Pub Date : 2018-08-27DOI: 10.15226/2374-6890/5/5/001114
Enrique López Gavilánez, K. Franco, Angel Segale Bajana, Noemi Bautista Litardo, M. Chávez, Mario Hernández Bonilla, Narcisa Solorzano Romero, Marcos loor Goya
Objective: To analyze thyroid cancer (TC) mortality rates from 1990 to 2016 in Ecuadorian men and women and compare their trends with Latin American and international trends. Design: A population-based temporal-trend study using the database of the Ecuadorian National Death Registry. Methods: Crude and age-adjusted mortality rates were calculated, and age-related mortality rates were standardized with the world population (WHO). Trends in age-standardized mortality rates were estimated by join point regression analysis. The trends were expressed as annual percentage change (APC) and average annual percentage change (AAPC). Results: In total, TC caused 2,107 deaths (1,475 women and 632 men) in the selected period. The mortality in men showed a statistically non-significant decrease. The estimated APC was −0.4% (P = 0.70), and the average AAPC was −0.4% (P = 0.70) without any identified jointpoint. In women, the mortality decreased significantly between 1990 and 1998, with the estimated APC being −6.6% (P < 0.05). However, it increased significantly from 1998 to 2016, with the estimated APC of 5.4% (P < 0.05), and a jointpoint was identified; the AAPC was 1.4 (P = 0.30). Conclusions: While TC mortality in Ecuadorian men showed a decrease, that in Ecuadorian women showed an initial decrease and a final increase. Our findings can be contrasted with the global data, which show decreases in TC mortality in both sexes.
{"title":"Trends of Thyroid Cancer Mortality Rates in Ecuador","authors":"Enrique López Gavilánez, K. Franco, Angel Segale Bajana, Noemi Bautista Litardo, M. Chávez, Mario Hernández Bonilla, Narcisa Solorzano Romero, Marcos loor Goya","doi":"10.15226/2374-6890/5/5/001114","DOIUrl":"https://doi.org/10.15226/2374-6890/5/5/001114","url":null,"abstract":"Objective: To analyze thyroid cancer (TC) mortality rates from 1990 to 2016 in Ecuadorian men and women and compare their trends with Latin American and international trends. Design: A population-based temporal-trend study using the database of the Ecuadorian National Death Registry. Methods: Crude and age-adjusted mortality rates were calculated, and age-related mortality rates were standardized with the world population (WHO). Trends in age-standardized mortality rates were estimated by join point regression analysis. The trends were expressed as annual percentage change (APC) and average annual percentage change (AAPC). Results: In total, TC caused 2,107 deaths (1,475 women and 632 men) in the selected period. The mortality in men showed a statistically non-significant decrease. The estimated APC was −0.4% (P = 0.70), and the average AAPC was −0.4% (P = 0.70) without any identified jointpoint. In women, the mortality decreased significantly between 1990 and 1998, with the estimated APC being −6.6% (P < 0.05). However, it increased significantly from 1998 to 2016, with the estimated APC of 5.4% (P < 0.05), and a jointpoint was identified; the AAPC was 1.4 (P = 0.30). Conclusions: While TC mortality in Ecuadorian men showed a decrease, that in Ecuadorian women showed an initial decrease and a final increase. Our findings can be contrasted with the global data, which show decreases in TC mortality in both sexes.","PeriodicalId":73731,"journal":{"name":"Journal of endocrinology and diabetes","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46841566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-08-06DOI: 10.15226/2374-6890/5/4/001112
Attakpa Sèlidji Eugène, M. Amina, Sangare Maxime Machioud, G. Félix, A. Rodrigue, Amoussa Abdou Madjid, Lagnika Latifou, B. Lamine, B. Seri, N. Khan
In the present study, we investigated the biochemical alterations and gene expression of carbohydrate and lipid metabolism after oral administration of Phyllanthus amarus. The quantitative estimation of total phenols, tannins and flavonoids showed that the extracts are rich in these compounds antioxidant potential of the ethanolic extract of the stem leaves of Phyllanthus amarus Schumach. & Thonn. Was evaluated by using 1, 1-diphenyl-2-picrylhydrazyl (DPPH) scavenging assay. The extract showed significant activities in all antioxidant assays compared to the reference antioxidant ascorbic acid in a dose dependent manner. Phyllanthus amarus significantly reduced the blood glucose level starting on the second week. Furthermore, the extract of P amarus showed significant increase in plasma insulin and tissue glycogen contents. The antidyslipidemic effect was demonstrated by a significant reduction in plasma total cholesterol (TC), triglycerides (TG), and low density lipoprotein-cholesterol (LDL-C), while the cardio-protective lipid, high density lipoprotein-cholesterol (HDL-C), was increased. Phyllanthus amarus also modulated the activities of carbohydrate-metabolizing enzymes by significantly increasing the activity of hexokinase and pyruvate kinase (p<0.05) and significantly reducing the activity of glucose-6-phosphatase, fructose-1,6-diphosphatase and glycogen phosphorylase (p<0.05). Phyllanthus amarus administration up-regulated mrna expression of Glucose Transporter-2 (GLUT-2), and increased lipolysis and cholesterol metabolism through up-regulation of lipoprotein lipase (LPL), Sterol Responsible Element Binding Protein-1a (STREBP-1a) expression. FAS expression was down regulated. The Phyllanthus amarus induced increase in serum insulin level, glucokinase (GK), aldolase, pyruvate kinase (PK), succinate dehydrogenase (SDH), and glycogen synthase activities in addition to a higher expression of insulin receptor A (IRA), GK, SDH.
{"title":"Molecular Mechanisms of Hypoglycemic and Antioxidative Effects of Phyllanthus Amarus on Streptozotocin-Induced Diabetic Rats","authors":"Attakpa Sèlidji Eugène, M. Amina, Sangare Maxime Machioud, G. Félix, A. Rodrigue, Amoussa Abdou Madjid, Lagnika Latifou, B. Lamine, B. Seri, N. Khan","doi":"10.15226/2374-6890/5/4/001112","DOIUrl":"https://doi.org/10.15226/2374-6890/5/4/001112","url":null,"abstract":"In the present study, we investigated the biochemical alterations and gene expression of carbohydrate and lipid metabolism after oral administration of Phyllanthus amarus. The quantitative estimation of total phenols, tannins and flavonoids showed that the extracts are rich in these compounds antioxidant potential of the ethanolic extract of the stem leaves of Phyllanthus amarus Schumach. & Thonn. Was evaluated by using 1, 1-diphenyl-2-picrylhydrazyl (DPPH) scavenging assay. The extract showed significant activities in all antioxidant assays compared to the reference antioxidant ascorbic acid in a dose dependent manner. Phyllanthus amarus significantly reduced the blood glucose level starting on the second week. Furthermore, the extract of P amarus showed significant increase in plasma insulin and tissue glycogen contents. The antidyslipidemic effect was demonstrated by a significant reduction in plasma total cholesterol (TC), triglycerides (TG), and low density lipoprotein-cholesterol (LDL-C), while the cardio-protective lipid, high density lipoprotein-cholesterol (HDL-C), was increased. Phyllanthus amarus also modulated the activities of carbohydrate-metabolizing enzymes by significantly increasing the activity of hexokinase and pyruvate kinase (p<0.05) and significantly reducing the activity of glucose-6-phosphatase, fructose-1,6-diphosphatase and glycogen phosphorylase (p<0.05). Phyllanthus amarus administration up-regulated mrna expression of Glucose Transporter-2 (GLUT-2), and increased lipolysis and cholesterol metabolism through up-regulation of lipoprotein lipase (LPL), Sterol Responsible Element Binding Protein-1a (STREBP-1a) expression. FAS expression was down regulated. The Phyllanthus amarus induced increase in serum insulin level, glucokinase (GK), aldolase, pyruvate kinase (PK), succinate dehydrogenase (SDH), and glycogen synthase activities in addition to a higher expression of insulin receptor A (IRA), GK, SDH.","PeriodicalId":73731,"journal":{"name":"Journal of endocrinology and diabetes","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44339090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-07-23DOI: 10.15226/2374-6890/5/4/001111
M. Zimering
{"title":"Thyroid Hormone Resistance in Identical Twin Sisters with Atrial Fibrillation: Case Report and Review of the Literature","authors":"M. Zimering","doi":"10.15226/2374-6890/5/4/001111","DOIUrl":"https://doi.org/10.15226/2374-6890/5/4/001111","url":null,"abstract":"","PeriodicalId":73731,"journal":{"name":"Journal of endocrinology and diabetes","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47712427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-07-11DOI: 10.15226/2374-6890/5/4/001110
Carine Ghassan Richa, Mohamad Souheil El Rawas
Background: Thyroidectomy is a challenging treatment for refractory amiodarone induced thyrotoxicosis (AIT). Objectives: The authors’ aim in this article is to conduct a systematic review of the currently available literature regarding thyroidectomy for the treatment of refractory AIT. Methods: The authors’ systematic review yielded 14 studies encompassing 39 patients. Results: All patients in this study developed thyrotoxicosis on amiodarone especially those with cardiac fragility and benefit from thyroidectomy to control all the symptoms of the hyperthyroid state without surgical risk or consequence on the cardiac status. Conclusion: Thyroidectomy remains the definitive management of refractory AIT and should be instituted sooner rather than later in a patient suffering from this condition. Received: June 18, 2018; Accepted: July 02,2018; Published: July 11,2018 *Corresponding author: Carine Ghassan Richa, Department of Endocrinology, Rafic El Hariri University Hospital, Beirut, Lebanon, Tel: +961 70144157;Email: karine.richa69@gmail.com
{"title":"Surgery in Refractory Amiodarone-Induced Thyrotoxicosis","authors":"Carine Ghassan Richa, Mohamad Souheil El Rawas","doi":"10.15226/2374-6890/5/4/001110","DOIUrl":"https://doi.org/10.15226/2374-6890/5/4/001110","url":null,"abstract":"Background: Thyroidectomy is a challenging treatment for refractory amiodarone induced thyrotoxicosis (AIT). Objectives: The authors’ aim in this article is to conduct a systematic review of the currently available literature regarding thyroidectomy for the treatment of refractory AIT. Methods: The authors’ systematic review yielded 14 studies encompassing 39 patients. Results: All patients in this study developed thyrotoxicosis on amiodarone especially those with cardiac fragility and benefit from thyroidectomy to control all the symptoms of the hyperthyroid state without surgical risk or consequence on the cardiac status. Conclusion: Thyroidectomy remains the definitive management of refractory AIT and should be instituted sooner rather than later in a patient suffering from this condition. Received: June 18, 2018; Accepted: July 02,2018; Published: July 11,2018 *Corresponding author: Carine Ghassan Richa, Department of Endocrinology, Rafic El Hariri University Hospital, Beirut, Lebanon, Tel: +961 70144157;Email: karine.richa69@gmail.com","PeriodicalId":73731,"journal":{"name":"Journal of endocrinology and diabetes","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67332565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-06-29DOI: 10.15226/2374-6890/5/3/001108
Grzyb K, J. N, O. E
The oral glucose tolerance test (OGTT) is performed in patients in whom abnormalities of glucose metabolism are suspected, but the criteria for diagnosing diabetes are not yet met. It is also routinely carried out in the management of diseases associated with a more or less pronounced disturbance of glucose intolerance. According to the current guidelines, during OGTT glycemia is measured before and two hours after the administration of glucose. In pregnancy, three measurements are obligatory (0’, 60’, 120’). When additional indications are present, glycemia is assessed also 30 minutes after the administration of glucose and when reactive hypoglycemia is suspected, the test is extended to 180 minutes. As of late, it is becoming a more and more common practice to measure blood glucose also 60 minutes post-administration. This technique is more reliable for the assessment of glucose tolerance disturbance. Self-observations also indicate this. It seems sensible to introduce a recommendation of such measurement as a routine practice.
{"title":"Increased Plasma Glucose Level after 1 Hour of Challenge in The Oral Glucose Tolerance Test (OGTT) as an Indicator of Pre-Diabetes","authors":"Grzyb K, J. N, O. E","doi":"10.15226/2374-6890/5/3/001108","DOIUrl":"https://doi.org/10.15226/2374-6890/5/3/001108","url":null,"abstract":"The oral glucose tolerance test (OGTT) is performed in patients in whom abnormalities of glucose metabolism are suspected, but the criteria for diagnosing diabetes are not yet met. It is also routinely carried out in the management of diseases associated with a more or less pronounced disturbance of glucose intolerance. According to the current guidelines, during OGTT glycemia is measured before and two hours after the administration of glucose. In pregnancy, three measurements are obligatory (0’, 60’, 120’). When additional indications are present, glycemia is assessed also 30 minutes after the administration of glucose and when reactive hypoglycemia is suspected, the test is extended to 180 minutes. As of late, it is becoming a more and more common practice to measure blood glucose also 60 minutes post-administration. This technique is more reliable for the assessment of glucose tolerance disturbance. Self-observations also indicate this. It seems sensible to introduce a recommendation of such measurement as a routine practice.","PeriodicalId":73731,"journal":{"name":"Journal of endocrinology and diabetes","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67332462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-06-28DOI: 10.15226/2374-6890/5/3/001107
Lorenc A, O. E
Diabetes during pregnancy may occur as pregestational or gestational diabetes mellitus. Throughout gestation there is a close relationship between maternal and fetal blood glucose concentrations. Maternal hyperglycemia leads to hyperglycemia of the fetus, stimulating the fetal pancreas to synthesize excessive amounts of insulin. At the time of delivery, after separation of the placenta, the flow of glucose to the newborn that is appropriate for hyperglycemia is suddenly interrupted. Excessive insulin production in the fetus in response to maternal hyperglycemia can cause severe hypoglycaemia during the neonatal period. It is a very common complication of maternal diabetes. In healthy children during the first 4-6 postnatal hours there is a physiological decrease in glucose level from the mother’s blood level to about 2.5 mmol / l (45 mg / dl). This is related to still not fully developed adaptive mechanisms. There is strong evidence that good glycemic control is essential for an optimal outcome of pregnancy in diabetic women. Despite advances in perinatal care, infants of diabetic mothers remain at risk for a multitude of physiologic, metabolic, and congenital complications such as preterm birth, macrosomia, respiratory distress, hypoglycemia, hypocalcemia, hyperbilirubinemia, hypertrophic cardiomyopathy, and congenital anomalies, particularly of the central nervous system.
{"title":"Maternal Diabetes Mellitus – Risk Factor for Fetus and Infant","authors":"Lorenc A, O. E","doi":"10.15226/2374-6890/5/3/001107","DOIUrl":"https://doi.org/10.15226/2374-6890/5/3/001107","url":null,"abstract":"Diabetes during pregnancy may occur as pregestational or gestational diabetes mellitus. Throughout gestation there is a close relationship between maternal and fetal blood glucose concentrations. Maternal hyperglycemia leads to hyperglycemia of the fetus, stimulating the fetal pancreas to synthesize excessive amounts of insulin. At the time of delivery, after separation of the placenta, the flow of glucose to the newborn that is appropriate for hyperglycemia is suddenly interrupted. Excessive insulin production in the fetus in response to maternal hyperglycemia can cause severe hypoglycaemia during the neonatal period. It is a very common complication of maternal diabetes. In healthy children during the first 4-6 postnatal hours there is a physiological decrease in glucose level from the mother’s blood level to about 2.5 mmol / l (45 mg / dl). This is related to still not fully developed adaptive mechanisms. There is strong evidence that good glycemic control is essential for an optimal outcome of pregnancy in diabetic women. Despite advances in perinatal care, infants of diabetic mothers remain at risk for a multitude of physiologic, metabolic, and congenital complications such as preterm birth, macrosomia, respiratory distress, hypoglycemia, hypocalcemia, hyperbilirubinemia, hypertrophic cardiomyopathy, and congenital anomalies, particularly of the central nervous system.","PeriodicalId":73731,"journal":{"name":"Journal of endocrinology and diabetes","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49273692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-06-26DOI: 10.15226/2374-6890/5/3/001106
Grzyb Karolina, D. Aleksandra, Jainta Natalia, O. Ewa
Vitamin A as an essential micronutrient is needed for multiple physiological processes. The association between this nutrient and glucose metabolism has been documented in numerous studies with animals and humans. Vitamin A is required for the maintenance of pancreatic β and α cell mass and for glucose-stimulated insulin secretion. Moreover, the vitamin and its metabolites modulate insulin resistance. Many studies indicate the role of vitamin A in the pathogenesis of type 1 diabetes through its effect on regulation of autoimmune processes and β cell mass as well as in type 2 diabetes through its effect on insulin resistance. Retinol ‘family’ plays an important role in maintaining the correct glucose metabolism, so it is essential to provide the homeostasis of this nutrients in the body. Awareness of pathophysiology of retinol’s impact on the organism is crucial, one of the most costly chronic diseases may be prevented by food fortification and it may result in insertion of newest drugs in diabetology.
{"title":"Considering The Role of Vitamin A in Glucose Metabolism","authors":"Grzyb Karolina, D. Aleksandra, Jainta Natalia, O. Ewa","doi":"10.15226/2374-6890/5/3/001106","DOIUrl":"https://doi.org/10.15226/2374-6890/5/3/001106","url":null,"abstract":"Vitamin A as an essential micronutrient is needed for multiple physiological processes. The association between this nutrient and glucose metabolism has been documented in numerous studies with animals and humans. Vitamin A is required for the maintenance of pancreatic β and α cell mass and for glucose-stimulated insulin secretion. Moreover, the vitamin and its metabolites modulate insulin resistance. Many studies indicate the role of vitamin A in the pathogenesis of type 1 diabetes through its effect on regulation of autoimmune processes and β cell mass as well as in type 2 diabetes through its effect on insulin resistance. Retinol ‘family’ plays an important role in maintaining the correct glucose metabolism, so it is essential to provide the homeostasis of this nutrients in the body. Awareness of pathophysiology of retinol’s impact on the organism is crucial, one of the most costly chronic diseases may be prevented by food fortification and it may result in insertion of newest drugs in diabetology.","PeriodicalId":73731,"journal":{"name":"Journal of endocrinology and diabetes","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44498354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-06-22DOI: 10.15226/2374-6890/5/4/001105
F. Amaro, S. Tumini
In the pediatric age HbA1c values below 7.5% represent the ideal metabolic and glicemic target in DMT1 patients, but the literature shows that many of them are still very far from reaching this goal. The introduction of rapid and basal analogues, the reappearance of Continuous Subcutaneous insulin infusion (CSII), the progress in Continuous Glucose Monitoring (CGM) systems, the introduction of Sensor Augmented Pump (SAP), insulin pump system with Predictive Low-Glucose Management (PLGM) or Predictive Hyperglycemia and Hypoglycemia Minimization (PHHM) have brought about significant improvements in treatment options. The most promising new basal insulins are insulin degludec and insulin glargine U-300. The aim of this review is to analyze emerging data from the literature, also considering real-life data, in order to identify the clinical implication of the use of these new molecules. Received: May 16, 2018; Accepted: June 15, 2018; Published: June 22, 2018 *Corresponding author: Flavia Amaro, Department of Pediatrics, G. D’Annunzio University, Chieti, Italy, E-mail: flavia.amaro@hotmail.it
在儿童年龄段，HbA1c值低于7.5%代表DMT1患者理想的代谢和血糖目标，但文献显示，许多DMT1患者离这一目标还很遥远。快速和基础类似物的引入，持续皮下胰岛素输注(CSII)的重新出现，连续葡萄糖监测(CGM)系统的进展，传感器增强泵(SAP)的引入，具有预测性低血糖管理(PLGM)或预测性高血糖和低血糖最小化(PHHM)的胰岛素泵系统带来了治疗选择的显着改善。最有前途的新型基础胰岛素是去糖精胰岛素和甘精胰岛素U-300。本综述的目的是分析文献中的新数据，并考虑实际数据，以确定使用这些新分子的临床意义。收稿日期:2018年5月16日;录用日期:2018年6月15日;通讯作者:Flavia Amaro，意大利基耶蒂G. D 'Annunzio大学儿科学系，E-mail: flavia.amaro@hotmail.it
{"title":"The Possible Role of New Basal Insulin Analogues in Pediatric Population","authors":"F. Amaro, S. Tumini","doi":"10.15226/2374-6890/5/4/001105","DOIUrl":"https://doi.org/10.15226/2374-6890/5/4/001105","url":null,"abstract":"In the pediatric age HbA1c values below 7.5% represent the ideal metabolic and glicemic target in DMT1 patients, but the literature shows that many of them are still very far from reaching this goal. The introduction of rapid and basal analogues, the reappearance of Continuous Subcutaneous insulin infusion (CSII), the progress in Continuous Glucose Monitoring (CGM) systems, the introduction of Sensor Augmented Pump (SAP), insulin pump system with Predictive Low-Glucose Management (PLGM) or Predictive Hyperglycemia and Hypoglycemia Minimization (PHHM) have brought about significant improvements in treatment options. The most promising new basal insulins are insulin degludec and insulin glargine U-300. The aim of this review is to analyze emerging data from the literature, also considering real-life data, in order to identify the clinical implication of the use of these new molecules. Received: May 16, 2018; Accepted: June 15, 2018; Published: June 22, 2018 *Corresponding author: Flavia Amaro, Department of Pediatrics, G. D’Annunzio University, Chieti, Italy, E-mail: flavia.amaro@hotmail.it","PeriodicalId":73731,"journal":{"name":"Journal of endocrinology and diabetes","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48025602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-06-20DOI: 10.15226/2374-6890/5/4/001113
M. Çalışkan, M. Kizilgul, O. Ozcelik, S. Beysel, E. Çakal
Aim: Pentraxin 3 (PTX3) is an acute-phase glycoprotein, which is increased in patients with cardiovascular disease (CVD) and considered as a predictor of CVD in the general population. Accumulating evidence suggests that even mild primary hyperparathyroidism (PHPT) has an elevated risk for CVD. We aimed to investigate plasma PTX3 levels before and after parathyroidectomy in patients with primary hyperparathyroidism and determine its relationship with cardiovascular risk factors Material and Method: Twenty-nine patients with PHPT and 26 healthy controls were enrolled in the study. Anthropometric and laboratory parameters were recorded both before and 6 months after parathyroidectomy. Serum PTX3 levels were measured using a human PTX3 enzyme-linked immunosorbent assay. Results: Plasma PTX3 concentrations were similar between before and after parathyroidectomy and control group (10.97 ± 16.0, 11.97 ± 11.49, 7.88 ± 9.48, respectively, p>0.05). Systolic blood pressure, diastolic blood pressure, carotid intima-media thickness (CIMT) and calcium, parathormone, fasting plasma glucose, alkaline phosphatase concentrations were higher in the PHPT group (p<0.05). Creatinine and phosphorus concentrations were higher in the control group (p<0.05). PTX3 was not correlated with cardi-metabolic risk factors except body mass index (BMI) (r2:0.414, p:0.0253). Conclusion: Plasma PTX3 was not increased as well was not changed after parathyroidectomy in patients with PHPT. The PTX3 was correlated with BMI; however, it was not associated with other cardio-metabolic risk factors including DBP, CIMT, and CRP. These findings might support PTX3 cannot be used as a cardio-metabolic risk marker in patients with PHPT.
{"title":"Pentraxin 3 as A Cardiovascular Marker in Primary Hyperparathyroidism","authors":"M. Çalışkan, M. Kizilgul, O. Ozcelik, S. Beysel, E. Çakal","doi":"10.15226/2374-6890/5/4/001113","DOIUrl":"https://doi.org/10.15226/2374-6890/5/4/001113","url":null,"abstract":"Aim: Pentraxin 3 (PTX3) is an acute-phase glycoprotein, which is increased in patients with cardiovascular disease (CVD) and considered as a predictor of CVD in the general population. Accumulating evidence suggests that even mild primary hyperparathyroidism (PHPT) has an elevated risk for CVD. We aimed to investigate plasma PTX3 levels before and after parathyroidectomy in patients with primary hyperparathyroidism and determine its relationship with cardiovascular risk factors Material and Method: Twenty-nine patients with PHPT and 26 healthy controls were enrolled in the study. Anthropometric and laboratory parameters were recorded both before and 6 months after parathyroidectomy. Serum PTX3 levels were measured using a human PTX3 enzyme-linked immunosorbent assay. Results: Plasma PTX3 concentrations were similar between before and after parathyroidectomy and control group (10.97 ± 16.0, 11.97 ± 11.49, 7.88 ± 9.48, respectively, p>0.05). Systolic blood pressure, diastolic blood pressure, carotid intima-media thickness (CIMT) and calcium, parathormone, fasting plasma glucose, alkaline phosphatase concentrations were higher in the PHPT group (p<0.05). Creatinine and phosphorus concentrations were higher in the control group (p<0.05). PTX3 was not correlated with cardi-metabolic risk factors except body mass index (BMI) (r2:0.414, p:0.0253). Conclusion: Plasma PTX3 was not increased as well was not changed after parathyroidectomy in patients with PHPT. The PTX3 was correlated with BMI; however, it was not associated with other cardio-metabolic risk factors including DBP, CIMT, and CRP. These findings might support PTX3 cannot be used as a cardio-metabolic risk marker in patients with PHPT.","PeriodicalId":73731,"journal":{"name":"Journal of endocrinology and diabetes","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43162008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-01-01Epub Date: 2018-07-23DOI: 10.15226/2374-6890/5/4/01111
Mark B Zimering
Aim: To report identical twin sisters harboring the A317T mutation in the thyroid hormone beta receptor gene (TR β) who developed atrial fibrillation and refractory congestive heart failure in the sixth decade of life. To critically assess whether the A317T mutation may be responsible for increased cardiotoxicity compared to other thyroid hormone beta receptor gene mutations.
Methods: A 59-year-old woman referred for evaluation of abnormal thyroid function tests had been experiencing frequent spells of tachycardia associated with dyspnea, and dizziness necessitating multiple hospitalizations. Elevation in free thyroxine (T4), total triiodothyronine (T3) and inappropriately normal thyroid stimulating hormone (TSH) was consistent with a clinical diagnosis of thyroid hormone resistance. Magnetic resonance imaging of the brain was negative for a TSH-secreting pituitary adenoma. A blood sample was sent for thyroid hormone receptor gene mutational analysis, but it would require eight weeks to complete processing.
Results: A modified L-T3 suppression test was used to assess thyroid-pituitary axis feedback. After three weeks' of cytomel (L-T3) (25 micrograms daily) TSH decreased by 50%, and free T4 level decreased by 22% compared to baseline levels. Genetic testing revealed a heterozygous A317T mutation in the thyroid hormone beta receptor gene. Serial two-dimensional echocardiography demonstrated evolution to left atrial enlargement over a three-year period. Prior published literature suggests a less than 10% prevalence of atrial fibrillation in adults with thyroid hormone resistance harboring various TR-β gene mutations. Yet all five of five (100%) adults having the A317T mutation were reported to experience atrial fibrillation by age 50.
Conclusions: A new kindred with resistance to thyroid hormone harboring the A317T disease-causative mutation is described in which identical twin sisters had a mid-life onset of atrial fibrillation and refractory congestive heart failure.
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