Search Results

You are looking at 71 - 80 of 202 items for

  • Abstract: Arteries x
  • Abstract: Atherosclerosis x
  • Abstract: Carotid x
  • Abstract: Circulation x
  • Abstract: Ghrelin x
  • Abstract: Stroke x
  • Abstract: Veins x
  • Abstract: Heart x
  • Abstract: Cardio* x
Clear All Modify Search
Henri Honka Turku PET Centre, University of Turku, Turku, Finland

Search for other papers by Henri Honka in
Google Scholar
PubMed
Close
,
Jukka Koffert Turku PET Centre, University of Turku, Turku, Finland
Department of Gastroenterology, Turku University Hospital, Turku, Finland

Search for other papers by Jukka Koffert in
Google Scholar
PubMed
Close
,
Saila Kauhanen Division of Digestive Surgery and Urology, Turku University Hospital, Turku, Finland

Search for other papers by Saila Kauhanen in
Google Scholar
PubMed
Close
,
Nobuyuki Kudomi Faculty of Medicine, Kagawa University, Kagawa, Japan

Search for other papers by Nobuyuki Kudomi in
Google Scholar
PubMed
Close
,
Saija Hurme Department of Biostatistics, University of Turku, Turku, Finland

Search for other papers by Saija Hurme in
Google Scholar
PubMed
Close
,
Andrea Mari Institute of Neuroscience, National Research Council, Padua, Italy

Search for other papers by Andrea Mari in
Google Scholar
PubMed
Close
,
Andreas Lindqvist Department of Clinical Sciences, Lund University Diabetes Centre, Malmö, Sweden

Search for other papers by Andreas Lindqvist in
Google Scholar
PubMed
Close
,
Nils Wierup Department of Clinical Sciences, Lund University Diabetes Centre, Malmö, Sweden

Search for other papers by Nils Wierup in
Google Scholar
PubMed
Close
,
Riitta Parkkola Department of Radiology, University of Turku and Turku University Hospital, Turku, Finland

Search for other papers by Riitta Parkkola in
Google Scholar
PubMed
Close
,
Leif Groop Department of Clinical Sciences, Lund University Diabetes Centre, Malmö, Sweden

Search for other papers by Leif Groop in
Google Scholar
PubMed
Close
, and
Pirjo Nuutila Turku PET Centre, University of Turku, Turku, Finland
Department of Endocrinology, Turku University Hospital, Turku, Finland

Search for other papers by Pirjo Nuutila in
Google Scholar
PubMed
Close

Aims/hypothesis

The mechanisms for improved glycemic control after bariatric surgery in subjects with type 2 diabetes (T2D) are not fully known. We hypothesized that dynamic hepatic blood responses to a mixed-meal are changed after bariatric surgery in parallel with an improvement in glucose tolerance.

Methods

A total of ten morbidly obese subjects with T2D were recruited to receive a mixed-meal and a glucose-dependent insulinotropic polypeptide (GIP) infusion before and early after (within a median of less than three months) bariatric surgery, and hepatic blood flow and volume (HBV) were measured repeatedly with combined positron emission tomography/MRI. Ten lean non-diabetic individuals served as controls.

Results

Bariatric surgery leads to a significant decrease in weight, accompanied with an improved β-cell function and glucagon-like peptide 1 (GLP-1) secretion, and a reduction in liver volume. Blood flow in portal vein (PV) was increased by 1.65-fold (P = 0.026) in response to a mixed-meal in subjects after surgery, while HBV decreased in all groups (P < 0.001). When the effect of GIP infusion was tested separately, no change in hepatic arterial and PV flow was observed, but HBV decreased as seen during the mixed-meal test.

Conclusions/interpretation

Early after bariatric surgery, PV flow response to a mixed-meal is augmented, improving digestion and nutrient absorption. GIP influences the post-prandial reduction in HBV thereby diverting blood to the extrahepatic sites.

Open access
Caishun Zhang Special Medicine Department, College of Basic Medicine, Qingdao University, Qingdao, China

Search for other papers by Caishun Zhang in
Google Scholar
PubMed
Close
,
Junhua Yuan Special Medicine Department, College of Basic Medicine, Qingdao University, Qingdao, China

Search for other papers by Junhua Yuan in
Google Scholar
PubMed
Close
,
Qian Lin Special Medicine Department, College of Basic Medicine, Qingdao University, Qingdao, China

Search for other papers by Qian Lin in
Google Scholar
PubMed
Close
,
Manwen Li Special Medicine Department, College of Basic Medicine, Qingdao University, Qingdao, China

Search for other papers by Manwen Li in
Google Scholar
PubMed
Close
,
Liuxin Wang Hyperbaric Oxygen Therapy Department, Yuhuangding Hospital Affiliated to Qingdao University, Yantai, China

Search for other papers by Liuxin Wang in
Google Scholar
PubMed
Close
,
Rui Wang Special Medicine Department, College of Basic Medicine, Qingdao University, Qingdao, China

Search for other papers by Rui Wang in
Google Scholar
PubMed
Close
,
Xi Chen Physiology Department, College of Basic Medicine, Qingdao University, Qingdao, China

Search for other papers by Xi Chen in
Google Scholar
PubMed
Close
,
Zhengyao Jiang Physiology Department, College of Basic Medicine, Qingdao University, Qingdao, China

Search for other papers by Zhengyao Jiang in
Google Scholar
PubMed
Close
,
Kun Zhu Intensive Care Unit Department, Affiliated Hospital of Qingdao University, Qingdao, China

Search for other papers by Kun Zhu in
Google Scholar
PubMed
Close
,
Xiaoli Chang Institute of Acupuncture, Shandong University of Traditional Chinese Medicine, Jinan, China

Search for other papers by Xiaoli Chang in
Google Scholar
PubMed
Close
,
Bin Wang Special Medicine Department, College of Basic Medicine, Qingdao University, Qingdao, China
Medical Microbiology Department, College of Basic Medicine, Qingdao University, Qingdao, China

Search for other papers by Bin Wang in
Google Scholar
PubMed
Close
, and
Jing Dong Special Medicine Department, College of Basic Medicine, Qingdao University, Qingdao, China
Physiology Department, College of Basic Medicine, Qingdao University, Qingdao, China

Search for other papers by Jing Dong in
Google Scholar
PubMed
Close

Ghrelin plays a pivotal role in the regulation of food intake, body weight and energy metabolism. However, these effects of ghrelin in the lateral parabrachial nucleus (LPBN) are unexplored. C57BL/6J mice and GHSR−/− mice were implanted with cannula above the right LPBN and ghrelin was microinjected via the cannula to investigate effect of ghrelin in the LPBN. In vivo electrophysiological technique was used to record LPBN glucose-sensitive neurons to explore potential udnderlying mechanisms. Microinjection of ghrelin in LPBN significantly increased food intake in the first 3 h, while such effect was blocked by [D-Lys3]-GHRP-6 and abolished in GHSR−/− mice. LPBN ghrelin microinjection also significantly increased the firing rate of glucose-excited (GE) neurons and decreased the firing rate of glucose-inhibited (GI) neurons. Additionally, LPBN ghrelin microinjection also significantly increased c-fos expression. Chronic ghrelin administration in the LPBN resulted in significantly increased body weight gain. Meanwhile, no significant changes were observed in both mRNA and protein expression levels of UCP-1 in BAT. These results demonstrated that microinjection of ghrelin in LPBN could increase food intake through the interaction with growth hormone secretagogue receptor (GHSR) in C57BL/6J mice, and its chronic administration could also increase body weight gain. These effects might be associated with altered firing rate in the GE and GI neurons.

Open access
Jiaxi Li Department of Physiology, Xiangya School of Medicine, Central South University, Changsha, Hunan, China

Search for other papers by Jiaxi Li in
Google Scholar
PubMed
Close
,
Pu Huang Department of Health Management Center, Changsha Central Hospital, University of South China, Changsha, Hunan, China

Search for other papers by Pu Huang in
Google Scholar
PubMed
Close
,
Jing Xiong Department of Endocrinology, Xiangya Third Hospital, Central South University, Changsha, Hunan, China

Search for other papers by Jing Xiong in
Google Scholar
PubMed
Close
,
Xinyue Liang Department of Physiology, Xiangya School of Medicine, Central South University, Changsha, Hunan, China

Search for other papers by Xinyue Liang in
Google Scholar
PubMed
Close
,
Mei Li Department of Physiology, Xiangya School of Medicine, Central South University, Changsha, Hunan, China

Search for other papers by Mei Li in
Google Scholar
PubMed
Close
,
Hao Ke Department of Physiology, Xiangya School of Medicine, Central South University, Changsha, Hunan, China

Search for other papers by Hao Ke in
Google Scholar
PubMed
Close
,
Chunli Chen Department of Dermatology, Xiangya Third Hospital, Central South University, Changsha, Hunan, China

Search for other papers by Chunli Chen in
Google Scholar
PubMed
Close
,
Yang Han Department of Physiology, Xiangya School of Medicine, Central South University, Changsha, Hunan, China

Search for other papers by Yang Han in
Google Scholar
PubMed
Close
,
Yanhong Huang Department of Physiology, Xiangya School of Medicine, Central South University, Changsha, Hunan, China

Search for other papers by Yanhong Huang in
Google Scholar
PubMed
Close
,
Yan Zhou Department of Physiology, Xiangya School of Medicine, Central South University, Changsha, Hunan, China

Search for other papers by Yan Zhou in
Google Scholar
PubMed
Close
,
Ziqiang Luo Department of Physiology, Xiangya School of Medicine, Central South University, Changsha, Hunan, China
Hunan Key Laboratory of Organ Fibrosis, Central South University, Changsha, Hunan, China

Search for other papers by Ziqiang Luo in
Google Scholar
PubMed
Close
,
Dandan Feng Department of Physiology, Xiangya School of Medicine, Central South University, Changsha, Hunan, China
Hunan Key Laboratory of Organ Fibrosis, Central South University, Changsha, Hunan, China

Search for other papers by Dandan Feng in
Google Scholar
PubMed
Close
, and
Chen Chen School of Biomedical Sciences, University of Queensland, St Lucia, Brisbane, Queensland, Australia

Search for other papers by Chen Chen in
Google Scholar
PubMed
Close

Objective

Ghrelin regulates body weight, food intake, and blood glucose. It also regulates insulin secretion from pancreatic islet cells. LEAP2 is a newly discovered endogenous ligand of the growth hormone secretagogue’s receptor (GHSR). It not only antagonizes the stimulation of GHSR by ghrelin but also inhibits the constitutive activation of GHSR as an inverse agonist. Type 2 diabetes (T2D) patients have endocrine disorders with metabolic imbalance. Plasma levels of ghrelin and LEAP2 may be changed in obese and T2D patients. However, there is no report yet on circulating LEAP2 levels or ghrelin/LEAP2 ratio in T2D patients. In this study, fasting serum ghrelin and LEAP2 levels in healthy adults and T2D patients were assessed to clarify the association of two hormones with different clinical anthropometric and metabolic parameters.

Design

A total of 16 females and 40 males, ages 23–68 years old normal (n  = 27), and T2D patients (n  = 29) were enrolled as a cross-sectional cohort.

Results

Serum levels of ghrelin were lower but serum levels of LEAP2 were higher in T2D patients. Ghrelin levels were positively correlated with fasting serum insulin levels and HOMA-IR in healthy adults. LEAP2 levels were positively correlated with age and hemoglobin A1c (HbA1c) in all tested samples. Ghrelin/LEAP2 ratio was negatively correlated with age, fasting blood glucose, and HbA1c.

Conclusions

This study demonstrated a decrease in serum ghrelin levels and an increase in serum LEAP2 levels in T2D patients. LEAP2 levels were positively correlated with HbA1c, suggesting that LEAP2 was associated with T2D development. The ghrelin/LEAP2 ratio was closely associated with glycemic control in T2D patients showing a negative correlation with glucose and HbA1c.

Open access
Milène Tetsi Nomigni INSERM, University of Rouen, Department of Endocrinology, Departments of Endocrinology, Pathology, Department of Pathology, Department of Endocrinology, INSERM, U982, Laboratory of Neuronal and Neuroendocrine Differentiation and Communication, Institute for Research and Innovation in Biomedicine, Mont‐Saint‐Aignan, France
INSERM, University of Rouen, Department of Endocrinology, Departments of Endocrinology, Pathology, Department of Pathology, Department of Endocrinology, INSERM, U982, Laboratory of Neuronal and Neuroendocrine Differentiation and Communication, Institute for Research and Innovation in Biomedicine, Mont‐Saint‐Aignan, France

Search for other papers by Milène Tetsi Nomigni in
Google Scholar
PubMed
Close
,
Sophie Ouzounian INSERM, University of Rouen, Department of Endocrinology, Departments of Endocrinology, Pathology, Department of Pathology, Department of Endocrinology, INSERM, U982, Laboratory of Neuronal and Neuroendocrine Differentiation and Communication, Institute for Research and Innovation in Biomedicine, Mont‐Saint‐Aignan, France

Search for other papers by Sophie Ouzounian in
Google Scholar
PubMed
Close
,
Alice Benoit INSERM, University of Rouen, Department of Endocrinology, Departments of Endocrinology, Pathology, Department of Pathology, Department of Endocrinology, INSERM, U982, Laboratory of Neuronal and Neuroendocrine Differentiation and Communication, Institute for Research and Innovation in Biomedicine, Mont‐Saint‐Aignan, France

Search for other papers by Alice Benoit in
Google Scholar
PubMed
Close
,
Jacqueline Vadrot INSERM, University of Rouen, Department of Endocrinology, Departments of Endocrinology, Pathology, Department of Pathology, Department of Endocrinology, INSERM, U982, Laboratory of Neuronal and Neuroendocrine Differentiation and Communication, Institute for Research and Innovation in Biomedicine, Mont‐Saint‐Aignan, France

Search for other papers by Jacqueline Vadrot in
Google Scholar
PubMed
Close
,
Frédérique Tissier INSERM, University of Rouen, Department of Endocrinology, Departments of Endocrinology, Pathology, Department of Pathology, Department of Endocrinology, INSERM, U982, Laboratory of Neuronal and Neuroendocrine Differentiation and Communication, Institute for Research and Innovation in Biomedicine, Mont‐Saint‐Aignan, France

Search for other papers by Frédérique Tissier in
Google Scholar
PubMed
Close
,
Sylvie Renouf INSERM, University of Rouen, Department of Endocrinology, Departments of Endocrinology, Pathology, Department of Pathology, Department of Endocrinology, INSERM, U982, Laboratory of Neuronal and Neuroendocrine Differentiation and Communication, Institute for Research and Innovation in Biomedicine, Mont‐Saint‐Aignan, France
INSERM, University of Rouen, Department of Endocrinology, Departments of Endocrinology, Pathology, Department of Pathology, Department of Endocrinology, INSERM, U982, Laboratory of Neuronal and Neuroendocrine Differentiation and Communication, Institute for Research and Innovation in Biomedicine, Mont‐Saint‐Aignan, France

Search for other papers by Sylvie Renouf in
Google Scholar
PubMed
Close
,
Hervé Lefebvre INSERM, University of Rouen, Department of Endocrinology, Departments of Endocrinology, Pathology, Department of Pathology, Department of Endocrinology, INSERM, U982, Laboratory of Neuronal and Neuroendocrine Differentiation and Communication, Institute for Research and Innovation in Biomedicine, Mont‐Saint‐Aignan, France
INSERM, University of Rouen, Department of Endocrinology, Departments of Endocrinology, Pathology, Department of Pathology, Department of Endocrinology, INSERM, U982, Laboratory of Neuronal and Neuroendocrine Differentiation and Communication, Institute for Research and Innovation in Biomedicine, Mont‐Saint‐Aignan, France
INSERM, University of Rouen, Department of Endocrinology, Departments of Endocrinology, Pathology, Department of Pathology, Department of Endocrinology, INSERM, U982, Laboratory of Neuronal and Neuroendocrine Differentiation and Communication, Institute for Research and Innovation in Biomedicine, Mont‐Saint‐Aignan, France

Search for other papers by Hervé Lefebvre in
Google Scholar
PubMed
Close
,
Sophie Christin-Maitre INSERM, University of Rouen, Department of Endocrinology, Departments of Endocrinology, Pathology, Department of Pathology, Department of Endocrinology, INSERM, U982, Laboratory of Neuronal and Neuroendocrine Differentiation and Communication, Institute for Research and Innovation in Biomedicine, Mont‐Saint‐Aignan, France
INSERM, University of Rouen, Department of Endocrinology, Departments of Endocrinology, Pathology, Department of Pathology, Department of Endocrinology, INSERM, U982, Laboratory of Neuronal and Neuroendocrine Differentiation and Communication, Institute for Research and Innovation in Biomedicine, Mont‐Saint‐Aignan, France

Search for other papers by Sophie Christin-Maitre in
Google Scholar
PubMed
Close
, and
Estelle Louiset INSERM, University of Rouen, Department of Endocrinology, Departments of Endocrinology, Pathology, Department of Pathology, Department of Endocrinology, INSERM, U982, Laboratory of Neuronal and Neuroendocrine Differentiation and Communication, Institute for Research and Innovation in Biomedicine, Mont‐Saint‐Aignan, France
INSERM, University of Rouen, Department of Endocrinology, Departments of Endocrinology, Pathology, Department of Pathology, Department of Endocrinology, INSERM, U982, Laboratory of Neuronal and Neuroendocrine Differentiation and Communication, Institute for Research and Innovation in Biomedicine, Mont‐Saint‐Aignan, France

Search for other papers by Estelle Louiset in
Google Scholar
PubMed
Close

Hirsutism induced by hyperandrogenism can be associated with polycystic ovary syndrome, 21-hydroxylase (OH) deficiency or androgen-secreting tumors, including ovarian and adrenal tumors. Adrenal androgen-secreting tumors are frequently malignant. Adrenal oncocytomas represent rare causes of hyperandrogenism. The aim of the study was to investigate steroidogenic enzyme expression and steroid secretion in an androgen-secreting adrenal oncocytoma in a young woman presenting with hirsutism. Hyperandrogenism was diagnosed on the basis of elevated plasma Δ4-androstenedione and testosterone levels. Pelvic ultrasound was normal, CT scanning revealed a right adrenal mass. Androgens were assessed in adrenal and ovarian vein samples and proved a right adrenal origin. Adrenalectomy normalized androgen levels and the adrenal tumor was diagnosed as an oncocytoma. Real time-PCR, immunohistochemistry and cell culture studies were performed on tumor explants to investigate the steroid secretion profile. Among enzymes required for cortisol synthesis, 17α-OH and 3β-hydroxysteroid dehydrogenase 2 (3β-HSD2) were highly expressed whereas 21-OH and 11β-OH were weakly produced at the mRNA and/or protein levels. Enzymes involved in testosterone production, 17β-HSD5 and 17β-HSD3, were also detected. ACTH receptor was present in the tissue. Cortisol, Δ4-androstenedione and testosterone secretions by cultured cells were increased by ACTH. These results provide the first demonstration, to our knowledge, of abnormal expression profile of steroidogenic enzymes in an adrenocortical oncocytoma. Our results also indicate that Δ4-androstenedione hypersecretion resulted from high 17α-OH and 3β-HSD2 expression in combination with low expression of 21-OH and 11β-OH. Testosterone production was ascribed to occurrence of 17β-HSD5 and 17β-HSD3. Finally, our results indicate that androgen secretion was stimulated by ACTH.

Open access
P R van Dijk Diabetes Centre, Departments of Internal Medicine, General Practice, Langerhans Medical Research Group, Department of Internal Medicine, Division of Cell Biology, Faculty of Health Sciences, Isala Clinics, PO Box 10400, 8000 G.K. Zwolle, The Netherlands

Search for other papers by P R van Dijk in
Google Scholar
PubMed
Close
,
S J J Logtenberg Diabetes Centre, Departments of Internal Medicine, General Practice, Langerhans Medical Research Group, Department of Internal Medicine, Division of Cell Biology, Faculty of Health Sciences, Isala Clinics, PO Box 10400, 8000 G.K. Zwolle, The Netherlands
Diabetes Centre, Departments of Internal Medicine, General Practice, Langerhans Medical Research Group, Department of Internal Medicine, Division of Cell Biology, Faculty of Health Sciences, Isala Clinics, PO Box 10400, 8000 G.K. Zwolle, The Netherlands

Search for other papers by S J J Logtenberg in
Google Scholar
PubMed
Close
,
K H Groenier Diabetes Centre, Departments of Internal Medicine, General Practice, Langerhans Medical Research Group, Department of Internal Medicine, Division of Cell Biology, Faculty of Health Sciences, Isala Clinics, PO Box 10400, 8000 G.K. Zwolle, The Netherlands
Diabetes Centre, Departments of Internal Medicine, General Practice, Langerhans Medical Research Group, Department of Internal Medicine, Division of Cell Biology, Faculty of Health Sciences, Isala Clinics, PO Box 10400, 8000 G.K. Zwolle, The Netherlands

Search for other papers by K H Groenier in
Google Scholar
PubMed
Close
,
N Kleefstra Diabetes Centre, Departments of Internal Medicine, General Practice, Langerhans Medical Research Group, Department of Internal Medicine, Division of Cell Biology, Faculty of Health Sciences, Isala Clinics, PO Box 10400, 8000 G.K. Zwolle, The Netherlands
Diabetes Centre, Departments of Internal Medicine, General Practice, Langerhans Medical Research Group, Department of Internal Medicine, Division of Cell Biology, Faculty of Health Sciences, Isala Clinics, PO Box 10400, 8000 G.K. Zwolle, The Netherlands
Diabetes Centre, Departments of Internal Medicine, General Practice, Langerhans Medical Research Group, Department of Internal Medicine, Division of Cell Biology, Faculty of Health Sciences, Isala Clinics, PO Box 10400, 8000 G.K. Zwolle, The Netherlands

Search for other papers by N Kleefstra in
Google Scholar
PubMed
Close
,
H J G Bilo Diabetes Centre, Departments of Internal Medicine, General Practice, Langerhans Medical Research Group, Department of Internal Medicine, Division of Cell Biology, Faculty of Health Sciences, Isala Clinics, PO Box 10400, 8000 G.K. Zwolle, The Netherlands
Diabetes Centre, Departments of Internal Medicine, General Practice, Langerhans Medical Research Group, Department of Internal Medicine, Division of Cell Biology, Faculty of Health Sciences, Isala Clinics, PO Box 10400, 8000 G.K. Zwolle, The Netherlands
Diabetes Centre, Departments of Internal Medicine, General Practice, Langerhans Medical Research Group, Department of Internal Medicine, Division of Cell Biology, Faculty of Health Sciences, Isala Clinics, PO Box 10400, 8000 G.K. Zwolle, The Netherlands

Search for other papers by H J G Bilo in
Google Scholar
PubMed
Close
, and
H J Arnqvist Diabetes Centre, Departments of Internal Medicine, General Practice, Langerhans Medical Research Group, Department of Internal Medicine, Division of Cell Biology, Faculty of Health Sciences, Isala Clinics, PO Box 10400, 8000 G.K. Zwolle, The Netherlands
Diabetes Centre, Departments of Internal Medicine, General Practice, Langerhans Medical Research Group, Department of Internal Medicine, Division of Cell Biology, Faculty of Health Sciences, Isala Clinics, PO Box 10400, 8000 G.K. Zwolle, The Netherlands

Search for other papers by H J Arnqvist in
Google Scholar
PubMed
Close

In type 1 diabetes mellitus (T1DM), low concentrations of IGF1 and high concentrations of IGF-binding protein 1 (IGFBP1) have been reported. It has been suggested that these abnormalities in the GH–IGF1 axis are due to low insulin concentrations in the portal vein. We hypothesized that the i.p. route of insulin administration increases IGF1 concentrations when compared with the s.c. route of insulin administration. IGF1 and IGFBP1 concentrations in samples derived from an open-label, randomized cross-over trial comparing the effects of s.c. and i.p. insulin delivery on glycaemia were determined. T1DM patients were randomized to receive either 6 months of continuous i.p. insulin infusion (CIPII) through an implantable pump (MIP 2007C, Medtronic) followed by 6 months of s.c. insulin infusion or vice versa with a washout phase in between. Data from 16 patients who had complete measurements during both treatment phases were analysed. The change in IGF1 concentrations during CIPII treatment was 10.4 μg/l (95% CI −0.94, 21.7 μg/l; P=0.06) and during s.c. insulin treatment was −2.2 μg/l (95% CI −13.5, 9.2 μg/l; P=0.69). When taking the effect of treatment order into account, the estimated change in IGF1 concentrations was found to be 12.6 μg/l (95% CI −3.1, 28.5 μg/l; P=0.11) with CIPII treatment compared with that with s.c. insulin treatment. IGFBP1 concentrations decreased to −100.7 μg/l (95% CI −143.0, −58.3 μg/l; P<0.01) with CIPII treatment. During CIPII treatment, parts of the GH–IGF1 axis changed compared with that observed during s.c. insulin treatment. This supports the hypothesis that the i.p. route of insulin administration is of importance in the IGF1 system.

Open access
Jung Soo Lim Department of Internal Medicine, Institute of Evidence-Based Medicine, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Gangwon-do, South Korea

Search for other papers by Jung Soo Lim in
Google Scholar
PubMed
Close
,
Seung-Eun Lee Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Gangnam-gu, Seoul, South Korea

Search for other papers by Seung-Eun Lee in
Google Scholar
PubMed
Close
,
Jung Hee Kim Department of Internal Medicine, Seoul National University College of Medicine, Jongno-gu, Seoul, South Korea

Search for other papers by Jung Hee Kim in
Google Scholar
PubMed
Close
,
Jae Hyeon Kim Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Gangnam-gu, Seoul, South Korea

Search for other papers by Jae Hyeon Kim in
Google Scholar
PubMed
Close
, and
The Korean Adrenal Gland and Endocrine Hypertension Study Group, Korean Endocrine Society
Search for other papers by The Korean Adrenal Gland and Endocrine Hypertension Study Group, Korean Endocrine Society in
Google Scholar
PubMed
Close

Purpose

To evaluate the clinical characteristics and prognostic factors in patients with adrenocortical carcinoma (ACC) in South Korea.

Methods

A nationwide, registry-based survey was conducted to identify pathologically proven ACC at 25 tertiary care centers in South Korea between 2000 and 2014. Cox proportional hazard model and log-rank test were adopted for survival analysis.

Results

Two hundred four patients with ACC were identified, with a median follow-up duration of 20 months (IQR 5–52 months). The median age at diagnosis was 51.5 years (IQR 40–65.8 years), and ACC was prevalent in women (n = 110, 53.9%). Abdominal pain was the most common clinical symptom (n = 70, 40.2%), and ENSAT stage 2 was most common (n = 62, 30.4%) at the time of diagnosis. One hundred sixty-nine patients underwent operation, while 17 were treated with other modalities. The remission rate was 48%, and median recurrence-free survival time was 46 months. Estimated 5-year recurrence-free rate was 44.7%. There were more women, large tumor, atypical mitosis, venous invasion, and higher mitotic count in cancer recurrence group. Estimated 5-year overall survival and disease-specific survival rates were 64.5 and 70.6%, respectively. Higher ENSAT stage and advanced pathologic characteristics were risk factors for all-cause mortality of ACC. Large tumor size and cortisol-secreting tumor were additional risk factors for ACC-specific death.

Conclusions

We report the first epidemiologic study regarding ACC in an Asian population. ENSAT stage 4; lymph node involvement; non-operative group; and invasion of vein, sinusoid, or capsule were associated with an increased risk for all-cause mortality.

Open access
Yang Lv Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai, China

Search for other papers by Yang Lv in
Google Scholar
PubMed
Close
,
Xu Han Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai, China

Search for other papers by Xu Han in
Google Scholar
PubMed
Close
,
Chunyan Zhang Department of Clinical Laboratory, Zhongshan Hospital, Fudan University, Shanghai, China

Search for other papers by Chunyan Zhang in
Google Scholar
PubMed
Close
,
Yuan Fang Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai, China

Search for other papers by Yuan Fang in
Google Scholar
PubMed
Close
,
Ning Pu Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai, China

Search for other papers by Ning Pu in
Google Scholar
PubMed
Close
,
Yuan Ji Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai, China

Search for other papers by Yuan Ji in
Google Scholar
PubMed
Close
,
Dansong Wang Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai, China

Search for other papers by Dansong Wang in
Google Scholar
PubMed
Close
,
Xu Xuefeng Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai, China

Search for other papers by Xu Xuefeng in
Google Scholar
PubMed
Close
, and
Wenhui Lou Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai, China

Search for other papers by Wenhui Lou in
Google Scholar
PubMed
Close

Purpose

Chromogranin A (CgA) and neuron-specific enolase (NSE) are important markers for neuroendocrine tumors; however, the clinical value of combining these markers has not been well studied. In this study, we investigated the utility of each marker individually and in combination for patients with nonfunctional pancreatic neuroendocrine tumors (NF-pNETs).

Patients and Methods

In this study, NF-pNET patients and controls were recruited from December 2011 to March 2016; 784 serum samples from peripheral vein were collected. The clinical characteristics and biomarker values of all the individuals were recorded and analyzed. Tumor burdens were calculated by CT/MRI scan. Receiver-operating characteristic curves were constructed to assess the diagnostic predictive values; sensitivity and specificity were calculated to determine the cut-off value. Therapeutic responses reflected on the changes of the biomarkers’ concentration were assessed by the RECIST criterion. Clinical relations between the prognosis and the biomarker values were also analyzed. Statistical significance was defined as P value less than 0.05.

Results

Among the 167 NF-pNETs patients, 82 were males (49.1%) and the mean age was 50.0 (17.4). The mean CgA values of G1, G2 and G3 NF-pNENs were 75, 121 and 134 μg/L (P < 0.05), respectively. In NF-pNETs, CgA correlated with the WHO tumor grade (WHO G1 vs G2, P < 0.05); the linear regression relationships were found between the tumor burdens (both in pancreas and liver) and CgA concentration (P < 0.001); changes in CgA and NSE concentrations also reflect treatment response (P < 0.001).

Conclusion

CgA and NSE are important diagnostic and follow-up markers in patients with NF-pNETs. The combined monitoring of CgA and NSE possesses more accuracy than individual values of CgA and NSE at predicting prognosis and disease progression.

Open access
Jesper Krogh Department of Endocrinology & Metabolism, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark

Search for other papers by Jesper Krogh in
Google Scholar
PubMed
Close
,
Peter Plomgaard Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
Department of Clinical Biochemistry, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark

Search for other papers by Peter Plomgaard in
Google Scholar
PubMed
Close
,
Ruth Frikke-Schmidt Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
Department of Clinical Biochemistry, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark

Search for other papers by Ruth Frikke-Schmidt in
Google Scholar
PubMed
Close
,
Sten Velschow Fluisense ApS, Lillerød, Denmark

Search for other papers by Sten Velschow in
Google Scholar
PubMed
Close
,
Jesper Johannesen Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
Department of Pediatrics, Copenhagen University Hospital - Herlev & Gentofte, Copenhagen, Denmark

Search for other papers by Jesper Johannesen in
Google Scholar
PubMed
Close
,
Linda Maria Hilsted Department of Clinical Biochemistry, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark

Search for other papers by Linda Maria Hilsted in
Google Scholar
PubMed
Close
,
Malene Schrøder Fluisense ApS, Lillerød, Denmark

Search for other papers by Malene Schrøder in
Google Scholar
PubMed
Close
, and
Ulla Feldt-Rasmussen Department of Endocrinology & Metabolism, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark

Search for other papers by Ulla Feldt-Rasmussen in
Google Scholar
PubMed
Close

Repeated blood sampling is required in certain clinical and research settings, which is currently performed by drawing blood from venous catheters requiring manual handling of each sample at the time of collection. A novel body-worn device for repeated serial samples, Fluispotter®, with automated extraction, collection, and storage of up to 20 venous dried blood spot samples over the course of 20 h may overcome problems with current methods for serial sampling. The purpose of this study was to assess the performance and safety of Fluispotter for the first time in healthy subjects. Fluispotter consists of a cartridge with tubing, a reservoir for flushing solution, pumps and filterpaper, and a multi-lumen catheter placed in the brachial vein. We recruited healthy subjects for testing in an in-hospital setting. Fluispotter was attached by an anesthesiologist to 22 healthy subjects of which 9/22 (40.9%) participants had all 20 samples taken, which was lower than the goal of complete sampling in 80% of the subjects (P = 0.02). The main reason for sample failure was clogging of blood flow which was observed in 11/22 (50%) of the participants. No serious adverse events occurred, and the participants rated the pain from the insertion and the removal of catheter as very low. A cortisol profile showed nadir values at midnight and highest values at 05:00 h. Although full sampling was not successful in all participants, the Fluispotter technology proved safe and highly acceptable to the participants producing the expected cortisol profile without the requirement of staff during sample collection.

Open access
Tomaž Kocjan Department of Endocrinology, Diabetes and Metabolic Diseases, University Medical Centre Ljubljana, Ljubljana, Slovenia
Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia

Search for other papers by Tomaž Kocjan in
Google Scholar
PubMed
Close
,
Gaj Vidmar Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
University Rehabilitation Institute, Ljubljana, Slovenia
FAMNIT, University of Primorska, Koper, Slovenia

Search for other papers by Gaj Vidmar in
Google Scholar
PubMed
Close
,
Peter Popović Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
Clinical Institute of Radiology, University Medical Centre Ljubljana, Ljubljana, Slovenia

Search for other papers by Peter Popović in
Google Scholar
PubMed
Close
, and
Milenko Stanković Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
Clinical Institute of Radiology, University Medical Centre Ljubljana, Ljubljana, Slovenia

Search for other papers by Milenko Stanković in
Google Scholar
PubMed
Close

The 20-point clinical prediction SPACE score, the aldosterone-to-lowest potassium ratio (APR), aldosterone concentration (AC) and the AC relative reduction rate after saline infusion test (SIT) have recently been proposed for primary aldosteronism (PA) subtyping prior to adrenal vein sampling (AVS). To validate those claims, we performed a retrospective cross-sectional study that included all patients at our center who had positive SIT to confirm PA and were diagnosed with either bilateral disease (BPA) according to AVS or with lateralized disease (LPA) if biochemically cured after adrenalectomy from November 2004 to the end of 2019. Final diagnoses were used to evaluate the diagnostic performance of proposed clinical prediction tools. Our cohort included 144 patients (40 females), aged 32–72 years (mean 54 years); 59 with LPA and 85 with BPA. The originally suggested SPACE score ≤8 and SPACE score >16 rules yielded about 80% positive predictive value (PPV) for BPA and LPA, respectively. Multivariate analyses with the predictors constituting the SPACE score highlighted post-SIT AC as the most important predictor of PA subtype for our cohort. APR-based tool of <5 for BPA and >15 for LPA yielded about 75% PPV for LPA and BPA. The proposed post-SIT AC <8.79 ng/dL criterion yielded 41% sensitivity and 90% specificity, while the relative post-SIT AC reduction rate of >33.8% criterion yielded 80% sensitivity and 51% specificity for BPA prediction. The application of any of the validated clinical prediction tools to our cohort did not predict the PA subtype with the high diagnostic performance originally reported.

Open access
Peiwen Zheng School of Mental Health, Wenzhou Medical University, The Affiliated Kangning Hospital, Wenzhou, China

Search for other papers by Peiwen Zheng in
Google Scholar
PubMed
Close
,
Fan Wang Beijing Hui-Long-Guan Hospital, Peking University, Beijing, China

Search for other papers by Fan Wang in
Google Scholar
PubMed
Close
,
Hui Li Psychosomatic Medicine Research Division, Inner Mongolia Medical University, Huhhot, China

Search for other papers by Hui Li in
Google Scholar
PubMed
Close
,
Hanlu Chen School of Mental Health, Wenzhou Medical University, The Affiliated Kangning Hospital, Wenzhou, China

Search for other papers by Hanlu Chen in
Google Scholar
PubMed
Close
,
Mengtong Li School of Mental Health, Wenzhou Medical University, The Affiliated Kangning Hospital, Wenzhou, China

Search for other papers by Mengtong Li in
Google Scholar
PubMed
Close
,
Haozheng Ma School of Mental Health, Wenzhou Medical University, The Affiliated Kangning Hospital, Wenzhou, China

Search for other papers by Haozheng Ma in
Google Scholar
PubMed
Close
,
Jue He School of Mental Health, Wenzhou Medical University, The Affiliated Kangning Hospital, Wenzhou, China

Search for other papers by Jue He in
Google Scholar
PubMed
Close
,
Li Chen School of Mental Health, Wenzhou Medical University, The Affiliated Kangning Hospital, Wenzhou, China

Search for other papers by Li Chen in
Google Scholar
PubMed
Close
,
Yanlong Liu School of Mental Health, Wenzhou Medical University, The Affiliated Kangning Hospital, Wenzhou, China

Search for other papers by Yanlong Liu in
Google Scholar
PubMed
Close
, and
Haiyun Xu School of Mental Health, Wenzhou Medical University, The Affiliated Kangning Hospital, Wenzhou, China

Search for other papers by Haiyun Xu in
Google Scholar
PubMed
Close

Objective

This study aimed to reveal associations between metabolic hormones in cerebral spinal fluid (CSF) and cigarette smoking-induced weight gain and to explore the underlying mechanism.

Methods

A total of 156 adult men were included, comprising active smokers and nonsmokers. In addition to demographic information and body mass index (BMI), plasma levels of ApoA1 and ApoB, high-density lipoprotein, low-density lipoprotein, cholesterol, triglyceride, alanine aminotransferase, aspartate aminotransferase, and gamma-glutamyl transferase in the participants were measured. Moreover, the metabolic hormones adiponectin, fibroblast growth factor 21 (FGF21), ghrelin, leptin, and orexin A, as well as the trace elements iron and zinc in CSF, were assessed.

Results

Compared to nonsmokers, active smokers showed higher BMI, and elevated CSF levels of FGF21, Zn, and Fe, but decreased levels of metabolic hormones adiponectin, ghrelin, leptin, and orexin A. Negative correlations existed between CSF FGF21 and ghrelin, between CSF Zn and ghrelin, as well as between CSF Fe and orexin A in active smokers. Furthermore, elevated CSF FGF21 and Zn predicted ghrelin level decrease in the smokers.

Conclusion

These data relate smoking-induced weight gain to its neurotoxic effect on the neurons that synthesize metabolic hormones such as adiponectin, ghrelin, leptin, or orexin A in the brain, by disrupting mitochondrial function and causing oxidative stress in the neurons.

Open access