scholarly journals The exon 3-deleted/full-length Growth Hormone Receptor Polymorphism Does Not Influence the Effect of Puberty or Growth Hormone Therapy on Glucose Homeostasis in Short Non-Growth Hormone-Deficient Small-for-Gestational-Age Children: Results from a Two-Year Controlled Prospective Study

2008 ◽  
Vol 93 (7) ◽  
pp. 2709-2715 ◽  
Author(s):  
L. Audí ◽  
A. Carrascosa ◽  
C. Esteban ◽  
M. Fernández-Cancio ◽  
P. Andaluz ◽  
...  

Abstract Context: The exon 3-deleted/full-length (d3/fl) GH receptor polymorphism (d3/fl-GHR) has been associated with responsiveness to GH therapy in short small-for-gestational-age (SGA) patients, although consensus is lacking. However, its influence on glucose homeostasis, at baseline or under GH therapy, has not been investigated. Objective: Our objective was to evaluate whether the d3/fl-GHR genotypes influence insulin sensitivity in short SGA children before or after puberty onset or during GH therapy. Design: We conducted a 2-yr prospective, controlled, randomized trial. Setting: Thirty Spanish hospitals participated. Auxological, GH secretion, and glucose homeostasis evaluation was hospital based, whereas molecular analyses and data computation were centralized. Patients: Patients included 219 short SGA children [body mass index sd score (SDS) ≤ 2.0]; 159 were prepubertal (group 1), and 60 had entered puberty (group 2). Intervention: Seventy-eight patients from group 1 were treated with GH (66 μg/kg·d) for 2 yr (group 3). Main Outcome Measures: Previous and 2-yr follow-up auxological and biochemical data were recorded, d3/fl-GHR genotypes determined, and data analyzed. Results: In groups 1 and 2, fasting glucose, insulin, homeostasis model assessment (HOMA), and quantitative insulin sensitivity check index (QUICKI) were similar in each d3/fl-GHR genotype. Group 2 glucose, insulin, and HOMA were significantly higher and QUICKI lower than in group 1. In group 3 GH-treated patients, height SDS, growth velocity SDS, fasting glucose, insulin, and HOMA significantly increased as did body mass index SDS at the end of the second year, and QUICKI decreased during the first and second years, with no differences among the d3/fl-GHR genotypes. Conclusion: In short SGA patients, the d3/fl-GHR genotypes do not seem to influence prepubertal or pubertal insulin sensitivity indexes or their changes over 2 yr of GH therapy (66 μg/kg·d).

PEDIATRICS ◽  
1969 ◽  
Vol 43 (6) ◽  
pp. 989-1004
Author(s):  
R. Youlton ◽  
S. L. Kaplan ◽  
M. M. Grumbach

The growth hormone (GH) response to insulin-induced hypoglycemia and to arginine infusion has been evaluated in 60 children with growth retardation. These children have been classified into three groups: Group 1-9 children had peak serum growth hormone values of 7 mµg/ml or greater to both stimuli, a normal growth hormone response. Group 2-18 children had peak GH values of ≤ 3 mµg/ml to both stimuli, an abnormal response indicating growth hormone deficiency. Group 3-6 children had a blunted GH response (> 3 < 7 mµg/ml) to both stimuli; 8 showed a normal rise in serum GH following arginine infusion (> 7 mµg/ml) but exhibited no rise, or a minimal one, following insulin administration; 9 children had minimal increase in serum GH concentration following arginine infusion but showed a normal GH response to insulin administration (> 7mµg/ml). Children included in Group 3 represent a heterogenous population. In some patients with a blunted response to both stimuli, evidence of partial or less severe form of GH deficiency was found, whereas in 17 of 18 children exhibiting a disparate response the impaired growth was not attributable to growth hormone deficiency. The blood glucose at all sampling periods was significantly lower following insulin administration in patients in Group 2 than that observed for children in Group 1 and 3. The blood glucose was significantly lower at 90 and 120 minutes following arginine infusion in Group 2 compared to values for patients in Group 1 and 3. Changes in serum insulin in response to the infusion of arginine did not provide a useful index of discrimination among these groups. Administration of diethylstilbestrol, 10 mg/day times 2 days, prior to testing can modify the GH response to both hypoglycemia and arginine; it is a useful ancillary procedure in children with blunted or disparate responses. These studies suggest that two types of stimulation tests are necessary to establish the diagnosis of isolated GH deficiency with a high degree of probability.


1996 ◽  
Vol 150 (2) ◽  
pp. 329-342 ◽  
Author(s):  
H A Spoudeas ◽  
P C Hindmarsh ◽  
D R Matthews ◽  
C G D Brook

Abstract To determine the aetiopathology of post-irradiation growth hormone (GH) deficiency, we performed a mixed longitudinal analysis of 56 24 h serum GH concentration profiles and 45 paired insulin-induced hypoglycaemia tests (ITT) in 35 prepubertal children, aged 1·5–11·8 years, with brain tumours in the posterior fossa (n=25) or cerebral hemispheres (n = 10). Assessments were made before (n = 16), 1 year (n = 25) and 2 to 5 years (n = 15) after a cranial irradiation (DXR) dose of at least 30 Gy. Fourier transforms, occupancy percentage, first-order derivatives (FOD) and mean concentrations were determined from the GH profiles taken after neurosurgery but before radiotherapy (n = 16) and in three treatment groups: Group 1: neurosurgery only without DXR (n = 9); Group 2: ≥30 Gy DXR only (n = 22); Group 3: ≥30 Gy DXR with additional chemotherapy (n = 9). Results were compared with those from 26 short normally growing (SN) children. Compared with SN children, children with brain tumours had faster GH pulse periodicities (200 min vs 140 min) and attenuated peak GH responses to ITT (24·55 (19·50–30·20) vs 8·32 (4·57–15·14) mU/I) after neurosurgery, before radiotherapy. However, spontaneous GH peaks (19·05 (15·49–23·44) vs 14·13 (9·12–21·38) mU/l), 24 h mean GH (5·01 (4·37–5·62) vs 3·98 (2·63–5·89) mU/l) and FODs (1·43 (1·17–1·69) vs 1·22 (0·88–1·56) mU/l per min) were similar. The abnormalities present before radiotherapy persisted in group 1 children at 1 year when 24 h mean GH (2·45 (1·17– 5·01) mU/l) and FODs (0·73 (0·26–1·20) mU/l per min) were additionally suppressed, although partial recovery was evident by 2 years. With time from radiotherapy, there was a progressive increase in GH pulse periodicity (Group 2: 200 min at 1 year, 240 min at ≥2 years; Group 3: 140 min at 1 year, 280 min at ≥2 years) and a decrease in 24 h mean GH (Group 2 vs Group 3 at ≥2 years: 2·45 (1·70–3·47) vs 1·86 (1·32–2·69) mU/l) and FODs (Group 2 vs Group 3 at ≥2 years; 0·56 (0·44–0·69) vs 0·44 (0·27–0·61) mU/l per min). Initial discrepancies between measures of spontaneous and stimulated (ITT) GH peaks were lost by 2 or more years (spontaneous vs ITT; Group 2: 7·76 (5·89–9·77) vs 3·80 (0·91–15·84) mU/l; Group 3: 6·03 (4·27–8·32) vs 3·80 (0·31–46·77) mU/l). After cranial irradiation, a number of changes evolved within the GH axis: faster GH pulse periodicities and discordance between physiological and pharmacological tests of GH secretion before irradiation gave way to a slow GH pulse periodicity, decreased GH pulse amplitude and rate of GH change (FOD) and, with time, eventual concordance between physiological and pharmacological measures. The evolution of these disturbances may well reflect differential pathology affecting hypothalamic GH-releasing hormone and somatostatin. Journal of Endocrinology (1996) 150, 329–342


2013 ◽  
Vol 59 (3) ◽  
pp. 8-12
Author(s):  
L V Kvitkova ◽  
D A Borodkina ◽  
O V Gruzdeva ◽  
O L Barbarash ◽  
A A Silonova ◽  
...  

The present study involed the patients (n=100) presenting with myocardial infarction (MI). Based on the body mass index, they were allocated to three groups: those with normal body mass index (BMI) (18.5≤BMI< 25 kg/m2; n=32; group 1), overweight patients (25≤BMI <30 kg/m2; n=42; group 2), and obese patients (BMI≤30 kg/m2; n=27; group 3). The laboratory studies included the measurement of serum adipocytokine levels (leptin, adiponectin, and free fatty acids (FFA)) in conjunction with the evaluation of insulin resistance (IR). All the patients regardless of BMI had the waist circumference in excess of the upper limit of the normal gender-specific values. Deviations from the reference values of leptin, adiponectin, and FFA levels were observed in 65.6% of the patients with normal BWI, in 69.0% of the overweight patients, and in 70.3% of the obese patients. In the patients of all the three groups, significant correlation was documented between waist circumference and the levels of leptin (group 1: r=0.3100, p=0.00; group 2: r=0.32, p=0.00; group 3: r=0.37, p=0.03) and adiponectin (group 1: r=-0.43, p=0.00; group 2: r=-0.35, p=0.04; group 3: r=-0.18, p=0.01). Moreover, the waist circumference significantly correlated with the occurrence of IR (group 1: r=0.11, p=0.04; group 2: r=0.45, p=0.00, group 3: r=0.34, p=0.03). It is concluded that the observed deviations of the parameters of interest from the respective reference values suggest disturbances in the metabolic and secretory functions of the visceral adipose tissue associated with the enlargement of its volume).


2017 ◽  
Vol 89 (3) ◽  
pp. 219 ◽  
Author(s):  
Mehmet Zeynel Keskin ◽  
Salih Budak ◽  
Evrim Emre Aksoy ◽  
Cem Yücel ◽  
Serkan Karamazak ◽  
...  

Aim: To evaluate the effects of body mass index (BMI) ratio on semen parameters and serum reproductive hormones. Materials and methods: The data of 454 patients who prsented to male infertility clinics in our hospital between 2014 and 2015 were analyzed retrospectively. Weight, height, serum hormone levels and semen analysis results of the patients were obtained. BMI values were calculated by using the weight and height values of the patients and they were classified as group 1 for BMI values ≤ 25 kg/m2, as group 2 for BMI values 25-30 kg/m2 and as group 3 for BMI values ≥ 30 kg/m2. Results: The mean values of BMI, semen volume, concentration, total motility, progressive motility, total progressive motile sperm count (TPMSC), normal morphology according to Kruger, head abnormality, neck abnormality, tail abnormality, FSH, LH, prolactin, T/E2, total testosterone and estradiol parameters of the patients were considered. Patients were divided according to BMI values in Group 1 (n = 165), Group 2 (n = 222) and Group 3 (n = 56). There was no statistically significant difference in terms of all variables between the groups. Conclusions: We analyzed the relationship between BMI level and semen parameters and reproductive hormones, demonstrating no relationship between BMI and semen parameters. In our study, BMI does not affect semen parameters although it shows negative correlation with prolactin and testosterone levels.


2020 ◽  
Vol 92 (5) ◽  
pp. 1-5
Author(s):  
Atakan Ozkan ◽  
Aylin Hande Gokce ◽  
Feridun Suat Gokce

<b>Background:</b> Acute appendicitis is the most common cause of acute abdomen. Delay in diagnosis increases the mortality and morbidity. <br><b>Aim: </b>In this study, we aimed to investigate whether the body mass index is useful in diagnosis and whether the neutrophil /lymphocyte and platelet/lymphocyte ratios can help in determining the inflammation level of acute appendicitis. <br><b>Meterial and Methods:</b> Cases of appendectomy performed between June 2012 and December 2018 in our clinic were analyzed retrospectively. Based on the pathology results of the cases included in the study, 4 groups were formed, i.e.: Group 1 (initial stage), Group 2 (catarrhal stage), Group 3 (phlegmonous-gangrenous stage) and Group 4 (perforation). The study compared age, body mass index, leukocyte values, red cell distribution width (RDW), neutrophil/lymphocyte ratio (NLR), platelet /lymphocyte ratio (PLR), and mean platelet volume (MPV) between groups. <br><b> Results:</b> 828 cases were included in the study. When compared between groups, the values of Group 3 and Group 4 were higher than those of Group 1 and Group 2 for PLR and NLR. There was no difference in RDW and MPV values in the blood. When Body Mass Index (BMI) was compared between groups, it was found to be significantly higher with increasing histopathological stage. <br><b>Conclusion:</b> In acute appendicitis, the blood leukocyte value, elevated PLR and NLR are helpful in diagnosis. We aimed to emphasize that the diagnosis of acute appendicitis is delayed in patients with a BMI above 30 and/or at age of over 40 years, with the perforation rate being determined more frequently.


2017 ◽  
Vol 07 (02) ◽  
pp. e128-e133
Author(s):  
Amy O'Neil Dudley ◽  
Zachary Jenner ◽  
Hector Mendez-Figueroa ◽  
Viviana Ellis ◽  
Suneet Chauhan

Objective This study aims to compare composite maternal and neonatal morbidities (MM, NM) among pregnant women with diabetes mellitus whose body mass index (BMI) at delivery was < 30 (group 1), 30.0 to 39.9 (group 2), and ≥ 40 kg/m2 (group 3). We hypothesized that increased BMI class at delivery would be associated with worsening maternal and neonatal outcomes. Methods This is a retrospective cohort study. MM was defined as: chorioamnionitis, wound infection, eclampsia, diabetic ketoacidosis, hypoglycemia admission, third/fourth degree laceration, and/or death. NM was defined as umbilical arterial pH < 7.0, 5 minute Apgar < 4, respiratory distress syndrome, mechanical ventilation, neonatal sepsis, stillbirth, and/or death. Odds ratios were adjusted for possible confounders. Results MM was noted in 8, 13, and 24% of groups 1, 2, and 3, respectively, and significantly more common in group 2 versus 1 (adjusted odds ratio [aOR]: 1.66) and group 3 versus 1 (aOR: 3.06). NM was noted in 7, 8, and 15% of each BMI group, respectively, and differed significantly between group 3 vs. 2 (aOR: 1.77). Conclusions The increased rate of morbidities between the BMI groups is useful to inform diabetic women and highlights the need for further investigation of diabetes and obesity as comorbidities in pregnancy.


2017 ◽  
Vol 2 (2) ◽  
pp. 30-33
Author(s):  
MS S Nurdina ◽  
VI I Kupaev ◽  
OV V Sazonova

Aim - to investigate the influence of IL-17, IL-10 on the level of asthma control among obese patients. Materials and methods. 79 patients with asthma aged from 18 to 65 years were enrolled in our study and categorized into three groups according to their body mass index (BMI): group 1 - normal BMI (27 (34,2%) patients, age 50±13,8), group 2 - overweight (28 (35,4%) patients, age 44±16,5) and group 3 - obese (24 patients (30,4%), age 57,3±8,2). These patients underwent spirometry and were compared for clinical characteristics, plasma level of IL-17 and IL-10 using ELISA assay. Results. IL-17 concentrations were higher in the obese and uncontrolled asthmatics. Statistically significant correlation between the level of IL-10 and BMI was not found. Conclusions. Our study shows that cytokines IL-17 play an important role in the immune response of asthma in obese patients, and represent an important therapeutic target for the asthma treatment.


2021 ◽  
pp. 112067212110437
Author(s):  
Emine Temel ◽  
Nazife Aşikgarip ◽  
Kemal Örnek

Purpose: To determine the relation of choroidal structural parameters and body mass index (BMI) in an adult population. Methods: About 144 eyes of 144 healthy individuals were incorporated. There were four groups according to BMI values: Group 1 (⩽18.5), group 2 (18.6–24.9), group 3 (25.0–29.9), and group 4 (30.0–34.9). The enhanced depth imaging optical coherence tomography images were binarized using Image-J software. Choroidal thickness (CT), circumscribed choroidal area (CCA), luminal area (LA), stromal area (SA), and choroidal vascularity index (CVI) were calculated. Results: Mean subfoveal, nasal, and temporal CT were lower in group 4 rather than group 1 ( p = 0.032, p = 0.001, and p < 0.001, respectively). Mean nasal and temporal CT also showed a decrease in group 4 as compared to group 2 ( p = 0.04 and p = 0.039). Mean CCA and LA were decreased in group 4 in comparison to group 3 ( p = 0.001 and p = 0.001), group 2 ( p < 0.001 and p < 0.001), and group 1 ( p = 0.001 and p < 0.001). Mean SA showed a decrease only in group 3 rather than group 2 ( p = 0.021) and group 1 ( p = 0.008). Mean CVI was decreased in group 3 and group 4 in comparison to group 1 ( p < 0.001 and p < 0.001) and group 2 ( p = 0.002 and p < 0.001). Conclusion: Increased BMI percentile was associated with a decrease in CT and structural parameters.


Circulation ◽  
2021 ◽  
Vol 143 (Suppl_1) ◽  
Author(s):  
Michael M Hammond ◽  
Joanne M Murabito ◽  
Ludovic Trinquart ◽  
Emelia J Benjamin ◽  
Honghuang Lin ◽  
...  

Introduction: The prevalence of obesity is rising. Most previous studies that examined the relationship between body mass index (BMI) and physical activity measured BMI at a single time-point, ignoring the time-varying nature of BMI. The relationship between BMI trajectories and habitual physical activity in community settings remains unclear. Objective: To assess the relationship between BMI trajectories and habitual physical activity measured by daily steps from a smartwatch, among participants enrolled in the electronic Framingham Heart Study (eFHS). We hypothesized that participants whose BMI trajectories increased over a 14-year period prior to the step assessment take fewer daily steps, compared to participants who maintained stable BMI trajectories during the same time period. Methods: We used a semiparametric group-based modelling method to identify BMI trajectory patterns. Participants who attended exams 1, 2, and 3 were included in building the trajectories. Daily steps were recorded from the smartwatch provided at exam 3 with “active days” defined as days with ≥ 5watch wear-hours. We excluded participants with <30 active days. The median follow-up period for step count was 357 days (IQR: 467 days). We used generalized linear models that accounted for correlation between daily steps in the same individuals to examine the longitudinal relationship between BMI trajectory groups and daily step counts, adjusting for relevant covariates. Results: We identified three trajectory groups for the 837 eFHS participants. Group 1 included 292 participants (mean age 54 years, 57% women) whose BMI was stable (slope: 0.005, p=0.75); Group 2 included 468 participants (mean age 53 years, 56% women) whose BMI increased slightly (slope: 0.123, p<9.2e-17); and Group 3 included 77 participants (mean age 50 years, 70% women) who had the largest increase of BMI (slope: 0.318, p=2.8e-22).Adjusting for age, sex, wear time and race/ethnicity, participants in group 3 (Δ1437 steps P< 0.0001) and Group 2 (Δ422 steps, P=0.04) took significantly fewer steps, compared to participants in Group 1 (Model 1). The effect sizes were slightly attenuated but remained significant after additionally adjusting for hypertension, type 2 diabetes, current smoking, and cardiovascular disease: Group 3 took 1258 fewer steps, P=0.0001; Group 2 took 406 fewer steps, P=0.04 (Model 2). We further adjusted for sleep apnea, education, and marital status in Model 3 and observed that on average Group 3 took 1120 fewer steps (P= 0.0007) and Group 2 took 382 fewer steps (P= 0.06), compared to Group 1. Conclusion: Participants whose BMI trajectory increased over time took significantly fewer steps compared to participants with more stable BMI trajectories. Our findings suggest that levels of physical activity may correlate with greater weight gain during adulthood.


1996 ◽  
Vol 135 (4) ◽  
pp. 421-424 ◽  
Author(s):  
J Bellone ◽  
G Aimaretti ◽  
MR Valetto ◽  
S Bellone ◽  
C Baffoni ◽  
...  

Bellone J. Aimaretti G, Valetto MR, Bellone S, Baffoni C, Arvat E, Seminara S, Camanni F, Ghigo E, Acute administration of recombinant human growth hormone inhibits the somatotrope responsiveness to growth hormone-releasing hormone in childhood. Eur J Endocrinol 1996:135: 421–4. ISSN 0804–4643 In adulthood the growth hormone (GH) response to growth hormone-releasing hormone (GHRH) is inhibited by previous acute administration of either GH or GHRH and it is restored by substances that inhibit hypothalamic somatostatin release. Because in children the GH response to GHRH is not affected by previous neurohormone administration, it has been suggested that in childhood a GH increase is not able to trigger the somatostatin-mediated negative GH autofeedback mechanism. To verify this hypothesis, in 25 children (8 girls and 17 boys; 15 prepubertal and 10 in pubertal stages II–IV) with familial short stature (normal height velocity and insulin-like growth factor I levels) we studied the effect of acute iv administration of different recombinant human GH doses (group 1, N = 5, 0.06U/kg; group 2, N = 6, 0.01 U/kg; group 3, N = 7, 0.005 U/kg at −150 min or saline on the GH response to GHRH (1 μg/kg iv at 0 min). In another group (N = 7), we studied the effect of 0.005 U/kg iv recombinant human GH or saline on the GH response to GHRH combined with arginine (0.5 g/kg iv over 30 min), which likely inhibits hypothalamic somatostatin release. Serum GH increases after recombinant human GH were dose-dependent (GH peak, mean±sem, 171.7 ± 24.4, 33.3 ± 3.9 and 21.8 ± 5.1 μg/l, respectively). The administration of recombinant human GH strongly inhibited the GHRH-induced GH rise in all groups (group 1, 7.1 ± 1.7 vs 23.1 ± 7.6 μg/l, p < 0.05; group 2, 9.5 ±2.8 vs 26.9±8.5 μg/l, p < 0.05; group 3, 9.1 ±2.7 vs 34.8 ± 7.2 μg/l, p< 0.02). The GH response to arginine + GHRH (56.9 ± 13.3 μg/l) was higher than that to GHRH alone recorded in group 1 (p < 0.005), group 2 (p < 0.01) and group 3 (p < 0.01), while exogenous recombinant human GH failed to inhibit it (45.0 ± 9.4 μg/l). Our results demonstrate that in childhood, as well as in adulthood, recombinant human GH administration inhibits the somatotrope responsiveness to GHRH. This inhibitory effect is likely to be mediated by hypothalamic somatostatin release. Ezio Ghigo, Divisione di Endocrinologia, Ospedale Molinette, C.so Dogliotti 14, 10126 Torino, Italy


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