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Biomedical subjects

G Pagano

Publications and source records attributed to G Pagano.

At least 181 records · Page 10Linked to original sources
PubMed1988

Insulin binding to monocytes and in vivo peripheral insulin sensitivity are normal in Graves' disease.

Insulin resistance in hyperthyroidism seems to depend on increased glucose production rather than on decreased glucose utilization. A decreased insulin binding on different target cells has been reported in patients in whom an in vivo evaluation of peripheral insulin sensitivity was lacking. In 20 patients with Graves' disease (6 males, 14 females), aged 40.0 +/- 2.0 yr, BMI 23.7 +/- 0.7, and in 20 well-matched controls we performed the following tests: 75 g o.G.T.T., euglycemic-hyperinsulinemic clamp at 50 microU/ml combined with D-[3-3H] glucose infusion in tracer amounts, in vitro insulin binding on circulating monocytes. Fasting plasma glucose values were similar in the two groups, whereas plasma insulin values were significantly higher in hyperthyroids (21.4 +/- 2.5 vs 10.6 +/- 0.6 microU/ml, p less than 0.01). The values of peripheral glucose utilization (5.61 +/- 0.24 vs 6.01 +/- 0.22 mg/kg-min) and of total specific insulin binding (4.07 +/- 0.20 vs 4.39 +/- 0.23% bound to 10(7) cells/ml) were not significantly different in the two groups. These results indicate that in vitro and in vivo data, when recorded in the same patients, are concordant to confirm a normal peripheral tissue sensitivity to insulin in Graves' disease.

Adult↗
PubMed1988

Effect of short-term treatment with bezafibrate on plasma fibrinogen, fibrinopeptide A, platelet activation and blood filterability in atherosclerotic hyperfibrinogenemic patients.

The effect of bezafibrate (BZF) on plasma fibrinogen levels has been studied in 62 patients with atherosclerotic vasculopathy and hyperfibrinogenemia (643 +/- 15 (SEM) mg/dl). In a preliminary study, 15-30 days of BZF therapy (400-600 mg/day) normalized fibrinogen values in 16 subjects were compared to 16 controls. The effect was rapid and dose-dependent, and discontinuation in 6 patients who could not complete the study was followed by a rebound increase. A controlled study with 400 mg/day in the other 24 patients for 15 days showed that BZF lowered fibrinogen, PF4, blood filterability and platelet aggregating thresholds to the normal range. BTG and FpA decreased significantly compared to the placebo group (12 and 12 patients randomly distributed) without any variation in potentially biassing hematologic values (WBC, PLTS, Ht, lipids and plasma glucose). BZF may be of value in chronic treatment of hyperfibrinogenemia in atherosclerotic patients with a view to improving the haemorheologic pattern and, hence, reducing activation of the coagulation pathway.

Adult↗
PubMed1988

Insulin resistance in Graves' disease: a quantitative in-vivo evaluation.

Hyperthyroidism is considered to be an insulin-resistant state, but a quantitative evaluation of some action of insulin is still lacking. We performed euglycaemic clamp at about 350 and 7000 pmol l-1 plasma insulin concentration in combination with the 3H-glucose infusion in 12 patients with Graves' disease and in 12 matched controls. Fasting plasma insulin (126 +/- 6.5 vs. 77.5 +/- 5.7 pmol l-1; P less than 0.001), C-peptide (502 +/- 36 vs. 363 +/- 41 pmol l-1; P less than 0.001) and glucagon (47 +/- 3.3 vs. 33.3 +/- 3 pmol l-1; P less than 0.01) were significantly higher in hyperthyroids than in euthyroids. Basal hepatic glucose production was significantly higher in hyperthyroids than in euthyroids (18.3 +/- 1.4 vs. 9.2 +/- 0.5 mumol l-1; P less than 0.0001), and its suppression during physiological hyperinsulinaemia was only 50% in hyperthyroids. Glucose utilization and suppression of lipolysis were normally stimulated by insulin. All parameters altered during hyperthyroidism were normalized during methimazole-induced euthyroidism. We conclude that insulin resistance involves mainly glucose rather than lipid and is selective at the hepatic level.

Adult↗
PubMed1988

Exercise-induced microalbuminuria in diabetes is associated with the urinary excretion of cationic proteins.

Urinary protein components, highly cationic in nature (pI 10.9), with apparent molecular weights of 65 kD, 45 kD, and 28 kD were detected in type I diabetic patients before (2/7), during (4/7) and after (1/7) exercise. Based on the apparent isoelectric point and molecular weights, the urinary cationic components in the urines of type I diabetic patients were superimposable to purified cationic proteins derived from human platelets. Furthermore, they also shared common antigenic components as evidenced by the ability of a goat anti-human platelet-derived cationic protein serum to immunoprecipitate the 45 kD protein fraction. The latter induced vascular permeability when injected intradermally in the rabbit's skin. The occurrence of urinary cationic proteins was associated with the significant increase in albumin excretion rate (AER) in diabetic patients. No urinary cationic components were ever detected in the urines of 6 healthy subjects before, during, or after exercise. The possible pathogenetic relevance of the urinary excretion of cationic proteins in diabetic AER is discussed.

Adolescent↗
PubMed1988

Univariate and multivariate analysis of associated factors of retinopathy in 894 Italian adult diabetics.

The prevalence of diabetic retinopathy and the evaluation of its risk factors is poorly known in Italian population. Therefore, we have studied 894 diabetic outpatients (420 males, 474 females, 27.6% IDDs, 38.1% insulin-treated) in order to investigate the effect of clinical and metabolic characteristics on the frequency of diabetic retinopathy, classified into six different classes. In univariate analyses age, duration of disease, systolic and diastolic blood pressure, blood urea nitrogen, 24 hr proteinuria and fasting glycemia significantly correlated (p less than 0.001) with severity of retinopathy. The significance was confirmed in multivariate analysis for duration, age and systolic blood pressure (p less than 0.001). Stratification by type of diabetes showed that undefined onset of diabetes probably reduced in NID patients the power of duration as an associated factor of retinopathy. Worsening of this complication in three clinical classes of therapy (diet, oral and insulin-treatment) is evident too. Finally, our 11 variables in the step-wise multiple-regression analysis explain only 16.8% of diabetic retinopathy in all patients, but 36.6% in selected ID subjects.

Adolescent↗
PubMed1987

Deflazacort vs prednisone. Effect on blood glucose control in insulin-treated diabetics.

Glucocorticoid treatment produces a deterioration of blood glucose control in diabetics. Recent reports have indicated that deflazacort is less diabetogenic than prednisone in healthy subjects. Ten insulin-treated diabetics who required steroid drugs were treated with deflazacort (30 mg/d for four weeks) and prednisone (25 mg/d for four weeks) in randomized, double-blind design after a pretreatment period of four weeks. At the end of each treatment, plasma glucose profile (five determinations per day), hemoglobin A1 level, and insulin requirements were compared. Mean (+/- SEM) plasma glucose level (139 +/- 28 vs 169 +/- 32 mg/dL [7.7 +/- 1.5 vs 9.4 +/- 1.8 mmol/L]) and hemoglobin A1 values (8.81% +/- 1.19% vs 10.71% +/- 1.17% of total hemoglobin) were significantly lower after deflazacort than after prednisone. Also, insulin requirement was significantly lower after deflazacort than after prednisone (29.3 +/- 11.6 vs 47.3 +/- 2.0 U/d). These results indicate that deflazacort, when employed in an anti-inflammatory dose equivalent to prednisone, should prove advantageous in insulin-treated diabetics who require steroid treatment.

Aged↗
PubMed1987

Genetic, immunologic, and environmental heterogeneity of IDDM. Incidence and 12-mo follow-up of an Italian population.

The 1-yr incidence of insulin-dependent diabetes mellitus (IDDM) in a population of the Piedmont and Aosta Valley area of Italy was recorded. Anti-virus antibodies (e.g., Coxsackie B1-6, mumps, cytomegalovirus), islet cell antibodies (ICAs), and HLA-A, -B, -C, and -DR were determined in 74 IDDM patients (38 males, 36 females) and in controls. Total IDDM incidence was 5.0/100,000, and the incidence for those less than 20 yr of age was 11.6/100,000. Anti-virus antibody frequency was not different in IDDM patients and controls. ICAs were present in 58% of IDDM patients at onset and in 30% after 12 mo, and complement-fixing ICAs were found in 39 and 17%, respectively. IDDM was significantly and positively associated with DR3/DR4 and negatively associated with DR2 and DR5. ICA frequency was significantly higher in DR3/DR4 heterozygote patients than in patients without DR3 and DR4. These results suggest that in this IDDM population viral etiology is not evident, ICAs offer only a partial pathogenetic explanation, and genetic and immunologic heterogeneity is evident.

Adolescent↗
PubMed1986

Sublethal pH decrease may cause genetic damage to eukaryotic cell: a study on sea urchins and Salmonella typhimurium.

Further evidence is reported here of genetic and developmental damage that can be induced by a sublethal pH decrease. The effects of three inorganic acids (HCl, H2SO4, and H3PO4) on embryos and sperm from the sea urchins Sphaerechinus granularis and Paracentrotus lividus were evaluated. In addition, acidification of the medium was tested for spontaneous reversion to His+ prototrophy in Salmonella typhimurium (strains TA97, TA98, TA100, TA102, TA1535) up to toxic levels, by both liquid incubation and agar plate incorporation. The induction of developmental and mitotic abnormalities in S. granularis confirmed our previous observations on P. lividus. Embryotoxicity was exerted in S. granularis more severely by H3PO4 than by HCl or H2SO4 (pH 7 to 6), while the induction of mitotic abnormalities appeared at a pH of less than or equal to 6.5 irrespective of the acids used. By suspending S. granularis or P. lividus sperm in acidified filtered seawater (fsw) and then inseminating the eggs in natural fsw (pH = 8.0), the offspring showed developmental and mitotic abnormalities. Low-pH-induced spermiotoxicity was ruled out in our experiments, since fertilization success of acid-exposed sperm was actually enhanced, as compared to sperm suspended in untreated fsw. The exposure of S. typhimurium to different pH's (ranging from 4 to 9) invariably failed to induce any changes in reversion rates, regardless of the acids (or alkali) being used. These results suggest that extracellular acidification may cause sublethal damage that in turn leads to an impairment of mitotic activity and cell differentiation.

Cells↗
PubMed1986

Feedback inhibition of insulin secretion is altered in cirrhosis.

Hyperinsulinemia in human cirrhosis is generally considered an expression of reduced hepatic insulin degradation. To determine whether hyperinsulinemia may also depend on an altered feedback inhibition of insulin secretion, we performed euglycemic hyperinsulinemic clamp studies, infusing 40, 372, or 1280 mU/m2 X min biosynthetic human insulin in 30 compensated cirrhotic patients with portal hypertension and impaired glucose tolerance and 25 normal subjects, matched for age, sex, and weight. Mean fasting plasma insulin was significantly higher in cirrhotic patients [26.1 +/- 2.3 vs. 12.4 +/- 0.6 (+/- SE) microU/ml; P less than 0.001], while fasting plasma glucose levels were similar in the 2 groups. The mean plasma C-peptide level was significantly higher in cirrhotic patients, both basally (2.7 +/- 0.1 vs. 1.7 +/- 0.1 ng/ml; P less than 0.001) and during the clamp studies. Suppression of C-peptide at 120 min of the clamp was significantly less in cirrhotic patients (37 +/- 7% vs. 79 +/- 4%, 52 +/- 9% vs. approximately 100%, and 54 +/- 4% vs. approximately 100% during the 40, 372, and 1280 mU/m2 X min insulin infusions, respectively). The fasting C-peptide to insulin molar ratio was significantly lower in cirrhotic patients (5.4 +/- 0.3 vs. 6.4 +/- 0.3; P less than 0.005). The MCR of insulin at the three steady states was not significantly different between the 2 groups, whereas the basal systemic delivery rate of insulin was significantly higher in cirrhotic patients (14.7 +/- 1.7 vs. 6.5 +/- 0.4 mU/m2 X min; P less than 0.001). These results suggest that reduced feedback inhibition of insulin secretion may contribute to the hyperinsulinemia associated with cirrhosis.

Adult↗
PubMed1986

Insulin resistance in human liver cirrhosis is not modified by porto-systemic surgical shunt.

Cirrhosis of the liver is characterized by glucose intolerance and hyperinsulinaemia. It is considered an insulin resistant state with both a receptor and a post-receptor defect of insulin activity. It would appear that reduced hepatic degradation rather than increased B-cell production is responsible for hyperinsulinaemia. The effect of surgical portosystemic shunt on insulin resistance was studied in 18 cirrhotics with impaired glucose tolerance (12 males, 6 females; mean age 46.9 +/- 0.7 years) by measuring: glucose production (3H-glucose infusion), glucose utilisation (euglycaemic clamp at approximately 100, approximately 1000 and approximately 10,000 microU/1), plasma insulin and C-peptide levels, and liver function indices (serum bilirubin, albumin, ALT, GGT) before and 2 months after surgery. Liver sorbitol clearance was also employed to measure variations in the functional liver plasma flow induced by the shunt. No significant changes were noted in: glucose production (1.94 +/- 0.17 SEM vs 1.96 +/- 0.17 mg/kg/min), glucose utilisation (metabolic clearance rate: 3.32 +/- 0.48 vs 3.42 +/- 0.43 at approximately microU/ml; 9.70 +/- 1.0 vs 9.16 +/- 0.9 at approximately 1000 microU/ml; 10.92 +/- 1.1 vs 11.07 +/- 0.8 ml/kg/min at approximately 10 000 microU/ml), fasting plasma insulin, C-peptide and C-peptide/insulin molar ratio (4.66 +/- 0.47 vs 5.50 +/- 0.54), and the liver function indices. By contrast, there was a significant decrease in functional liver plasma flow (813 +/- 34 vs 604 +/- 34 ml/min, P less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1986

Age related changes of glucagon binding and activity in isolated rat hepatocytes.

Hepatocytes isolated from young and old rats were compared for glucagon binding and its biological effect. Liver cells from young rats showed a receptor binding of the hormone significantly higher than cells from old rats. Such a behaviour was paralleled by the activity of the hormone. In fact, the glucagon-dependent stimulation of adenylate cyclase in the hepatocytes from the former group of animals was twice as high as in the latter.

Adenylyl Cyclases↗
PubMed1985

pH-induced changes in mitotic and developmental patterns in sea urchin embryogenesis. I. Exposure of embryos.

The effects of different pH conditions have been investigated on sea urchin larval development following exposure of embryos to controlled, though changing, decreases or increases of seawater pH. The pH of filtered natural seawater was initially adjusted with 1 N HCl of 1 N KOH and then was altered back to its normal values (8.0-8.2) by the exchange with atmospheric CO2 and subsequent carbonic acid equilibrium. During cultures, pH was regularly monitored. When developing embryos were reared in different pH conditions, larval differentiation was sharply affected by an apparently moderate pH decrease, such as 0.5 pH units. However, even pH decreases as small as 0.2 pH units from the normal value showed reproducible damage to embryogenesis. This damage appeared to be early and irreversible, since the exposure of cleaving embryos resulted in more severe developmental defects than exposure of posthatching blastulae. Moreover, mitotic abnormalities were observed following early exposure of embryos to decreased pH. Increased pH, up to 8.6 (approximately 0.5 pH units above normal value), failed to exert any adverse effect on subsequent development. Moreover, an initial pH increase (8.5-8.7) resulted in the final adjustment of culture pH to 8.1-8.2, thus providing optimal conditions for rearing embryos. Two attempts to stabilize culture pH were performed by decreasing gaseous exchanges or by using Tris as a buffering agent. Both approaches appeared to be impractical, thus ruling out any further attempts. The results point out the hazards of acid contamination in restricted bodies of seawater, leading to apparently "moderate" decreases in pH, which can result in severe damage to some marine organisms, both adult and larval forms.

Animals↗
PubMed1985

pH-induced changes in mitotic and developmental patterns in sea urchin embryogenesis. II. Exposure of sperm.

pH decrease and increase were tested for their ability to affect the fertilizing capacity of sea urchin sperm, as well as to induce developmental defects and mitotic abnormalities in the embryos generated by pretreated sperm. Seawater (sw) at different pH values was obtained by mixing acidified (HCl) sw and alkalinized (KOH) sw. Thereafter sperm were exposed to different pHs for a defined time interval, or subjected to inactivation, while suspended in sw at defined pHs, as long as their fertilizing capacity was maintained. The study was carried out over the pH range 5-9; sperm showed optimal fertilizing capacity between pH 6 and 7. Below pH 6 and above pH 8 a drop in the fertilizing capacity was observed, whereas at normal sw pH (8.0-8.2) sperm showed intermediate values. pH decrease in sperm suspension induced a reproducible increase in developmental defects and mitotic abnormalities in the offspring of pretreated sperm. This effect displayed a dose-response relationship, which was most evident for pH ranging from 7 to 8. The effects of decreased pH were detected as well in terms of quantitative changes in mitotic activity, which decreased in embryos generated by sperm exposed to low pH (5-6). The results are consistent with the induction of genetic damage following exposure of sperm to low pHs. This observation suggests a genotoxic action of hydronium ions per se. Another possible explanation for the observed genotoxicity of decreased pH might be based on the pH-dependent activity of several genotoxins present in sw at trace levels.

Animals↗
PubMed1985

Mechanism of insulin resistance in human liver cirrhosis. Evidence of a combined receptor and postreceptor defect.

Insulin resistance in liver cirrhosis may depend on either reduced sensitivity (receptor defect) and/or reduced response to insulin (postreceptor defect). To clarify the mechanism of such resistance, a [3H]glucose infusion (0.2 microCi/min) was performed for 120 min before and during a euglycemic clamp at approximately 100, 1,000, and 10,000 microU/ml steady state plasma insulin concentration in 18 compensated cirrhotics with portal hypertension and impaired glucose tolerance, and 18 healthy volunteers with no family history of diabetes, matched for sex, age, and weight. Mean fasting plasma insulin (29.2 +/- 3.4 SEM vs. 14.8 +/- 1.1 microU/ml) was significantly higher (P less than 0.001) in cirrhotics, while fasting plasma glucose was much the same in the two groups. Glucose use (milligrams per kilogram per minute) was significantly lower in cirrhotics at all three steady state plasma insulin levels: 3.04 +/- 0.34 vs. 7.72 +/- 0.61 (P less than 0.001) at approximately 100; 6.05 +/- 1.07 vs. 11.45 +/- 1.24 (P less than 0.001) at approximately 1,000; and 11.69 +/- 0.69 vs. 14.13 +/- 0.74 (P less than 0.05) at approximately 10,000 microU/ml. Mean plasma C-peptide was significantly higher in cirrhotics both basally and during the steady states (P less than 0.001); it was completely suppressed at approximately 10,000 microU/ml in controls and only 57.5% of the baseline in cirrhotics. Endogenous glucose production (milligrams per kilogram per minute) was much the same in the two groups in the fasting state and almost entirely suppressed in the controls (0.10 +/- 0.05 vs. 0.48 +/- 0.11, P less than 0.001) at approximately 100 microU/ml; at approximately 1,000 microU/ml a residual glucose production, 0.07 +/- 0.05, was observed in the cirrhotics only. In addition, insulin binding and 3-ortho-methyl-glucose transport were studied in vitro in six cirrhotics and six controls. Insulin binding to circulating monocytes and isolated adipocytes was significantly lower (P less than 0.025) in cirrhotics in all insulin concentration studies. Glucose transport values on isolated adipocytes were significantly lower in cirrhotics both basally (P less than 0.001) and at maximal insulin concentration (P less than 0.05). These results suggest that insulin resistance in human cirrhosis is more dependent on depressed peripheral glucose use than on increased endogenous glucose production, and that a combined receptor and postreceptor defect in insulin action on target cells seems to be present.

Adipose Tissue↗
PubMed1985

Moderate guar-gum addition to usual diet improves peripheral sensitivity to insulin and lipaemic profile in NIDDM.

The addition of vegetable fibres to the diabetic diet has been reported to ameliorate glycaemic and plasma lipid profiles, and Guar flour seems to obtain the best results. At its usual dose, Guar produces several gastro-intestinal side effects. A lower dose (4 + 4 g/day) was therefore employed in 10 non-insulin dependent diabetics (NIDD). The following parameters were measured at the end of treatment and after a control period: HbA1 levels, hepatic glucose production (3H-Glucose infusion), peripheral sensitivity to insulin and insulin secretion (hyperglycaemic clamp), and specific insulin binding to isolated monocytes. The ultracentrifugal plasma lipid pattern was also measured. No significant body weight change was recorded during the study. A significant glycaemic and insulinaemic decrease in the fasting state was observed after Guar, together with a significant decrease of HbA1 levels (from 8.5 +/- 0.4 to 7.9 +/- 0.4%, p less than 0.05) and amelioration of peripheral sensitivity to insulin (M/I = 14.3 +/- 6.6 versus 24.3 +/- 8.8, p less than 0.025; 50% increase of insulin binding to circulating monocytes) without significant variation of the fasting hepatic glucose production. Decreased B-cell stimulation by flattening post-prandial glycaemic peaks may be an explanation of the reduction of insulin resistance via down-regulation mechanism. As far as the lipid profile is concerned, a significant reduction in total and LDL cholesterol (p less than 0.05 and p less than 0.01) and an increase in HDL-phospholipids (p less than 0.05) were recorded after Guar. These results suggest that Guar in low doses is well accepted and can contribute to a better glycaemic and lipaemic control in NIDDM.

Blood Glucose↗