فهرست مطالب

International Journal of Endocrinology and Metabolism
Volume:9 Issue: 3, Jun 2011

  • تاریخ انتشار: 1390/11/15
  • تعداد عناوین: 9
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  • Sunil Kumar Kota, Surendra Ugale, Neeraj Gupta, Vishwas Naik, Siva Krishna Kota, Kvs Hari Kumar, Kirtikumar D. Modi Page 374
    Background
    Laparoscopic leal inter Position(II) with sleeve gastrectomy (SG) is an upcoming procedure that helps to improve metabolic profile and leads to weight reduction without causing significant malabsorption, paving the way for usage of the term “metabolic surgery.”
    Objectives
    To determine the impact of this novel procedure on glycemic control and the accompanying metabolic abnormalities of type 2 diabetes mellitus (T2DM).Patients and
    Methods
    The II and SG procedures were performed in 38 patients (M:F = 24:14). Despite their usage of optimum dosage of oral hypoglycemic agents (OHAs) and/or insulin, all patients exhibited poorly controlled T2DM (mean glycosylated hemoglobin [HbA1C]: 9.57 ± 2 %). The primary outcome was a remission of diabetes (HbA1C < 6.5% without OHA/insulin). Secondary outcomes included a reduced need for antidiabetic agents and a reduction in symptoms of metabolic syndrome.
    Results
    The mean follow up time was 11.3 ± 9 months (range: 3–32 months). Participants were 47.5 ± 8.8 years of age (range: 29–64 years), had diabetes for a mean duration of 9.7 ± 8.8 years (range: 1–32 years), and had a mean preoperative body mass index (BMI) of 32.05 ± 7.5 kg/m2. Thirty patients (79%) exhibited hypertension, 19 (50%) had dyslipidemia, and 19 (50%) harbored significant microalbuminuria. Postoperatively, glycemic parameters (fasting and post lunch blood sugars, and HbA1C) improved for all patients (P < 0.05) at all intervals. Eighteen patients (47%) experienced a remission in diabetes and the remaining patients received a significantly lower OHA dosage. All patients demonstrated 15–30% weight loss (P < 0.05). Twenty-seven patients (90%) experienced a remission in hypertension. At 2 years, the mean reduction in HbA1C (36%) was greater than the reduction in BMI (20%). A declining trend in postoperative levels of lipids and microalbuminuria became evident, although the reduction was significant for microalbuminuria only
    Conclusions
    The laparoscopic II with SG procedure appears promising for gaining control of T2DM and associated morbidities. To substantiate our preliminary findings, additional long-term data that involves a larger number of patients is necessary.
  • Flavio Mena, Nilda Navarro, Alejandra Castilla Page 382
    Background
    Previous studies used western blotting to show that prolactin (PRL) released from the adenohypophysis (AP) of lactating rats in vitro contains size variants from 7–14 kDa to 70–97 kDa. These variants when eluted from sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) gels and incubated with AP lactotrophs from male rats and rats in other conditions, promoted the selective stimulation and/or inhibition of the in vitro release of PRL variants.
    Objectives
    In the present study, we determined the regulatory effects of dopamine (DA), thyrotropin-releasing hormone (TRH), and oxytocin (OT) on release of PRL variants from AP lactotrophs.
    Materials And Methods
    Primary cultures of lactotrophs from lactating rats, which were non-suckled (NS) for 6 h or suckled (S) for 15 min after NS, were incubated with PRL variants that were electroeluted from SDS-PAGE gels along with different doses of DA (0.5, 1.0, 1.5 µM), TRH (0.1, 1.0, 10 µM), or OT (0.1, 1.0, 10 µM). The secretion of PRL from the lactotrophs was determined by enzyme-linked immunosorbant assay.
    Results
    The results showed stimulatory and/or inhibitory effects of DA, TRH, and OT on the release of PRL variants from AP lactotrophs both by the presence of PRL variants.
    Conclusions
    These results indicate that PRL variants are released from AP lactotrophs, and, in concert with hypothalamic hormones, they regulate the release of PRL from lactating rat APs.
  • Ivana Zofkova, Veronika Cirmanova, Petr Kasalicky, Vera Lanska, Vaclav Vyskocil, Petr Matucha, Milan Bayer Page 391
    Background
    The muscle-bone unit represents an evolutionary system, in which both of its components are under the common control of the insulin-like growth factor I (IGF-I), sex hormones, and vitamin D. The mutual interactions between these hormones maintain integrity, growth and maturation of pubertal bone mass. Thus, insufficiency of any of these hormones will negatively influence development of the skeleton during puberty.
    Objectives
    The aim of the study as to analyse the correlation between muscle mass, total bone mineral content (BMC), bone mineral density (BMD) of the lumbar spine (BMD L1-L4), and serum or urine hormones.
    Materials And Methods
    Total BMC (g) and areal BMD L1-L4 (g/cm2 and Z-score) as well as muscle mass and fat mass (g) were assessed by means of dual-energy X-ray absorptiometry (DXA). The Z-score is the number of standard deviations a patient´s BMD which differs from the average BMD of their age, sex, and ethnicity. This Parameter is used in children. Muscle force (N) was measured using a dynamometer.
    Results
    The simple correlations showed strong positive associations between BMC or BMD L1-L4 (g/cm2) and serum phosphate, estradiol, insulin-like growth factor (IGF-I), leptin and fat masses, and muscle force (P < 0.001 for all parameters). Positive correlations were also observed between BMD and serum phosphate (P < 0.01), IGF-I (P < 0.01), estradiol (P < 0.001), leptin (P < 0.01), fat and lean mass (P < 0.001 and P < 0.001, respectively) and muscle force (P < 0.001). The partial correlations, after eliminating the impact of height, Tanner stage, and physical activity level, confirmed positive relationships between either BMC or BMD L1-L4 and lean mass (P < 0.001 and P < 0.001, respectively) and fat mass (P < 0.001 for BMC and BMD). Furthermore, a positive relationship was observed between serum leptin and both BMC and BMD (Z score) (P < 0.05 and P < 0.05, respectively). After removing the effects of height, Tanner stage, and physical activity, positive associations were observed between lean mass and IGF-I (P < 0.01), leptin levels (P < 0.05), and muscle force (P < 0.01).
    Conclusions
    On the basis of the study results, it can be expected that low values of lean or fat mass, and insufficient production of IGF-I or leptin, could negatively influence bone development in pubertal girls.
  • Paula Alvarez-Vazquez, Lourdes Constenla, Ricardo V. Garcia-Mayor, Alejandra Larranaga, Diana Valverde Page 397
    Background
    Graves’ disease (GD) is an autoimmune disease that develops as a result of a complex interaction between genetic and environmental factors. Numerous studies have demonstrated the important role of CTLA4 gene polymorphisms in the susceptibility to this disease. The CTLA4 gene is located on chromosome 2q33 and codes for the T-cell receptor, which negatively modulates the immune response by disabling T cells.
    Objectives
    The aim of the present work was to determine whether A/G dimorphism at position +49 of exon 1 in the CTLA4 gene contributes to the severity and clinical manifestations of GD.Patients and
    Methods
    We performed clinical and genetic studies on 100 Graves’ patients and 50 healthy controls. We determined the subjects’ genotypes for the +49 A/G polymorphism of the CTLA4 gene by PCR and an enzyme restriction test. Comparison of individual clinical and laboratory variables between genotypes was performed using SPSS 17. 0 (SPSS, Chicago, IL, USA).
    Results
    We found a statistically significant relationship between CTLA4 gene polymorphism and ophthalmopathy in Graves’ patients.
    Conclusions
    The +49A/G SNP of the CTLA4 gene is related to the development of Graves’ disease; however, more studies are necessary to clarify the role of the CTLA4 gene in influencing GD susceptibility and to explore other potential costimulation pathways in this disorder.
  • Taymour Mohammed El-Sherry, Derar Derar, Hasan Ali Hussein, Ahmed Yusef Shahin, Salem Fahmy Page 403
    Background
    Clomiphene citrate (CC) has been considered as the most effective drug to treat female infertility which is highly effective in inducing ovulation in females with anovulation or oligo-ovulation, however, it may induce partial inhibition of ovulation because of its inhibitory action on follicular growth and atresia of nonantral and mature follicles.
    Objectives
    The present experiment was conducted to study the effect of CC on follicular development (experiment 1) and superovulation (experiment 2) during the first follicular wave in Rahmani sheep with a 22-day ovulation cycle.Patients and
    Methods
    In experiment 1, the animals were divided into 2 groups, namely, control (n = 7) and CC (n = 6) groups. The estrous cycles of the animals in both groups were synchronized by administering two 15-mg/mL doses of Dinoprost at a 10-day interval. Onset of ovulation (day 0 [D0]) was confirmed by performing transrectal ultrasonography. The animals in the CC group received 100 mg of oral CC daily for 5 consecutive days. In experiment 2, the estrous cycles of the animals were synchronized as mentioned previously, and the animals were divided into 2 groups: (1) the equine chorionic gonadotropin (eCG) group (n = 4), in which the animals received 2000 IU of eCG intramuscularly (i.m.) for 5 days, and (2) the eCG and CC group (n = 5), in which the animals received 2000 IU of eCG i.m and 100 mg CC orally for 5 days.
    Results
    We observed a significant (P < 0.05) increase in the number of follicles from D2 to D5 and in the levels of estradiol (E2) from D1 to D4 after CC treatment, with no significant differences between the progesterone (P4) levels in both the groups. The increase in the number of follicles in the eCG and CC group was not as significant as that in the eCG group. The E2 level in the eCG group was significantly higher than that in the eCG and CC group from D1 to D3.
    Conclusions
    In conclusion, administration of CC increased the number of the growing follicles and plasma E2 levels. However, CC administered during superovulation did not increase the number of ovulating follicles and negatively affected the E2 level.
  • Ali Kiani, Mette Olaf Nielsen Page 409
    Metabolic programming (MP) is defined the induction, deletion, or impaired development of a somatic structure or “setting” of a physiological system by an early life stimulus. Epidemiological and animal studies support the theory that suboptimal intrauterine conditions are associated with non-communicable disease (NCD) in adulthood. Using ovine models, we investigated the long-term consequences of late gestation undernutrition on glucose–insulin axis function and energy metabolism. We found that early life undernutrition had life-lasting consequences on insulin-secretory and adipose lipolytic capacity as well as intermediary metabolism later in life. Furthermore, we showed that suboptimal intrauterine nutrition impairs energy expenditure (EE) in gestation, apparently via an increase in the energy cost of conceptus development. Our findings, and those of other studies, support the hypothesis that energy balance is, to a certain extent, programmed early in life, presumably through appetite, EE, physical activity, and/or disproportional postnatal growth programming.
  • Sunil Kumar Kota, Siva Krishna Kota, Prabhas Ranjan Tripathy, Sruti Jammula, Lalit Kumar Meher, Kirtikumar D. Modi Page 416
    Pheochromocytomas have been described to be associated with rare vascular abnormalities, most common of them being renal artery stenosis. A 40-year-old woman was admitted to our hospital with the complaints of headache, sweating, anxiety, dizziness, nausea, vomiting, and severe hypertension. Examination revealed absent carotid and upper-limb pulses with an intact lower-limb pulse. Abdominal computed tomography revealed the presence of a left adrenal pheochromocytoma. An aortogram showed total occlusion of the aortic arch arteries. the Pheochromocytoma was surgically removed, and the patient was then administered steroid treatment for arteritis. To the best of our knowledge, the occurrence of pheochromocytoma along with aortoarteritis has not been reported thus far. The possible mechanisms underlying such an involvement have been discussed in this study.
  • Vincenza Cifarelli, Drew Hays, Stephen D. Hursting Page 422