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Biomedical subjects

M L Sievers

Publications and source records attributed to M L Sievers.

At least 37 records · Page 2Linked to original sources
PubMed1983

Hyperinsulinemia in obesity: lack of relation to gastric emptying of glucose solution or to plasma somatostatin levels.

To investigate some factors that may be related to the hyperinsulinemia of obesity, we measured fractional gastric emptying rates and changes of circulating levels of glucose, insulin, and somatostatin-like immunoreactivity (SLI) following the intragastric instillation of glucose in age-matched obese and nonobese Pima Indians with normal glucose tolerance. Results for the nonobese Pimas were also compared with findings for age- and weight-matched Caucasians with normal glucose tolerance. The levels of fasting plasma insulin and the integrated insulin response to glucose were significantly greater (P less than 0.01) in obese than in nonobese Pimas. Mean rates of fractional gastric emptying, both in the basal state and after the glucose load, were similar for the three groups. The fractional gastric emptying rates after a glucose load were strongly correlated with the integrated responses of both plasma glucose and insulin in the nonobese Caucasians (r = 0.88, 0.90; P less than 0.01) but not in either Pima group. There were no significant differences in peripheral plasma SLI for any of the three groups, either in the basal state or after the glucose load. These findings suggest that the hyperinsulinemia of established obesity is not mediated by alterations in the gastric emptying rate of liquids or by peripheral plasma SLI concentrations. They do not, however, exclude defects in gastric emptying of solid foods. Nor do they exclude the possibility that gastric or D-cell abnormalities exist during the period of fat accumulation but recede after obesity is established.

Adult↗
PubMed1983

Hypergastrinemia in obese noninsulin-dependent diabetes: a possible reflection of high prevalence of vagal dysfunction.

To elucidate the relation of noninsulin-dependent (type II) diabetes mellitus to plasma levels of gastrin, pepsinogen I, and pepsinogen II, gastric acid secretion, and gastric emptying, we studied diabetic and nondiabetic obese Pima Indian subjects. Fasting and postprandial plasma gastrin concentrations were significantly higher (P less than 0.02) in diabetic than in nondiabetic subjects, but gastric acid outputs basally, after an acaloric liquid meal, and in response to betazole were similar in the two groups. Plasma pepsinogen I and pepsinogen II levels were also similar in both groups. A significant negative relation (r = -0.84; P less than 0.01) was found between basal gastrin levels and gastric acid production in nondiabetic Indians, but not in diabetic Pimas. The fractional gastric emptying rate of an acaloric liquid meal was significantly decreased in diabetic Pimas (P less than 0.01); and at least one test showing abnormal vagal function, as estimated by the Valsalva maneuver, heart rate changes between deep expiration and inspiration, and postural hypotension, was found in every diabetic subject. These findings suggest that hypergastrinemia in type II diabetes is not related to hypochlorhydria, but, instead, results from autonomic dysfunction with slow gastric emptying.

Adult↗
PubMed1982

Decreasing incidence of disseminated coccidioidomycosis among Piman and San Carlos Apache Indians. A probable environmental basis.

Among Piman and San Carlos Apache Indians, the rates of disseminated disease and death from coccidioidomycosis have declined 67 percent (p less than 0.001) and 71 percent (p less than 0.01), respectively, between the first and second half of a 22-year observation period (1959-1980), despite a lack of significant change in the rate of primary infection (as determined by the coccidioidin skin test) between the two 11-year periods. The two tribal groups studied comprised 76 percent of the Indian population in the endemic area. More than 90 percent of Pimans and San Carlos Apaches have full Indian heritage, and almost all of them have been lifelong inhabitants of the endemic region. There is no evidence that genetic factors are responsible for the Indians' decrease in mortality and mortality from disseminated coccidioidomycosis. Improvements in housing and working conditions appear to have lessened the exposure to dust laden with C immitis, decreased the size of infecting inoculum, and, thereby, contributed to a decline in disseminated coccidiodomycosis among these native Americans, who have often been considered to have increased susceptibility to this fungal infection. Thus, the outcome of coccidioidal infection in American Indians seems to be largely determined by environmental influences. The possibility of decreasing disseminated disease rates by reducing the inhalation of arthroconidia also has important implications for other ethnic groups.

Adolescent↗
PubMed1981

Skeletal fluorosis from eating soil.

A woman with chronic pyelonephritis developed progressive muscular weakness and bone pain. For twenty years she had habitually ingested fluoride-rich soil. Osteosclerosis was found on x-ray examination, and fluorosis was confirmed by bone biopsy. Renal failure augmented skeletal retention of excessive fluoride intake which, in turn, appears to have intensified symptomatic renal osteodystrophy. Skeletal fluorosis from this unexpected source has not been previously described.

Adult↗