Determinación de los niveles séricos de 25-hidroxivitamina D y sus variaciones estacionales en una población normal joven / Determination of 25-hydroxyvitamin D serum levels and its seasonal variations in a healthy young population

25-hydroxyvitamin D has a longer half life and its serum levels have less daily variations than calcitrol. Thus, its measurement is a better indicator of vitamin D status. Vitamin D was measured using a competitive protein binding radioassay in 61 subjects (27 males) aged 21 to 57 years old, during july to august (winter) and february and march of the next year (summer). 25-hydroxyvitamin levels were 28.8ñ1.5 and 30.9ñ2.3 ng/ml during winter and summer respectively. No differences were found between men and women. Ninety five percent confidence levels were between 13 and 50 ng/ml. Levels in 1 patient with malabsorption were 9.3 ng/ml, in 2 patients with hypophosphemic osteomalacia were 2.1 and 9.3 ng/ml, in 12 patients with alcoholic cirrhosis were 16.4ñ1.3 ng/ml, in 4 patients with primary osteoporosis were 23.3ñ0.7 and in 3 patients receiving vitamin D were 334ñ33.2 ng/ml. Normal levels of 25-hydroxyvitamin D range from 13 to 50 ng/ml in normal adults, there are no differences between men and women and seasonal variations are minimal

Efecto de un preparado en forma de gel de 17 ß estradiol sobre diferentes parámetros hormonales en mujeres menopáusicas / Effects of a 17 ß estradiol gel preparation on different hormonal parameters in menopausal women

Different delivery forms of supplemental estrogens may differ in their hormonal effects. The aim of this study was to assess the effects of a daily dose of 2.5 g of 17 ß estradiol transdermal gel, given during four weeks, on hormon levels of six postmenopausal women. At the fourth week we observed a significant increase in estradiol and a dicrease in FSH levels. estrone levels alsa increased but the estradiol-estrone ratio was maintained in values over 1. No changes in SHBG or IGF1 levels were observed. Two patients that used the gel in the abdominal skin achieved lower estradiol levels (below 60 pg/ml). We conclude that the gel increased serum estradiol levels over 60 pg/ml in four of six women, that there is a big individual variability and the application zone could influence the serum estradiol levels achieved

Efecto de la fluoxetina sobre la insulino resistencia en pacientes obesos no diabéticos / Effects of fluoxetine on insulin resistance in non diabetic patients

Fluoxetine, a serotonin re-uptake inhibitor with antidepressive and appetite reduction effects, could improve insulin sensitivity. The aim of this work was to assess this effect of fluoxetine in obese subjects. We studied 12 subjects with a body mass index over 30, with normal oral glucose tolerance test and not subjected to dietary restrictions. Insulin sensitivity using Bergman's minimal model, sex hormone binding globulin (SHBG) and insulin like growth factor binding protein 1 (BP 1) were evaluated before and after three weeks of treatment with 60 mg OD of fluoxetine. During treatment, subjects lost a mean of 1.9 kg. When compared with basal values, insulin sensitivity index (S1) improved significantly at the end of threatment (1.71ñ0.44 and 2.72ñ0.63 respectively), SHBG increased (28.9ñ5.1 and 18.2ñ3.4 nM/ml respectively) and BP 1 did not change (2.8ñ0.9 and 1.5ñ0.3 ng/ml respectively). The changes in insulin sensitivity did not correlate with weight changes (r=0.4 NS). Weight or insulin sensitivity changes did not correlate with initial degree of insulin resistance. We conclude that the improvement in insulin sensitivity elicited by fluoxetine is not related to weight changes and may be useful in the treatment of insulin resistant obese subjects

Mejoría de la insulinosensibilidad asociada al uso prolongado de acipimox en un obeso mórbido / Improvement of insulin sensitivity associated to the large use of acipimox in a morbidly obese patient

Insulin sensitivity was estimated in a morbidity obese, insulin-resistant, glucose-intolerant patient before and after 4 weeks of treatment with acipimox (250 mg t.i.d), an orally-administred, long-acting antilypolitic drug. The ensuing fall in circulating levels of fasting free fatty acids was associated with a clear amelioration of insulin resistance, as assessed by a minimal model analysis of a frequently sampled intravenous glucose tolerance test as well as by an oral glucose tolerance test. Similarly, this treatment brought about a reappearence of GH response to oral stimulation with clonidine. The evidence showing acipimox-induced amelioration of insulin resistance in this patient without diet, exercise or weight loss should encourage exploring the potential utility of this drug in this type of patient