Growth hormone treatment of children with short stature secondary to intra-uterine growth retardation: effect of 2 years' treatment and 2 years' follow-up.

Growth hormone (GH) treatment has been proposed to improve final height in patients with short stature associated with intra-uterine growth retardation (IUGR). In this study, 30 prepubertal patients aged 9.5 +/- 0.9 years with IUGR and normal GH secretion on pharmacological testing were treated with GH. These patients had a mean birth length of -3.11 +/- 0.80 SDS, and mean growth retardation of -2.58 +/- 0.49 SDS for chronological age. GH, 1.4 IU/kg/week (= 0.07 mg/kg/day), was given for 2 years. Height gain (calculated as the difference of height SDS at baseline and after 2 years) was 1.3 +/- 0.4 SD and was not significantly correlated with height SDS or growth velocity at baseline. These data confirm that 2 years of recombinant human GH treatment increases height gain in patients with IUGR. Two years after treatment interruption, mean gain was maintained at +1.08 SDS and 83% of the children had normal height.

[The French diabetic population. Results of a study using a representative sample]. / La population diabétique en France. Résultats d'une étude portant sur un panel représentatif.

The aim of this study was to assess the prevalence of diabetes mellitus in France, the existing treatment used and the effect of this chronic disease on everyday life patterns of the diabetic population. A survey was undertaken by Lilly laboratories and SOFRES medical institute from November to December 1992, which involved randomly screening 20,000 french families. After the screening questionnaire was sent at to the 20,000 families, the following feedback was obtained: 996 patients have been identified. More than 80% of the patients (that is, 122 were insulin treated and a further 674 were identified as NIDDM) replied to the second self assessment questionnaire. It was possible to make an estimation of the prevalence of diabetes mellitus in France that is to say: 1.9% of the general population. The general practitioner makes the primary diagnosis in more than 80% of the cases, and treats 97% of the NIDDM patients and 74% of the insulin treated diabetic patients. The diabetic patients have an average of 8 consultations per year with their general practitioners and 3-4 consultations per year with the endocrinologist. Therapeutic management of the NIDDM patients is based mainly on diet (82%) alone or in association with drugs. 32% of patients primary treated by drugs and secondary by insulin are not satisfied with their glycemic control (vs 22% of IDDM patients and 15% of NIDDM patients). Less than 35% of diabetic women are current users of contraception. More than one third of children who were born from a diabetic mother had a birth weight above 4 kgs.

Cephalic phase of insulin secretion and food stimulation in humans: a new perspective.

Insulinemia and glycemia were measured at a 1-min interval at the hour of a lunch meal in human subjects. When no food was presented to naive subjects (n = 4), cyclic oscillations of insulinemia were found (period, 12-20 min; amplitude, 2.8-10.3 microU/ml). It is proposed that these spontaneous oscillations must be taken into consideration when evaluating the insulin response on cephalic contact with food stimuli; they might otherwise constitute a source of artifacts. Four subjects were then submitted to a series of four test meals scheduled at a 1-wk interval. Although their prandial glycemia remained comparable with preprandial values for the first 16 min of the meals, insulinemia often exhibited early peaks (within a few min after meal onset) whose amplitude appeared related to palatability conditions. Evidence suggests that the insulin peaks triggered by cephalic stimulation are Pavlovian reflexes that become conditioned to the test situation. A typical neuroendocrine response to alimentary frustration is also described. The results are discussed in perspective with animal works, in terms of the effects of neuroendocrine events on feeding behavior.

Reflex insulin response associated to food intake in human subjects.

The occurrence of a reflex insulin discharge at the beginning of a meal, and its possible influence on intake were studied in 7 normal weight humans. Each subject was tested twice under three standard meal conditions. The evolutions of insulinemia and glycemia were recorded over an 84 min observation period, starting 2 min before food presentation. Blood was drawn continuously from an antecubital vein, and collected in 1-min samples for the first 30 min, and then in 3-min samples. The average glycemia curve was stable until some 18-20 min after meal onset. By contrast, a significant rise in plasma insulin appeared as early as the 4th min after meal onset and it is hypothesized to be preabsorptive, of cephalic and/or gastric origin. However, inter-test variations were large even in the same person. Schematically, three types of early insulin responses were observed: high and/or sustained rise, moderate and/or short increase, moderate decrease in plasma insulin. The shape of the early insulin response was not related to any meal characteristic. The potential biological and behavioral significance of the early insulin release is discussed.

Phospholipases A1 and A2 in subcellular fractions and plasma membranes of Krebs II ascites cells.

A method is described for the localization and characterization of phospholipases A1 and A2 (EC3.1.1.4) in Krebs II ascites cells, particularly in the plasma membranes. Cells were lysed with a Dounce homogenizer in an isotonic sucrose medium. Plasma membranes sediment with mitochondria and lysosomes during subcellular fractionation and are finally isolated on a continuous sucrose gradient. The membranes are localized at two levels in the gradient, at densities of 1.06 and 1.15, in which 5'-nucleotidase (EC 3.1.3.5) activity exhibits a 9- and 21-fold purification, respectively. Total contamination by endoplasmic reticulum, lysosomes, and mitochondria is 17 percent for the low-density membrane fraction and 25 percent for the high-density fraction. The phospholipases A present in Krebs II cells are active at pH 4.0 and pH 7.5. At the 2 pH values, they have A1 and A2 specificities. The intracellular distribution of acidic forms is comparable to that of acid phosphatase (EC 3.1.3.1), while neutral forms are localized like lactate dehydrogenase (EC 1.1.1.27). A small proportion of neutral phospholipase A2 has the same repartition on the sucrose gradient as nicotinamide adenine dinucleotide diaphorase (EF 1.6.4.3), an endoplasmic reticulum marker, and as 5'-nucleotidase, a plasma membrane marker.