0000000000006028
AUTHOR
M. Donatelli
Insulin resistance and endogenous digoxin-like factor in obese hypertensive patients with glucose intolerance
Hypertensive obese subjects with glucose intolerance have hyperinsulinaemia, insulin resistance and intracellular cation imbalance resulting in increased sodium content. The aim of our study was to assess in these patients plasma levels of endogenous digoxin-like factor (EDLF), an inhibitor of the sodium-pump mechanism. We studied 14 hypertensive and 12 normotensive subjects with obesity and glucose intolerance for fasting blood glucose, and plasma insulin, C-peptide and EDLF levels: the two groups were matched for age and BMI and were studied after a 2-week wash-out period from hypotensive drugs. Compared with normotensives, hypertensive subjects had higher plasma insulin levels, a greater…
Metabolically healthy polycystic ovary syndrome (MH-PCOS) and metabolically unhealthy polycystic ovary syndrome (MU-PCOS): a comparative analysis of four simple methods useful for metabolic assessment.
Study question Is it possible to distinguish metabolically healthy polycystic ovary syndrome (MH-PCOS) from metabolically unhealthy PCOS (MU-PCOS) by simple diagnostic tools such as body mass index (BMI), waist/hip ratio (WHR), at-risk category suggested by Androgen Excess Society (AES) and visceral adiposity index (VAI)? Summary answer VAI could be an easy and useful tool in clinical practice and in population studies for assessment of MU-PCOS. What is known already VAI is a good indicator of insulin sensitivity and cardiometabolic risk in oligo-ovulatory women with PCOS. Study design, size, duration We conducted a cross-sectional study of 232 women with PCOS in a university hospital setti…
Toxic adenoma and papillary thyroid carcinoma in a patient with Graves' disease.
A case of a very rare association of toxic adenoma and papillary carcinoma with Graves’ disease is presented. A 34-year-old woman developed Graves’ disease with mild ophthalmopathy. An ultrasound revealed diffuse thyroid enlargement with a hypoechoic pattern and a hypoechoic nodule with regular edges of 1.6 cm in diameter at the lower pole of the left lobe. A thyroid 131I scintiscan showed a diffuse and homogeneous 131I distribution. The 131I uptake (RAIU) was elevated. One year later, while still on a low dose of methimazole, the patient had a recurrence of hyperthyroidism following an iodine load from a contrast agent. A further thyroid ultrasound confirmed the previously described patter…
Central obesity and hypertension. Relationship between fasting serum insulin, plasma renin activity, and diastolic blood pressure in young obese subjects
This study was designed to evaluate the role of fasting serum insulin and plasma renin activity in obesity-induced hypertension. In view of this, plasma catecholamines, fasting serum insulin (IRI), urinary sodium excretion (NaU), plasma renin activity (PRA), and plasma aldosterone (PA) levels were assessed in young (age less than 40 years) normotensive (n = 27) and hypertensive (n = 14) subjects with central obesity and in lean normotensives (n = 20). Central obesity was evaluated by waist-to-hip ratio (WHR) according to the indication of the Italian Consensus Conference of Obesity. PRA, PA, IRI, and plasma norepinephrine levels were significantly (P < .05) higher in both obese groups than …
Expression of thyroid hormone receptor isoforms in the hypertrophic heart of spontaneously hypertensive rats
Thyroid hormones (THs) enhance MHC alpha gene- and repress MHC beta gene-transcription in the heart, by interacting with specific nuclear receptors (TRs), that bind to regulatory sequences localized upstream of basal promoter of myosin heavy chain (MHC) genes. The overall effects of THs include an increase in V1- and a decrease in V3-myosin isozyme concentration in the heart. Myosin V1 contains two MHC alpha chains and has a higher ATPase activity than V3 isoform, which contains two beta chains. Previous studies on papillary muscles of spontaneously hypertensive rats (SHRs) showed that heart hypertrophy is accompanied by a shift from alpha to beta MHC accumulation. The present study was aim…
Evaluation of B-cell secretion and peripheral insulin resistance during pregnancy and after delivery in gestational diabetes mellitus with obesity
Nine pregnant women with gestational diabetes mellitus (GDM) were studied. Six normal pregnant women and six normal nonpregnant women were evaluated as control groups. All the women underwent oral glucose tolerance test and glucose clamp during the third trimester of pregnancy and two months after delivery. During OGTT, glucose, C-peptide and insulin plasma levels were determined. C-peptide and insulin values in the late phase of OGTT were higher during pregnancy than after delivery in both groups. In gestational diabetic women, the M-value in the second steady-state during glucose clamp was lower than in controls, both during pregnancy and after delivery. Nevertheless, in both groups the M…
Study of pituitary secretion in relation to retinopathy in patients with juvenile diabetes mellitus.
Fifteen juvenile diabetic patients with normal eye fundus, 6 with non proliferative retinopathy, 5 with proliferative retinopathy and 5 healthy control subjects were studied in order to investigate pituitary function in relation to diabetic retinopathy. ACTH values at 08(00) and 18(00), hPRL and TSh secretion in response to 200 microgram TRH i.v., and GH secretion in response to 500 mg oral L-dopa were evaluated. In all diabetic subjects, 08(00) ACTH levels were lower than in controls. Basal hPRL, TSH and GH values of the diabetics did not differ from those of the controls. No significant differences were found in hPRL levels in response to TRH, whereas significantly lower TSH responses wer…
A low reported energy intake is associated with metabolic syndrome.
Background and aims: Metabolic syndrome (MS) may be associated with the presence of an energy sparing metabolism that predisposes to the excess accumulation of body fat. This study examined the relationship between reported energy intake and obesity in individuals with and without MS. Methods and results: Ninety consecutive non-diabetic obese subjects were divided into two groups based on the presence (MS+: n= 50) or absence (MS-: n= 40) of metabolic syndrome. The study design was cross-sectional. The three-day food record method was used to assess the subjects' usual energy intake and the Diet Readiness Test (DRT) was also administered. Compared to the MS- group, the MS+ group had a signif…
Circulating endothelin-1 levels in type 2 diabetic patients with ischaemic heart disease.
To investigate whether circulating endothelin-1 (Et-1) may be related to the increased incidence and severity of ischaemic heart disease in type 2 diabetes mellitus, we compared the concentrations in type 2 diabetic patients and in non-diabetic patients with coronary artery disease (CAD) angiographically documented. Plasma levels of Et-1 were determined in 34 type 2 diabetic patients with CAD (16 with stable angina, 6 with unstable angina, 12 with previous myocardial infarction) and in 19 nondiabetic patients with CAD (4 with stable angina, 5 with unstable angina, 10 with previous myocardial infarction). Fifteen diabetic patients without CAD and 9 healthy volunteers served as control subjec…
Treatment of patients with duodenal ulcer positive for helicobacter pylori infection: ranitidine or omeprazole associated with colloidal bismuth subcitrate plus amoxicillin
Abstract This study evaluated treatment of patients affected with duodenal ulcer positive for Helicobacter pylori . We compared patients treated with ranitidine plus amoxicillin plus colloidal bismuth subcitrate (n = 20) with patients treated with omeprazole plus amoxicillin plus colloidal bismuth subcitrate (n = 20) with regard to: (1) healing of duodenal ulcer; (2) eradication of H pylori ; and (3) recurrence of ulcer. Baseline and follow-up for 24 months were performed through clinical, laboratory, and endoscopic tests. The ulcer healing rate was 95% in the ranitidine group and 100% in the omeprazole group; the H pylori eradication rate was 90% and 95%, respectively. During follow-up, on…
The effects of muscular exercise on glucose, free fatty acids, alanine and lactate in type I diabetic subjects in relation to metabolic control.
Metabolic effects of muscular exercise were studied in eleven subjects with type I diabetes mellitus during poor metabolic control, and again during good metabolic control, and in ten healthy control subjects. All the subjects were submitted to a submaximal gradual triangular test on an electrically braked bicycle ergometer; glucose, FFA, alanine and lactate were measured at rest, and after exercise. In poorly controlled patients, glucose and FFA were unchanged after exercise, whereas blood alanine and lactate increased by a percentage similar to that of the controls, and well-controlled diabetic patients. Baseline alanine concentrations were lower and lactate concentrations higher than in …
The influence of high dose intravenous immunoglobulins on immunological and metabolic pattern in newly diagnosed type I diabetic patients
In autoimmune disease the functional deficiency of T suppressor cells, also described in Type I diabetes, may be restored through immunoglobulin (Ig) infusion, which increases antigen phagocytosis, NK activity, cell clones and antibody anti-idiotype responses. Sixteen Type I diabetic patients were studied: eight were treated soon after the initial correction of disease-onset glycemic deterioration with intensive intravenous (i.v.) 7S Ig treatment (0.4 g/kg/BW) for 1 week and once per week for 6 months, whilst the remaining patients constituted the control group. All patients were evaluated during the study for metabolic and immunological parameters. A reduction in insulin requirement compar…
Cardiac changes in subclinical and overt hyperthyroid women: retrospective study
This retrospective and descriptive 4-year study was undertaken to describe cardiac changes in subclinical and overt hyperthyroidism.We revised the charts of 386 consecutive cardiopathic women whose blood samples were referred to the Radioimmunoassay Laboratory to evaluate thyroid function from 1 January 1997 through 31 December 2000.After excluding women because euthyroid or hypothyroid, or taking amiodarone and women with hypertension, rheumatic disease, myocardial infarction, a total of 31 hyperthyroid women were thus selected for the study: 19 with subclinical hyperthyroidism and 12 with overt hyperthyroidism. The prevalence of atrial fibrillation did not differ between subclinical (48%)…
Liver eosinophilic infiltrate is a significant finding in patients with chronic hepatitis C.
Eosinophilic infiltrate of liver tissue is described in primary cholestatic diseases, hepatic allograft rejection and drug-induced liver injury, but its significance and its implications in chronic hepatitis C are unknown. The aim of this study was to investigate the clinical significance of eosinophilic liver infiltrate in patients with chronic hepatitis C. We retrospectively evaluated 147 patients with chronic hepatitis C. The presence of eosinophilic infiltrate was investigated in liver biopsies, and a numeric count of eosinophilic leucocytes in every portal tract was assessed. An eosinophilic infiltrate of liver tissue (> or =3 cells evaluated in the portal / periportal spaces) was obse…
Thyroid hormones induce sumoylation of the cold shock domain-containing protein PIPPin in developing rat brain and in cultured neurons.
We previously identified a cold shock domain (CSD)-containing protein (PIPPin), expressed at high level in brain cells. PIPPin has the potential to undergo different post-translational modifications and might be a good candidate to regulate the synthesis of specific proteins in response to extracellular stimuli. Here we report the effects of thyroid hormone (T3) on PIPPin expression in developing rat brain. We found that a significant difference among euthyroid- and hypothyroid- newborn rats concerns sumoylation of nuclear PIPPin, that is abolished by hypothyroidism. Moreover, T3-dependence of PIPPin sumoylation has been confirmed in cortical neurons purified from brain cortices and culture…
Effect of dual blockade of renin–angiotensin system on TGFβ1 and left ventricular structure and function in hypertensive patients
The effects of 24 weeks losartan and ramipril treatment, both alone and in combination, on left ventricular mass (LVM), circulating transforming growth factor beta1 (TGFbeta1), procollagen type I (PIP) and III (PIIIP), have been evaluated in hypertensive (HT) patients. A total of 57 HT with stage 1 and 2 essential hypertension were included. After 4 weeks run in, a randomized double-blind, three arms, double dummy, independent trial was used. All HT patients were randomly allocated to three treatment arms consisting of losartan (50 mg/daily), ramipril (5 mg/ daily) and combined (losartan 50 mg/daily + ramipril 5 mg/daily) for 24 weeks. TGFbeta1, PIP and PIIIP, LVM, LVM/h(2.7) and other echo…
The impact of coexistent diabetes on the prevalence of coronary heart disease.
Abstract The increased risk of developing cardiovascular disease in diabetic population has been well documented, but the prevalent mechanism of this susceptibility is still only partly explained. We compared the impact of diabetes on ischemic heart disease in patients hospitalized in a public general hospital over a 10-year period. The prevalence of coronary heart disease (CHD) was consistently higher among diabetic population [namely, among non-insulin-dependent diabetes mellitus (NIDDM) patients] when compared with the nondiabetic population. The prevalence was similar in both genders, increasing with age, and was independent from body-mass index, history of smoking, metabolic control, o…
Effect of aging and hypertension on β-myosin heavy chain in heart of spontaneously hypertensive rats
During aging rat myocardium undergoes structural changes characterized by a shift in the synthesis of myosin heavy chain (MHC) from V1 isoform, composed of two alpha-MHC, to V3 isoform, composed of two beta-MHC. In rat, besides ageing, cardiac hypertrophy as adaptive response to a superimposed pressure load (such as hypertension) is characterized by predominance of V3 myosin isoform. The aim of our study was to evaluate the expression of beta-MHC in right (RV) and left (LV) ventricles of spontaneously hypertensive rats (SHRs), a well defined animal model of hypertension, in relation to aging. We used very young (8-week old) and young (15-week old) SHRs and age-matched normotensive Harlan Sp…
Study on maternal, fetal and amniotic prolactin in gestational diabetic women, at term.
In order to determine whether prolactin secretion was affected in diabetic pregnancy, maternal, fetal and amniotic fluid prolactin (PRL) concentrations were measured in gestational non treated diabetic women at parturition. Amniotic fluid PRL levels, though higher than those in maternal and fetal serum, were significantly lower than those of the controls (p less than 0.005); no case of respiratory distress syndrome or congenital malformation was found at birth.
Plasma endothelin-1 levels in patients with angina pectoris and normal coronary angiograms.
Some patients with typical angina and electrocardiographic evidence of ischemia have normal coronary angiograms. These patients have a reduced coronary flow reserve and abnormal endothelium-dependent vasodilator responses; this syndrome is known as microvascular angina. Among endothelium-derived peptides, endothelin-1 (ET-1) is a potent vasoconstrictor and an important modulator of microvascular function.Plasma ET-1 was measured in 13 patients with typical angina, instrumental evidence of ischemia, and normal arteriograms and in 20 normal control subjects.Mean concentration of ET-1 was 2.89+/-1.24 pmol/L in patients with angina and normal angiograms and 1.99+/-0.81 pmol/L in normal control …
Effects of muscular exercise on erythrocyte adenosine triphosphate concentration in patients with insulin-dependent diabetes mellitus.
Type I diabetes mellitus represents a metabolic disorder in which intracellular glycolytic pathway is inhibited by insulin deficiency, with the subsequent decreased availability of energetic substrates such as ATP. Some aspects of the energetic metabolism in response to an intensive demand (muscular exercise) were investigated, in a group of 10 ketotic diabetic patients, by measuring erythrocyte adenosine triphosphate (ATP) and blood glucose, free fatty acids (FFA) and lactate levels. In the diabetic subjects, in comparison with normal subjects, the decreased levels of erythrocyte ATP at rest did not increase after exercise, while the increased levels of FFA at rest did not diminish after e…
Effects of dynamic exercise and metabolic control on left ventricular performance in insulin-dependent diabetes mellitus
In subclinical diabetic cardiomyopathy, previous reports did not positively correlate the altered cardiac performance with metabolic parameters. Fifteen insulin-dependent diabetic subjects, without any clinical or instrumental evidence of heart diseases, were studied. Signs of diabetic microangiopathy were absent. Systolic time intervals, metabolic and hormonal parameters (blood glucose, free fatty acids, blood lactate and plasma norepinephrine) were evaluated at rest and after dynamic exercise during poor (MAGE 6.36 +/- 0.72 mmol/l) and good (MAGE 3.46 +/- 0.66 mmol/l) metabolic control, obtained by means of insulin therapy. Rest values of systolic time intervals were normal during poor an…
Comparison of roxatidine and ranitidine in the treatment of refractory duodenal ulcer
Abstract Fourteen patients with duodenal ulcer not healed after treatment with ranitidine at the standard dosage of 300 mg/day for 12 weeks were enrolled in the study. Eight patients were treated with roxatidine acetate, 150 mg/day, for 8 weeks (group A); six patients received treatment with ranitidine, 600 mg/day, for 8 weeks (group B). Efficacy of treatment was evaluated on the basis of reduction of ulcer pain, lowering of maximal acid output (MAO) levels, and cicatrization of ulcer lesion. The patients treated with roxatidine showed a significant reduction in MAO levels after 4 weeks, whereas the patients treated with ranitidine showed a significant reduction in MAO levels after 8 weeks.…