Clinical endocrinology
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Clinical endocrinology · Jan 1994
Comparative StudyEnergy expenditure and body composition in growth hormone deficient adults on exogenous growth hormone.
We assessed whether the obesity observed in growth hormone deficient adults is maintained by a reduction in energy expenditure. We studied the effects of exogenous growth hormone on energy expenditure and body composition. ⋯ Obesity maintenance in growth hormone deficient adults is not a consequence of reduced total energy expenditure or a reduced exercise energy output. There was also no evidence for an energy sparing mechanism. Energy expenditure was increased by exogenous growth hormone but was not associated with a loss in fat mass or body weight suggesting the need for dietetic advice for those already obese at the outset of therapy.
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Clinical endocrinology · Dec 1993
Comparative StudyDifferences in testosterone metabolism by beard and scalp hair follicle dermal papilla cells.
Androgens have paradoxically different effects on hair follicles depending on body site, stimulating beard growth while inducing regression in some areas of the scalp. The mesenchyme derived dermal papilla at the base of the hair follicle regulates many aspects of the growth of follicular epithelium, and is probably the site of androgen action. Since 5 alpha-dihydrotestosterone is considered to be the active intracellular androgen in many target tissues and is required for some androgen-mediated hair growth, such androgen-sensitive cells should contain 5 alpha-reductase. This study was designed to investigate whether cultured human dermal papilla cells contain 5 alpha-reductase and whether the metabolic capacity varies with the body site of the follicle in line with the clinical picture. ⋯ The production of 5 alpha-dihydrotestosterone by beard cells concurs with the poor beard growth in men with 5 alpha-reductase deficiency, supporting our hypothesis that androgens mediate their effects on the hair follicle via the mesenchyme-derived dermal papilla.
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Clinical endocrinology · Sep 1993
The regulation of insulin-like growth factor binding protein (IGFBP)-1 during prolonged fasting.
Insulin-like growth factor binding protein (IGFBP)-1 levels increase overnight, being inversely related to changes in insulin. With prolonged fasting IGFBP-1 levels increase further. In animal studies high IGFBP-1 levels increase plasma glucose levels possibly by regulating the insulin-like actions of 'bio-available' plasma IGF. Following prolonged fasting, there is an increase in insulin requirement. A proportion of this reversible insulin resistance may be due to inhibitory effects of high IGFBP-1 levels on IGF action. This study examined the regulation of IGFBP-1 in the presence of reversible insulin resistance. ⋯ In man, insulin appears to regulate circulating IGFBP-1 levels in all circumstances, this regulation being unaffected by the resistance to insulin action induced by prolonged fasting. The high IGFBP-1 levels were statistically related to the higher glucose levels and may have directly contributed to the increased insulin requirement observed after prolonged fasting.
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Clinical endocrinology · Jun 1993
Comparative StudyThe plasma ACTH, AVP, CRH and catecholamine responses to conventional and laparoscopic cholecystectomy.
We compared the responses of the stress hormones, cortisol, ACTH, vasopressin (AVP), corticotrophin releasing hormone (CRH) and catecholamines to elective conventional and laparoscopic cholecystectomy. ⋯ For both procedures, the peak of ACTH secretion after incision is likely to be AVP dependent, and the timing of peak levels of these two hormones was significantly related. Subsequent ACTH secretion may be the result of an interaction between AVP and CRH. Laparoscopic cholecystectomy results in a smaller AVP rise than does the conventional procedure, and plasma AVP falls more rapidly post-operatively. During the period of observation, ACTH, CRH, cortisol and adrenaline responses were not significantly lessened by the laparoscopic approach, but there was a significant increase in the noradrenaline response. Stress hormone monitoring may assist further improvements in surgical technique.
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We aimed to assess total body composition and to study the interrelationships between fat and lean tissue mass with total and regional bone mass in healthy British post-menopausal women. ⋯ Both fat and lean tissue mass are related to total and regional bone mass in post-menopausal women, the relationship being strongest for fat mass. Body weight shows stronger correlations with bone mass than either height or body mass index. In view of the direction and magnitude of changes in fat, lean tissue and bone mineral after the menopause, adiposity and muscularity are more likely to be determinants of peak bone mass than of the rate of post-menopausal bone loss.