ABSTRACT
Se analizó el efecto de tibolona sobre los niveles de glucosa e insulina en 18 mujeres posmenopáusicas. Se determinaron los niveles de glucosa en ayuno e insulina antes del tratamiento y a los tres meses de la administración diaria de 2.5 mg de tibolona. Los niveles de glucosa no se modificaron por la administración de tibolona; sin embargo, los niveles de insulina disminuyeron significativamente (p < 0.01). Las lipoproteínas de alta y baja densidad, así como el colesterol total y los triglicéridos no se modificaron con la administración de tibolona. Estos datos sugieren que la tibolona reduce la discreta hiperinsulinemia que se presenta en la menopausia y que no ejerce un efecto sobre los niveles de glucosa en ayuno, demostrando un efecto positivo sobre el metabolismo de carbohidratos.
Subject(s)
Humans , Female , Middle Aged , Blood Glucose , Estrogen Replacement Therapy , Hyperinsulinism , Steroids , PostmenopauseABSTRACT
Durante la etapa posmenopáusica, la reducción de leptina circulante se ha relacionado con el incremento de peso corporal; sin embargo los resultados de los diferentes estudios han sido contradictorios y sólo se ha encontrado un incremento leve de la leptina con la terapia hormonal de reemplazo (THR). En este trabajo se hipotetizó que las concentraciones de leptina no estaban relacionadas con el hipoestrogenismo y que no se incrementaban por la THR. Para probar nuestra hipótesis se estudiaron 22 casos consecutivos de mujeres en etapa posmenopáusica, de 46 a 60 años de edad, que habían tomado al menos por 12 meses 2.5 mg diarios de tibolona. Otras 12 mujeres posmenopáusicas, agrupadas por edad y peso, sin THR, se utilizaron como grupo control. No se observaron diferencias significativas en las concentraciones de leptina entre las mujeres que estaban bajo la administración de tibolona (8.1 ñ 4.2ng/mL) y el grupo control (7.4 ñ 3.7 ng/mL). Las pacientes tratadas con tibolona presentaron disminución significativa de los niveles de insulina e incremento de IGF-l en comparación con el grupo testigo. De estos datos se puede concluir que la THR con tibolona no produce un incremento en la leptina circulante en mujeres menopáusicas, por lo que es probable que los niveles de leptina no ejerzan efecto sobre el peso corporal.
Subject(s)
Humans , Female , Middle Aged , Estradiol , Hormone Replacement Therapy , Leptin/blood , Postmenopause/metabolism , Body Mass Index , Insulin , ObesityABSTRACT
Background. Several series reported in the literature concerning the results of the treatment of acromegaly have difficult to evaluated because the indicators are inaccurate Methods. We investigated the usefulness of insulin. Like growth factor binding protein-3 (IGFBP) levels to determine disease activity after surgical treatment of acromegaly in 13 patients with confirmed somatotroph adenoma. Results. Before surgery, all 13 non-treated patients had levated serum levels of IGFBP-3 as well as total and free IGF-I. In addition, there was no overlap with the normal controls (p < 0.001). IGFBP-3 levels correlated significantly (0.91, p < 0.001) with GH suppressibility by glucose after surgery. Conclusions. These data confirm that IGFBP-3 is a better indicator of acromegalic activity than either total or free IGF-i. There was a high correlation with GH suppressibility by glucose after surgery; both free and total IGF-I could be considered sensitive markers only for diagnosis of active acromegaly but not for efficacy of surgery
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Acromegaly/metabolism , Adenoma/metabolism , Insulin-Like Growth Factor I/metabolism , Pituitary Neoplasms/metabolism , Adenoma/surgery , Pituitary Neoplasms/surgery , Somatomedins/metabolismABSTRACT
It has been proposed that automated systems for immunoenxymometric assay (IEMA) may substitute traditional radioimmunoassay (RIA) for measurement of luteinizing hormone (LH) and follicle stimulating hormone (FSH) in blood due to the advantage of being more rapid, higher sensitivity, lower cost and not requiring radioactive reagents. The study was designed to evaluate both systems using serum samples to determine luteinizing hormone (LH) and follicle stimulatin hormone (FSH) concnetrations. The automatic system (ES-300) for IEMA utilized two monoclonal antibodies, one of them on the solid phase was the specific extractant for the antigen, and the other was a peroxidase labeled antibody which recognizes a different epitope in the antigen molecule, specifically bound in linear proportion to the antigen concentration. Blood samples were obtained from patients who were treated at the hospital for various clinical problems ("problem group") as well as blood samples from patients in whom FSH and LH concentrations were already known ("high", "medium" and "low" levels) by previous RIA ("control group"). IEMA showed a higher sensitivity, 0.42 and 0.96 mIU/ml for FSH and LH, respectively, whereas RIA was 1.95 mIU/ml for both hormones. Intra and interassay coefficient of variation were below 10 percent within the range of 15-50 mIU/ml for FSH and 5-100 mIU for LH; however, the coeffcient of variation was 15 - 25 percent at lower concentrations of FSH and LH. Accuracy of IEMA was evaluated by recovery percentage, thus when high and medium concentrations of FSH and LH were analyzed the recovery was between 99 -104 percent. On the other hand, the recovery was 100 percent when low levels of FSH and LH were used. In coclusion, IEMA resulted reliale when FSH and LH concentrations are in the middle and high range; likewise, the detection limit of IEMA was lower than RIA, particularly for FSH. On the bases of these results, IEMA showed several advantages over RIA, but its reliability diminishes when serum samples contain low FSH and LH concentrations. It is important to extend theses studies to steroid assays and elaborate a database in each laboratory