bluuebunny/crossref_metadata_2025_split huggingface dataset:
Glycoprotein hormone α‐subunit secretion in prolactinomas and in non‐functioning adenomas: relation with the tumour size
Authors: Warnet André , Porsova‐Dutolt Irena , Lahlou Najiba , Seret‐Beguet Domlnlque , Lajeunle Ellsabeth , Chanson Phillppe , Wolmant France , Lot Gulllaume , Guillausseau Pierre‐Jean , Roger Marc 
Published: March 2008

SummaryOBJECTIVE Free giycoproteln hormone α‐subunit plasma levels have been reported to be Increased In glycoprotein hormone‐secreting adenomas and In acromegaly, but rarely In prolactinomas and In only two cases of Cushing's disease. The prevalence of elevated plasma α‐subunit levels. In patients with non‐functioning adenomas is still unclear. In addition, no previous work has described plasma a‐subunit levels. In a comprehensive series of adenomas characterized by In‐vivo secretion and/or Immunocytochemistry.PATIENTS Thirty‐seven patients with definite prolactinomas and 48 with non‐functioning tumours characterized by Immunocytachemistry were studied, from a series of 145 consecutive patients Including 33 acromegallcs, 18 patients with glycoprotein hormone‐secreting adenomas and 9 with Cushing's disease.MEASUREMENTS Plasma free α‐subunit was measured by radioimmunoassay in all patients and In a large sample of normal subjects to establish normal ranges according to sex, age and menstrual status. Tumour volume index was the product in cm3 of length, width and height of the adenoma as assessed by computerized tomography or magnetic resonance Imaging.RESULTS Twelve of the 37 (32%) patients with prolactinomas had Increased plasma a‐subunit levels; their tumours were significantly larger with significantly higher plasma PRL levels than those of patients without Increased plasma α‐subunit levels(P < 0·02). All prolactlnomas above 50 cm3 were associated with α‐subunit secretion, whereas only 6 of 29 smaller tumours were similarly associated. Twelve of the 48 ‘non‐functlonlng’ adenomas actually secreted α‐subunit in vivo: 8 gonado‐trophin‐secreting, 2 ‘pure’α‐secreting, one with negative Immunocytachemistry and one necrotic adenoma. Their volumes were significantly higher than those of adenomas without increased plasma α‐subunit levels (P < 0·04). Plasma α‐subunit levels were increased in the 6 patients with TSH‐secreting adenomas, 8 of 12 with FSH‐secreting adenomas, 11 of 33 acromegalics and none of those with Cushing's disease.CONCLUSION Plasma free α‐subunit levels were Increased in 49 of 145 patients (34%). For prolactinomas and ‘non‐functioning’ adenomas, α‐subunit hypersecretion was seen more often with larger tumours. Half of the cases with Increased free α‐subunit. In this series were patients harbouring an adenoma which did not stain for an intact glycoprotein hormone.
Serum lactogens possessed normal bioactivity in patients with lactation insufficiency
Authors: Livingstone Verity H. , Gout Peter W. , Crickmer Sean D. , Fox Kelly , Prior Jerllynn C. 
Published: March 2008

SummaryOBJECTIVE insufficient breast milk is the most common reason for premature termination of breast‐feeding. The causes of lactation insufficiency are usually multifactorial; In a small percentage of cases it Is due to primary lactation failure of unknown origin. The aim of this study was to Investigate whether lactation insufficiency of unknown origin could be caused by serum lactogens that had reduced biological activity.DESIGN Women with lactation Insufficiency of unknown origin and normal lactating controls were subjected to a standardized breast‐feeding test for assessment of milk production. Thirty minutes later, serum samples were obtained for determination of total lactogen bioactivity, using an in‐vitro bioassay, and levels of prolactin (PRL) and growth hormone (GH) using radiolmmunoassay (RIA).PATIENTS Twelve lactating mothers with a clinical diagnosis of lactation insufficiency of unknown origin were compared with 12 matched mothers with normal lactation.MEASUREMENTS The Nb2 lymphoma Cell bioassay was used to measure total lactogen bioactivity In sera. Conventional RIA kits were used to estimate serum PRL and GH concentrations.RESULTS Mean milk yield on standardized test feed was 21·6 mi for patients and 146·5 mi for controls. In both patient and control groups the total serum lactogen bioactivity ranged from about 150 to 5000 mlU/l, while the serum RIA (PRL + GH) levels ranged from about 350 to over 7000 mlU/l. There was no evidence of lactogens with reduced bioactivity in the patients' sera.CONCLUSION Lactation insufficiency In the women studied cannot be explained by serum lactogens that possess unusually low bioactivity.
Comparison of changes in bone mineral in idiopathic and secondary osteoporosis following therapy with cyclical disodium etidronate and high dose calcium supplementation
Authors: Orme S. M. , Simpson M. , Stewart S. P. , Oldroyd B. , Westmacott C. F. , Smith M. A. , Belchetz P. E. 
Published: March 2008

SummaryOBJECTIVE Our clinical practice has been to offer treatment with cyclical disodlum etidronate and high dose calcium supplements (1500–1600 mg/day) to ail female patients with osteoporosis who are unable or unwilling to take hormone replacement therapy (HRT), and male osteoporotics. In a retrospective study we compared the effect of this treatment on measures of bone mineral over a 12‐month period in women wlth post‐menopausal and secondary osteoporosis. We also assessed its effects in 10 male osteoporotics.DESIGN A retrospective analysis of 83 consecutive patients with osteoporosis who completed 12 months of treatment with disodlum etldronate and calcium and who had a dual energy X‐ray absorptiometry (DEXA) scan at baseline and foilowing 12 months of therapy.PATIENTS The study Included 73 women (45 post‐meno‐pausal and 28 secondary osteoporotics) and 10 men with established osteoporosis as shown by spinal and femoral bone mineral densities (BMD) > 2 standard deviations (SD) below young normals, and radioiogical evidence of osteoporosis.MEASUREMENTS Each patient had routine biochemistry at baseline, an X‐ray of thoracic and lumbar spine and a DEXA scan of lumbar spine (L2‐L4) and femoral neck. The DEXA scan was repeated following 12 months of therapy.RESULTS There was no difference between increase in spinal BMD in the post‐menopausal (5·7%) versus secondary osteoporotic group (6·7%). There was a significant increase in spinal BMD at 12 months in the 10 male osteoporotics (9·0%, P < 0·01). No overall change in femoral neck BMD was noted.CONCLUSIONS Cyclical disodium etidronate given with hlgh dose calcium supplements is equally effective in increasing spinal bone mineral density in post‐menopausal and secondary osteoporosis. It also results in a significant rise In spinal bone mineral density in male osteoporotics. Whether this produces a reduction in fracture rates is unknown.
The effect of growth hormone replacement on serum lipids, lipoproteins, apolipoproteins and cholesterol precursors in adult growth hormone deficient patients
Authors: Russell‐Jones D. L. , Watts G. F. , Welssberger A. , Naoumova R. , Myers J. , Thompson G. R. , Sönksen P. H. 
Published: March 2008

SummaryOBJECTIVE Adult patients with growth hormone deflciency are thought to be at higher risk of mortallty from cardiovascular disease. We therefore investlgated the effect of recombinant human growth hormone (rhGH) replacement therapy on fasting serum concentrations of IIplds, lipoproteins and cholesterol precursors in adult growth hormone deficient patients.DESIGN Double‐blind placebo controlled trial. Patients were randomly allocated to placebo or rhGH replacement therapy (0·018 Ulkglday for 1 month followed by 0·036 Ufkglday for 1 month).PATIENTS Eighteen patients with severe growth hormone deficiency.MEASUREMENTS Fasting lipid, lipoprotein and cholesterol precursors (lathosterol and mevalonic acid) were measured at baseline and after 2 months.RESULTS In the rhGH treated group there was a significant fall in serum cholesterol (P < 0·01) (6·44 ±0·49 to 5·71 ± 0·48 mmol/l), LDL cholesterol (P < 0·02) (4·29 ± 0·49 to 3·62 ± 0·44 mmol/l), LDL cholesterollHDL cholesterol ratio (P < 0·02) (3·99 · 0·62 to 3·26 ± 0·39), apollpo‐protein B (P>0·01 (1·30 ± 0·11 to 1·15 ± 0·11 g/l) and mevalonic acid (P<0·05) (13·4 ±10·96 to 6·21 ± 1·91 μg/l). There were no significant changes In triglycerides, HDL cholesterol, apolipoprotein A1, lipoprotein (a) or lathosterol concentrations. In the GH treated group the rise in serum insulln was inversely correlated wlth the fall in cholesterol (P < 0·05), LDL cholesterol (P < 0·01) and apolipoproteln B (P < 0·01). There were no significant changes in any of the measured variables in the placebo group.CONCLUSION We conclude that GH may be involved in the regulation of lipid and lipoprotein metabolism and that rhGH replacement therapy of adult GHD patients is associated with beneficial changes in lipid and lipoprotein profiles. The reduction in mevalonic acid is consistent with up‐regulation of hepatic LDL receptors caused by GH and this may explain the fall in LDL cholesterol and apolipoprotein B concentrations.
Serum insulin‐like growth factor I in a random population sample of men and women: relation to age, sex, smoking habits, coffee consumption and physical activity, blood pressure and concentrations of plasma lipids, fibrinogen, parathyroid hormone and osteocalcin
Authors: Landin‐Wllhelmsen Kerstin , Wllhelmsen Lars , Lappast George , Rosen Thord , Lindstedt Goran , Lundberg Per‐Arne , Bengtsson Bengt‐Áke 
Published: March 2008

SummaryOBJECTIVE There Is a cllnlcal need for population based reference values for serum Insulin‐like growth factor I (IGF‐I). We have therefore determined serum IGF‐i concentrations In a random population sample from Sweden and have related the levels to age, sex, llfe style factors, blood pressure, body composition, blood llplds, plasma fibrlnogen, Parathyroid hormone (PTH) and osteocalcin.PATIENTS Wlthln the framework of the WHO MONICA Project In the city of Göteborg, Sweden, 197 men and 195 women aged 25–64 years were studied.RESULTS Women aged 25–34 years had higher IGF‐I concentration than men (mean 278 vs 227 μg/l) but In the interval 55–64 years values were lower In women than In men (158 vs 171 μg/l). IGF‐I correlated positively with height and inversely with age, body mass Index, systolic blood pressure and total cholesterol in both sexes. Negative relations between IGF‐I and hlgh density llpoprotelncholesterol, as well as with amount of tobacco smoked, were found in men, and between IGF‐I and diastolic blood pressure, triglycerldes and PTH in women. When age was allowed for in multivariate analyses, most of these relations disappeared. However, among men IGF‐l was positively assoclated with flbrlnogen and negatively with age and smoking. IGF‐I was negatively assoclated with age and coffee consumptlon in women.CONCLUSION The present data can be used as reference values for IGF‐I (at least in Caucasians) for the diagnosis of growth hormone dlsturbances and as guidelines for growth hormone substitution.
Age‐related and gender‐related occurrence of pituitary adenomas
Authors: Mindermann Thomas , Wilson Charles B. 
Published: March 2008

SummaryOBJECTIVE To evaluate the various types of pituitary adenomas according to sex and age group. Few studies have attempted such an analysis, and most have focused on specific age groups, especially children. Recent data suggest that the frequency of different types of pituitary adenomas varies according to age and sex.DESIGN A retrospective review of the records of 2230 patients who underwent surgery for a pituitary adenoma at the University of California, San Francisco (UCSF), between January 1969 and June 1993.METHODS The distribution of tumours was analysed according to age at surgery, sex, and the clinical pheno‐type of the tumour. Age groups were defined as the decades of life.RESULTS Prolactinomas were the most common tumours (39%), followed by endocrlne‐inactive adenomas, growth‐hormone‐releasing adenomas, and adrenocorficotrophic hormone‐releasing adenomas causing Cushing's disease; ACTH‐releasing adenomas causing Nelson's syndrome and thyrotrophin (TSH)‐releasing adenomas were rare. The female‐to‐male ratio differed considerably between the various adenoma types and between age groups. Prolactinomas, ACTH‐releasing adenomas, and TSH‐releasing adenomas occurred mostly in females; endocrine‐inactive and GH‐releasing adenomas occurred mostly in males. In older age groups, all adenoma types, except for endocrine‐inactive adenomas, tended to assume a more balanced gender distribution. Among patients with prolactinomas, endocrine‐inactive, ACTH‐releasing, and to a lesser extent GH‐releasing adenomas, the greatest discrepancy in gender distribution seemed to coincide with the peak Occurrence of each tumour type. The peak Occurrence was from the second to the fifth decade of life for prolactinomas and from the fourth to the eighth decade for endocrine‐inactlve adenomas. GH‐releasing, ACTH‐releasing, and TSH‐releaslng adenomas were more evenly distributed throughout the adult life span.CONCLUSIONS The frequency of pitultary adenomas varies greatly according to age and sex. The various adenoma types have thelr peak occurrence in distinctly dlfferent age groups and differ greatly in their female‐to‐male ratios. The female‐to‐male ratio for a given adenoma type varies greatly with age.
Bone mineral density in thyroxine treated females with or without a previous history of thyrotoxicosis
Authors: Franklyn Jayne , Betteridge Joan , Holder Roger , Daykin Jacquie , Lilley John , Sheppard Michael 
Published: March 2008

SummaryOBJECTIVE The results of studies examining the influence of T4 therapy upon bone mineral density (BMD) are conflicting. This conflict may, in part, reflect Inclusion of patients with varying thyroid disorders. We have therefore examined the influence of preceding thyroid history and T4 therapy on BMD.DESIGN Case‐control studies of patients on long‐term T4 therapy who have or have not previously received radio‐iodine treatment for thyrotoxicosis, as well as previously thyrotoxic patients who have not required T4 replacement.PATIENTS Twenty‐seven premenopausal and 60 post‐menopausal females with a past history of thyrotoxicosis and subsequent T4 treated hypothyroidism (group l), 39 post‐menopausal females with a past history of radio‐iodine treated thyrotoxicosis not receiving T4 (group 2) and 22 post‐menopausal females with primary hypothyroidism on T4 (group 3). Female controls individually matched to patients by age and menopausal status.MEASUREMENTS BMD measured by dual‐energy X‐ray absorptiometry. Serum biochemistry and tests of thyroid function.RESULTS No significant differences were found in femoral or lumbar spine BMD measurements between premenopausal patients and controls in group 1 or between group 2 patients and controls. Measurements of BMD at all sites were lower in post‐menopausal patients in groups 1 and 2 than in controls; when allowance was made for differences In BMD due to body mass index by analysis of variance, significant reductions in femoral trochanter BMD (3·9%, P <0·05) and lumbar spine (5·6–8·5%, P <0·01) BMD results were found in post‐menopausal females In group 1 and reductions in femoral trochanter (3·9%, P <0·01), Ward's triangle (5·6%, P <0·05) and lumbar spine (8·5%, P <0·01) BMD results in group 2. Separate analysis of BMD results of those with normal or reduced serum TSH did not affect outcome. BMD measurements were not significantly correlated with duration of T4 therapy, T4 dose, or serum free T4 or TSH in any patient group.CONCLUSIONS Thyroxine therapy alone does not represent a significant risk factor for loss of bone mineral density but there is a risk of bone loss in post‐menopausal (but not premenopausal) females with a previous history of thyrotoxicosis treated with radioiodine.
Mineralocorticoid and glucocorticoid status in idiopathic haemochromatosis
Authors: Walsh C. H. , Murphy A. L. , Cunningham S. , McKenna T. J. 
Published: March 2008

SummaryOBJECTIVE A number of studies have suggested that both primary (Addison's disease) and secondary adrenal failure may be caused by idiopathic haemochromatosis. There is little information on mineralocorticoid secretion. We have assessed the mineralocorticoid and glucocorticoid status of patients with idiopathic haemochromatosis. DESIGN Cross‐sectional study.PATIENTS Eighteen males and one female with confirmed idiopathic haemochromatosis were investigated. Seven of the subjects had hepatic cirrhosis and three had hypogonadotrophic hypogonadism.MEASUREMENTS A short Synacthen (tetracosactrin) test was undertaken in addition to an overnight metyrapone test and an insulin stress test. In addition, plasma aldosterone (PA) and plasma renin activity (PRA) were measured in a group of patients in the basal state and again in the upright position.RESULTS The short Synacthen test, overnight metyrapone test and insulin stress test were normal In all subjects. The PA, PRA, and PA/PRA ratios In the upright position were not significantly different in the patients with idiopathic haemochromatosis compared to control subjects.CONCLUSION In this patient population, no abnormality of either the pituitary adrenal axis or mineralocorticoid status was detected. Adrenocortical dysfunction is likely to be exceptionally rare in idiopathic haemochromatosis.
Augmented 17α‐hydroxyprogesterone response to ACTH stimulation as evidence of decreased 21‐hydroxylase activity in patients with incidentally discovered adrenal tumours ('incidentalomas')
Authors: Seppel Thomas , Schlaghecke Reiner 
Published: March 2008

SummaryOBJECTIVE Recent studies have indicated that the syndrome of congenital adrenal hyperplasia due to 21‐hydroxylase deficiency is closely associated with the development of benign adrenocortical tumours. Tumour formation is thought to be a consequence of ACTH hypersecretion which results from the lack of glucocorticoid synthesis.The aim of this study was to evaluate 21‐hydroxylase activity in patients with an incidentally discovered adrenal mass ('Incidentaloma') without a history of congenital adrenal hyperplasia.DESIGN A prospective study of 52 patients admitted to a single hospital.PATIENTS Fifty‐two consecutive subjects (mean age 56·0 years, range 24–81 years) with an incidentally discovered adrenal tumour were studied.MEASUREMENTS The 21‐hydroxylase reserve was assessed by intravenous bolus administration of 1‐24 ACTH (tetracosactrin) with measurement of basal and stimulated serum 17α‐hydroxyprogesterone (17‐OHP) concentrations. Impaired 21‐hydroxylase activity was defined as an exaggerated 17‐OHP response, with a 17‐OHP increment exceeding 7‐9nmolll. Basal and stimulated cortisol concentrations, and basal ACTH were also measured.RESULTS Baseline levels of 17‐OHP were normal in 44 and elevated in 8 subjects. In 37 patients (71·2%), the 17‐OHP increment following ACTH administration exceeded 7·9nmol/l, demonstrating mildly decreased 21‐hydroxylase activity. In these subjects, the peak serum 17‐OHP correlated with the tumour diameter. In the patients with apparently normal 21‐hydroxylase activity, no significant correlation was found between 17‐OHP concentrations and tumour size. All patients had a stimulated serum cortisol above 550 nmol/l reflecting intact adrenal gluco‐corticoid reserve. There were no other differences between the group with exaggerated and the group with normal 17‐OHP Increment. The tumours were removed from two women with augmented 17‐OHP responses and this was followed by normalization of 17‐OHP dynamics.CONCLUSIONS Biochemical evidence for partial 21‐hydroxyiase defiency is a common finding in patients with an adrenal Incidentaloma, even in the absence of a congential adrenal hyperpiasia history. Exaggerated 17‐OHP increment is not accompanied by decreased adrenal glucocorticoid reserve. Normalization of the 17‐OHP response after surgical treatment suggests that the phenomenon results from reduced 21‐hydroxyiase activity in the tumour, which retains ACTH responsiveness.
Serum lipoprotein lipid profile in women with the polycystic ovary syndrome: relation to anthropometric, endocrine and metabolic variables
Authors: Holte Jan , Bergh Torbjörn , Berne Christian , Lithell Hans 
Published: March 2008

SummaryOBJECTIVE Although often associated with insulin resistance and glucose intolerance, various lipoprotein abnormalities have been found in polycystic ovary syndrome (PCOS) but not Invariably so when the degree of obesity is taken into account. We have therefore Investigated the serum lipid profile in a group of women with polycystic ovary syndrome with and without obesity. DESIGN Cross‐sectional study of serum lipoprotein lipids and plasma free fatty acids in relation to anthropometric, metabolic and hormonal variables in women with PCOS and weight‐matched controls.PATIENTS Twenty‐four obese (Pob, mean BMI ± SD 30·6±3·3kg/m2) and 25 non‐obese (Pnob, 22·2 ±2·3kg/m2) women with PCOS. Twenty obese (Cob, 30·2 ± 3·5 kg/m2) and 20 non‐obese (Cnob, 21·4 ± 1·5 kg/m2) controls.MEASUREMENTS Fasting concentrations of plasma free fatty acids, serum cholesterol and triglycerides in high density lipoproteins (HDL), low density lipoproteins (LDL) and very low density lipoproteins (VLDL) In relation to insulin sensitivity index (M/I; assessed with the euglycaemic insulin clamp), glucose tolerance (k‐value; intravenous glucose tolerance test), basal serum hormone concentrations, and body fat distribution (skinfolds and waist hip ratio).RESULTS Plasma concentrations of free fatty acids were markedly higher in Pob than in the other groups (all P < 0 001). The lipoprotein lipids did not differ between Pob and Cob, or between the non‐obese groups, whereas both obese groups had higher serum concentrations of triglycerides, totally and in VLDL, and lower HDL‐cholesterol than their non‐obese counterparts. Pob also had higher serum levels of total and LDL‐cholesterol than Pnob. Pob had a more pronounced subcutaneous truncal‐abdominal adiposity, higher fasting insulin levels and lower M/I than the other groups, and a lower k‐value than Cob. Cob had higher levels of fasting insulin than Cnob. Free fatty acid levels correlated with the k‐value (inversely) in both women with PCOS and controls, and with M/I (inversely), age and testosterone levels in PCOS. Step‐wise regression analysis for the total population, comparing endocrine, anthropometric and metabolic explanatory variables, showed that the serum levels of HDL‐cholesterol and triglycerides were mainly correlated with body fat distribution (both) and fasting insulin levels (triglycerides), and levels of total and LDL‐cholesterol with BMI and age.CONCLUSIONS Plasma free fatty acid correlations were markedly increased In obese women with PCOS, closely associated with the lower insulin sensitivity and lower glucose tolerance in these women. In spite of these profound metabolic aberrations, the lipoprotein lipid profile was not significantly more abnormal in obese women with PCOS than in their weight‐matched controls.