipid and lipoprotein Lp(a) levels in patients with RA.Patients with RA, n=50, aged 24–65 years and healthy controls, n=50 were...

Introduction: Dysregulation of the insulin-like Growth Factor (IGF) system and particularly IGF-I and IGF binding protein-1 (IGFBP-1) has been implicated in the pathogenesis of obesity, diabetes mellitus and its complications such as cardiovascular disease and nephropathy, but relatively little is known about the genomics of the IGF system in health and disease.Methods: Six single nucleotide polymorphisms (SNPs) were genotyped in the IGFBP-1 gene, in a r...

Introduction: Dysregulation of the Insulin-like Growth Factor (IGF) system and particularly IGF-I and IGF-binding protein 1 (IGFBP-1) has been implicated in the aetiopathogenesis of obesity, diabetes mellitus and such complications such as cardiovascular disease and nephropathy. However, relatively little is known about the genomics of the IGF system in health and disease.Methods: Six single nucleotide polymorphisms (SNPs) were genotyped in the IGFBP1...

Background and Aims: Components of metabolic syndrome (MS) carry an increased risk for cardiovascular disease (CVD). People with abnormal glucose regulation are more prone to develop complications. At diagnosis 20-30% of type 2 diabetic (T2DM) patients (pts) already have neuropathy-one of the most dangerous complications. Cardiac autonomic neuropathy (CAN) is associated with five-fold risk of mortality. Our aim was to study possible relation between CAN and some components of ...

Background and Aims: There are consistent findings about increased prevalence of depressive disorders in diabetes. The aim of the study was to reveal prevalence of depression in patients (pts) with type 1 (DM1) and type 2 (DM2) diabetes.Materials and Methods: Totally, 157 pts with DM were questioned. To assess depression degree Beck’s scale was used, and 83 depressive pts (scores >10), were allocated into 2 groups (Gr.): Gr.1 (n=44)–...

Background and Aims: At diagnosis 20–30% of patients (pts) with type2 diabetes (T2DM) have neuropathy, that often goes unrecognized. Cardiac autonomic neuropathy (CAN) is associated with five-fold risk of mortality. As today there is no specific treatment for overt neuropathy, it is important to use prevention and timely revealing. The goal of the work was to evaluate prevalence of peripheral neuropathy and CAN in pts with newly diagnosed T2DM.Mater...

Background and aims: Combination of drugs, affecting early insulin secretion and peripheral insulin resistance are a good therapeutic option for patients (pts) with type 2 diabetes mellitus (T2DM). The aim of the present work was to compare efficacy of Repaglinide+Metformin and Sulphonilurea+Metformine in obese T2DM pts.Materials and methods: A total of 107 pts with T2DM not well-controlled on monotherapy. Repaglinide - naïve were allocated into 2 g...

Introduction: Propensity to centripetal adiposity is an ethnic characteristic amongst South Asians, which may underlie the excess risk for both coronary heart disease (CHD) and diabetes in this population. Circulating levels of adipocytokines (hormones which include leptin, adiponectin, tumour necrosis factor (TNF-alpha)) and C-reactive protein (CRP) reflect the adipose tissues endocrine and metabolic activity, and are implicated in CHD.Methods: We compa...

Introduction: Compared to ethnically European men, Pakistani origin men living in the UK have a lower circulating total and free testosterone level, corresponding with greater central adiposity and higher insulin resistance. Within a South Asian group we have now examined the effect of migration to the UK on male testosterone level.Methods: Circulating testosterone concentration was measured by automated immunoassay in 97 Gujarati males resident in India...

Background: Diabetes Mellitus is one of the endocrine disorders that invloved many organs in the body. Many of diabetes patients show cutaneous mainifestations. This study is performed to assess the prevelance of different skin manifestations in diabetic patients reffered to Ahvaz Jondishapour University Diabetes Center.Methods: All diabetic patients (type 1 and type 2) refferd to our diabetes center since 2003 to 2004 enrrold in this study. A questioner...

Leptin is a circulating hormone produced primarily by the adipose tissue, which controls food intake and energy homeostasis. Important peripheral actions of leptin involve inhibition of insulin biosynthesis and secretion in pancreatic ß-cells. In turn, insulin stimulates leptin secretion from adipose tissue, establishing a hormonal regulatory feedback loop: ‘adipo-insular axis’. The aim of our study was to determine the interrelations between leptin, insulin/ins...

It is clear that effective control of blood glucose, hypertension and dyslipidemia, may prevent development of vascular complications in type 2 diabetes (T2DM).The aim of the present work was to reveal correlation between glycemia levels and mortality rate in T2DM patients (pts) with prior myocardial infarction (PMI).Materials: Totally, 131 T2DM pts with PMI were studied (mean age – 57.2±3.1 yrs; diabetes duration – ...

The aim: To reveal relation between altered left ventricular (LV) geometry (G) and contractile ability (CA) in nonbese type 2 diabetic (DM2) patients with mild hypertension (MH).Materials and methods: BP at rest, 24-h ambulatory BP monitoring and echocardiography were investigated in 70 non-obese males, aged 25–50 yrs. They were divided into the following groups: Gr.1, n=15 – DM2 and normal BP, fasting C-peptide (C-p, ng/ml) 4.3±0.9...

Background: Impaired circadian blood pressure (BP) variation is a frequent phenomenon in hypertensive type 2 diabetic (T2DM) patients (pts), and is considered a risk factor for development of cardiovascular complication. The aim - to assess the effect of Lacidipine on left ventricular mass (LVM) and BP in hypertensive T2DM pts.Materials and methods: Totally 32 T2DM pts with mild-to-moderate hypertension (20 m/12 f, mean age 57±9.6 yrs) were allocate...