Pub Date : 2023-11-01Epub Date: 2023-09-26DOI: 10.1055/a-2181-6664
Nosipho R Dimba, Nhlakanipho Mzimela, Palesa Mosili, Phikelelani S Ngubane, Andile Khathi
Introduction: Chronic consumption of a high-calorie diet compromises the gut microbiota and the integrity of the intestinal wall, which causes translocation of bacterial lipopolysaccharides (LPS) into the blood. This elicits the secretion of pro-inflammatory cytokines, resulting in inflammation. However, how a high-fat high carbohydrate diet affects intestinal permeability and its possible role in the development of prediabetes have not been investigated. This study investigated the effects of HFHC diet-induced prediabetes on gut microbiota and intestinal permeability in male Sprague Dawley rats.
Methods: The animals were randomly assigned into the non-prediabetic (NPD) and diet-induced prediabetic (PD) groups (n=6) for 20 weeks. Then, the fecal samples were analyzed to measure the gut microbiota level of Firmicutes, Bacteroidetes, and Proteobacteria in both animal groups. Blood glucose, plasma insulin, serum zonulin, plasma LPS, soluble CD14, tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), C-reactive protein (CRP), and intestinal fatty-acid binding protein (IFABP) concentrations were measured.
Results: The PD group had a reduction in the Firmicutes and an increase in Bacteroidetes and Proteobacteria levels compared to those in the NPD group. Blood glucose, insulin concentration, serum zonulin, and plasma sCD14 concentrations in the PD group increased significantly, while plasma LPS concentrations were similar to the NPD group. Concentrations of plasma TNF-α, IL-6, CRP, and IFABP, an intracellular protein expressed in the intestine, increased in PD compared to the NPD group.
Conclusions: the study results cumulatively suggest that chronic consumption of the HFHC diet may be associated with the dysregulation of gut microbiota, leading to increased intestinal permeability.
{"title":"Investigating the Association Between Diet-Induced \"Leaky Gut\" and the Development of Prediabetes.","authors":"Nosipho R Dimba, Nhlakanipho Mzimela, Palesa Mosili, Phikelelani S Ngubane, Andile Khathi","doi":"10.1055/a-2181-6664","DOIUrl":"10.1055/a-2181-6664","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic consumption of a high-calorie diet compromises the gut microbiota and the integrity of the intestinal wall, which causes translocation of bacterial lipopolysaccharides (LPS) into the blood. This elicits the secretion of pro-inflammatory cytokines, resulting in inflammation. However, how a high-fat high carbohydrate diet affects intestinal permeability and its possible role in the development of prediabetes have not been investigated. This study investigated the effects of HFHC diet-induced prediabetes on gut microbiota and intestinal permeability in male Sprague Dawley rats.</p><p><strong>Methods: </strong>The animals were randomly assigned into the non-prediabetic (NPD) and diet-induced prediabetic (PD) groups (n=6) for 20 weeks. Then, the fecal samples were analyzed to measure the gut microbiota level of <i>Firmicutes, Bacteroidetes,</i> and <i>Proteobacteria</i> in both animal groups. Blood glucose, plasma insulin, serum zonulin, plasma LPS, soluble CD14, tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), C-reactive protein (CRP), and intestinal fatty-acid binding protein (IFABP) concentrations were measured.</p><p><strong>Results: </strong>The PD group had a reduction in the <i>Firmicutes</i> and an increase in <i>Bacteroidetes</i> and <i>Proteobacteria</i> levels compared to those in the NPD group. Blood glucose, insulin concentration, serum zonulin, and plasma sCD14 concentrations in the PD group increased significantly, while plasma LPS concentrations were similar to the NPD group. Concentrations of plasma TNF-α, IL-6, CRP, and IFABP, an intracellular protein expressed in the intestine, increased in PD compared to the NPD group.</p><p><strong>Conclusions: </strong>the study results cumulatively suggest that chronic consumption of the HFHC diet may be associated with the dysregulation of gut microbiota, leading to increased intestinal permeability.</p>","PeriodicalId":94001,"journal":{"name":"Experimental and clinical endocrinology & diabetes : official journal, German Society of Endocrinology [and] German Diabetes Association","volume":" ","pages":"569-576"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41176310","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 : 2023-11-01Epub Date: 2023-10-24DOI: 10.1055/a-2174-7958
Magdalena Danowska, Marek Strączkowski
Skeletal muscle is the tissue directly involved in insulin-stimulated glucose uptake. Glucose is the primary energy substrate for contracting muscles, and proper metabolism of glucose is essential for health. Contractile activity and the associated Ca2+signaling regulate functional capacity and muscle mass. A high concentration of Ca2+and the presence of calmodulin (CaM) leads to the activation of calcineurin (CaN), a protein with serine-threonine phosphatase activity. The signaling pathway linked with CaN and transcription factors like the nuclear factor of activated T cells (NFAT) is essential for skeletal muscle development and reprogramming of fast-twitch to slow-twitch fibers. CaN activation may promote metabolic adaptations in muscle cells, resulting in better insulin-stimulated glucose transport. The molecular mechanisms underlying the altered insulin response remain unclear. The role of the CaN/NFAT pathway in regulating skeletal muscle hypertrophy is better described than its involvement in the pathogenesis of insulin resistance. Thus, there are opportunities for future research in that field. This review presents the role of CaN/NFAT signaling and suggests the relationship with insulin-resistant muscles.
{"title":"The Ca2+/Calmodulin-dependent Calcineurin/NFAT Signaling Pathway in the Pathogenesis of Insulin Resistance in Skeletal Muscle.","authors":"Magdalena Danowska, Marek Strączkowski","doi":"10.1055/a-2174-7958","DOIUrl":"10.1055/a-2174-7958","url":null,"abstract":"<p><p>Skeletal muscle is the tissue directly involved in insulin-stimulated glucose uptake. Glucose is the primary energy substrate for contracting muscles, and proper metabolism of glucose is essential for health. Contractile activity and the associated Ca<sup>2+</sup>signaling regulate functional capacity and muscle mass. A high concentration of Ca<sup>2+</sup>and the presence of calmodulin (CaM) leads to the activation of calcineurin (CaN), a protein with serine-threonine phosphatase activity. The signaling pathway linked with CaN and transcription factors like the nuclear factor of activated T cells (NFAT) is essential for skeletal muscle development and reprogramming of fast-twitch to slow-twitch fibers. CaN activation may promote metabolic adaptations in muscle cells, resulting in better insulin-stimulated glucose transport. The molecular mechanisms underlying the altered insulin response remain unclear. The role of the CaN/NFAT pathway in regulating skeletal muscle hypertrophy is better described than its involvement in the pathogenesis of insulin resistance. Thus, there are opportunities for future research in that field. This review presents the role of CaN/NFAT signaling and suggests the relationship with insulin-resistant muscles.</p>","PeriodicalId":94001,"journal":{"name":"Experimental and clinical endocrinology & diabetes : official journal, German Society of Endocrinology [and] German Diabetes Association","volume":" ","pages":"589-594"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50159571","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}
Introduction: Pioglitazone is an insulin sensitizer used for the treatment of type 2 diabetes mellitus (T2DM) by activating peroxisome proliferator-activated receptor gamma. This study aimed to investigate the effects of pioglitazone on white adipose tissue (WAT) and brown adipose tissue (BAT) in diet-induced obese (DIO) mice.
Methods: C57BL/6 mice were treated with pioglitazone (30 mg/kg/day) for 4 weeks after a 16-week high-fat diet (HFD) challenge. Body weight gain, body fat mass, energy intake, and glucose homeostasis were measured during or after the treatment. Histopathology was observed by hematoxylin and eosin, oil red O, immunohistochemistry, and immunofluorescence staining. Expression of thermogenic and mitochondrial biogenesis-related genes was detected by quantitative real-time PCR and western blotting.
Results: After 4-week pioglitazone treatment, the fasting blood glucose levels, glucose tolerance, and insulin sensitivity were significantly improved, but the body weight gain and fat mass were increased in DIO mice. Compared with the HFD group, pioglitazone did not significantly affect the weights of liver and WAT in both subcutaneous and epididymal regions. Unexpectedly, the weight of BAT was increased after pioglitazone treatment. Histological staining revealed that pioglitazone ameliorated hepatic steatosis, reduced the adipocyte size in WAT, but increased the adipocyte size in BAT.
Conclusion: Though pioglitazone can promote lipolysis, thermogenesis, and mitochondrial function in WAT, it leads to impaired thermogenesis, and mitochondrial dysfunction in BAT. In conclusion, pioglitazone could promote the browning of WAT but led to the whitening of BAT; the latter might be a new potential mechanism of pioglitazone-induced weight gain during T2DM treatment.
{"title":"Pioglitazone-Enhanced Brown Fat Whitening Contributes to Weight Gain in Diet-Induced Obese Mice.","authors":"Piaojian Yu, Wei Wang, Wanrong Guo, Lidan Cheng, Zhiping Wan, Yanglei Cheng, Yunfeng Shen, Fen Xu","doi":"10.1055/a-2178-9113","DOIUrl":"10.1055/a-2178-9113","url":null,"abstract":"<p><strong>Introduction: </strong>Pioglitazone is an insulin sensitizer used for the treatment of type 2 diabetes mellitus (T2DM) by activating peroxisome proliferator-activated receptor gamma. This study aimed to investigate the effects of pioglitazone on white adipose tissue (WAT) and brown adipose tissue (BAT) in diet-induced obese (DIO) mice.</p><p><strong>Methods: </strong>C57BL/6 mice were treated with pioglitazone (30 mg/kg/day) for 4 weeks after a 16-week high-fat diet (HFD) challenge. Body weight gain, body fat mass, energy intake, and glucose homeostasis were measured during or after the treatment. Histopathology was observed by hematoxylin and eosin, oil red O, immunohistochemistry, and immunofluorescence staining. Expression of thermogenic and mitochondrial biogenesis-related genes was detected by quantitative real-time PCR and western blotting.</p><p><strong>Results: </strong>After 4-week pioglitazone treatment, the fasting blood glucose levels, glucose tolerance, and insulin sensitivity were significantly improved, but the body weight gain and fat mass were increased in DIO mice. Compared with the HFD group, pioglitazone did not significantly affect the weights of liver and WAT in both subcutaneous and epididymal regions. Unexpectedly, the weight of BAT was increased after pioglitazone treatment. Histological staining revealed that pioglitazone ameliorated hepatic steatosis, reduced the adipocyte size in WAT, but increased the adipocyte size in BAT.</p><p><strong>Conclusion: </strong>Though pioglitazone can promote lipolysis, thermogenesis, and mitochondrial function in WAT, it leads to impaired thermogenesis, and mitochondrial dysfunction in BAT. In conclusion, pioglitazone could promote the browning of WAT but led to the whitening of BAT; the latter might be a new potential mechanism of pioglitazone-induced weight gain during T2DM treatment.</p>","PeriodicalId":94001,"journal":{"name":"Experimental and clinical endocrinology & diabetes : official journal, German Society of Endocrinology [and] German Diabetes Association","volume":" ","pages":"595-604"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41143753","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}
I. Vardarli, T. Brandenburg, L. Hegedüs, R. Attanasio, E. Nagy, E. Papini, P. Perros, F. Weidemann, K. Herrmann, D. Führer
OBJECTIVE To identify the attitudes of German thyroid specialists towards the clinical treatment of hypothyroidism using thyroid hormones (TH). METHODS All members of the thyroid section of the German Endocrine Society (DGE) were e-mailed an invitation to participate in a web-based survey about substitution with TH. RESULTS Out of 206 members of the DGE's thyroid section, 163 (79.1%) responses were received and included in the analysis. Of responding members, 98.6% used levothyroxine (LT4) as the treatment of choice, and 45.4% also prescribed combination therapy with liothyronine (LT4+LT3) in their clinical practice (p<0.001). LT4+LT3 combination was favored in patients with persistent hypothyroidism symptoms despite biochemical euthyroidism on LT4 treatment (p<0.001). Of all respondents, 26.4% never indicated TH therapy for euthyroid patients (p<0.001), while the remainder would consider THs for one or more indications (62.9% for euthyroid infertile women with high anti-thyroid antibody levels (p<0.001), 7.1% in patients with severe hypercholesterolemia, as complementary treatment (p=0.007), and 57.1% in patients with simple goiter (p<0.001)). In conditions that could interfere with LT4 absorption, most respondents still preferred tablets and did not expect a significant difference when switching from one LT4 formulation to another. CONCLUSION For German thyroid specialists, LT4 is the treatment of choice for hypothyroidism. Combination therapy with LT4+LT3 was considered for patients with persistent symptoms. Even in conditions that could affect bioavailability, German thyroid specialists prefer LT4 tablets rather than other LT4 formulations, such as liquid or soft-gel capsules. The widespread use of thyroid hormone for non-hypothyroid conditions is not consistent with current evidence and needs further study.
{"title":"A Questionnaire Survey of German Thyroidologists on the Use of Thyroid Hormones in Hypothyroid and Euthyroid Patients: The THESIS (Treatment of Hypothyroidism in Europe by Specialists: An International Survey) Collaborative.","authors":"I. Vardarli, T. Brandenburg, L. Hegedüs, R. Attanasio, E. Nagy, E. Papini, P. Perros, F. Weidemann, K. Herrmann, D. Führer","doi":"10.1055/a-1832-0644","DOIUrl":"https://doi.org/10.1055/a-1832-0644","url":null,"abstract":"OBJECTIVE\u0000To identify the attitudes of German thyroid specialists towards the clinical treatment of hypothyroidism using thyroid hormones (TH).\u0000\u0000\u0000METHODS\u0000All members of the thyroid section of the German Endocrine Society (DGE) were e-mailed an invitation to participate in a web-based survey about substitution with TH.\u0000\u0000\u0000RESULTS\u0000Out of 206 members of the DGE's thyroid section, 163 (79.1%) responses were received and included in the analysis. Of responding members, 98.6% used levothyroxine (LT4) as the treatment of choice, and 45.4% also prescribed combination therapy with liothyronine (LT4+LT3) in their clinical practice (p<0.001). LT4+LT3 combination was favored in patients with persistent hypothyroidism symptoms despite biochemical euthyroidism on LT4 treatment (p<0.001). Of all respondents, 26.4% never indicated TH therapy for euthyroid patients (p<0.001), while the remainder would consider THs for one or more indications (62.9% for euthyroid infertile women with high anti-thyroid antibody levels (p<0.001), 7.1% in patients with severe hypercholesterolemia, as complementary treatment (p=0.007), and 57.1% in patients with simple goiter (p<0.001)). In conditions that could interfere with LT4 absorption, most respondents still preferred tablets and did not expect a significant difference when switching from one LT4 formulation to another.\u0000\u0000\u0000CONCLUSION\u0000For German thyroid specialists, LT4 is the treatment of choice for hypothyroidism. Combination therapy with LT4+LT3 was considered for patients with persistent symptoms. Even in conditions that could affect bioavailability, German thyroid specialists prefer LT4 tablets rather than other LT4 formulations, such as liquid or soft-gel capsules. The widespread use of thyroid hormone for non-hypothyroid conditions is not consistent with current evidence and needs further study.","PeriodicalId":94001,"journal":{"name":"Experimental and clinical endocrinology & diabetes : official journal, German Society of Endocrinology [and] German Diabetes Association","volume":"39 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91344974","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}
BACKGROUND Previous studies have presented inconsistent results on the relationship between serum uric acid and skeletal muscle mass (SMM). We aimed to explore whether a higher serum uric acid level was associated with low SMM in the Chinese population. METHODS We performed a cross-sectional analysis of 6595 subjects aged 45 years or older. They were tested for fasting blood glucose, total cholesterol, triglycerides, high-density lipoprotein-cholesterol, low-density lipoprotein-cholesterol, uric acid, blood urea nitrogen, creatinine, and estimated glomerular filtration rate. SMM was accessed by dual-energy x-ray absorptiometry using two approaches: weight-adjusted appendicular skeletal muscle mass (ASM)% and ASM/BMI (body mass index (kg/m2)). Low SMM was defined as a cut-off point of ASM/BMI<0.789 for men and<0.512 for women. RESULTS Compared with their normal group, patients with hyperuricemia had lower ASM% (29.33±2.33 vs 30.03±2.34 for males and 24.71±1.99 vs 25.19±2.07 for females, P<0.01) and ASM/BMI (0.83±0.10 vs 0.85±0.10 for male and 0.60±0.07 vs 0.62±0.07 for female), with a higher prevalence of the associated low SMM in both sexes (35.2 vs 26.5% for male and 10.5 vs 5.9% for female, P<0.01). Pearson analysis showed that ASM% and ASM/BMI were negatively correlated with SUA (male: ASM/BMI, r=-0.097, ASM%, r=-0.146; female: ASM/BMI, r=-0.151, ASM%, r=-0.157; all P<0.001). Logistic regression analysis showed a positive association of hyperuricemia with adjusted risk of low SMM association. CONCLUSIONS In a middle-aged and elderly Chinese population, hyperuricemia is independently and positively associated with low SMM and can vary by age and gender.
背景以往的研究对血清尿酸与骨骼肌质量(SMM)之间的关系给出了不一致的结果。我们的目的是探讨中国人群中较高的血清尿酸水平是否与低SMM相关。方法我们对6595名年龄在45岁及以上的受试者进行了横断面分析。检测空腹血糖、总胆固醇、甘油三酯、高密度脂蛋白-胆固醇、低密度脂蛋白-胆固醇、尿酸、血尿素氮、肌酐和肾小球滤过率。采用双能x线骨密度仪测量SMM,采用两种方法:体重调整后的阑尾骨骼肌质量(ASM)%和ASM/BMI(体重指数(kg/m2))。低SMM被定义为男性ASM/BMI<0.789,女性<0.512的分界点。结果与正常组相比,高尿酸血症患者的ASM%(男性29.33±2.33 vs 30.03±2.34,女性24.71±1.99 vs 25.19±2.07,P<0.01)和ASM/BMI(男性0.83±0.10 vs 0.85±0.10,女性0.60±0.07 vs 0.62±0.07)较低,且相关的低SMM患病率在两性中较高(男性35.2 vs 26.5%,女性10.5 vs 5.9%, P<0.01)。Pearson分析显示,ASM%和ASM/BMI与SUA呈负相关(男性:ASM/BMI, r=-0.097, ASM%, r=-0.146;女性:ASM/BMI, r=-0.151, ASM%, r=-0.157;所有P < 0.001)。Logistic回归分析显示高尿酸血症与低SMM相关的校正风险呈正相关。结论:在中国中老年人群中,高尿酸血症与低SMM独立且正相关,且随年龄和性别而变化。
{"title":"Hyperuricemia Associated with Low Skeletal Muscle in the Middle-Aged and Elderly Population in China.","authors":"Lingyan Chen, Li Wu, Qian Li, Yu Hu, Hui Ma, Huan-Dong Lin, Xin Gao","doi":"10.1055/a-1785-3729","DOIUrl":"https://doi.org/10.1055/a-1785-3729","url":null,"abstract":"BACKGROUND\u0000Previous studies have presented inconsistent results on the relationship between serum uric acid and skeletal muscle mass (SMM). We aimed to explore whether a higher serum uric acid level was associated with low SMM in the Chinese population.\u0000\u0000\u0000METHODS\u0000We performed a cross-sectional analysis of 6595 subjects aged 45 years or older. They were tested for fasting blood glucose, total cholesterol, triglycerides, high-density lipoprotein-cholesterol, low-density lipoprotein-cholesterol, uric acid, blood urea nitrogen, creatinine, and estimated glomerular filtration rate. SMM was accessed by dual-energy x-ray absorptiometry using two approaches: weight-adjusted appendicular skeletal muscle mass (ASM)% and ASM/BMI (body mass index (kg/m2)). Low SMM was defined as a cut-off point of ASM/BMI<0.789 for men and<0.512 for women.\u0000\u0000\u0000RESULTS\u0000Compared with their normal group, patients with hyperuricemia had lower ASM% (29.33±2.33 vs 30.03±2.34 for males and 24.71±1.99 vs 25.19±2.07 for females, P<0.01) and ASM/BMI (0.83±0.10 vs 0.85±0.10 for male and 0.60±0.07 vs 0.62±0.07 for female), with a higher prevalence of the associated low SMM in both sexes (35.2 vs 26.5% for male and 10.5 vs 5.9% for female, P<0.01). Pearson analysis showed that ASM% and ASM/BMI were negatively correlated with SUA (male: ASM/BMI, r=-0.097, ASM%, r=-0.146; female: ASM/BMI, r=-0.151, ASM%, r=-0.157; all P<0.001). Logistic regression analysis showed a positive association of hyperuricemia with adjusted risk of low SMM association.\u0000\u0000\u0000CONCLUSIONS\u0000In a middle-aged and elderly Chinese population, hyperuricemia is independently and positively associated with low SMM and can vary by age and gender.","PeriodicalId":94001,"journal":{"name":"Experimental and clinical endocrinology & diabetes : official journal, German Society of Endocrinology [and] German Diabetes Association","volume":"50 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84921055","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}
OBJECTIVE The insulinoma is a rare tumor of the pancreas, that can lead to spontaneous hypoglycemia due to an excessive insulin secretion. The 72-hour fast is the gold standard for finding the correct diagnosis. Endoscopic ultrasound (EUS) is an established examination method to identify the suspicious lesion. Previous studies correlate the measured size of insulinoma and their endocrine behavior. This study was designed to find a relation between these variables. METHODS We took the data of patients which had a histological confirmed insulinoma after receiving an endoscopic ultrasound in our department. Size and echogenicity were correlated with the endpoint of the 72-hour fast and hormone levels. RESULTS A total of 45 patients were identified. Most insulinoma were small with a volume of < 2cm3 (median 1.15cm3). There was no correlation between the duration of fasting, hormone levels and the size of the insulinoma. In addition, in a subgroup analysis, no connection could be established between the size of the insulinoma and the amount of insulin that was released after oral glucose exposure. We found out that homogeneous tumors were significantly smaller and had a lower Ki-67 index. Furthermore, there was a tendency towards a shorter period of duration for the 72-hour fast for the small tumors. DISCUSSION This data suggests that the measured size of insulinoma by EUS is not related to the time until termination of the 72-hour fast and measured hormone levels. The echogenicity seems more important, showing that homogenous tumors are an indicator for a higher differentiation, which can result in a shorter duration of fasting period. The differences in the secretion behavior of the insulinomas could complicate the correlation of size and duration of the 72-hour fast.
{"title":"Is the size of insulinoma predictive for its endocrine behavior? An endoscopic ultrasound study.","authors":"Jan Adelmeyer, Franziska Göbel, P. Kann","doi":"10.1055/a-1840-7492","DOIUrl":"https://doi.org/10.1055/a-1840-7492","url":null,"abstract":"OBJECTIVE\u0000The insulinoma is a rare tumor of the pancreas, that can lead to spontaneous hypoglycemia due to an excessive insulin secretion. The 72-hour fast is the gold standard for finding the correct diagnosis. Endoscopic ultrasound (EUS) is an established examination method to identify the suspicious lesion. Previous studies correlate the measured size of insulinoma and their endocrine behavior. This study was designed to find a relation between these variables.\u0000\u0000\u0000METHODS\u0000We took the data of patients which had a histological confirmed insulinoma after receiving an endoscopic ultrasound in our department. Size and echogenicity were correlated with the endpoint of the 72-hour fast and hormone levels.\u0000\u0000\u0000RESULTS\u0000A total of 45 patients were identified. Most insulinoma were small with a volume of < 2cm3 (median 1.15cm3). There was no correlation between the duration of fasting, hormone levels and the size of the insulinoma. In addition, in a subgroup analysis, no connection could be established between the size of the insulinoma and the amount of insulin that was released after oral glucose exposure. We found out that homogeneous tumors were significantly smaller and had a lower Ki-67 index. Furthermore, there was a tendency towards a shorter period of duration for the 72-hour fast for the small tumors.\u0000\u0000\u0000DISCUSSION\u0000This data suggests that the measured size of insulinoma by EUS is not related to the time until termination of the 72-hour fast and measured hormone levels. The echogenicity seems more important, showing that homogenous tumors are an indicator for a higher differentiation, which can result in a shorter duration of fasting period. The differences in the secretion behavior of the insulinomas could complicate the correlation of size and duration of the 72-hour fast.","PeriodicalId":94001,"journal":{"name":"Experimental and clinical endocrinology & diabetes : official journal, German Society of Endocrinology [and] German Diabetes Association","volume":"30 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89967465","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}
{"title":"Young Awardees in Endocrinology Presenting Hot Topics.","authors":"M. Reincke, H. Biebermann","doi":"10.1055/a-1718-3001","DOIUrl":"https://doi.org/10.1055/a-1718-3001","url":null,"abstract":"","PeriodicalId":94001,"journal":{"name":"Experimental and clinical endocrinology & diabetes : official journal, German Society of Endocrinology [and] German Diabetes Association","volume":"267 1","pages":"280-281"},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75002965","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}
The stereotypic and oversimplified relationship between female sex hormones and undesirable behavior dates to the earliest days of human society, as already the ancient Greek word for the uterus, "hystera" indicated an aversive connection. Remaining and evolving throughout the centuries, transcending across cultures and various aspects of everyday life, its perception was only recently reframed. Contemporarily, the complex interaction of hormonal phases (i. e., the menstrual cycle), hormonal medication (i. e., oral contraceptives), women's psychological well-being, and behavior is the subject of multifaceted and more reflected discussions. A driving force of this ongoing paradigm shift was the introduction of this highly interesting and important topic into the realm of scientific research. This refers to neuroscientific research as it enables a multimodal approach combining aspects of physiology, medicine, and psychology. Here a growing body of literature points towards significant alterations of both brain function, such as lateralization of cognitive functions, and structure, such as gray matter concentrations, due to fluctuations and changes in hormonal levels. This especially concerns female sex hormones. However, the more research is conducted within this field, the less reliable these observations and derived insights appear. This may be due to two particular factors: measurement inconsistencies and diverse hormonal phases accompanied by interindividual differences. The first factor refers to the prominent unreliability of one of the primarily utilized neuroscientific research instruments: functional magnetic resonance imaging (fMRI). This unreliability is seemingly present in paradigms and analyses, and their interplay, and is additionally affected by the second factor. In more detail, hormonal phases and levels further influence neuroscientific results obtained through fMRI as outcomes vary drastically across different cycle phases and medication. This resulting vast uncertainty thus tremendously hinders the further advancement of our understanding of how female sex hormones might alter brain structure and function and, ultimately, behavior.This review summarizes parts of the current state of research and outlines the essential requirements to further investigate and understand the female brain's underlying physiological and anatomical features.
{"title":"'That Time of the Month' - Investigating the Influence of the Menstrual Cycle and Oral Contraceptives on the Brain Using Magnetic Resonance Imaging.","authors":"Verena Schuster, A. Jansen","doi":"10.1055/a-1816-8203","DOIUrl":"https://doi.org/10.1055/a-1816-8203","url":null,"abstract":"The stereotypic and oversimplified relationship between female sex hormones and undesirable behavior dates to the earliest days of human society, as already the ancient Greek word for the uterus, \"hystera\" indicated an aversive connection. Remaining and evolving throughout the centuries, transcending across cultures and various aspects of everyday life, its perception was only recently reframed. Contemporarily, the complex interaction of hormonal phases (i. e., the menstrual cycle), hormonal medication (i. e., oral contraceptives), women's psychological well-being, and behavior is the subject of multifaceted and more reflected discussions. A driving force of this ongoing paradigm shift was the introduction of this highly interesting and important topic into the realm of scientific research. This refers to neuroscientific research as it enables a multimodal approach combining aspects of physiology, medicine, and psychology. Here a growing body of literature points towards significant alterations of both brain function, such as lateralization of cognitive functions, and structure, such as gray matter concentrations, due to fluctuations and changes in hormonal levels. This especially concerns female sex hormones. However, the more research is conducted within this field, the less reliable these observations and derived insights appear. This may be due to two particular factors: measurement inconsistencies and diverse hormonal phases accompanied by interindividual differences. The first factor refers to the prominent unreliability of one of the primarily utilized neuroscientific research instruments: functional magnetic resonance imaging (fMRI). This unreliability is seemingly present in paradigms and analyses, and their interplay, and is additionally affected by the second factor. In more detail, hormonal phases and levels further influence neuroscientific results obtained through fMRI as outcomes vary drastically across different cycle phases and medication. This resulting vast uncertainty thus tremendously hinders the further advancement of our understanding of how female sex hormones might alter brain structure and function and, ultimately, behavior.This review summarizes parts of the current state of research and outlines the essential requirements to further investigate and understand the female brain's underlying physiological and anatomical features.","PeriodicalId":94001,"journal":{"name":"Experimental and clinical endocrinology & diabetes : official journal, German Society of Endocrinology [and] German Diabetes Association","volume":"76 1","pages":"303-312"},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74534516","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}
B. Kulzer, J. Aberle, T. Haak, M. Kaltheuner, J. Kröger, R. Landgraf, M. Kellerer
Diabetes is a chronic disease that poses considerable challenges for people with diabetes in their daily therapy. In addition to drug therapy, the therapy behaviour of the person with diabetes plays a significant role in the prognosis of the disease. In diabetes therapy, it is therefore important to define therapy goals together with the person with diabetes, taking into account a multitude of biological, somatic, social and behavioural factors, and to support those affected as best as possible in implementing therapy goals into their personal living environment and their self-management. The most important superordinate therapy goals for diabetes are described in the evidence-based guidelines for type 1 and type 2 diabetes [1, 2], as well as in the Disease Management Program (DMP) requirements guideline (DMP-A-RL) [3]. ▪ Maintaining or improving the quality of life limited by diabetes: For people with diabetes, maintaining the quality of life is the most important goal of diabetes therapy [4]. This means remaining as physically and psychologically healthy as possible despite and with diabetes, being able to realise one’s own life goals and being socially integrated – without being limited in areas of life that are important for people, such as family/relationship, job, interests, leisure time, etc. Study results show relatively consistently that these goals, which are important for people with diabetes, have not yet been achieved worldwide [5, 6]. ▪ Preventing symptoms of the disease: Elevated, decreased or even highly-fluctuating glucose levels (increased glucose variability) can lead to symptoms such as an increased urge to urinate (polyuria), a strong feeling of thirst (polydipsia), fatigue, weakness and tiredness. Symptoms that should be avoided during therapy also include dry or itchy skin, neuropathic symptoms and fluctuations in lens refractive power due to osmotic effects of increased glucose levels. ▪ Preventing acute complications: It is important to prevent side effects of antihyperglycaemic therapy, in particular hypoglycaemia – especially severe hypoglycaemia in which the affected person is dependent on external help (e. g., by relatives or medical staff). As well, it is important to prevent severe hyperglycaemic metabolic derailments (e. g., diabetic ketoacidosis) because of the associated burdens and dangers for the person with diabetes, as well as the associated health risks, which can be lethal in some cases. Fundamentals of Diabetes Management
糖尿病是一种慢性疾病,对糖尿病患者的日常治疗提出了相当大的挑战。除药物治疗外,糖尿病患者的治疗行为对疾病的预后也起着重要作用。因此,在糖尿病治疗中,重要的是与糖尿病患者一起确定治疗目标,考虑到多种生物、躯体、社会和行为因素,并尽可能地支持那些受影响的人在他们的个人生活环境和自我管理中实施治疗目标。1型和2型糖尿病的循证指南[1,2]以及疾病管理计划(DMP)要求指南(DMP- a - rl)[3]中描述了糖尿病最重要的上级治疗目标。▪维持或改善受糖尿病限制的生活质量:对于糖尿病患者来说,维持生活质量是糖尿病治疗最重要的目标[4]。这意味着即使患有糖尿病,也要尽可能保持身体和心理健康,能够实现自己的生活目标,融入社会——不受家庭/关系、工作、兴趣、休闲时间等对人们重要的生活领域的限制。研究结果相对一致地表明,这些对糖尿病患者很重要的目标尚未在全球范围内实现[5,6]。▪预防疾病症状:血糖水平升高、降低甚至剧烈波动(血糖变异性增加)可导致尿频增加(多尿)、强烈口渴感(渴渴)、疲劳、虚弱和疲倦等症状。治疗期间应避免的症状还包括皮肤干燥或发痒、神经病变症状以及由于葡萄糖水平升高的渗透效应引起的晶状体屈光度波动。▪预防急性并发症:重要的是要预防抗高血糖治疗的副作用,特别是低血糖——特别是严重低血糖,患者依赖外部帮助(如亲属或医务人员)。此外,预防严重的高血糖代谢脱轨(如糖尿病酮症酸中毒)也很重要,因为这会给糖尿病患者带来相关的负担和危险,以及相关的健康风险,在某些情况下可能是致命的。糖尿病管理基础
{"title":"Fundamentals of Diabetes Management.","authors":"B. Kulzer, J. Aberle, T. Haak, M. Kaltheuner, J. Kröger, R. Landgraf, M. Kellerer","doi":"10.1055/a-1624-5080","DOIUrl":"https://doi.org/10.1055/a-1624-5080","url":null,"abstract":"Diabetes is a chronic disease that poses considerable challenges for people with diabetes in their daily therapy. In addition to drug therapy, the therapy behaviour of the person with diabetes plays a significant role in the prognosis of the disease. In diabetes therapy, it is therefore important to define therapy goals together with the person with diabetes, taking into account a multitude of biological, somatic, social and behavioural factors, and to support those affected as best as possible in implementing therapy goals into their personal living environment and their self-management. The most important superordinate therapy goals for diabetes are described in the evidence-based guidelines for type 1 and type 2 diabetes [1, 2], as well as in the Disease Management Program (DMP) requirements guideline (DMP-A-RL) [3]. ▪ Maintaining or improving the quality of life limited by diabetes: For people with diabetes, maintaining the quality of life is the most important goal of diabetes therapy [4]. This means remaining as physically and psychologically healthy as possible despite and with diabetes, being able to realise one’s own life goals and being socially integrated – without being limited in areas of life that are important for people, such as family/relationship, job, interests, leisure time, etc. Study results show relatively consistently that these goals, which are important for people with diabetes, have not yet been achieved worldwide [5, 6]. ▪ Preventing symptoms of the disease: Elevated, decreased or even highly-fluctuating glucose levels (increased glucose variability) can lead to symptoms such as an increased urge to urinate (polyuria), a strong feeling of thirst (polydipsia), fatigue, weakness and tiredness. Symptoms that should be avoided during therapy also include dry or itchy skin, neuropathic symptoms and fluctuations in lens refractive power due to osmotic effects of increased glucose levels. ▪ Preventing acute complications: It is important to prevent side effects of antihyperglycaemic therapy, in particular hypoglycaemia – especially severe hypoglycaemia in which the affected person is dependent on external help (e. g., by relatives or medical staff). As well, it is important to prevent severe hyperglycaemic metabolic derailments (e. g., diabetic ketoacidosis) because of the associated burdens and dangers for the person with diabetes, as well as the associated health risks, which can be lethal in some cases. Fundamentals of Diabetes Management","PeriodicalId":94001,"journal":{"name":"Experimental and clinical endocrinology & diabetes : official journal, German Society of Endocrinology [and] German Diabetes Association","volume":"44 12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82698852","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}
B. Balletshofer, D. Böckler, H. Diener, J. Heckenkamp, W. Ito, Marcos Katoh, H. Lawall, N. Malyar, Y. Oberländer, P. Reimer, K. Rittig, M. Zähringer
{"title":"Position Paper on the Diagnosis and Treatment of Peripheral Arterial Disease (PAD) in People with Diabetes Mellitus.","authors":"B. Balletshofer, D. Böckler, H. Diener, J. Heckenkamp, W. Ito, Marcos Katoh, H. Lawall, N. Malyar, Y. Oberländer, P. Reimer, K. Rittig, M. Zähringer","doi":"10.1055/a-1624-3631","DOIUrl":"https://doi.org/10.1055/a-1624-3631","url":null,"abstract":"","PeriodicalId":94001,"journal":{"name":"Experimental and clinical endocrinology & diabetes : official journal, German Society of Endocrinology [and] German Diabetes Association","volume":"352 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76402180","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}