ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1992.tb02347.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1992.tb02348.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1992.tb02349.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

OBJECTIVE Parathyroid hormone‐related protein (PTHrP), initially discovered as the factor responsible for the syndrome of humoral hypercalcaemia of malignancy, has also been found to be expressed in placenta, in pregnant uterus, in the fetus at many locations, and in the lactating mammary gland. This study sought to establish whether PTHrP reaches the maternal circulation when it is expressed in mammary tissue during lactation or in the maternal reproductive tract during gestation.DESIGN Blood samples were collected from 53 subjects: 18 pregnant women in all stages of gestation, 19 lactating mothers and 16 non‐lactating post‐partum controls.MEASUREMENTS PTHrP was measured using a specific and validated radioimmunoassay. Parathyroid hormone was measured by two‐site immunoradiometric assay. Total calcium was measured by atomic absorption spectre‐photometry.RESULTS Circulating levels of PTHrP were readily detectable in 12 of 19 nursing mothers (range 2.7–7.8 pmol/1) but in none of the mothers who were bottle feeding. PTHrP was also detected in one of 18 pregnant subjects. Parathyroid hormone concentrations were lower in lactating mothers (2.3 ± 1.0 pmol/1), than in non‐lactating mothers (3.5 ± 1.2 pmol/1) (P<0.01).CONCLUSION PTHrP reaches the maternal circulation during lactation in amounts which could produce a

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1992.tb02350.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

OBJECTIVE We determined the effect of subclinical hyperthyroidism (defined as low circulating TSH with normal serum free T4) and subclinical hypothyroidism (raised serum TSH with normal free T4) on fasting levels of blood lipids.DESIGN Prospective study of lipid concentrations in patients identified as having abnormal TSH.PATIENTS Patients were identified in a population screening study of those over 60 years, with persistently low TSH with normal free T4 (n= 27) or high TSH but normal free T4 (n= 57). Patients were matched to controls with normal serum TSH by age, sex and body mass index.MEASUREMENTS Serum TSH, free T4, free T3, total cholesterol, low density lipoprotein (LDL) cholesterol and high density lipoprotein (HDL) cholesterol.RESULTS Serum free T4 measurements were significantly higher in those with subclinical hyperthyroidism than in their controls (P<0.001) and lower in those with subclinical hypothyroidism than in matched controls (P<0.001). Measurement of fasting lipids in patients and controls revealed a marked (12.2%) reduction in serum total cholesterol in subclinical hyperthyroidism (P<0.01); no significant difference in fasting lipids between patients with subclinical hypothyroidism and controls was observed.CONCLUSIONS Differences in free T4 between those with low or high TSH and controls with normal TSH suggest that abnormalities of TSH directly reflect thyroid hormone excess and deficiency. A reduction in cholesterol in those with subclinical hyperthyroidism suggests a direct influence of thyroid hormone excess on lipid metabolism in these patients.

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1992.tb02351.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

The serum concentration of soluble interleukin‐2 receptor (sIL‐2R) is a marker of T‐lymphocyte activation. Increased circulating sIL‐2R has been reported in untreated Graves' disease. This finding has been interpreted as the consequence of the autoimmune activation, but recent data suggest that sIL‐2R is directly correlated to thyroid state. The aim of this study was to elucidate the respective roles of autoimmunity and thyroid function in modulating serum sIL‐2R.DESIGN AND PATIENTS sIL‐2R was evaluated in 20 normal euthyroid subjects and in a large series of patients with autoimmune and non‐autoimmune thyroid disorders in different functional state.MEASUREMENTS sIL‐2R was assayed by a solid‐phase monoclonal antibody assisted ELISA method.RESULTS Serum sIL‐2R in normals was 461 ± 186 U/ml (mean ± SD). Increased sIL‐2R was found in 61 hyperthyroid patients with Graves' disease (1610 ± 962 U/ml,P<0.0001) and in 23 with toxic adenoma (1121 ± 598 U/ml,P<0.0001). Restoration of euthyroidism lowered to normal sIL‐2R in both groups. Serum sIL‐2R was higher in euthyroid Graves' disease patients with active than in those with non‐active ophthalmopathy. Decreased serum sIL‐2R (228 ± 93 U/ml,P<0.0001) was found in 30 patients hypothyroid after total thyroidectomy. Highly variable circulating sIL‐2R (range 100–1456 U/ml, mean ± SD: 379 ± 301 U/ml) was found in 49 patients with hypothyroid Hashimoto's thyroiditis (P= NSvsnormals;P<0.02vspost‐thyroldectomy hypothyroid patients). Treatment with L‐thyroxine increased sIL‐2R in all thyroldectomized and in the majority of Hashimoto's thyroidltis patients. In individual Hashimoto's thyroiditis patients (mostly with increased serum sIL‐2R), L‐thyroxine caused a decrease of circulating sIL‐2R. sIL‐2R was normal in 29 patients with euthyroid Hashimoto's thyroiditis. Both in Graves' disease and in Hashimoto's thyroiditis, no correlation was found between sIL‐2R and anti‐thyroglobulin, anti‐thyroid peroxidase and anti‐thyrotrophin‐receptor autoantibodies. Highly significant positive correlation between serum thyroid hormones and sIL‐2R was found in all study groups.CONCLUSIONS In thyroid disorders thyroid hormones are the main regulator of serum sIL‐2R concentration. The contribution of autoimmune activation may be detected only in some patients with autoimmune hypothyroidism, while in Graves' dis

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1992.tb02352.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

OBJECTIVE Genetic factors have been proposed to account for the development of ophthalmopathy in a proportion of patients with Graves' disease. The aim of this study was to confirm the previously reported association between blood group P1and thyroid‐associated ophthalmopathy.DESIGN A prospective study of sequential Caucasian patients.PATIENTS We studied 169 patients with Graves' disease, 84 of whom had grade 3,4 or 6 ophthalmopathy and 85 had no eye signs.MEASUREMENTS Blood group P1was measured by a standard serologlcal technique.RESULTS The frequency of the P1blood group was 74.1% in the patients without eye signs and 77.4% in those with ophthalmopathy (X2= 025,P>0.1). By Woolf's method there was no significant difference in the test for heterogeneity of estimates between the present and the previously reported series of Graves' patients. Combining the results (n= 279), the pooled relative risk for ophthalmopathy with blood group P1did not differ significantly from 10(X2= 233,P>0.1).CONCLUSIONS The presence of blood group P1In patients with Graves' disease does not appear to be associated with an increased risk of developing thyroid‐associated ophthalmopa

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1992.tb02353.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

OBJECTIVE We aimed to assess total body composition and to study the Interrelationships between fat and lean tissue mass with total and regional bone mass in healthy British post‐menopausal women.DESIGN AND PATIENTS Total body composition and regional bone mass were measured in 97 healthy post‐menopausal women recruited from the general community. The mean age was 57.9 years, range 49–65.MEASUREMENTS Total body composition (fat, lean tissue and bone mineral) and regional bone density in the lumbar spine and femur were measured by dual energy X‐ray absorptiometry on a Lunar DPX.RESULTS Significant negative correlations with age were found for total body bone mineral density (r= ‐0.200,P= 0.049), and lumbar spine bone mineral density (r= ‐ 0.28,P= 0.006); the calculated rate of bone loss from these two sites was 0.33 and 0.7% per annum respectively. Fat tissue mass showed a positive correlation with age (r= 0.22,P= 0.03). High correlations were observed between total body and regional bone mineral density (r= 0.755–0.829,P<0.001). After adjustment for age and lean mass, statistically significant correlations were seen between fat tissue mass and all bone mass measurements (P<0.01–0.001), the strongest correlations being found for total body bone mineral content and density (r=0.477 and 0.488 respectively). Lean tissue mass showed a strong correlation with total body bone mineral content (r= 0.580,P<0.001), after adjustment for age and fat mass; It was less strongly correlated with other bone mass measurements than fat mass, showing only weak correlations with total body, trochanterlc and lumbar spine bone mineral density (r= 0.228–0.246,P<0.05). Age‐adjusted body weight showed stronger correlations with total and regional bone mass than did either body mass index or height.CONCLUSIONS Both fat and lean tissue mass are related to total and regional bone mass in post‐menopausal women, the relationship being strongest for fat mass. Body weight shows stronger correlations with bone mass than either height or body mass index. In view of the direction and magnitude of changes in fat, lean tissue and bone mineral after the menopause, adiposity and muscularity are more likely to be determinants of peak bone mass than of the rate of post

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1992.tb02354.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

OBJECTIVE Since it is not clear whether testosterone or dihydrotestosterone is the active hormone in bone metabolism, we wished to assess the effect of finasteride, a 5α‐reductase inhibitor, on vertebral bone mineral density and parameters of bone and mineral metabolism.DESIGN Patients were treated in a randomized, double‐blind controlled study with either placebo, 1 or 5 mg/day finasteride.PATIENTS Twenty‐three men with benign prostatic hyper‐plasla (BPH) were included in this study; eight received placebo, seven were allocated to treatment with 1 mg/day, and eight to 5 mg/day finasteride for 12 months.MEASUREMENTS Vertebral bone mineral density was measured at the lumbar spine by dual energy X‐ray bone densltometry. Serum calcium, phosphorus, parathyroid hormone, osteocalcln and vitamin D metabolites were measured regularly. Urinary calcium and creatinlne excretion were monitored as well.RESULTS Finasteride caused a significant decrease in serum dlhydrotestosterone after 6 and 12 months, but no effect on serum testosterone. Vertebral bone mineral density remained unaltered. None of the other parameters monitored were affected except for a small unexplained increase in 1,25‐dihydroxyvitamin D in the group receiving 5 mg finasteride/day.CONCLUSIONS Testosterone is probably the active hormone in bone metabolism. However, oestradiol, the product of testosterone aromatization (which remains unaltered under finasteride) may yet be another possible responsible steroid in the maintenance of bone density. We can also not rule out that the small amount of dihydrotestosterone remaining under finasteride administration is sufficient for maintaining normal bon

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1992.tb02355.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

OBJECTIVE We evaluated the effect of sex steroids on the lipid fractions (cholesterol, triglycerldes, LDL‐C, HDL‐C and subtractions HDL2‐C and HDL3‐C) and on the apollpo‐proteins (A‐I and B) in relation to age in women.DESIGN Twenty‐eight normally cycling women belonging to three age groups (20–29,n= 11; 30–39,n= 10; 40–49,n= 7) had blood samples taken dally during one cycle.MEASUREMENTS Serum lipld fractions, apollpoprotelns (Apo) and ovarian steroids were measured daily during the menstrual cycle. Diet and exercise were also evaluated.RESULTS Each age group had comparable profiles for dally serum concentrations of oestradiol, progesterone and testosterone. There were no significant variations of the lipid fractions or of the ApoA‐I and ApoB during the menstrual cycle in each group. Using regression analysis, modifications of cholesterol, triglycerides, LDL‐C and ApoB were partially but significantly correlated with age. These changes occurred in spite of similar serum concentrations of oestradiol, progesterone and testosterone in the three groups. Lipld fractions were also affected by the increase of body mass index with age, especially HDL‐C and HDL2C. However, there were no differences in lipld and energy intake or in energy expenditure during physical leisure activities.CONCLUSIONS These results indicate that physiological fluctuations of ovarian steroids have no effects on llplds and Apo in normally cycling women of increasing age. In this study, the age related changes in the lipld fractions were partially correlated with body mass index but not with

ISSN:0300-0664    

DOI:10.1111/j.1365-2265.1992.tb02356.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY