scholarly journals The Biochemical Diagnosis of Acromegaly

2021 ◽  
Vol 10 (5) ◽  
pp. 1147
Author(s):  
Amit Akirov ◽  
Hiba Masri-Iraqi ◽  
Idit Dotan ◽  
Ilan Shimon
Keyword(s):  
English Language ◽  
Diagnostic Delay ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Published Data ◽  
Biochemical Diagnosis ◽  
Key Factor ◽  
Assay Methods ◽  
Serum Gh

Background: The diagnosis of acromegaly still poses a clinical challenge, and prolonged diagnostic delay is common. The most important assays for the biochemical diagnosis and management of acromegaly are growth hormone (GH) and insulin-like growth factor-1 (IGF-1). Objective: Discuss the role of IGF-1, basal serum GH, and nadir GH after oral glucose tolerance test (OGTT) for the diagnosis, management, and treatment of patients with acromegaly. Methods: We performed a narrative review of the published data on the biochemical diagnosis and monitoring of acromegaly. An English-language search for relevant studies was conducted on PubMed from inception to 1 January 2021. The reference lists of relevant studies were also reviewed. Results: Serum IGF-1 levels, basal GH values, and nadir GH after OGTT play a major role in the diagnosis, management, and treatment of patients with acromegaly. Measurement of IGF-1 levels is the key factor in the diagnosis and monitoring of acromegaly, but basal and nadir GH following OGTT are also important. However, several factors may significantly influence the concentrations of these hormones, including assay methods, physiologic and pathologic factors. In some cases, discordant GH and IGF-1 levels may be challenging and usually requires additional data and monitoring. Conclusion: New GH and IGF-1 standards are much more precise and provide more accurate tools to diagnose and monitor patients with acromegaly. However, all these biochemical tools have their limitations, and these should be taken under consideration, along with the history, clinical features and imaging studies, when assessing patients for acromegaly.

scholarly journals Glycated Albumin as Marker for Early Hyperglycemia Detection in Adolescent with β Thalassemia Major

2021 ◽  
Vol 13 (3) ◽  
pp. 281-8
Author(s):  
Dewinda Candrarukmi ◽  
Annang Giri Moelyo ◽  
Muhammad Riza
Keyword(s):  
Diabetes Mellitus ◽  
Characteristic Curve ◽  
Glycated Albumin ◽  
Fasting Blood Glucose ◽  
Thalassemia Major ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Single Blind ◽  
Endocrine Complications

BACKGROUND: Hyperglycemia is one of the most common endocrine complications in children with β thalassemia major. Though the current diagnostic marker either requires fasting, has low reproducibility, or it is not an accurate for thalassemia patients. Glycated albumin (GA) is a quick and easy alternative marker for hyperglycemia detection and monitoring of glycemic control. However to date, no studies have analyzed the role of GA value in detection of hyperglycemia in children with thalassemia major. This study analyzed the value of GA as an alternative screening marker for hyperglycemia detection in children with β thalassemia major.METHODS: A single-blind prospective diagnostic test was conducted in 9 to 18 years old children with β thalassemia major and who were treated at the Dr. Moewardi Regional General Hospital between October 1, 2018 and December 31, 2019. In a single, fasted study visit, height, weight, fasting blood glucose (FPG), GA, oral glucose tolerance test (OGTT) were measured. The area under a receiver operating characteristic curve (AUC) was used to determine the cut-off value at which hyperglycemia prediction (OGTT ≥140 mg/dL) display optimal sensitivity and specificity. RESULTS: Among the 53 children with β thalassemia major, 1 (1.9%) had diabetes mellitus and 4 (7.5%) had prediabetes based on their OGTT values. The median GA value in this study was 10.9% (range: 7.6–12.4%). GA had a low AUC (0.646, p=0.287) for hyperglycemia detection in pediatric patients with β thalassemia major. At a cut-off of 11.45%, GA demonstrated 60% sensitivity and 60.4% specificity.CONCLUSION: GA cannot be used as an alternative marker for hyperglycemia detection in children with β thalassemia major.KEYWORDS: hyperglycemia, diabetes mellitus, prediabetes, β thalassemia major, glycated albumin 

scholarly journals Inhibition of Ceramide De Novo Synthesis Affects Adipocytokine Secretion and Improves Systemic and Adipose Tissue Insulin Sensitivity

2018 ◽  
Vol 19 (12) ◽  
pp. 3995 ◽  
Author(s):  
Agnieszka U. Blachnio-Zabielska ◽  
Hady Razak Hady ◽  
Adam R. Markowski ◽  
Adam Kurianiuk ◽  
Alicja Karwowska ◽  
...  
Keyword(s):  
Adipose Tissue ◽  
De Novo ◽  
Tolerance Test ◽  
Hormone Sensitive Lipase ◽  
Enzyme Linked Immunosorbent Assay ◽  
Oral Glucose ◽  
Necrosis Factor Alpha ◽  
Fat Depots ◽  
Tnf Α

Ceramide accumulation in muscle and in liver is implicated in the induction of insulin resistance. Much less in known about the role of ceramide in adipose tissue. The aim of the present study was to elucidate the role of ceramide in adipose tissue and to clarify whether lipids participate in the regulation of adipocytokine secretion. The experiments were performed on male Wistar rats divided into three groups: 1. Control, 2. fed high fat diet (HFD), and 3. fed HFD and treated with myriocin. Ceramide (Cer) and diacylglycerol (DAG) content were analyzed by LC/MS/MS. Hormone sensitive lipase (HSL) phosphorylation was analyzed by Western Blot. Plasma adiponectin and tumor necrosis factor alpha (TNF-α) concentration were measured by enzyme-linked immunosorbent assay. An oral glucose tolerance test (OGTT) and insulin tolerance test (ITT) was also performed. In HFD group, total DAG and Cer content was elevated in both subcutaneous and visceral adipose tissue, which was accompanied by increased glucose, insulin, and HOMA-IR value. Myriocin treatment restored HOMA-IR as well as glucose and insulin concentration to control values. Moreover, myriocin decreased not only Cer, but also DAG levels in both fat depots. Furthermore, we observed a strong correlation between adiponectin (negative) and TNF-α (positive) and Cer in both fat tissues, which suggests that Cer is involved in the regulation of adipocytokine secretion.

scholarly journals TNF signaling impacts glucagon-like peptide-1 expression and secretion

2018 ◽  
Vol 61 (4) ◽  
pp. 153-161 ◽  
Author(s):  
Sufang Chen ◽  
Wei Wei ◽  
Minjie Chen ◽  
Xiaobo Qin ◽  
Lianglin Qiu ◽  
...  
Keyword(s):  
Insulin Secretion ◽  
Glucose Metabolism ◽  
Glucose Tolerance ◽  
Glucose Tolerance Test ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Glucagon Like Peptide ◽  
Glucagon Like Peptide 1 ◽  
Deficient Mice

Numerous studies have implicated tumor necrosis factor α (TNFα) in the pathogenesis of type 2 diabetes. However, the role of its primary receptor, TNF receptor 1 (TNFR1), in homeostatic regulation of glucose metabolism is still controversial. In addition to TNFα, lymphotoxin α (LTα) binds to and activates TNFR1. Thus, TNFα and LTα together are known as TNF. To delineate the role of TNF signaling in glucose homeostasis, the present study ascertained how TNF signaling deficiency affects major regulatory components of glucose homeostasis. To this end, normal diet-fed male TNFR1-deficient mice (TNFR1−/−), TNFα/LTα/LTβ triple-deficient mice (TNF/LT∆3) and their littermate controls were subjected to intraperitoneal glucose tolerance test, insulin tolerance test and oral glucose tolerance test. The present results showed that TNFR1−/− and TNF/LT∆3 mice vs their controls had comparable body weight, tolerance to intraperitoneal glucose and sensitivity to insulin. However, their tolerance to oral glucose was significantly increased. Additionally, glucose-induced insulin secretion assessments revealed that TNFR1 or TNF/LT deficiency significantly increased oral but not intraperitoneal glucose-induced insulin secretion. Consistently, qPCR and immunohistochemistry analyses showed that TNFR1−/− and TNF/LT∆3 mice vs their controls had significantly increased ileal expression of glucagon-like peptide-1 (GLP-1), one of the primary incretins. Their oral glucose-induced secretion of GLP-1 was also significantly increased. These data collectively suggest that physiological TNF signaling regulates glucose metabolism primarily through effects on GLP-1 expression and secretion and subsequently insulin secretion.

scholarly journals Glucagon-like peptide-2 and glucagon in patients with acromegaly and Cushing’s disease: secretion features and influence on glucose metabolism

2017 ◽  
Vol 63 (5) ◽  
pp. 299-306
Author(s):  
Lubov V. Machekhina ◽  
Ekaterina А. Shestakova ◽  
Zhanna Е. Belaya ◽  
Larisa V. Nikankina ◽  
Lyudmila I. Astafieva ◽  
...  
Keyword(s):  
Cushing’S Disease ◽  
Glucagon Secretion ◽  
Pituitary Surgery ◽  
Tolerance Test ◽  
Cushing's Disease ◽  
Oral Glucose ◽  
Glucagon Level ◽  
Metabolism Regulation ◽  
History Of

Aim. To analyze secretion of GLP-2 and glucagon in patients with Cushing’s disease (CD) and acromegaly in response to glucose load. Material and methods. The study included 42 patients with Cushing’s disease and acromegaly; the mean patient age was 37.5 years. All patients were newly diagnosed with Cushing’s disease and acromegaly: none of them had a history of previous drug therapy, radiotherapy, or pituitary surgery. All patients underwent the oral glucose tolerance test with measurements of glucose, glucagon, and GLP-2 levels at 0, 30, and 120 min, respectively. Results. A significantly higher glucagon level was observed in CD patients at all cut-off points (р=0.001); in acromegaly patients, the glucagon level did not significantly differ from that in controls (р=0.12). The GLP-2 concentration in CD patients was also significantly higher compared to that in controls (р<0.001). There were no significant differences between acromegaly patients and controls. We also found a strong correlation between GLP-2 and glucagon levels at 0 and 30 min in CD patients. In acromegaly patients, a correlation between GLP-2 and glucagon levels was observed only at 0 min. Different GLP-2 and glucagon secretion patterns in patients with CD and acromegaly suggest a direct influence of glucocorticoids on glucagon secretion and no influence in the case of IGF-1. Conclusion. The found correlation between GLP-2 and glucagon levels might help specify the role of GLP-2 in carbohydrate metabolism regulation. Interactions of cortisol, IGF-1, and GLP-2 look promising for a better understanding of secondary hyperglycemia pathogenesis.

Long-term effect of 90Y pituitary implantation in acromegaly

1987 ◽  
Vol 115 (3) ◽  
pp. 301-306 ◽  
Author(s):  
A. Jadresic ◽  
L. E. Jimenez ◽  
G. F. Joplin
Keyword(s):  
Hormone Replacement ◽  
Cumulative Effect ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Pituitary Fossa ◽  
Long Term Effect ◽  
Long Term Trends ◽  
Pituitary Irradiation ◽  
Serum Gh

Abstract. This report examines the long-term trends in GH levels and pituitary function in a group of 38 acromegalic patients who were selected insofar as we were able to follow them up for more than 10 years after a single dose of 90Y interstitial pituitary irradiation as the sole treatment. Mean serum GH had fallen from 106 to 24 mIU/l within 3–6 months and then slowly declined to 4 mIU/l after 10 years. GH levels of ≤ 5 mIU/l during a 50 g oral glucose tolerance test were obtained in 8% of patients at 3–6 months and in 18% at 1 year, the cumulative percentage increasing to 53% at 10, and 76% at 14 years. The percentage of patients requiring hormone replacement therapy rose from nil pre-implant to 16% by 3–6 months, and then slowly increased to 39% by 14 years. Serial coned radiographs of the pituitary fossa were available for 32 patients. By 10 years, 16 showed thickening of the dorsum sellae and/or reduction of at least one diameter by 3 mm. Concerning symptoms, all 29 patients whose GH level fell to ≤ 5 mIU/l showed improvements, 22 becoming asymptomatic. Seven patients with lesser falls in GH levels (from a mean of 193 to a mean of 15 mIU/l) all improved, one becoming asymptomatic. Two showed no variation. These results show that 90Y pituitary implants have a cumulative effect over the years in inducing remission and hypopituitarism in acromegalic patients, the early decline in GH levels being swifter than from other forms of irradiation.

Sign in / Sign up

Export Citation Format

Share Document