scholarly journals Exocrine Pancreatic Function in Girls with Anorexia Nervosa

Nutrients ◽  
2021 ◽  
Vol 13 (9) ◽  
pp. 3280
Author(s):  
Żaneta Malczyk ◽  
Wojciech Roczniak ◽  
Bogdan Mazur ◽  
Jarosław Kwiecień ◽  
Katarzyna Ziora ◽  
...  
Keyword(s):  
Anorexia Nervosa ◽  
Leptin Receptor ◽  
Serum Insulin ◽  
Study Groups ◽  
Exocrine Pancreatic Function ◽  
Exocrine Function ◽  
Time To Peak ◽  
Soluble Leptin Receptor ◽  
Pancreatic Exocrine ◽  
The Relationship

Objectives: To assess pancreatic exocrine function in patients with anorexia nervosa using a breath test with 13C-labeled mixed triglycerides (MTG-BT) and to determine the relationship between the test results and selected biochemical and hormonal parameters. Material and methods: Anthropometric measurements, biochemical and hormonal parameters (serum leptin, soluble leptin receptor (sLR), acylated and desacylated ghrelin, free leptin index (FLI)), and MTG-BT were performed in a group of 31 girls with the restrictive type of AN, as well as 38 healthy girls (C). Results: The average cumulative dose of 13C-triglycerides recovered with exhaled air (%CD) was similar in both study groups, while the average time from 13C-triglycerides administration to peak 13CO2 excretion in expired air (time to peak (TTP)) was significantly longer in patients with AN compared to C. In both groups, %CD correlated negatively with FLI. TTP correlated negatively with sLR and FLI in the AN and with serum insulin and HOMA-IR values in the C. Conclusions: In girls with AN, the pancreatic efficiency of lipase secretion was found to be normal, while the kinetics of this enzyme secretion were disturbed. These changes may result from disorders in the functioning of the adipose–insular and islet–acinar axes.

scholarly journals Hormonal and Body Composition Predictors of Soluble Leptin Receptor, Leptin, and Free Leptin Index in Adolescent Girls with Anorexia Nervosa and Controls and Relation to Insulin Sensitivity

2004 ◽  
Vol 89 (7) ◽  
pp. 3486-3495 ◽  
Author(s):  
Madhusmita Misra ◽  
Karen K. Miller ◽  
Cecilia Almazan ◽  
Kavitha Ramaswamy ◽  
Avichal Aggarwal ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Body Mass Index ◽  
Body Composition ◽  
Anorexia Nervosa ◽  
Body Fat ◽  
Adolescent Girls ◽  
Leptin Receptor ◽  
Percent Body Fat ◽  
Healthy Controls ◽  
Soluble Leptin Receptor

Abstract Anorexia nervosa (AN) is associated with very low levels of leptin, a cytokine secreted by adipose tissue and known to suppress appetite. Leptin may play a permissive role in onset of puberty and in resumption of gonadal function in conditions of undernutrition. The soluble leptin receptor (sOB-R) is the main leptin binding protein, and the ratio of serum leptin to sOB-R provides a measure of the free leptin index (FLI), which may be a more accurate determinant of leptin function. Determinants of sOB-R and FLI have not been examined in an adolescent population. We examined levels of sOB-R, leptin, and FLI, and body composition and hormonal determinants of these variables in 23 adolescent girls with AN and 21 healthy adolescent girls of comparable maturity prospectively over 1 yr. Measures of insulin resistance and adiponectin were also examined. We determined changes in levels of sOB-R, leptin, and FLI with weight recovery (defined as an increase in body mass index of ≥10%, n = 11), and with resumption of menstrual cycles (n = 13). Girls with AN had significantly higher levels of sOB-R (P = 0.0008) and significantly lower levels of leptin and FLI (P < 0.0001 for both) than healthy controls, and levels of FLI were reduced more than levels of leptin in girls with AN compared with controls. An inverse correlation was noted between levels of leptin and sOB-R for the group as a whole (r = −0.64, P < 0.0001) but not in girls with AN considered alone. The most important predictor of levels of sOB-R was cortisol in the group as a whole (r = 0.61, P < 0.0001) and in girls with AN considered alone (r = 0.66, P = 0.0008). Other independent predictors of sOB-R levels for the entire group were percent body fat (r = −0.44, P = 0.003) and levels of IGF-I (r = −0.37, P = 0.01). The most important predictors of leptin and FLI were body mass index and percent body fat. An inverse relationship was noted between measures of insulin resistance and sOB-R levels, whereas a positive association was noted between these measures and leptin and FLI. Adiponectin values did not differ in girls with AN compared with healthy controls and did not correlate with sOB-R, leptin, or FLI. Weight recovery resulted in significant decreases in levels of the sOB-R (24.7 ± 1.7 to 17.6 ± 1.2 U/ml, P = 0.004), and increases in levels of leptin (4.4 ± 1.0 to 13.7 ± 2.9 μg/liter, P = 0.02). Resumption of menstrual function, but not weight recovery alone, was associated with significant increases in FLI (0.19 ± 0.04 to 0.50 ± 0.09 μg/U × 10−3, P = 0.02). We demonstrate an increase in levels of sOB-R and a decrease in the FLI in adolescent girls with AN, and also demonstrate that cortisol is the most important predictor of levels of sOB-R in this condition. Levels of leptin and FLI, conversely, are primarily predicted by body composition. Weight recovery is associated with a decrease in sOB-R and an increase in leptin. Resumption of menses is associated with significant increases in the FLI, suggesting that free leptin may be an important determinant of menstrual recovery.

scholarly journals Serum concentrations of adipocyte fatty acid binding protein in patients with anorexia nervosa

2009 ◽  
pp. 577-581
Author(s):  
D Haluzíková ◽  
I Dostálová ◽  
P Kaválková ◽  
T Roubíček ◽  
M Mráz ◽  
...  
Keyword(s):  
Anorexia Nervosa ◽  
Fatty Acid ◽  
Fatty Acid Binding Protein ◽  
Leptin Receptor ◽  
Serum Levels ◽  
Fatty Acid Binding ◽  
Metabolic Alterations ◽  
Chronic Malnutrition ◽  
Acid Binding Protein ◽  
Soluble Leptin Receptor

Serum adipocyte fatty acid-binding protein (FABP) concentrations are linked to human obesity and other features of metabolic syndrome. Whether FABP associates with metabolic alterations in chronic malnutrition is unknown. In the present study, we measured fasting serum levels of FABP, leptin, soluble leptin receptor, adiponectin, resistin, C-reactive protein (CRP), insulin, glucose, cholesterol and triglycerides in 19 patients with a restrictive type of anorexia nervosa (AN) and in 16 healthy agematched control women (C). Body mass index, serum leptin, and CRP concentrations were significantly lower, while serum adiponectin and soluble leptin receptor levels were significantly higher in AN relative to C group. Serum insulin, glucose, cholesterol and triglyceride levels did not differ between the groups studied. Serum FABP levels were unchanged in patients with AN and were not related to any of parameters studied. We conclude that, in contrast to patients with obesity where FAPB is a prominent marker of metabolic alterations, chronic malnutrition in AN does not significantly affect its serum levels.

Simultaneous assessments of exocrine pancreatic function by cholesteryl-[14C]octanoate breath test and measurement of plasma p-aminobenzoic acid

1995 ◽  
Vol 41 (4) ◽  
pp. 599-604 ◽  
Author(s):  
M J Bruno ◽  
F J Hoek ◽  
B Delzenne ◽  
D J van Leeuwen ◽  
C D Schteingart ◽  
...  
Keyword(s):  
Breath Test ◽  
Test Sample ◽  
Exocrine Pancreatic Function ◽  
Pancreatic Function ◽  
Single Sample ◽  
Exocrine Function ◽  
Aminobenzoic Acid ◽  
Aminosalicylic Acid ◽  
Exocrine Insufficiency ◽  
Pancreatic Exocrine

Abstract Two noninvasive tests for assessing pancreatic exocrine function, the cholesteryl-[14C]octanoate breath test and the HPLCN-benzoyl-tyrosyl-p-aminobenzoic acid/p-aminosalicylic acid (NBT-PABA/PAS) test, were simultaneously performed in nine patients with pancreatic exocrine insufficiency due to chronic pancreatitis and in nine healthy volunteers. 14CO2 output in breath and plasma PABA concentration rose slowly in patients but increased rapidly in healthy subjects. The measurement time giving the best discrimination between both groups was 120 min for the cholesteryl-[14C]octanoate breath test and 90 min for the plasma PABA test. At these points, both single-sample tests had essentially identical diagnostic sensitivity. The diagnostic sensitivities of the two single-sample tests were equal to that of the cumulative 6-h urinary PABA recovery and the cumulative 6-h urinary PABA/PAS ratio. We conclude that, for both the cholesteryl-[14C]octanoate breath test and the plasma PABA test, a single test sample is sufficient for rapid detection of impaired exocrine pancreatic function.

scholarly journals Impaired exocrine pancreatic function in different stages of type 1 diabetes

2021 ◽  
Vol 9 (1) ◽  
pp. e001158
Author(s):  
Nicoletta Dozio ◽  
Rita Indirli ◽  
Gian Maria Giamporcaro ◽  
Laura Frosio ◽  
Alessandra Mandelli ◽  
...  
Keyword(s):  
Exocrine Pancreatic Function ◽  
Retinol Binding Protein ◽  
Exocrine Function ◽  
Healthy Controls ◽  
Pancreatic Amylase ◽  
Fecal Elastase ◽  
Elastase 1 ◽  
Pancreatic Exocrine ◽  
New Onset

IntroductionAim of this study was to investigate the pancreatic exocrine function in patients with type 1 diabetes (T1D) by multiple non-invasive tests.Research design and methodsThe study is a single-center, cross-sectional study of pancreatic exocrine function in adult patients with new-onset or long-standing T1D and healthy controls.ResultsHealthy controls, new-onset T1D, and long-standing T1D were similar for age at the time of the study, gender and body mass index (BMI) categories. Age of onset of T1D patients with long-standing disease was younger than that of patients with new-onset T1D (p<0.001). As expected, the three groups differed for C-peptide and hemoglobin A1c (HbA1c) levels. Lipase activity measured by 13C-mixed triglyceride breath test was reduced progressively, although not significantly, from controls to recent-onset T1D and long-standing T1D participants. Fecal elastase-1 was significantly lower in participants with T1D, either new onset or long standing. Pancreatic amylase, lipase, retinol binding protein and prealbumin were significantly different across the groups, with a significant trend toward lower values in long-standing T1D and intermediate values in new-onset T1D, while no differences were observed for total amylase. The markers of impaired exocrine function tests (fecal elastase-1, serum pancreatic amylase and lipase) and of nutritional status (retinol binding protein and prealbumin levels) correlated with the reduction of fasting and urinary C-peptide.ConclusionsOur results confirm that exocrine pancreatic impairment is a feature of T1D, with low fecal elastase-1, serum pancreatic amylase and lipase as specific markers, associated with reduced levels of nutritional indexes. Moreover, the evidence of more advanced insufficiency in long-standing disease reflects the chronic nature of this process, and its correlation with the residual β-cell function suggests parallel pathways for the impairment of the endocrine and exocrine pancreatic function.

scholarly journals Study of Serum Insulin Level in Hypertensive Patients

1970 ◽  
Vol 4 (1) ◽  
pp. 13-16
Author(s):  
MN Uddin ◽  
MZ Ali ◽  
NWB Jahan ◽  
MA Rashid ◽  
MK Sultan ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Blood Pressure ◽  
Serum Insulin ◽  
Study Groups ◽  
Serum Glucose ◽  
Ionized Calcium ◽  
Hypertensive Patients ◽  
Significant Difference ◽  
Serum Ionized Calcium ◽  
The Relationship

Background and aims: Hypertension is a frequent and almost ubiquitous health disorder, prevalent both in developed and developing countries. Hyperinsulinemia and insulin resistance have been suggested to be closely associated with the pathogenesis of essential hypertension. However there is considerable controversy in this regards. The present study was designed to explore the relationship between serum insulin and serum ionized calcium in non diabetic and diabetic hypertensive subjects. Subjects and Methods: A total of 57 hypertensive and diabetic hypertensive patients attending out patients department of the BIRDEM and NICVD were included in the study. Fasting serum glucose was measured by glucose oxidase method, lipid profile was measured by enzymatic method. Serum insulin was measured by Enzyme Linked Immunosorbent assay (ELISA) method and serum ionized calcium by the Ion Sensitive Electrode (ISE) technique. Results: Glucose-insulin ratios were calculated as the index for insulin. Serum insulin (pmol/ml), Mean ± SD, 147 ± 48 in DC and 170 ± 80 in DH groups vs 118 ± 21 in NC and 120 ± 41 in EH groups, p= 0.023 and p= 0.031 respectively. Although, from the serum insulin results, the diabetic groups seemed to have insulin resistance, the glucose-insulin ratios in the two groups were significantly lower compared to nondiabetic groups (Glucose-insulin ratio, mmol/pmol, 0.066 ± 0.025 in DC, 0.074 ± 0.025 in DH vs 0.044 ± 0.11 in NC, 0.043 ± 0.012 in EH, p= 0.005 - 0.0001). The serum ionized calcium in the healthy subject, first time reported in the country by an up to date method (1.17 ± 0.05 M ± SD), were within the range found in healthy subjects of the other populations. No significant difference in the serum Ca2+ could be found between any of the study groups. Also, serum Ca2+ did not correlate with blood pressure, glucose or insulin in any of the study groups or with all the patients as a whole. Serum total cholesterol, triglyceride, HDLc and LDLc levels in the DC, EH and DH group did not show any significant difference compared to NC group and among the groups. The lipid abnormality as reflected by the mean LDL-HDL cholesterol ratios was the highest in the DH group but the differences were not statistically significant compared to the NC, DC and EH group. Conclusions: The data suggest the following conclusions: a) Serum ionized calcium level in our population is similar to that reported for other population. b) Serum glucose and insulin by themselves do not have any direct influence on serum ionized calcium. c) Non obese diabetes mellitus subjects in our population do not show insulin resistance as the primary defect. Rather, there is significant decompensation of the insulin secretory capacity in the subjects. d) Insulin resistance should be measured directly in relation to blood pressure and Ca2+ in appropriate groups of subjects to explore the relationship between insulin resistance, hyperinsulinemia and serum ionized calcium. Keywords: Serum Insulin; Hypertension DOI: http://dx.doi.org/10.3329/cardio.v4i1.9384 Cardiovasc. J. 2011; 4(1): 13-16

SOLUBLE LEPTIN RECEPTOR LEVELS IN PATIENTS WITH ANOREXIA NERVOSA

2002 ◽  
Vol 28 (3) ◽  
pp. 199-205 ◽  
Author(s):  
Jarmila Krizova ◽  
Hana Papezova ◽  
Denisa Haluzikova ◽  
Jitka Parizkova ◽  
Jan Jiskra ◽  
...  
Keyword(s):  
Anorexia Nervosa ◽  
Leptin Receptor ◽  
Soluble Leptin Receptor

scholarly journals The role of soluble leptin receptor in the pathogenesis of coronary heart disease

2021 ◽  
Vol 20 (3) ◽  
pp. 34-45
Author(s):  
E. A. Polyakova
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Blood Serum ◽  
Leptin Receptor ◽  
Serum Insulin ◽  
Visceral Obesity ◽  
Soluble Leptin Receptor ◽  
Tnf Α ◽  
Artery Disease

Introduction. The participation of soluble leptin receptor (SLR) in the formation of hyperleptinemia and leptin resistance in patients with coronary artery disease (CAD) in combination with obesity is discussed. Aim. Study of the role of SLR in the pathogenesis of ischemic heart disease. Materials and methods. A cohort study of 744 patients was performed: 465 patients with CAD (56 years old, Q1=44; Q3=62), 270 patients without CAD (52 years old, Q1=44; Q3=56). Methods: EchoCG, heart computed tomography, coronary angiography. In the blood serum, the lipids, glucose, creatinine, uric acid, and c-reactive protein were assessed using a highly sensitive method (HF-CRP). Concentrations of SLR, leptin (LN), adiponectin (total and high molecular weight), fatty acid binding protein-4 (FABP-4) tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), serum insulin were determined by enzyme immunoassay. Results. The level of SLR in blood serum in men and women with CAD is lower than in men without CAD (p <0.001). In CAD patients, obesity was associated with a low SLR level in the blood serum and a high free LN index. At a serum SLR concentration of <7.5ng/ml in men with CAD, the incidence of obesity was higher simultaneously with signs of visceral obesity of the heart, the presence of atherosclerotic plaques in the common carotid arteries, high glycaemic levels, insulin, IL-6, and LN in serum, serum LN/adiponectin ratio and a high HOMA-IR index. Diabetes mellitus, visceral obesity, high levels of hs-CRP, TNF-α, FABP-4, serum insulin, and HOMA-IR index were more often detected in women with coronary artery disease with SLR <10.2 ng/ml. In men and women with CAD, there were no differences in SLR concentration depending on the extent of coronary atherosclerosis. Conclusion. An increase in the free LN index indicates the disruption of connections in the leptin-receptor system and reflects the mechanisms of compensation for overcoming the resistance of peripheral tissues to leptin, which is confirmed by a noticeable negative relationship between the levels of SLR and leptin in the serum of men with coronary artery disease. A low concentration of SLR in patients with CAD is associated with obesity, pro-atherogenic and pro-inflammatory markers of cardiovascular diseases.

scholarly journals Diencephalic Syndrome due to Hypothalamic Tumor: A Model of the Relationship between Weight and Puberty Onset

2006 ◽  
Vol 91 (7) ◽  
pp. 2467-2473 ◽  
Author(s):  
Raja Brauner ◽  
Christine Trivin ◽  
Michel Zerah ◽  
Jean-Claude Souberbielle ◽  
François Doz ◽  
...  
Keyword(s):  
Growth Rate ◽  
Surgical Resection ◽  
Leptin Receptor ◽  
The Body ◽  
Tumor Treatment ◽  
Presenting Symptoms ◽  
Soluble Leptin Receptor ◽  
Diencephalic Syndrome ◽  
Plasma Leptin ◽  
The Relationship

Abstract Context: Changes in body weight, statural growth rate, and puberty may be the presenting symptoms of hypothalamic-pituitary tumors. Objective: The objective of the study was to assess the relationship between the tumor and its treatment and the weight, growth rate, and onset of puberty, using the diencephalic syndrome of emaciation as model. Patients: Eleven patients seen before 1 yr of age, except one aged 9 yr, for diencephalic syndrome of emaciation due to hypothalamic pilocytic astrocytoma, were treated by surgical resection (n = 9), cranial irradiation (n = 7), and/or chemotherapy (n = 10). Results: At diagnosis, growth rate was normal, despite the emaciation, and there was no hypothalamic-pituitary deficiency, except in the oldest patient. After tumor treatment, all had GH and thyroid-stimulating hormone deficiencies, but only three, who underwent major surgical resection, also had ACTH deficiency and diabetes insipidus. Eight became obese, and all but the oldest had transient precocious puberty. Plasma leptin concentrations were very low at diagnosis, increased after tumor treatment, and decreased transiently in one boy when the testosterone increased. The plasma soluble leptin receptor concentrations changed in the opposite direction, leading to an increase in the free leptin index, including in the three patients whose tumor was reduced without surgery. The body mass index was correlated positively with plasma leptin (rho = 0.73, P = 0.0004) and free leptin index (rho = 0.63, P &lt; 0.004) and negatively with ghrelin (rho = −0.49, P &lt; 0.03) concentrations. Conclusions: The obesity that occurs after treatment of hypothalamic tumors is not due to dysregulation of leptin secretion because it and plasma soluble leptin receptor remain regulated by factors like testosterone. This study also shows the influence of weight, possibly via leptin secretion, on the transient hypothalamic-pituitary-gonadal activation that occurs during the first year of life.

Evidence of Impaired Pancreatic Exocrine Function in Patients with Anorexia Nervosa

1985 ◽  
Vol 69 (s12) ◽  
pp. 63P-63P
Author(s):  
P.N. Foster ◽  
C. Duggan ◽  
H.F. Goode ◽  
J. Kelleher ◽  
R.V. Heatley ◽  
...  
Keyword(s):  
Anorexia Nervosa ◽  
Pancreatic Exocrine Function ◽  
Exocrine Function ◽  
Pancreatic Exocrine
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