Enhancement of neutrophil function by granulocyte-macrophage colony- stimulating factor involves recruitment of a less responsive subpopulation

Human granulocyte-macrophage colony-stimulating factor (GM-CSF) enhances numerous functions of mature neutrophils (PMN) including phagocytosis, superoxide responses to chemotaxins, antibody-dependent cellular cytotoxicity, and expression of complement receptors. A central question concerns whether the mechanism of enhancement involves quantitative increases in the response of all cells v subpopulation recruitment. The effects of GM-CSF on individual cell light scatter changes, membrane potential, and oxidant responses induced by the chemoattractant N-formyl-methionyl-leucyl-phenylalanine (FMLP) were assessed by flow cytometry and by scoring individual cells for nitroblue tetrazolium dye (NBT) reduction. GM-CSF produced a dose- and time-dependent shift in forward light scatter that was very similar in character to that seen with FMLP or leukotriene B4 stimulation. Although not capable of depolarizing the cells directly, GM-CSF primed PMNs for enhanced membrane potential responses to FMLP by significantly increasing the proportion of depolarizing cells when compared with diluent-treated controls after a 60-minute incubation at 37 degrees C (79.4% +/- 3.4% v 29.5% +/- 4.7% GM-CSF v diluent, mean +/- SE, P less than .005, n = 11). Subpopulation recruitment by GM-CSF treatment was also demonstrated by the FMLP-elicited NBT test. Taken together, these results indicate that GM-CSF can modulate the function of mature PMN by enhancing the proportion of responsive cells.     

Polymorphonuclear leukocyte heterogeneity in neonates and adults

We have used a mouse monoclonal antibody (31D8) to determine whether differences in neutrophil (PMN) subpopulations might help explain decreased PMN chemotaxis in neonates compared with that of adults. 31D8 has been shown to bind heterogeneously to adult PMNs. Approximately 80% of the PMNs that strongly bind 31D8 (31D8 "bright") are the same cells that depolarize and migrate chemotactically when stimulated with the chemoattractant N-formyl-methionylleucylphenylalanine, while the 20% that weakly bind 31D8 fail to similarly respond. All neonatal PMNs bound 31D8 heterogeneously. There was a smaller population of 31D8 "bright" cells in neonates at birth (76% +/- 6%, n = 45) compared with that of neonates at three to 15 days of age (82% +/- 5%, n = 10, P less than 0.002) and both were smaller than that of adults (88% +/- 4%, n = 45, P less than 0.001 and P less than 0.001). Neonatal cord PMNs, which traversed a micropore filter in a modified Boyden chemotaxis chamber in the presence of a chemoattractant, had an increased percentage of 31D8 "bright" cells (89% +/- 7%) than did PMNs which remained above the filter (82% +/- 7%, n = 10, P = 0.034). PMN chemotaxis was less in neonates at birth (32.7 +/- 4.5 micron) than at three to six days of age (36.8 +/- 11.3 micron) and both were decreased compared with that of adults (69.1 +/- 12.4 micron, P less than 0.001 and P less than 0.001). These findings indicate that decreased PMN chemotaxis in neonates may be due in part to a smaller PMN subpopulation of highly motile cells.     

Blood pressure response during maximal exercise in apparently healthy men and women

The blood pressure (BP) response during a maximal ergometer bicycle test was studied in 190 apparently healthy subjects (95 men and 95 women) aged 21-70 years. The starting load was 50 W and was increased by 50 W every 4 min until exhaustion. Mean physical performance expressed as cumulative work was 2276 +/- 789 W in men and 1109 +/- 276 W in women (P less than 0.0001). The maximum heart rate was similar in men and women and declined significantly with age (r = -0.78, P less than 0.001 for men and r = -0.64, P less than 0.0001 for women). The mean maximal systolic blood pressure (MSBP) was 193 +/- 23 mmHg in men and 171 +/- 21 mmHg in women (P less than 0.0001). Men aged greater than or equal to 50 years had a MSBP of 201 +/- 22 mmHg, compared to 188 +/- 22 mmHg in those aged less than 50 years (P less than 0.01). Women aged greater than or equal to 60 years had a MSBP of 190 +/- 21 mmHg compared to 166 +/- 19 mmHg in their younger counterparts (P less than 0.001). The diastolic BP showed a similar modest increase at all ages and in both sexes. SBP is dependent on age and gender and this must be taken into consideration when assessing a normal response in individual patients.     

Increased production of superoxide anion by neonatal polymorphonuclear leukocytes stimulated with a chemotactic peptide

In order to assess the functional property of neonatal polymorphonuclear leukocytes (PMNs), we studied their chemoattractant-stimulated superoxide anion (O2-) production using a soluble chemotactic peptide N-formyl-methionyl-leucyl-phenylalanine (FMLP) as a PMN stimulus. O2- production by neonatal PMNs was increased: when stimulated with 10(-7)M FMLP, O2- values (nanomoles; mean +/- SE) produced by 10(6) PMNs were 16.5 +/- 1.3 for neonatal PMNs and 12.6 +/- 0.6 for adult PMNs (p less than .02). When studied under various concentrations (10(-9) to 10(-6)M) of FMLP, neonatal PMNs produced more O2- than adult cells under the stimulation of a lower concentration (10(-8)M) as well as a higher concentration (10(-7)M) of FMLP. The increased O2- production by neonatal PMNs was also observed under their stimulation by phorbol myristate acetate. Neonatal and adult PMNs produced equal amounts of O2- when stimulated with a particulate stimulus of opsonized zymosan. To analyze further the mechanism for the increase in FMLP-induced O2- production by neonatal PMNs, we next studied whether there was some abnormality in their FMLP receptors. Neonatal PMNs had normal numbers of FMLP receptors; the receptor numbers (mean) per cell were 54,000 in neonatal PMNs and 56,000 in adult cells. Additionally, the FMLP receptors had normal affinity for the peptide. These results demonstrate that the increased production of O2- by FMLP-stimulated neonatal PMNs is not due to the abnormality of its binding to the receptors but is due to that of the subsequent events.     

Breathing route during sleep

Nasal obstruction has been associated with apneic episodes during sleep. However, the normal distribution of nasal and oral air flow while asleep has not been investigated. To determine the normal route of ventilation during sleep, we studied 7 healthy men and 7 healthy women using a sealed face mask that mechanically separated nasal and oral air flow. Standard sleep staging techniques were employed. The subjects slept 297 +/- 29 (SEM) min, with a mean of 197 +/- 15 min of ventilation recorded. Ventilation was decreased during sleep as has been previously demonstrated. However, during sleep, we found that men breathed a greater percentage of total ventilation through the mouth (29.0 +/- 8.2%) than did women (5.0 +/- 1.0%, p less than 0.02). The same trend applied during wakefulness but did not reach significance (p = 0.06). Although none was symptomatic, 4 subjects, all men, had more than 3 apneas per hour. These 4 men had a greater percentage of mouth ventilation (37.3 +/- 19.0%) than did the other 10 subjects with few or no apneas (8.1 +/- 2.7%, p less than 0.02). It was also noted that increasing age in men was associated with an increasing percentage of mouth ventilation (r = 0.83 p less than 0.03) but this relationship was not observed in women. We conclude that mouth breathing may be associated with apneas during sleep and that breathing through the mouth occurs commonly in men, particularly in those who are older. This suggests that nasal breathing may be important in the maintenance of ventilatory rhythmicity during sleep.     

Gorog Thrombosis Test: analysis of factors influencing occlusive thrombus formation.

We used the Gorog Thrombosis Test to analyze the factors influencing the occlusion time, which represents platelet activation and subsequent occlusive thrombus formation, in 132 healthy Japanese volunteers (116 men, 16 women; mean age, 45.0 +/- 12.0 years). The Gorog Thrombosis Test was designed to evaluate platelet aggregation and thrombolytic activity under a high shear stress condition (175 dynes/cm) in a native blood sample in vitro. The mean +/- SD occlusion time was 154.8 +/- 64.7 s (men, 153.4 +/- 64.2 s and women, 165.4 +/- 56.5 s). The occlusion time was inversely correlated with von Willebrand factor ristocetin cofactor activity (VWF:Rco) (r = -0.242, P = 0.0055) and von Willebrand factor antigen (r = -0.230, P = 0.0080). The mean occlusion time in the group with VWF:Rco of at least 170% (137 s) was significantly shorter than that in the group with VWF:Rco less than 170% (156 s, P < 0.05). Platelet counts, other coagulation markers and smoking showed no significant correlations with occlusion time. Red blood cells (r = -0.177, P = 0.0365), hemoglobin (r = -0.191, P = 0.0245) and hematocrit (r = -0.182, P = 0.0329) also showed inverse correlations with the occlusion time. This report is the first to clearly demonstrate the role of von Willebrand factor in the formation of occlusive thrombi in the Gorog Thrombosis Test.     

Vascular endothelial function in patients with slow coronary flow

BACKGROUND: Slow coronary flow (SCF) in a normal coronary angiogram is a well-recognized clinical entity, but its etiopathogenesis remains unclear. DESIGN: The aim of the study was to determine endothelial function in patients with SCF using a flow-mediated dilatation (FMD) technique in the brachial artery. METHODS: Coronary flow was quantified using the corrected thrombosis in myocardial infarction (TIMI) frame count (CTFC) method. Endothelial function was studied in 27 patients with SCF (23 men, four women, mean age 47.6+/-8.7 years) and in 30 people with normal coronary flow (NCF) (22 men and eight women, mean age 47.5+/-7.4 years). RESULTS: The flow-mediated diameter increase in the SCF group was significantly smaller than that in the NCF group (3.48+/-0.10% compared with 9.11+/-0.10%, P < 0.001). The percentage of nitroglycerine (NTG)-induced dilatation was not significantly different between patients with SCF and people with NCF (16.8+/-1.1% compared with 17.1+/-1.1%, P = 0.87). Simple regression analysis showed that mean CTFC (CTFC(m)) was strongly and inversely related to the percentage of FMD (r = -0.29, P < 0.01) in all participants. When the patients with SCF were excluded, CTFC(m) was still inversely related to the percentage of FMD (r = -0.36, P < 0.05). CTFC(m) was also inversely related to NTG-induced dilatation in the 57 participants (r = -0.23, P < 0.05). Multiple regression analysis showed that CTFC(m) was inversely related to the percentage of FMD only (r = -0.37, P < 0.05). CONCLUSIONS: These findings suggest that endothelial function is impaired in people with SCF and that CTFC correlates well with endothelial dysfunction.     

Sex-related differences in peripheral glucose metabolism in normal subjects

The metabolic response of muscle tissue to glucose ingestion was studied in 10 normal men (M) and women (F) by using the forearm balance technique and indirect calorimetry simultaneously. During the 3 hours after a 75 g--oral glucose load, glucose uptake per unit muscle mass was significantly higher in women than in men, F = 187.3 +/- 26.9 vs M = 116.7 +/- 9.5 mg/100 g forearm muscle (P less than 0.05). A significant difference in muscle glucose fate was also observed since the amount of glucose utilized through a nonoxidative pathway was significantly higher in women, F = 84.5 +/- 2.6% (161.8 +/- 27.3 mg/100 g forearm muscle) vs M = 75.3 +/- 2.2% (87.2 +/- 8.6 mg/100 g forearm muscle) (P less than 0.05), whereas the amount of glucose oxidized in relation to glucose uptake was significantly higher in men, M = 24.7 +/- 2.2% (28.2 +/- 3.2 mg/100 g forearm muscle) vs F = 15.5 +/- 2.6% (27.8 +/- 5.4 mg/100 g forearm muscle) (P less than 0.05). No significant differences in insulin response to glucose ingestion were detected between groups. The women showed greater suppression of serum free fatty acids (FFA) levels in relation to basal levels than men. We conclude that: 1) after ingesting 75 g glucose, normal women showed greater glucose uptake per unit muscle mass than normal men, 2) for 3 hours after the ingestion of 75 g glucose, the predominant tendency toward utilizing glucose by a nonoxidative pathway is more marked in normal women than in normal men, and 3) the higher glucose uptake per unit muscle mass in the female group in the presence of an insulin response not significantly different from that of the male group suggests that muscle insulin sensitivity is greater in normal women.     

Excretion of free catecholamines in relation to age, sex and blood pressure

The influence of age, sex and hypertension on urinary excretion of free catecholamines was evaluated in 190 men (64 hypertensive patients) and 75 women (10 hypertensive patients). Noradrenaline correlates positively with age in healthy men (r = 0.37, p less than 0.001) and women (r = 0.36, p less than 0.001). Adrenaline and dopamine do not show any significant correlation with age. Noradrenaline excretion is slightly higher in young (less than or equal to 39 years of age) and significantly higher in old (greater than or equal to 40 years of age) hypertensive patients than in age-matched control subjects. Noradrenaline (32 +/- 15 micrograms X 24 h-1) and adrenaline excretion (9 +/- 7 micrograms X 24 h-1) are lower in the group of younger women than in younger men (52 +/- 23 and 19 +/- 12 micrograms X 24 h-1). We assume that the lower excretion of free catecholamines in younger women is significant for a lower sympathetic activity.     

The effects of rhGM-CSF on the neutrophil respiratory burst when studied in whole blood

A simple semiquantitative cytofluorometric method has been developed for measuring neutrophil respiratory burst activity in whole blood samples. This technique avoids the introduction of laboratory artefacts which modulate neutrophil function. In addition, flow cytometric analysis allows the response to be studied in individual cells. We show here that neutrophils examined freshly ex vivo, exhibit only weak respiratory burst activity in response to stimulation with the chemotactic peptide FMLP (10(-6) M). Prior incubation with rhGM-CSF results in an increase in the number of responding cells from 13.5 +/- 2.36% (mean +/- SEM) to 46.7 +/- 6.3% (P less than 0.0001) with an increase in total respiratory burst activity of 567% (P = 0.001). The majority of neutrophils in whole blood (67.1 +/- 8.1%) exhibit respiratory burst activity in response to stimulation with phorbol ester (1 micrograms/ml of TPA), and this response is also significantly primed by rhGM-CSF (P = 0.004). The enhancement of respiratory burst activity induced by rhGM-CSF is due to both recruitment of previously unresponsive neutrophils, and to intensification of the response of the responding cells. In vivo administration of rhGM-CSF also results in priming of the respiratory burst in response to FMLP, although the enhancement of activity is not as great as that obtained when pre-infusion blood samples are incubated with rhGM-CSF in vitro.     

Quantitation of apolipoprotein A-I of human plasma high density lipoprotein.

High density lipoproteins (HDL) may be controlled via their major apolipoprotein, A-I. To study this apolipoprotein, a simple, precise, and accurate immunodiffusion assay for A-I was developed and applied in a sample of Bell Telephone Company employees. A-I showed a slight increase with age in men (r=0.11, n=263) and women (r=0.15, n=257). A-I correlated closely with HDL cholesterol (r=0.72). It was weakly related to total triglyceride in women (r=0.24) but was inversely related in men (r=-0.17). Women on estrogen had the highest A-I levels (149 mg/dl +/- 26, x +/- S.D., n=29, p is less than 0.05), followed by women on combination oral contraceptives (141 +/- 26, n=80) whereas women on no medication had lower levels (129 +/- 25, n=99, p is less than 0.01) but men had the lowest levels (120 +/- 20, p is less than 0.01) In a separate group of 14 women given estrogen for 2 wks (1 mug/kg/day), A-I increased by 24%. Thus A-I is increased by exogenous and, most likely, endogenous estrogen, Among hyperlipidemic referral subjects, those with hypercholesterolemia (n=43) and hypertriglyceridemic women (n=33) had normal A-I levels. Among hypertriglyceridemic men both A-I and HDL cholesterol values were decreased (115 +/- 20, p is less than 0.01 and 37 +/- 3, p is less than 0.01, respectively, n=68) but were significantly lower among a group of myocardial infarction survivors (107 +/- 16, p is less than 0.01, and 27 +/- 6, p is less than 0.01, respectively, n=24). High density lipoprotein levels and the content of cholesterol in HDL associated with A-I appear to be decreased in coronary heart disease.     

Left ventricular mass in normal Indian population.

A prospective study was conducted to ascertain the distribution of the left ventricular mass in normal adult Indian population and to establish the upper limit of the same. Four hundred and eighty normal subjects (men = 310; women = 170), in the age group of 18 to 60 years were screened echocardiographically, to estimate the left ventricular mass. The left ventricular mass in men was found to be 124 +/- 32 gm whereas in women it was 93 +/- 37 gm. The upper limit of the left ventricular mass (mean +/- 2 SD) was found to be 189 gm and 167 gm, for men and women respectively. The left ventricular mass in both men and women correlated with the body weight (r = 0.51, p less than 0.001; r = 0.22, p less than 0.001), height (r = 0.27, p less than 0.001; r = 0.22, p less than 0.01), and the body surface area (r = 0.49, p less than 0.001; r = 0.27, p less than 0.001), whereas it was found to be independent of age (r = 0.01, p = NS; r = 0.10, p = NS). In men alone the diastolic blood pressure influenced the left ventricular mass (r = 0.27, p less than 0.001), otherwise the left ventricular mass was independent of systemic blood pressure variations within the normal range. The left ventricular mass in the present study differs significantly from the Western population.     

Suppressor cell function in sarcoidosis.

We investigated the role of suppressor cells in the depressed cellular immunity of patients with sarcoidosis. The mean response in 16 patients with active sarcoidosis to three concentrations of phytohemagglutinin was significantly (P less than 0.01) less than control values. Passage of the cells over glass wool resulted in a 116% increase in response to phytohemagglutinin in patients and a 39% decrease in control subjects. Addition of indomethacin to phytohemagglutinin cultures increased the response of cells in patients with sarcoidosis by 192% +/- 32% versus a 112% +/- 18%-increase for control subjects (mean +/- SEM, P less than 0.05). Patients had an increased percentage of monocytes in peripheral blood mononuclear cell preparations, and the percent monocytes correlated with the percent increase in phytohemagglutinin response after glass wool passage (r = 0.62, P less than 0.05). Thus, several factors contribute to the depressed phytohemagglutinin response in sarcoidosis patients: an increased suppression by the prostaglandin-producing suppressor cell, an increased percentage of monocytes, and an as yet undefined factor.     

Effects of age, gender and metabolic factors on endothelium-dependent vasodilation: a population-based study.

OBJECTIVES: A progressive decline in endothelium-dependent vasodilation (EDV) in the human forearm with age has previously been reported. The aim of this study was to evaluate the interplay between age, gender and metabolic factors on EDV in healthy subjects in a population-based study. SETTING: Tertiary university hospital. SUBJECTS AND DESIGN: Thirty-six healthy men and 30 women, aged 20-69 years, underwent measurements of forearm blood flow (FBF) at rest and during local infusions of 2 and 4 microg min-1 of metacholine (evaluating EDV) and 5 and 10 microg min-1 of sodium nitroprusside (evaluating endothelium-independent vasodilation, EIDV) and during reactive hyperaemia by venous occlusion plethysmography. RESULTS: Age was inversely related to EDV (r = - 0.41, P < 0.05 in men; r = - 0.61, P < 0.01 in women) and maximal FBF during reactive hyperaemia in both men and women. EIDV was significantly related to age in an inverse way in women only. EDV was more pronounced in females than in males before menopause (48 +/- 3 SD years, 635 +/- 186 vs. 502 +/- 269% in males, P < 0.05), but similar in women and men thereafter (374 +/- 141 vs. 370 +/- 185% in men). The slope of the regression line for the relationship between age and EDV was flatter in premenopausal than in postmenopausal women (- 2.3 vs. - 6.4), whilst this slope was similar in younger and older men (- 5.5 vs. - 5.3). In multiple regression analysis, fasting blood glucose levels and the waist/hip ratio remained the only significant predictors of EDV in men (P < 0.01 for both), whilst age was the only significant independent predictor of EDV in women (P < 0.01). CONCLUSION: The interplay between age and metabolic factors as determinants of endothelial function is different in healthy men and women.     

Estimates of circulating monomeric calcitonin: physiological studies in normal and thyroidectomized man

To avoid the limitations of present human calcitonin (hCT) assays, we have developed a silica extraction and concentration method for plasma hCT that lowers the detection limit of the assay 40-fold (to 0.5-1.0 pg/ml), and markedly improves specificity of the assay for the CT monomer (hCT-M). Extraction recoveries of radioiodinated and unlabeled synthetic hCT-M added to 20 ml plasma were, respectively, 90 +/- 1% and 99 +/- 4% (mean +/- SE). Gel filtration chromatography of plasma from patients with medullary thyroid carcinoma demonstrated that the extract was markedly enriched in hCT-M. Basal plasma immunoreactive hCT was measured before (iCT) and after extraction (exCT) in 60 normal individuals; basal exCT levels were higher in young men than in young women [8.0 +/- 0.8 (+/- SE) vs. 4.6 +/- 0.5 pg/ml; P less than 0.001] and higher in elderly men than in elderly women (9.4 +/- 0.8 vs. 4.7 +/- 0.6 pg/ml; P less than 0.05), but not different with age. Calcium infusions (2 mg Ca/kg over 5 min) in 36 subjects showed a significantly greater secretory capacity for exCT in men than in women, but showed no decline of exCT response with age. There was no correlation between basal iCT and exCT concentrations, but there was a good correlation between peak Ca-stimulated iCT and peak Ca-stimulated exCT levels (r = 0.94; P less than 0.001), suggesting that hCT-M was the main form released by acute stimulation. The mean extractable CT level in 6 totally thyroidectomized individuals was 2.7 +/- 0.3 pg/ml and did not increase after Ca challenge. We found no significant differences in basal or Ca-stimulated exCT levels measured in 5 women on 3 different occasions over the span of 1 menstrual cycle. After a meal, exCT levels did not change in women, but there was a consistent increase in the men (28 +/- 7% over baseline at 3 h; P less than 0.01). In summary, plasma concentrations of exCT and, most likely, hCT-M were very low (less than 10 pg/ml in most healthy adults) and always increased after calcium infusion. The measurement of plasma exCT is a useful technique that provides new sensitivity and specificity for the study of hCT physiology.     

THE RESPONSE OF OBESE SUBJECTS TO CONTINUOUS INFUSION OF HUMAN PANCREATIC GROWTH HORMONE-RELEASING FACTOR 1–44

The growth hormone (GH) response of seven obese subjects to a 4 h continuous infusion of human pancreatic GH-releasing factor, 0.3 micrograms/kg/h, has been compared with that obtained in seven sex and age matched controls. The pattern of response was normal in the obese but peak GH levels (mean +/- SEM: 13.8 +/- 1.9 compared to 30.9 +/- 4.7 mU/l, P less than 0.01) and integrated GH levels (mean +/- SEM: 27.1 +/- 3.6 compared to 62.0 +/- 9.7 mU/l/h, P less than 0.01) were reduced in obese subjects. There was a negative correlation between the integrated GH response and the percentage ideal body weight (r = -0.80, P less than 0.05), but no significant correlation with somatomedin-C levels (r = +0.72; P = 0.07). Obese subjects have an impaired GH response to infusion of GH-releasing factor which is not related to negative feedback by somatomedins.     

No relation of tuberculin reactivity with quantitative analysis of peripheral blood lymphocyte subsets in haemodialysis patients.

Anergic response to tuberculin (PPD) is well known in haemodialysis patients (HDp). This cross-sectional controlled study was conducted to analyse the correlation of PPD response with demographical features, nutritional parameters and the distribution of peripheral blood lymphocyte (PBL) subtypes. In this study 29 HDp (17 men, 12 women; mean age 30.9 +/- 9.5 years) and 13 controls (eight men, five women; mean age 29.2 +/- 6.4 years) were included. The mean time spent on dialysis was 20.5 +/- 17.4 months. The mean PPD response was lower in HDp than controls (7.5 +/- 8 mm vs. 15 +/- 4 mm, P = 0.001). Fourteen patients (48%) were PPD (-) (eight men, six women; mean age 34.1 +/- 11.1 years) and 15 were PPD (+) (normergic) (nine men, six women; mean age 26.8 +/- 3.4 years). No difference was observed between PPD (-) and (+) groups for age, sex and time spent on dialysis. As nutritional parameters, body mass index, serum albumin, creatinine and cholesterol levels were measured and no differences were found between controls and the PPD (-) and (+) groups. Absolute lymphocyte counts were lower in HDP compared to controls (1290 +/- 296 vs. 1570 +/- 307 cells ml-1; P = 0.01). PBL subtype percentages and absolute counts (CD3, CD4, CD8, CD4/CD8, HLADR+CD3+, CD16+56+, CD19) were also similar between PPD(-) and (+) HDp. It was concluded that PPD response cannot be predicted by the distribution of PBL subtypes. The most probable cause of this observation is regulation of PPD reactivity by in situ immune cells whose composition is not reflected in the distribution of PBL.     

Reliability of the measurement of postprandial thermogenesis in men of three levels of body fatness.

To determine the reliability of the measurement of postprandial thermogenesis by indirect calorimetry and to clarify further the relationship of obesity to thermogenesis in men, the thermic effect of a 720-kcal, mixed liquid meal was compared in 13 lean men (mean +/- SEM, 11.2% +/- 1.4% body fat), 10 average men (22.4% +/- 1.6% body fat), and 12 obese men (33.4% +/- 1.6% body fat) on two occasions. Resting metabolic rate (RMR) was measured for 3 hours: (1) in the fasted state, and (2) after a 720-kcal mixed liquid meal, on two occasions. The thermic effect of the meal, calculated as the postprandial energy expenditure minus the fasting RMR (kcal/3h), was greater for the lean and average men than for the obese men during both trials (P less than .001), but was only marginally different between the lean and average groups (P = .16). The mean values for the two trials were similar and the measurement of thermogenesis was highly reproducible with a reliability coefficient of r = .932 (P less than .001). Across all groups, thermogenesis correlated strongly with percent body fat (r = -.64, P less than .01), but within the average men, thermogenesis was uncorrelated with percent body fat (r = .09) but highly correlated with the glucose response to the meal (r = -.75, P less than .05). Thus, factors other than body fatness, such as insulin sensitivity, may determine thermogenesis within this heterogeneous middle group.(ABSTRACT TRUNCATED AT 250 WORDS)     

Skeletal muscle potassium increases after diet and weight reduction in obese subjects with normal and impaired glucose tolerance

Body composition calculated from total body potassium and skeletal muscle potassium were studied in middle-aged obese men and women with normal and impaired glucose tolerance as well as Type II diabetes before and after advice on calorie reduction during twelve months. The subjects were compared with healthy lean men and women. Mean weight loss was 6.6 kg (P less than 0.05). Lean body mass and body fat decreased 2.0 kg (P less than 0.05) and 4.6 kg (P less than 0.05), respectively. Total body potassium decreased by a mean of 146 +/- 49 mmol (P less than 0.01). Obese men with Type II diabetes and impaired glucose tolerance had lower total body potassium and muscle potassium levels than obese healthy men. After dieting, the obese men and women increased their muscle potassium levels with a mean of 2.8 mmol/100 fat-free dry weight to 42.6 +/- 2.6 mmol/100 g fat-free dry weight (P less than 0.05), but they were still below the levels of the lean controls, 44.4 +/- 1.3 MMOL/100 g fat-free dry weight, (P less than 0.01). Increase in skeletal muscle potassium was correlated to decrease in body weight, r = 0.55 (P less than 0.01) and to decrease in fasting blood glucose, r = 0.42 (P less than 0.05).     

Increase in H-Y antigen-positive lymphocytes in hirsute women: effects of cyproterone acetate and estradiol treatment

To investigate a possible relationship between lymphocyte H-Y antigen expression and plasma androgen concentrations in hirsute women, 27 hirsute women were studied. A significant increase in the percentage of H-Y-positive lymphocytes was found in both hirsute women with idiopathic hirsutism [13.4 +/- 2.9% (+/- SD); n = 15] and hirsute women with the polycystic ovary syndrome (13.0 +/- 2.8%; n = 12) compared to that in normal women (10.0 +/- 1.9%; n = 30; P less than 0.0005). Plasma testosterone and androstenedione concentrations, % H-Y+ lymphocytes, and hirsutism scores diminished during oral cyproterone acetate (50 mg/day) and percutaneous estradiol (3 mg/day) treatment. Significant correlations between % H-Y+ lymphocytes and hirsutism scores (P less than 0.001), % H-Y+ lymphocytes and plasma T concentrations (P less than 0.01) were found. We conclude that 1) women can produce H-Y antigen in the same way as men; 2) hirsutism is associated with an increase in H-Y antigen; and 3) the antiandrogen cyproterone acetate reduces H-Y antigen expression on lymphocytes.