Biomedical subjects

N H Ertel

Publications and source records attributed to N H Ertel.

58 records · Page 4Linked to original sources

PubMedDate not supplied

An acute rise in serum phosphorus after single-dose oral metyrapone.

Metyrapone, an 11 beta-hydroxylase inhibitor, is widely used as a pharmacologic test for ACTH reserve. During studies on the pharmacodynamics of metyrapone and the response of plasma 11-deoxycortisol and cortisol, we fortuitously noted a consistent change in serum phosphate but no other routine laboratory chemistry determination. For these studies 12 control subjects were given oral methyrapone (30 mg/kg) at midnight. Serum phosphate (P) concentration was measured in fasting subjects at 08:00 on the morning before and after the administration of metyrapone. In 11 of 12 subjects, serum P increased from a mean of 3.6 +/- 0.7 (SD) mg/100 ml to a mean of 4.2 +/- 0.07 (SD) mg/100 ml on the morning following the drug. No increase in P was noted following the same dose of metyrapone in four patients on acute or chronic steroid therapy or in patients with primary or secondary hypoadrenocorticism. In addition, two addisonian patients were given either a saline or a hydrocortisone infusion for four hours. While the hydrocortisone infusion resulted in a drop in serum P, there was no decrease during saline infusions. These findings suggest that an acute rise in serum P after a single dose of metyrapone might be a rapid indicator of adrenocortical blockade leading to increased ACTH secretion, and cortisol and/or ACTH might play a role in P homeostasis.

Adult↗

PubMedDate not supplied

A comparison of carbohydrate metabolism after sucrose, sorbitol, and fructose meals in normal and diabetic subjects.

Sucrose, sorbitol, and fructose (35 g) were fed to normal and diabetic subjects as a component of a 400-calorie breakfast. In both normal and diabetic subjects, the mean peak increment in plasma glucose was highest after the sucrose meals (44.0 mg/dl for normal subjects; 78.0 mg/dl for diabetic subjects); lowest after sorbitol meals (9.3 mg/dl for normal subjects; 32.3 mg/dl for diabetic subjects); and intermediate after the fructose meals (29.0 mg/dl for normal subjects; 48.0 mg/dl for diabetic subjects). In normal subjects, the mean peak increment of plasma immunoreactive insulin followed a similar pattern, but in diabetic subjects there was no significant difference between the three groups. We conclude that fructose or sorbitol, given as part of a meal, results in lower glucose levels in both normal and diabetic subjects, but that the latter is not related to a difference in insulin release.

Adult↗

PubMedDate not supplied

Plasma glucose and insulin after fructose an high-fructose corn syrup meals in subjects with non-insulin-dependent diabetes mellitus.

The impact on plasma glucose of 35 g of fructose or an equicaloric amount (43.75 g) of high-fructose corn syrup (HFCS) (as part of a 400-calorie meal) was measured in six patients with non-insulin-dependent diabetes mellitus (NIDDM). Blood samples were collected periodically at all points for all patients for 3 h for plasma glucose (PG) and insulin (IRI) determinations. The mean peak PG increment was higher after the HFCS meal (66.5 mg/dl) than after the fructose meals (45.5 mg/dl). When increase in the mean plasma glucose concentration (delta PG) after the fructose meals were compared with the delta PG after the HFCS meals, there was statistical significance at 15 min (P less than 0.02) and 30 min (P less than 0.05). The total areas under the 3-h curves of mean delta PG showed a highly significant (P less than 0.001) difference between the fructose meal (5601 planimetry U) compared with the HFCS meal (8023 planimetry U). Mean changes in IRI after meals with either sweetener were comparable. These findings suggest that fructose is superior to HFCS as a sweetening agent in patients with NIDDM.

Blood Glucose↗

PubMedDate not supplied

The effects of sucrose, fructose, and high-fructose corn syrup meals on plasma glucose and insulin in non-insulin-dependent diabetic subjects.

We have previously shown that fructose and sorbitol given with a standard meal cause less increment in plasma glucose than sucrose and high fructose corn syrup (HFCS) in patients with NIDDM. However, there was no direct comparison of sucrose with HFCS. Sixteen men and one woman aged 54-67) with NIDDM were given either 35 g sucrose, 35 g fructose, or 43.75 g HFCS containing 35 g carbohydrate as part of a 400-calorie test meal. Blood samples were obtained at frequent intervals up to 3 h and were analyzed for glucose and insulin. As compared with a fructose meal, the mean increment in plasma glucose (delta PG) after a sucrose meal was significantly higher at 45 min and after an HFCS meal it was significantly higher at 30 and 45 min, but sucrose and HFCS meals did not differ. When delta PGs were compared in nine patients with basal PG greater than 140 mg/dl and in eight patients with basal PG less than 140 mg/dl, differences in delta PG after sucrose and HFCS versus fructose meals became more significant but still did not differ from each other. The integrated total areas under the delta PG curves after sucrose, HFCS, and fructose meals were not statistically different. However, the areas under the curves up to 90 min after sucrose and HFCS meals, which did not differ, were greater than the fructose meal. The mean delta IRI after sucrose meals was markedly elevated at 45, 60, and 75 min (P less than 0.05) and after HFCS meals at 45 min as compared with fructose meals.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗