Search PubMed⌕ Search

Biomedical subjects

I Jialal

Publications and source records attributed to I Jialal.

At least 109 records · Page 6Linked to original sources
PubMed1990

125I-insulin binding to circulating erythrocytes, monocytes and cultured fibroblasts in non-obese patients with polycystic ovarian disease.

The insulin receptor status of circulating erythrocytes, monocytes and cultured fibroblasts were studied in non-obese Indian women with polycystic ovarian disease (PCOD) with no clinical evidence of acanthosis nigricans and age, height and weight matched reference subjects. The women with polycystic ovaries had decreased mean maximum specific binding to erythrocytes (PCOD 7.4 +/- 0.6%, normal women 11.5 +/- 0.3%; p less than 0.0001) and monocytes (PCOD 2.4 +/- 0.3%, normal women 4.1 +/- 0.4%; p less than 0.003) when compared to the normal women. This decreased binding was attributed to a change in both receptor number and affinity. 125I-insulin binding to cultured fibroblasts revealed similar mean maximum specific binding and affinity values in both groups studied. Although further work is necessary to exclude genetic or post-receptor defects, it is likely that an environmental factor is implicated in the decreased 125I-insulin binding to erythrocytes and monocytes.

Adult↗
PubMed1989

Insulin and C-peptide secretion in non-obese patients with polycystic ovarian disease.

Plasma glucose, immunoreactive insulin (IRI) and C-peptide responses during an oral glucose tolerance test (oGTT) were assessed in 11 non-obese patients with polycystic ovarian disease (PCOD) and 11 reference subjects matched for age, height and weight. Also, 6 patients with PCOD and 6 normal women were subjected to intravenous glucose tolerance testing (ivGTT) On oGTT, all subjects exhibited normal glucose tolerance; however, PCOD patients had significantly higher mean plasma glucose levels at 30, 60, 90 and 120 min and higher mean incremental glucose areas. In addition the patients with polycystic ovaries showed higher mean basal IRI and C-peptide levels, higher mean glucose stimulated IRI and C-peptide levels and higher mean incremental IRI and C-peptide values. The molar ratios of C-peptide/IRI were significantly lower in the PCOD group at all time intervals after glucose stimulation when compared to the normal women. During ivGTT, there were significantly higher mean glucose levels at 5, 40, 50 and 60 min in the PCOD group when compared to the reference group. The IRI response to intravenous glucose in the PCOD women was similar to the reference group. The findings on oGTT suggest that non-obese patients with PCOD have increased pancreatic IRI secretion as well as impaired hepatic extraction of the hormone.

Administration, Oral↗
PubMed1989

Prognostic importance of admission plasma glucose in diabetic and non-diabetic patients with acute myocardial infarction.

We assessed the relationship of plasma glucose concentrations measured on admission to mortality during the acute phase of myocardial infarction in 143 diabetic patients and 277 patients without a previous history of diabetes. Mortality in hospital in patients not known to have diabetes increased significantly from 4 per cent in patients with admission plasma glucose below 8 mmol/l to 35 per cent in patients with admission plasma glucose above 11 mmol/l. In diabetic patients the mortality increased with increasing admission plasma glucose but the difference was not significant. In patients with diabetes mean admission plasma glucose levels of the survivors and those who died were similar, whilst in the non-diabetic group the mean plasma glucose levels of the patients who did not survive were significantly higher than those of the survivors. Stepwise logistic regression analyses identified admission plasma glucose level as an important predictor of mortality in the non-diabetic group but not in the diabetic patients. Plasma glucose level on admission is an important prognostic indicator in non-diabetic patients, in that hyperglycaemia is associated with a higher mortality. In diabetic patients a clear relationship between admission plasma glucose and mortality was not demonstrated.

Adult↗
PubMed1989

Differences in the metabolism of oxidatively modified low density lipoprotein and acetylated low density lipoprotein by human endothelial cells: inhibition of cholesterol esterification by oxidatively modified low density lipoprotein.

The rate of degradation of oxidatively modified low density lipoprotein (Ox-LDL) by human endothelial cells was similar to that of unmodified low density lipoprotein (LDL), and was approximately 2-fold greater than the rate of degradation of acetylated LDL (Ac-LDL). While LDL and Ac-LDL both stimulated cholesterol esterification in endothelial cells, Ox-LDL inhibited cholesterol esterification by 34%, demonstrating a dissociation between the degradation of Ox-LDL and its ability to stimulate cholesterol esterification. Further, while LDL and Ac-LDL resulted in a 5- and 15-fold increase in cholesteryl ester accumulation, respectively, Ox-LDL caused only a 1.3-fold increase in cholesteryl ester mass. These differences could be accounted for, in part, by the reduced cholesteryl ester content of Ox-LDL. However, when endothelial cells were incubated with Ac-LDL in the presence and absence of Ox-LDL, Ox-LDL led to a dose-dependent inhibition of cholesterol esterification without affecting the degradation of Ac-LDL. This inhibitory effect of Ox-LDL on cholesteryl ester synthesis was also manifest in normal human skin fibroblasts incubated with LDL and in LDL-receptor-negative fibroblasts incubated with unesterified cholesterol to stimulate cholesterol esterification. Further, the lipid extract from Ox-LDL inhibited cholesterol esterification in LDL-receptor negative fibroblasts. These findings suggest that the inhibition of cholesterol esterification by oxidized LDL is independent of the LDL and scavenger receptors and may be a result of translocation of a lipid component of oxidatively modified LDL across the cell membrane.

Acetylation↗
PubMed1988

Spectrum of thyroid function abnormalities in gestational trophoblastic neoplasia.

The relative influences of the putative thyroid stimulator, pregnancy state and non-thyroidal illnesses, were assessed in 52 patients with gestational trophoblastic neoplasia (GTN). In this study biochemical thyroid status was assessed with the aid of thyrotrophin (TSH) measurements by a sensitive immunoradiometric assay and measurement of total and free thyroid hormone concentrations. The reference group consisted of 63 patients with normal pregnancy. Thyroid function in the GTN patients was also compared with that in 36 female patients with Graves' disease and 34 female patients with non-thyroidal illnesses. We found the major influence on thyroid functions in Group I ('Hyperthyroid') patients with GTN to be the presence of the thyroid stimulator, while non-thyroidal illnesses played an important role in Group II ('High T4 syndrome') and III ('euthyroid') patients with GTN. Thyroid function was also stimulated in Group II patients. The influence of pregnancy was seen in all three groups of patients with GTN, who had higher TBG concentrations than non-pregnant patients. We conclude that there is a spectrum of thyroid function abnormalities in GTN, and that thyroid function in an individual patient is determined by the relative influence of the thyroid stimulator, non-thyroidal illnesses and the pregnancy.

Adolescent↗
PubMed1988

The low plasma testosterone levels of young Indian infarct survivors are not due to a primary testicular defect.

A case control study was performed to determine whether the hypotestosteronaemia described in men with coronary artery disease could be the result of primary testicular dysfunction. Testicular function was assessed by comparing the response of 10 young Indian men with myocardial infarction to human chorionic gonadotrophin (HCG) injection to that of 10 healthy age and weight matched controls. The basal testosterone levels in the patients were significantly lower (12.71 +/- 1.36 nmol/l vs 16.51 +/- 0.79 nmol/l; P = 0.01) and the basal oestradiol levels significantly higher than the controls (120.67 +/- 8.81 pmol/l vs 94.05 +/- 8.23 pmol/l; P = 0.02). There was no difference in the sex hormone binding globulin concentrations. However, following HCG stimulation the patients demonstrated a normal response with a 2-fold increase in testosterone. There was no difference in the testosterone and oestradiol levels of the patients and controls following HCG stimulation. This normal response in our patients demonstrates that the hypotestosteronaemia in Indian men with myocardial infarction is not due to a primary testicular dysfunction but probably is a result of increased aromatization of testosterone to oestradiol.

Adult↗
PubMed1988

Plasma lipids can be reliably assessed within 24 hours after acute myocardial infarction.

Total serum cholesterol and triglycerides were measured in 159 Indian patients (134 males) with acute myocardial infarction during their stay in hospital (days 1 and 2) and 3 months later in order to assess whether lipid levels measured soon after acute myocardial infarction represent basal values. Early and 3 month lipid levels were also compared according to the sex and glucose tolerance of the patients. The mean total cholesterol levels on admission (day 1) were comparable to the 3 month values in both men (6.09 +/- 0.10 vs 6.18 +/- 0.09 mmol/l) and women (6.75 +/- 0.30 vs 6.44 +/- 0.22 mmol/l) irrespective of glucose tolerance. In the entire group cholesterol levels on day 2 were significantly lower than the admission and 3 month values. Nevertheless there was a significant correlation between day 2 and 3 month values (P less than 0.0005). Serum triglyceride levels on day 2 were influenced by glucose tolerance and were significantly lower than the 3 month values in patients with normal glucose tolerance but not in patients with abnormal glucose tolerance. However there with a significant correlation between day 2 triglyceride values in patients with both normal and abnormal glucose tolerance. These results suggest that serum cholesterol measured on admission after acute myocardial infarction may be reliably used to represent basal values in both men and women irrespective of glucose tolerance. Although cholesterol and triglycerides measured on day 2 vary with either the gender or glucose tolerance of the patients, these values are still a useful guide to the patients' basal lipid state.

Adult↗
PubMed1988

Abnormal glucose tolerance is the dominant risk factor in South African Indian women with myocardial infarction.

Risk factors for coronary artery disease were determined at least 3 months following myocardial infarction in 90 Indian women between the ages of 26 and 60 years. The risk factors were analysed according to age (greater than 45 vs. less than or equal to 45 years) and also their prevalence was compared to that of 76 healthy age- and sex-matched Indian controls. In the total patient cohort, 98% had at least one major coronary risk factor. Older patients (greater than 45 years) were characterized by a higher risk profile: mean number of risk factors 2.7 compared to 1.9 in women less than or equal to 45 years (p less than 0.005). Diabetes mellitus was the commonest risk factor and was present in 78% of patients. While diabetes mellitus was detected with similar frequency in both age groups of patients (79 and 77%), hypertension, lipid aberrations and family history of myocardial infarction were encountered more frequently in the older women. Compared to the control population, the patients had a higher frequency of lipid abnormalities (p less than 0.0005), obesity (p less than 0.01) and a positive family history of myocardial infarction in first-degree relatives (p less than 0.01). The prevalence of smoking was low both among patients (10%) and control subjects (5%). This analysis thus indicated that of the identifiable risk factors, diabetes mellitus was most prominent in all age groups with hypertension and lipid aberrations being significant synergistic factors in the older women.

Adult↗
PubMed1988

Evidence for increased absorption of glucose and decreased hepatic extraction of insulin in South African Indians.

It has been previously demonstrated that Indians have an exaggerated insulin response to oral glucose when compared to Africans. In an attempt to determine the reasons for this phenomenon matched groups of Indian and African volunteers were subjected to oral and intravenous glucose tolerance testing. It was concluded that the increased absorption of glucose and reduced hepatic extraction of insulin contributed to the hyperinsulinism in Indians.

Adult↗
PubMed1988

Autoantibodies to thyroxin and triiodothyronine.

Two clinically euthyroid patients with multinodular goiter were found to have high "free" thyroxin (Amerlex-M, Amersham and Coat-a-Count, DPC) and triiodothyronine (Amerlex-M) concentrations (FT4 and FT3, respectively). The presence of antibodies to T4 and T3 was confirmed by the finding that polyethylene glycol precipitated a far greater proportion of radioactivity when radiolabeled FT4 or FT3 analog (Amerlex-M) was incubated with serum from these patients than was true for normal subjects. With this method we could not demonstrate antibodies to thyroid hormones in 116 healthy volunteers. Of 101 hyperthyroid patients tested, one had antibodies to T4 but none had antibodies to T3. One patient had antibodies to T4, and one to T3, of 36 hypothyroid patients tested. All patients with thyroid hormone antibodies also demonstrated antithyroglobulin antibodies (measured immunoradiometrically). Evidently, the presence of thyroid hormone antibodies should be suspected when results of thyroid-function tests are discordant with the clinical state, and we suggest that measurement of thyrotropin by an assay with improved detection limits will aid in correctly determining thyroid status.

Adolescent↗
PubMed1987

Hyperparathyroidism in twin pregnancy. A case report.

Primary hyperparathyroidism (PHPT) and associated bony changes are rare in pregnancy; the approach to this condition and its management are discussed. This is probably the first report of PHPT in twin pregnancy and the clinical, radiological and biochemical features are described.

Adult↗
PubMed1987

Management of diabetes mellitus.

The management of diabetes mellitus involves patient education and dietary modifications, both of which play a key role in determining the success of therapy. Other therapeutic measures include oral hypoglycaemic agents and insulin. In type II diabetic patients not responding to diet alone the second-generation sulphonylureas are preferred. Biguanides are indicated in the very obese type II diabetic, provided there are no contraindications. Where insulin therapy is indicated (e.g. type 1 diabetes mellitus), the trend is to use a human preparation because it evokes a very weak antibody response. Optimal diabetes control, as gauged by home blood glucose monitoring and glycosylated haemoglobin levels or, in the case of type II diabetics, fasting blood glucose levels, prevents the acute symptoms of diabetes mellitus as well as coma and in addition appears to minimise the risk of vascular complications.

Biguanides↗
PubMed1987

A sensitive immunoradiometric assay for serum thyroid-stimulating hormone. A first-line investigation for thyroid function.

The value of a highly sensitive immunoradiometric assay for thyroid-stimulating hormone (TSH) in distinguishing between hyperthyroid patients and normal controls is discussed. The assay has a sensitivity of 0.3 microU/ml and correctly categorised all patients in this study as either hyperthyroid or euthyroid. An approach to thyroid function testing using this sensitive TSH assay as a first-line investigation is presented.

Adult↗
PubMed1987

The occurrence of Z-type diabetes (tropical pancreatic diabetes) in the South African Indian.

The presentation of diabetes in the young South African Indian is atypical in that insulin-dependent diabetes mellitus is rare, while non-insulin-dependent diabetes mellitus is common. In addition, youthful onset of tropical diabetic syndrome (J-type diabetes) is extremely rare. To date there appear to be no reports on a further tropical malnutrition diabetic syndrome associated with pancreatic fibrosis and calcification (Z-type diabetes). Four Indian patients with features consistent with the diagnosis of Z-type diabetes are described. All were asthenic, came from a poor socio-economic background and developed insulin-requiring diabetes in their youth; 3 of the 4 patients had pancreatic calcification.

Adolescent↗
PubMed1987

Risk factors in young Indian males with myocardial infarction.

Risk factors were assessed in 108 young Indian males with myocardial infarction. The mean age was 36 years (range 21-40 years). Cigarette smoking was the most common risk factor (79% of patients). Serum cholesterol levels were above 6.5 mmol/l in 50% and serum triglyceride levels were above 2.0 mmol/l in 53% of patients. High-density lipoprotein cholesterol levels below 0.83 mmol/l were found in 52% of patients. Ninety-six per cent of patients had one or more of the following risk factors: a history of cigarette smoking, hypercholesterolaemia, hypertension, and abnormal glucose tolerance. Thus, in young Indian males with myocardial infarction, one or more risk factors are usually present.

Adult↗
PubMed1987

Evaluation of the integrated 3-hour plasma cortisol concentration as a test for Cushing's syndrome.

Twenty-four hour urinary free cortisol and mean and integrated 13h00-16h00 plasma cortisol levels were measured in 9 patients with proven Cushing's syndrome (5 with Cushing's disease, 2 with ectopic adrenocorticotrophic hormone production due to bronchial carcinoma and 2 with adrenal adenomas) and in 21 patients without Cushing's syndrome. The 24-hour urinary free cortisol levels and mean and integrated 13h00-16h00 plasma cortisol estimations clearly distinguished patients with Cushing's syndrome from those without. However, adequate suppression on dexamethasone suppression tests (false negatives) were obtained in 3 of the 9 patients with Cushing's syndrome. Since the integrated 13h00-16h00 plasma cortisol estimation is cheaper and simpler than the mean 13h00-16h00 plasma cortisol estimation, we recommend it as an adjunct in the diagnosis of Cushing's syndrome.

Cushing Syndrome↗