DHEA, DHEAS and prolactin correlate with glucose control parameters in women of fertile age with type-1 diabetes mellitus.

The aim of our work was to provide data from women of fertile age with type 1 diabetes mellitus about the endogenous androgens and on their relations to the parameters of diabetes control. Forty-two women were examined, they did not use contraceptives for at least three months prior to the examination. A multivariate regression analysis showed that the daily insulin dose, the fasting glycemia and the HbA1c values and patient's age correlated negatively with dehydroepiandrosterone sulfate, dehydroepiandrosterone and prolactin levels. The testosterone/dehydroepiandrosterone sulfate ratio correlated positively with daily insulin dose and patient's age. In contrast to adrenal androgens the values of other hormones, including total and free testosterone, androstenedione, dihydrotestosterone, estradiol, LH, FSH, 17-OH-P, progesterone and cortisol revealed no significant correlation. To conclude, significant relations between the glucose control parameters and the adrenal androgens and prolactin were demonstrated. These relationships should be considered as an important factor influencing diabetes control so the additional cardiovascular risk in women with DM1.

T2D risk haplotypes of the TCF7L2 gene in the Czech population sample: the association with free fatty acids composition.

The association of transcription factor 7-like 2 (TCF7L2) gene variants with the pathogenesis of T2D, gestational diabetes and polycystic ovary syndrome (PCOS) was examined. The study involved 1460 individuals: 347 T2D patients (D); 261 gestational diabetics (G); 147 offspring of T2D (O); 329 women with PCOS, and 376 controls (C). The SNPs: rs7901695; rs7903146; rs12255372 in the TCF7L2 gene were genotyped. Anthropometric and biochemical parameters, oGTT derived indices were assessed. In addition, free fatty acids (FFAs) were evaluated in 183 non-diabetic women. The CTT haplotype showed the strongest association with T2D with OR 1.57, p=0.0003. The frequency of the CTT/CTT haplotype was decreasing in following order: D 10.6, O 9.5, G 6.1, C 5.3 and PCOS 4.9 [%]. Among CTT carriers, significantly decreased levels of oGTT-stimulated insulin and C-peptide as well as proportions of fasting PUFAs were observed. The carriership of CTG/TCG was associated with gestational diabetes, OR 2.59, p=0.036. The association of TCF7L2 haplotypes with T2D and gestational diabetes but not with PCOS was confirmed. Novel association of TCF7L2 with FFAs composition was found.

Changes of plasma obestatin, ghrelin and NPY in anorexia and bulimia nervosa patients before and after a high-carbohydrate breakfast.

Peptides ghrelin, obestatin and neuropeptide Y (NPY) play an important role in regulation of energy homeostasis, the imbalance of which is associated with eating disorders anorexia (AN) and bulimia nervosa (BN). The changes in ghrelin, obestatin and NPY plasma levels were investigated in AN and BN patients after administration of a high-carbohydrate breakfast (1604 kJ). Eight AN women (aged 25.4+/-1.9, BMI: 15.8+/-0.5), thirteen BN women (aged 22.0+/-1.05, BMI: 20.1+/-0.41) and eleven healthy women (aged 25.1+/-1.16, BMI: 20.9+/-0.40) were recruited for the study. We demonstrated increased fasting ghrelin in AN, but not in BN patients, while fasting obestatin and NPY were increased in both AN and BN patients compared to the controls. Administration of high-carbohydrate breakfast induced a similar relative decrease in ghrelin and obestatin plasma levels in all groups, while NPY remained increased in postprandial period in both patient groups. Ghrelin/obestatin ratio was lower in AN and BN compared to the controls. In conclusions, increased plasma levels of fasting NPY and its unchanged levels after breakfast indicate that NPY is an important marker of eating disorders AN and BN. Different fasting ghrelin and obestatin levels in AN and BN could demonstrate their diverse functions in appetite and eating suppression.

Evaluation of hepatic 11 beta-hydroxysteroid dehydrogenase activity by cortisone acetate test in young adults with diabetes mellitus type 1.

Cortisone acetate test was performed in twelve young adult patients with diabetes mellitus type 1, after dexamethasone administration to suppress endogenous cortisol production. Previous screening revealed that all of the subjects had peak cortisol responses in the range from subnormal to normal, as determined by a low-dose Synacthen test. The aim was to find out whether these patients would exhibit different conversion of cortisone to cortisol by 11beta-hydroxysteroid dehydrogenase. Using multifactorial ANOVA the following significant relationships were obtained between cortisol or cortisol/cortisone ratio measured during the test and other parameters examined a) before dexamethasone suppression and b) during the test: a) Cortisol at 120(th) minute negatively correlated with daily insulin dose and positively with basal aldosterone. Cortisol/cortisone ratio at 60(th), 120(th), 180(th), and 240(th) minute negatively correlated with basal aldosterone/plasma renin activity ratio, urinary free cortisol/24 hours and positively with basal dehydroepindrosterone sulphate. b) Cortisol at 120(th) minute negatively correlated with suppressed basal serum glycemia; cortisol/cortisone ratio during the whole test negatively correlated with supressed basal ACTH. The examination of peripheral metabolism of cortisol using cortisone acetate test in patients with diabetes mellitus type 1 showed adaptive changes of 11beta-hydroxysteroid dehydrogenace activity associated with altered cortisol tissue supply.

[Birth weight and genetic risk of type 2 diabetes in Czech population]. / Porodní hmotnost a genetické pozadí rizika diabetes mellitus 2. typu u ceské populace.

INTRODUCTION: Birth weight is associated with type 2 diabetes mellitus and other late-onset metabolic diseases. Reduced birth weight is associated with an increased risk of insulin resistance, type 2 diabetes, and atherosclerosis. Also high birth weight represents risk factor for development of type 2 diabetes later in life. In this study, we investigate whether type 2 diabetes risk-confering alleles and biochemical as well as anthropometrical type 2 diabetes risk markers associate with birth weight in our Czech cohort. RESULTS: Association between high birth weight and higher BMI in adulthood was found. Low birth weight was associated with higher glycaemia and insulinaemia as well as lower peripheral insulin sensitivity during oGTT. The examination of candidate genes provides evidence that Ngn3 and PPARalpha are involved in final birth weight regulation. CONCLUSION: According to our results, we suggest that birth weight should be an integral part of medical history record.

[Neuropeptide Y, ghrelin and leptin plasma levels in anorexia nervosa patients and their changes during six-week refeeding]. / Plazmatické hladiny neuropeptidu Y, ghrelinu a leptinu a pacientek s anorexia nervosa a jejich zmeny po sestitýdenní realimentaci.

OBJECTIVE: Anorexia nervosa (AN) is characterized by markedly changes in hormone secretion influencing food intake, energy homeostasis and long-term body weight regulation. The aim of this study was to determine neuropeptide Y (NPY), ghrelin and leptin plasma levels and their changes after six weeks of nutritional-rehabilitation program in severely malnourished anorexia nervosa patients. METHODS: Ten women with DSM-IV diagnosed anorexia nervosa, hospitalized (BMI 14.74 +/- 0.43; age 23.3 +/- 1.0) and ten age-matched healthy women (BMI 21.45 +/- 0.72; age 24.3 +/- 0.8) were enrolled to the study. Fasting plasma levels of NPY, ghrelin and leptin were measured before and after the treatment. RESULTS: Fasting plasma ghrelin and NPY levels were significantly increased in AN patients comparing to healthy women, while plasma leptin was decreased. After six weeks of the treatment plasma ghrelin levels significantly decreased and plasma leptin levels increased. Plasma NPY levels didn't change during the treatment, average BMI significantly increased in AN patients. CONCLUSIONS: We confirmed that ghrelin and leptin plasma levels express actual nutritional status of a body and did change during the six-weeks refeeding in AN patients. Plasma leptin levels together with constantly increased NPY levels indicate to persisting dysregulation of appetite and body weight control mechanisms in AN patients.

Simultaneous decrease of plasma obestatin and ghrelin levels after a high-carbohydrate breakfast in healthy women.

Ghrelin is a gut peptide produced mainly by stomach, well known to induce appetite stimulatory actions. Obestatin, a recently identified peptide derived from preproghrelin, was initially described to antagonize stimulatory effect of ghrelin on food intake. The postprandial response of obestatin and its relationship with ghrelin in humans remains unknown. We therefore investigated the postprandial response of obestatin and total ghrelin, acyl and desacyl ghrelin and neuropeptide Y (NPY) to a high-carbohydrate breakfast (1 604 kJ) in eight healthy women (age: 24.2+/-0.82 years; BMI 21.6+/-0.61 kg/m(2)). Blood samples were collected before the meal, and 30, 60, 90, 120 and 150 min after the breakfast consumption. Postprandial plasma obestatin concentrations significantly decreased compared with preprandial levels as well as total ghrelin concentrations and reached the lowest values 90 and 120 min after the meal consumption, respectively (p<0.05). Plasma acyl and desacyl ghrelin concentrations decreased after the breakfast and reached lowest values in 30 and 60 min, respectively (p<0.05). Plasma NPY concentrations were lower than preprandial levels 90 and 150 min after consuming breakfast (p<0.05). In conclusion, we demonstrated in healthy young women that plasma obestatin concentrations decrease similarly to ghrelin after a high-carbohydrate breakfast.

The UCP1 gene polymorphism A-3826G in relation to DM2 and body composition in Czech population.

UNLABELLED: Mitochondrial uncoupling contributes to the control of energy expenditure. The brown fat specific uncoupling protein 1 (UCP1) mRNA was detected in intraperitoneal and extraperitoneal adipose tissue in adult humans. The A-3826G polymorphism in the UCP1 gene promoter region was found to be associated with reduced mRNA expression indicating that the polymorphism is of functional importance. OBJECTIVE: To determine allelic frequencies and genotypic distribution of the A-3826G polymorphism and to study its possible association with anthropometric parameters and biochemical markers of glucose and lipid metabolism in type 2 diabetes mellitus (DM2) patients (n=295), in offspring of DM2 patients (n=113), and in healthy adults without family history of DM2 (n=120). RESULTS AND DISCUSSION: In the whole cohort of 528 subjects, the G allele was observed with a frequency of 0.26. Genotypic distribution did not differ between diabetics and controls. However, in the offspring of DM2 patients, significantly higher BMI and a trend towards higher waist to hip ratio, waist to height ratio, waist circumference, and subcutaneous fat mass was observed in the AG genotype compared with the wild-type. Similar tendency was evident in the control group. This indicates possible involvement of the A-3826G polymorphism in the regulation of body composition.

Increased insulin sensitivity in patients with anorexia nervosa: the role of adipocytokines.

Anorexia nervosa (AN) is characterized by self-induced starvation leading to severe weight and fat loss. In the present study, we measured fasting plasma levels of adiponectin, leptin, resistin, insulin and glucose in 10 women with a restrictive type of AN and in 12 healthy women (C). Insulin sensitivity was determined according to homeostasis model assessment of insulin resistance (HOMA-R). Plasma resistin, leptin and insulin levels were significantly decreased, whereas plasma adiponectin levels were significantly increased in patients with AN compared to the C. HOMA-R was significantly decreased in patients with AN compared to the C group. Plasma adiponectin and leptin concentrations negatively and positively correlated with the body mass index and percentage body fat in both groups. Plasma adiponectin levels were negatively related to plasma insulin levels in the AN group only. In conclusion, we demonstrated that AN is associated with significantly decreased plasma leptin and resistin levels, markedly increased plasma adiponectin levels and increased insulin sensitivity. Plasma leptin and adiponectin levels were related to the body size and adiposity. Hyperadiponectinemia could play a role in increased insulin sensitivity of patients with AN. Neither body size and adiposity nor insulin sensitivity are the major determinants of plasma resistin levels in AN.

[The role of adiponectin in increased insulin sensitivity of patients with anorexia nervosa]. / Uloha adiponektinu pri zvýsené inzulinové senzitivite u pacientek s anorexia nervosa.

The aim of the present study was to determine the relationship between plasma levels of adipocytokine adiponectin and the degree of insulin sensitivity in patients with anorexia nervosa (AN). AN is a psychiatric disorder characterized mainly by severe malnutrition and loss of body fat. We measured fasting plasma adiponectin, insulin and glucose levels in ten women with a restrictive type of AN and in twelve healthy normal-weight women. Plasma adiponectin levels were significantly increased in patients with AN compared to healthy women (p < 0.01) and were negatively related to body mass index and percent body fat in both groups. Plasma adiponectin levels were negatively related to plasma insulin levels in the AN group only. Using homeostasis model assessment of insulin resistance (HOMA-IR), we found significantly increased insulin sensitivity in patients with AN compared to control women (p < 0.05). In conclusion, hyperadiponectinemia in patients with AN might contribute to increased insulin sensitivity in these patients.

[Serious manifestation of primary hypothyroidism]. / Závazná manifestace primární hypotyreózy.

Thyroid gland diseases are the most frequent endocrinopathy and can be often seen in adult population. They occur at least by 5% of the population and the occurence increases with age, in females aging 45 and more, as thyroid gland diseases in this age group are represented approximately by 20%. Due to a complex influence of thyroid hormones in humans, diagnosis of thyroid disease may remain unsuspected under other disease with typical symptoms; the most serious of them is cardiogenic manifestation. When thyroid disease suspected, methods of diagnostics are very comprehensive and broad. Treatment on time can prevent serious complications. Case-study presenting a female patient with untreated primary hypothyroidism that had caused serious cardiac symptoms.

Increased lipolysis of subcutaneous abdominal adipose tissue and altered noradrenergic activity in patients with Cushing's syndrome: an in-vivo microdialysis study.

Cushing's syndrome is associated with typical central redistribution of adipose tissue. The aim of the study was to assess lipolysis and catecholamines and their metabolites in subcutaneous abdominal adipose tissue using an in-vivo microdialysis technique. Nine patients with Cushing's syndrome and nine age-, gender- and body mass index (BMI)-matched control subjects were included in the study. Local glycerol concentrations were significantly increased in subcutaneous adipose tissue of patients with Cushing's syndrome (p<0.001). Plasma noradrenaline, dihydroxyphenylglycol and dihydroxyphenylalanine were decreased in patients with Cushing's syndrome (p<0.02, p<0.05, and p<0.02, respectively). Adrenaline, noradrenaline, dihydroxyphenylglycol and dihydroxyphenylalanine concentrations in subcutaneous abdominal adipose were non-significantly higher in patients with Cushing's syndrome. In conclusion, we showed that lipolysis in subcutaneous adipose tissue of patients with Cushing's syndrome is significantly increased as compared to healthy subjects. This finding together with non-significantly increased local catecholamine concentrations in these patients suggests a possible link between increased lipolysis and catecholaminergic activity in subcutaneous adipose tissue.