ABSTRACT
Ceramides are sphingolipids with a structural function in the cell membrane and are involved in cell differentiation, proliferation and apoptosis. Recently, these chemical species have been pointed out as potential biomarkers in different diseases, due to their abnormal levels in blood. In this research, we present an overall strategy combining data-independent and dependent acquisitions (DIA and DDA, respectively) for identification, confirmation, and quantitative determination of ceramides in human serum. By application of liquid chromatography-tandem mass spectrometry (LC-MS/MS) method in DIA mode we identified 49 ceramides including d18:1, d18:0, d18:2, d16:1, d17:1 and t18:0 species. Complementary, quantitative determination of ceramides was based on a high-throughput and fully automated method consisting of solid-phase extraction on-line coupled to LC-MS/MS in DDA to improve analytical features avoiding the errors associated to sample processing. Quantitation limits were at pg mL-1 level, the intra-day and between-days variability were below 20 and 25 %, respectively; and the accuracy, expressed as bias, was always within ±25 %. The proposed method was tested with the CORDIOPREV cohort in order to obtain a qualitative and quantitative profiling of ceramides in human serum. This characterization allowed identifying d18:1 ceramides as the most concentrated with 70.8% of total concentration followed by d18:2 and d18:0 with 13.0 % and 8.8 %, respectively. Less concentrated ceramides, d16:1, d17:1 and t18:0, reported a 7.1 % of the total content. Combination of DIA and DDA LC-MS/MS analysis enabled to profile qualitative and quantitatively ceramides in human serum.
Subject(s)
Ceramides , Tandem Mass Spectrometry , Humans , Chromatography, Liquid , Sphingolipids , ApoptosisABSTRACT
The intertidal rocky shores in continental Chile have high species diversity mainly in northern Chile (18-27° S), and one of the most widespread species is the gastropod Echinolittorina peruviana (Lamarck, 1822). The aim of the present study is do a first characterization of spatial distribution of E. peruviana in along rocky shore in Antofagasta town in northern Chile. Individuals were counted in nine different sites that also were determined their spectral properties using remote sensing techniques (LANDSAT ETM+). The results revealed that sites without marked human intervention have more abundant in comparison to sites located in the town, also in all studied sites was found an aggregated pattern, and in six of these sites were found a negative binomial distribution. The low density related to sites with human intervention is supported when spectral properties for sites were included. These results would agree with other similar results for rocky shore in northern and southern Chile.
As costas rochosas entremarés no Chile continental apresentam alta diversidade de espécies, principalmente no norte do país (18-27 ° S), e uma das espécies mais difundidas é o gastrópode Echinolittorina peruviana (Lamarck, 1822). O objetivo do presente estudo é fazer uma primeira caracterização da distribuição espacial de E. peruviana no costão rochoso da cidade de Antofagasta no norte do Chile. Os indivíduos foram contados em nove locais diferentes onde também foram determinadas suas propriedades espectrais usando técnicas de sensoriamento remoto (LANDSAT ETM +). Os resultados revelaram que os locais sem intervenção humana marcada apresentam maior abundância em comparação aos locais localizados no município. Também em todos os locais estudados foi encontrado um padrão agregado, sendo que em seis desses locais foi encontrada uma distribuição binomial negativa. A baixa densidade relacionada a sites com intervenção humana é suportada quando as propriedades espectrais para sites foram incluídas. Esses resultados concordariam com outros resultados semelhantes para costões rochosos no norte e no sul do Chile.
Subject(s)
Animals , Marine Environment , Coasts , Gastropoda/growth & development , Remote Sensing Technology , Binomial DistributionABSTRACT
Abstract The intertidal rocky shores in continental Chile have high species diversity mainly in northern Chile (18-27° S), and one of the most widespread species is the gastropod Echinolittorina peruviana (Lamarck, 1822). The aim of the present study is do a first characterization of spatial distribution of E. peruviana in along rocky shore in Antofagasta town in northern Chile. Individuals were counted in nine different sites that also were determined their spectral properties using remote sensing techniques (LANDSAT ETM+). The results revealed that sites without marked human intervention have more abundant in comparison to sites located in the town, also in all studied sites was found an aggregated pattern, and in six of these sites were found a negative binomial distribution. The low density related to sites with human intervention is supported when spectral properties for sites were included. These results would agree with other similar results for rocky shore in northern and southern Chile.
Resumo As costas rochosas entremarés no Chile continental apresentam alta diversidade de espécies, principalmente no norte do país (18-27 ° S), e uma das espécies mais difundidas é o gastrópode Echinolittorina peruviana (Lamarck, 1822). O objetivo do presente estudo é fazer uma primeira caracterização da distribuição espacial de E. peruviana no costão rochoso da cidade de Antofagasta no norte do Chile. Os indivíduos foram contados em nove locais diferentes onde também foram determinadas suas propriedades espectrais usando técnicas de sensoriamento remoto (LANDSAT ETM +). Os resultados revelaram que os locais sem intervenção humana marcada apresentam maior abundância em comparação aos locais localizados no município. Também em todos os locais estudados foi encontrado um padrão agregado, sendo que em seis desses locais foi encontrada uma distribuição binomial negativa. A baixa densidade relacionada a sites com intervenção humana é suportada quando as propriedades espectrais para sites foram incluídas. Esses resultados concordariam com outros resultados semelhantes para costões rochosos no norte e no sul do Chile.
ABSTRACT
Abstract The intertidal rocky shores in continental Chile have high species diversity mainly in northern Chile (18-27° S), and one of the most widespread species is the gastropod Echinolittorina peruviana (Lamarck, 1822). The aim of the present study is do a first characterization of spatial distribution of E. peruviana in along rocky shore in Antofagasta town in northern Chile. Individuals were counted in nine different sites that also were determined their spectral properties using remote sensing techniques (LANDSAT ETM+). The results revealed that sites without marked human intervention have more abundant in comparison to sites located in the town, also in all studied sites was found an aggregated pattern, and in six of these sites were found a negative binomial distribution. The low density related to sites with human intervention is supported when spectral properties for sites were included. These results would agree with other similar results for rocky shore in northern and southern Chile.
Resumo As costas rochosas entremarés no Chile continental apresentam alta diversidade de espécies, principalmente no norte do país (18-27 ° S), e uma das espécies mais difundidas é o gastrópode Echinolittorina peruviana (Lamarck, 1822). O objetivo do presente estudo é fazer uma primeira caracterização da distribuição espacial de E. peruviana no costão rochoso da cidade de Antofagasta no norte do Chile. Os indivíduos foram contados em nove locais diferentes onde também foram determinadas suas propriedades espectrais usando técnicas de sensoriamento remoto (LANDSAT ETM +). Os resultados revelaram que os locais sem intervenção humana marcada apresentam maior abundância em comparação aos locais localizados no município. Também em todos os locais estudados foi encontrado um padrão agregado, sendo que em seis desses locais foi encontrada uma distribuição binomial negativa. A baixa densidade relacionada a sites com intervenção humana é suportada quando as propriedades espectrais para sites foram incluídas. Esses resultados concordariam com outros resultados semelhantes para costões rochosos no norte e no sul do Chile.
Subject(s)
Humans , Animals , Ecosystem , Gastropoda , ChileABSTRACT
The intertidal rocky shores in continental Chile have high species diversity mainly in northern Chile (18-27° S), and one of the most widespread species is the gastropod Echinolittorina peruviana (Lamarck, 1822). The aim of the present study is do a first characterization of spatial distribution of E. peruviana in along rocky shore in Antofagasta town in northern Chile. Individuals were counted in nine different sites that also were determined their spectral properties using remote sensing techniques (LANDSAT ETM+). The results revealed that sites without marked human intervention have more abundant in comparison to sites located in the town, also in all studied sites was found an aggregated pattern, and in six of these sites were found a negative binomial distribution. The low density related to sites with human intervention is supported when spectral properties for sites were included. These results would agree with other similar results for rocky shore in northern and southern Chile.
Subject(s)
Ecosystem , Gastropoda , Animals , Chile , HumansABSTRACT
PURPOSE: Obesity increases the risk of cardiovascular disease, type 2 diabetes mellitus and cancer development. Autophagy and apoptosis are critical processes for development and homeostasis in multicellular organisms and have been linked to a variety of disorders. We aimed to investigate whether the quantity and quality of dietary fat can influence these processes in the adipose tissue of obese people. METHODS: A randomized, controlled trial within the LIPGENE study assigned 39 obese people with metabolic syndrome to 1 of 4 diets: (a) a high-saturated fatty acid diet, (b) a high-monounsaturated fatty acid (HMUFA) diet, and (c, d) two low-fat, high-complex carbohydrate diets supplemented with long-chain n-3 polyunsaturated fatty acids (LFHCC n-3) or placebo (LFHCC), for 12 weeks each. RESULTS: We found an increase in the expression of autophagy-related BECN1 and ATG7 genes after the long-term consumption of the HMUFA diet (p = 0.001 and p = 0.004, respectively) and an increase in the expression of the apoptosis-related CASP3 gene after the long-term consumption of the LFHCC and LFHCC n-3 diets (p = 0.001 and p = 0.029, respectively). CASP3 and CASP7 gene expression changes correlated with HOMA index. CONCLUSION: Our results suggest that the processes of autophagy and apoptosis in adipose tissue may be modified by diet and that the consumption of a diet rich in monounsaturated fat may contribute to adipose tissue homeostasis by increasing autophagy. They also reinforce the notion that apoptosis in adipose tissue is linked to insulin resistance. CLINICAL TRIAL REGISTRATION NUMBER: ClinicalTrials.gov NCT00429195.
Subject(s)
Adipocytes/cytology , Adipose Tissue/physiopathology , Apoptosis , Autophagy , Dietary Fats/administration & dosage , Adult , Aged , Autophagy-Related Protein 7/genetics , Autophagy-Related Protein 7/metabolism , Beclin-1/genetics , Beclin-1/metabolism , Blood Glucose/metabolism , Caspase 3/genetics , Caspase 3/metabolism , Caspase 7/genetics , Caspase 7/metabolism , Diet, Fat-Restricted , Diet, High-Fat , Fatty Acids/administration & dosage , Fatty Acids, Monounsaturated/administration & dosage , Fatty Acids, Omega-3/administration & dosage , Female , Gene Expression Regulation , Homeostasis , Humans , Insulin Resistance , Male , Metabolic Syndrome/physiopathology , Middle Aged , Obesity/physiopathology , Single-Blind MethodABSTRACT
SCOPE: Heating during the process of cooking alters the chemical properties of foods and may affect subsequent postprandial inflammation. We tested the effects of four meals rich in different oils subjected to heating on the postprandial inflammatory metabolism of peripheral blood mononuclear cells (PBMCs). METHODS AND RESULTS: Twenty obese participants received four breakfasts following a randomized crossover design, consisting of milk and muffins made with different oils (virgin olive oil (VOO), sunflower oil (SFO), and a mixture of seeds oil (SFO/canola oil) with added either dimethylpolysiloxane (SOD), or natural antioxidants from olive mill wastewater alperujo (phenols; SOP)), previously subjected to 20 heating cycles. Postprandial inflammatory status in PBMCs was assessed by the activation of nuclear NF-κB, the concentration in cytoplasm of the NF-κB inhibitor (IκB-α), the mRNA levels of NF-κB subunits and activators (p65, IKKß, and IKKα) and other inflammatory molecules (TNF-α, IL-1ß, IL-6, MIF, and JNK), and lipopolysaccharide (LPS) levels. VOO and SOP breakfasts reduced NF-κB activation, increased IκB-α, and decreased LPS plasma concentration. SFO increased IKKα, IKKß, p65, IL-1b, IL-6, MIF, and JNK mRNA levels, and plasma LPS. CONCLUSION: Oils rich in phenols, whether natural (VOO) or artificially added (SOP), reduce postprandial inflammation, compared with seed oil (sunflower).
Subject(s)
Antioxidants/administration & dosage , Fatty Acids, Monounsaturated/administration & dosage , Obesity/metabolism , Phenol/administration & dosage , Plant Oils/administration & dosage , Cross-Over Studies , Dimethylpolysiloxanes/metabolism , Fatty Acids, Monounsaturated/chemistry , Food Handling/methods , Hot Temperature , Humans , I-kappa B Kinase/blood , I-kappa B Proteins/blood , Inflammation/drug therapy , Interleukin-1beta/blood , Interleukin-6/blood , Leukocytes, Mononuclear/drug effects , Leukocytes, Mononuclear/metabolism , Lipopolysaccharides/blood , Middle Aged , NF-KappaB Inhibitor alpha , NF-kappa B/blood , Obesity/physiopathology , Olive Oil , Plant Oils/chemistry , Postprandial Period , Rapeseed Oil , Sunflower Oil , Tumor Necrosis Factor-alpha/metabolismSubject(s)
Humans , Female , Infant , Pulmonary Emphysema/complications , Pulmonary Emphysema , Cystic Adenomatoid Malformation of Lung, Congenital/complications , Cystic Adenomatoid Malformation of Lung, Congenital , Cystic Adenomatoid Malformation of Lung, Congenital/surgery , Pneumonectomy , Radiography, Thoracic , Tomography, X-Ray ComputedABSTRACT
Introducción. Pocos estudios han utilizado instrumentos estandarizados para evaluar la psicopatología de los trastornos de la conducta alimentaria en niños y adolescentes. Objetivo. El objetivo de este estudio fue determinar las propiedades psicométricas de la versión en español del Cuestionario infantil para trastornos de la conducta alimentaria (CITCA). Método. Se aplicaron los siguientes instrumentos a sujetos con edades entre 7-17 años: K-SADS-PL-MX, el Test de actitudes alimentarias-40 (TAA-40) y el CITCA. Resultados. Participaron 98 mujeres, la edad promedio fue 12,5 años ± 2,5 (7-17). El coeficiente alpha de Cronbach para el total del EITCA fue de 0,92. La estructura factorial mostró que los reactivos se agruparon en dos componentes principales, los cuales explicaban el 74,4% de la varianza. La validez convergente entre el CITCA y el TAA-40 fue significativa: r = 0,832 (p = 0,01). La validez de criterio al comparar el CITCA con el K-SADS-PL-MX fue aceptable: r = 0,899(p = 0,01). El test-retest a los 15 días correlacionó positivamente: r = 0,967 (p = 0,01) (AU)
Objective. The objective of this study was to determine the psychometric properties of the Kid´s Eating Disorders Survey (KEDS)-Spanish version [Cuestionario infantil para trastornos de la conducta alimentaria (CITCA)]. Method. The following instruments were applied to subjects aged 7-17 years: K-SADS-PL-MX, Eating AttitudeTest-40 (EAT- 40) and CITCA (Spanish version of the KEDS).Results. A total of 98 females, age 12.5 + 2.5 (7-17), participated. Cronbachs alpha coefficient for the total of the KEDS was 0.92. The scale items were grouped into two main components, which accounted for 74.4% of the variance. The convergent validity between the Spanish version of the KEDS and the EAT-40 was significant: r =0.832 (p = 0.01). The criterion validity, on comparing the Spanish version of the KEDS with the K-SADS-PL-MX, was acceptable, with a r = 0.899 (p = 0.01). The test-retest at 15 days was positive: r = 0.967 (p = 0.01) (AU)
Subject(s)
Humans , Male , Female , Child , Adolescent , Psychometrics/instrumentation , Nutrition Disorders/diagnosis , Nutrition Disorders/psychology , Reproducibility of Results , Surveys and QuestionnairesABSTRACT
Cytokeratins (CK) constitute a family of cytoskeletal intermediate filament proteins that are typically expressed in epithelial cells. An abnormal structure and function are effects that are clearly related to liver diseases as non-alcoholic steatohepatitis, cirrhosis and hepatocellular carcinoma. We have previously observed that sodium arsenite (SA) induced the synthesis of CK18 protein and promotes a dose-related disruption of cytoplasmic CK18 filaments in a human hepatic cell line. Both abnormal gene expression and disturbance of structural organization are toxic effects that are likely to cause liver disease by interfering with normal hepatocyte function. To investigate if a disruption in the CK18 expression pattern is associated with arsenite liver damage, we investigated CK18 mRNA and protein levels in liver slices treated with low levels of SA. Organotypic cultures were incubated with 0.01, 1 and 10 microM of SA in the absence and presence of N-acetyl cysteine (NAC). Cell viability and inorganic arsenic metabolism were determined. Increased expression of CK18 was observed after exposure to SA. The addition of NAC impeded the oxidative effects of SA exposure, decreasing the production of thiobarbituric acid-reactive substances and significantly diminishing the up regulation of CK18 mRNA and protein. Liver arsenic levels correlated with increased levels of mRNA. Mice treated with intragastric single doses of 2.5 and 5 mg/kg of SA showed an increased expression of CK18. Results suggest that CK18 expression may be a sensible early biomarker of oxidative stress and damage induced by arsenite in vitro and in vivo. Then, during SA exposure, altered CK expression may compromise liver function.
Subject(s)
Arsenites/toxicity , Keratin-18/biosynthesis , Liver/drug effects , Animals , Keratin-18/genetics , Liver/metabolism , Male , Mice , Mice, Inbred BALB C , Oxidative Stress , RNA, Messenger/metabolism , Thiobarbituric Acid Reactive Substances/metabolismABSTRACT
Rasa Aragonesa ewes were used to evalutate whether treatment with melatonin implants in spring could modify: (i) the response to the male effect in terms of oestrous behaviour and ovulation rate; and (ii) the maintenance of sexual activity and ovulation rate at medium term, i.e. over the next 306 days. On 12 April, 42 ewes were divided into two groups, with (M; n = 21) or without (C; n = 21) a subcutaneous implant containing 18 mg melatonin. On 17 May (day 0), three aproned rams were introduced to each group to induce a ram effect. Ewes were observed for oestrus daily. The rams were removed 40 days later after which one aproned ram was introduced daily. Oestrous detection continued until 28 February, 306 days after the first male-female contact. The ovulation rate was determined by endoscopy in the first three cycles after ram introduction and in September-October and January. Progesterone was assayed from blood samples taken on 6 May, 10 and from day 0 to day 22 after ram introduction. Luteal activity before ram introduction was seen in 33% (M) and 29 (C)% of the ewes, respectively. Significantly more M ewes showed oestrous behaviour during the first 40 days after ram introduction (M: 100%; C: 62%; P < 0.01). Similar differences were observed for ewes anovulatory at ram introduction (M: 100%, C: 47%; P < 0.01). These differences were maintained over the three oestrous cycles in both groups. Treatment with melatonin implants was without detrimental effect on cyclic functions in the following breeding season, after seasonal anoestrus. Melatonin treatment significantly increased (P < 0.05) the mean ovulation rate of the first (1.62 +/- 0.11 versus 1.31 +/- 0.13), second (1.78 +/- 0.15 versus 1.36 +/- 0.15) and third cycles (M: 1.73 +/- 0.12 versus C: 1.27 +/- 0.14). There was a significant interaction between the effects of cyclicity at day 0 and melatonin treatment on the ovulation rate in the first cycle (P < 0.05). The mean ovulation rates of both groups were similar at the beginning (September) and middle (January) of the subsequent breeding season. Overall, the results confirmed that melatonin implants, combined with the ram effect, improved the reproductive parameters of reduced-seasonality ewes during spring mating, without impairing sexual activity or ovulation rate during the subsequent breeding season.
Subject(s)
Estrus/drug effects , Melatonin/administration & dosage , Ovulation/drug effects , Seasons , Sexual Behavior, Animal/drug effects , Sheep/physiology , Animals , Breeding , Drug Implants , Female , Male , Melatonin/blood , Progesterone/bloodABSTRACT
Two experiments were carried out in order to determine whether melatonin can improve secretion of progesterone in vivo, and its effect on embryonic development in vitro. In the first experiment, blood samples were collected from 5 ewes at 15 min intervals for 2 h at 7 and 10 days after withdrawal of progestagen pessaries. The first hour constituted a control period, which ended with an intravenous administration of 3 microg/(kg bw)(0.75) melatonin. All the ewes on day 7 and three of the ewes on day 10 showed a progesterone response to melatonin challenge, defined as an increase in the plasma progesterone concentration in at least two consecutive samples during the post-treatment period above the mean+2SD of the values in the pre-treatment period. A paired t-test revealed a significant effect of melatonin on the overall plasma progesterone concentrations before and after the challenge, both on day 7 (pre, 0.61 +/- 0.11; post, 0.73 +/- 0.13 ng/ml; p<0.01) and day 10 (pre, 1.16 +/- 0.19; post, 1.30 +/- 0.20 ng/ml; p<0.05). Ninety-one thawed embryos (46 morulae and 45 blastocysts) were used in the second experiment, being cultured with or without 1 microg/ml melatonin. If the embryos were blastocysts when the culture started. melatonin increased the percentage that had hatched after 24 h of culture (p<0.01), and there was a lower percentage of degenerated embryos at the end of the incubation period (p<0.05). It may be concluded that melatonin treatment in sheep can increase both fertility and prolificacy by improving luteal function and embryonic survival.
Subject(s)
Embryo, Mammalian/drug effects , Melatonin/pharmacology , Progesterone/metabolism , Sheep/blood , Sheep/embryology , Animals , Blastocyst/drug effects , Embryonic and Fetal Development/drug effects , Female , In Vitro Techniques , Morula/drug effects , Progesterone/blood , Time FactorsABSTRACT
In mid-September, 1 month before the insertion of intravaginal pessaries to induce sexual activity, blood samples were collected every 4 days from 16 ewe lambs aged 7 months, in order to determine the incidence of ovulations by measurement of plasma progesterone concentrations. It has been studied whether the response to a progestagen treatment of ewe lambs apparently close to puberty could be modified by the onset of the ovarian events preceding puberty. The effect of the presence or absence of ovulations prior to progestagen treatment on the potential reproductive performance (fertility, litter size and fecundity), embryo development [embryo quality and interferon-tau (IFNtau) secretion], luteal function (progesterone secretion in vitro) and endometrial progesterone content was studied in seven ovulating (Ov+) and nine nonovulating ewe lambs (Ov-) on day 14 after mating. The best potential reproductive results were obtained with Ov+ animals, although these differences could not be initially attributed to either different progesterone secretion in vitro or concentration of endometrial progesterone. Irrespective of the experimental groups, secretion of progesterone by luteal tissue from ewe lambs with normal embryos was significantly greater (p<0.05) than that of animals with abnormal embryos or with no embryos. Normal embryos secreted a higher amount of IFN-tau than those embryos classified as abnormal (p<0.07). In conclusion, ewe lambs which exhibit luteal activity before puberty have the highest levels of reproductive performances after a progestagen treatment. Corpora lutea from ewe lambs with normal embryos had higher rates of progesterone secretion in vitro and their embryos had a higher IFN-tau production by the embryos, indicating greater capacity for subsequent development.
Subject(s)
Corpus Luteum/physiology , Embryonic and Fetal Development/physiology , Interferon Type I/biosynthesis , Pregnancy Proteins/biosynthesis , Reproduction/physiology , Sheep/physiology , Animals , Corpus Luteum/metabolism , Endometrium/chemistry , Estrus Synchronization , Female , Pregnancy , Progesterone/analysis , Progesterone/blood , Sheep/embryologyABSTRACT
Se estudió la influencia de la realización de un cultivo y/o antibiograma en la efectividad de la terapia antimicrobiana prescrita a los pacientes internados en el Hospital Base San José del Servicio de Salud Metropolitano Norte, durante el período comprendido entre junio y agosto de 1990. Se realizó un seguimiento intensivo prospectivo con el fin de precisar el origen de la infección, identificar el germen infectante y evaluar la eficacia de la terapia. Se estudiaron 212 pacientes a los cuales se les diagnóstico un total de 236 infecciones. El 10,6%de ellas fueron de origen intrahospitalario. En el 38,6%de las terapias se tomó en cuenta el cultivo y/o antibiograma, siendo ello significativamente más frecuente para las que afectaron al sistema urinario. Se encontró influencia en la efectividad de la terapia cuando se efectuó este examen y llama la atención que las terapias inefectivas disminuyeron a la mitad cuando no se consideró esta prueba en el enfoque terapéutico
Subject(s)
Anti-Bacterial Agents/therapeutic use , Bacterial Infections/drug therapy , Microbial Sensitivity TestsSubject(s)
Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Humans , Male , Female , Biopsy , Granuloma, Giant Cell , Jaw/injuriesABSTRACT
The cause of insulin resistance in lipodystrophic diabetes is unknown but has generally been ascribed to dysfunction at either the receptor or post receptor level. In a 14 year-old girl with total acquired lipodystrophy, subcutaneous and intravenous insulin requirements approximated 600 units daily. However, circulating total and free insulin levels were not increased, and during testing by the euglycemic clamp method, the glucose response to increasing free insulin concentrations was within the range found in eight subjects with insulin-dependent diabetes. Insulin clearance during the euglycemic clamp was 43, 98, 115, and 116 mL/kg/min at each of four insulin infusion rates compared to means of 13, 13, 12, and 11 in the control subjects with diabetes. No detectable degrading activity was present in serum, and serum inhibited insulin degradation normally. Binding of insulin to IgG, IgM, and IgE was not increased, insulin binding to monocytes and erythrocytes was not sufficiently abnormal to account for the the insulin resistance, and insulin receptor increased insulin clearance or accelerated degradation of insulin by tissues.
Subject(s)
Diabetes Mellitus, Lipoatrophic/blood , Insulin Resistance , Adolescent , Erythrocytes/metabolism , Female , Humans , Immunoglobulins/metabolism , Insulin/blood , Metabolic Clearance Rate , Monocytes/metabolism , Protein Binding , Receptor, Insulin/metabolismABSTRACT
Hyperinsulinemic hypoglycemia secondary to nesidioblastosis persisted in a 4-year-old girl despite a 95% pancreatectomy and high-dose diazoxide treatment. Current literature suggests that dietary treatment, specifically protein restriction, of patients who are receiving diazoxide is ineffective and that further surgical pancreatectomy is required. However, in this patient, marked leucine sensitivity was demonstrated and a subsequent reduction in leucine intake eliminated hypoglycemia and the need for total or nearly total pancreatectomy. Therefore, dietary alteration should be considered in some patients with hyperinsulinism as an adjunct to other medical treatment.
