Effects of low-dose losartan treatment on persistent microalbuminuria in normotensive Type 1 diabetic subjects

To examine the effect of low-dose losartan, an angiotensin II antagonist, on persistent microalbuminuria in normotensive Type 1 diabetes mellitus, 16 subjects with Type 1 diabetes were randomly assigned to two 2-month treatment periods, with either losartan (25 mg/day) or enalapril (5 mg/day) in a single-blind cross-over design. Urinary albumin excretion (UAE), blood pressures, lipids, glycemia, HbA(1c), serum potassium and creatinine clearance were measured before and after each treatment period. The UAEs were similarly reduced after both treatments. The median UAE decreased by 27.8%, from 162 (range 65-250) to 117 (34-190) mg/day (p0.05 in all) changed by either the enalapril or losartan treatment. No significant differences were found between the effects of enalapril and losartan. In conclusion, losartan treatment reduces microalbuminuria as effectively as enalapril in normotensive Type 1 diabetic patients. (J. Endocrinol. Invest. 24: 608-611, 2001) (C) 2001, Editrice Kurtis

Effects of metformin plus rosuvastatin on hyperandrogenism in polycystic ovary syndrome patients with hyperlipidemia and impaired glucose tolerance

Aim: We aimed to compare the effects of metformin and metformin-rosuvastatin combination therapies on hyperandrogenism in patients with polycystic ovary syndrome (PCOS). Patients and methods: Thirty-eight PCOS patients with hyperlipidemia and impaired glucose tolerance, who were followed at Department of Endocrinology and Metabolism out-patient clinic of Cerrahpasa Medical School were included in the study. Twenty patients had lifestyle changes and metformin (2000 mg/day) therapy (M group) and 18 had statin (rosuvastatin 10 mg/day) in addition to this therapy (MR group). Total and free testosterone, DHEAS, FSH, LH, estrodiol, fasting glucose, insulin, and high-sensitivity C-reactive protein (hs-CRP) levels, lipid parameters and homeostasis model assesment index (HOMA-IR) were evaluated for each patient before and 12 weeks after the treatment. Results: After 12 weeks of treatment body mass index (BMI), insulin and glucose levels, HOMA-IR had similar decreaments in both groups, whereas there was a greater decline of the total and free testosterone levels in MR group (p<0.001, p=0.004, respectively). DHEAS levels did not change in M group, however, significantly decreased in MR group after treatment (p=0.8, p=0.002, respectively). As expected hsCRP, triglyceride, total and LDL-cholesterol levels decreased more in MR group. Conclusion: Metformin and rosuvastatin combination therapy could lead to a better reduction on hyperandrogenism and on atherosclerosis-related factors in PCOS, in addition to improving lipid parameters. (J. Endocrinol. Invest. 35: 905-910, 2012) (C) 2012, Editrice Kurti

ALTERNATE DAYS TREATMENT WITH TERIPARATIDE IN POSTSURGICAL HYPOPARATHYROIDISM

The conventional treatment of hypoparathyroidism consists of vitamin ID analogues in combination with oral calcium supplementation. This treatment modalities induce chronic hypercalciuria which leads to nephrocalcinosis, nephrolithiasis and renal insufficiency. Here we report the case of a 32-year-old woman who developed hypocalcemia and hypercalciuria under treatment with high doses of vitamin D analogs and oral calcium. She had cerebral calcification, nephrocalcinosis under this treatment. Stable calcium levels were achieved with synthetic human parathyroid hormone treatment that was given in alternate days. PTH appears to be an alternative and effective treatment in hypoparathyroidism

Glucocorticoid receptors on mononuclear leukocytes in polycystic ovary syndrome

Objective. Many studies have suggested that there is a possible hormonal dysregulation of hypothalamic-pituitary-adrenal (HPA) axis and an increased cortisol clearance in patients with polycystic ovary syndrome (PCOS). Therefore in this study, we have examined the role of glucocorticoid receptor/s (GR) characteristics in the developing of these abnormalities in patients with PCOS. Method. For this purpose, the number and affinity of GR in peripheral mononuclear leukocytes (MNL) of 10 patients with PCOS and 10 healthy women (controls) were determined. Results. There were no significant differences in the number (6500 +/- 1001 sites/cell and 6352 +/- 1697 sites/cell, respectively; P > 0.05) and affinity (3.93 +/- 0.89 nM and 4.49 +/- 0.71 nM, respectively; P > 0.05) of GR between the PCOS patients and the controls. Conclusions. These results suggest that the alterations in the HPA axis and in the cortisol metabolism observed in PCOS are not related to GR deficiency. (C) 1998 International Federation of Gynecology and Obstetrics

Does Helicobacter pylori-induced gastritis enhance food-stimulated insulin release?

The fact that H. pylori gastritis results in an increased secretion of basal and meal-stimulated gastrin, which is also a physiologic amplifier of insulin release directed us to investigate whether H, pylori gastritis may lead to an enhancement of nutrient-stimulated insulin secretion. For this purpose, we have investigated the insulin responses to both oral glucose and a mixed meal in 15 patients with H. pylori gastritis before and one month after the eradication therapy and also in 15 H. pylori-negative control subjects. The areas under the curve (AUC) for serum insulin following both oral glucose and a mixed meal in the patients with H, pylori gastritis before the eradication were significantly (P < 0.05) higher than those in the H. pylori-negative controls, After the eradication of H. pylori, the AUC for serum insulin following oral glucose and mixed meal decreased by 9.4% and 13.1%, respectively (P < 0.001 in both), and serum basal and meal-stimulated gastrin levels decreased significantly (P < 0.001). These results suggest that H. pylori gastritis enhances glucose and meal-stimulated insulin release probably by increasing gastrin secretion