Endocrine Abstracts

Gout, which is commonly associated with hyperuricaemia, affects 0.2% of the population. Hyperuricaemia has a heterogeneous aetiology that may be due to either over production and/or reduced renal clearance, of urate. In order to identify the mechanisms underlying reduced excretion of urate, we undertook positional cloning studies of familial juvenile hyperuricaemic nephropathy (FJHN), which is an autosomal dominant disorder characterised by hyperuricaemia, a low fractional ren...

Males display an increased level of cardiovascular morbidity and mortality than age matched females. Among the genetic factors responsible for the relationship between higher cardiovascular risk and male gender are the sex chromosomes. In this study we investigated the association between serum lipid profile and a polymorphism on the non-recombining region of the human Y chromosome in a population of young Caucasian individuals. 1157 young males were recruited form the general...

Inhibiting 11beta-hydroxysteroid dehydrogenase type 1 (11HSD1) has been proposed to prevent local regeneration of cortisol from cortisone, and thus enhance hepatic and adipose insulin sensitivity. In healthy men and patients with type 2 diabetes, the non-selective 11HSD inhibitor carbenoxolone enhances hepatic insulin sensitivity but, paradoxically, does not increase peripheral glucose disposal. In obesity, 11HSD1 activity and mRNA are increased in adipose biopsies. We tested ...

Objective: To investigate the effect of grape procyanidins(GPC) on proliferation and apoptosis of normal pancreas beta cells and the oxygen injury cells. Method: The cultured pancreas beta cells(BRIN-BD11) were transferred to 12-well plates. Cells were divided into two groups: oxygen injury and no oxygen injury. (1) Oxygen injury cells were damaged by 100 micromoles per litre H2O2 after pretreatment of 50 milligrams per litre,100 milligrams per litre ...

BackgroundHeart failure is a syndrome of vaso-constriction and hormone abnormalities. There is an excess of catabolic and vasoconstrictor hormones and a relative deficiency of anabolic hormones. Vaso-dilating drugs improve symptoms in heart failure and inhibition of some catabolic / vasoconstrictor hormones improves prognosis. We aimed to study the direct vascular effects of testosterone resistance arteries from men with heart failure.Methods6 resistance arteries w...

Recent analysis has shown that up to 18 percent of the Irish population are obese; a further 40 percent are overweight. Orlistat (Xenical)is a gastrointestinal lipase inhibitor that limits absorption of ingested fat thus aiding weight reduction. We report the use of orlistat outside the clinical trial setting in Ireland from 7 April 2000 to 30 June 2001.A total of 5,251 patients (4,376 women, 875 men) attended 240 weight management clinics (229 in primary care and 11 in se...

Proadrenomedullin N-terminal 20 peptide (PAMP) and adrenomedullin are hypotensive peptides that are cleaved from the proadrenomedullin peptide. Adrenomedullin can act via the complex calcitonin receptor like receptor (CRLR) and receptor activity modifying protein (RAMP) 2 or the putative receptor, CRLR/RAMP3 complex. CGRP (Calcitonin gene related peptide) binding is conferred by the CRLR/RAMP1 complex. This study was carried out to see how adrenomedullin and PAMP affected the ...

We describe a 3 year old Scottish girl with polyuria and nocturia and a past history of congenital heart disease. In addition to her excess fluid intake she had reduced food intake, failure to thrive and growth failure. Her sister, father, grandfather and a paternal aunt and uncle had a clear history of polyuria, nocturia and excess thirst. A fluid deprivation test revealed peak serum Na, serum and urine osmolalities were 147 mmol/L, 300 mOs/kg, 176 mOs/kg, respectively, in th...

IntroductionRecent studies have confirmed that IGF-I is an important determinant of future glucose homeostasis and cardiovascular risk. Insulin-like growth factor binding protein-3 (IGFBP-3) is the principal carrier protein for IGF-I in the circulation. Therefore we tested the relationship of IGF-I and IGFBP-3 to insulin resistance in an ethnic group with a high incidence of type 2 diabetes and cardiovascular disease.Methods. In a population-based study 100 subjects of...

ApoB isoforms are components of the chylomicron, and of the atherogenic LDL and Lp(a) particles. Ex26 is exceptionally long at 7.57kb as most exons are <500bp. Ex26 is also the site of RNA editing, which generates the ApoB48 isoform instead of ApoB100. The first 3kb of ex26 contains 15 sequences matching the splice site consensus, which could be used in splicing, but are not. Splice sites matching the consensus but which are not used are called pseudosites. How the spliceos...

ObjectiveMeasurement of insulin sensitivity has always been a key interest in the clinical investigation of Type 2 diabetes mellitus. Previous studies have shown good correlation between the Oral Glucose Insulin Sensitivity (OGIS) Model and the gold standard euglycaemic hyperinsulinaemic glucose clamp. This study is to describe OGIS as an index for insulin sensitivity derived from glucose-insulin model in a clinical setting.Methods468 non-diabetes patients and 224 ...

The objective of this study was to determine the correlation between serum zinc level and neutrophil respiratory burst in patients with type 2 diabetes mellitus. 40 type 2 diabetic patients (20 with foot ulcers) and 20 healthy controls were recruited. The local ethical committee approved the study, and written, informed consent was obtained from every participant before enrolment in the study. 20 millilitres of heparinized venous blood were taken from each individual in the fa...

The contribution to adult growth hormone deficiency (GHD) of hormone replacement and other aspects of hypopituitarism are poorly defined. We compared baseline characteristics and response to GH treatment of patients with isolated GHD (IGHD, 16 patients) to patients with multiple pituitary hormone deficiencies (MPD, 135 patients). At baseline, MPD patients showed significantly greater waist-hip ratios (0.87 plus/minus 0.007 vs. 0.82 plus/minus 0.02, mean plus/minus SD; P < 0...

Obesity is associated with the development of the metabolic syndrome, and the current epidemic of childhood obesity raises enormous concerns regarding future pandemics of diabetes and cardiovascular disease.We report preliminary data from 26 obese caucasian children (age 3.8-17.8yrs; 16 prepubertal/10 adolescents; mean Body Mass Index Standard Deviation Score (BMI SDS) +3.85 - range 2.61-6.66) who attend our paediatric obesity clinic. BMI SDS was calculated using British 1...

DM 2 is a genetic disorder characterized by reduced insulin action and impaired insulin secretion. Metabolism of healthy Lithuanian citizens with an inherited risk for DM 2 was compared with a control group without a family history of DM 2. 84 normotensive first degree relatives (FDR) (23M, 61F) with at least one parent or sibling with DM 2 were investigated. 89 normotensive and glucose tolerant ubjects without family history of DM 2 and with a comparable distribution of age, ...

This study was designed to evaluate whether weight change in type 2 diabetes leads to deteriorating glycaemic control necessitating treatment escalation, or whether deteriorating glycaemic control results in medication change and possible weight gain.We studied 702 type 2 diabetic subjects with a follow-up of 56 plus/minus 2 months (mean plus/minus S.E.) treated on diet, metformin or sulphonylurea, alone or in combination. Patients who remained on diet alone (40 plus/minus...

Childhood obesity is increasing in prevalence and is associated with insulin resistance and Type II diabetes in later life. Site-specific differences in adipose tissue accumulation and associated insulin sensitivity may contribute to these problems.The aims of our study were: 1. To isolate and characterise, subcutaneous (SC) and visceral (V) preadipocytes using small biopsies from pre-pubertal children (ages:4-8years(n=3)) undergoing elective abdominal surgery, with normal...

Objectives: We have recently demonstrated a wide variation in insulin resistance (IR) occurs in polycystic ovarian syndrome and type 2 diabetes. Changes in insulin metabolism and increased insulin resistance (IR) after the menopause have previously been reported. It is unknown if the biological variation of IR is affected by the menopause and is evaluated here.Methods: The biological variation of IR was assessed by measuring IR at four day intervals on 10 consecutive occas...

Background: Sotos syndrome is an uncommon condition characterised by rapid growth, large body size and acromegaloid facies.There is limited data on metabolic abnormalities in Sotos syndrome.Aims: We investigated insulin sensitivity and secretion rates in a 22 year old girl with Sotos syndrome, prompted by the observation of a flat glucose response after an oral glucose challenge.Methods: Glucose tolerance was assessed with a 75g 2-h oral glucose tolerance test (OGTT), ...

Introduction: Women with gestational diabetes mellitus (GDM) have a reported 17% to 63% risk of developing type 2 diabetes. This study aims to identify the factors in GDM patients which can predict the risk of postpartum impaired glucose tolerance(IGT) and overt diabetesMethods: A cohort study was conducted on 2416 pregnant women referred to five university hospital clinics. The universal screening was performed with a GCT- 50g and those with plasma glucose level >= 130...

Aim:To study hypertension in diabetics and non-diabetics, it's degree of control and the type of antihypertensive agents used.Method:The study was conducted at King Abdulaziz University Hospital in Jeddah, Saudi Arabia. Hypertensive patients being followed at the medical outpatient clinic from February 2001 to February 2002 were studied. They were divided into two groups according to the presence or absence of diabetes. The following data were recoded; age, sex, na...

Background. Males with coronary disease have lower levels of endogenous testosterone than unaffected males. It is not known if low testosterone is a cause, effect or an epi-phenomenon of ischaemic heart disease.We hypothesised that androgen deficient men treated surgically with complete resolution of their symptoms would have a higher subsequent testosterone than men with persistent angina.Methods. Subjects were recruited after angiography. All subjects were biochemically ...

Background: Octreotide LAR is used in the treatment of Acromegaly and is effective in reducing growth hormone levels in the majority of patients. With the introduction of the Endocrine Specialist Nurse it has been possible to take their care into the community.Method: A questionnaire was administered for both patients and practice nurses, to enable us to highlight the benefits and identify any problems. It was sent to 27 patients who receive Octreotide LAR and 27 GP Surger...

Introduction: The incidence of diabetes is increasing worldwide and type 2 diabetes in younger people is a growing phenomenon. From 1998 we have studied 21 subjects with early onset type 2 diabetes.Methods:11 subjects(7 males) with type 2 diabetes, age 23.7 plus/minus 1.01 years and 10 subjects(8 males) age 35.4 plus/minus 11.7 years were studied with an insulin modified (0.05 unit per kg ) intravenous glucose tolerance test. BMI was 34.3 plus/minus 1.4 kg per m2</sup...

Introduction: Diabetes ketoacidosis (DKA) remains a significant cause of mortality and morbidity in patients with diabetes. We reviewed all DKA episodes occurring in a large inner city teaching hospital between January 1997 and December 2001.Methods: A retrospective chart analysis was performed on 108 episodes of DKA identified through hospital inpatients enquiry (HIPE). DKA was defined as the triad of hyperglycaemia, ketonuria and acidosis with pH<7.35. All patients ha...

Alstrom syndrome is an autosomal recessive disorder characterised by obesity, sensorineural deafness, cone-rod dystrophy and hypergonadotrophic hypogonadism. Diabetes in these patients is characterised by severe insulin resistance.We describe the management of diabetes in a 28 year old male patient with Alstrom syndrome and severe insulin resistance. Obesity developed early in childhood and at 3 years weight was 22.2 kg. Genetic studies revealed that the patient is a compo...

PCOS has major long-term health implications that are closely linked to the Metabolic Syndrome. The prevalence of the Metabolic Syndrome is high among migrant and indigenous South Asian populations. We have previously demonstrated that migrant South Asians with PCOS have a greater degree of insulin resistance than white Europeans with PCOS. As there is a paucity of data on PCOS among indigenous South Asian populations, consecutive consenting anovular PCOS subjects (80) and age...

IntroductionMetformin is being increasingly used in the treatment of Polycystic Ovary Syndrome where it improves the metabolic and reproductive parameters through the improvement of insulin sensitivity. Observations noted that it also tended to prevent weight gain or even facilitate weight loss. Trials carried out have positively enforced this in obese patients as well as those with Polycystic Ovary Syndrome.We were interested to see if a similar favourable effect coul...

Background and Aims:Over the next decade, the projected epidemic of Diabetes, their subsequent treatment requirements and complication management will emerge as a major threat to future public health. There are always demands for greater efficiency and cost-effectiveness within healthcare service especially in the bigger scale population study. Our aim is to develop a computerized system to facilitate diagnosis of Diabetes mellitus through co-ordination of multiple healthc...

Case Report:A 69 year old man was referred for assessment of hypoglycaemic events. Type 2 diabetes was diagnosed 4 years previously and treatment with metformin 2000mg per day had provided adequate control (HbA1c 7.5%). In the 4 months prior to referral, the patient had lost 8kg in weight and had had more than 10 episodes of sweating, tremor and disorientation. Eventually capillary blood glucose measurements were undertaken which suggested hypoglycaemia which was confirmed...

Aim:To determine the type of infections in admitted diabetics for the introduction of preventive measures.Method:Medical records of diabetics admitted to the medical unit of King Abdulaziz University Hospital in Jeddah, Saudi Arabia in the period between January 1999 to December 1999 were studied. Positive cultures were identified and the following informations were collected, age, sex, type of diabetes and it's duration, type of infection, causative organism, pres...

Background: The absorption kinetics of soluble insulin are complex. Soluble insulin is absorbed after a delay as the hexameric form dissociates before being absorbed as the dimer.Patients using soluble insulin are instructed to inject 15-30 minutes before meals.In practice few patients comply with these recommendations.The aims of this study were to identify the proportion of patients injecting at the recommended time and to assess any association between injection timing and ...

Objective: To examine immunoglobulin concentrations in the sera of children with type 1 diabetes and to compare them with those found in non-diabetic subjects.Patients and Method: Serum immunoglobulin A and D concentrations were measured by ELISA in 35 children with type 1 diabetes and 46 healthy children (younger than 15 years of age).Results: Serum immunoglobulin levels increase until the age of 15 but no sex variation has been found. Age variation of the mean immuno...

This research is a descriptive and analytic study which was carried out to investigate the Fasting Blood Sugar of first trimester and 24-28 weeks , and 50-gram Glucose Challenge Test at 24-28 weeks of gestational age in non-diabetic pregnant women and their effect on the infants' weight in Shariati Hospital in Tehran .The means of the Fasting Blood Sugar for the first trimester , 24-28 weaks and Glucose Challenge Test were 81.15 , 80.8 and 111.75 miligrams per deciliter re...

Unusual causes for hypokalaemia in diabeticsA 36 year old diabetic presented acutely in October 2002. The history comprised anorexia, vomiting and lethargy for 5 days. He was non compliant with his medication (metformin 500mg bd) and drank excess alcohol.The pulse was 120 per minute regular, blood pressure 110/80, 34 respirations per minute, and a capillary glucose of 42 mg/dl.His Glasgow Coma Score was 13/15 and there were papular yellow skin lesions over his trun...