International Journal of Endocrinology and Metabolism
Volume:6 Issue: 4, Dec2008

We examined the hypothesis that the PPAR Gamma activator, Pioglitazone, has a fat depot specific effect and aimed at determining the ef-fects of pioglitazone on changes in total and re-gional fat distribution, serum adiponectin levels, carotid artery intimal thickness, and subcutane-ous adipose tissue histology in otherwise healthy obese men and women from a minority popu-lation. This is a double-blind, randomized, controlled trial, single site study of the minority population in south central Los Angeles. Thirty-five obese, but otherwise healthy, men and women (waist-to-hip ratio >0.95 for men and >0.85 in women) were ran-domly assigned into three groups: Group A: pla-cebo; group B, pioglitazone 30 mg/day, and group C, pioglitazone 45 mg/day, for a duration of 6 months. The primary outcome measures were changes in visceral fat as measured by Computerized Tomography scan (CT Scan) of the abdomen and thigh, body composition by Dual energy X-ray Absorptiometry Scan (DXA scan) and carotid artery intima-media thickness as measured by ultrasound. Serum adiponectin levels and the size and number of adipocytes were also measured. At baseline, mean age, proportion of female participation, race and ethnicity distribu-tion, blood pressure, Body Mass Index (BMI) and anthropometric measures of subjects in the three groups were not statistically different. After 6 months, we observed significant decrease of intramuscular fat and significant increase of subcutaneous thigh fat in groups B and C as compared to group A. The average carotid artery intimal thickness increased in group A (p<0.01), but not in group B, and decreased in group C (p<0.01). Serum adiponectin levels rose sharply (p<0.001) in the treatment groups only. A signifi-cant positive correlation was observed between the change of the adiponectin levels and subcu-taneous thigh fat. Results of this study supports the use of pioglitazone in the prevention of stroke and peripheral vascular disease in high-risk populations.

Paraoxonase (PON) is a serum esterase, asso-ciated with HDL-C. It decreases the oxidation of LDL-C. Serum PON1 activity has been shown to diminish in several diseases. We investigated the serum PON1 activity and lipid profiles in di-abetic and non-diabetic end stage renal disease (ESRD) patients and controls as well as serum PON1 activity pre and post dialysis. For this study we re-cruited 92 patients with ESRD on hemodialysis, and 46 healthy controls. The patients were as-signed into diabetic and non-diabetic groups (each, n=46 each). Serum lipid profiles including total cholesterol, triglycerides, HDL-C, apolipo-protein A-1, apolipoprotein B, Lipoprotein (a) se-rum PON activity, oxidized LDL-C and total an-tioxidant capacity were compared among groups. Furthermore, pre and post dialysis serum PON activity were also compared. Serum levels of total cholesterol, HDL-C, LDL-C and apoA-I were lower in the ESRD patients, compared to controls. While serum PON activity was significantly lower in the ESRD than in controls, it did not differ significantly between diabetic and non-diabetic patients with ESRD. Serum PON activity was observed to rise significantly postdialysis, compared to predialysis, 69±48 vs. 72±50 IU/ml and 47±32 vs. 53±37 IU/ml in diabetic and non- diabetic patients respectively, the increase being significantly correlated with the quality of hemoidalysis. To conclude, reduced serum pa-raoxonase activity in diabetes and non-diabetes ESRD may further predispose lipids to oxida-tion. Enhancement of the quality of hemodialysis can increase serum PON activity in hemodialysis patients.

Resistin, an adipocyte secreted hormone, has been suggested to link obesity with type 2 di-abetes and insulin resistance in rodent models, but its relevance to human diabetes remains un-certain. The aim of this study was to investigate the relationship between serum resistin concen-trations with markers of insulin resistance and obesity in type 2 diabetes and non-diabetic obese subjects. In this cross sectional study, consisting of 35 obese subjects with type 2 diabetes (16 women and 19 men, age 44.63±1.08 yr) and 35 obese non-diabetic subjects (19 women and 16 men, age 43.54±1.54 yr), fasting lipid profiles were measured by enzymatic methods; NycoCard HbA1c system was used to measure HbA1c. Serum resistin, insulin and glucose levels were measured by an enzyme immunoassay, and glucose oxidase methods respectively. Insulin resistance index was calculated from fasting glucose and insulin according to homeostasis model assessment (HOMA-IR). Mean insulin resistance index (HOMA-IR), HbA1c, diastolic blood pressure, triglyce-rides and fasting glucose in diabetics were sig-nificantly higher than in non-diabetic subjects (p<0.05). There was no significant difference in resistin levels between non-diabetic (7.16±3.72 ng/ml) and diabetic (6.40±3.66 ng/ml) obese sub-jects. Resistin levels in diabetic (7.46±3.98 vs. 5.51± 3.20 ng/mL) and non-diabetic (8.15±4.60 vs. 5.97±2.31 ng/mL) women were significantly higher than men in both groups. A significant negative correlation between diastolic blood pressure and resistin (r= -0.381; p=0.024) was ob-served only in the control groups. Based on the results, it appears that resistin links between obesity and type II di-abetes in humans is still a controversial topic and requires further investigation.

Adequate nutrition is crucial for growth and maintenance of the body skeleton health; nu-trients consumed affect leptin and adiponectin levels and bone mass. This study was done to determine the relationship between serum leptin, adiponectin and bone mass with energy intake and nutrients in postmenopausal women, 40-60 years old. The present cross-sectional study was done on 85 postmenopausal women, aged 40-60 years. Samples of fasting blood were taken to determine serum concentra-tions of leptin and adiponectin and bone mineral density was measured by the DXA method in the two areas of L2-4 and the femoral neck. Food intake was documented using questionnaires in-cluding food frequency and data was analyzed by FP2 software. Leptin had a negative relationship with energy intake, protein and magnesium and a positive relationship with carbohydrate; there was a positive relationship between adiponectin and energy and carbohydrate intakes. BMD of femur had a negative relationship with energy and carbohydrate, while it had positive relation-ship with calcium, and there was direct and sig-nificant relationship between BMD of the spine and zinc intake. Increase in consumption of carbo-hydrates and decrease in consumption of protein led to increase in leptin levels. Consumption of calcium and zinc can have a protective effect on bones.

Since the varying different contents of amylose in rice grains have different effects on blood sugar, we examined the effect of consumption of three varieties of rice on glucose response in healthy subjects, to compare the glycemic effects of 50 g carbohydrate in the Basmati, Kazemi and Sorna pearl varieties of rice in normal subjects. Thirty healthy subjects (13 males and 17 females), were evaluated 4 times at 1 week intervals. On the first day, all subjects consumed 50 g glucose, and were then divided into 3 groups. Each group consumed one of the 3 types of rice with 50 g carbohydrate con-tent each week. Blood samples were collected before and at 15, 30, 60 nd 120 minutes after tak-ing of glucose and rice consumption. The Gly-cemic index (GI) was calculated for each rice as the ratio of the incremental area under the 3-hour glycemic response curve to rice to the in-cremental area under the 3-hour glycemic re-sponse curve to 50 g glucose. The GIs of Sorna pearl, Kazemi and Basmati were 52.2±5.1, 67.6±13 and 61.2±6.1 re-spectively, with that of Sorna pearl being lower than the others (p<0.05). Maximum changes in blood sugar for Sorna pearl, Kazemi and Basmati were 21.8±12, 27.4±6 and 31.7±5.9 mg/dL, respec-tively. Glycemic index and glycemic load for Sorna pearl rice were lower than for the other two rice types, difference statistically sig-nificant. The effect of Sorna pearl rice consumption in diabetes mellitus patients however needs more study.

The new WHO classification provides the foun-dation for tumor diagnosis, patient treatment and tools for clinico-epidemiological research. This study was conducted to determine the fre-quency and update the histological aspects of different endocrine and neuroenodocrine tumors for clinical significance and to minimize unclas-sified lesions. Five hundred biopsies were analyzed in the Pathology Department of King Edward Medical University from 1st June 2004 to 31st December 2005. Tumors were diag-nosed with light microscopy using the new WHO classification. Following 500 biopsies, 145 (29%) Endo-crine(ET) and Neuroendocrine Tumors (NET) were found; majority of the former, ET, n=112 (77.2%), were in the thyroid, of which 84 (75%) were follicular adenomas and 28 (25%) were carcinomas, of the 28 carcinomas, the frequencies were: papillary carcinoma (PC) 21 (75%); anaplastic(AC) 4 (14.28%); follicular(FC) 2 (7.14%); and medullary (MC) 1 (3.57%). Of the 145, 33 (22.8%) were neuroendocrine tumors (NET), with the following types and frequencies: adrenal 13 (39.5%); pituitary 10 (30.5%); pancreatic 4 (12%); parathyroid 3(9%); appendix 1 (3%); and rectum 1 (3%). One NET detected in the thyroid region was a well-differentiated neuroendocrine carcinoma (WDNEC). Among adrenal NETs, of 13 only 2 (14.4%) were malignant and diagnosed as a cortical and a neuroblastoma respectively, while all others were benign NETS, as follows: cortical adenoma 2 (15.38%); pheochromocytoma 7 (53.8%) and 1 (7.69%) ganglio neuroblastoma, and ganglioneuroma each respectively. All pituitary, parathyroid and pancreatic NETS were benign in nature. NETS of the appendix and rectum were WDNETS, while that of the lung was a WDNEC. Findings of this study confirm that the WHO classification provides uniform, simple, repro-ducible and practical criteria for diagnosis of ETs and NETS.

The hippocampus plays a vital role in spatial learning and memory. Testosterone appears to mediate spatial discrimination and the GABAer-gic system has also been reported to have a criti-cal role in this effect. In the present study we in-vestigated the interaction between testosterone (androgenic receptor agonist) and bicuculline (GABAA receptor antagonist) on spatial learning and memory performance in male Wistar rats. Cannulae were implanted into the CA1 of rats bilaterally and drugs were injected before daily training in the Morris water maze (MWM). In the first experiment, testosterone (0, 20, 40, 80 µg the 0.5 µl DMSO/side) was injected intra-CA1 before each session. In the second experiment, intra-CA1 injection of bicuculline (0, 1, 2, 4 µg 0.5 µl saline/side) were given before every session. In the last experiment, testosterone 80 µg, 0.5 µl and bicuculline 2 µg, 0.5 µl were injected into the CA1. The results showed that testosterone 80 µg or bicuculline 2 µg, each given separately, and also microinjection of both testosterone + bicuculline increased travel distance and escape latency to find the platform, as compared to their vehicles. It is shown that administration of testosterone and bicuculline separately impaired spatial learning and memory. Microinjection of bicuculline after testosterone treatment did not change spatial learning impairment when com-pared to testosterone and bicuculline injected separately.