The Journal of clinical endocrinology and metabolism
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J. Clin. Endocrinol. Metab. · May 2013
Linear association between household income and metabolic control in children with insulin-dependent diabetes mellitus despite free access to health care.
In health care systems with a user fee, the impact of socioeconomic factors on pediatric insulin-dependent diabetes mellitus (IDDM) control could be due to the cost of accessing care. ⋯ We report a linear association of household income with metabolic control of IDDM in childhood. Given that Canada has a system of free universal access to health care, confounding by access to care is unlikely. Considering the impact of poorly controlled IDDM in childhood on the development of long-term complications, our findings suggest that the higher complication rate found in adults of low socioeconomic status might originate from the poor control that they experienced in childhood. Support for the care of IDDM children from low-income neighborhoods should be increased.
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J. Clin. Endocrinol. Metab. · May 2013
Randomized Controlled Trial Comparative Study Clinical TrialComparison of postprandial profiles of ghrelin, active GLP-1, and total PYY to meals varying in fat and carbohydrate and their association with hunger and the phases of satiety.
The relationship between postprandial peptides at circulating physiological levels and short-term appetite control is not well understood. ⋯ The results demonstrate that under these conditions, these peptides respond differently to ingested nutrients. Ghrelin and GLP-1, but not PYY, were associated with short-term control of appetite over the measurement period.
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J. Clin. Endocrinol. Metab. · May 2013
Multicenter StudyThe relationship between vitamin D status and adrenal insufficiency in critically ill children.
Recent studies in critically ill populations have suggested both adrenal insufficiency (AI) and vitamin D deficiency to be associated with worse clinical outcome. There are multiple mechanisms through which these pleiotropic hormones might synergistically influence critical illness. ⋯ We did not find evidence of a direct association between vitamin D status and critical illness-related AI. However, our results do suggest that vitamin D deficiency exacerbates the effect of AI on cardiovascular stability in critically ill children.
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J. Clin. Endocrinol. Metab. · May 2013
Case ReportsFirst report of bilateral pheochromocytoma in the clinical spectrum of HIF2A-related polycythemia-paraganglioma syndrome.
Molecular genetic research has so far resulted in the identification of 10 well-characterized susceptibility genes for hereditary pheochromocytoma (PHEO) or paraganglioma (PGL). Recently, a new syndrome characterized by multiple PGLs and somatostatinomas associated with congenital polycythemia due to somatic mutations in HIF2A has been reported. ⋯ This case represents the first association of a somatic HIF2A gain-of-function mutation with PHEO and congenital polycythemia, and it alerts physicians to perform proper genetic screening in patients presenting with multiple norepinephrine-producing PHEOs and polycythemia. This report also extends the previous findings of a new syndrome of only multiple PGLs, somatostatinomas, and polycythemia to multiple PHEOs.
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J. Clin. Endocrinol. Metab. · May 2013
Prevalence and consequences of vitamin D insufficiency in women with takotsubo cardiomyopathy.
The purpose of this study was to identify the prevalence and clinical consequences of vitamin D insufficiency in patients with takotsubo cardiomyopathy. ⋯ Women diagnosed with takotsubo cardiomyopathy have a high prevalence of vitamin D insufficiency. In our prospective study of 25 women with takotsubo cardiomyopathy, this was associated with worse hemodynamic parameters.