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Biomedical subjects

S Mora

Publications and source records attributed to S Mora.

At least 55 records · Page 3Linked to original sources
PubMed1999

Serum levels of insulin-like growth factor I and the density, volume, and cross-sectional area of cortical bone in children.

Insulin-like growth factor I (IGF-I) is a major regulator of bone growth during childhood. However, beyond knowledge that IGF-I influences longitudinal growth, its associations to changes in the cross-sectional dimensions, the volume, or the material density of bone during growth are unknown. We assessed the relationships between serum IGF-I and measurements of cross-sectional area, cortical bone area, and cortical bone density at the midshaft of the femur in 197 normal healthy white children and adolescents (103 boys and 94 girls; aged 7.8-18.2 yr). Bone determinations were obtained using computed tomography, and levels of IGF-I were measured by RIA after an extraction procedure. IGF-I correlated significantly with both cross-sectional area (r = 0.49; P < 0.0001) and cortical bone area (r = 0.50; P < 0.0001), but did not correlate with the material density of cortical bone (r = -0.08). Multiple regression analyses showed that circulating levels of IGF-I were associated with cross-sectional area (P = 0.03) and cortical bone area (P = 0.04) values, even after correcting for the confounding effects of age, gender, weight, and femoral length. We conclude that IGF-I is a major determinant of the cross-sectional properties of bone, but does not influence the material density of bone, in the appendicular skeleton.

Adolescent↗
PubMed1999

Biochemical markers of bone turnover and the volume and the density of bone in children at different stages of sexual development.

Bone mass and biochemical markers of bone turnover increase significantly during puberty. We studied the possible relationships between markers of bone formation and bone resorption and increases in skeletal size, bone volume, and bone density in healthy children at different stages of sexual development. Serum concentrations of bone specific alkaline phosphatase (BALP) and osteocalcin (bone Gla protein, BGP), urinary levels of pyridinoline (Pyr) and deoxypyridinoline (Dpyr) and computed tomography (CT) measurements of the cross-sectional areas of the vertebrae and the femurs, the apparent density of cancellous bone in the vertebrae, and the volume and the material density of cortical bone in the femurs were determined in 126 boys and 143 girls, ages 7-18 years. Serum levels of BALP and BGP and urinary concentrations of Pyr and Dpyr peaked in early puberty and were lowest in the later stages of puberty. CT measurements for the cross-sectional areas of the vertebrae and the femurs, the femoral cortical bone areas, and the apparent density of cancellous bone increased in all children during puberty, while values for material bone density did not change significantly with the stage of sexual development. BALP and BGP showed significant inverse correlations with the material density of bone (r = -0.23 and -0.24, respectively), but no association with bone volume in the appendicular or axial skeleton. In contrast, Pyr and Dpyr correlated with femoral cross-sectional area (r = -0.24 and -0.33, respectively) and cortical bone area (r = -0.29 and -0.33, respectively), and with the apparent density of vertebral cancellous bone (r = -0.26 and -0.19, respectively), but not with the material density of bone. We conclude that, during puberty, there is a differential association between the two components of bone mass and the markers of bone formation and bone resorption; while markers of bone formation are related to the material density of bone, markers of bone resorption are related to the volume of bone.

Adolescent↗
PubMed1999

Longitudinal changes of bone density and bone resorption in hyperthyroid girls during treatment.

Low bone mineral density (BMD) and increased bone turnover are common features of untreated hyperthyroidism in adult patients. The effect of treatment on BMD is still controversial. BMD and bone metabolism in hyperthyroid children have not been thoroughly investigated. In the present study, we measured spinal and whole body BMD by dual-energy X-ray absorptiometry in a group of 13 girls (aged 5.0-14.9 years) at diagnosis of hyperthyroidism. The bone resorption rate was assessed by urine measurement of N-terminal telopeptide of type I collagen (NTX). Hyperthyroid patients have been studied longitudinally during treatment. BMD values and NTX urine concentrations have been also determined in 155 healthy Caucasian girls (aged 2.4-24.2 years). Spinal and whole body bone density measurements were significantly lower compared with healthy controls in untreated hyperthyroid girls, after correction for differences in age and anthropometric measurements (p </= 0.033). Bone density measurements obtained after 12 and 24 months of treatment were no longer different from those of healthy girls. NTX urine levels at diagnosis of thyrotoxicosis were significantly higher than those found in healthy controls (p < 0.0001); 6 months after treatment, the urine levels did not show significant differences, and they remained stable after 12 and 24 months of therapy. Inverse correlations at diagnosis were found between serum-free thyroxine (FT4) serum levels and spinal (r = -0.42) and whole body bone density (r = -0.41); FT4 and free triiodothyronine serum levels directly correlated with the NTX concentration (r = 0. 77, and r = 0.71, respectively). In conclusion, the results of the present study demonstrate that low bone density values and high bone resorption rates are found in hyperthyroid children and adolescents at diagnosis of the disease. Our data also demonstrate that antithyroid treatment is able to reduce dramatically the bone resorption and to increase significantly both spinal and total body BMD, granting physiologic conditions for the achievement of the best obtainable peak bone mass.

Adolescent↗
PubMed1998

Comparison of clinical-radiological and molecular findings in hypochondroplasia.

Hypochondroplasia is an autosomal dominant skeletal dysplasia characterized by disproportionate short stature. A mutation (N540K) in the fibroblast growth factor receptor 3 (FGFR3) gene was described in some patients with this condition. The aims of the study were to identify the frequency of the FGFR3 gene mutation, to define the salient clinical and radiological abnormalities of the affected subjects, and to verify the contribution of molecular findings to the clinical and radiological definition of hypochondroplasia. Based on the most common radiological criteria, we selected 18 patients with a phenotype compatible with hypochondroplasia. Height, sitting height, and cranial circumference were measured in all patients. Radiographs of the lumbar spine, left leg, pelvis, and left hand were also obtained. The presence of the N540K mutation was verified by restriction enzyme digestions. Half of our patients carried the N540K mutation. Although similar in phenotype to the patients without the mutation, they showed in addition relative macrocephaly. The association of the unchanged/narrow interpedicular distance with the fibula longer than the tibia was more common in patients with gene mutation. Although we did not find a firm correlation between genotype and phenotype, in our study the N540K mutation was most often associated with disproportionate short stature, macrocephaly, and with radiological findings of unchanged/narrow interpedicular distance and fibula longer than tibia.

Adolescent↗
PubMed1998

Urinary markers of bone turnover in healthy children and adolescents: age-related changes and effect of puberty.

During growth, bones change their dimensions rapidly with the changes involving both formation and resorption processes. Small cross-linked peptides coming from type I collagen molecules are excreted in urine when bone is resorbed. To date, conflicting results have been presented concerning the age- and puberty-related changes of urinary markers. The purpose of the present study was to verify the effect of age, gender, and puberty on the urinary excretion of type I collagen degradation products in healthy children and adolescents. Timed spot urines from 176 children (4-20 years old) and 50 young adults were analyzed. The concentrations of N-telopeptides of type I collagen (NTx), pyridinolines (Pyr), and deoxypyridinolines (Dpyr) were measured, and the results were normalized to creatinine. Age-related changes in cross-links excretion were observed. The levels decreased with age, and a peak of excretion was shown at the beginning of adolescence. Prepubertal levels of all the markers were four- to five-fold higher than in adults, and they decreased towards adult levels in late puberty. Girls had significantly higher levels of all biochemical markers than boys at pubertal stage 2. We also observed a remarkable effect of puberty on the levels of bone degradation products that was independent of age and gender. Our results indicate that bone resorption is high in children relative to that in adults, and that urinary levels of NTx, Pyr, and Dpyr change as a function of age, gender, and puberty.

Adolescent↗
PubMed1998

Assessment of skeletal maturation in infants: comparison between two methods in hypothyroid patients.

BACKGROUND: Conventional skeletal radiography is the standard technique for assessing skeletal age. However, radiography cannot demonstrate cartilage and is therefore of lesser value in infancy when the ossification centres are composed mainly of cartilage. By comparison, US clearly demonstrates cartilage and bone. OBJECTIVE: In the present study, we compared radiography and sonography for the assessment of skeletal age in neonates and infants. MATERIALS AND METHODS: Because delayed skeletal maturation is a feature of congenital hypothyroidism and assessment of skeletal age is routinely performed in our centre, we studied 55 hypothyroid infants (aged 7-66 days). AP radiographs and sonograms, acquired using high-frequency scanners, were obtained and dimensions of the distal femoral epiphyseal ossification centre (DFE) were compared. RESULTS: Measurements of DFE by the two methods showed excellent correlation (R = 0.94, P = 0.0001). Radiographs did not demonstrate a DFE in 11 infants, and US did not show it in 6. In no infant did radiography demonstrate DFE not seen by US. Moreover, DFE dimensions on US were larger than those measured on radiographs. Infants with absent thyroid gland had a DFE significantly smaller than those infants with ectopic or normally placed glands (P < 0.001), on both radiographs and sonograms. CONCLUSION: Our data suggest that sonography is a valid alternative to standard radiography for the assessment of skeletal age in infants.

Age Determination by Skeleton↗
PubMed1998

Effects of LHRH on avoidance conditioning in normally cycling and ovariectomized female rats.

Several studies have demonstrated that the peptide LHRH can modify behavior in the male rat. Peripheral and intracerebral infusions of LHRH impair the acquisition of conditioned avoidance responses (CARs) and increase some spontaneous motor behaviors, such as head shaking and grooming. The present study was undertaken to detect the effects of LHRH on the acquisition of CARs and spontaneous motility in normally cycling and ovariectomized (OVX) Sprague-Dawley female rats. Normally cycling females were separated in four groups, according to the stage of the estrous cycle. Ovariectomized female rats were pretreated, 48 h before the experiment, with estradiol benzoate (10 microg/kg) or corn oil. LHRH (6.25, 25, or 50 microg/kg) was subcutaneously injected and the behavioral tests began 1 h after. Low doses of LHRH stimulated the acquisition of CARs during proestrus, estrus, and metestrus, whereas higher doses impaired conditioning in all the four stages of the cycle. High doses of LHRH impaired acquisition in OVX rats treated with oil and potentiated the depressant effects of EB on this behavior. The effects of LHRH on spontaneous motor activity were either stimulatory or inhibitory, according to the hormonal status and the dose administered. High doses of LHRH decreased motor responses in the diestrous rat. All the doses of LHRH increased the number of headshakes during proestrus, estrus, and metestrus, while the other motor responses were scarcely or not affected by LHRH in these stages. In OVX rats LHRH increased rearing, head shaking, and grooming behavior. These results support a role of LHRH in the modulation of conditioned and spontaneous behavior. They could provide an explanation to the behavioral changes observed across the estrous cycle and those observed after EB priming in OVX rats.

Animals↗
PubMed1998

Dexamethasone in the diagnostic work-up of growth hormone deficiency.

OBJECTIVE: Acute administration of dexamethasone (dexa) has recently been shown to induce growth hormone (GH) release. To ascertain the efficacy of this stimulus in assessing GH secretory status in children, we tested it in a large group of patients with short stature. METHODS: We administered dexamethasone at the dose of 2 mg/m2 to 44 short normal children and 19 GH deficient (GHD) children, either orally or intravenously and compared the results of the dexa-test to the more classical clonidine test. RESULTS: The oral dexa-test induced a GH peak similar to the clonidine test (clo) (controls clo: 23.8 +/- 7.8 mU/l, median 22.8, range 15.2-45.4 vs. control dexa: 20.6 +/- 10.8, median 16.8, range 8-47, P = 0.2. GHD clo: 9.8 +/- 2.6, median 9.2, range 6.4-13.4 vs. GHD dexa: 9.4 +/- 3.4, median 10.2, range 4.6-14, P = 0.8). Its sensitivity and specificity with respect to the clonidine test were 91% (10/11 GHD) and 65% (15/23 controls), respectively. The GH peak after i.v. dexa was smaller than that after clonidine (control clo: 30.6 +/- 14 micrograms/l, median 24.8, range 14.2-62.4 vs. control dexa: 21.6 +/- 5.4, median 21.6, range 11.2-33, P = 0.01. GHD clo: 7.4 +/- 4.2, median 8.8, range 0.4-11.8 vs. GHD dexa: 6.4 +/- 5.6, median 5.8, range 0.4-16.2, P = 0.17) with sensitivity and specificity of 87% (7/8 GHD) and 90% (19/21 controls), respectively. The lower potency of dexamethasone could account for these figures, since when a different cut-off was used (12 mU/l and 11 mU/l for the oral and i.v. route) both sensitivity and specificity were improved. More data are needed to support these findings and establish a clear cut-off. In the control group, no difference was found between GH peak after oral or i.v. dexa but GH-area under the curve (AUC) was larger for i.v. than for oral dexa. No side effects were noted. CONCLUSIONS: Intravenous dexamethasone appears to be a promising stimulus for the detection of GH deficiency in children, particularly for use in outpatients.

Administration, Oral↗
PubMed1998

Reversal of low bone density with a gluten-free diet in children and adolescents with celiac disease.

Osteoporosis is a common finding in adult celiac disease patients; however, there are still few data regarding children and adolescents. In the present study we measured the bone mineral density (BMD) in children and adolescents at diagnosis of celiac disease and after approximately 1 y of a gluten-free diet. BMD was measured at the lumbar spine and in the whole skeleton by dual-energy X-ray absorptiometry in 44 celiac disease patients aged 2.58-20.42 y at diagnosis. BMD was also measured in a subset of 25 patients after 1.4 +/- 0.04 y of a gluten-free diet. BMD was compared with that of 177 healthy control subjects aged 1.52-20.99 y. Lumbar spine and whole-body BMD values at diagnosis of celiac disease were significantly lower than in control subjects (P = 0.015 and P = 0.0001, respectively) after differences in age and anthropomorphic variables were controlled for. The subjects studied after the gluten-free diet had BMD values not significantly different from those of control subjects. In conclusion, children and adolescents with celiac disease have remarkably reduced lumbar spine and whole-body bone density. A gluten-free diet promotes a rapid increase of BMD that leads to a complete recovery of bone mineralization. These results emphasize the need for an early diagnosis and treatment in patients with celiac disease to obtain an adequate peak bone mass at the end of puberty.

Absorptiometry, Photon↗
PubMed1997

Chronic high-fat feeding and middle-aging reduce in an additive fashion Glut4 expression in skeletal muscle and adipose tissue.

The interaction of middle-aging and chronic high-fat feeding on glucose transport in skeletal muscle and adipose tissue was examined. To this end, we studied the effects of 6 month treatment with a high-fat diet in 12-month old rats. Chronic high-fat feeding led to a substantial reduction in GLUT4 glucose transporter expression both in adipose tissue and in skeletal muscle, which was additive to the reduction in GLUT4 protein content detected in aged rats. In parallel, the high-fat diet led to a reduced insulin-stimulated glucose transport in the incubated soleus muscle and isolated adipocytes; insulin resistance induced by high-fat feeding was superimposed to the decreased insulin response detected in aged rats. Different mechanisms were responsible for GLUT4 repression in response to high-fat feeding or aging in skeletal muscles and adipose tissue.

Adipose Tissue↗
PubMed1997

Heterologous expression of rab4 reduces glucose transport and GLUT4 abundance at the cell surface in oocytes.

To evaluate the role of the small rab GTP-binding proteins in glucose transporter trafficking, we have heterologously co-expressed rab4 or rab5 and GLUT4 or GLUT1 glucose transporters in Xenopus oocytes. Co-injection of rab4 and GLUT4 cRNAs resulted in a dose-dependent decrease in glucose transport; this effect was specific for rab4, since co-injection of an inactive rab4 mutant or rab5 cRNA did not have any effect on glucose transport. The effect of rab4 was selective for GLUT4, since no effect was detected in GLUT1-expressing oocytes. The inhibitory effect of rab4 on GLUT4-induced glucose transport was not the result of a change in overall cellular levels of GLUT4 glucose transporters. However, rab4 expression caused a marked decrease in the abundance of GLUT4 transporters present at the cell surface. Finally, rab4 and inhibitors of PtdIns 3-kinase showed additive effects in decreasing glucose transport in GLUT4-expressing oocytes. We conclude that rab4 plays an important role in the regulation of the intracellular GLUT4 trafficking pathway, by contributing to the intracellular retention of GLUT4 through a PtdIns 3-kinase-independent mechanism.

Animals↗
PubMed1997

Bone modeling indexes at onset and during the first year of follow-Up in insulin-dependent diabetic children.

Osteopenia has been described as a complication of insulin-dependent diabetes mellitus (IDDM). We measured bone modeling indexes during the first year of IDDM. At each time point the values obtained from diabetic children have been compared with those of control subjects. We selected 27 prepubertal children with IDDM (6.35 +/- 2.16 years). We also enrolled 30 healthy prepubertal children of comparable age (5.85 +/- 3.05 years). Height, height standard deviation scores, glycated haemoglobin (HbA1C), basal c-peptide concentrations, insulin dose, serum concentrations of procollagen type I C-terminal propeptide (PICP), and collagen type I C-terminal telopeptide (ICTP) were measured at onset of IDDM and at 3, 6 and 12 months. ICTP was in the normal range at onset of IDDM and decreased during the follow-up to reach a significant difference compared to controls after 3, 6 and 12 months of insulin treatment (P < 0.04). PICP concentrations increased significantly at 3 months (P = 0.05) compared to onset. At 3 and 12 months PICP values were significantly higher than those of control children (P = 0.04). Correlations were found between PICP concentrations and HbA1C and c-peptide at onset of diabetes (r = -0.45 and r = 0.47, respectively). Bone formation at onset of IDDM is not impaired; the introduction of insulin therapy, together with the achievement of a good metabolic control, determines an increase of bone matrix formation coupled with a decrease of bone resorption, that determines a positive balance of bone modeling.

Adolescent↗
PubMed1997

Ketanserin effects on rat behavioral responses: modifications by the estrous cycle, ovariectomy and estradiol replacement.

The present investigation was designed to explore the influence of estrous cycle phase, ovariectomy, and estradiol replacement on the behavioral effects of the 5-HT2 receptor antagonist, ketanserin. The parameters under investigation were ketanserin-influenced acquisition of conditioning avoidance responses (CARs), and the performance of some spontaneous motor behaviors. Ketanserin (KET 3 mg/kg) injected subcutaneously 30 min before testing improved active conditioned avoidance in intact female rats at estrus, and in ovariectomized (OVX) rats with estradiol replacement. Furthermore, KET impaired performance in female rats at diestrus and after ovariectomy. In male rats, which were included in this study in order to compare their behavioral responses with those exhibited by female rats, KET administration enhanced acquisition of CARs. These results provide behavioral evidence for the hypothesis that central serotonergic activity is a function of the hormonal status of the animal. An additional segment of the present study focussed on motoric behaviors. Spontaneous motor activity, number of rears, and time spent in grooming behavior were significantly increased by KET in all groups studied. In contrast, blockade of 5-HT2 receptors failed to induce significant changes in the number of head shakes. Relationships between ovarian hormones and the central serotonergic system are discussed.

Animals↗
PubMed1997

Ketanserin and anxiety levels: influence of gender, estrous cycle, ovariectomy and ovarian hormones in female rats.

The influence of gender, estrous cycle, ovariectomy and ovarian hormones on the behavioral effects of the 5-HT2 receptor antagonist, ketanserin (KET), was studied. Intact males, female rats in the four stages of the estrous cycle and ovariectomized (OVX) female rats 14 days after surgery were used. The OVX rats received progesterone [PROG, 25 mg/kg, subcutaneously (SC)] and/or estradiol benzoate (EB, 10 micrograms/kg, SC). KET (3 mg/kg, SC) was injected 30 min before testing. All the animals were subjected to the following behavioral tests: exploration of an elevated plus-maze and retention of a passive-avoidance response. KET enhanced the exploration of the open arms in diestrous female rats but inhibited this behavior during the other stages of the cycle and in OVX rats injected either with oil or EB. This dose of KET was ineffective in males and in OVX rats injected with PROG. Furthermore, KET inhibited the retention of the passive avoidance response in males, in diestrous and metestrous female rats and in OVX rats injected with oil. In estrous females and in OVX rats injected with EB, KET enhanced the passive-avoidance response. These results demonstrate that the sensitivity to KET differs with the gender, estrous cycle and hormonal treatment and suggest that central serotonergic activity is influenced by the hormonal status of the animal.

Animals↗
PubMed1997

Nonacidotic proximal tubulopathy transmitted as autosomal dominant trait.

The family of a patient with a nonacidotic and hypercalciuric proximal tubulopathy was studied. The proband showed glycosuria, aminoaciduria, tubular proteinuria, renal hypophosphatemia, and urate tubular hyporeabsorption without bicarbonate loss. He also presented increased urine calcium excretion, plasma 1,25-dihydroxyvitamin D, and enteral calcium absorption. Clinical consequences of the tubulopathy were osteopenia and calcium kidney stones. Fifteen of the proband's relatives were studied; six of them had renal hypophosphatemia, 10 presented hypercalciuria, and three showed both hypercalciuria and hypophosphatemia. No other reabsorption defects were observed. High plasma levels of 1,25-dihydroxyvitamin D were found in 13 family members; their values correlated positively with calcium excretion and negatively with tubular phosphate reabsorption. None produced stones or had reduced mineral bone density. Hypophosphatemia and hypercalciuria occurred in the two generations studied; their transmission was independent of gender, and male-to-male transmission occurred for both defects. Our findings suggest that a genetic alteration of proximal tubular function could cause multiple reabsorption defects in the proband or renal phosphate leakage in the proband's relatives. The genotypic alteration causing the proximal dysfunctions may be monogenic, with an autosomal dominant pattern of inheritance and variable expressivity. Increased calcium excretion may be due to the proximal tubular alteration; alternatively, it may be the result of a genetic background predisposing to idiopathic hypercalciuria. Phosphate and calcium loss could stimulate 1,25-dihydroxyvitamin D synthesis in proximal tubular cells.

Absorption↗
PubMed1997

Bone turnover in neonates: changes of urinary excretion rate of collagen type I cross-linked peptides during the first days of life and influence of gestational age.

New markers have been used to monitor the changes of bone turnover occurring during growth. Data on bone turnover rate during the perinatal period are, however, very scarce. In the present study we evaluated bone turnover rate, assessed by the measurement of urinary N-terminal telopeptide of type I collagen (NTx) concentrations, at different gestational ages, and we documented the trend of bone turnover rate occurring in the first days after birth. Urine samples were obtained from 83 healthy full term newborn infants, 16 preterm, and 17 infants of diabetic mothers (IDMs). The first miction after birth was collected. Urine samples were also collected 24 and 48 h after birth. NTx was measured by an enzyme-linked immunosorbent assay (Osteomark, Ostex International, Inc. Seattle, WA). The relationship between NTx at birth and all the other variables has been evaluated using multiple regression analysis. The changes of NTx excretion over time and the effect of the groups were studied by multivariate analysis of variance (MANOVA) for repeated measures. We found a remarkable association between gestational age and NTx concentrations at birth (R = 0.56; p < 0.00001). NTx concentrations showed a progressive decrement, reaching a nadir between the 38th and the 42nd week of gestation. The NTx concentrations changed significantly during the first 48 h of life in the three groups. Moreover, preterm infants had NTx excretion values at birth significantly higher than full term infants (p < 0.001), whereas NTx excretion rates of IDMs were not different from those of the other two groups of subjects. In conclusion, gestational age seems to be the major determinant of bone turnover in neonates; NTx excretion rate is higher before term, it slows in proximity of delivery, and it increases significantly during the first 48 h of life. Preterm infants have higher bone turnover rate than full term infants. NTx excretion rate of IDMs was comparable with those of the control subjects.

Biomarkers↗
PubMed1996

Expression and insulin-regulated distribution of caveolin in skeletal muscle. Caveolin does not colocalize with GLUT4 in intracellular membranes.

Caveolin is believed to play an important role in sorting processes, vesicular trafficking, transmembrane signaling, and molecular transport across membranes. In this study we have evaluated the expression and distribution of caveolin in skeletal muscle and its interaction with GLUT4 glucose carriers. Caveolin was expressed to substantial levels in muscle and its expression was regulated in muscle; aging and high fat diet enhanced caveolin expression in skeletal muscle and inversely, myogenesis down-regulated caveolin in L6E9 cells. Under fasting conditions, most of caveolin was found in intracellular membranes and the caveolin present in the cell surface was found in both sarcolemma and T-tubules. Insulin administration led to a redistribution of caveolin from intracellular high density membrane fractions to intracellular lighter density fractions and to the cell surface; this pattern of insulin-induced redistribution was different to what was shown by GLUT4. These results suggests that caveolin is a component of an insulin-regulated machinery of vesicular transport in muscle. Quantitative immunoisolation of GLUT4 vesicles obtained from different intracellular GLUT4 populations revealed the absence of caveolin which substantiates the lack of colocalization of intracellular GLUT4 and caveolin. This indicates that caveolin is not involved in intracellular GLUT4 trafficking in skeletal muscle.

Animals↗