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  • 1
    Publication Date: 2022-01-31
    Description: We assessed the potential of Calcium (Ca) isotope fractionation measurements in blood (δ44/42CaBlood) and urine (δ44/42CaUrine) as a new biomarker for the diagnosis of osteoporosis. One hundred post-menopausal women aged 50 to 75 years underwent dual-energy X-ray absorptiometry (DXA), the gold standard for determination of bone mineral density. After exclusion of women with kidney failure and vitamin D deficiency (〈25 nmol/l) 80 women remained in the study. Of these women 14 fulfilled the standard diagnostic criteria for osteoporosis based on DXA. Both the δ44/42CaBlood (p 〈 0.001) and δ44/42CaUrine (p = 0.004) values were significantly different in women with osteoporosis (δ44/42CaBlood: −0.99 ± 0.10‰, δ 44/42CaUrine: +0.10 ± 0.21‰, (Mean ± one standard deviation (SD) n = 14) from those without osteoporosis (δ44/42CaBlood: −0.84 ± 0.14‰, δ44/42CaUrine: +0.35 ± 0.33‰, (SD), n = 66). This corresponded to the average Ca concentrations in morning spot urine samples ([Ca]Urine) which were higher (p = 0.041) in those women suffering from osteoporosis ([Ca]Urine-Osteoporosis: 2.58 ± 1.26 mmol/l, (SD), n = 14) than in the control group ([Ca]Urine-Control: 1.96 ± 1.39 mmol/l, (SD), n = 66). However, blood Ca concentrations were statistically indistinguishable between groups ([Ca]Blood, control: 2.39 ± 0.10 mmol/l (SD), n = 66); osteoporosis group: 2.43 ± 0.10 mmol/l (SD, n = 14) and were also not correlated to their corresponding Ca isotope compositions. The δ44/42CaBlood and δ44/42CaUrine values correlated significantly (p = 0.004 to p = 0.031) with their corresponding DXA data indicating that both Ca isotope ratios are biomarkers for osteoporosis. Furthermore, Ca isotope ratios were significantly correlated to other clinical parameters ([Ca]Urine, ([Ca]Urine/Creatinine)) and biomarkers (CRP, CTX/P1NP) associated with bone mineralization and demineralization. From regression analysis it can be shown that the δ44/42CaBlood values are the best biomarker for osteoporosis and that no other clinical parameters need to be taken into account in order to improve diagnosis. Cut-off values for discrimination of subjects suffering from osteoporosis were − 0.85‰ and 0.16‰ for δ44/42CaBlood and δ44/42CaUrine, respectively. Corresponding sensitivities were 100% for δ44/42CaBlood and ~79% for δ44/42CaUrine. Apparent specificities were ~55% for δ44/42CaBlood and ~71%. The apparent discrepancy in the number of diagnosed cases is reconciled by the different methodological approaches to diagnose osteoporosis. DXA reflects the bone mass density (BMD) of selected bones only (femur and spine) whereas the Ca isotope biomarker reflects bone Ca loss of the whole skeleton. In addition, the close correlation between Ca isotopes and biomarkers of bone demineralization suggest that early changes in bone demineralization are detected by Ca isotope values, long before radiological changes in BMD can manifest on DXA. Further studies are required to independently confirm that Ca isotope measurement provide a sensitive, non-invasive and radiation-free method for the diagnosis of osteoporosis.
    Type: Article , PeerReviewed
    Format: text
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  • 2
    ISSN: 1749-6632
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Natural Sciences in General
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1749-6632
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Natural Sciences in General
    Type of Medium: Electronic Resource
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  • 4
    Electronic Resource
    Electronic Resource
    Amsterdam : Elsevier
    Journal of Steroid Biochemistry 19 (1983), S. 127 
    ISSN: 0022-4731
    Source: Elsevier Journal Backfiles on ScienceDirect 1907 - 2002
    Topics: Biology , Chemistry and Pharmacology
    Type of Medium: Electronic Resource
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  • 5
    Electronic Resource
    Electronic Resource
    Amsterdam : Elsevier
    Regulatory Peptides 5 (1983), S. 184 
    ISSN: 0167-0115
    Source: Elsevier Journal Backfiles on ScienceDirect 1907 - 2002
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 6
    ISSN: 1436-6215
    Keywords: Acarbose ; hydrogen exhalation ; methane exhalation ; insulin ; gastric inhibitory polypeptide ; intestinal bacteria
    Source: Springer Online Journal Archives 1860-2000
    Topics: Agriculture, Forestry, Horticulture, Fishery, Domestic Science, Nutrition , Medicine
    Description / Table of Contents: Zusammenfassung An gesunden Probanden unter standardisierter, ballaststoffarmer Mischkost mit bzw. ohne Acarbose wurden kurz- und mittelfristige Einflüsse auf Toleranzerscheinungen mittels Bestimmung von Peptidhormonen und Atemgasmessungen untersucht. Wasserstoff und Methan wurden im Tagesprofil quantitativ bestimmt. Dabei bewirkte Acarbose infolge von Kohlenhydratvergärung im Dickdarm einen rund 20fachen Anstieg der Wasserstoffexhalation, die Methanexhalation änderte sich im Mittel nur wenig. Methanbildende Probanden exhalierten nach Stimulierung durch Acarbose signifikant weniger Wasserstoff als Personen ohne Methanbildung. Die unter Acarbose erniedrigten Glukose-, Insulin- und GIP- bzw. erhöhten Glukagonspiegel zeigen die verzögerte Glukoseresorption an und sind im regulatorischen Rahmen der Kohlenhydratassimilation verständlich. Im Laufe einer fünfwöchigen Acarboseeinnahme zusammen mit standardisierter Kost nahmen die aufgetretenen abdominellen Empfindungen wie z.B. Meteorismus deutlich ab, während die mikrobielle Kohlenhydratfermentation erhöht und die GIP-Sekretion erniedrigt blieben. Funktionelle Reaktionen des Gastrointestinaltrakts auf die durch Acarbose bewirkte veränderte Kohlenhydratzufuhr in das Colon wurden somit anhand von drei unabhängigen Parametern untersucht: anaerobe Gasproduktion, Freisetzung von Peptidhormonen und subjektive abdominelle Empfindungen. Die objektiven Parameter scheinen längerfristig konstant zu bleiben, während subjektive Parameter in dieser Zeit Anpassung zeigen.
    Notes: Summary Short and middle term effects of Acarbose were studied in volunteers on a standardized, low-fibre, mixed diet for the development of tolerance phenomena with gas exhalations and some peptide hormone levels as main parameters. Both hydrogen and methane were measured quantitatively as diurnal profiles. Acarbose caused an about 20-fold increase of H2 exhalation and had only moderate effects on methane production, indicating the presence of fermentable carbohydrates in the large bowel. Methanogenic individuals exhaled significantly less H2 than did nonmethanogenic subjects. Changes in blood glucose, serum insulin, GIP, gastrin, and plasma glucagon, caused by Acarbose, reflected delayed glucose absorption and were plausible within the regulatory framework of carbohydrate assimilation. When the Acarbose regime was maintained for 5 weeks on a controlled diet, abdominal sensations like e.g. meteorism declined remarkably while carbohydrate fermentation remained high and lowered GIP was sustained. Thus functional responses of the gastro-intestinal tract to altered carbohydrate supplies, elicited by Acarbose, were found by 3 independent parameters: anaerobic gas production, peptide hormone levels, and subjective abdominal sensations. The objective parameters seem to remain constant in the longer run, while subjective parameters show long-term adaptation.
    Type of Medium: Electronic Resource
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  • 7
    Electronic Resource
    Electronic Resource
    Springer
    European journal of nutrition 29 (1990), S. 2-12 
    ISSN: 1436-6215
    Keywords: Adipositas ; Appetitverhalten ; lankgettige Aminosäuren ; Serotonin ; Peptidhormone ; obesity ; appetite ; large neutral amino acids ; serotonin ; peptide hormones
    Source: Springer Online Journal Archives 1860-2000
    Topics: Agriculture, Forestry, Horticulture, Fishery, Domestic Science, Nutrition , Medicine
    Description / Table of Contents: Summary This review focuses on neurotransmitter and neuropeptide actions on food ingestion, as well as on some of the mechanisms that may lead to the development and maintenance of obesity. In particular, the role of hypothalamic amines (catecholamines, serotonin) in appetite control is described. Thus, hypothalamic noradrenaline appears to stimulate food intake, while an enhanced brain serotonergic neurotransmission leads to a suppression of food ingestion, preferentially of carbohydrate intake. The involvement of brain serotonin neurons in appetite control is most attractive, since serotonin synthesis and release is readily affected by either precursor loading (i.e., l-tryptophan) or pharmacological manipulation (e.g., drugs such as fenfluramine or fluoxitene). Recent data now suggest that at least a subgroup of obese patients is characterized by a disturbed serotonergic neurotransmission, thus exhibiting behaviors such as carbohydrate craving. Among neuropeptides involved in appetite control, the most attractive candidate appears to be corticotropin-releasing hormone which is released by neurons of the paraventricular nucleus and produces a stress-like activation of the organism, and has a strong appetite-suppressant effect.
    Notes: Zusammenfassung Ziel dieser Ausführungen soll es sein, die Komplexität zentralnervöser Mechanismen bei der Appetitkontrolle zu skizzieren und damit zu verdeutlichen, daß es hier sicher nicht einen solitären Ansatz zur Erklärung der Nahrungswahl und -aufnahme gibt und damit auch nicht für die Erklärung von Eßstörungen. Die beschriebenen Neurotransmitter und Neurohormone sind eher im Sinne von Neuromodulatoren beteiligt an der Regulation des Eßverhaltens; da sie miteinander interagieren, kann man sich ähnlich wie bei anderen physiologischen hierarchischen Systemen (z. B. der Blutgerinnung) hier auch eine Kaskade von neuroendokrinen Veränderungen vorstellen. Von größter Bedeutung ist, daß weder das gastrointestinale noch das zentralnervöse System hier autonome Steuerorgane sind, sondern sich gegenseitig beeinflussen. Einen sicheren Ansatzpunkt aus diesen Erkenntnissen heraus für z.B. die Behandlung der Adipositas haben wir zum jetzigen Zeitpunkt nicht, vielversprechend ist ohne Frage die mögliche Beeinflussung des serotoninergen Systems, hier sind aber noch weitere Grundlagenuntersuchungen (insbesondere zur Frage der Nahrungsselektion) dringend notwendig. Letztlich können wir das Eßverhalten natürlich nicht auf eine neuroendokrine Ebene reduzieren und es von Umweltereignissen und intrapsychischen Vorgängen und Wahrnehmungen (Hunger, Geschmackswahrnehmung, erlerntes Eßverhalten) trennen. Nahrungswahl und -aufnahme ist ohne Frage eine biopsychologische Verhaltensweise, so daß die geschilderten neurobiologischen Mechanismen nicht nur Ursache, sondern auch Folge sein können.
    Type of Medium: Electronic Resource
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  • 8
    ISSN: 1432-1440
    Keywords: Pheochromocytoma ; MIBG scintigraphy ; Intraoperative staging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Metaiodobenzylguanidine (MIBG) imaging is a well-established method for locating intra-and extraadrenal pheochromocytomas. We investigated whether preoperative injection of 123-I-MIBG might be useful for intraoperative staging of chromaffine tumor cells. This was performed in a 46-year-old patient in whom the diagnosis of a malignant pheochromocytoma had been established by 123-I-MIBG imaging and enhanced catecholamine secretion. The rationale for intraoperative staging in this patient was a discrepancy between computed tomography (CI) of the abdomen and the radionuclide imaging, because scintigraphy revealed a mass with MIBG uptake in the right lower abdomen that could not be visualized by CT. We thus applied a preoperative dose of 4 mCi 123-I-MIBG and determined tissue activity by direct organ measurement. A right abdominal mass was thus identified with an activity of 10×104 impulses/s as compared to normal tissue (15×102). The left-sided tumor was found to be identified correctly by prior CT and MIBG imaging. We thus conclude that intraoperative application of this single probe measurement might help to identify chromaffine tumor cells that have not been located fully by CT.
    Type of Medium: Electronic Resource
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  • 9
    ISSN: 1432-1440
    Keywords: Diabetes mellitus ; Insulin-dependent diabetics ; Non-insulin-dependent diabetics ; Blood glucose ; Insulin secretion ; Dietary carbohydrates ; Dietary fats ; Dietary proteins ; Dietary fibre
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The postprandial insulin requirements after three mixed meals of equal carbohydrate and energy content were assessed in 10 type-1 and 12 type-2 diabetics by a glucose-controlled insulin infusion system. These were compared with the glycemic response to the same meals of 10 healthy individuals (glycemic index). In type-1 diabetics, we found the highest insulin requirements after consumption of a continental breakfast (low fibre, low protein, high fat). Ten percent less insulin was infused after milk (low fat, high protein) and 30% less after an English breakfast (high fibre, high protein). Type-2 diabetics showed no significant differences in insulin requirements between the three test meals. The glycemic response in healthy individuals had no relation to these insulin requirements. Continental and English breakfast had a similar glycemic effect, whereas milk produced only 30% of the blood glucose response observed after the continental breakfast. These results indicate that neither the carbohydrate content (exchange lists) nor the glycemic index enable prediction of postprandial insulin requirements in insulin-deficient diabetes. For this purpose, we propose the insulin-need index, elaborated by testing whole meals in closed-loop experiments with type-1 diabetics.
    Type of Medium: Electronic Resource
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  • 10
    ISSN: 1432-1440
    Keywords: Acromegaly ; Growth Hormone ; Somatomedin C ; Somatostatin
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary This study examined the effects of the long-acting selective mini somatostatin analogue (SMS) 201-995 in two acromegalic patients who were treated for 3 and 6 months, respectively. During treatment the mean growth hormone levels (25.3 and 20.8 ng/ml vs 5.9 and 10.6 ng/ml) and somatomedin C levels (6.2 and 6.2 IU/ml vs 3.3 and 3.8 IU/ml) decreased and the patients reported an improvement in their symptoms. The main side effect was an increase in stool fat excretion which did exceed the normal range (〈7 g/day) in one patient. Five acromegalics who received 2 × 50 µg SMS 201-995/day for 5 days showed a significant increase of stool fat excretion (1.7 vs 3.5 g/day;p〈0.05). Fasting blood glucose levels, glucose tolerance, and glycosylated hemoglobin were not essentially effected. It is concluded that SMS 201-995 offers new possibilities in the treatment of acromegaly. The gastrointestinal and diabetogenic side effects of this substance, however, should be carefully monitored.
    Type of Medium: Electronic Resource
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