RESUMEN
Altered sex hormone levels are thought to play an important role in adult-onset diseases including obesity, cardiovascular disease, and diabetes. They contribute to these complex diseases through changes in their availability, which is influenced, in part, by binding proteins. Insulin resistance, which is characteristic of these diseases, along with increased insulin secretion, is a physiologic change that occurs normally during pregnancy. To determine the relationship between insulin resistance and sex hormone levels, we examined the associations of sex hormone-binding globulin (SHBG) and testosterone with measures of glycemia and insulinemia in a healthy pregnant population. We measured fasting serum SHBG and testosterone levels in 215 Hispanic mothers of Mexican ancestry from the HAPO Study cohort and tested for associations between SHBG and testosterone levels and maternal plasma glucose and C-peptide. After adjusting for confounding variables, serum total testosterone (TT) was positively associated with fasting C-peptide (0.18 µg/l higher for TT higher by 1 SD, p=0.001) and 1-h C-peptide (0.79 µg/l higher for TT higher by 1 SD, p<0.001). Free testosterone (FT) was also positively associated with fasting C-peptide (0.19 µg/l higher for FT higher by 1 SD, p<0.001), and 1-h C-peptide (0.83 µg/l higher for FT higher by 1 SD, p<0.001). Although these findings are from a single cohort, this study provides evidence for an association between testosterone and C-peptide during pregnancy in a nondiabetic Hispanic obstetric population.
Asunto(s)
Péptido C/sangre , Hiperglucemia/sangre , Complicaciones del Embarazo/sangre , Testosterona/sangre , Glucemia/metabolismo , Estudios de Cohortes , Femenino , Humanos , Hiperglucemia/etnología , Insulina/sangre , Americanos Mexicanos , México/etnología , Embarazo , Complicaciones del Embarazo/etnología , Resultado del Embarazo , Globulina de Unión a Hormona Sexual/metabolismo , Estados UnidosRESUMEN
CONTEXT: The high incidence of insulin resistance, type 2 diabetes, and metabolic syndrome in Western societies and their impact on quality of life emphasize the importance of identifying underlying susceptibility loci for metabolic diseases. The polycystic ovary syndrome (PCOS) susceptibility locus D19S884 allele 8 (A8) is associated with measures of insulin resistance, beta-cell dysfunction, and other metabolic phenotypes in PCOS families. We now investigate the role of D19S884 A8 in pregnancy. OBJECTIVE: Using the multiethnic Hyperglycemia and Adverse Pregnancy Outcome cohort, we assessed the associations of D19S884 A8 with measures of maternal glycemia and fetal size. DESIGN: We tested for association of maternal D19S884 A8 with maternal outcomes (fasting, 1-h, and 2-h plasma glucose, and fasting and 1-h C-peptide from an oral glucose tolerance test) and fetal and maternal D19S884 A8 with fetal outcomes (birth weight, length, head circumference, sum of skin folds, fat mass, cord C-peptide, and 2-h neonatal plasma glucose). SUBJECTS: We analyzed 4424 Caucasian mothers and 3347 offspring of northern European ancestry, 1957 Thai mothers and 2089 offspring from Bangkok, 1208 Afro-Caribbean mothers and 1209 offspring from Barbados, and 774 Hispanic mothers and 762 offspring from Bellflower, California. RESULTS: After adjusting for confounding variables and multiple testing, neither maternal nor fetal D19S884 A8 showed significant evidence for association with any of the outcomes tested. CONCLUSIONS: The PCOS susceptibility locus, D19S884 A8, is not a major factor contributing to glycemia during pregnancy or fetal size in a general obstetric population.
Asunto(s)
Glucemia/genética , Desarrollo Fetal/genética , Predisposición Genética a la Enfermedad/genética , Alelos , Peso al Nacer/genética , Péptido C/genética , Femenino , Estudios de Asociación Genética , Genotipo , Humanos , Resistencia a la Insulina/genética , Síndrome del Ovario Poliquístico/genética , Embarazo , Resultado del Embarazo/genéticaRESUMEN
A 99mTc-MDP bone scan was performed on a 65-yr-old woman because of joint pain. The study showed bilateral lung uptake and no abnormalities of the affected joints. Wegener's vasculitis was diagnosed. Lung uptake on bone scans has been noted in various conditions but not Wegener's vasculitis. The differential diagnosis of lung uptake on bone scan should include Wegener's vasculitis.
Asunto(s)
Huesos/diagnóstico por imagen , Granulomatosis con Poliangitis/diagnóstico por imagen , Pulmón/diagnóstico por imagen , Medronato de Tecnecio Tc 99m , Anciano , Diagnóstico Diferencial , Femenino , Humanos , Artropatías/diagnóstico por imagen , Radiografía , CintigrafíaRESUMEN
A case of fatal oral poisoning with formic acid resulting in shock, metabolic acidosis, and hemolysis is reported. The formic acid concentration on admission was 348 micrograms/mL, which, together with an increase in lactic acid, contributed to the metabolic acidosis. Because it has been suggested in the literature that formic acid might induce hemolysis via a direct cytotoxic action on the RBCs, an in vitro study was performed using human RBCs in saline, phosphate buffered saline, and plasma in order to define the mechanism of the hemolysis. These experiments indicate that the hemolysis is not a cytotoxic effect of formic acid but is related to the degree of acidity in itself.