RESUMO
Ercc1 has an essential role in the nucleotide excision repair (NER) pathway that protects against ultraviolet (UV)-induced DNA damage and is also involved in additional repair pathways. The premature death of simple Ercc1 mouse knockouts meant that we were unable to study the role of Ercc1 in the skin. To do this, we have used the Cre-lox system to generate a skin-specific Ercc1 knockout. With a Cre transgene under control of the bovine keratin 5 promoter we achieved 100% recombination of the Ercc1 gene in the epidermis. Hairless mice with Ercc1-deficient skin were hypersensitive to the short-term effects of UV irradiation, showing a very low minimal erythemal dose and a dramatic hyperproliferative response. Ultraviolet-irradiated mice with Ercc1-deficient skin developed epidermal skin tumours much more rapidly than controls. These tumours appeared to arise earlier in actinic progression and grew more rapidly than tumours on control mice. These responses are more pronounced than have been reported for other NER-deficient mice, demonstrating that Ercc1 has a key role in protecting against UV-induced skin cancer.
Assuntos
Reparo do DNA/genética , Proteínas de Ligação a DNA/fisiologia , Endonucleases/fisiologia , Epiderme/enzimologia , Neoplasias Induzidas por Radiação/enzimologia , Neoplasias Cutâneas/enzimologia , Raios Ultravioleta/efeitos adversos , Animais , DNA/efeitos da radiação , Dano ao DNA , Proteínas de Ligação a DNA/deficiência , Proteínas de Ligação a DNA/genética , Progressão da Doença , Endonucleases/deficiência , Endonucleases/genética , Epiderme/patologia , Epiderme/efeitos da radiação , Feminino , Marcação de Genes , Genes Letais , Integrases , Masculino , Camundongos , Camundongos Pelados , Camundongos Knockout , Neoplasias Induzidas por Radiação/genética , Especificidade de Órgãos , Neoplasias Cutâneas/genética , TransgenesRESUMO
OBJECTIVE: To determine the consequences of applying revised American Diabetes Association (ADA) (1997) and World Health Organization (WHO) (1998) recommendations for the classification of glucose intolerance in women with previous gestational diabetes mellitus (GDM). RESEARCH DESIGN AND METHODS: There were 192 women with previous GDM who took an oral glucose tolerance test (OGTT) 1-86 months after delivery and were classified by WHO (1985), ADA (1997, fasting glucose), and revised WHO (1998) guidelines. RESULTS: Among the 165 women without a preexisting diagnosis of diabetes, WHO-1985 and ADA-1997 provided similar estimates of diabetes prevalence (13.3% vs. 11.5%) but widely differing estimates of impaired glucose homeostasis (31.5% impaired glucose tolerance [IGT] by WHO-1985 vs. 10.9% impaired fasting glucose by ADA-1997 criteria). Overall, 56 women (34%) showed a classification discrepancy between WHO-1985 and ADA-1997 criteria, including 44 with normal fasting glucose by ADA-1997 criteria, but abnormal 2-h glucose by WHO-1985 criteria (40 IGT, 4 diabetes). The cardiovascular risk profile of these women was more favorable than that of 18 women with impaired fasting glucose. WHO-1998 recommendations reproduced ADA-1997 findings when used as a fasting screen, but behaved similarly to WHO-1985 criteria when 2-h glucose values were also analyzed. CONCLUSIONS: All criteria produced similar estimates of diabetes prevalence. However, analyses based on a single fasting glucose screen (and a threshold of 6.1 mmol/l) failed to identify 60% of women with abnormal 2-h glucose levels. Screening women with previous GDM (and by analogy, other groups at high risk of diabetes) with a single fasting glucose has low sensitivity for the detection of abnormal glucose tolerance. Recent guidelines recommending this approach require reevaluation.
Assuntos
Glicemia/metabolismo , Diabetes Mellitus/epidemiologia , Diabetes Gestacional/sangue , Intolerância à Glucose/classificação , Teste de Tolerância a Glucose , Adulto , Diabetes Mellitus/sangue , Inglaterra , Jejum , Feminino , Seguimentos , Intolerância à Glucose/sangue , Intolerância à Glucose/epidemiologia , Homeostase , Humanos , Gravidez , Prevalência , Valores de Referência , Estados Unidos , Instituições Filantrópicas de Saúde , Organização Mundial da SaúdeRESUMO
The effect of dietary fat source in liquid, semipurified diets was studied with 22 Yorkshire pigs. The four treatment groups were fed diets containing 32% butterfat, corn oil, coconut oil or lard on a dry matter basis. Pigs were delivered by Cesarean section and maintained under pathogen-free conditions. Gain and efficiency of feed use were greater (P less than .05) for pigs fed coconut oil than for pigs fed corn oil or lard. In a second trial, choice white grease was added to a starter diet at levels of 0, 4, 8 and 12%. Individual performance of 68 early-weaned (about 27 d of age) Yorkshire pigs was monitored for 35 d. Levels of corn and soybean meal were altered to maintain a constant ratio of other nutrients to digestible energy. Feed intake decreased as fat level increased (linear effect, P less than .004). Gains the first 2 wk also decreased linearly with fat level (P less than .06). Efficiency of feed use was not significantly affected by dietary fat level, but efficiency of use of calculated digestible energy tended to decrease (P less than .07) with added fat.
Assuntos
Peso Corporal , Gorduras na Dieta , Suínos/fisiologia , Animais , Animais Recém-Nascidos , Manteiga , Cocos , Gorduras na Dieta/administração & dosagem , Metabolismo Energético , Comportamento Alimentar , Feminino , Vida Livre de Germes , Masculino , Óleos , Desmame , Zea maysAssuntos
Leucemia/enzimologia , Proteínas Mutantes/antagonistas & inibidores , Piperidinas/farmacologia , Proteína Tirosina Fosfatase não Receptora Tipo 11/antagonistas & inibidores , Pirimidinas/farmacologia , Regulação Alostérica , Animais , Linhagem Celular Tumoral , Humanos , Mutação de Sentido IncorretoRESUMO
Persistently hyperphosphorylated Akt contributes to human oncogenesis and resistance to therapy. Triciribine (TCN) phosphate (TCN-P), the active metabolite of the Akt phosphorylation inhibitor TCN, is in clinical trials, but the mechanism by which TCN-P inhibits Akt phosphorylation is unknown. Here we show that in vitro, TCN-P inhibits neither Akt activity nor the phosphorylation of Akt S473 and T308 by mammalian target of rapamycin or phosphoinositide-dependent kinase 1. However, in intact cells, TCN inhibits EGF-stimulated Akt recruitment to the plasma membrane and phosphorylation of Akt. Surface plasmon resonance shows that TCN, but not TCN, binds Akt-derived pleckstrin homology (PH) domain (K(D): 690 nM). Furthermore, nuclear magnetic resonance spectroscopy shows that TCN-P, but not TCN, binds to the PH domain in the vicinity of the PIP3-binding pocket. Finally, constitutively active Akt mutants, Akt1-T308D/S473D and myr-Akt1, but not the transforming mutant Akt1-E17K, are resistant to TCN and rescue from its inhibition of proliferation and induction of apoptosis. Thus, the results of our studies indicate that TCN-P binds to the PH domain of Akt and blocks its recruitment to the membrane, and that the subsequent inhibition of Akt phosphorylation contributes to TCN-P antiproliferative and proapoptotic activities, suggesting that this drug may be beneficial to patients whose tumors express persistently phosphorylated Akt.
Assuntos
Acenaftenos/metabolismo , Acenaftenos/farmacologia , Membrana Celular/metabolismo , Proteínas Proto-Oncogênicas c-akt/metabolismo , Ribonucleotídeos/metabolismo , Ribonucleotídeos/farmacologia , Proteínas Quinases Dependentes de 3-Fosfoinositídeo , Animais , Apoptose , Linhagem Celular Tumoral , Fator de Crescimento Epidérmico/metabolismo , Fator de Crescimento Epidérmico/farmacologia , Imunofluorescência , Amplificação de Genes , Humanos , Peptídeos e Proteínas de Sinalização Intracelular/metabolismo , Espectroscopia de Ressonância Magnética , Proteínas de Membrana/metabolismo , Fosfoproteínas/química , Fosfoproteínas/metabolismo , Fosforilação/efeitos dos fármacos , Reação em Cadeia da Polimerase , Proteínas Serina-Treonina Quinases/metabolismo , Estrutura Terciária de Proteína , Proteínas Proto-Oncogênicas c-akt/química , Transdução de Sinais , Ressonância de Plasmônio de Superfície , Serina-Treonina Quinases TOR/metabolismoRESUMO
AIMS/HYPOTHESIS: We assessed the impact of ethnic origin on metabolism in women following gestational diabetes mellitus (GDM). MATERIALS AND METHODS: Glucose regulation and other features of the metabolic syndrome were studied at 20.0 (18.2-22.1) months (geometric mean [95% CI]) post-partum in women with previous GDM (185 European, 103 Asian-Indian, 80 African-Caribbean). They were compared with the same features in 482 normal control subjects who had normal glucose regulation during and following pregnancy. RESULTS: Impaired glucose regulation or diabetes by WHO criteria were present in 37% of women with previous GDM (diabetes in 17%), especially in those of African-Caribbean and Asian-Indian origin (50 and 44%, respectively vs 28% in European, p=0.009). BMI, waist circumference, diastolic blood pressure, fasting triglyceride and insulin levels, and insulin resistance by homeostatic model assessment (HOMA), were increased following GDM (p<0.001 for all, vs control subjects). Where glucose regulation was normal following GDM, basal insulin secretion (by HOMA) was high (p<0.001 vs control subjects). Irrespective of glucose regulation in pregnancy, Asian-Indian origin was associated with high triglyceride and low HDL cholesterol levels, and African-Caribbean with increased waist circumference, blood pressure, and insulin levels, together with insulin resistance and low triglyceride concentrations. Nonetheless, the GDM-associated features were consistent within each ethnic group. The metabolic syndrome by International Diabetes Federation criteria was present in 37% of women with previous GDM, especially in non-Europeans (Asian-Indian 49%, African-Caribbean 43%, European 28%, p=0.001), and in 10% of controls. CONCLUSIONS/INTERPRETATION: Following GDM, abnormal glucose regulation and the metabolic syndrome are common, especially in non-European women, indicating a need for diabetes and cardiovascular disease prevention strategies.
Assuntos
Glicemia/metabolismo , Diabetes Gestacional/epidemiologia , Etnicidade/classificação , Síndrome Metabólica/epidemiologia , Algoritmos , Pressão Sanguínea , Índice de Massa Corporal , Diabetes Gestacional/fisiopatologia , Inglaterra/epidemiologia , Jejum , Feminino , Humanos , Insulina/sangue , Lipídeos/sangue , Síndrome Metabólica/etiologia , Síndrome Metabólica/fisiopatologia , Gravidez , Estudos RetrospectivosRESUMO
The ability of benzoyl peroxide to inhibit metabolic co-operation in rodent cell cultures may be relevant to its recently reported tumour promoting activity in mouse epidermis. We show here that non-toxic doses of this compound reduce metabolic co-operation between human epidermal keratinocytes to approximately 30% of that found in controls. The doses of benzoyl peroxide used did not affect keratinocyte morphology or their rate of attachment to the culture substratum. These results could be important as benzoyl peroxide is widely used in industry.
Assuntos
Peróxido de Benzoíla/toxicidade , Peróxidos/toxicidade , Fenômenos Fisiológicos da Pele , Animais , Comunicação Celular/efeitos dos fármacos , Sobrevivência Celular/efeitos dos fármacos , Células Cultivadas , Criança , Humanos , Masculino , Camundongos , Pele/citologia , Pele/efeitos dos fármacos , Acetato de Tetradecanoilforbol/toxicidade , Transcrição Gênica/efeitos dos fármacos , Transcrição Gênica/efeitos da radiaçãoRESUMO
OBJECTIVE: To assess the prevalence and characteristics of islet cell autoimmunity amongst women with gestational diabetes selected from South Asian and Afro-Caribbean as well as European populations. DESIGN: Cross-sectional retrospective survey of subject cohort. POPULATION: Three hundred and twenty-one women with a recent history of gestational diabetes (173 European, 86 South Asian and 62 Afro-Caribbean), a median (range) of 22 (1-150) months postpartum. RESULTS: Antibodies to Glutamic acid decarboxylase were found in 13 (4%) of these women. There was no difference in the prevalence of anti-glutamic acid decarboxylase positivity between the three ethnic groups (European 4.6%, South Asian 3.5%, Afro-Caribbean 3.2%). Anti-glutamic acid decarboxylase positive women were leaner than anti-glutamic acid decarboxylase negative women (body mass index, median (upper-lower quartile) 23.9 (22.5-26.7) vs 26.6 (23.4-30.5)kg/m2, P = 0.03, P = 0.049 allowing for ethnicity). There was no difference between glutamic acid decarboxylase-positive and glutamic acid decarboxylase-negative women for age, family history of diabetes, waist/hip ratio, prevalence of insulin treatment during pregnancy, postpartum glucose status, lipid profile and indices of insulin action and beta-cell function. CONCLUSIONS: Markers of islet cell autoimmunity are found as frequently in gestational diabetes women of South Asian and Afro-Caribbean origin, as they are in European subjects. Identification of future risk of type 1 diabetes is relevant to the planning of clinical management and intervention strategies in women with gestational diabetes of all major ethnic groups.
Assuntos
Autoanticorpos/sangue , Autoimunidade/imunologia , Diabetes Gestacional/etnologia , Glutamato Descarboxilase/sangue , Ilhotas Pancreáticas/imunologia , Adulto , Sudeste Asiático/etnologia , Estudos Transversais , Diabetes Gestacional/imunologia , Europa (Continente)/etnologia , Feminino , Humanos , Londres/epidemiologia , Gravidez , Estudos Retrospectivos , Índias Ocidentais/etnologiaRESUMO
The chalcone 3,4,3',4',5'-pentamethoxychalcone is a potent cytotoxic agent. A series of chalcones and (E)-4-(4'-hydroxyphenyl)but-3-en-2-one were prepared and assessed for their ability to inhibit cell growth in vitro. The cytotoxicity correlates with their ability to bind to tubulin as measured by immunofluorescence, cell cycle analysis and disruption of microtubule assembly. Some of the chalcones were shown to bind to the type II oestrogen receptor.
Assuntos
Antineoplásicos/química , Ciclo Celular/efeitos dos fármacos , Chalcona/análogos & derivados , Chalcona/química , Propiofenonas/química , Tubulina (Proteína)/efeitos dos fármacos , Animais , Antineoplásicos/síntese química , Antineoplásicos/toxicidade , Divisão Celular/efeitos dos fármacos , Sobrevivência Celular/efeitos dos fármacos , Chalcona/toxicidade , Chlorocebus aethiops , Desenho de Fármacos , Humanos , Indicadores e Reagentes , Células K562 , Microtúbulos/efeitos dos fármacos , Microtúbulos/ultraestrutura , Estrutura Molecular , Propiofenonas/síntese química , Propiofenonas/toxicidade , Relação Estrutura-Atividade , Suínos , Células VeroRESUMO
Two series of cytotoxic (IC50, K562 cell line, 1-24 microM) alpha-aminomethyl substituted lactones 3 and 4 were prepared by stereoselective Michael-type addition of amines to alantolactone (1) and isoalantolactone (2). The lactones 1 and 2 and their amine adducts induce apoptosis and act as alkylating agents.
Assuntos
Aminas/química , Antineoplásicos/síntese química , Lactonas/farmacologia , Antineoplásicos/farmacologia , Apoptose/efeitos dos fármacos , Ciclo Celular/efeitos dos fármacos , Divisão Celular/efeitos dos fármacos , Técnicas de Química Combinatória , Humanos , Concentração Inibidora 50 , Células K562 , Lactonas/síntese química , Relação Estrutura-Atividade , Células Tumorais Cultivadas/efeitos dos fármacosRESUMO
A series of diarylamines, diaryl and arylbenzyl ethers based on combretastatin A-4 was prepared and evaluated for anticancer activity. 2-Methoxy-5-(3',4',5'-trimethoxyphenoxymethyl)phenol was the most active (IC50, K562 20 nM) and caused significant G2/M cell cycle arrest.
Assuntos
Antineoplásicos Fitogênicos/farmacologia , Antineoplásicos/farmacologia , Éteres/farmacologia , Estilbenos/farmacologia , Antineoplásicos/síntese química , Antineoplásicos/química , Antineoplásicos Fitogênicos/síntese química , Antineoplásicos Fitogênicos/química , Ciclo Celular/efeitos dos fármacos , Divisão Celular/efeitos dos fármacos , Colchicina/antagonistas & inibidores , Colchicina/metabolismo , Éteres/síntese química , Éteres/química , Humanos , Concentração Inibidora 50 , Estrutura Molecular , Plantas Medicinais/química , Ligação Proteica/efeitos dos fármacos , Estilbenos/síntese química , Estilbenos/química , Tubulina (Proteína)/metabolismo , Células Tumorais CultivadasRESUMO
A high-yielding, two-step stereoselective synthesis of the anticancer drug (Z)-combretastatin A-4 (1) has been devised. The method uses the Perkin condensation of 3,4,5-trimethoxyphenylacetic acid and 3-hydroxy-4-methoxybenzaldehyde followed by decarboxylation of the cinnamic acid intermediate using copper and quinoline. The iodine-catalyzed isomerization of the Z isomer 1 results in complete conversion to the E isomer. The Suzuki cross-coupling of an aryl boronic acid and vinyl bromide has also been successfully employed to produce both Z and E isomers of combretastatin A-4 stereoselectively. Both methods are far superior to the current five-step Wittig synthesis in which both isomers are produced nonstereoselectively.
Assuntos
Antineoplásicos Fitogênicos/síntese química , Estilbenos/síntese química , Antineoplásicos Fitogênicos/química , Estereoisomerismo , Estilbenos/química , Relação Estrutura-AtividadeRESUMO
Tubulin is the biochemical target for several clinically used anticancer drugs, including paclitaxel and the vinca alkaloids vincristine and vinblastine. This review describes both the natural and synthetic agents which are known to interact with tubulin. Syntheses of the more complex agents are referenced and the potential clinical use of the compounds is discussed. This review describes the biochemistry of tubulin, microtubules, and the mitotic spindle. The agents are discussed in relation to the type of binding site on the protein with which they interact. These are the colchicine, vinca alkaloid, rhizoxin/maytansine, and tubulin sulfhydryl binding sites. Also included are the agents which either bind at other sites or unknown sites on tubulin. The literature is reviewed up to October 1997.
Assuntos
Antineoplásicos/farmacologia , Fuso Acromático/efeitos dos fármacos , Moduladores de Tubulina , Antibióticos Antineoplásicos/farmacologia , Antineoplásicos/síntese química , Antineoplásicos Fitogênicos/farmacologia , Sítios de Ligação , Colchicina/farmacologia , Desenho de Fármacos , Humanos , Lactonas/farmacologia , Macrolídeos , Maitansina/farmacologia , Microtúbulos/química , Microtúbulos/efeitos dos fármacos , Paclitaxel/farmacologia , Ligação Proteica , Fuso Acromático/química , Reagentes de Sulfidrila/farmacologia , Tubulina (Proteína)/química , Tubulina (Proteína)/efeitos dos fármacos , Vimblastina/farmacologia , Vincristina/farmacologiaRESUMO
Aurantiamide acetate (N-benzoyl-1-phenylalanyl-1-pheylalaninol acetate) has been isolated by chromatographic separation of a methanol extract of Arisaema erubescens and its structure confirmed by synthesis.
Assuntos
Dipeptídeos/isolamento & purificação , Medicamentos de Ervas Chinesas , Linhagem Celular , Sobrevivência Celular/efeitos dos fármacos , Dipeptídeos/química , Dipeptídeos/farmacologia , Doxorrubicina/toxicidade , Humanos , Leucemia , Extratos Vegetais , Raízes de Plantas , Células Tumorais CultivadasRESUMO
A 644-membered library of chalcones was prepared by parallel synthesis using the Claisen-Schmidt base-catalyzed aldol condensation of substituted acetophenones and benzaldehydes. The cytotoxicity of these chalcones was conveniently determined upon the crude products directly in 96-well microtiter test plates by the conventional MTT assay. This method revealed seven chalcones of IC(50) less than 1 microM of which 4'-hydroxy-2,4,6,3'-tetramethoxychalcone (5a) was the most active [IC(50) (K562), 30 nM]; it causes cell cycle arrest at the G(2)/M point and binds to tubulin at the colchicine binding site.
Assuntos
Antineoplásicos/síntese química , Antineoplásicos/farmacologia , Chalcona/síntese química , Chalcona/farmacologia , Sais de Tetrazólio , Tiazóis , Acetofenonas/síntese química , Acetofenonas/química , Técnicas de Química Combinatória , Ensaios de Seleção de Medicamentos Antitumorais , Humanos , Espectroscopia de Ressonância Magnética , Reprodutibilidade dos Testes , Células Tumorais CultivadasRESUMO
AIMS: It has been reported that short individuals are more likely to have abnormalities of glucose homeostasis. The aim of this study was to examine the relationship between adult height and gestational diabetes mellitus (GDM), taking into account possible artefactual or confounding explanations. METHODS: Three hundred and forty-six women with previous GDM (169 European, 102 South Asian, 75 Afro-Caribbean) and 470 control women with no previous history of GDM (282 European, 94 South Asian and 94 Afro-Caribbean) were studied. Post-partum glucose status and height were measured. RESULTS: European and South Asian women with previous GDM were shorter than control women from the same ethnic groups (European: (mean +/- SD) 162.9 +/- 6.1 vs. 165.3 +/- 6.8 cm, P < 0.0001; South Asian: 155.2 +/- 5.4 vs. 158.2 +/- 6.3 cm, P = 0.003, adjusted for age). A similar, but non-significant trend was observed among Afro-Caribbean women (162.2 +/- 6.2 vs. 163.7 +/- 6.1 cm, P = 0.1). Similar, significant height differences were observed in Europeans and South Asians when analysis was restricted to those GDM women who had received insulin during pregnancy. There was no association between height and glucose tolerance postpartum within the GDM group. CONCLUSIONS: European and South Asian women with previous GDM are shorter than control women from the same ethnic groups. The data demonstrate that this is unlikely to be an artefact resulting from the use of an fixed 75 g load in women of differing sizes, and suggest that there are likely to be common pathophysiological mechanisms underlying GDM and the determination of final adult height.
Assuntos
Estatura , Diabetes Gestacional/sangue , Diabetes Gestacional/fisiopatologia , Gravidez/sangue , Adulto , Ásia/epidemiologia , Glicemia/análise , Índice de Massa Corporal , Peso Corporal , Região do Caribe/etnologia , Europa (Continente)/etnologia , Feminino , Teste de Tolerância a Glucose , Humanos , Londres , Paridade , Grupos Raciais , Valores de Referência , Estudos Retrospectivos , Fatores de TempoRESUMO
A series of substituted chalcones was synthesised and screened for cytotoxic activity against the K562 human leukaemia cell line. (E)-3-(3"-Hydroxy-4"-methoxyphenyl)-2-methyl-1-(3',4',5'- trimethoxyphenyl)-prop-2-en-1-one [IC50 (K562) 0.21 nM] was found to be the most active. A relationship between the conformation and cytotoxicity of the chalcones is discussed.
Assuntos
Antineoplásicos/química , Antineoplásicos/toxicidade , Chalcona/análogos & derivados , Chalcona/toxicidade , Antineoplásicos/síntese química , Ciclo Celular/efeitos dos fármacos , Divisão Celular/efeitos dos fármacos , Sobrevivência Celular/efeitos dos fármacos , Chalcona/síntese química , Chalcona/química , Cristalografia por Raios X , Desenho de Fármacos , Humanos , Células K562 , Modelos Moleculares , Conformação Molecular , Estrutura Molecular , Relação Estrutura-AtividadeRESUMO
OBJECTIVE: Hypopituitary adults on conventional replacement have low concentrations of metabolic fuels throughout the night, possibly related to GH deficiency or to decreased cortisol levels overnight. We investigated whether GH replacement corrects the overnight fuel deficiency. DESIGN: We measured circulating levels of metabolic fuels: glucose, non-esterified fatty acids (NEFA), glycerol and 3-hydroxybutyrate (3-OHB) and insulin concentrations over 24 h (from 0730 h to 0700 h) in hypopituitary adults before and after GH treatment in a randomized double-blind placebo-controlled trial of 3 months' duration. PATIENTS: Thirteen hypopituitary patients, 8 women and 5 men, were studied. RESULTS: Six patients (4 women and 2 men) received GH and 7 patients (4 women and 3 men) were allocated to receive placebo. There was no difference in fasting (0730 h), area under the curve (AUC) between 2400 h and 0700 h (overnight) and AUC over 24 h for plasma glucose, 3-OHB, glycerol and insulin concentrations as a result of GH treatment. Fasting and overnight AUC for NEFA were significantly higher on GH treatment ((mean +/- SEM) 243 +/- 29 vs. 446 +/- 90 micromol/l, P = 0.03, 1522 +/- 208 vs. 2167 +/- 123 micromol/l H, P = 0.046, respectively), but AUC over 24 h was not affected significantly. No significant changes in any fuel were seen in the placebo group. The changes in fasting, overnight and 24 h AUC for glucose, 3-OHB, glycerol and insulin levels with GH and with placebo for 3 months were similar. The changes in fasting and overnight AUC for NEFA before and after 3 months were significantly different in the group treated with GH vs. the group treated with placebo (median (lower-upper quartile) 104 (90-276) vs. -89 (-98 to 26) micromol/l, P = 0.002; 633 (263-967) vs. -895 (-1379 to -494) micromol/l h, P = 0.002, respectively), but the changes in 24-h AUC for NEFA were not significant between the two groups. CONCLUSIONS: GH replacement in hypopituitary adults increases fasting and overnight (between 2400 h and 0700 h) non-esterified fatty acid concentrations, consistent with the known lipolytic effect of GH. GH did not influence the concentrations of other metabolic fuels or insulin.
Assuntos
Glicemia/metabolismo , Ácidos Graxos não Esterificados/sangue , Glicerol/sangue , Hormônio do Crescimento Humano/uso terapêutico , Hipopituitarismo/tratamento farmacológico , Ácido 3-Hidroxibutírico/sangue , Adulto , Idoso , Área Sob a Curva , Método Duplo-Cego , Feminino , Humanos , Hipopituitarismo/sangue , Insulina/sangue , Masculino , Pessoa de Meia-IdadeRESUMO
OBJECTIVE: Leptin acts as a satiety factor in regulating food intake and body homeostasis, but its regulation is not well defined. Specific leptin receptors have been found in the brain and it has been hypothesized that leptin production by adipose tissue is under neuroendocrine control. A circadian rhythm has been demonstrated with highest leptin levels between midnight and early morning hours. The possibility that hypopituitarism (or pituitary surgery +/- radiotherapy) abolishes this leptin rhythm was investigated by measuring serum leptin levels during a 24-h period in patients with impaired pituitary function. PATIENTS AND DESIGN: Circulating leptin levels were measured hourly over 24-h in 14 hypopituitary patients (8 women and 6 men) using a sensitive and specific radioimmunoassay. Hypopituitarism was the consequence of pituitary tumors treated surgically and/or with radiotherapy. All patients were GH deficient and were receiving conventional replacement with cortisol (n = 13), thyroxine (n = 12) and desmopressin (n = 4) but not with GH. RESULTS: A significant diurnal variation in circulating leptin concentrations was observed in 13 of the 14 patients. The mean (+/- SEM) leptin levels for 8 women were 51.9 (+/- 10.7) ng/ml and for 6 men 11.0 (+/- 2.0) micrograms/l. The overall lowest leptin levels (29.3 +/- 7.9 ng/ml) were observed at 0830 h after overnight fasting, rising gradually to maximum levels (43.0 +/- 9.8 ng/ml) at 0200 h declining thereafter towards fasting values. The mean (+/- SEM) magnitude of circadian variation in absolute leptin levels from the calculated mean level for each patient was 5.6 (+/- 1.2) ng/ml (8.4 +/- 1.4 for women and 1.9 +/- 0.3 for men). The mean (+/- SEM) of the ratio of the amplitude versus mean leptin levels over 24 h for each individual patient was 0.18 (+/- 0.02) (0.19 +/- 0.03 for women and 0.18 +/- 0.02 for men). CONCLUSIONS: A circadian rhythm for leptin is generally present in hypopituitary patients who had undergone pituitary surgery and/or radiotherapy, with the highest serum leptin levels being obtained between midnight and early morning hours. Although some patients had some residual pituitary activity, intact hypothalamic-pituitary function is not essential for leptin's circadian rhythm.
Assuntos
Ritmo Circadiano , Hormônio do Crescimento/deficiência , Hipopituitarismo/sangue , Proteínas/metabolismo , Feminino , Humanos , Hipopituitarismo/etiologia , Leptina , Masculino , Pessoa de Meia-Idade , Neoplasias Hipofisárias/radioterapia , Neoplasias Hipofisárias/cirurgia , RadioimunoensaioRESUMO
OBJECTIVES: To determine whether simulation of significant impairment of the hand will have a predictable impact on degree of functional loss at the wrist and hand. DESIGN: Single subject repeat measures using before-after trial comparisons and healthy volunteer subjects. SETTING: Occupational therapy section of a large academic medical center. OTHER PARTICIPANTS: Twenty adult volunteer student subjects from an occupational therapy education (OTE) department were included. All were between ages 18 and 43 years, right hand dominant, and in excellent general health. There were 19 women and 1 man, reflecting gender distribution of the OTE student body. INTERVENTION: A simulated fusion of the carpometacarpal (CMC) joint of the thumb was achieved by immobilization in an individually fabricated splint designed to maximally restrict motion at the first CMC joint. Impairment ratings (baseline vs splinted) according to the AMA Guides were obtained by Greenleaf testing, and upper extremity function was quantitatively assessed before and after splinting. MAIN OUTCOME MEASURES: Measures of upper extremity function included grip and pinch strength, wrist torque, and speed of performance on the Valpar Small Tools test, Jebsen Hand Function test, and an exploratory measure, the Functional Life Activity Test (FLAT). RESULTS: Significant impairments were achieved for all subjects after splinting and according to Greenleaf testing. Splinting resulted in significant reductions in grip and pinch strength, wrist torque, and significant slowing of performance on the Valpar, Jebsen, and FLAT tests. Regressions of degree of impairment on degree of functional loss after splinting, and according to each of the above measures, were not significant. CONCLUSIONS: Impairment of the hand was simulated to a mild-to-moderate degree as measured according to the AMA Guides. This imposed significant reductions in motion at key joints of the wrist and hand as well as significant reductions in grip and pinch strength and wrist torque. A corresponding and significant slowing of performance on a variety of measures of upper extremity function of an industrial and nonindustrial nature was also seen. However, and for the first time, correlation and regression reveals that it is not possible to predict degree of functional loss attributable to degree of impairment for the hand. It thus appears that, for mild-to-moderate clinical impairments, the associated impairment rating is a poor estimator of functional loss at the hand and should be used cautiously, if at all, as a criterion for disability determination.