Endocrine and Metabolic Science最新文献

Objective

This study provided a rough estimate incidence of primary pediatric central diabetes insipidus (CDI) and examines the diagnostic factors between pediatric CDI and primary polydipsia (PP).

Methods

We collected 27 patients with chief complaints of polyuria and/or polydipsia from January 2014 to December 2018 in the Department of Pediatrics, Our University Hospital.

Results

We diagnosed type 1 diabetes mellitus (T1DM) in 16 patients, CDI in 5, PP in 5, and nocturnal enuresis in 1. The rough estimate incidence rate of pediatric CDI was 0.71/100,000/year. The diagnostic factors were a body mass index (BMI), urine gravity in the morning, urine volume and intake volume over 24 h, and bright spots in the posterior pituitary in a magnetic resonance image (MRI). The cutoff value of urine gravity in the morning for CDI was <1.010, with a sensitivity of 100 % and specificity of 100 %. The cutoff value of urine volume over 24 h for CDI was >2299 mL/m², with a sensitivity of 100 % and specificity of 85.7 %. No pediatric CDI patients had the bright spot in the posterior pituitary of their MRI, using a type 1–weighted image; however, only 1 out of 4 PP patients did not show the bright spot.

Conclusion

The rough estimate incidence of pediatric CDI with polydipsia and polyuria under the limited condition was 0.71/100,000/year, which was very low. Distinguishable factors between CDI patients and PP patients were BMI, urine and intake volumes over 24 h, and a bright spot on an MRI. Further studies with multiple institutes and more patients are required to confirm these findings.

Zinc (Zn) has proven to play a key role in spermatogenesis. The present study focused on the nutritional supplementation of Zn against cisplatin (CP)-induced spermatogonial and testicular dysfunctions.

Thirty-two (32) mature male Sprague Dawley rats were randomized into four groups of eight (n = 8) rats each – Control group (received 2 ml of normal saline); Zn group (received 1 mg/kg body weight (bwt) of Zn sulfate); Cisplatin group treated intraperitoneally with a single dose (10 mg/kg bwt) of CP; and CP + Zn group, after induction of testicular toxicity, were treated (orally) with 1 mg/kg bwt of Zn sulfate. The procedure lasted for 8 weeks. Parameters tested include testicular histology, sperm parameters, testosterone (TT), follicle-stimulating hormone (FSH) and luteinizing hormone (LH), catalase (CAT), superoxide dismutase (SOD), peroxidase (POD), glutathione reductase (GR), thiobarbituric acid reactive substances (TBARS).

Cisplatin significantly decreases (p < 0.05) sperm quality, testosterone, FSH and LH, epithelial cell height, tubular diameter, number of spermatogonia, spermatocytes, and spermatids with concomitant increase in thiobarbituric acid reactive substances (TBARS). Zinc supplementation reversed the toxic effect of CP on sperm characterization, hormone profiling, histological and biochemical parameters.

Zinc supplementation, therefore, ameliorates the deleterious effect of CP on cytoarchitecture of the testis, protected the seminiferous epithelium, and reduced oxidative stress thereby promoting spermatogenesis.

Nutrient contents of sugar palm (Borassus flabellifer) fruit pulp (SPFP) cultivated in Bangladesh are yet to be well-reviewed. Moreover, the nutrient contents of other popularly consumed edible portions of sugar palm fruit, i.e., immature endosperm (IE), and germinated endosperm (GE) are not studied yet. The current study showed that SPFP, IE, and GE were rich in carbohydrate, fiber, sodium, potassium, and zinc. IE contained the highest amount of fiber, while SPFP contained the highest amount of copper. Twenty-five phytochemicals having known antidiabetic effects were investigated for their presence in pulp, immature & germinated endosperm. GE contained the highest number of phytochemicals (23) followed by IE (19) and SPFP (14). Diabetic patients usually avoid edible portions of sugar palm, fearing that these may further deteriorate existing hyperglycemia. In the present study, this suspicion was investigated in alloxan-induced diabetic rats through supplementary feeding of SPFP, IE, & GE in addition to the regular diet for the nine consecutive weeks. Study results clearly showed that SPFP, IE, & GE significantly reduced fasting blood glucose (FBG) levels of experimental rats. GE showed maximum antidiabetic effects followed by IE and SPFP, respectively. GE, and IE returned the FBG levels within normal range by the end of the sixth week but not by the SPFP. Endosperms supplemented diabetic rats maintained the normal FBG levels even after withdrew the supplementary diets. These results suggested that supplemental feeding of the GE and IE to the experimental diabetic rats may restore alloxan damaged pancreatic β-cell function, and the reasons might be the presence of fiber, zinc and phytochemicals content of the endosperm.

Severely ill COVID–19 (Corona Virus Disease of 2019) patients have a hyperinflammatory condition with a high concentration of pro-inflammatory cytokines termed the cytokine storm. This milieu is reported to cause acute lung injury, oxygen deprivation, multiorgan damage, critical illness, and often death. Post SARS–CoV–2 (Severe Acute Respiratory Syndrome Coronavirus 2) infection, the fight between the invading virus and the host's immune system would either terminate in recovery, with eradication of the infection and regulation of the immune system; or there would be a continuation of immune attacks even after the virus has been cleared, leading to immune dysregulation and disease. This outcome is chiefly dependent on two factors: (1) the patient's immune response, and (2) sufficiency plus efficiency of the regulator(s). Concerning the first, the present research introduces a framework based on different types of immune responses to SARS–CoV–2 along with known disease examples, and how this relates to varying clinical outcomes and treatment needs for COVID–19 patients. About the second factor of ‘regulator(s)’, part 1 of the manuscript described in depth the regulatory role of progesterone in COVID–19. The present study investigates five immunity patterns and the status of the regulatory hormone progesterone with respect to the two established demographic risk factors for COVID–19 high-severity: male sex, and old age. The study evaluates the status of progesterone as a credible determinant of immune regulation and dysregulation. It duly relates the immunity patterns to clinical outcomes and evinces indications for clinical use of progesterone in COVID–19. It proposes a clear answer to the question: "why are males and old patients most likely to have critical illness due to COVID–19?" The study highlights clinical domains for the use of progesterone in COVID–19. Part 2 of this research introduces the concept of immunity patterns and immunity grading. These concepts herewith provided for the clinical course of COVID–19 also apply to other hyperinflammatory conditions. Possible clinical applications of progesterone to treat critically ill COVID–19 patients will open an avenue for hormonal treatments of infections and other immune-related diseases.

Background and Aims

Hypertension is gradually becoming a major health burden in Nigeria; the most populous African nation. Often this starts unnoticed, but later, this disorder leads to complications and death if not properly managed. This study assessed the level of peroxisome proliferator-activated receptor-gamma (PPAR-γ), insulin, glucose and lipid profile components in hypertensive Nigerians.

Methods

A total number of four hundred and nineteen volunteers consisting of two hundred and fifteen (215) hypertensive and two hundred and four (204) normotensive participants (of which two hundred and sixty (260) and one hundred and fifty-nine (159) were female and male respectively) participated in this study. Blood pressure of all volunteers was measured and blood samples of the consenting participants were collected in their fasting state and were analyzed for PPAR-γ, insulin, glucose, glycated haemoglobin (HbA1c) and lipid profile using enzyme-linked immunosorbent assay and Cobas C-111 auto-analyzer respectively. Homeostatic model assessment for insulin resistance (HOMA-IR) was calculated.

Results

The mean body mass index (BMI) and blood pressure of hypertensive volunteers were higher (P<0.05) than the control. The female participants had higher (p<0.05) BMI and systolic blood pressure when compared with male counterpart. The circulating levels of PPAR-γ were not significantly different (P>0.05) between hypertensive and control volunteers as well as between gender studied. The glucose, insulin, total cholesterol (TC), high density lipoprotein cholesterol (HDL-c) and Low density lipoprotein cholesterol (LDL-c) were higher in hypertensive volunteers (P<0.05). Insulin, HOMA-IR, total cholesterol, triglycerides and HDL-c were significantly raised (p<0.05) in female participants when compared with male. Negative association existed between PPAR-γ and HbA1c (P<0.001), and between PPAR-γ and glucose (P>0.05). Positive association existed between HOMA-IR and HbA1c, HOMA-IR and Glucose (P<0.001), HOMA-IR and Cholesterol (P<0.05).

Conclusion

Hypertensive volunteers demonstrated higher BMI, insulin, glucose, HbA1c, HOMA-IR, and LDL-c all these could precipitate metabolic dysfunction.

SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2) infection is a global medical challenge. Experience based medicines and therapies are being attempted and vaccines are being developed. SARS-CoV-2 exhibits varied patterns of infection and clinical presentations with varied disease outcomes. These attributes are strongly suggestive of some variables that differ among individuals and that affect the course of SARS-CoV-2 infection and symptoms of COVID-19 (Corona Virus Disease of 2019). Sex hormones vary with ageing, between the sexes, among individuals and populations. Sex hormones are known to play a role in immunity and infections. Progesterone is a critical host factor to promote faster recovery following Influenza A virus infection. Anti-inflammatory effects of progesterone are noted. In part 1 of the current study the regulatory role of progesterone for SARS-CoV-2 infection and COVID-19 is analyzed. The role of progesterone at different stages of the SARS CoV-2 infection is investigated with respect to two types of immunity status: immune regulation and immune dysregulation. Progesterone could have various alleviating impacts from SARS-CoV-2 entry till recovery: reversing of hypoxia, stabilizing of blood pressure, controlling thrombosis, balancing electrolytes, reducing the viral load, regulation of immune responses, damage repair, and clearance of debris among others. The present research adds to the available evidence by providing a comprehensive and thorough evaluation of the regulatory role of progesterone in SARS COV-2 infection, COVID-19 pathogenesis, and immune dysregulation. The available evidence has implications for upcoming studies about pathophysiology of COVID-19, as well as the roles of progesterone and other hormones in other infectious diseases.

A stable narrow range of extracellular calcium concentration in the blood is essential for life. The calcium-sensing receptor (CaSR), a member of the G protein-coupled receptors family, is required to adjust the set point of blood extracellular calcium concentration, thus regulate parathyroid hormone (PTH) secretion and renal calcium excretion. Loss or gain function of CaSR mutations may result in either hyper- or hypocalcaemia. The CaSR activating mutations increase its sensitivity to extracellular ionized calcium (Ca²⁺). As consequence, PTH synthesis and secretion are suppressed continuously at normal ionized calcium concentrations. Patients display hypocalcaemia, hyperphosphatemia and lower levels of PTH. Urinary calcium excretion is increased due to the decreased circulating inappropriately PTH level and the activation of the renal tubular CaSR. Therefore, CaSR becomes a good potential clinical therapeutic target for hypoparathyroidism treatment. In order to define new drugs and improve medical management of hypoparathyroidism patients, this study attempts to identify new CaSR variants and analyse in detail the functional change of these CaSR variants, thus better understand the molecular mechanism involved. The study is based on collected hypoparathyroidism patients in our clinical site. In the study we enrolled in 10 patients, obtained all their clinical results and DNA results from seven patients. Our results indicated that the effect of serum intact PTH level correlated to change of serum Ca²⁺ and phosphate level. The CaSR carrying newly identified DNA variants displayed strong phosphorylation of phospholipase C and mitogen-activated protein kinases. Although the size of clinical cases need to be accumulated, current cases have showed a tendency that the identified multiple DNA variants in CaSR gene revealed an effect on the diagnostic criterion of the hypocalcaemic syndrome. It is undeniable that our research has certain limitations. So far, we tested several DNA variants at the same time, further functional examination for individual DNA variant would largely help to be better understand the mechanisms of CaSR regulation on extracellular calcium concentration.

Increased activity of the sympathetic nervous system (SNS) may play an important role in the development of hypertension and in adiposity disorders. We aimed to investigate the influence of increased sympathetic tone and hypothalamic–pituitary–adrenal (HPA) axis activation in metabolic parameters by evaluating the morphometry of isolated adipocytes from different fat pads and energy consumption. Serum levels of catecholamines, HPA hormones, T3 and adipokines were measured in 15-weeks-old Wistar (WIS), Wistar-Kyoto (WKY), Spontaneously Hypertensive Rats (SHR) and WIS treated with N^G-nitro-L-arginine methyl ester (L-NAME). L-NAME and SHR showed a reduced adiposity when compared to their controls, which may be related to higher concentrations of T3. However, SHR presented the most evident lipodystrophy, presenting significant changes in the morphometry from isolated adipocytes and the production of adipokines. Thus, our study suggests that endocrine changes in hypertension models may highlight possible therapeutic targets in the treatment of metabolic changes associated with hypertension.