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K Vondra

Publications and source records attributed to K Vondra.

At least 37 records · Page 2Linked to original sources
PubMed2001

[Effect of long-term treatment with metformin on steroid levels and parameters of insulin resistance in women with polycystic ovary syndrome].

BACKGROUND: Insulin resistance is probably the key factor in the pathogenesis of polycystic ovary syndrome, and thus insulin sensitization can be a beneficial treatment. We tried to investigate effects of long-term therapy with metformin in polycystic ovary syndrome on steroid levels, ovarian steroidogenesis and on insulin resistance and secretion. We also tried to find predictors of the successful therapy (in terms of improvement of menstrual cyclicity). METHODS AND RESULTS: 24 oligo/amenorhoeic women with polycystic ovary syndrome were included into the study. Basal blood samples were taken for the determination of testosterone, estradiol, androstenedione, dehydroepiandrosterone, dehydroepiandrosterone-sulphate, 17OH progesterone, 17OH pregnenonole, sex-hormone binding globulin and cortisol. Gonadoliberin (GnRH) analogue test was performed with estimation of the same steroids and LH. Oral glucose tolerance test was done with dextrose, and with estimation of glucose, insulin, and C peptide. HOMA model assessment was used for calculation of insulin resistance and insulin secretion. All examinations were done before and after 27 +/- 4 weeks (average +/- standard deviation) of therapy with metformin 1000 mg/day. Significant improvement in menstrual cyclicity was observed in 58% of women. No significant change in basal steroid levels was found. A trend towards decline in insulin resistance and secretion was detected. Significant decrease in the mean stimulated testosterone level (from 1.74 to 1.54 nmol/l, 95% CI 1.42-2.08 and 1.21-1.87; p < 0.05), 17OH progesterone level (from 3.32 to 2.37, 95% CI 1.42-2.08 and 1.21-1.87; p < 0.05), LH (from 9.1 to 4.8 IU/l, 95% CI 6.4-12.8 and 3.4-6.8; p < 0.05), and estradiol level (from 0.91 to 0.43 nmol/l, 95% CI 0.69-1.19 and 0.38-0.65; p < 0.01) were detected. The best prediction of the improvement in menstrual cyclicity after metformin was achieved with the combination of basal 17OH progesterone, androstendione, testosterone and SHBG. This model correctly classified 86.7% of subjects. CONCLUSIONS: Long-term therapy with metformin led to the improvement in menstrual cyclicity, without significant change in basal steroid levels or parameters of insulin resistance.

17-alpha-Hydroxypregnenolone↗
PubMed2001

[Osteopenia and osteoporosis in diabetic women over 40 years of age].

BACKGROUND: The aim of this study was to find the prevalence of osteopenia and osteoporosis in postmenopausal diabetic females and its association with the diabetic compensation and angiopathic complications. METHODS AND RESULTS: Bone mineral density was measured in 156 diabetic females, 44 of them had type 1 diabetes mellitus (mean age 53 +/- 8.9 years) and 112 type 2 (mean age 60 +/- 9.2 years). In the lumbar spine and proximal femur the prevalence of osteoporosis varied between 9-11% and 18-20% respectively. The respective prevalence of osteopenia amounted 30-36% and 34-48%. No statistically significant differences were found between type 1 and type 2 diabetes. Any association with diabetic compensation and the diabetic microangiopathic complications was not found. Only in females with osteoporosis the prevalence of cardiovascular heart disease was higher than in those with normal bone mineral density. CONCLUSION: The prevalence of osteoporosis and osteopenia in postmenopausal diabetic women is similar to those in the common population of the respective age.

Adult↗
PubMed2001

The effects of long-term metformin treatment on adrenal and ovarian steroidogenesis in women with polycystic ovary syndrome.

OBJECTIVE: To evaluate adrenal and ovarian steroidogenesis before and after long-term treatment with metformin in women with polycystic ovary syndrome (PCOS). DESIGN AND METHODS: Twenty-four women with PCOS were evaluated before and after treatment (27+/-4 weeks) with metformin (1000 mg/day) using adrenocorticotrophin (ACTH), GnRH analogue and oral glucose tolerance (oGTT) tests. For statistical evaluation, ANOVA and Wilcoxon's test were used. RESULTS: In 58% of the women a significant improvement in menstrual cyclicity was observed. No significant change in basal steroid levels was found. After ACTH stimulation, a significant decrease in the activity of 3 beta-hydroxysteroid dehydrogenase in C(21) steroids (P<0.05) and in 17 beta-hydroxysteroid dehydrogenase (P<0.01) was observed, as was an increase in the activity of C17,20-lyase in the Delta(4) pathway (P<0.01). A significant growth in the dehydroepiandrosterone (DHEA)/DHEA-sulfate ratio (P<0.05) was detected. With regard to ovarian steroidogenesis, a significant decrease in the stimulated levels of testosterone (P<0.05), index of free testosterone (P<0.01), LH (P<0.05) and oestradiol (P<0.01), and an increase in the levels of 17-hydroxypregnenolone (P<0.05) were detected. In the indices of ovarian enzyme activities, we observed a significant decrease in 3 beta-hydroxysteroid dehydrogenase in C21 steroids (P<0.01), in C17,20-lyase in the Delta 5 pathway (P<0.01), in 17 beta-hydroxysteroid dehydrogenase (P<0.05) and in aromatase. In glucose metabolism, a tendency towards reduction in the homeostasis model assessment (HOMA)-R (for insulin resistance) and HOMA-F (for beta cell function) was detected. In addition, an increase in the levels of C peptide during oGTT was observed (P<0.01). CONCLUSIONS: Long-term metformin treatment reduced various steroid enzymatic activities both in the ovary and the adrenal glands, without apparent changes in basal steroid levels and in insulin sensitivity.

Adrenal Glands↗
PubMed2000

An analysis of the relationship between insulin resistance and the activity of steroid C17,20-lyase and 3beta-hydroxysteroid dehydrogenase in ovaries and adrenals in women with polycystic ovary syndrome.

Polycystic ovary syndrome (PCOS) is connected with insulin resistance (IR), and often with the hypersecretion of adrenal androgens. Mutual relationships between IR and adrenal and ovarian steroidogenesis were investigated in the group of 19 oligo/amenorhoeic women with PCOS. The age and body mass index (BMI) of the patients were 21+/-4.7 years and 26.4+/-5 kg/m2 (average+/-SD), respectively. All underwent a 60-minute adrenocorticotrophic hormone (ACTH) stimulation test, a gonadoliberin analogue (GnRHa) test with buserelin and an oral glucose tolerance test (oGTT) in the early follicular phase of the menstrual cycle. When absolute stimulated steroid levels after GnRHa were studied, a significant positive correlation between DHEA and area under curve during oGTT for C peptide (AUC-CP) (r=0.477, p= 0.039) and a borderline negative correlation (r=-0.404, p= 0.087) between AUC-CP and 17-OH progesterone, were found. Considering steroid values after ACTH, a significant positive correlation of IR index was found only with 17-OH-progesterone (r=0.499, p= 0.03). When stimulated enzymatic activities (expressed as product/ precursor ratios) were analyzed using factor analysis, a positive relationship between IR and ovarian C17,20-lyase in both delta4 and delta5 pathway was revealed. On the other hand, no relationship was confirmed between IR and enzymatic activities in the adrenals. The authors conclude that insulin resistance and/or hyperinsulinemia is probably not the primary factor responsible for the exaggerated adrenal androgen secretion found in a great number of patients with PCOS.

17-alpha-Hydroxyprogesterone↗
PubMed1998

[Importance of short-term administration of low doses of somatostatin analog in the development and remission of type 1 diabetes mellitus in adult patients].

The objective of the presented work was to evaluate the short-term administration of octreotide on the development, onset and persistence of remission in recent insulin-dependent diabetics. The importance of remission means for the patient a clinically favourable condition with satisfactory metabolic compensation and a greater metabolic stability during the subsequent course of the disease. The period of remission is important from the aspect of prevention of late organ complications. Two-week treatment with octreotide, 150 micrograms/day, administered during the first month after establishment of the diagnosis was not associated with serious undesirable effects. Treatment with octreotide led to more frequent development of remission, partial and complete, as compared with a control group. In the majority of diabetics in the intervened group remission started immediately after administration of octreotide. The serum value of peptide-C as part of the glucagon test made at the time of diagnosis had a predictive value for the development of induced and spontaneous remission. Octreotide administration increased the probable development of remission even in patients with a substantially lower peptide C value at the time of diagnosis as compared with controls. The preliminary results indicate also a protraction of the remission period.

Adult↗
PubMed1996

[Dermatoglyphics--an attempt to predict diabetes].

Dermatoglyphs do not change throughout life. The authors sought their "predictive type" for diabetes with regard to the possibility of early prediction and thus prevention of the development of diabetes, in particular type 2. They used a point score of the abnormality in three qualitative and two quantitative signs and found, as compared with the normal population, in groups of subjects with impaired glucose tolerance, DM II and DM I deviations with an increasing significance. The frequency of thus assessed abnormalities in each subject on both hands (0-10) was compared in relations to the diagnosis and family-history of diabetes and the authors evaluated the incidence of different abnormalities in the whole group of 300 subjects and in sub-groups. After statistical evaluation the authors conclude that the abnormality of the qualitative sign of the C line (lacking or reduced) could be considered as another early predictive factor: in the offsprings of diabetics for both types of diabetes, in the remainder for DM type 1.

Dermatoglyphics↗
PubMed1996

[Thyroglobulin and microsome autoantibodies and their clinical significance in adult type I diabetics].

In 34 patients with type 1 diabetes manifested in postadolescent age (mean age at time of diagnosis 25 years, 18 women and 16 men) after the establishment of the diagnosis perspectively the presence of antibodies against thyroglobulin and the microsomal fraction and their relation to affection of the thyroid gland was investigated. During an investigation of 20% of the patients the authors provided repeatedly evidence of the presence of both antibodies, in 23% repeatedly only against microsomes. In 21% some antibodies were detected only once. In the course of the investigation in 65% of the patients thyroid antibodies were found. The clinically most serious affection of the thyroid gland (from the sonographic an functional aspect) was found in groups 1 an 2, while in groups 3 and 4 in the majority of patients the thyroid gland was not affected. A different pathogenesis of the disease in the above groups is suggested in the areas of DR and DQ during HLA typing, the behaviour of other antibodies and differences in dermatoglyphic examinations. Moreover there is a high ratio of women in the first two groups (61%) and conversely of men in groups 3 and 4. In the discussion attention is drawn to the different course of diabetes in patients with thyroid autoimmunity.

Adult↗
PubMed1992

[Manifestations and early course of type I diabetes mellitus--a decisive period from the viewpoint of controlling the further development of the disease].

The autoimmune process focused on B-cells of the islets of Langerhans and leading gradually to their destruction is latent before the manifestation of diabetic symptoms. The detection of this preclinical stage in particular in sporadic cases is in common clinical practice, due to the low prevalence of the disease in the population and pretentious character as regards applied methods, unreal. Therefore attention is focused on the period of clinical manifestation of the diabetic syndrome and its early stages when by early diagnosis and intensive insulin or immunosuppressive treatment it is still possible to preserve a substantial proportion of functional B-cells and influence in an effective manner the onset and duration of remission. The authors summarize experience assembled during the eighties, incl. therapeutic procedures and problems of active immunomodulation in the prehyperglycaemic stage of the disease.

Diabetes Mellitus, Type 1↗
PubMed1991

[Insulitis--new findings on the role of genetic and external factors].

The autoimmune process focused on B-cells of the islets of Langerhans and leading gradually to their destruction and the development of type I diabetes takes place under the morphological picture of insulitis. The disease affects genetically predisposed individuals. At the end of the eighties knowledge was greatly expanded due to methods of molecular genetics. The majority of authors assumes that in the pathogenesis of insulitis also environmental factors participate. More detailed information is provided on chemical compounds, nutritive substances and viruses.

Animals↗
PubMed1990

[Changes in magnesium and ionized calcium serum levels in disorders of glucose tolerance].

In a group of 58 subjects with a strictly defined glucose tolerance (38 normal--nGT, 10 impaired glucose tolerance--pGT, 10 type II diabetics treated by diet) the authors investigated the mutual relationship between changes in the blood sugar level and insulin serum level in relation changes of calcium, ionized calcium, magnesium and total proteins. In addition to expected differences in the native blood sugar level and insulinaemia, the authors found in pGT group in reduction of ionized calcium and magnesium on fasting. In the course of the oGTT in pGT group there is a rise of ionized calcium and magnesium and thus the changes, as compared with the initial value, differ significantly from changes in subjects with a normal glucose tolerance and in type II diabetics. The differences in the pattern total calcium are less marked, the changes of total protein did not differ. Evaluation of correlations revealed a only significant relationship between the change of ionized calcium and blood sugar level after 120 mins, in DM II. The findings suggest a different calcium and magnesium metabolism after a glucose load in subjects with an impaired glucose tolerance. It is not clear whether a cause of the disorder is involved or a possible compensatory mechanism. The clinical impact will have to be examined.

Calcium↗
PubMed1987

Preparation and implementation of pancreas transplantation programme in diabetic patients.

Having reviewed the state-of-the art trends in pancreas transplantation over the world, the authors describe their own experimental studies preceding elaboration of the technique of pancreatic segment transplantation with duct obliteration. In their technique, the splenic artery is interposed in the course of the iliac arteries of the recipient. The procedure of the selection of diabetic patients suitable for a combined pancreas and kidney transplantation is presented. The results in 13 recipients with insulin-dependent diabetes and progressed organ complications are evaluated. In these patients a combined pancreas and kidney transplantation is of a better prognosis compared with the conventional treatment methods.

Adult↗
PubMed1987

New ways in treatment on insulin-dependent diabetes.

In our work we have tried to show that the only appropriate method of treatment for a type I diabetic is that which helps to maintain a near-normal compensation, which does not bother the patient and allows him a flexible way of life, and for which there is a sufficient technical equipment including the possibility of blood glucose monitoring. We have found out that all modes of insulin administration are effective, all can achieve a good compensation. Where the both conventional methods (basal-bolus regimen, multiple doses regimen) fail, we use the continuous subcutaneous insulin infusion (CSII). But we warn of undue optimism, and we recommend to use the CSII treatment only during hospitalization, when an exact blood glucose monitoring can be secured. An out-patient CSII treatment is--according to our experience--possible only when a consiliary supervision or a phone consultation of the patient with the attending team can be provided round the clock. We recommend therefore to use CSII routinely as a method of treatment only when the following preconditions are fulfilled an exact indication, education and motivation, technical equipment, and therapeutic supervision in outpatient treatment.

Adolescent↗
PubMed1987

Serum lipids and apolipoproteins in families of postinfarction men.

The study of relatives of postinfarction patients was designed to assess the familial associations of lipids (total cholesterol, triglycerides, high density lipoprotein-cholesterol), and of apolipoproteins A and B. Examination of 493 individuals from 106 families showed only some familial associations of serum lipids between mothers and offspring and among siblings, but similar associations in apolipoproteins among all groups of direct relatives (i.e. between mothers and offspring, among siblings and between fathers and offspring). Associations among direct relatives, and their absence between spouses, suggest the genetic influence on lipoproteins. Apolipoproteins appear to be a more suitable means of detecting such associations than serum lipid levels.

Adult↗