Reduction of serum testosterone levels during chronic glucocorticoid therapy

The effect of chronic glucocorticoid therapy on serum testosterone levels was studied in men aged 67 +/- 4 (SD) years with chronic pulmonary disease. The serum testosterone level was reduced in 14 of 16 patients to a mean value of 211 +/- 93 ng/dL, compared with 449 +/- 111 ng/dL in 11 age- and disease-matched control patients (p less than 0.001). The corticosteroid dosage and the serum testosterone level were inversely related (r = -0.78). Testosterone binding to serum proteins was not significantly affected. Basal gonadotrophin levels were not elevated while their secretory responses to exogenous gonadotrophin-releasing hormone (GnRH) were intact. We conclude that glucocorticoid therapy commonly reduces serum testosterone levels in older men due to alteration of hypothalamic GnRH secretion.     

Elevation of serum lipid levels during diuretic therapy of hypertension

In a study attempting to improve coronary risk status, serum cholesterol and triglyceride levels were measured before and during treatment of 74 patients with mild primary hypertension. In 35 patients there was a satisfactory reduction in elevated blood pressure levels with diet therapy alone. In the remaining 39 patients a diuretic drug was required in addition to the diet. Diet therapy alone was followed by a decrease of $\text{11 mg}\text{100 ml}$ in mean serum cholesterol (p < 0.01 versus pretreatment value) and no change in serum triglyceride. The use of diuretics was accompanied by an average increase of $\text{11 mg}\text{100 ml}$ in serum cholesterol and of $\text{34 mg}\text{100 ml}$ in serum triglyceride (p < 0.01 versus pretreatment level for both). In a subgroup of 21 patients with greatest elevations in lipid levels during the administration of diuretics, little improvement in coronary risk status occurred because the increase in serum cholesterol balanced the decrease in systolic blood pressure, according to Framingham risk tables. If the level of serum lipids is a factor in the pathogenesis of coronary atherosclerosis, then the observed effect of diuretic drugs to elevate serum cholesterol and triglyceride levels may explain, in part, the continuing high rate of occurrence of myocardial infarction during the treatment of hypertension.     

血脂康降脂作用与血清一氧化氮关系的研究

目的 :探讨血脂康降脂治疗及预防冠心病的机制。方法 :测定 38例高胆固醇血症患者在服药前及服药后第 4、8周与 2 0例正常对照者的血脂及血清一氧化氮 (NO)水平。结果 :①治疗前高胆固醇组与对照组相比 ,血清总胆固醇 (TC)、低密度脂蛋白胆固醇 (LDL C)明显升高 ,NO明显降低。②血脂康治疗 4周后 ,血清TC、LDL C明显下降 ,NO无改变 ,至第 8周 ,血清NO显著上升。③治疗后LDL C下降值与NO上升值呈负相关 (r=- 0 .6 9,P <0 .0 5 )。结论 :血脂康除有效降脂外 ,还能提高血清NO水平 ;血清NO水平随LDL C降低而上升 ,可能是降脂治疗及预防冠心病发生的重要机制之一     

Changes in serum leptin levels during GnRH agonist therapy

The purpose of the present study was to investigate changes in serum leptin levels during GnRH agonist therapy. Twenty regularly menstruating women with uterine leiomyomas were enrolled. These subjects were given GnRH agonist (leuprorelin acetate, 3.75 mg) monthly for 4 months. Serum leptin and estradiol (E2) levels were measured at the two time points of day 1 or 2 of the menstrual cycle and the end of GnRH agonist therapy. Weight, total body fat mass, percentage of body fat, and total body lean mass were measured by whole body scanning with dual-energy X-ray absorptiometry. The ratio of serum leptin levels to total body fat mass (leptin-fat mass ratio), and the ratio of serum leptin levels to total body lean mass (leptin-lean mass ratio) were calculated. All subjects became amenorrheic after the initial administration of GnRH agonist. Baseline E2 levels were 45.4 +/- 21.0 pg/mL, which significantly decreased after GnRH agonist therapy (13.3 +/- 4.2 pg/mL, p<0.01). Baseline leptin levels were 8.7 +/- 8.1 ng/mL, which did not differ from the values after 4 months of GnRH agonist administration (8.9 +/- 6.8 ng/mL). Total body fat mass significantly increased from 20.0 +/- 10.4 to 21.0 +/- 9.4 kg (p<0.05), while total body lean mass significantly decreased (34.5 +/- 4.2 kg to 33.3 +/- 3.9 kg, p<0.01). However, leptin-fat mass ratio after GnRH agonist therapy did not differ from the baseline values (0.39 +/- 0.16 ng/mL/kg vs 0.38 +/- 0.16 ng/mL/kg). Hypogonadism does not have a major impact on circulating leptin levels.     

Alterations in serum thyroid hormonal indices with colestipol-niacin therapy

A serial blood-lipid-lowering study at the University of Southern California yielded unexpected findings on routine thyroid function monitoring. After 1 year of combined colestipol and niacin therapy, patients had reduced total serum thyroxine (T4) levels and increased triiodothyronine uptake ratios, an indicator of apparent decreases in thyroxine-binding globulin levels. Calculation of the free T4 index partially but not completely corrected for the apparent decrease in thyroxine-binding globulin, as determined by a relatively small decrease in the free T4 index compared with a large decrease in T4. Sequential sampling, using three separate methods, showed reduced thyroxine-binding globulin levels. The mechanism for these changes is unknown, but the fact that these patients were essentially euthyroid needs emphasis because the use of combined colestipol and niacin therapy is becoming more widespread.     

胰岛素治疗对血清中胰岛素样生长因子I水平的影响

To explore the effect of insulin therapy on serum level of insulin-like growth factor-I(IGF-I)in patients with type 2 diabetes mellitus.The results showed that serum IGF-I level increased[(126.70±51.91 vs 90.04±43.68)μg/L,P<0.01]and was positively correlated with insulin level in patients with type 2 diabetes mellitus after exogenous insulin therapy(r=0.298,P<0.05).     

胰岛素治疗对血清中胰岛素样生长因子I水平的影响

探讨胰岛素治疗对2型糖尿病患者血清中胰岛素样生长因子I(IGF-I)水平的影响以及两者之间的关系.结果 发现2型糖尿病患者外源性胰岛素治疗可增加血清中的IGF-I水平[(126.70±51.91对90.04±43.68)μg/L,P<0.01],并且IGF-I水平与胰岛素水平呈正相关(r=0.298,P<0.05).

Abstract：

To explore the effect of insulin therapy on serum level of insulin-like growth factor-I(IGF-I)in patients with type 2 diabetes mellitus.The results showed that serum IGF-I level increased[(126.70±51.91 vs 90.04±43.68)μg/L,P<0.01]and was positively correlated with insulin level in patients with type 2 diabetes mellitus after exogenous insulin therapy(r=0.298,P<0.05).     

胰岛素治疗对血清中胰岛素样生长因子I水平的影响

To explore the effect of insulin therapy on serum level of insulin-like growth factor-I(IGF-I)in patients with type 2 diabetes mellitus.The results showed that serum IGF-I level increased[(126.70±51.91 vs 90.04±43.68)μg/L,P<0.01]and was positively correlated with insulin level in patients with type 2 diabetes mellitus after exogenous insulin therapy(r=0.298,P<0.05).     

Effect of postmenopause and hormone replacement therapy on serum adiponectin levels

Little is known about the effects of menopause and hormone replacement therapy (HRT) on adiponectin production. The objectives of the study were to compare levels of serum adiponectin in post- and premenopausal women, to test whether adiponectin levels are related to endogenous estradiol and sex hormone-binding globulin (SHBG) levels, to determine whether HRT influences serum adiponectin, and to investigate relationships of adiponectin levels with cardiovascular risk factors. One hundred four women matched for body mass index were enrolled in this study, and among them were 34 postmenopausal HRT nonusers, 34 postmenopausal HRT users, and 36 premenopausal healthy women with regular menstrual cycles. We evaluated waist circumference and waist-to-hip ratio (WHR) in each women. Serum was assayed for adiponectin, estradiol, SHBG, triglycerides (TGs), total cholesterol, high-density lipoprotein cholesterol, and fasting glucose levels. Post- and premenopausal women showed no significant differences in adiponectin and SHBG concentrations. There were no differences in serum adiponectin levels between postmenopusal HRT nonusers and users; however, SHBG concentrations were higher in HRT users. The simple linear regression analyses of all studied women indicated that serum adiponectin was negatively correlated with body mass index, waist circumference, WHR, and TG levels. Positive correlation was observed between adiponectin and high-density lipoprotein cholesterol as well as between adiponectin and SHBG levels. There were no relationships between adiponectin and estradiol levels in all studied women and among subgroups. Multiple regression analysis showed that WHR and TG were significant independent predictors of serum adiponectin. In conclusion, serum adiponectin levels are not influenced by menopausal status or serum estradiol levels. Exogenous estrogen treatment does not significantly affect serum adiponectin concentrations.     

Relationship of serum 2.5 oligoadenylate synthetase activity during interferon therapy to pretreatment levels or genotypes of serum HCV-RNA

2.5 oligoadenylate synthetase (2.5AS) activity is induced during interferon (IFN) therapy of patients with chronic hepatitis C. It is assumed that the genotype and quantitative level of hepatitis C virus RNA (HCV-RNA) in serum preceding IFN therapy are closely associated with the response to IFN. However, it is not clear whether these viral factors may affect 2.5AS activity during IFN therapy. We analyzed 2.5AS activity during IFN therapy in patients with different genotypes or levels of serum HCV-RNA. However, there were no statistical differences es in 2.5AS activity among them. In the present study, those viral factors were not associated with the induction of 2.5AS activity during IFN therapy, and it is unlikely that differences in response to IFN among patients with different genotypes or quantitative levels of HCV-RNA depend on the 2.5AS pathway.     

Elevation of serum total cholesterol and triglyceride levels during amiodarone therapy

Over the last decade there has been increasing awareness that some cardiovascular medications may adversely affect serum cholesterol concentrations. It has been suggested previously that amiodarone may alter serum cholesterol, triglyceride and glucose concentrations, but no substantive data support this observation. During the course of a 1-year study of adverse effects in patients taking amiodarone, 21 patients with normal total serum cholesterol before entry in the study were prospectively investigated for changes in lipid metabolism. A statistically significant sustained rise of 17% in total serum cholesterol occurred from a baseline of 178 +/- 7 mg/dl (4.6 +/- 0.2 mmol/liter) to 208 +/- 9 mg/dl (5.4 +/- 0.2 mmol/liter). Ten of the patients developed elevations of cholesterol above the 75th percentile for their age and sex. This group experienced a sustained rise of 20% in mean cholesterol concentration from baseline, had statistically significant elevations of triglyceride concentrations and had higher glucose and desethylamiodarone concentrations than patients who did not develop elevations in cholesterol greater than the 75th percentile. It may be possible to predict these differences in response as early as 4 to 8 weeks after starting therapy. Because amiodarone is increasingly used in patients without ischemic heart disease or life-threatening arrhythmias, the potential atherogenic risk of these metabolic abnormalities merits further investigation.