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Casamitjana L, Giménez-Palop O, Corripio R, Pareja R, Berlanga E, Rigla M, Oliva JC, Caixàs A. Glucagon stimulation test to assess growth hormone status in Prader-Willi syndrome. J Endocrinol Invest 2021; 44:621-629. [PMID: 32720093 PMCID: PMC7878226 DOI: 10.1007/s40618-020-01367-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 07/16/2020] [Indexed: 11/24/2022]
Abstract
PURPOSE Growth hormone deficiency (GHD) must be confirmed before starting treatment in adults with Prader-Willi syndrome (PWS). Most studies use the growth-hormone-releasing hormone plus arginine (GHRH-arginine) test. No data are available on the glucagon stimulation test (GST) in PWS. We compared the utility of fixed-dose (1 mg) GST versus GHRH-arginine test in diagnosing GHD. METHODS Adults and late adolescents with PWS underwent both tests on separate days. In the GHRH-arginine test, GHD was defined according to body mass index. In the GST, two cutoffs were analyzed: peak GH concentration < 3 ng/mL and < 1 ng/mL. For analyses, patients were divided into two groups according to body weight (≤ 90 kg and > 90 kg). RESULTS We analyzed 34 patients: 22 weighing ≤ 90 kg and 12 weighing > 90 kg. In patients weighing ≤ 90 kg, the two tests were concordant in 16 (72.72%) patients (k = 0.476, p = 0.009 with GST cutoff < 3 ng/mL, and k = 0.450, p = 0.035 with GST cutoff < 1 ng/mL). In patients weighing > 90 kg, the two tests were not concordant with GST cutoff < 3 ng/mL, but were concordant in 11 (91.6%) patients (k = 0.833, p = 0.003) with GST cutoff < 1 ng/mL. GH peaks on the two tests correlated (r = 0.725, p = 0.008). CONCLUSION Fixed-dose (1 mg) GST using a peak GH cutoff of < 3 ng/mL or < 1 ng/mL promises to be useful for screening for GHD in adults and late adolescents with PWS. However, in those weighing > 90 kg, the < 1 ng/mL cutoff seems better. Larger studies are necessary to establish definitive glucagon doses and cutoffs, especially in extremely obese patients.
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Affiliation(s)
- L Casamitjana
- Endocrinology and Nutrition Department, Hospital Universitari Parc Taulí, C/ Parc Taulí, 1, 08208, Sabadell, Spain
- Medicine Department, Universitat Autònoma de Barcelona, Bellaterra, Spain
- Institut d'Investigació i Innovació Parc Taulí (I3PT), Sabadell, Spain
| | - O Giménez-Palop
- Endocrinology and Nutrition Department, Hospital Universitari Parc Taulí, C/ Parc Taulí, 1, 08208, Sabadell, Spain
- Medicine Department, Universitat Autònoma de Barcelona, Bellaterra, Spain
- Institut d'Investigació i Innovació Parc Taulí (I3PT), Sabadell, Spain
| | - R Corripio
- Medicine Department, Universitat Autònoma de Barcelona, Bellaterra, Spain
- Institut d'Investigació i Innovació Parc Taulí (I3PT), Sabadell, Spain
- Pediatrics Department, Hospital Universitari Parc Taulí, Sabadell, Spain
| | - R Pareja
- Endocrinology and Nutrition Department, Hospital Universitari Parc Taulí, C/ Parc Taulí, 1, 08208, Sabadell, Spain
- Institut d'Investigació i Innovació Parc Taulí (I3PT), Sabadell, Spain
| | - E Berlanga
- Institut d'Investigació i Innovació Parc Taulí (I3PT), Sabadell, Spain
- Clinical Laboratory Department, UDIAT, Corporació Sanitària Universitària Parc Taulí, Sabadell, Spain
| | - M Rigla
- Endocrinology and Nutrition Department, Hospital Universitari Parc Taulí, C/ Parc Taulí, 1, 08208, Sabadell, Spain
- Medicine Department, Universitat Autònoma de Barcelona, Bellaterra, Spain
- Institut d'Investigació i Innovació Parc Taulí (I3PT), Sabadell, Spain
| | - J C Oliva
- Institut d'Investigació i Innovació Parc Taulí (I3PT), Sabadell, Spain
- Epidemiology Department, Fundació Parc Taulí, Sabadell, Spain
| | - A Caixàs
- Endocrinology and Nutrition Department, Hospital Universitari Parc Taulí, C/ Parc Taulí, 1, 08208, Sabadell, Spain.
- Medicine Department, Universitat Autònoma de Barcelona, Bellaterra, Spain.
- Institut d'Investigació i Innovació Parc Taulí (I3PT), Sabadell, Spain.
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Larruzea A, Aguadero V, Orellana R, Berlanga E. High-fluorescent cells: A marker of malignancy in the analysis of body fluid samples. Int J Lab Hematol 2018; 40:e43-e45. [DOI: 10.1111/ijlh.12793] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Accepted: 01/18/2018] [Indexed: 11/30/2022]
Affiliation(s)
- A. Larruzea
- Clinical Biochemistry Department; Institut d'Investigació i Innovació Parc Taulí I3PT; Parc Taulí Hospital Universitari; Universitat Autònoma de Barcelona; Sabadell Spain
| | - V. Aguadero
- Clinical Biochemistry Department; Institut d'Investigació i Innovació Parc Taulí I3PT; Parc Taulí Hospital Universitari; Universitat Autònoma de Barcelona; Sabadell Spain
| | - R. Orellana
- Pathology Department; Institut d'Investigació i Innovació Parc Taulí I3PT; Parc Taulí Hospital Universitari; Universitat Autònoma de Barcelona; Sabadell Spain
| | - E. Berlanga
- Clinical Biochemistry Department; Institut d'Investigació i Innovació Parc Taulí I3PT; Parc Taulí Hospital Universitari; Universitat Autònoma de Barcelona; Sabadell Spain
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Llauradó G, Ceperuelo-Mallafré V, Vilardell C, Simó R, Albert L, Berlanga E, Vendrell J, González-Clemente JM. Impaired endothelial function is not associated with arterial stiffness in adults with type 1 diabetes. Diabetes Metab 2013; 39:355-62. [PMID: 23643350 DOI: 10.1016/j.diabet.2013.03.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2012] [Revised: 03/12/2013] [Accepted: 03/12/2013] [Indexed: 01/12/2023]
Abstract
AIM This study investigated the relationship between endothelial dysfunction (ED) and arterial stiffness (AS) in adults with type 1 diabetes and no clinical cardiovascular (CV) disease. METHODS A total of 68 patients with type 1 diabetes and 68 age- and gender-matched healthy (non-diabetic) subjects were evaluated. ED was assessed by reactive hyperaemia peripheral arterial tonometry (RH-PAT) and by serum concentrations of soluble intercellular adhesion molecule-1 (sICAM-1), soluble vascular cell adhesion molecule-1 (sVCAM-1) and E-selectin. AS was assessed by aortic pulse wave velocity (aPWV). All statistical analyses were stratified by gender. RESULTS Adults with type 1 diabetes had RH-PAT index scores similar to those of their matching controls [men: 1.55 (1.38-1.98)% versus 1.61 (1.40-2.17)%, P=0.556; women: 2.07 (1.55-2.31)% versus 2.08 (1.79-2.49)%; P=0.215]. However, after adjusting for potential confounders, type 1 diabetes emerged as the main determinant of the RH-PAT index in women. Also, differences between genders in both the controls and type 1 diabetes patients disappeared. Men with diabetes had higher serum concentrations of E-selectin, and women had higher serum concentrations of sICAM-1, sVCAM-1 and E-selectin than their respective controls. However, after adjusting for potential confounders, only the differences in sICAM-1 (women) and E-selectin (both genders) remained significant. No association was found between aPWV and the RH-PAT index and ED markers after adjusting for CV risk factors. CONCLUSION ED was increased in adults with type 1 diabetes compared with age-matched non-diabetic subjects. Also, gender differences in ED were lost in type 1 diabetes. However, ED was not associated with AS after adjusting for potential confounders. These findings suggest that ED occurs earlier than AS in type 1 diabetes.
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Affiliation(s)
- G Llauradó
- Department of Diabetes, Endocrinology and Nutrition, Hospital of Sabadell, Corporació Sanitària i Universitària Parc Taulí (Universitat Autònoma de Barcelona), 08208 Sabadell, Spain
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Llauradó G, Gallart L, Tirado R, Megia A, Simón I, Caixàs A, Giménez-Palop O, Berlanga E, Vendrell J, González-Clemente JM. Insulin resistance, low-grade inflammation and type 1 diabetes mellitus. Acta Diabetol 2012; 49:33-9. [PMID: 21290251 DOI: 10.1007/s00592-011-0257-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2010] [Accepted: 01/14/2011] [Indexed: 01/01/2023]
Abstract
To assess the relationships between insulin resistance and low-grade inflammation in subjects with type 1 diabetes mellitus (T1DM) who do not have clinical macrovascular complications. A total of 120 subjects diagnosed with T1DM 14 years before were evaluated for the following: (1) sex, age, body mass index, waist-to-hip ratio (WHR), blood pressure, smoking, alcohol intake, insulin dose, HbA1c and lipid profile; (2) microvascular complications; (3) plasma concentrations of soluble fractions of tumour necrosis factor-α receptors type 1 and 2, interleukin-6, adiponectin, leptin and high-sensitivity C-reactive protein (hs-CRP); and (4) insulin resistance (estimation of the glucose disposal rate-eGDR). Those subjects with an eGDR below the median of the same sex group were classified as insulin resistant and the others as insulin sensitive. Insulin-resistant men, compared to the insulin-sensitive, had higher WHR (0.89 ± 0.08 vs. 0.83 ± 0.05; P < 0.01), higher systolic [121 (118-125) vs. 114 (108-120) mmHg; P = 0.01] and diastolic [73 (66-80) vs. 67 (70-73) mmHg; P = 0.02] blood pressures, higher HbA1c values [8.7 (8.1-9.9) vs. 7.5 (7.2-8.0) %; P < 0.01] and higher hs-CRP concentrations [1.16 (0.61-3.20) vs. 0.49 (0.31-0.82) mg/dl; P = 0.01], but no other significant differences between groups were found. Insulin-resistant women had higher WHR and HbA1c values, compared to the insulin-sensitive, but they did not have any other differences. In men, hs-CRP correlated significantly with WHR and HbA1c (r = 0.363; P = 0.016 and r = 0.317; P = 0.036, respectively), after adjusting for age, alcohol intake, smoking and microvascular complications. Insulin-resistant men with T1DM have an increase in plasma concentrations of hs-CRP. Central obesity and HbA1c are its main determinants.
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Affiliation(s)
- G Llauradó
- Department of Diabetes, Endocrinology and Nutrition, Hospital de Sabadell, Corporació Sanitària i Institut Universitari Parc Taulí, Spain.
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Larrosa M, Gomez A, Casado E, Moreno M, Vázquez I, Orellana C, Berlanga E, Ramon J, Gratacos J. Hypovitaminosis D as a risk factor of hip fracture severity. Osteoporos Int 2012; 23:607-14. [PMID: 21394494 DOI: 10.1007/s00198-011-1588-z] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2010] [Accepted: 02/09/2011] [Indexed: 10/18/2022]
Abstract
SUMMARY In a cross-sectional study including 324 patients older than 65 years admitted to our hospital for osteoporotic hip fracture, we found that those patients with a more severe vitamin D deficiency had more severe osteoporotic hip fractures (Garden grades III-IV and Kyle III-IV). INTRODUCTION To identify possible differences in baseline characteristics of patients with different types of osteoporotic hip fracture. METHODS Cross-sectional study including consecutive individuals over 65 admitted to our hospital for osteoporotic hip fracture over a year. Demographic data, fracture type, comorbidities, history of osteoporosis, functional capacity, nutritional status and vitamin D storage were evaluated. RESULTS We included 324 patients (83 ± 7 years, 80% women). Two hundred sixteen patients (67%) had vitamin D deficiency (25OHD3 <25 ng/ml). In patients with severe femoral neck or intertrochanteric fractures (Garden III-IV and Kyle III-IV), vitamin D deficiency was more frequent (74%) and severe (25OHD3 20 ± 15 ng/ml) than in patients with less severe fractures (57%, 25OHD3 26 ± 21 ng/ml). Forty-three percent of patients had previous fractures. Only 15% of patients had been previously diagnosed with osteoporosis and 10% were receiving treatment. Patients receiving vitamin D supplements have higher 20OHD3 levels and less severe fractures. CONCLUSIONS Although vitamin D levels are not different between patients with intracapsular or extracapsular hip fractures, a more severe vitamin D deficiency seems to be associated to more severe osteoporotic hip fractures. A prior vitamin D supplementation could avoid a higher severity of these fractures.
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Affiliation(s)
- M Larrosa
- Rheumatology Department, University Institute Parc Taulí (UAB), Parc Tauli s/n, 08208 Sabadell, Barcelona, Spain.
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Gavarró A, Cebollero A, Berlanga E, Campos F, Torra M. PO3-89 RELATIONSHIP BETWEEN LIPOPROTEIN (A) SERUM LEVELS AND PLASMA LIPIDS IN A PAEDIATRIC POPULATION. ATHEROSCLEROSIS SUPP 2007. [DOI: 10.1016/s1567-5688(07)71099-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Gavarró A, Ustrell R, Berlanga E, Campos F, Torra M. Mo-P1:107 Serum LP(A) concentrations in a group of dislipaemic patients attended in corporació parc tauli. ATHEROSCLEROSIS SUPP 2006. [DOI: 10.1016/s1567-5688(06)80242-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Gavarró A, Berlanga E, Campos F, Salceda F, Roselló M. Evaluation of a direct method to determine LDL-cholesterol levels. Atherosclerosis 2000. [DOI: 10.1016/s0021-9150(00)81267-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Guizar-Sahagun G, Rivera F, Babinski E, Berlanga E, Madrazo M, Franco-Bourland R, Grijalva I, González J, Contreras B, Madrazo I. Magnetic resonance imaging of the normal and chronically injured adult rat spinal cord in vivo. Neuroradiology 1994; 36:448-52. [PMID: 7991089 DOI: 10.1007/bf00593681] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
We assessed the capacity of MRI to show and characterise the spinal cord (SC) in vivo in normal and chronically injured adult rats. In the chronically injured animals the SC was studied by MRI and histological examination. MRI was performed at 1.5 T, using gradient-echo and spin-echo (SE) sequences, the latter with and without gadolinium-DTPA (Gd-DTPA). Several positions were tried for good alignment and to diminish interference by respiratory movements. Images of the SC were obtained in sagittal, coronal, and axial planes. Normal SC was observed as a continuous intensity in both sequences, although contrast resolution was better using SE; it was not possible to differentiate the grey and white matter. Low signal was seen in the damaged area in chronically injured rats, which corresponded to cysts, trabeculae, mononuclear infiltrate, and fibroglial wall on histological examination. Gd-DTPA failed to enhance the SC in normal or chronically injured rats. It did, however, cause enhancement of the lesion after acute SC injury.
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Affiliation(s)
- G Guizar-Sahagun
- Centro de Investigación del Proyecto Camina, A. C. México City, México
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