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Query: UMLS:C0011849 (diabetes)
 277,896 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A rare case of acromegaly developing gross hyperlipidemia not associated with overt diabetes was presented. Gross hyperlipidemia revealed type V hyperlipoproteininemia, according to agarose gel electrophoretic pattern of serum lipoprotein. Before pituitary surgery, the serum levels of cholesterol and triglyceride were 320 mg/dl and 1830 mg/dl respectively, and the basal level of growth hormone was markedly elevated, ranging from 129 to 231 ng/ml with the mean +/- SD of 168 +/- 39 ng/ml. The enzymatic activities of hepatic triglyceride lipase (H-TGL) and lipoprotein lipase (LPL) were 14.2 and 1.50 mumoles/ml/hour, respectively. H-TGL activity was normal, while LPL activity was extremely low compared to those of normal subjects. After combined therapy with pituitary surgery and 60Co radiation, the serum level of growth hormone was decreased to 35.9 +/- 8.6 ng/ml in the mean +/- SD, but not normalized. However, the serum level of triglyceride was decreased and both H-TGL and LPL activities were increased to 19.3 and 2.7 mumoles/ml/hour, respectively. LPL activity was increased 79% compared to the level of pretreatment. Agarose gel electrophoretic pattern of lipoprotein changed from type V to type IV and ultracentrifugal analysis showed that very low density lipoprotein (VLDL)-cholesterol was decreased and intermediate density lipoprotein (IDL)-cholesterol, low density lipoprotein (LDL)-cholesterol and high density lipoprotein (HDL)-cholesterol were increased.
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PMID:Secondary type V hyperlipoproteinemia in an acromegalic patient without overt diabetes. 708 27

One hundred and fifty-five acromegalics, 76 males (mean age 44 +/- 1.3 years) and 79 females (45 +/- 1.4 years) were studied. The frequency of clinical features were: acral enlargement 100 per cent, hyperhidrosis 65 per cent, headache 55 per cent, paraesthesiae 49 per cent, cardiac problems 34 per cent, hypertension 32 per cent, diabetes mellitus (clinical and chemical) 27 per cent, and visual field defects 6 per cent. Signs and symptoms, and particularly headache, did not show any relation with the size or shape of pituitary tumours, nor with growth hormone (GH) values, age, sex or weight. Mean of GH values at 60, 90 and 120 minutes during a GTT averaged 135 mIU/l, range 8-1833. Diabetes mellitus was more frequent and severe in patients with higher GH values, occurring in 32 per cent of patients with mean GH values greater than or equal to 50 mIU/l and only in 16 per cent of the rest (p less than 0.05). GH values correlated positively with size of tumours. Forty-nine per cent of patients presented with entirely intrasellar tumours, 27 per cent with suprasellar extensions and 23 per cent with partially empty sellae. The mean GH (238 mIU/l) of patients with suprasellar extensions was significantly higher (p less than 0.004) than those of the others. Younger acromegalics showed a tendency to larger tumours. Early treatment of acromegaly, particularly in young patients and those presenting with high GH values, is recommended.
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PMID:The acromegaly syndrome. Relation between clinical features, growth hormone values and radiological characteristics of the pituitary tumours. 711 79

Serum lipids were analyzed in 16 patients with active acromegaly. Of these 62.5% had hyperlipidaemia defined as exceeding and 90% fiducial limits of normal controls. The mean serum cholesterol (5.50 mmol/l) and triglyceride (4.09 mmol/l) levels of the patients were significantly higher than those of age-matched normal controls. Type V hyperlipoproteinaemia was observed in two cases and type III hyperlipoproteinaemia in one. There was no difference in the incidence of diabetes between the normolipidaemic (n = 6) and hyperlipidaemic (n = 10) groups. Serum levels of growth hormone in hypercholestelaemic patients (n = 3) were significantly higher than those of normolipidaemic patients and combined hyperlipidaemic patients (n = 5 tended to have higher levels of growth hormone than normolipidaemic patients. In cases developing type III or type V hyperlipoproteinaemia, the activity of hepatic triglyceride lipase of lipoprotien lipase was decreased, but in increased when serum GH levels fell after therapy for acromegaly. It is suggested that 1) growth hormone may play some role on the pathogenesis of hyperlipidaemia associated with acromegaly, and 2) growth hormone has an inhibitory effect on H-TGL and LPL, and so hyperlipoproteinaemia in some cases of acromegaly might be caused by low H-TGL or LPL activity resulting from high growth hormone levels.
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PMID:The incidence and pathogenesis of hyperlipidaemia in 16 consecutive acromegalic patients. 711 4

The present paper is based on findings reported in the literature and concerned with various possible methods of preventing heat and/or pregnancy without resorting to ovariohysterectomy. The drugs used to suppress and prevent oestrus, such as progestagens, testosterone and 19-nortestosterone derivates, are reviewed, the mechanism of action, mode of administration and advantages and disadvantages being discussed. Progestagens are particularly found to affect the uterus (CEH) and mammary glands (increased incidence of mammary tumours), and they may also induce diabetes mellitus and acromegaly. On the other hand, the untoward side-effects of 19-nortestosterone derivatives are found to be mainly due to their androgenic action, resulting in enlargement of the clitoris, vaginitis, changes of behaviour and masculinization of puppies when the drug is administered during pregnancy. Subsequently, those mechanical and surgical procedures which are less commonly employed, are discussed. The pros and cons of the various methods and drugs as well as the possible causes of the difference in gestagenic effect of a number of progestational agents are discussed in greater detail.
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PMID:[Prevention of oestrus and/or pregnancy in dogs by methods other than ovariohysterectomy (author's transl)]. 719 29

Plasma motilin levels were measured by dextran-charcoal radioimmunoassay in normal subjects and in patients with diabetes mellitus and certain other disorders. Fasting plasma motilin in normal subjects determined by a single blood sampling varied considerably within a range of 50 to 545 pg/ml. Repeated blood sampling revealed cyclic fluctuations in plasma motilin during fasting, with a peak appearing between an interval of 100 to 120 min which was accompanied by gastric contraction as determined with a balloon inserted into the stomach. Meal ingestion caused a transient but significant rise in plasma motilin, followed by a progressive decrease with an absence of the secretory episode. On the other hand, plasma motilin levels decreased, without an initial increase, following oral and intravenous glucose loading. Fasting plasma motilin levels were significantly elevated in patients with diabetes mellitus, and chronic liver diseases but within normal limits in patients with acromegaly and hyperthyroidism. Repeated blood samplings showed cyclic fluctuation in plasma motilin levels in diabetic patients. Levels rose after meal ingestion to a peak higher than that in normal subjects and remained higher until 120 min. In summary, 1) fasting plasma motilin levels in normal subjects varied considerably because of cyclic fluctuations, 2) meal ingestion caused a transient rise in plasma motilin, followed by a decrease, whereas glucose administration produced only a decrease, 3) plasma motilin levels were elevated in patients with diabetes mellitus.
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PMID:Plasma motilin levels in normal subjects and patients with diabetes mellitus and certain other diseases. Fasting levels and responses to food and glucose. 722 17

In man, the assay of insulin receptors is performed on circulating monocytes or erythrocytes. In physiology, insulin binding decreases with age; it is lower in women during the luteal phase of the menstrual cycle or during administration of oestrogen-progestogen oral contraceptives; it exhibits diurnal variation; it increases after physical training; it depends on the diet, being inversely correlated with its carbohydrate content; finally, rapid variations in binding affinity are observed after glucose ingestion or after breakfast. In pathology, obese people are resistant to the effects of insulin and they have decreased numbers of receptors on blood cells; short-term fasting induces an increase in the binding affinity, while a long term hypocaloric diet leads to an increase in receptor numbers. Similarly non-insulin-dependent, maturity onset diabetics, even without overweight, have low numbers of binding sites, which are increased by diet or after treatment by sulfonylureas. In the syndrome of insulin resistance and acanthosis nigricans, there is a decrease in hormone binding, which is either primary (Type A) or is secondary to the effects of circulating antibodies to the insulin receptor (Type B). In acromegaly, insulinomas, liver cirrhosis and acute viral diseases the binding of insulin is decreased. On the contrary, variable results have been reported in cases of lipoatrophic diabetes, leprechaunism, uremia and glucocorticoid administration. Finally, an increase in insulin receptors has been observed in anorexia nervosa and in insulino-penic diabetes.
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PMID:[The insulin receptors of the blood cells and their study in disease states in man (author's transl)]. 734 Jun 95

The effects of glucagon on the adrenergic system have been studied in experimental and clinical conditions. 1. in vitro studies: In the first experiment a continuous flow incubation system was developed in which the secretory response to these drugs was characterized by a serial fluorimetric assay of catecholamines in the effluent medium. Pig adrenal medulla or human pheochromocytoma were studied. There was an initial massive release of catecholamines which declined to basal levels (0.02 micrograms/mg) after 1.5 hours. When 10(-4) glucagon was infused for 10 minutes following 2 hours of preincubation, both adrenaline and nonadrenaline outputs rose abruptly to concentrations of 0.08 micrograms/mg and 0.07 micrograms/mg respectively. In the second experiment the effect of these drugs on the in vitro release of catecholamines from the isolated in vitro chromaffin granules of the pig adrenal medulla were studied. The results were the same as in the previous experiment. 2. clinical studies: The effects of glucagon were studied on the blood pressure and urinary catecholamine levels of healthy control subjects, of patients suffering from essential hypertension, thyroid disease, diabetes mellitus and acromegaly. Glucagon induced a slight but constant increase in blood pressure. By contrast no significant urinary catecholaline elevation was evoked. There was no difference in the effect of intravenous glucagon between normal subjects and patients suffering from the above-mentioned disorders.
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PMID:[A reevaluation of the glucagon provocative test for pheochromocytoma--on the in vitro release of catecholamine from the adrenal medulla or pheochromocytoma tissue, and on the effect of intravenous glucagon on urinary catecholamine excretion and blood pressure (author's transl)]. 740 74

Treatment of acromegaly is effective in reversing the reduced life-span of patients only when serum growth hormone (GH) concentrations are lowered to less than 2.5 micrograms/l. Usual treatments achieve this goal in no more than 50-60% of patients. The effects of octreotide were studied in a prospective, open label study with 68 acromegalic patients enrolled in 10 Italian centers. Octreotide was administered sc at a dose of 100 micrograms t.i.d. for 1 year. After 3 months of therapy, octreotide was effective in decreasing serum GH levels below 2.5 micrograms/l in 16 out of 64 acromegalic patients (25%). Fifteen of them had pretreatment GH levels below 25 micrograms/l. Insulin-like growth factor I (IGF-I) levels normalized in about 40% of patients. No further GH reduction was observed after 1 year of treatment. The presence of abnormal GH responses to thyrotropin-releasing hormone (TRH) and gonadotropin-releasing hormone was reduced from 54 to 24% and from 16 to 12%, respectively. Tumor shrinkage was observed in 50% of 26 non-irradiated patients after 12 months of treatment. Both basal and TRH-stimulated serum prolactin levels significantly decreased in the 11 hyperprolactinemic patients. Although serum thyrotropin, free triiodothyronine and free thyroxine concentrations were not modified, a significant reduction of thyrotropin response to TRH was observed in the 9th month of therapy. In non-diabetic patients, an increase of mean blood glucose levels without modifications of fasting morning concentrations was found. About one-quarter of the patients with overt diabetes mellitus had an impairment of their metabolic control. Main clinical symptoms of acromegaly improved in 70-80% of patients.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Effects of treatment with octreotide in acromegalic patients--a multicenter Italian study. Italian Multicenter Octreotide Study Group. 758 66

Exaggerated growth hormone (GH) responses to various provocative stimuli have been reported previously in insulin-dependent diabetes mellitus (IDDM). Little is known about GH response to synthetic gonadotropin-releasing hormone (GnRH) in diabetes. It has been reported to be exaggerated in active acromegaly. We investigated GH, follicle-stimulating hormone (FSH) and luteinizing hormone (LH) levels after GnRH administration in seven IDDM and eight non-insulin-dependent diabetic (NIDDM) patients. They were poorly controlled from a metabolic point of view. Ten healthy subjects served as the control group. FSH and LH levels increased significantly after GnRH in all groups. In contrast, GnRH did not elicit significant GH increments above baseline levels in any group. Moreover, mean areas under the GH curves were comparable among the three groups. These results suggest that poorly controlled IDDM and NIDDM does not lead to inappropriate GH responses to GnRH.
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PMID:Does gonadotropin-releasing hormone administration affect serum growth hormone levels in poorly controlled insulin-dependent and non-insulin-dependent diabetes mellitus? 759 3

Acromegaly is a clinical syndrome that most typically is the manifestation of adenomatous hyperplasia of growth hormone-secreting cells in the pituitary gland. Although the primary process is benign, many disfiguring and potentially serious complications can develop. Because of the slow evolution of signs and symptoms, acromegaly can be a diagnostic challenge. Furthermore, many common diseases, such as hypertension, diabetes mellitus and hyperlipidemia, occur secondary to acromegaly but may initially be treated as isolated primary processes. Systematic evaluation should be performed if acromegaly is suspected. The diagnosis is based on clinical observation, hormonal assays and selective radiologic imaging. Acromegaly is most often treated surgically, but radiotherapy and drug therapy can be effective alternatives.
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PMID:Diagnosis and treatment of acromegaly. 760 64


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