bluuebunny/crossref_metadata_2025_split huggingface dataset:
Peripheral glucose metabolism in human hyperprolactinaemia
Authors: Foss M. C. , Paula F. J. A. , Paccola G. M. G. F. , Piccinato C. E. 
Published: March 2008

SummaryOBJECTIVE Prolactin has important biological actions in several species which include metabolic control and waterlelectrolyte balance. However, human PRL has generally been characterized as a mammotrophic hormone and it is unknown whether PRL has any important metabolic actions. This study was thus conducted to evaluate the effect of hyperprolactinaemia on peripheral muscle glucose metabolism.DESIGN The study was designed to determine forearm muscle glucose uptake and utilization (oxidative and non‐oxidative metabolism) in normal and hyperprolactinaemic subjects in the post‐absorptive state and lor 3 hours after the ingestion of 75 g of glucose. Peripheral glucose metabolism was analysed by the forearm technique to estimate muscle exchange of substrates combined with local indirect calorimetry.PATIENTS Eight hyperprolactinaemic patients (HP group, 6 females and 2 males) and ten normal sublects (N group, 7 females and 3 males) were studied. The hyperprolactinaemic patients showed no clinical or laboratory evidence of acromegaly or hypothyroidism and were not using any PRL releasing drugs.MEASUREMENTS Forearm blood flow was measured by capacitance plethysmography and arterial and venous blood samples were drawn simultaneously to determine plasma glucose, serum FFA, total blood CO2 and O2 and serum insulin in the post‐absorptive state (0 time) and at 30, 60, 120 and 180 minutes after glucose Ingestion.RESULTS No significant difference in glucose uptake by the forearm muscle tissue was observed between the N and HP groups (823 plusmn; 103 vs 828 ± 110 μmol/100 ml forearm 3h, respectively), nor were any significant differences observed in the intracellular utilization of glucose (oxidative and non‐oxidative metabolism). However, the serum insulin levels after glucose ingestion were significantly higher in hyperprolactinaemic patients than in normal subjects, especially at 30 (N 283 ± 46 vs HP 581 ± 133 pmol/l) and 60 minutes (N 291 ± 37 vs HP 544 ± 61 pmol/l). Furthermore, after glucose ingestion the suppression of serum FFA levels was smaller in the hyperprolactinaemic patients than in normal subjects.CONCLUSIONS This study demonstrated that insulin resistance is associated with the presence of spontaneous human hyperprolactinaemia. The hyperinsulinaemia detected in the hyperprolactinaemic patients after the oral glucose stimulus did not determine a proportional Increase in forearm glucose uptake and utilization, which were similar to the normal levels. The suppression of serum free fatty acid concentrations was also smaller in hyperprolactlnaemlc patients during the oral glucose challenge, suggesting an impaired antilipolytic effect of Insulin.
Ovaries in sexual precocity
Authors: Bridges Nicola A. , Cooke Alex , Healy Michael J. R. , Hindmarsh Peter C. , Charles G. D. Brook  
Published: March 2008

SummaryBACKGROUND AND OBJECTIVE Ovarian Uh8SOnOgra‐phy may be helpful in distinguishing the various types of precocious puberty, and the ovarian appearances Increasingly influence choice of therapy In these girls. We examined retrospectively the ovarian volume and prevalence of polycystic ovarian appearance at ultrasound in girls with sexual precocity.DESIGN Ultrasound examinations were obtained from girls who presented with sexual precocity. If there were several scans from the same Individual, the latest was analysed.PATIENTS The girls were divided Into groups: untreated central precoclous puberty (n= 25), central precocious puberty treated with GnRH analogue (n= 18) or with GnRH analogue and recombinant human OH (n= 11), girls who had stopped treatment with GnRH analogue and GH (n= 12), premature thelarche and thelarche variant (n= 15) and premature adrenarche (n= 14).MEASUREMENTS Ovarian volume was calculated and the ovaries were assessed for polycystic appearance using standard criteria. Ovarian volume standard deviation (SD) scores were calculated using means and standard deviations derived from a control population and compared using analysis of variance. Differences from control data were assessed using Student's t‐test.RESULTS Ovarian volume SD scores for all the groups studied were greater than those for control subjects. Girls who had stopped treatment with GnRH analogue and GH had mean ovarian volume of 6.98 mi and ovarian volume SD score (+1·72) greater than that of girls having treatment with GnRH analogue alone (+1·24). Polycystic appearance ovaries were found in 83% of scans in girls who had stopped treatment with GnRH analogue and GH. The ovarian volume SD score of girls with premature adrenarche was less than that of girls with untreated central precoclous puberty.CONCLUSIONS Girls with central precocious puberty had large ovaries which did not return to a volume appropriate for age. Girls treated with GnRH analogue and GH developed very large ovaries when they stopped treatment, and had an Increased prevalence of ovaries with a polycystic appearance. Central precocious puberty, or some aspect of Its treatment, results In an Increased prevalence of polycystic ovarian appearance.
Effect of age on bone density and bone turnover in men
Authors: Wishart J. M. , Need A. O. , Horowitz M. , Morris† H. A. , Nordin B. E. C. 
Published: March 2008

SummaryOBJECTIVE Little Is known about the pattern of age‐related bone loss in men, and although androgens are required for optimum bone mass it Is not clear whether the fall in bone mass with age in men is related to failing androgens.DESIGN Cross‐sectional measurement of bone density, at five sites, and markers of bone resorption and formation in 147 normal volunteers aged 20‐83 years.SUBJECTS Healthy laboratory workers, hospital staff, their relatives, and husbands of women attending our osteoporosis clinic.MEASUREMENTS Forearm density (fat corrected), spine L2‐L4, femoral neck, Ward's triangle and trochanter density; serum procollagen I C‐terminal extension peptide, osteocalcin, bone alkaline phosphatase and collagen I C‐terminal telopeptlde; fasting urine hydroxy‐proline/creatinine, pyridinoline/creatinine and deoxy‐pyridinoline/creatinine; and free androgen Index (FAI), measured as serum testosterone/sex hormone binding globulin.RESULTS Bone loss accelerated at most sites after age 50. There was a significant fall In FAI from the third decade onwards. The levels of ail bone markers fell with age.CONCLUSIONS Bone loss In men appears to accelerate from age 50 and is associated with decreased bone formation which may be associated with falling levels of free androgen.
Reduced growth hormone secretion with maintained periodicity following cranial irradiation in children with acute lymphoblastic leukaemia
Authors: Lannering B. , Rosberg S. , Marky I. , Moëll C. , Albertsson‐Wikiand K. 
Published: March 2008

SummaryOBJECTIVE Low dose cranial irradiation in children with acute lymphoblastic leukaemia (ALL) has been reported to reduce GH secretion in puberty. A recent study also reported a disturbed periodicity of GH secretion during puberty. We have focused on the different stages of puberty in studying these two parameters of GH secretion and have also compared the effects of 18 vs 24 Gy radiation dose.PATIENTS AND MEASUREMENTS Thirty‐four children previously treated for ALL were compared with a control group of 208 healthy normally growing children. GH secretion was measured as 24‐hour profiles. RESULTS In children treated for ALL, OH Secretion rate and OH peak amplitude were below the median values for controls, both before puberty and during all stages of puberty. The difference between patients and controls was most pronounced in late puberty. Radiation with 18 or 24 Gy gave similar results. However, time sequence analysis showed a similar periodicity of GH secretion in both patient and control groups before, as well as during, puberty. Thus, before puberty a broad range of cycles per 24 hours was seen. These synchronized during puberty to a predominant OH peak frequency of one every 3‐4 hours.CONCLUSIONS After low dose cranial irradiation with 18 or 24 Gy, the total amount of GH secreted is reduced both before and during puberty. We could not confirm previous findings of impaired periodicity of GH secretion in these Children.
Growth hormone responses to dexamethasone in healthy females throughout the menstrual cycle
Authors: Thakore Jogin H. , Dinan Timothy G. 
Published: March 2008

SummaryOBJECTIVE In health, acute administration of dexamethasone (DEX) leads to growth hormone release. As sex steroids have a profound Influence on the somatotrophic axis, we decided to investigate the effects of DEX on OH release throughout the menstrual cycle.DESIGN A within subjects, randomized double‐blind counter‐balanced design was employed.METHODOLOGY Baseline levels Of GH, oestradiol and progesterone were taken at three the points In two consecutive menstrual cycles, after which 4mg of oral DEX or placebo was administered. Plasma samples for OH estimation were taken at 60,180,240 and 300 minutes. Each woman was tested 6 times, 3 times with placebo and 3 times with DEX.SUBJECTS Six women with regular menstrual cycles were studied.MEASUREMENTS Plasma OH, oestradiol and Progesterone were measured by radioimmunoassay. RESULTS When expressed as maximum change from base line (AGH) mean OH responses to DEX Increased Incrementally from early (12·2 ± 2·5 μ/I), through mid (25·6 ± 33 μ/I) to late (37·2 ± 3·5 μ/I) cycle. This represents a significant effect of cycle phase on GH responses to DEX (P < 0.05). GH responses at both the mid‐cycle and the luteal the points are different from those during the follicular phase (P < 0.05) and differences between mid‐cycle and luteal phases just fall to reach significance (P < 015). Responses to placebo did not vary from baseline. Plasma oestradiol values were significantly correlated with GH responsivity to active drug throughout the cycle (P < 0.05); the same was not true of progesterone. CONCLUSION Our study has demonstrated that dexa‐methasone‐mediated GH release shows a stepwise Increase throughout the menstrual cycle.
Plasma catecholamines in patients with Addison's disease
Authors: Bornstein S. R. , Breldert M. , Ehrhart‐Bornstein M. , Kloos B. , Scherbaum W. A. 
Published: March 2008

SummaryBACKGROUND AND OBJECTIVE TWO endocrine tissues are present within the adrenal gland: the steroid producing cortical cells and the catecholamine producing chromaffin cells. Glucocorticolds occur in high concentrations in the adrenal medulla. In vitro, glucocorticolds have been shown to induce the enzyme phenyl‐N‐methyl‐transferase which is necessary for the production of adrenaline in adrenal medullary cells. The purpose of this study was to evaluate the possible significance of a local glucocorticold effect on adrenomedullary function. DESIGN Plasma catecholamine levels were measured in patients with autoimmune Addison's disease where local production of corticosterolds is deficient In the presence of intact chromaffin tissue.MEASUREMENTS Catecholamines were measured by high pressure liquid chromatography and ACTH, renin and adrenal steroids by radioimmunoassay.PATIENTS Nineteen Addisonian patients (9 females, 10 males) were treated according to a standard reglie with oral cortisone acetate (37·5 mg/day) and fludrocortisone (0·1 mg/day). All patients were clinically well.RESULTS Mean plasma adrenallne in patients with Addison's disease was significantly reduced compared to a sex and age matched control group (males (n= 10) 143 ± 36 pmol/1, controls (n= 27) 303 ± 30 pmol/1, P < 0·01; females (n= 9) 77 ± 25pmol/1, controls (n= 27) 293 ± 21 pmol, P < 0·001). The noradrenallne: adrenallne ratio was clearly higher in patients with Addison's disease (males 24 ± 4, controls 9 ± 1, P < 0·01; females 45 ± 6, controls 9 ± 1, P < 0·01CONCLUSION We conclude that the physiologically high local glucocorticold concentration may be responsible for normal adrenaline production under basal conditions.
Increased 17a‐hydroxyprogesterone response to ACTH in silent adrenal adenoma: cause or effect?
Authors: Del Monte P. , Bernasconi D. , Bertoiazzi L. , Meozzi M. , Badaracco B. , Torre R. , Marugo M. 
Published: March 2008

SummaryOBJECTIVE Recent studies suggest a possible connection between silent adrenal nodules and mild forms of 21‐hydroxylase deficiency. It remains unclear whether the enzymatic deficiency is generalized or Intrinsic to the adrenal mass. To help to clarify this, we have studied 17a‐OH‐progesterone (17OH‐P) response to ACTH stimulation in a group of patients with adrenal ‘incidentaloma’ in comparison with normal subjects. In patients who underwent surgical treatment, the test was repeated to evaluate possible modifications in 17OH‐P behaviour after resection of the adrenal mass.SUBJECTS AND METHODS Fifteen subjects with incidentally discovered asymptomatic adrenal masses were studied. Basal hormone evaluations were normal, with normal cortisol suppression after low‐dose dexamethasone. Iodocholesterol scanning, performed in 12 patients, showed normal bilateral adrenal uptake in 2 subjects and an increased uptake on the side of the lesion in 10 subjects. In every patient, ACTH stimulation was performed to evaluate the secretory response of cortisol, 17OH‐P, progesterone and dehydroeplandrosterone sulphate. An identical test was performed in 10 control subjects with normal adrenal glands, matched for age and sex.In Six patients with an adrenal lesion >3·5cm, the ACTH stimulation test was repeated one month after surgery.RESULTS The 17OH‐P response to ACTH stimulation was significantly higher in subjects with adrenal ‘Incidentaloma’ than In controls (P< 0·01). In particular, 10 subjects out of 15 (66%) evidenced a 17OH‐P peak > 18 nmol/l at 60 minutes. No differences were seen in baseline 17OH‐P or cortisol levels or in cortisol response to ACTH between the two groups. Dehydroepiandrosterone sulphate concentrations were significantly lower in patients with adrenal ‘Incidentaloma’ than in normals.In SIX patients who had an increased 17OH‐P response to ACTH on initial evaluation, the ACTH test was repeated one month after surgery. In five of these patients, 17OH‐P response to ACTH was clearly reduced, suggesting that in these cases the enzymatic defect was restricted to the adenoma. In the other patient, however, stimulated 17OH‐P levels remained unchanged. In this case, therefore, all of the adrenal tissue seems to be involved, suggesting a late‐onset 21‐hydroxylase deficiency. No significant modifications in cortisol response to ACTH were observed.CONCLUSION It seems therefore that in some cases of incidentaloma the steroidogenic enzymatic defect may be secondary to the adenomatous proliferation, while in others such defects may Induce the development of silent adrenal nodules.
The contribution of hypogonadism to the development of osteoporosis in thalassaemia major: new therapeutic approaches
Authors: Anapllotou Margarita L. G. , Kastanias Isidoros T. , Psara Panagiota , Evangelou Evangelos A. , Liparaki Maria , Dimitriou Panaglotis 
Published: March 2008

SummaryOBJECTIVE The osteoporosis seen in thaiassaemia major is of multifactorial origin. The aim of the study was to evaluate the contribution of hypogonadism to the development of this osteoporosis and to assess the efficacy of new sex hormone replacement therapy regimens.DESIGN AND PATIENTS Sixty‐Seven patients were studied: 12 were hypogonadal, 32 had been on previous hormone replacement therapy (conjugated oestrogens plus medroxyprogesterone for females, depot testosterone esters for males): 10 had received continuous courses of treatment and 22 3‐monthly on/off courses, and 22 were eugonadal without previous replacement therapy. Twenty‐seven of the above patients were evaluated prospectively at 16 and 32 months during different therapeutic approaches (12 without treatment, 7 on continuous replacement and 8 on/off schemes followed by continuous therapy during the second observation period). The continuous schemes comprised either trans‐dermal oestradiol (100 μg) plus medroxyprogesterone for females or hCG to produce serum testosterone concentrations within normal range, for males.MEASUREMENTS Bone mineral density (BMD) and bone mineral content (BMC) of lumbar spine and distal end of radius were measured by dual‐energy X‐ray absorptiometry.RESULTS Spinal BMD was found to be more than 30% lower than that of controls matched for sex and age with no difference between sexes. Radial BMD was less impaired and showed significantly (P<0·01) higher levels in males (decrease of 5·8±2·3, mean±SD) than In femalea (‐14·5±3·4%, mean±SD). In the retrospective evaluation it was found that the hypogonadal group had the lowest (P<0·0001) BMD levels (0·62±0·01, mean ± SE) and the highest were observed on the continuous replacement group (0·83 ± 0·04), whereas the values of the other groups were similar. In a multiple regression analysis model it was found that only sex steroid levels were related to the BMD measurements (for oestradiol t=2·6, P= 0·01 and for testosterone t= 6·5, P= 0·0001), whereas parameters related to haemolytic anaemia and desferrioxamine treatment were not. In the prospective study the continuous replacement group increased BMD and BMC values more than the on/off treatment courses (P= 0·01).CONCLUSIONS Hypogonadism seems to play an important role in the development of osteopenia‐osteoporosis in thalassaemia major; continuous hormone replacement therapy with transdermal oestrogen for females or hCG for responding males best improves the bone density parameters.
Characteristics of acromegalic patients with a good response to octreotide, a somatostatin analogue
Authors: Yang I.M. , Woo J.T. , Kim S.W. , Kim J.W. , Kim Y.S. , Choi Y.K. 
Published: March 2008

SummaryBACKGROUND AND OBJECTIVES In GH‐secreting pituitary tumours somatostatin receptor density has been correlated with octreotide responsiveness. Little is known about the other endocrine characteristics of patients with good responses to octreotide. The purpose of this study was to determine the characteristics of these patients.PATIENTS We studied 30 patients with active acromegaly. Five had been treated with either transsphenoidal adenomectomy or conventional radiotherapy without cure of GH excess.DESIGN Patients were divided into good or poor octreotide responders. Patients whose GH level decreased to less than 20% of basal and below 20 mU/l after a subcutaneous injection of 100 μg of octreotide were defined as good octreotide responders. We compared tumour size, basal GH secretory pattern, responses to TRH, GnRH and bromocriptine, and mutation of the α‐subunit of stimulatory GTP‐binding protein (Gα) between the two groups.MEASUREMENT Tumour size was determined by CT or MRI. Basal GH level was measured hourly between 0800 and 1600 h. GH responses to TRH and GnRH were measured every 30 minutes for 2 hours, and the GH response to oral bromocriptine was measured hourly for 6 hours. The mutation of Gα gene between codons 184 and 251 was examined by direct sequencing using PCR in 5 patients of each group whose tumour tissues were available for the genomic DNA extraction.RESULTS Seventeen patients (57%) were good octreotide responders (group I) and 13 (43%) were poor responders (group II). The mean age, sex, tumour size, tumour grade and the basal OH secretory pattern were not significantly different between the two groups. Group I responded more frequently than group II to TRH (65 vs 25%). Fifty‐three per cent of group I patients and none of group II were good bromocriptine responders. Forty‐one per cent of group I patients responded to both TRH and bromocriptine. Three of 5 group I tumours had point mutations at codon 201 of the Gα, gene, none of 5 group II tumours had mutations. CGT(Arg) was replaced with TGT(Cys) in two tumours and with AGT(Ser) in one. No mutations were found at codon 227. All three tumours with mutations were from patients responsive to TRH. Two of the three were also good bromocriptine responders.CONCLUSIONS These data Suggest that good octreotide responders are more likely to respond to TRH or bromocriptine. Good octreotide responders may include subgroups with different levels of TRH and dopamine receptor expression. A possible relation between octreotide response and the mutation of Gα gene should be investigated.
Two cases of Wegener's granulomatosis involving the pituitary
Authors: Roberts G. A. , Eren E. , Sinclair H. , Pelling M. , Burns A. , Bradford R. , Maurice‐Williams R. , Black C. M. , Finer N. , Bouloux P‐M. G. 
Published: March 2008

SummaryWe describe two patients with Wegener's granulomatosis Involving the pituitary. The diagnosis of Wegener's granulomatosis was inferred from the histological appearance of biopsy tissue and the presence of anti‐neutrophil cytoplasmic antibodies with cytoplasmic distribution in the first case, in which disease remained confined to the pituitary, causing anterior and posterior pituitary dysfunction. In the second case the diagnosis was made by the progressive Involvement of other organ systems, compatible histology and the presence of anti‐neutrophil cytoplasmic antibodies with cytoplasmic distribution. In neither patient did posterior pituitary dysfunction respond to immunosuppressive therapy, despite remission of other features of systems vasculitis. Panhypopituitarism in association with isolated pituitary Wegener's granulomatosis has not previously been described.
The effects of high altitude on hypothalamic‐pituitary secretory dynamics in men
Authors: Ramirez German , Herrera Rafael , Plneda David , Blttle Polly A. , Rabb Hamld A. , Bercu Barry B. 
Published: March 2008

SummaryOBJECTIVE Individuals adapted to high altitude (HA) have abnormalities In endocrine function and specifically In the pituitary‐thyroid axis and aldosterone regulation. In this study we assessed hypothalamic‐pituitary function In men adapted to high altitude living using exogenous administration of synthetic hypothalamic hormonesDESIGN Growth hormone releasing hormone (Geref 1‐29) 1 /μg/kg, TRH 500/μg, GHRH 100 μg and ovine cortlcotro‐phin releasing hormone (oCRH) 1 μg/kg were simultaneously administered Intravenously to two groups of men: 12 born and raised In the city of Pasto, Colombia, South America, located at an altitude of 2600 m In the southern Colombian Andes (HA group) and 10 men living at sea level (SL) in Tampa, FloridaMEASUREMENTS The following hormones were measured: GH, IGF‐I, TSH, T4, free T4, free T3, PRL, ACTH, β‐endorphln and Cortisol. IGF binding proteln‐3 (IGFBP‐3) and Cortisol binding globulin (CBG) were also measured.RESULTS G H response to G H R H In HA men was exaggerated compared to SL men, and I G F‐I concentration was also significantly Increased In the presence of normal levels of IGFBP‐3. No differences in T S H or P R L responses were found following TRH. HA men had lower basal total T4 levels, but higher free T4 and free T3 concentrations. The basal ACTH concentrations in the HA men were significantly lower than SL, although the response to oCRH was still present. β‐Endorphln basal levels were similar at HA and SL but the response to oCRH at HA was blunted. At HA, basal Cortisol levels as well as C B G were elevated compared to SL and, In contrast to SL, did not increase significantly after endogenous ACTH secretion.CONCLUSIONS This study Is the first description of exaggerated G H response to the administration of G H R H In HA men and also of a significant increase in I G F‐I concentration in the same subjects in the presence of normal levels of IGFBP‐3. An altered hypothalamic‐pituitary response was found in HA men after administration of oCRH characterized by a significantly lower basal ACTH concentration at HA, although the response to oCRH was present but the β‐endorphin response to oCRH was blunted. At HA, basal Cortisol levels, as well as C B G, were elevated and the Cortisol levels did not significantly Increase after endogenous ACTH secretion. We have characterized the differences in hypothalamic‐pituitary dynamics after the administration of TRH, GnRH and oCRH In HA men comparing their response to age/ sex matched SL men