Glucagon response to arginine stimulation in obese and diabetic children.

The effect of arginine infusion on blood sugar and plasma levels of growth hormone and glucagon has been studied in children with clinical diabetes mellitus and in obese children with normal carbohydrate tolerance. Basal levels of plasma GH are significantly lower in obese children than in diabetics and controls; in obese subjects the increment of GH is significantly lower than in diabetics and controls. Basal plasma glucagon levels are comparable in all three groups despite the high sugar levels in diabetic patients. After arginine infusion there is a significant rise in glucagon levels without significant differences between the three groups.

Effect of physical exercise on secretion of growth hormone, glucagon, and cortisol in obese and diabetic children.

The effect of muscular exertion of moderate intensity on blood sugar (BS), plasma levels of growth hormone (GH), glucagon, and cortisol (F) has been studied in endocrinologically normal children with short stature and compared with children with clinical diabetes mellitus and obese children with normal and diminished carbohydrate tolerance. In diabetic children, physical exertion induces a rise in plasma GH levels comparable to that in controls; in obese children with normal or with diminished glucose tolerance, the rise is considerably smaller. Physical exertion caused no change in F levels in the groups tested, although basal level in the obese children was significantly higher than in the controls. Basal glucagon levels were similar in all groups and showed no change on physical exertion. The behavior of GH and glucagon in diabetic children was comparable to that in the controls even where blood sugar level was high.

Effect of somatostatin on blood sugar, plasma growth hormone, and glucagon levels in diabetic children.

In nine children with clinically overt insulin-dependent diabetes mellitus the authors injected cyclic somatostatin (3 mug./kg. bolus, followed by infusion of 13 mug./kg. in 60 minutes) and measured blood glucose, plasma growth hormone, and glucagon concentrations throughout the infusion. The rapid administration produced no significant changes of these parameters. With the prolonged infusion there was a significant reduction of blood glucose from a mean of 148 +/- 19.7 to a mean of 88.5 +/- 18.1 mg./100 ml. (P less than 0.005) and of plasma glucagon from a basal mean of 33.3 +/- 2.4 to a minimum mean of 22.1 +/- 1.7 pg./ml. (P less than 0.01). There was a statistically significant correlation between the two parameters (0.01 less than P less than 0.05). Plasma GH values also diminished during the infusion, but the reduction was not statistically significant. These results show that somatostatin lowers blood glucose concentrations as a secondary effect of inhibition of glucagon secretion. Somatostatin is not suitable for therapy in diabetes. We speculate that a similar substance with a more prolonged and specific action on glucagon might prove of practical value in the treatment of diabetes mellitus.

C-peptide response to arginine stimulation in diabetic children.

The extent and the clinical significance of residual beta cell function has been evaluated by radioimmunoassay of C-peptide in 41 diabetic children in different stages of evolution, using an arginine tolerance test. In control subjects a significant rise of C-peptide levels occurred after the infusion with arginine. In patients at the onset of the disease and in patients not in the remission stage, C-peptide levels showed no increment and basal values were significantly lower than in healthy control children. Children during the remission phase showed basal and peak values not significantly different from controls. A positive correlation was found between highest CPR levels compared to basal CPR values and to the age at onset of diabetes; a negative correlation was found between the duration of the disease and insulin requirement.

The effect of alpha1-24-corticotropin on growth hormone release in prepubertal children.

The effect of alpha1-24-corticotropin-Zn on the results of pituitary stimulation tests (moderate standardized physical exercise, arginine infusion, insulin-induced hypoglycemia) was studied in 27 prepubertal children with non-endocrine retardation of growth and development. After administration of 1 mg alpha1-24-corticotropin, the basal blood glucose and plasma cortisol levels rose significantly. However, the growth hormone increase after the three stimulation tests was significantly lower than without the corticotropin injection. The results demonstrate the inhibiting effect of alpha1-24-corticotropin on growth hormone secretion.

Muscular exertion: a test of pituitary function in children.

The elevated level of growth hormone after moderate standardized physical exercise was compared with that induced by intravenous arginine infusion and by insulin induced hypoglycemia in children with normal pituitary function. Tests were performed on 49 prepubertal children (34 boys and 15 girls); in 42 cases the increase was significant for all three tests, in 5 cases the response was minimal after insulin stimulation but normal after arginine and physical exertion; in 1 case arginine produced no response but the other tests were positive; in 1 case there was a response to arginine but none to insulin or physical exertion. The results indicate that frequently more than one test is necessary for the diagnosis of normal pituitary function; physical exertion being a physiologic test, is simple to perform, acceptable to the children and without side effects. It appears the test of first choice because it can be used in patients seen ambulatorily, other tests being performed in case of doubt or negative response.

[Evaluation of arterial pressure in the first 3 days of life in a group of healthy newborn infants weighing between 2000 and 4600 g at birth]. / Valutazione della pressione arteriosa nei primi tre giorni di vita in un gruppo di neonati sani con peso alla nascita da 2000 a 4600 g.

Systolic, mean and diastolic arterial pressure (AP) was measured on the first and third days of life in a group of 270 infants born in our Hospital. The aim of this work is to see if there are modifications of AP in the first 3 days of life, and correlations between AP and weight at birth, gestational age, and different methods of delivery. Gestational age was between 34 and 42 weeks and birth weight between 2000 and 4600 grams. We excluded infants who developed any illness, those with a low Apgar score, and those whose mothers were given antihypertensive drugs. None of the examined infants received transfusion or drug which could affect the AP. Blood pressure was measured using the automatic oscillometric method. The infant's group was divided into 6 subgroups according to weight (table 1). For statistical analysis we used linear regressions and Student's "t" test. According to our data no correlation was found between birth weight and AP, nor between AP and gestational age; results obtained from other studies concerning this subject didn't agree. On the other and, we found an increase of values of AP in the third day; this agrees with the results of other Authors and is considered a consequence of the rise in peripheral vascular resistance in the postanal period. No difference was observed between the AP values of infants born by normal delivery and cesarean section.

Type 1 diabetes and Coxsackie virus infection.

The role played by viruses in the aetiopathogenesis of type 1 diabetes mellitus has been studied by several authors; in particular the importance of Coxsackie virus B4 infection has been stated by some authors and not confirmed by others. 43 diabetic children were studied at the time of the diagnosis of the disease. No viruses could be isolated from stools; the titres of anti-Coxsackie viruses B1 to 6 complement fixing antibodies and anti-Coxsackie virus B4 neutralizing antibodies, compared to controls, indicated that Coxsackie virus infection was not associated with the onset of diabetes in these children. A cross-reaction with anti-Coxsackie viruses sera and a human pancreas demonstrated that there are not antigens in common between these viruses and the human pancreas.

Soy allergy is not common in atopic children: a multicenter study.

The aim of the present study was to evaluate the prevalence of soy allergy (positive skin test and positive challenge test) in a large cohort of atopic children, many of them soy fed early in life for several months. In order to investigate the prevalence of soy allergy, two groups of children were enrolled into the study. The first group comprised a cohort of 505 children with personal history suggestive of food allergy. The second group included 243 children born of atopic parents, who had been soy protein formula fed for the first six months of life for the prevention of cow's milk allergy and who had been prospectively followed up, from birth to 5 years. As regards the prevalence of soy allergy in the cohort of children suffering from allergic disease: 31/505 children (6%) had positive skin prick test to soy, however only six of the 31 children with positive skin prick test to soy had positive challenge test to soy. With regard to the prevalence of soy allergy in the children who had been soy protein formula fed in the first six months of life (second group): 14/243 children (6%) had positive skin prick test to soy, but the double blind placebo control oral food challenge to soy was positive in only one of these 14 children. In conclusion documented soy allergy is not common in atopic children.