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J Soler

Publications and source records attributed to J Soler.

At least 37 records · Page 2Linked to original sources
PubMed2003

Ultrasonographic thyroid volume as a reliable prognostic index of radioiodine-131 treatment outcome in Graves' disease hyperthyroidism.

OBJECTIVE: We studied the relationship between thyroid volume, thyroid function and immunological markers of Graves' disease (GD) to determine prognostic factors of treatment response to low-dose radioiodine-131 (131I). MATERIAL AND METHODS: A prospective study of 40 patients with GD hyperthyroidism treated with 131I (141 +/- 85MBq) and 10 GD patients who went spontaneously into remission (controls). Free T4, total T3 and basal TSH levels, TSH-receptor antibodies (TRAb) and anti-thyroid peroxidase antibodies (TPOAb) were studied. Thyroid volume was determined by ultrasonography. Logistic regression models were used to predict the probability of final thyroid status. Receiver-operating characteristics (ROC) curves and Hosmer Lemeshow tests were used to evaluate the final statistical models. RESULTS: Of 40 patients treated with 131I, 16 became euthyroid, 12 hyperthyroid and 12 hypothyroid at 12 months. Median thyroid volume was reduced from 24.8 ml before to 8.5 ml at 12 months (p<0.001). In 10 control patients, the median reduction was from 16.6 ml to 11.3 ml (p=0.029). Thyroid volume reduction was lower in the hyperthyroid than in the euthyroid group, but higher in the hypothyroid group. Thyroid volume at baseline and at 3 months predicted hyperthyroidism outcome with a cut-off of 45 ml and 24.4 ml, respectively (odds ratio 1.074, p=0.003, ROC curve 0.78 and odds ratio 1.182, p=0.012, ROC curve 0.86 respectively). Thyroid volume at 6 months differentiated the hyperthyroid group with a cut-off of 17 ml. Thyroid volume at 3 and 6 months with a cut-off of 8.5 ml and 9.3 ml respectively, predicts permanent hypothyroidism outcome (odds ratio 0.768 and 0.685, p=0.012 and p=0.008, ROC curve 0.89 and 0.88, respectively). Changes in thyroid echogenicity and TRAb and TPOAb levels did not show any predictive value in the follow-up after 131I therapeutic outcome. CONCLUSION: The study shows that the ultrasonographic thyroid volume at 3 and 6 months after low-dose 131I treatment for GD hyperthyroidism could be a reliable prognostic factor of thyroid function outcome in the first year after treatment, and also reveals that the changes in the thyroid echogenicity and in the immunological markers of GD have no prognostic value.

Adult↗
PubMed2002

Identification and partial purification of K88ab Escherichia coli receptor proteins in porcine brush border membranes.

Six receptor proteins, with molecular masses ranging from 94 to 27 kDa, that bind to Escherichia coli K88ab fimbriae were recovered from brush border membranes and were detected after solubilization with Triton X-114. The recovery of these receptor proteins in the aqueous phase suggests their peripheral localization. The 63-, 60- and 33-kDa K88ab binding proteins were recovered using gel-filtration chromatography of the aqueous phase.

Animals↗
PubMed2002

Successful medical treatment of two patients with eosinophilic oesophagitis.

BACKGROUND/PURPOSE: Significant oesophageal eosinophilia is associated with oesophagitis and gastroesophageal reflux (GER). Eosinophilic oesophagitis is a rare disease that causes thickening of the oesophageal wall, narrowing of the oesophageal lumen, and severe motor disturbance. METHODS AND RESULTS: Two 12 yr-old patients with eosinophilic oesophagitis were studied prospectively. Clinical and investigation details are presented. Elemental formula was administered until complete remission of disease. Final outcome was assessed after 3 months on regular diet with exclusion of specific allergic components. Both patients responded to the dietary manipulation. CONCLUSIONS: Eosinophilic oesophagitis must be included in the differential diagnosis when dealing with oesophageal strictures of unknown or unclear aetiology. Elimination diet therapy plays a crucial role in ameliorating the course of the illness. Blood eosinophilia correlates with therapeutic response and with improvement of the disease.

Barium Sulfate↗
PubMed2002

Pituitary-thyroid axis, thyroid volume and leptin in healthy adults.

OBJECTIVE: Patients with thyroid diseases usually have disturbances relating to body weight and thermogenesis. On the other hand, leptin is involved in the regulation of body weight, food intake and thermogenesis. Some studies have investigated the relationship between leptin and dysthyroid states, but the complex interactions between leptin and pituitary-thyroid axis have led to controversial results. DESIGN: The aims of this cross-sectional study were to investigate the relationship among basal TSH, ultrasonographic thyroid volume and leptin in a group of 268 healthy adults randomly selected from our city, L'Hospitalet de Llobregat, Barcelona, an area free of iodine deficiency. In this euthyroid group, we determined basal TSH, thyroid autoantibodies, leptin concentrations, and thyroid volume by ultrasonography, body anthropometry, and body composition. RESULTS: All subjects were free of goitre and were negative for anti-thyroid antibodies. Basal TSH concentrations were 1.49 +/- 0.8 mU/l in males and 1.67 +/- 0.83 mU/l in females (p = 0.6). Anti-thyroid antibodies were negative in all cases; leptin concentrations were 6.1 +/- 4 ng/ml in males and 16.8 +/- 11.7 ng/ml in females (p = 0.0001). Thyroid volume was 9.8 +/- 4.6 ml in males and 6.5 +/- 2 ml in females (p = 0.001). There were significant correlations among leptin concentrations and anthropometric and body composition variables in both sexes, without correlation with TSH concentrations. There was no significant correlation between anthropometric and body composition variables and thyroid volume in males but there was a correlation in females. In females, there was a positive correlation between leptin and thyroid volume (r = 0.181, p = 0.038). In males, there was a negative correlation between TSH concentrations and thyroid volume (r = - 0.271, p = 0.002). CONCLUSIONS: We did not find any correlation between leptin levels and pituitary-thyroid axis in this control population. The correlation between leptin and thyroid volume in females is probably a consequence that leptin and thyroid volume are regulated in parallel by variables relating to anthropometry and body composition.

Adult↗
PubMed2002

Correlated response to selection for litter size in pigs: I. Growth, fat deposition, and feeding behavior traits.

Data on individually tested pigs from a line selected for litter size (H) and a control line (C) were used to estimate the correlated responses to litter size in growth, fat, and feeding behavior patterns from 75 to 165 d of age. During the test period, BW and ultrasonic midback (UMB) and loin (ULB) backfat were recorded periodically on the same animal. Individual voluntary feed intake (DFI), number of visits (NVD), and feeding time (FTD) were measured on a daily basis using an automatic feeding system. Third degree polynomial models with random regression coefficients were used to describe BW, UMB, ULB, DFI, NVD, and FTD as a function of age. The first derivative of the model for BW was used to estimate growth rate. Several measurements of efficiency were obtained using polynomial models on accumulated DFI, NVD, and FTD. The difference between the genetic means of animals from line H and line C was used to estimate correlated responses. The H pigs showed higher BW throughout most of the test period (2.29 +/- 0.90 kg at 135 d of age, P < 0.05) but they were not different (P = 0.18) from C pigs at the end of the test (102 kg, SD 9). Thus, despite both lines showing similar average growth rate on the test, line H grew faster at the start of the test (34 +/- 11 g/d, P < 0.01), but it grew more slowly by the end (-68 +/- 27 g/d, P < 0.05). Fat deposition rate differed between lines, with H pigs showing higher UMB (1.26 +/- 0.23 mm, P < 0.01) and ULB (1.32 +/- 0.28 mm, P < 0.01) at 165 d of age. The difference between lines in total on-test feed intake was not significant (P= 0.10), but intake was slightly higher in line H between 105 and 135 d of age (2.28 +/- 1.25 kg, P = 0.07). Line H showed a higher feed efficiency up to about 100 d of age, whereas line C performed better from this age until 165 d of age. However, differences never exceeded 18 +/- 6 g of weight gain per kilogram of feed consumption (P < 0.01). Total feed efficiency throughout the test period was slightly higher in line C (1.37 +/- 0.77 kg of weight gain after eating 185 kg of feed, P = 0.08). Lines H and C had distinct feeding patterns with regard to eating frequency. Pigs from line H ate less frequently, but instead they spent more time and ate more per visit. In the long term, selection for litter size could result in pigs with less capacity of lean growth.

Adipose Tissue↗
PubMed2001

[Renal expression of intercellular adhesion molecule-1 (ICAM-1) in IgA deposit mesangial nephropathy. A tubulointerstitial lesion marker].

BACKGROUND: The aim of this study was to determine the significance of the renal expression of ICAM-1 in IgA nephropathy (IgAN). PATIENTS AND METHOD: First, we identified ICAM-1 (CD54) expression in tubular epithelial cells and interstitial leucocytes in renal biopsies from 45 patients with IgAN and 29 patients with non-glomerulonephritis nephropathy (non-GN). We then analysed the relationship between this expression and both histological and clinical data at the time of renal biopsy and after 2.4 (2) (X [SD]) years in IgAN, and 1.8 (1.5) years in non-GN. RESULTS: In IgAN, tubular ICAM-1 positive staining was seen in 25 (55%) biopsies; it was associated with extracapillary proliferation, glomerulosclerosis involving less than 50% of glomerular area, interstitial cell infiltration and tubular atrophy. ICAM-1 positive interstitial leucocytes were 234 (307)/mm2; this expression correlated with glomerulosclerosis, tubular atrophy, interstitial fibrosis and serum creatinine (Cr) level. In patients with 50% increase in Cr level, ICAM-1 positive interstitial leucocytes were 516 (360)/mm2 as compared with 66 (87.8)/mm2 (U = 16; p < 0.005) in patients with stable Cr. In non-GN, tubular ICAM-1 expression was observed in 7 (24%) biopsies. CONCLUSIONS: Tubular and Interstitial expression of ICAM-1 can be a marker of tubulointerstitial damage in IgAN. Interstitial ICAM-1, rather than tubular ICAM-1, may predict the progression of this disease.

Adult↗
PubMed2001

[The impact of COPD on hospital resources: the specific burden of COPD patients with high rates of hospitalization].

OBJECTIVES: 1) To know the impact of chronic obstructive pulmonary disease (COPD) on hospital care (visits to the emergency room and admission); and 2) to identify and describe COPD patients whose use of health care is high (COPD-HC), also assessing the costs generated by such patients. METHOD: We reviewed the files of all patients with COPD receiving care at our hospital in 1998, looking at age, sex, smoking, simple spirometry, arterial gases at rest, number of admissions, duration of hospital stay, and number of visits to the emergency room. After describing the sample, patients were stratified in three groups by use of hospital care: group A, patients not requiring hospital care; group B, patients requiring less care than the COPD-HC group; and group C, COPD-HC. The criteria used to define the COPD-HC group were 1) >= 2 admissions in one year, 2) >= 3 visits to the emergency room, without admission in one year, or 3) 1 admission and 2 visits to the emergency room for COPD exacerbation in one year. RESULTS: Three hundred twenty cases were studied, 3 women (0.9%) and 317 men (99.1%), mean age 71 9 years. One hundred twenty-six patients (39.4%) made 263 visits in 1998, accounting for 1.1% of all emergencies (n = 23,750) and 4.05% of all medical emergencies (n = 6,489). Ninety-two patients (28.7%) were admitted for exacerbation of COPD. One hundred twenty-six admissions were made over the course of the year, accounting for 9.6% of all admissions to the internal medicine wards (n = 1,309). The 39 patients (12.2%) who were classified COPD-HC generated 160 emergency visits (60.8%) and 72 admissions due to COPD (57.1%). The analysis of variation revealed statistically significant differences among the 3 groups for age, FEV1, FVC and PaO2, but not for PaCO2. COPD-HC patients had the lowest values for FEV1, FVC and PaO2 and were older. CONCLUSIONS: COPD generates high demand for hospital care. A small group of COPD patients (12.2%) accounts for nearly 60% of hospital visits for this disease. The group requiring greater care generally has more severe disease (older, more severe bronchial obstruction and hypoxemia).

Adult↗
PubMed2001

[Cushing's disease in the 90's: a review].

Since 1932 when Cushing's disease has been described, several important advances have been made in diagnosis and management. However several points remain obscure and there is no general agreement among authors. An accurate biological diagnosis is one of the difficulties found when we face a patient with hypercortisolism. In addition, corticotropin dependent syndrome should be distinguished from the independent one, as well as identifying the source of ACTH hypersecretion. The main problem in Cushing's disease is to localise the secreting adenoma and at the moment there is not any diagnostic method with absolute sensibility and specificity. Magnetic Resonance Imaging shows a sensibility of 77% and 87% especificity; inferior petrosal sinus sampling may help in localising the side, where the adenoma lies, although an appropriate technique is mandatory. New developing techniques, such as intraoperative doppler and assessment of ACTH levels in the peripituitary veins may help us in localising the source of ACTH hypersecretion. Sometimes the adenoma cannot be identified and a surgical exploration of the pituitary is required. If an adenoma is found, a 89% probility of curation has been reported; on the contrary, incomplete tumor removal, no tumor found at surgery, or the presence of the so-called corticotrop hyperplasia where followed of bad results and may explain the failed surgery. Then, hypofisectomy, hemi-hypofisectomy, radiotherapy, photon knife or gamma knife, may be of help in the control of this condition. We reviewed the recent literature and analysed the diagnostic strategies and teatments currently available for this illness. In addition we propose an algohritm for diagnosis and treatment and analyze our results in a consecutive series of 38 patients.

Adrenocorticotropic Hormone↗
PubMed2001

Leptin in type 2 diabetic or myotonic dystrophic women.

BACKGROUND: Insulin resistance is an important determinant of circulating leptin concentrations in humans, but its independent contribution on plasma leptin levels are controversial. In the present study, we characterized plasma leptin levels and their regulation in women with 2 different insulin resistance states: type 2 diabetes and myotonic dystrophy disease, and in controls. MATERIAL AND METHODS: We studied 3 groups of women: 21 type 2 diabetic patients, 20 myotonic dystrophic patients and a control group of 20 normoglycemic subjects, matched in age and body mass index. Body composition, fasting glucose and insulin, IGF-I, IGF-binding protein-3 and leptin were studied. Body composition was measured using a bioelectrical impedance analyser. Insulin sensitivity (in percentage) was modeled according to a computer-based homeostasis model assessment model. Data are expressed in mean +/- SEM. RESULTS: In both groups of patients, glucose concentrations were higher in type 2 diabetic patients than in myotonic dystrophic patients, and insulin concentrations and insulin sensitivity were similar in the 2 groups of patients (82.4 +/- 18.6% in type 2 diabetic patients vs. 69.7 +/- 9.7% in myotonic dystrophic patients, p = 0.2) and lower than in controls. Serum leptin and leptin/fat mass ratio were higher in myotonic dystrophic patients than in type 2 diabetic patients (30 +/- 4.9 ng/ml vs. 17.7 +/- 2.6 ng/ml, p = 0.03 and 2.32 +/- 0.69 ng/ml/kg vs. 1.07 +/- 0.2 ng/ml/kg, p = 0.02, respectively) or those found in controls. In type 2 diabetic patients, leptin concentrations were correlated with body mass index and body fat, and in myotonic dystrophic patients leptin concentrations were correlated with age, body mass index, fasting insulin and lower insulin sensitivity, whereas leptin concentrations were not correlated with body fat. CONCLUSIONS: These findings suggest that leptin concentrations and regulation in myotonic dystrophic patients are different from type 2 diabetes.

Adult↗
PubMed2001

Body composition assessment in type 1 diabetes mellitus patients over 15 years old.

BACKGROUND: The aim of the present study was to assess the anthropometric characteristics and body composition in type 1 diabetic patients and compare the results with a randomly selected control population. MATERIAL AND METHODS: We studied 75 type 1 diabetic patients, 43 male and 32 female, recruited from consecutive diagnosed type 1 diabetic patients attending the Endocrine Unit and treated with a intensive insulin regimen, and 93 control subjects, 44 males and 49 females representative of the census of this city. We performed a dietary recall in patients and determined anthropometric characteristics, both in patients and controls, body weight, height, body-mass index, waist-hip ratio and body composition parameters: total body water, free-fat mass, body free-fat mass, fat mass and body fat by bioelectrical impedance analyser. RESULTS: In diabetic male patients, we observed lower waist-hip ratio than in controls, 0.84 +/- 0.06 vs. 0.88 +/- 0.07, p = 0.021, higher free-fat mass in female diabetic patients, 48.5 +/- 5.6 vs. 45.6 +/- 5.9 kg, p = 0.03, lower fat mass in male diabetic patients, 9.5 +/- 6.9 vs. 14.6 +/- 8.5 kg, p = 0.003. We did not find any correlation among the parameters of body composition and dietary macronutrient intake in patients. CONCLUSIONS: The present study exposes the differences in anthropometric characteristics and body composition in type 1 diabetes mellitus, especially lower waist-hip ratio in male, higher free-fat mass in female and lower fat mass in male.

Adult↗
PubMed2001

Water metabolism disturbances at different stages of primary thyroid failure.

The aim of the present study was to study salt and water metabolism in thyroid deficiency. We performed an oral water loading test (OWL) and a hypertonic 5% saline infusion test (HSI) in 16 patients with overt primary hypothyroidism before replacement treatment (PRE group) and after, in eight patients with subclinical hypothyroidism (SUB group) and in 16 normal individuals (CG group). In the PRE group, a lower free water clearance was detected in the OWL (P < 0.022), with lower plasma osmolality (OWL: P < 0.005; HSI: P < 0.001) and arginine vasopressin (AVP) (OWL: P < 0.001; HSI: P < 0.001) than the CG group, across both tests; they normalized with the replacement treatment. The same plasma abnormalities were detected in the SUB group with the HSI. Although the AVP and thirst thresholds did not differ between the groups, the lag between them was lower in the PRE (4.1+/-3.2 mOsm/kg) and SUB group (2.6+/-2.1 mOsm/kg) than in the CG group (13.3+/-9.2 mOsm/kg) (P < 0.05). There were no differences in atrial natriuretic hormone (ANH), plasma renin activity (PRA) and plasma aldosterone among the groups. These results indicate that plasma hypo-osmolality and low levels of AVP are present in primary hypothyroidism, and indeed are already present in the subclinical phase of the disease. An overlap between the thresholds of thirst and AVP seem to play a role in these abnormalities, but ANH, PRA and plasma aldosterone do not appear to contribute.

Adolescent↗
PubMed2000

Establishment of reference values for standard dose short synacthen test (250 microgram), low dose short synacthen test (1 microgram) and insulin tolerance test for assessment of the hypothalamo-pituitary-adrenal axis in normal subjects.

OBJECTIVE: To assess the integrity of the hypothalamo-pituitary-adrenal(HPA) axis, many authors have proposed the short synacthen test (ACTH1-24, Tetracosactrin) as a replacement for the insulin tolerance test (ITT). The aim of this study was to compare the plasma cortisol response obtained with both short synacthen tests (high dose (HDT, 250 microgram) and low dose (LDT, 1 microgram)) with the peak reached during the ITT in healthy volunteers, and to establish the plasma cortisol cut-off level in each test. SUBJECTS AND METHODS: Thirty healthy subjects (16 F, 14 M), mean age 34 years, underwent both short synacthen tests. Twenty healthy subjects, 15 of whom (11 F, nine M) belonged to the above group, mean age 30 years, underwent an ITT. Plasma cortisol was measured using a chemiluminiscence immunoassay. RESULTS: There were no differences between plasma cortisol 30 minutes after both short synacthen tests (HDT: 684 +/- 123, LDT: 669 +/- 119 nmol/l) and the peaks reached with the LDT (691 +/- 123 nmol/l) and the ITT (673 +/- 99 nmol/l). The only difference (P < 0.001) was found in the comparison of plasma cortisol peak reached with the HDT (802 +/- 142 nmol/l) with the other tests. Plasma cortisol levels obtained in the 5th percentile in each test were: at + 30 minutes: (HDT: 537, LDT: 489 nmol/l), peak: (HDT 649, LDT 498, ITT: 539 nmol/l). CONCLUSIONS: Comparison of the plasma cortisol response at + 30 minutes with both short ACTH tests and the peak in the insulin tolerance test did not reveal differences. Each test, for each time point and for each biochemical method, requires its own minimum threshold of normality to assess the hypothalamo-pituitary-adrenal axis.

Adult↗
PubMed2000

Serum leptin concentrations in patients with short-bowel syndrome.

BACKGROUND: Short-bowel syndrome is a state of severe malabsorption resulting from absence or removal of the small bowel for several causes. A number of short-bowel patients develop hyperphagia. Leptin, a protein secreted from adipose tissue, signals the amount of energy stores to the brain. OBJECTIVE: To study body composition and leptin regulation in short-bowel patients and to determine whether or not leptin concentrations are linked with hyperphagia. DESIGN: We studied 25 short-bowel patients (remnant bowel less than 150 cm) and 31 controls and 10 oral nutrition. Fifteen patients received total parenteral nutrition and 10 oral nutrition. Anthropometric measurements, body composition (by bioelectrical impedance), and cholesterol, triacylglycerol and leptin concentrations were studied in all subjects. RESULTS: There were no differences between short-bowel patients and controls in anthropometric variables, body composition, or leptin concentrations. Leptin concentrations were higher in short-bowel women than men (9.21+/-8.54 vs. 3.22+/-1.86 ng/ml, P=0.01). Leptin concentrations correlated positively with age (r=0.4, P=0.045), body mass index (r=0.52, P=0.007), fat mass (r=0.67, P=0.001) and body fat (r=0.68, P=0.0001); there were no correlations with other body composition parameters. We found no correlations between parenteral or oral nutrition and body composition parameters, or between leptin concentrations and the presence of hyperphagia. Logistic regression analysis showed that body fat correctly identified leptin concentrations in 60% of patients. CONCLUSIONS: Body composition, leptin concentrations and leptin regulation in patients with short-bowel syndrome are similar to those of controls. Leptin concentrations do not correlate with hyperphagia in short bowel-patients.

Adipose Tissue↗
PubMed2000

Effects of long-term treatment with GH in the bone mineral density of adults with hypopituitarism and GH deficiency and after discontinuation of GH replacement.

BACKGROUND: Only few previous studies have assessed the effects of long-term growth hormone (GH) replacement therapy on bone mineral density (BMD) in adult patients with GH deficiency. The aim of this study was to investigate the effects of long-term GH therapy on bone metabolism and BMD. MATERIAL AND METHODS: At the start of the study, 20 adults with GH deficiency were randomized to receive either GH, 0.25 IU x kg per week, or placebo. After 6 months, patients in the placebo group were switched to GH therapy, and they received GH for a further 18 months. Of the 20 patients, 14 were male and 6 female with GH deficiency of adult-onset. The mean age of the patients at the start of the study was 40.3+/-10.9 years and the duration of GH deficiency was 10.6+/-6.4 years. Patients deficient in pituitary hormones other than GH had been receiving stable replacement doses of appropriate hormones for at least 6 months before the start of the study. Rates of bone metabolism were assessed by measuring calcium, phosphate, alkaline phosphatase, calciuria, phosphaturia and osteocalcin. BMD was measured by dual X-ray absorptiometry. Body composition was calculated from measurements of bioelectrical impedance. RESULTS: Before GH treatment, BMD in the femoral neck was lower in patients than in controls. The rate of bone resorption markers increased significantly after 6 months and remained stable during the whole treatment period. BMD significantly increased in L2-L4 after 12 months of treatment with an increase of Z-score. The total BMD increase was 4.5+/-6.5%. BMD in the femoral neck increased after 12 months with an increase of Z-score after 18 months. The total increase was 10.4+/-18%. The total BMD increase was not different among patients with or without basal osteopenia. In both groups BMD in L2-L4 and in the femoral neck remained stable after 12 months without GH treatment. Sex, age, BMI and the time in which GH deficiency started, before or after the end of the peak of BMD, did not correlate with BMD. The BMD values and their response to GH treatment did not correlate with other associated deficiencies, and we did not find differences among BMD increase and GH dose, levels of insulin-growth factor-I, insulin growth factor binding protein-3, and parameters of body composition. CONCLUSIONS: The results of the study support previous ones that BMD is subnormal in adults with GH deficiency; that GH replacement therapy stimulates bone turnover with initial biochemical changes; and that in the long term, this stimulation results in a significant augmentation in BMD that continues to increase after 2 years and remains stable after 12 months of GH withdrawal.

Absorptiometry, Photon↗
PubMed2000

Determinants of thyroid volume as measured by ultrasonography in healthy adults randomly selected.

OBJECTIVES: The relationship between thyroid volume and anthropometric characteristics is a matter of controversy. The aim of this study was to investigate thyroid volume and its determinants in healthy adult subjects from a noniodine-deficient area. DESIGN AND PATIENTS: Of the 280 000 inhabitants of the city, served by L'Hospitalet de Llobregat, we randomly selected 880 subjects from the census of the city. The participation rate in the study was 44%; after application of several exclusion criteria, a further 28 subjects were excluded because of previously diagnosed thyroid disease. We finally studied 268 subjects representative of the census of the city: 134 male and 134 female, without thyroid disease. We determined the anthropometric characteristics, body mass index, waist-hip ratio, body surface area; body composition by bioelectrical impedance analyser; thyroid volume by ultrasonography; basal TSH, antithyroid antibodies and urinary iodine excretion. RESULTS: Thyroid volume in our population was higher in males (9.19 ml, CI 9.09-10.65) than in females (6.19 ml, CI 6.02-6.92), P = 0.001. Significant correlations were found among thyroid volume and body weight (r = 0.39, P = 0.0001), height (r = 0.44, P = 0.0001), body mass index (r = 0.13, P = 0.02), waist-hip ratio (r = 0.38, P = 0.0001), body surface area (r = 0.48, P = 0.0001), total body water (r = 0.14, P = 0.02), free fat mass (r = 0.47, P = 0.0001), fat mass (r = 0.37, P = 0.001) and body fat (r = 0.32, P = 0.001). Negative correlation was found between thyroid volume and basal TSH (r = -0.26, P = 0.001). No correlations were found among thyroid volume and iodine excretion, previous pregnancies in women, cigarette smoking and alcohol consumption. In a multiple regression analysis with thyroid volume as the dependent variable, body surface area was demonstrated to account for the 44% of variation of thyroid volume (P = 0.0001). CONCLUSION: It is important to know the reference values of the thyroid volume in a population free of iodine deficiency and its determinants. Body surface area accounts for much of the variation of thyroid volume. Age, gender, anthropometric variables, body composition variables and biological variables, do not significantly influence the thyroid volume when considered as possible additions to this baseline model.

Adult↗
PubMed2000

Linear correlation between beta-cell mass and body weight throughout the lifespan in Lewis rats: role of beta-cell hyperplasia and hypertrophy.

We determined the beta-cell replicative rate, beta-cell apoptosis, cross-sectional beta-cell area, and pancreatic beta-cell mass throughout the entire postweaning lifespan (months 1, 3, 7, 10, 15, and 20) of Lewis rats. Beta-cell replication was progressively reduced in the initial months of life but remained stable after month 7 (month 1, 0.99 +/- 0.10%; month 3, 0.24 +/- 0.04%; month 7, 0.12 +/- 0.02%; month 10, 0.14 +/- 0.02%; month 15, 0.10 +/- 0.03%; month 20, 0.13 +/- 0.03%; analysis of variance [ANOVA], P < 0.001). Beta-cell apoptosis was low and did not change significantly from month 1 to 20 of life. Cross-sectional area of individual beta-cells increased progressively in the initial months, remained stable from month 7 to 15, and increased again on month 20. The estimated number of beta-cells per pancreas, calculated as the ratio of total beta-cell mass to individual beta-cell mass, tripled from month 1 to 7 but did not change significantly thereafter. Beta-cell mass increased approximately 8 times from month 1 to 20 (month 1, 2.04 +/- 0.28 mg; month 20, 15.5 +/- 2.32 mg; ANOVA, P < 0.001) and showed a strong and significant linear correlation with body weight (r = 0.98, P < 0.001). In summary, we have shown that beta-cell replication was maintained throughout the lifespan in normal rats, clearly establishing that the beta-cell birth rate does not fall to 0, even in very old rats. Beta-cell mass increased throughout the lifespan, closely matching the increment in total body weight at any time point. This increment was selective for beta-cells, since the growth of the endocrine non-beta-cell mass was limited to the initial months of life. Both beta-cell hypertrophy and hyperplasia contributed to increased beta-cell mass in young animals, but only beta-cell hypertrophy was responsible for the increased beta-cell mass found in old animals. This study provides a global perspective for understanding the dynamics of beta-cell mass in young, adult, and aged animals.

Aging↗
PubMed2000

Bone mineral density in patients with type 1 diabetes mellitus.

Although osteopenia is often reported as a complication of type 1 diabetes mellitus, its frequency and severity remain unclear, and studies of bone mineral density in type 1 diabetics have yielded conflicting results. We measured bone mineral density at the lumbar spine and femoral neck in 88 Spanish adults with type 1 diabetes mellitus responsible for moderately severe complications. Mean age (+/- SD) was 28.9 +/- 8.8 years, and mean disease duration was 11.2 +/- 6.4 years. As compared to normal Spanish adults, bone mineral density was decreased in the patients at the lumbar spine (Z-score, -0.32 +/- 1.08; P < 0.001) but not at the femoral neck (Z-score, -0.21 +/- 1.03; P non-significant). The magnitude of bone loss in the diabetics was small (T-score, -0.38 +/- 1.13 at the lumbar spine and -0.37 +/- 1.08 at the femoral neck). Only three patients met WHO criteria for osteoporosis at one or both measurement sites. Patients with retinopathy (n = 37) had lower lumbar spine bone mineral density values than patients without retinopathy; however, this difference was no longer present after adjustment for age and disease duration. Bone mineral density values were similar in patients with (n = 13) and without microalbuminuria. Our findings suggest that bone loss is not a major problem in younger type 1 diabetics with short disease durations and no severe diabetic complications.

Absorptiometry, Photon↗