The Journal of clinical endocrinology and metabolism
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J. Clin. Endocrinol. Metab. · Oct 2007
Randomized Controlled TrialEffect of intensive insulin therapy on insulin sensitivity in the critically ill.
Hyperglycemia and hyperinsulinemia are common in intensive care unit (ICU) patients and relate to illness severity. Intensive insulin therapy (IIT) to maintain normoglycemia reduces morbidity and mortality. Blood glucose control explains this benefit because a high insulin dose is associated with adverse outcome. Mitogenic insulin effects could theoretically explain this link. ⋯ Normoglycemia can be maintained in ICU patients without a sustained further elevation of insulinemia. Together with the increased adiponectin levels, this finding suggests that IIT may improve insulin sensitivity. Skeletal muscle, but not liver, revealed an increased metabolic insulin signal. The therapy did not impose mitogenic risk in these tissues.
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J. Clin. Endocrinol. Metab. · Oct 2007
Impaired subjective health status in 256 patients with adrenal insufficiency on standard therapy based on cross-sectional analysis.
There is mounting evidence that current replacement regimens fail to restore health-related subjective health status fully in patients with adrenal insufficiency (AI). Here we evaluated the subjective health status in primary and secondary AI and the effect of concomitant disease. ⋯ Patients with AI on current standard replacement suffer from significantly impaired health-related subjective health status, irrespective of origin of disease or concomitant disease. Future studies will have to assess whether more physiological glucocorticoid replacement strategies in AI will ameliorate these impairments.
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J. Clin. Endocrinol. Metab. · Sep 2007
Genetic determinants of circulating insulin-like growth factor (IGF)-I, IGF binding protein (BP)-1, and IGFBP-3 levels in a multiethnic population.
Both circulating levels and genetic variation of IGFs have been associated with cancer risk, yet the relationship between the two is not well understood. ⋯ In summary, our study suggests that common genetic variation in IGFBP3 influences circulating levels of IGFBP-3 among African-Americans, Native Hawaiians, Japanese-Americans, Latinos, and whites.
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J. Clin. Endocrinol. Metab. · Sep 2007
Maternal vitamin D deficiency increases the risk of preeclampsia.
Vitamin D has direct influence on molecular pathways proposed to be important in the pathogenesis of preeclampsia, yet the vitamin D-preeclampsia relation has not been studied. ⋯ Maternal vitamin D deficiency may be an independent risk factor for preeclampsia. Vitamin D supplementation in early pregnancy should be explored for preventing preeclampsia and promoting neonatal well-being.
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J. Clin. Endocrinol. Metab. · Sep 2007
Hypothalamic-pituitary-adrenal axis function and the cellular immune response in former preterm children.
Animal data suggest that adverse early experiences may affect endocrine and immune functioning in later life. ⋯ The data suggest that preterm delivery may be associated with altered endocrine and immune functions well into late childhood.