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Biomedical subjects

H Hauner

Publications and source records attributed to H Hauner.

At least 109 records · Page 6Linked to original sources
PubMed1995

Body fat distribution and steroid hormone concentrations in obese adolescent girls before and after weight reduction.

The aim of this study was to investigate the role of body fat distribution on steroid hormone serum concentrations in obese adolescent girls before and after weight reduction. Ninety-two girls (age, 15.1 +/- 0.7 yr) with a mean body mass index of 31.2 +/- 4.6 kg/m2 participated in this 6-week intervention study. Initially, girls with abdominal obesity (waist to hip ratio, > 0.86; n = 30) had higher levels of total and free testosterone and lower levels of sex hormone-binding globulin as well as lower morning levels of total and free cortisol than girls with gluteal-femoral obesity (waist to hip ratio, < 0.80; n = 31) independent of their body mass index. After a mean weight loss of 8.3 +/- 2.6 kg by a standardized weight loss program, significant reductions were observed in estradiol, total and free testosterone, dehydroepiandrosterone sulfate, and the ratio of LH to FSH, whereas sex hormone-binding globulin and free cortisol levels increased significantly. Decreases in total and free testosterone and increases in total and free cortisol were significantly greater in the girls with abdominal obesity than in the girls with gluteal-femoral obesity. Our results suggest that obese girls with an abdominal pattern of fat distribution exhibit more pronounced steroid hormone aberrations, in particular a high androgenic activity, than girls with a gluteal-femoral pattern of fat distribution. The reduction of excess body weight by a conventional treatment regimen is associated with a remarkable improvement of steroid hormone abnormalities in this particular subtype of obese adolescent girls.

Adipose Tissue↗
PubMed1995

[Abdominal obesity and coronary heart disease. Pathophysiology and clinical significance].

The relationship between overweight and cardiovascular disease was a matter of debate for many years. Recent studies have demonstrated that obesity defined as body mass index of 30 kg/m2 or higher is associated with an exponential increase of cardiovascular complications. This effect is largely mediated by the induction of established risk factors such as dyslipidemia, hypertension and type 2 diabetes mellitus. Recently, there is growing evidence that the occurrence of most complications of obesity depends not only on the degree of overweight but also on the pattern of body fat distribution. Many data suggest that the anatomical localization of body fat is more important for the risk of developing complications than the adipose tissue mass per se. An abdominal, upper-body type of fat distribution, which can be easily determined by the measurement of waist and hip circumferences (waist/hip ratio = WHR), is also a confirmed risk factor for metabolic disturbances, hypertension and atherosclerosis, independent of body weight. However, the clinical appearance of these disturbances is frequently associated with the development of obesity. This network of metabolic disorders and their vascular complications is termed "metabolic syndrome" or "syndrome X" (Table 2). Abdominal obesity is now known to be closely associated with the metabolic syndrome and is regarded to represent its readily recognizable phenotypic feature. The components of the metabolic syndrome are characterized by varying forms and degrees of insulin resistance. It is assumed that insulin resistance, defined as diminished biological response to the action of insulin, represents the primary defect or at least the common pathogenetic link between these disturbances.(ABSTRACT TRUNCATED AT 250 WORDS)

Abdominal Muscles↗
PubMed1994

[Does long-term blood pressure reduction in patients with essential hypertension improve concomitant metabolic disorders?].

AIM: Aim of this study was to investigate the occurrence of metabolic abnormalities in patients with newly diagnosed essential hypertension and to assess the effects of a blood pressure lowering drug therapy on the respective variables. PATIENTS AND RESULTS: Twenty-six hypertensive subjects (12 female, 14 male) were included in the study. Twenty-one normotensive subjects (9 female, 12 male) served as a control group. During an oral glucose tolerance test the hypertensive subjects had higher blood glucose and serum insulin levels than the controls. The hypertensive patients also showed higher triglyceride concentrations and a more abdominal pattern of body fat distribution. In addition, the women with essential hypertension exhibited a higher free androgen index (32.2 +/- 14.8 vs 20.1 +/- 15.0%, p < 0.05) than the women of the control group. After a 3 to 6 month treatment period with nifedipine or nitrendipine the elevated blood pressure of the hypertensives was significantly reduced. In a second glucose tolerance test carried out in 13 patients blood glucose, serum insulin and triglyceride concentrations were significantly lower compared to the pretreatment period. The other metabolic and hormonal variables remained unchanged. CONCLUSION: This observation raises the question, whether a long-term vasodilatating antihypertensive therapy can improve the metabolic abnormalities found in patients with essential hypertension.

Adult↗
PubMed1994

[The treatment of type-1 diabetics with insulin-induced lipohypertrophy by liposuction].

Extensive areas of lipohypertrophy at the insulin injection sites on both thighs, upper arms and buttocks had developed in a 22-year-old woman with type 1 diabetes. Tissue biopsy showed fat cells of normal size, while the stromal cells in primary culture from the lipohypertrophy tissue demonstrated a greater degree of new fat-cell formation than normal fat tissue, i.e. there was fat-cell hyperplasia. Although the patient avoided these sites for insulin injection during the subsequent 18 months, the amount of excessive fat tissue did not decrease. As the very obvious fat pads distressed the patient, local liposuction was applied without complication at the six affected sites, removing a total of 2,000 ml of fat.-Liposuction is a low-risk curative procedure for removing extensive insulin-induced lipohypertrophic tissue and quickly achieves a cosmetically satisfactory result.

Adipose Tissue↗
PubMed1994

[The outpatient care of diabetics. An analysis of the local compulsory medical insurance data from Dortmund].

Outpatient care of diabetics was analysed for the year 1988 from data available through the AOK Health Insurance at Dortmund, Germany, using a representative sample of 368 diabetics (124 men, 244 women; mean age 66.9 years). Compared with a group of nondiabetics (n = 1104), matched for age and sex, the diabetics had more contacts with their medical practitioner (36.3 vs 24.9; P < 0.001), more prescriptions (43.3 vs 26.1; P < 0.001), and more overall medical attention (77.6 vs 51.3; P < 0.001). Blood sugar measurements were obtained in 90.5% of the diabetics, but HbA1 was measured in only 8.2%. Only 7.1% of diabetics were given test strips for self-monitoring of urinary and blood sugar levels. Fundoscopic examination had been undertaken in 18.5% of diabetics. Measurements of total cholesterol, triglyceride and creatinine concentrations and recordings of the ECG were done in about half of the diabetics. Outpatient diagnostic tests for cardiovascular diseases were performed in fewer than 2% of both the diabetic and the control groups. These data make it clear that the outpatient care of diabetics with respect to metabolic control and monitoring of diabetes-related disease urgently requires improvement.

Adult↗
PubMed1994

Body fat distribution and its association with metabolic and hormonal risk factors in women with angiographically assessed coronary artery disease. Evidence for the presence of a metabolic syndrome.

The aim of this study was to investigate the pattern of body fat distribution and its association with metabolic and hormonal cardiovascular risk factors in women undergoing coronary angiography. Thirty of the 51 women exhibited significant coronary artery disease (CAD) (group A), whereas the remaining 21 subjects were free of major coronary stenoses (group B). Twenty-five healthy women without clinical signs of CAD served as a control group (group C). Despite comparable age and body mass index the women of group A had a significantly higher waist-to-hip ratio (WHR), a measure of the pattern of body fat distribution, than those of group C (0.88 +/- 0.07 vs. 0.78 +/- 0.06, P < 0.01). In an oral glucose tolerance test a high prevalence of impaired glucose tolerance or diabetes was found in groups A and B (53% and 63%, respectively) compared with group C (4%, each P < 0.01). The women of groups A and B showed significantly higher blood pressure and triglyceride levels as well as lower HDL-cholesterol than those of group C, whereas total and LDL-cholesterol were not different between the groups. The serum concentrations of testosterone, sex-hormone-binding globulin (SHBG) and cortisol were comparable between the three groups and correlation analysis revealed positive associations between androgens and WHR (r = 0.36, P < 0.01) and serum insulin (r = 0.34, P < 0.01) respectively. These findings indicate that women with angiographically confirmed CAD, and those with clinical signs of CAD but without significant stenosis, frequently exhibit a metabolic syndrome characterized by a cluster of metabolic abnormalities which may underlie the atherosclerotic process.

Adipose Tissue↗
PubMed1994

Endothelin-1 inhibits the adipose differentiation of cultured human adipocyte precursor cells.

We studied the effect of endothelin-1 (ET-1) on the differentiation of adipocyte precursor cells obtained from human adipose tissue and cultured in a serum-free hormone-supplemented medium. ET-1 was found to inhibit in a dose-dependent manner the accumulation of lipid droplets and the expression of glycerol-3-phosphate dehydrogenase (GPDH), a marker of adipose differentiation. The half-maximal inhibitory effect was observed in the range of 8.5 x 10(-10) mol/L. Full inhibition required the continuous exposure of the cells to ET-1. The prevention of adipose conversion was not associated with a stimulation of mitogenesis. The presence of staurosporine, an inhibitor of the protein kinase C signaling pathway, completely prevented the inhibitory effect of ET-1 on adipose differentiation. Addition of ET-1 to newly developed fat cells also caused a suppression of GPDH activity without changing adipocyte morphology. Again, the magnitude of this effect was dependent on the exposure time. These findings suggest that ET-1 is a potent modulator of fat cell formation in man, which may act through activation of protein kinase C. Because of the close spatial relationship between fat cell precursors and blood vessels, ET-1 may exert its action in a paracrine manner.

Adipocytes↗
PubMed1994

Body-fat distribution and changes in the atherogenic risk-factor profile in obese adolescent girls during weight reduction.

We examined the effect of the pattern of body-fat distribution on the modification of atherogenic risk factors in obese adolescent girls during weight reduction. During the 6-wk program, which included a mixed diet of 4321 kJ/d and intensive physical exercise, the girls lost 8.5 +/- 2.4 kg and their waist-to-hip ratio (WHR) decreased from 0.86 +/- 0.05 to 0.81 +/- 0.05 (P < 0.01). Significant reductions were observed for total cholesterol, LDL cholesterol, uric acid, fasting insulin, and systolic and diastolic blood pressure. Girls with abdominal obesity (WHR > 0.88) had greater reductions in serum cholesterol, LDL cholesterol, and uric acid than did girls with gluteal-femoral obesity (WHR < 0.81). In a multivariate-regression analysis these differences could be partly explained by the greater weight loss of the girls with abdominal obesity. These results suggest that during weight reduction girls with abdominal obesity exhibit more beneficial changes in the atherogenic-risk-factor profile than do girls with gluteal-femoral obesity, partly because of a greater weight loss.

Adipose Tissue↗
PubMed1994

Transforming growth factor beta (TGF-beta) inhibits the differentiation of human adipocyte precursor cells in primary culture.

In order to improve our understanding of the control of adipose tissue development in man by adipogenic and antiadipogenic factors we studied the effect of transforming growth factor beta (TGF beta) on the differentiation of human adipocyte precursor cells cultured in a serum-free medium. Addition of TGF beta at concentrations ranging from 5 to 100 pmol/l for 24 h at the beginning of the differentiation process resulted in a dose-dependent reduced expression of glycero-3-phosphate dehydrogenase (GPDH) activity. Continuous exposure of cells to TGF beta completely blocked differentiation even at a concentration of 5 pmol/l. Under these conditions cells were not able to accumulate lipid droplets. This inhibitory effect of TGF beta was not mediated by stimulation of cell proliferation. Exposure of newly developed fat cells to TGF beta was also associated with a significant suppression of GPDH activity. A 10-day incubation of cells with TGF beta reduced GPDH activity by more than 80% compared to controls. Despite this suppressive effect cells retained the typical fat cell-like morphology. In conclusion, these data clearly suggest that TGF beta exerts an inhibitory action on human adipose tissue development and reduces the activity of a lipogenic key enzyme in newly formed fat cells.

Adipocytes↗
PubMed1993

Tumor necrosis factor-alpha prevents the differentiation of human adipocyte precursor cells and causes delipidation of newly developed fat cells.

We investigated the effect of the tumor necrosis factor-alpha (TNF alpha) on the differentiation of human adipocyte precursor cells in primary culture. Adipocyte precursors convert into fat cells within 12-16 days in a chemically defined, hormone-supplemented medium. Exposure of cultured preadipocytes to TNF alpha resulted in a dose- and time-dependent decrease in the number of developing fat cells and the activity of glycerol-3-phosphate dehydrogenase (GPDH), an established marker of adipocyte differentiation. A 24-h incubation with TNF alpha at a concentration of 5 nM suppressed GPDH activity by 55% compared to that in control cultures. Continuous exposure of the cells to TNF alpha completely blocked expression of the adipocyte phenotype and GPDH activity. The inhibitory action of TNF alpha was not associated with a change in cell number, as assessed by cell counting. The addition of 5 nM TNF alpha for 24 h to newly developed fat cells caused a rapid reduction of GPDH activity by approximately 50%. A 14-day exposure of differentiated cells to TNF alpha was followed by complete suppression of GPDH and a marked delipidation of the cells, including morphological changes, leading to the development of long spindle-shaped cytoplasmatic extensions. These results clearly demonstrate that TNF alpha inhibits the differentiation of human adipocyte precursor cells and, in addition, promotes the delipidation of mature fat cells. It is suggested that TNF alpha may be involved in the physiological control of human adipose tissue cellularity and function.

Adipose Tissue↗
PubMed1993

Association of elevated serum uric acid with coronary heart disease in diabetes mellitus.

The relationship between elevated serum uric acid (SUA) and coronary heart disease (CHD) is discussed controversially. In this cross-sectional study, we evaluated the association between hyperuricaemia and small- and large-vessel diseases in diabetic patients by analyzing clinical data of 7847 diabetic patients of both sexes (Type 1 diabetes: n = 3800, Type 2 diabetes: n = 4047). Elevated serum uric acid was defined as concentrations > 7.0 mg/dl in men and > 6.6 mg/dl in women. The prevalence of hyperuricaemia was dependent on age and duration of the disease in Type 1 diabetic patients, whereas in recently diagnosed Type 2 diabetic patients the prevalence of elevated uric acid levels was higher than in patients with long-standing Type 1 diabetes, without any further increase with longer duration of the disease. An elevated uric acid level was also associated with body weight, hypertension and nephropathy in both types of diabetes and in both sexes. In women, hyperuricaemia was correlated with the presence of coronary heart disease both in Type 1 and Type 2 diabetes (p < 0.05). The exclusion of hypertension and nephropathy in the multiple logistic regression had no effect on these associations. However, after adjustment for these two factors a significant correlation between hyperuricaemia and coronary heart disease was also found in Type 2 diabetic men. In addition, increased serum uric acid was associated with gangrene in male Type 2 diabetic patients (p < 0.05). These results suggest that elevated uric acid levels are correlated with the presence of coronary heart disease in female rather than in male diabetic patients, independently of hypertension and nephropathy.

Adolescent↗
PubMed1993

Diabetes prevalence from health insurance data: evaluation of estimates by comparison with a population-based diabetes register.

UNLABELLED: At present in Germany, data on the prevalence of diabetes can only be obtained by modelling health insurance data. The National Diabetes Register of the former (East) German Democratic Republic which, between 1960 and 1990, monitored approximately 98% of all diabetic subjects, provides a tool for evaluating epidemiological estimates from other data sources. Therefore, the following data bases were compared for the year 1988: (1) a 5% random-sample (n = 6478) of all subjects insured at a local statutory health insurance company in the city of Dormund; (2) related data from the population-based diabetes register of former East-Berlin and (3) of the former German Democratic Republic. All data were standardized by sex and age according to the 1988 population statistics of the Federal Republic of (West) Germany thus resulting in the apparent diabetes prevalence of the Western part of Germany at that time. RESULTS: total prevalence rates were (1) 4.8%, (2) 4.9%, and (3) 4.4% (p < 0.05). The percentages of insulin-treated patients were (1) 18%, (2) 19%, and (3) 16%, respectively. 54% (1), 37% (p < 0.05) (2), and 42% (p < 0.05) (3), of the patients received oral antidiabetic drugs. It is concluded that the three samples are comparable and that the diabetes prevalence rates as estimated from health insurance data and from the two population-based registers give corresponding conclusions. Sample-based health insurance data may provide a useful and reliable tool for epidemiological studies on diabetes mellitus.

Adult↗
PubMed1992

[Estimation of the incidence of diabetes in the Federal Republic of Germany based on insurance data. A secondary data analysis of a representative random sample of locally insured persons in the city of Dortmund].

All records relating to medical prescriptions and services relating to diabetes for a representative sample (n = 6478) of inhabitants of Dortmund in 1988, who were members of the Local Health Insurance in Dortmund, were analysed. 264 patients (4.08%) were receiving antidiabetic drugs during that year, 198 (3.06%) oral ones, 42 (0.65%) insulin and 24 (0.37%) both. 12.41% of all those insured over the age of 60 were on antidiabetic drugs, more women than men (5.08 vs 2.94%; P less than 0.001). The most frequently used oral antidiabetics were sulphonylurea ones (95.1%), while the proportion of biguanides was only 4.4%. On the basis of established diagnosis, regular blood sugar and HbA1 tests, as well as optic fundi examination, a further 104 persons (1.60%) are assumed to have diabetes but not treated by drugs. This sample indicates an overall prevalence of diabetes of 5.68% among the population. Relating it to the age and sex pattern of the population of the Federal Republic of Germany this corresponds to a prevalence of diagnosed diabetes of 4.82%. Thus there are probably a little less than 4 million diabetic citizens of the Federal Republic of Germany.

Age Factors↗