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Biomedical subjects

H Hauner

Publications and source records attributed to H Hauner.

At least 127 records · Page 7Linked to original sources

The relationship between body fat distribution and weight loss in obese adolescent girls.

Recent studies have demonstrated an association between the pattern of body fat distribution and the occurrence of cardiovascular risk factors. In this study, we evaluated changes in body fat distribution as defined by several anthropometric criteria during a six week weight reduction programme in 110 obese adolescent girls (mean age 15.2 +/- 0.4 years). The standardized regimen included a mixed diet of 1032 kcal/day and a daily exercise programme of 1-2 h duration. The mean weight loss was 8.6 +/- 2.8 kg, decreasing the body mass index (BMI) from 31.4 +/- 4.7 to 28.2 +/- 4.9 kg/m2 (P < 0.01). The reduction in body weight was accompanied by a significant decrease in the waist-to-hip ratio (WHR) from 0.86 +/- 0.06 to 0.81 +/- 0.05 (P < 0.01). The initial WHR was correlated with the degree of weight loss independent of the initial weight (r = 0.34, P < 0.001). Categorized according to the waist-to-hip ratio girls in the upper tertile (WHR > 0.88) lost significantly more weight than girls in the lower tertile (WHR < 0.80) (9.8 +/- 2.7 vs. 6.8 +/- 2.5 kg, P < 0.01). These findings suggest that girls with an abdominal type of obesity benefit more from a weight reduction programme than girls with a gluteal-femoral type of obesity.

Adipose Tissue↗

Sex hormone concentrations in men with angiographically assessed coronary artery disease--relationship to obesity and body fat distribution.

The relationship between circulating sex hormone levels and the occurrence of coronary artery disease (CAD) was studied in a group of 274 men undergoing coronary angiography. Hormone levels in men with CAD (n = 200) were compared to those in men found to be free of coronary lesions (n = 74). No significant differences were found for serum concentrations of estradiol, total testosterone, sex-hormone-binding globulin, free androgen index, dehydroepiandrosterone sulfate, or cortisol between the two groups. Serum androgens were negatively correlated to age in both groups, whereas estradiol was weakly associated with total cholesterol in the group of men without CAD. No consistent associations were detected between sex hormone levels and the degree of obesity or the distribution of body fat, the latter being assessed by the ratio of waist-to-hip circumferences. The results of this study do not support a significant role of sex steroid hormones in coronary artery disease in men.

Adult↗

[Successful insulin therapy in lipoatrophic diabetes].

Two and a half years after manifestation of treatment-refractory lipoatrophic diabetes a 16-year-old girl had blood-sugar levels of about 500 mg/dl and hypertriglyceridaemia with fasting levels of about 3000 mg/dl, while there was no increase in ketone bodies. All the clinical, histological and radiological findings were those of generalized fatty tissue atrophy. In addition, she had marked axillary and periorbital acanthosis nigricans. Main symptoms were fatigue, weakness and excessive appetite. Intravenous insulin of at first 1200 IU daily reduced blood-sugar levels to normal. A good metabolic state was maintained by intensive insulin treatment with four intramuscular injections daily. On a dosage of 600-700 IU daily the HbA1 value dropped from 16.7% to 7.8%, triglyceride concentration to 300-400 mg/dl. The symptoms also regressed with normalization of the metabolic state.

Adolescent↗

No association between islet cell antibodies and Coxsackie B, mumps, rubella and cytomegalovirus antibodies in non-diabetic individuals aged 7-19 years.

Viral antibodies were tested in a cohort of 44 islet-cell antibody-positive individuals age 7-19 years, and 44 of their islet cell antibody-negative age and sex-matched classmates selected from a population study of 4208 pupils who had been screened for islet cell antibodies. Anti-coxsackie B1-5 IgM responses were detected in 14 of 44 (32%) of the islet cell antibody-positive subjects and in 7 of 44 (16%) control subjects. This difference did not reach the level of statistical significance. None of the islet cell antibody-positive subjects had specific IgM antibodies to mumps, rubella, or cytomegalovirus. There was also no increase in the prevalence or the mean titres of anti-mumps-IgG or IgA and anti-cytomegalovirus-IgG in islet cell antibody-positive subjects compared to control subjects. These results do not suggest any association between islet cell antibodies, and possibly insulitis, with recent mumps, rubella or cytomegalovirus infection. Further studies are required to clarify the relationship between islet cell antibodies and coxsackie B virus infections.

Adolescent↗

Left ventricular function and wall thickness in long-term insulin-dependent diabetes mellitus: an echocardiographic study.

Left ventricular function and wall thickness were evaluated in 111 type I diabetic subjects (mean age 25.5 +/- 9 years, mean duration of diabetes 13.4 +/- 6.2 years), using 2-D-derived M-mode echocardiography. Patients were carefully selected for the absence of major coronary risk factors or manifest cardiac disorders, and compared with 91 age- and sex-matched control subjects. Fractional shortening and the maximal velocity of cirumferential fibre shortening did not differ significantly between the two groups. Furthermore, no differences were found in the diastolic functional parameter of velocity of circumferential fibre extension. Posterior wall thickness was significantly increased in the diabetic patients compared to the controls (9.5 +/- 1.8 mm vs. 8.4 +/- 1.3 mm. P less than 0.01). As the thickness of the interventricular septum was also moderately increased (9.2 +/- 2.2 mm vs. 8.9 +/- 1.7 mm, NS), these findings provide evidence for an early structural change of the myocardium in young diabetic patients without clinically relevant functional consequences.

Adult↗

Diastolic ventricular function in type 1 diabetic patients: a study using Doppler echocardiography.

The transmitral flow velocity pattern of 28 Type 1 diabetic patients and 39 age-matched healthy control subjects was studied for determination of left ventricular diastolic function. No patient had systemic hypertension, congestive heart failure, or ischaemic heart disease by clinical or electrocardiographic criteria. Echocardiographic measures of systolic ventricular function were within normal range in all subjects. The ratio of early to late transmitral peak flow velocity (ve/va) was significantly decreased in the diabetic patients (1.3 +/- 0.1 (+/- SE) vs 1.6 +/- 0.1, p less than 0.05), while other Doppler derived variables did not show any significant difference. No correlation of ve/va with duration of diabetes was found (r = -0.27), but it correlated with age in both groups (both r = -0.40, p less than 0.05). Furthermore, a significant correlation was found between ve/va and heart rate (r = -0.55 for diabetic patients, p less than 0.01; r = -0.58 for control subjects, p less than 0.01). After matching for heart rate (24 diabetic patients and 24 control subjects) no significant decrease of ve/va was observed in the diabetic group.

Adult↗

Thyrotropin-releasing hormone degradation in patients with insulin dependent diabetes mellitus. Effects of metabolic control.

We investigated thyrotropin releasing hormone (TRH) degradation in terms of half-life (t1/2) and metabolic clearance rate (MCR) in eight subjects with insulin dependent diabetes mellitus (IDDM) before and after strict metabolic control. The results were compared with those of six healthy control subjects. The basal plasma TRH-IR levels (31 +/- 9 fmoles/ml) were on the lowest normal limit in the IDDM patients and were not considerably changed (24 +/- 10) after strict metabolic control. The basal and delta max rise of TSH to TRH (200 micrograms i.v.) were not significantly different before or after improved metabolic control in IDDM and as compared to controls. The TRH-degradation curves showed similar exponential decay before and after improvement of metabolic control (t1/2: 7.6 +/- 0.4 min and 7.3 +/- 0.3 respectively; 6.5 +/- 0.4 min for the controls). The MCR of exogenously administered TRH in IDDM before (65.5 +/- 8.6 l/m2/day) and after (65.0 +/- 8.9) control was not different compared to the normals (76.5 +/- 9.6). The area under the plasma concentration-time curve (AUC) in IDDM before (52.193 +/- 6.773 fmoles.ml-1.min) and after improvement of metabolic control (53.186 +/- 7.856) was slightly higher than in the healthy subjects (40.151 +/- 3.741, n.s.). These findings demonstrate that a) the degradation of exogenous TRH is not dependent on the glucose metabolic state, b) insulin deficient diabetes mellitus does not affect the enzymatic system responsible for TRH degradation and, c) the hypothalamic-pituitary axis appears to be intact in IDDM.

Adolescent↗

Thyrotropin releasing hormone (TRH) immunoreactivity and thyroid function in obesity.

Circulating TRH-immunoreactive levels, the thyrotropin response to a TRH intravenous stimulation (200 micrograms) and thyroid hormone concentrations have been determined in 43 overweight subjects (body mass index 45 +/- 12 kg/m2, mean +/- s.d.) and 46 (body mass index 22 +/- 2 kg/m2) normal weight controls. The TRH levels measured by a recently developed, highly specific radioimmunoassay were similar among both groups (44 +/- 16 vs 40 +/- 12 fmol/ml, n.s.). The pattern of response of TSH to TRH was normal in the obese and no significant difference was observed between the peak TSH values of the obese and the normal group (8.3 +/- 2.8 vs 8.7 +/- 2.2 microU/ml, n.s.). No correlations were found between the degree of obesity and the concentrations of TRH, TSH and peripheral thyroid hormone levels. Three obese patients showed a delta-TSH of 18, 19 and 21 microU/ml at normal thyroid hormone concentrations as sign of latent hypothyroidism. These data indicate that in obesity: (a) the TSH response to i.v. TRH is not impaired, (b) circulating TRH-IR levels are not significantly changed and (c) the incidence of overt hypothyroidism is not increased.

Adult↗

Regional variation of adipose differentiation in cultured stromal-vascular cells from the abdominal and femoral adipose tissue of obese women.

The capacities of the adipocyte precursor pools to form new fat cells were compared in the abdominal and femoral adipose tissue regions of obese women. Adipose tissue samples were obtained from 24 females by needle biopsy. The stromal-vascular cells isolated by collagenase digestion were cultured in a chemically defined medium supplemented with 0.5 mumol/l insulin and 0.1 mumol/l cortisol. The extent of adipose differentiation was assessed by determination of glycerol-3-phosphate dehydrogenase (GPDH) activity after 18 days in culture. No significant differences were found between the two depots with regard to mean fat cell diameter and the number of stromal-vascular cells (abdominal vs femoral site: 134,800 +/- 7900 vs 138,800 +/- 6700 cells/g wet adipose tissue, n.s.). However, GPDH activities were significantly higher in cultured cells from the abdominal region as compared to those from the femoral depot (253.1 +/- 40.9 vs 155.8 +/- 21.4 mU/mg protein, P less than 0.01). These results suggest that regional differences exist in the capacity of adipose tissue depots to form new fat cells. This finding may help to understand changes in adipose tissue distribution during adult life.

Abdomen↗

[Prevalence of secondary complications in patients with type I diabetes mellitus. Results of a retrospective analysis of 549 type I diabetic patients of the Ulm University clinic].

In a retrospective study, we analyzed the prevalence of diabetes-associated late complications in 549 type 1 (insulin-dependent) diabetic patients who have been treated at the University Hospital of Ulm between 1980 and 1987. Retinopathy, proteinuria and neuropathy depended on the duration of the disease, whereas age was the major determinant of large vessel disease. After 20 years of diabetes, 85% of the patients showed retinopathy, half of them proliferative retinopathy, 52% had persistent proteinuria (greater than 500 mg/day), 20% of them were under dialysis. 74% of the patients showed signs of peripheral and/or autonomic neuropathy, 19% had manifestations of large vessel disease. There was no consistent correlation between the levels of glycosylated hemoglobin and the occurrence of diabetic late complications. However, hypertension was closely associated with both small and large vessel disease.

Adult↗

[Relationship of the left ventricular wall thickness to the degree of late microvascular complications in diabetes mellitus type I].

Left-ventricular wall thickness, measured by echocardiography, was determined in 111 normotensive diabetics (63 men and 48 women; mean age 26 +/- 9 years; diabetes duration 13.5 +/- 6.2 years) and 91 comparable control subjects. The interventricular septum was significantly thicker in diabetics than in controls: systolic 13.3 +/- 2.3 mm, diastolic 9.2 +/- 2.2 mm vs. systolic 12.5 +/- 2.1 mm and diastolic 8.9 +/- 1.7 mm (P less than 0.05). Posterior wall thickness measurements were: systolic 15.8 +/- 2.2 mm vs 14.6 +/- 2.0 mm (P less than 0.001), diastolic 9.5 +/- 1.8 mm vs 8.4 +/- 1.3 mm (P less than 0.01). Left-ventricular wall thickness increased stepwise with increasing severity of microvascular complications (retinopathy, nephropathy, neuropathy). There was a moderately close correlation between blood pressure values and the degree of microvascular complications (r = 0.49, P less than 0.01). These correlations indicate that increases in wall thickness are diabetes specific, but may be influenced by the level of blood pressure.

Adult↗

[Epidemiologic studies of the recognition of the preclinical phase of type I diabetes in school children].

Sera of 4208 schoolchildren in Ulm and surrounding areas (1916 boys, 2292 girls; mean age 13.9 [7-21] years) were analysed for the presence of cytoplasmatic islet-cell antibodies (ICA). ICA were demonstrated in 44 children (1.05%). Complement-fixing ICA (CF-ICA) were found in six of them, insulin autoantibodies (IAA) in seven. The early phase of insulin response in the intravenous glucose tolerance test was below the 1st percentile of normal controls in two of the ICA-positive children. In the course of the subsequent 6-9 months the ICA disappeared in half of the previously positive children. In the two with abnormal glucose tolerance tests ICA, CF-ICA and abnormal insulin secretion persisted during the observation period of 9 months. In another CF-ICA-positive schoolchild insulin response to the glucose tolerance test fell below the 1st percentile after 6 months. These results indicate that, even in an unselected group of children, persisting ICA and CF-ICA are high-risk markers for abnormal insulin secretion, which precedes the onset of type I diabetes.

Adolescent↗

Body fat distribution in men with angiographically confirmed coronary artery disease.

Body fat distribution and its relationship to coronary artery disease and established cardiovascular risk factors have been studied in a cohort of 286 men aged between 30 and 74 years undergoing coronary angiography. 207 (72.4%) patients showed stenosis (greater than 30%) or occlusion of one or more coronary arteries. whereas the remaining 79 (27.6%) men were free of coronary lesions and served as a control group. 112 men with angiographically defined coronary artery disease had an additional history of myocardial infarction. Body fat distribution was assessed by determining the waist-to-hip circumference ratio. A stepwise logistic regression analysis revealed that in addition to LDL-cholesterol (P = 0.0001) and age (P = 0.0005) an abdominal type of body fat distribution (P = 0.0129) is also a significant risk indicator for the occurrence of coronary artery disease (CAD) independent of body weight and other factors such as total cholesterol, HDL-cholesterol, triglycerides, insulin, systolic and diastolic blood pressure. The results of this study suggest that an abdominal type of fat distribution is associated with an increased risk of coronary artery disease.

Adipose Tissue↗

Complete adipose differentiation of 3T3 L1 cells in a chemically defined medium: comparison to serum-containing culture conditions.

The hormonal control of the adipose conversion of 3T3 L1 cells was studied in a chemically defined medium and compared to that under serum-containing conditions. Addition of insulin to a chemically defined medium (Dulbecco's Modified Eagle's Medium-Ham's F-12, 1:1) resulted in a dose-dependent increase in glycero-3-phosphate dehydrogenase activity, a lipogenic marker enzyme. The maximally effective concentration of insulin was in the range of 10(-8) and 10(-7) mol/liter. Glucocorticoids were ineffective in the absence of insulin and exhibited an inhibitory action in serum-containing medium. In the presence of insulin, corticosterone and other glucocorticoids showed a potent adipogenic activity, with a maximally effective concentration at 10(-8) mol/l. 1-Methyl-3-isobutylxanthine (MIX), a cAMP-elevating agent, was also found to induce the adipose differentiation process in the presence of insulin. The effect of MIX could be partly replaced by (Bu)2cAMP. A combination of insulin and, for the first 2 days, glucocorticoids and MIX promoted a complete conversion of 3T3 cells within 6-8 days. The concentrations of the factors required for adipose conversion were substantially lower than those in serum-containing medium. The adipose conversion in serum-free medium was associated with an increase in cell number, since 0.3 micrograms/ml cytosin arabinoside not only inhibited cell replication, but also prevented the expression of glycero-3-phosphate dehydrogenase activity. Our results demonstrate a complete adipose differentiation of 3T3 L1 cells in a chemically defined culture system supplemented with insulin, glucocorticoids, and factors that increase the cAMP content of the cells. This system may provide an improved model to study adipogenic and antiadipogenic factors under defined conditions.

1-Methyl-3-isobutylxanthine↗

[Stress testing of long-term type I diabetic patients with radionuclide ventriculography].

Left ventricular function was assessed by means of radionuclide ventriculography in 42 patients with long-standing (13 +/- 5 yrs) insulin-dependent diabetes mellitus and in eleven healthy age matched control subjects. Only diabetics were included in the study without diabetes related cardiac risk factors such as hypertension and CAD in order to evaluate diabetes specific changes of cardiac function. No differences were seen between diabetics and controls concerning heart rate and functional parameters of left ventricle in systole and diastole. The rapid filling period was not prolonged. According to our radionuclide data there is no evidence of diabetes related impairment of ventricular function in young patients with long-standing type-1-diabetes mellitus.

Adult↗