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Biomedical subjects

M Hanefeld

Publications and source records attributed to M Hanefeld.

At least 109 records · Page 6Linked to original sources
PubMed1989

Pathogenetic role of adipose tissue lipase deficit for development of hypertriglyceridaemia.

In 87 patients (74 males, 13 females; age 43 +/- 9.2 years) covering a wide range of triglyceride (TG) concentrations (8.8 to 80.7 mmol/l) the turnover of total serum TG has been measured using the technique of labelling endogenously synthesized TG with 3H-glycerol. In parallel, lipoprotein lipase activity in adipose tissue and the adipose-tissue lipase activity in post-heparin plasma have been assessed following an oral 50 g glucose load. Despite the well-recognized function of this enzyme for intravascular lipolysis no direct relationship between lipase activities and fractional catabolic rates (FCR), reflecting TG removal processes, was found. On the other hand, relative enzyme activities (per TG moles) are positively correlated with the FCR. However, a detailed analysis of this relationship revealed that only in HTG patients whose FCR are below 0.210 h-1 a rate-limiting influence of a relative lipase deficit can be shown. In these patients, a statistically significant elevation of concentrations of free fatty acids is supposed to contribute to the impairment of the TG removal.

Adipose Tissue↗
PubMed1989

Very low calorie diet therapy in obese non-insulin dependent diabetes patients.

VLCD is an effective and safe measure to reduce overweight in NIDDM. It substantially improves glucose control and corrects associated coronary risk factors, in particular dyslipoproteinaemia and hypertension. Both insulin secretion and insulin resistance were ameliorated by perfect glucose control with VLCD. Reliable data on long term efficacy and factors determining weight loss and success in permanent glucose control are urgently needed.

Blood Glucose↗
PubMed1988

[Intensive basic therapy decreases the need for drug treatment and improves glucose control: an important result of the diabetes intervention study].

In a period of five years in the diabetes intervention study (DIS), 1,139 diabetics aged 30-55 years, who in a 6-week screening phase had been classified as dietetically manageable, were treated in a controlled randomized study with intensified non-medicamentous basic therapy and--in a double blind trial--with 1,6 g clofibric acid. The essential components of the basic therapy were a fat-modified diet (so-called prudent diet) and recommendations for endurance training. Thus in comparison to the control group we succeeded in performing a ca. 40% decrease of the application of oral antidiabetic drugs. The fasting blood values were, nevertheless, with 155 mg% significantly lower than in the control group (169 mg%). Clofibric acid had no influence neither on the necessity to use insulin or oral antidiabetic drugs nor to the control of glycaemia.

Clinical Trials as Topic↗
PubMed1988

[The value of hypertension and metabolic factors on the development of coronary heart disease in type II diabetic patients].

In 1,126 newly manifested type II diabetics of the diabetes intervention study (628 male, 498 female) between 30 and 55 years of age by a univariate and multivariate analysis the influence of atherogenic risk factors on the development of the coronary heart disease was tested. The diagnosis coronary heart disease is based on the ECG at rest (Minnesota-code), in 796 test persons an exercise electrocardiogram was made. In a manifestation of diabetes males with coronary heart disease showed higher mean values for systolic and diastolic blood pressure, body mass index and serum triglycerides than the control group free of coronary heart disease. In females systolic and diastolic blood pressure, uric acid level and age were significantly increased. By means of multidimensional analysis of variance as to the major findings in the ECG at rest (Q/QS type) in males the diastolic blood pressure, in females the systolic blood pressure and the serum uric acid proved to be significant. Minor findings (above all disturbances of repolarisation) were in males significantly associated with the triglycerides and the diastolic blood pressure, in the females with the systolic blood pressure and the age. Test persons with a stage of coronary heart disease which is to be recognized only in the exercise ECG in the behaviour of the mean value of the atherogenic risk factors did not differ from the control group free of findings with the exception of the increased serum triglycerides in the females.

Blood Glucose↗
PubMed1988

Is the level of steroid hormones in the low density lipoprotein (LDL) particles responsible for the prostaglandin I2 inhibitory potency of LDL?

In LDL fractions, isolated by ultracentrifugation, sexual hormones are detectable. LDL from male volunteers contained a significantly higher level of testosterone than LDL from female volunteers. This difference, however, is not responsible for the enhanced ability of LDL from men versus LDL from women to inhibit PGI2 formation. The importance of LDL testosterone is contradicted by the following results: Firstly, the PGI2 inhibitory potency of LDL is independent of the age of volunteers and the recentrifugation of isolated LDL fractions, but the level of testosterone is diminished with increasing age of volunteers and after recentrifugation. Secondly, LDL from hyperlipidemic men type II a did not inhibit PGI2 formation, but the level of testosterone in the LDL of these volunteers is significantly higher than in LDL from healthy men.

Adult↗
PubMed1988

Effects of a bezafibrate sustained release formulation on plasma lipoproteins in patients with hypercholesterolemia. Importance of timing of tablet intake for efficacy.

The therapeutic effect of a single sustained release tablet of bezafibrate (Cedur retard, 400 mg) in primary hypercholesterolemia type IIa and type IIb was investigated in a placebo-controlled randomised study comparing the efficacy of morning vs. evening intake. The decrease in total cholesterol with the morning intake was 18.5% vs. 16.5% for the evening intake (n.s.). HDL-cholesterol increased more in patients taking bezafibrate retard at morning (29.6% vs. 22.4%, p less than 0.05). Bezafibrate was well tolerated. Animal experiments and precursor studies of cholesterol synthesis in man indicate peak activity of HMG-CoA reductase between 1 a.m. and 3 a.m. The data suggest that with normal eating habits during day time other modes of action of bezafibrate besides HMG-CoA reductase inhibition such as reduction of VLDL-synthesis in the liver and an increased fractional catabolic rate, could contribute to the therapeutic effect.

Alkaline Phosphatase↗
PubMed1988

More exercise for the hyperlipidaemic patients?

Epidemiological studies have left no doubt that moderate to vigorous physical training (PT) of endurance type decreases atherogenic lipoprotein fractions and increases vasoprotective lipoproteins. Depending on the underlying metabolic abnormality in various dyslipoproteinaemias a different response to endurance training was observed. PT is particularly effective in most forms of primary hypertriglyceridaemias. PT acts on both excessive VLDL production and fractional catabolic rate of TG--rich lipoproteins. However, improved removal seems to be of dominating importance. In primary hypercholesterolaemia LDL--cholesterol levels did not change during a 4 weeks exercise regimen with standardized isocaloric lipid lowering diet. In observational studies with hyperlipidaemic patients with stable body weight and under lipid lowering diet, during the first 4-6 weeks no significant effect on HDL was seen, whereas longterm studies clearly demonstrate an increase in HDL--cholesterol. Further beneficial effects of PT in hyperlipidaemic patients are improved glucose tolerance, down--regulation of hyperinsulinaemia, lowering of blood pressure and correction of hypercoagulability of the blood.

Arteriosclerosis↗
PubMed1987

Loss of fat, water, and protein during very low calorie diets and complete starvation.

The magnitude and composition of weight loss obtained in obese women on two forms of very low calorie protein-supplemented diets (Cambridge diet, Dresden drink) as well as by complete starvation has been investigated. With the VLCD, nitrogen equilibrium was reached on the 10th day of fasting, the cumulative nitrogen balance also being compensated. Nearly half of the body weight loss is due to loss of fat. In order to assess the benefit of fasting regimes, we propose to measure at least two parameters which are independent of each other, e.g., nitrogen balance and total body water. Both types of VLCD were equally effective, safe, and acceptable in achieving rapid body weight reduction.

Adipose Tissue↗
PubMed1987

[Presentation of an insulin-treated patient group within the scope of a 5-year study of the Diabetes Intervention Study (DIS)].

The diabetes intervention study (DIS) is an intervention and examination programme which in dietetically conducible diabetics who freshly became manifest shall decrease the incidence of cardiovascular diseases and analyse the influence of various steps of intervention on the course of diabetes. In the course of 5 years 54 out of 988 patients were insulinized by reason of deteriorations of metabolism. There were no significant differences between the intervention and control group concerning age, sex, index of ideal weight, fasting blood glucose, quantity of injected insulin and duration of the insulin treatment. By means of a C-peptide short-time test following glucagon stimulation an attempt of differentiation into type 1 and type 2 diabetics, was performed and compared with the results in literature.

Blood Glucose↗
PubMed1987

Predictive value of the index of desirable body weight for total body fat mass as measured by dilution of tritiated water--problems and limitations.

The index of desirable body weight is currently used for classification of patients' weights. We examined how it is related to the degree of adiposity, and whether it can serve in the prediction of body fat to the same degree as Quetelet's index. Sixty-five women and 142 men comprising a wide range of weight indices were studied. Body fat (F) was measured by the tritium dilution technique with a precision of +/- 1.26 kg. Regressions of F/W0 on the index of desirable weight W/W0 gave a correlation coefficient of 0.969 for women and 0.939 for men. Regressions of F/H2 on Quetelet's index W/H2 had correlation coefficients of the same order, i.e. 0.971 for women and 0.936 for men. Hence both indices are equally powerful for calculation of body fat within the study population. Further progress was achieved by multiple regression of F on W and W0 which yielded correlation coefficients of 0.976 for women and 0.953 for men. The residual standard deviation reflecting the mean difference between calculated and estimated fat was 3.4 kg for women and 3.8 kg for men. Despite this self-consistency, prediction of body fat for persons outside the study population is only possible within wide limits. These are given by about twice the residual standard deviation. Therefore, prediction of body fat from weight indices can only be used for detection of larger abnormalities in body composition.

Adult↗
PubMed1986

[Cardiologic findings in newly manifested type II diabetics of the diabetes intervention study].

In 1,126 newly manifested primarily purely dietetic manageable type II-diabetics (628 men, 498 women) of the diabetes intervention study (DIS) at the age from 30 to 55 years the prevalence of the ischaemic heart disease was established with the help of the ECG in rest (Minnesota code) and in 70% of the test persons by an additional electrocardiography after work. Including the two parameters in 9.2% of the diabetic men and 26.1% of the women electrocardiographic findings of an ischaemic heart disease could be proved. The proportion of pathological findings of the ECG increased with age. While the proportion of a probable ischaemic heart disease (code 1.1-1.2) in the ECG in rest and with 1.4% the same size in the two sexes, in women, the percentage of a possible ischaemic heart disease (code 1.3, 4.1-4.3/5-5.3/8.3) prevailed with statistical significance after the 45th year of age. The at present numerically largest study on newly detected diabetics of type II gives evidences to the previous cardial lesion when the diabetes is manifest at medium age on the basis of the homogeneity of the number of patients.

Adult↗
PubMed1985

Effects of high doses of oestrogens and androgens on lipoproteins: observations in the treatment of excessive growth with sexual hormones.

In a prospective study we investigated the changes of lipoprotein metabolism under therapy with high doses of oestrogens or androgens, applied to stop the excessive growth of very tall girls or boys. Therapy with 2 mg ethinyl oestradiol sulfonate per week for one year in 11 girls resulted in an increase in serum triglycerides, which was reversible after cessation, and a minimal rise of total cholesterol and HDL-cholesterol in the phase of adaptation to this treatment. Therapy with 1000 mg testosterone oenanthate per month for one year lead to a fall of triglycerides and HDL-cholesterol. These changes are considered as a regulative phenomenon, without consequences for the application of the high dosage therapy with these steroid hormones in the treatment of excessive growth.

Acid Phosphatase↗