Metabolism: clinical and experimental
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It has been suggested that serum insulin levels in subjects with recently diagnosed type II diabetes have been overestimated, and that after correction for proinsulin, true insulin levels are depressed rather than elevated. We tested this possibility in a cross-sectional study of a population-based sample of 328 adults living in Wadena, a Minnesota community in which residents are of northern European background. Specificity of insulin measurements was provided by an antibody blind to proinsulin and its major metabolite. ⋯ There was marked overlap of individual insulin levels from group to group. In summary, randomly selected adults in Wadena with IGT or asymptomatic diabetes showed, on average, elevated insulin levels, but physician-diagnosed diabetes was associated with relative diminution of serum insulin. In this population, the current view of insulin resistance in "early" diabetes was supported by insulin-specific measurements.
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The effects of agents used in the treatment of metabolic acidosis could depend on the induced changes in intracellular pH (pHi). To determine the effect of sodium bicarbonate on hepatic pHi and function, this agent was infused into anesthetized rats with acute metabolic acidosis due to either diabetic ketoacidosis (DKA) or HCl infusion. Hepatic pHi was measured by 31P-magnetic resonance spectroscopy (MRS). ⋯ With infusion of sodium bicarbonate, there was again an increase in pHi (delta pHi, + 0.27 +/- 0.06, P < .02) despite increases in both portal and hepatic venous PCO2. Lactate uptake was increased twofold to threefold (P < .001) by bicarbonate infusion in perfusions from both types of animals. Glucose output was increased twofold (P < .001) only in livers from normal animals.
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The influence of menstrual cycle phases and hormonal contraception on serum lipid and apolipoprotein (apo) levels was investigated in a group of normally menstruating young women. The study period covered a normal menstrual cycle (pretherapy), the fourth cycle of treatment with a triphasic oral contraceptive (OC) preparation, and the cycle immediately following interruption of therapy (cycle 5, posttherapy). Cycle phases were defined on the basis of serum hormone levels and basal body temperature determinations. ⋯ Apo AI and apo B were both higher under OCs, and apo B followed a trend similar to cholesterol during the two cycles. During the first month after discontinuation of OCs, cholesterol levels returned progressively to baseline values, while triglycerides were only partially decreased. We conclude that cyclic fluctuations in lipid levels do occur under the influence of both endogenous and exogenous sex hormones.
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The effects of growth hormone and insulin on the activity of pyruvate dehydrogenase were examined in the rat, both in vivo and in isolated hepatocytes. Liver mitochondria isolated from rats killed from five to 45 minutes after injection of 50 micrograms/100 g human growth hormone (hGH) or 25 micrograms/100 g insulin displayed a significant increase in the activity of basal pyruvate dehydrogenase (38% and 48% above control at ten minutes, respectively). These changes probably result from the conversion of the phosphorylated form to the nonphosphorylated form of pyruvate dehydrogenase since total enzyme activity was unaffected. ⋯ The effects of 100 nmol/L hGH and 100 nmol/L insulin on pyruvate dehydrogenase activity were not additive. Basal pyruvate dehydrogenase activity in hepatocytes exhibited linear kinetics; hGH or insulin increased the Vmax of the enzyme without changing its Km and did not affect the Vmax of the total enzyme activity. It is concluded that growth hormone is as potent and as efficient as insulin in its ability to stimulate the activity of liver pyruvate dehydrogenase, and thus may be a physiological activator of this enzyme.
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Case Reports
Plasma lipoprotein abnormalities associated with acquired hepatic triglyceride lipase deficiency.
Two enzymes, lipoprotein lipase (LPL) and hepatic triglyceride lipase (HTGL), are released into human plasma after intravenous injection of heparin. LPL is the major enzyme responsible for initiating catabolism of chylomicrons and very-low-density lipoproteins (VLDL). The physiological role of HTGL is less certain. ⋯ An increased proportion of lighter LDL (LDL1) and HDL (HDL2) was noted. In addition, after administration of heparin there was no shift in the distribution of apoE in plasma fractionated using a column containing 4% agarose. These findings are consistent with a postulated role of HTGL in metabolism of light LDL and HDL particles and some classes of apoE containing lipoproteins.