RESUMO
The GH deficiency syndrome in adults is characterized by changes in body composition, metabolic, cardiovascular and psychological profile. Such alterations fit the metabolic syndrome. Changes of blood pressure (BP) levels related to the presence of insulin resistance (IR) may be present in the GH-deficient adult prior to or after therapy with recombinant GH (hGH). The purpose of the study was to assess the relationship between BP and IR in GH-deficient adults after 24 months of replacement with hGH. Thirteen GH-deficient adults were studied [7 men and 6 women, with an average age of 38.6+/-14.14 yr body mass index (BMI) 25.83+/-2.26 kg/m2]. The BP was assessed by means of ambulatory monitoring of BP (AMBP), prior to the treatment and 12 and 24 months after replacement with hGH. Glucose metabolism was assessed by the homeostatic model assessment (HOMA), during the same periods. The average dosage of hGH utilized was 0.67+/-0.15 mg/day. In the analysis of BP levels, we observed a decrease of the diurnal systolic BP (SB P) (p=0.043) and a reduction of the diurnal systolic (p=0.002) and diastolic pressure loads (p=0.038). During the night there were no changes in BP levels. We observed an increase in the percentage of patients with a non-physiological nocturnal fall (non dippers) after replacement with hGH (61.53%). The mean HOMA, insulin and glucose in the fasting state did not present any statistically significant changes. Although the patients within the nondipper group had higher HOMA and insulin levels throughout the study, there were no changes in any of these parameters after GH replacement. All patients with HOMA >2.5 were within the non-dipper group, whereas all dippers had HOMA <2.5. In conclusion, 24 months of therapy with hGH do not seem to have affected glucose homeostasis, and since there is no relationship with the increase of the percentage of non-physiological nocturnal fall, we will need a longer observation time to discover the effects of this finding.
Assuntos
Pressão Sanguínea/efeitos dos fármacos , Ritmo Circadiano , Nanismo Hipofisário/tratamento farmacológico , Terapia de Reposição Hormonal/efeitos adversos , Hormônio do Crescimento Humano/uso terapêutico , Hipotensão/induzido quimicamente , Resistência à Insulina , Adulto , Glicemia/análise , Monitorização Ambulatorial da Pressão Arterial , Feminino , Hormônio do Crescimento Humano/efeitos adversos , Humanos , Insulina/sangue , Masculino , Pessoa de Meia-Idade , Fatores de TempoRESUMO
O presente trabalho compara a incidência de auto-anticorpos anti-insulina (IAA) e anti-pró-insulina (PAA) em diabéticos do tipo I de início recente e em seus parentes de primeiro grau. Foram estudados 33 indivíduos normais (grupo I), 16 diabéticos do tipo I de início recente (grupo II) e 141 parentes em primeiro grau de diabéticos do tipo I (grupo III). Os IAA e PAA foram determinados pelo método de radioensaio, sendo considerados anormais níveis de IAA acima de 0,584 pmol/L e de PAA acima de 0,441 pmol/L. Näo foram observadas diferenças significantes quanto a idade e sexo entre os 3 grupos. Nos indivíduos normais os níveis de PAA foram significantemente menores do que os de IAA. Entre os diabéticos de início recente foi encontrada uma incidência de IAA de 37,5 por cento e de PAA de 25,0 por cento, näo ocorrendo, entretanto, diferenças significantes entre os níveis destes dois anticorpos. Entre os parentes em primeiro grau a incidência de IAA foi de 3,5 por cento e de PAA de 7,8 por cento, näo ocorrendo também diferenças entre os dois testes. Houve uma correlaçäo significante entre os níveis dos IAA e dos PAA no grupo de diabéticos de início recente (r=0,64; p < 0,05). Os IAA e PAA parecem estar dirigidos contra o mesmo determinante antigênico e, portanto, têm o mesmo valor preditivo para o DM tipo I
Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Autoanticorpos/imunologia , Diabetes Mellitus Tipo 1/imunologia , Anticorpos Anti-Insulina/imunologia , Proinsulina/imunologia , Diabetes Mellitus Tipo 1/sangue , Anticorpos Anti-Insulina/sangue , Valor Preditivo dos Testes , Proinsulina/sangueRESUMO
1. Insulin autoantibodies (IAA) of first-degree relatives of type I diabetic patients and recent-onset type I diabetics were measured by radioimmunoassay. A cut-off of 60 nU/ml was established on the basis of the values of normal control individuals. The intra-assay coefficient of variation was 9.2% for a moderately positive serum (1908 +/- 176 nU/ml (mean +/- SD), N = 7; range, 1708 to 2158 nU/ml). The interassay coefficient of variation was 23.8% for a negative (normal control) serum (28.1 +/- 6.7 nU/ml, N = 6; range, 22 to 39 nU/ml) and 14.5% in a highly positive serum (6185 +/- 899 nU/ml, N = 7; range, 5053 to 7009 nU/ml). 2. Insulin autoantibody levels (mean +/- SEM) were 19.3 +/- 2.8 nU/ml (range, -19 to 40 nU/ml) in 25 controls, 24.8 +/- 3.4 nU/ml (range, -17 to 59 nU/ml) in 41 type II diabetic patients, 18.5 +/- 2.4 nU/ml (range, -58 to 268 nU/ml) in 171 first-degree relatives of type I diabetic patients and 208.9 +/- 87.0 nU/ml (range, 10 to 1101 nU/ml) in 16 recent-onset type I diabetic patients. IAA levels were significantly higher in the last group compared with the other groups (P < 0.01). 3. None of the controls or type II diabetics exceeded the upper limit of normality. In contrast, 9 of 171 (5.3%) first-degree relatives and 9 of 16 (56.0%) recent-onset type I diabetic patients had IAA levels above the 60 nU/ml cut-off point.(ABSTRACT TRUNCATED AT 250 WORDS)
Assuntos
Autoanticorpos/sangue , Diabetes Mellitus Tipo 1/genética , Diabetes Mellitus Tipo 1/imunologia , Insulina/imunologia , Adolescente , Adulto , Diabetes Mellitus Tipo 1/sangue , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
Insulin autoantibodies (IAA) of first-degree relatives of type diabetic patient and recent-onset type I diabetics were measured by radioimmunoassay. A cut-off of 60 nU/ml was established on the basis of the values of normal control individuals. The intra-assay coefficient of variation was 9.2% for a moderately positive serum (1908 ñ 176 nU/ml (mean ñ SD), N=7; range, 1708 to 2158 nU/ml). The interassay coefficient of variation was 23.8% for a negative (normal control) serum (28.1 ñ 6.7 nU/ml, N=6; range, 22 to 39 nU/ml) and 14.5% in a highly positive serum (6185 ñ 899 nU/ml, N=7; range, 5053 to 7009 nU/ml). Insulin autoantibody levels (mean ñ SEM) were 19.3 ñ 2.8 nU/ml (range, =-19 to 40 nU/ml) in 25 controls, 24.8 ñ 3.4 nU/ml (range, -17 to 59 nU/ml) in 41 type II diabetic patients, 18.5 ñ 2.4 nU/ml (range, -58 to 268 nU/ml) in 171 first-degree relatives of type I diabetic patients and 208.9 ñ 87.0 nU/ml (range, 10 to 1101 nU/ml) in 16 recent-onset type I diabetic patients. IAA levels were significantly higher in the last group compared with the other groups (P<0.01). None of the controls or type II diabetics exceeded the upper limit of normalyity. In contrast, 9 of 171 (5.3%) first-degree relatives and 9 of 16 (56.0%) recent-onset type I diabetic patients had IAA levels above the 60 nU/ml cut-off point. These data indicate that this method is effective for the detection of individuals who are at high risk to develop type I diabetes
Assuntos
Autoanticorpos , Autoimunidade/efeitos dos fármacos , Diabetes Mellitus Tipo 1 , Insulina , RadioimunoensaioRESUMO
Estudo retospectivo de 104 casos entre 10 e 20 anos de idade, atendidos em 1982 no Setor de Emergencia do HMSA.Foram levantados dados relativos a idade, sexo, cor mes e horario do atendimento, modo como chegaram ao hospital, destino dos pacientes e reincidencias. Do ponto de vista medico ha necessidade de ser bem investigado na amnamese o tipo de inalante usado, ja que seus efeitos imediatos sao semelhantes mas por serem diferentes em sua composicao diferem na sua toxicidade. O quadro psicossocial destes jovens e semelhantes. Buscam um prazer rapido, facil e barato, que lhes permita por instantes fugir de uma realidade dificil. A perda da autocritica e a sensacao de onipotencia apos a inalacao os levam a pratica de atos delinquenciais e frequentes contratos com a policia