Biomedical subjects

H Larsson

Publications and source records attributed to H Larsson.

At least 73 records · Page 4Linked to original sources

PubMed1996

Islet dysfunction in obese women with impaired glucose tolerance.

Insulin sensitivity and islet function were examined in 22 obese women: 11 with normal glucose tolerance (mean +/- SD body mass index [BMI], 32.2 +/- 2.8 kg/m2) and 11 with impaired glucose tolerance (BMI, 30.1 +/- 2.2 kg/m2). Thirteen non-obese women with normal glucose tolerance (BMI, 20.9 +/- 1.3 kg/m2) served as controls. All women were 58 to 59 years of age. Insulin sensitivity was measured with the euglycemic, hyperinsulinemic clamp. Insulin secretion was studied after intravenous arginine (5 g) at fasting, and at blood glucose levels of 14 and greater than 25 mmol/L. Insulin sensitivity was higher in non-obese (99.8 +/- 11.5 nmol/kg/min/pmol insulin/L) than in obese subject (P < or = .002), but did not differ between obese subjects with normal versus impaired glucose tolerance (47.2 +/- 8.8 v 45.5 +/- 5.2 nmol/kg/min/pmol insulin/L, difference not significant [NS]). Obese subjects with normal glucose tolerance had a higher insulin response to both glucose (P < or = .004) and arginine (P < or = .02) than nonobese women, and higher glucose potentiation of insulin secretion, slopeAIR (P = .05). Compared with obese subjects with normal glucose tolerance, the obese subjects with impaired glucose tolerance had a lower insulin response to glucose (P = .03) and to arginine at blood glucose levels of 14 mmol/L (P = .03), as well as a lower slopeAIR levels ( P = .03). Fasting glucagon was higher in obese subjects with normal glucose tolerance than in non-obese subjects with normal glucose tolerance (P = .006). In obese subjects with impaired glucose tolerance, the glucose inhibition of glucagon secretion, slope AGR, was lower than in obese subjects with normal glucose tolerance (P = .04). Thus, obese subjects with impaired glucose tolerance have altered glucose modulation of islet function, mainly manifested as reduced slope AIR and slope AGR, yet insulin sensitivity is not different than in equally obese subjects with normal glucose tolerance. We therefore conclude that islet dysfunction, and not a further reduction of insulin sensitivity, determines the development of impaired glucose tolerance in obesity.

Arginine↗

PubMed1996

Factors affecting growth and antibiotic susceptibility of Helicobacter pylori: effect of pH and urea on the survival of a wild-type strain and a urease-deficient mutant.

This study investigated how pH and the presence of urea affect the survival and growth of Helicobacter pylori and whether these factors affect susceptibility to antibiotics in vitro. The viability of a wild-type strain and a urease-deficient mutant of H. pylori was studied after incubation for 1 h in buffers at different pH values at 37 degrees C under microaerophilic conditions. Viable counts were not affected at pH 5 and pH 7. In buffer at pH 3, there were no viable organisms, but urea (6.25 mM) protected the wild-type strain, which survived well. At pH 9, urea further reduced the viability of H. pylori and flurofamide almost abolished the effect of urea on the wild-type strain. Neither urea nor flurofamide affected the viability of the urease-deficient mutant under the same conditions. Growth was also pH dependent and was enhanced in shake-cultures. At pH 5, urea supported growth of the wild-type strain, but at pH 7 a toxic effect on the bacteria was observed. Growth of H. pylori at pH 5.9 was poor, and susceptibility to amoxycillin, erythromycin and clarithromycin was markedly less than at pH 7.2 and 7.9. The bactericidal activities of metronidazole and tetracycline were similar at the different pH values studied. At neutral pH the killing rates of amoxycillin and clarithromycin were growth rate dependent. Susceptibility to metronidazole was enhanced in stationary cultures. The interaction obtained between the proton pump inhibitor, omeprazole, and amoxycillin at pH 7 was of additive type. These results suggest that pH and growth conditions may be important in the antibacterial efficacy of different antibiotics in vivo and also provide a possible explanation for the potentiating effect of omeprazole with antibiotics in the treatment of H. pylori infections.

Amoxicillin↗

PubMed1996

In vitro antibacterial activity of omeprazole and its selectivity for Helicobacter spp. are dependent on incubation conditions.

Factors affecting the in vitro antibacterial activity of omeprazole were studied. Our data show that 3H-labeled omeprazole covalently bound to Helicobacter pylori and to other gram-negative and gram-positive bacteria. The compound was found to bind to a broad range of proteins in H. pylori, and at pH 5, binding was enhanced 15-fold compared with binding at pH 7. The bactericidal activity correlated to the degree of binding, and at pH 5, a pH at which omeprazole readily converts to the active sulfenamide form, beta-mercaptoethanol, a known scavenger of sulfenamide, and fetal calf serum, to which noncovalent protein binding of omeprazole is known to occur, reduced the level of binding and almost entirely abolished the bactericidal activity. At pH 7 the killing activities of omeprazole and structural analogs (e.g., proton pump inhibitors) were dependent on the time-dependent conversion (half-life) to the corresponding sulfenamide. The bactericidal activity exerted by the sulfenamide form at pH 5 was not specific for the genus Helicobacter. However, in brucella broth at pH 7 with 10% fetal calf serum, only Helicobacter spp. were susceptible to omeprazole, with MBCs in the range of 32 to 64 micrograms/ml, and MBCs for more stable proton pump inhibitors were higher. Wild-type H. pylori and its isogenic urease-deficient mutant were equally susceptible to omeprazole. Thus, the urease is not a lethal target for omeprazole action in H. pylori. In conclusion, the antibacterial activities of omeprazole and analogs are dependent on pH and the composition of the medium used. Thus, at a low pH in buffer, these compounds have a nonselective action, whereas in broth at neutral pH, the mechanism of action is selective for Helicobacter spp.

Anti-Ulcer Agents↗

PubMed1996

Short-term dexamethasone treatment increases plasma leptin independently of changes in insulin sensitivity in healthy women.

Leptin has been demonstrated to correlate with body fat content in humans, but the regulation of leptin levels is poorly understood. Therefore, we studied the relation between fasting insulin, plasma leptin, and insulin sensitivity, as assessed by the hyperinsulinemic euglycemic clamp, before and after short term corticosteroid treatment, which is known to induce insulin resistance (3.0 mg dexamethasone, twice daily, for 48 h; total dose, 15 mg) in nine healthy women (mean +/- SE age, 58.6 +/- 0.1 yr; body mass index, 25.9 +/- 1.7 kg/m2). Dexamethasone increased fasting leptin levels by 114 +/- 14% (18.4 +/- 3.3 vs. 39.4 +/- 7.3 ng/ml; P = 0.001) and increased fasting insulin by 51 +/- 12% (P = 0.004). Concomitantly, insulin sensitivity was reduced to 45 +/- 5% (P = 0.001). The increase in leptin correlated with the reduction of insulin sensitivity (r = 0.68; P = 0.044), but this correlation was no longer significant after correction for body mass index. The correlation between the change in plasma leptin and body mass index (r = 0.79; P = 0.012), however, was independent of the change in both fasting insulin and insulin sensitivity. We conclude that short term corticosteroid treatment induces a doubling of fasting leptin in healthy humans. The dexamethasone-induced increase in leptin is dependent of body mass index, but not of insulin levels or insulin sensitivity, which suggests that the influence of dexamethasone on plasma leptin is not mediated by its influences on fasting insulin or insulin sensitivity.

Blood Glucose↗

PubMed1996

Peptide YY does not inhibit glucose-stimulated insulin secretion in humans.

Peptide YY (PYY) is localized to gut and pancreatic endocrine cells. it may therefore be involved in the regulation of insulin secretion as a gut hormone as well as an islet local regulator. in laboratory animals, the peptide inhibits stimulated insulin secretion, but its effects in humans are not known. We therefore infused PYY intravenously at a low (1 pmol x kg(-1) x min(-1); N = 4); or a high rate (5 pmol x kg(-1) x min(-1); N = 5) for 120 min in healthy women aged 52 years. After 30 min of infusion, glucose (0.5 g/kg) was injected rapidly. In separate control experiments, saline was infused instead of PYY. We found that PYY did not inhibit the acute insulin response to glucose or affect the glucose elimination rate, and PYY was also without influence on the basal plasma glucose and serum insulin levels during the 30-min infusion before the challenge with glucose. We therefore conclude that intravenous infusion of PYY does not affect glucose-stimulated insulin secretion in man.

Blood Glucose↗

PubMed1996

Plasma leptin levels correlate to islet function independently of body fat in postmenopausal women.

It has previously been demonstrated that plasma leptin correlates to body fat content. Increased body fat content is accompanied by low insulin sensitivity, which is compensated with increased insulin secretion. We therefore studied whether plasma levels of leptin also correlate to insulin secretion and sensitivity in humans. Therefore, we examined insulin sensitivity by the euglycemic-hyperinsulinemic clamp technique and measured the insulin response to intravenous arginine (5 g) at fasting and 14 mmol/l glucose in postmenopausal women. Percent body fat content was determined with impedance measurements. Log plasma leptin significantly correlated to percent body fat (r = 0.84, P < 0.001). In women with normal glucose tolerance (n = 36), partial correlation studies controlling for body fat content revealed significant correlations between log plasma leptin and fasting insulin levels (r = 0.39, P = 0.029), the insulin response to arginine at both glucose levels (r = 0.38 and r = 0.37, P < 0.036 for both), and the glucose potentiation of arginine-stimulated insulin secretion (r = 0.40, P = 0.025). In contrast, in women with impaired glucose tolerance (n = 17), these correlations were not significant. Plasma leptin did not correlate with insulin sensitivity independently of body fat content. To study whether the correlation between leptin and insulin would be explained by insulin stimulating leptin secretion, we examined plasma leptin during hyperinsulinemic conditions (689 +/- 41 pmol/l), under both euglycemia (5.0 mmol/l, n = 10) and hypoglycemia (2.5 mmol/l, n = 7). However, under both these conditions, plasma leptin was unaltered. In conclusion, plasma leptin 1) reflects body fat content and 2) correlates to insulin secretion independently of percent body fat in postmenopausal women with normal glucose tolerance.

Adipose Tissue↗

PubMed1996

Androgen activity as a risk factor for impaired glucose tolerance in postmenopausal women.

OBJECTIVE: Low sex hormone-binding globulin (SHBG) has been proposed as a risk factor for NIDDM development in women. Our aim was to study the relationship between SHBG and androgen activity and glucose tolerance, as well as insulin sensitivity, in women with impaired glucose tolerance (IGT). RESEARCH DESIGN AND METHODS: We studied 22 women with IGT and 46 women with normal glucose tolerance (NGT) aged 57-59 years. Free testosterone (androgen activity) was determined as the testosterone-to-SHBG ratio. A World Health Organization 75-g oral glucose tolerance test (OGTT) was performed, and insulin sensitivity was measured with a euglycemic-hyperinsulinemic clamp. RESULTS: Fasting glucose (P = 0.021), 2-h blood glucose after the OGTT (P < 0.001), and fasting insulin (P = 0.009) were higher in the IGT group, while insulin sensitivity did not differ significantly between the two groups (P = 0.065). We found that SHBG levels were lower in the IGT group (P = 0.004), while the testosterone-to-SHBG ratio was higher in the IGT than in the NGT group (P = 0.004). Insulin sensitivity correlated negatively with testosterone-to-SHBG ratio in both groups. The correlation was higher in the IGT (r = -0.67, P = 0.001) than in the NGT group (r = -0.29, P = 0.047). In contrast, the 2-h blood glucose correlated with testosterone-to-SHBG ratio in the IGT (r = 0.66, P = 0.001) but not the NGT group (r = -0.04, NS). CONCLUSIONS: Postmenopausal women with IGT have higher androgen activity than women with NGT, and the androgen activity correlates with the degree of glucose intolerance in IGT. Furthermore, in women with IGT, who have a high risk of NIDDM development, androgen activity seems to have an enhanced negative influence on insulin sensitivity. Therefore, androgen activity appears to be a risk factor for IGT.

Blood Glucose↗

PubMed1996

Potential therapeutic levels of glucagon-like peptide I achieved in humans by a buccal tablet.

OBJECTIVE: Glucagon-like peptide I(7-36) (GLP-I) amide, an endogenous incretin, has been identified as a potential adjunct to the treatment of NIDDM and has been studied following intravenous and subcutaneous injection. A mucoadhesive buccal GLP-I tablet containing 119 nmol has been developed to provide transmucosal absorption as a possible alternative to injection treatment. RESEARCH DESIGN AND METHODS: Eight healthy volunteers received a single tablet under fasting conditions in this randomized double-blind placebo-controlled study. A total GLP-I immunoreactivity was measured using COOH-terminal radioimmunoassay (RIA) (total peptide activity) and NH2-terminal RIA (active, nondegraded peptide). RESULTS: The mean (+/- SE) peak GLP-I concentration was 117 +/- 19 pmol/l and occurred 30 +/- 4 min after application. The mean placebo-adjusted area under curve was 8,145 +/- 873 pmol.min-1.l-1, consistent with a relative bioavailability of 7% versus intravenous injection and 47% versus subcutaneous injection. The levels of active peptide increased in parallel with total GLP-I. Half-life of peptide activity after buccal administration was 27 and 24 min measured with COOH-terminal and NH2-terminal RIA, respectively. Placebo adjusted insulin concentrations increased to a peak of 252 +/- 57 pmol/l, glucose decreased 1.4 +/- 0.2 mmo/l, and glucagon decreased 17 +/- 3 ng/l, consistent with the increase in plasma GLP-I concentrations. CONCLUSIONS: Therapeutic plasma levels of GLP-I in humans were achieved after a single buccal tablet. No increased degradation of GLP-I was found in the buccal mucosa compared to subcutaneous tissue. This alternative treatment form may be feasible in in the future for NIDDM.

Absorption↗

PubMed1996

Correlations between fatty acid composition of the erythrocyte membrane and blood rheology data.

The fatty acid composition of erythrocyte membrane phospholipids (phosphatidyl choline, PC, and phosphatidyl ethanolamine, PE) and erythrocyte filterability was studied in seven subjects with type II diabetics before and after change of therapy from oral hypoglycaemic agents to insulin. For comparison the same variables were also studied in 10 healthy controls. In the diabetic group the greatest changes in fatty acid composition were found before treatment in the PE fraction, corresponding to the inner part of the red cell membrane. We found increased values for 16:0 (p < 0.001), 18:1 (p < 0.01) and 20:4 (omega-6) (p < 0.05) and decreased values for 16:1 (p < 0.01) and 18:3 (omega-6) (p < 0.001), compared to values for the healthy controls. The proportion of fatty acids in the inner leaflet of the membrane did not correlate to the red cell filtrability in diabetics or healthy subjects. In the PC fraction, which corresponds to the outer leaflet of the erythrocyte membrane, we found higher values for 16:0 (NS), 18:1 (p < 0.05), 20:4 (omega-6) (NS) and 22:5 (omega-3) (p < 0.01), and lower values for 16:1 (p < 0.05) in diabetics, compared to healthy controls. In the PC fraction an increased proportion of 16:0 was inversely correlated with red cell transit time (RCTT) (p < 0.05), and increased proportions of 16:1 and 18:0 were correlated with a high RCTT (p < 0.05). Insulin treatment did not significantly change red cell deformability or the fatty acid composition of the red cell membrane. Our results also indicate that palmitic acid (16:0) may be favourable in the PC fraction and stearic acid (18:0) unfavourable with respect to the rheological properties of erythrocytes.

Aged↗

PubMed1995

Structure-activity relationship of omeprazole and analogues as Helicobacter pylori urease inhibitors.

Helicobacter pylori urease belongs to a family of highly conserved urea-hydrolyzing enzymes. A common feature of these enzymes is the presence of two Lewis acid nickel ions and a reactive cysteine residue in the active site. The H+/K(+)-ATPase inhibitor omeprazole is a prodrug of a sulfenamide which covalently modifies cysteine residues on the luminal side of the H+/K(+)-ATPase of gastric parietal cells. Omeprazole and eight analogues were selected based on their chemical, electronic, and kinetic properties, and each was incubated with viable H. pylori in phosphate-buffered saline at pH 7.4 for 30 min, after which 100 mM urea was added and the amount of ammonia formed analyzed after a further 10 min. Inhibition between 0% and 100% at a 0.1 mM concentration was observed for the different analogues and could be expressed as a function of the pKa-value of the pyridine, the pKa-value of the benzimidazole, the overall lipophilicity, and, most importantly, the rate of sulfenamide formation, in a quantitative structure-activity relationship. The inhibition was potentiated by a lower pH (favoring the formation of the sulfenamide) but abolished in the presence of beta-mercaptoethanol (a scavenger of the sulfenamide). Structural analogues incapable of yielding the sulfenamide did not inhibit ammonia production. Treatment of Helicobacter felis-infected mice with 230 mumol/kg flurofamide b.i.d. for 4 weeks, known to potently inhibit urease activity in vivo, as a means of eradicating the infection, was tested and compared with the effect of 125 mumol/kg omeprazole b.i.d. for 4 weeks. Neither treatment proved efficacious.

Ammonia↗

PubMed1995

The diagnostic and prognostic importance of ambulatory ST recording compared to a predischarge exercise test after an episode of unstable angina or non-Q wave myocardial infarction.

The diagnostic and prognostic value of ambulatory ST recordings after admission to the CCU and before discharge was compared to a symptom-limited predischarge exercise test in 170 men with unstable angina pectoris or non-Q wave myocardial infarction. ST depression in recordings before discharge identified a small group of patients (18%) out of whom 23% had a myocardial infarction within 3 months compared to 7% in those without this finding. The exercise test gave more diagnostic information, with ST depression found in 52% including 70% of those with ST depression at Holter monitoring. After 3 months, 13% of patients with ST depression at exercise test had a myocardial infarction compared to 5% in the other patients. ST depression at exercise also indicated an increased risk of myocardial and future severe angina over a longer time period. Thus ST recordings are recommended before discharge in all patients after an episode of unstable coronary artery disease as it identifies the patients with the most severe prognosis who might benefit from early revascularization. In those without ST depression at Holter a predischarge exercise test will give further information regarding the long-term risk for angina and coronary events.

Administration, Oral↗

PubMed1995

Effects of arginine on the secretion of insulin and islet amyloid polypeptide in humans.

Islet amyloid polypeptide (IAPP) is synthesized in islet B cells and stored in the secretory granules. We examined whether IAPP and insulin are released in parallel in humans. Arginine hydrochloride (5 g) was injected intravenously at three glucose levels in 11 healthy 58-year-old female subjects. In the fasting state (plasma glucose, 4.9 +/- 0.3 mM), serum insulin levels were 62 +/- 8 pM and plasma IAPP levels were 5.9 +/- 0.8 pM (r = 0.74, p < 0.01; insulin/IAPP ratio, 13.4 +/- 3.6). The insulin response to arginine was 426 +/- 84 pM (p < 0.001), whereas the IAPP response was 4.9 +/- 1.8 pM (p < 0.01) (r = 0.93, p < 0.001). At 16.3 +/- 0.5 mM glucose, the insulin response was increased to 1,516 +/- 325 pM (p < 0.001), whereas the IAPP response was increased to 10.4 +/- 2.8 pM (p < 0.01) (r = 0.91, p < 0.001). No further increases were seen at 35.0 +/- 2.0 mM glucose. The ratios of insulin response/IAPP response, which represent the relative secretion of the two peptides, were 169 +/- 31, 158 +/- 17, and 162 +/- 17, at the three glucose levels. Thus, the ratios of the insulin/IAPP responses to arginine were the same regardless of the glucose level, and the insulin and IAPP responses to arginine were highly correlated with each other at all glucose levels. We conclude that the two peptides are cosecreted in strict parallelism after arginine stimulation in humans over a wide range of glucose levels.

Amyloid↗

PubMed1995

Continuous monitoring of irrigating fluid absorption during transurethral surgery.

We have designed an automatic detector system for noninvasive monitoring of irrigating fluid absorption during transurethral resection of the prostate. Ethanol, which is used as a tracer for the fluid, is measured in the expired breath of the patient. The breath ethanol monitor can be used both in the awake patient and during general anaesthesia. A lap-top computer controls the monitor and calculates the fluid absorption 1-3 times per min and uses the pattern of ethanol changes to indicate whether the fluid is being taken by the intra- and/or extravascular route. The monitor has been used in routine operations for one year. The interpretation of absorption routes was checked by control methods or by evaluation of the postoperative breath-ethanol curve. We found the indicated absorption to be correct in all resections with absorption large enough for the monitor to present an interpretation.

Absorption↗

PubMed1995

Fasting blood glucose in determining the prevalence of diabetes in a large, homogeneous population of Caucasian middle-aged women.

OBJECTIVES: To determine the usefulness of a single, fasting blood glucose (FBG) value in measuring the prevalence of diabetes mellitus in a large, homogeneous population. DESIGN: Fasting blood glucose and 2-h oral glucose tolerance test (OGTT) values were determined. Based on the results of the OGTT, the sensitivity and specificity of different cut-off levels of FBG for the diagnosis of diabetes were assessed. ROC (receiver operating characteristic) analysis was performed on the data. SETTING: A health screening unit at the University Hospital in Malmö, Sweden. SUBJECTS: A total of 1843 Caucasian women without known diabetes aged 55-57 years. RESULTS: The prevalence of previously undiagnosed diabetes was 3.9% and the prevalence of impaired glucose tolerance (IGT) was 27.9% using the WHO cut-off values for 2-h blood glucose values after an OGTT. With an FBG cut-off value of 6.7 mmol L-1, the sensitivity of a single FBG value was 36.6%. Reducing the cut-off value to 6.0 mmol L-1 increased the sensitivity to 53.4%. At a cut-off level of 4.8 mmol L-1, the sensitivity reached the high value of 85.9%, but the specificity was only 45% and the predictive value of a positive test as low as 5.9%. ROC analysis showed that the optimal cut-off value for FBG in this population was 5.3 mmol L-1, giving a sensitivity and specificity of 77% but a positive predictive value of only 11.9%. CONCLUSIONS: This study has shown that in a large and homogeneous Caucasian population of women aged 55-57 years with a high prevalence of IGT, a single FBG value is not useful as a screening tool for diabetes mellitus.

Blood Glucose↗

PubMed1995

Nicotine attenuates the ventilatory response to hypoxia in the developing lamb.

Decreased ability to generate a hyperventilatory response to hypoxemia is believed to be an important mechanism in the pathophysiology of sudden infant death syndrome, and maternal smoking is a leading risk factor. To investigate whether there may be a link between these two observations, we studied five lambs at mean ages of 7, 17, and 27 d to determine the effects of an i.v. infusion of nicotine (0.5 microgram/kg/min) on ventilation when peripheral chemoreceptor activity was stimulated by hypoxia (0.1 FiO2) or briefly inhibited by hyperoxia. Ventilatory measurements were performed using a computer-aided occlusion valve device which permitted breath-by-breath determinations of inspiratory occlusion pressures (P0.1) and minute ventilation. Nicotine attenuated the early ventilatory response to hypoxia (min 1, 2, and 3 of the test) by 8, 26, and 37%, respectively, at the age of 7 d (analysis of variance overall, p < 0.05), by 23%, 23 and 37% at 17 d (p = NS) and by 40, 45, and 37% at 27 d (p < 0.05). The decrease in ventilation in response to hyperoxia during the control study without nicotine was 18, 35, and 34% at 7, 17, and 27 d, respectively. Nicotine caused a greater decrease in the response: 31, 45, and 46%, respectively, (p < 0.05 at 27 d). The paradoxical effects of nicotine, attenuation of the ventilatory response to hypoxia and augmentation of the response to hyperoxia, suggest that nicotine altered peripheral chemoreceptor oxygen sensitivity and most likely also affected central processing of the chemoreceptor input.(ABSTRACT TRUNCATED AT 250 WORDS)

Age Factors↗

PubMed1995

Glucose modulation of insulin and glucagon secretion is altered in impaired glucose tolerance.

Insulin and glucagon secretion was compared in women with impaired glucose tolerance (IGT; n = 19, age 58.4 +/- 0.3 yr; mean +/- SD) and women with normal glucose tolerance (NGT; n = 40, age 58.4 +/- 0.3 yr). Fasting plasma insulin levels were higher in IGT than in NGT (P = 0.026), whereas fasting glucose and glucagon levels were not different. Arginine was injected intravenously (5 g), which rapidly stimulated insulin and glucagon secretion in all subjects. Raising the blood glucose (BG) to 14 and 28 mmol/L potentiated insulin secretion and inhibited glucagon secretion. The acute insulin response to arginine (AIR = 2-5 min postload increase) at BG 14 mmol/L, but not at fasting BG or BG 28 mmol/L, was lower in IGT than in NGT (P = 0.033), as was the glucose potentiation of AIR (slopeAIR) (P = 0.020). The acute glucagon response (AGR) was higher in IGT than in NGT at BG 14 mmol/L (P = 0.016). SlopeAGR (glucose inhibition of AGR) was reduced in IGT (P = 0.001). In NGT, there was a significant inverse correlation between slopeAIR and slopeAGR (P = 0.002) not seen in IGT. We conclude that in IGT with normal fasting BG, the glucose modulation of islet function is impaired, indicating that islet dysfunction is an early lesion during the development of noninsulin-dependent diabetes mellitus.

Arginine↗

PubMed1995

UPPP for habitual snoring: a 5-year follow-up with respiratory sleep recordings.

Fifty-six men who underwent uvulopalatopharyngoplasty (UPPP) because of habitual snoring without preoperative obstructive sleep apnea (OSA), according to respiratory sleep recordings, were interviewed concerning persistent snoring and excessive daytime sleepiness (EDS). Renewed recordings were made in 53 of them at a median time of 63 months postoperatively. Median preoperative oxygen desaturation index (ODI) was 0; the median postoperative index was 1. Median duration of the preoperative obstructive respiratory pattern was 8% of total sleeping time, and the median duration postoperatively was 17%. (Significant individual increases were P = .0005 and P = .004, respectively.) Six patients answered to OSA criteria postoperatively. Weight increases were significantly correlated to increases in both ODI and obstructive respiratory pattern and to persistent snoring. Preoperatively 51 of 56 patients reported EDS, and 73% of the patients were improved or cured. From snoring, 87% reported improvement or cure. No patient had any serious sequelae of UPPP. Uvulopalatopharyngoplasty is a safe and effective treatment for habitual snoring, but it does not give absolute protection from development of OSA.

Body Mass Index↗

PubMed1995

Changes of blood viscosity in patients treated with 5-fluorouracil--a link to cardiotoxicity?

Cardiotoxicity is a serious but relatively unknown side-effect of treatment with 5-fluorouracil (5-FU). The underlying mechanism of 5-FU cardiotoxicity has not been defined. The aim of the present study was to determine whether hemorheological factors might in part explain 5-FU cardiotoxicity. Changes of blood and plasma viscosity, fibrinogen and hematocrit were studied in 11 patients treated by 5-FU. The study showed a decrease in blood and plasma viscosity during treatment with 5-FU, probably caused by a decrease of plasma fibrinogen. Reversible cardiotoxic effects were demonstrated in four patients.

Adult↗