Serum Levels of Osteocalcin and Insulin Resistance in Patients with Impaired Glucose Tolerance or New-Onset Diabetes Mellitus After Liver Transplantation.

Liver transplantation (LT) patients are at high risk of developing new-onset diabetes after transplantation (NODAT). Osteocalcin has been proposed as a mediator between bone tissue and glucose metabolism, but its role in the pathogenesis of diabetes is not defined yet. Our objective was to assess the relationship between serum osteocalcin and glucose metabolism parameters in liver transplantation recipients. A total of 187 liver transplantation patients were cross-sectionally studied, 54 of them developed NODAT. None had been diagnosed of diabetes mellitus prior to transplant. In 133 nondiabetic patients, a 75 g oral glucose tolerance test (OGTT) was performed to assess blood glucose, insulin, and C-peptide levels at baseline and 120 min. Serum total osteocalcin was measured at baseline in all patients.After OGTT, 10.5% of LT patients had NODAT criteria, 51.9% showed impaired glucose tolerance, and 37.6% had normal glucose tolerance. Overall, NODAT prevalence was 36.3%. HOMA-IR was significantly higher in NODAT compared with impaired glucose tolerance and normal glucose tolerance groups (p<0.001). Osteocalcin was inversely correlated to HOMA-IR (r=- 0.16, p=0.05), BMI (r=- 0.27, p=0.000) and waist circumference (r=- 0.21, p=0.005). Patients in the lowest osteocalcin tertile (< 16.5 ng/ml) had significantly higher fasting plasma glucose and HOMA-IR index (p=0.029 and 0.037, respectively) than those in medium or highest tertiles. In multiple linear regression analysis, osteocalcin was negatively associated with fasting plasma glucose (standardized ß coefficient-0.16; p=0.041) and 2-h insulin (standardized ß coefficient-0.21; p=0.028). Prevalence of NODAT/impaired glucose tolerance is high in liver transplantation patients and is associated with insulin resistance. In these patients total osteocalcin is inversely associated with plasma glucose level and insulin resistance indexes.

Early feeding of carnivorous rainbow trout (Oncorhynchus mykiss) with a hyperglucidic diet during a short period: effect on dietary glucose utilization in juveniles.

Based on the concept of nutritional programming in higher vertebrates, we tested whether an acute hyperglucidic stimulus during early life could induce a long-lasting effect on carbohydrate utilization in carnivorous rainbow trout. The trout were fed a hyperglucidic diet (60% dextrin) at two early stages of development: either at first feeding (3 days, stimulus 1) or after yolk absorption (5 days, stimulus 2). Before and after the hyperglucidic stimulus, they received a commercial diet until juvenile stage (>10 g). Fish that did not experience the hyperglucidic stimuli served as controls. The short- and long-term effects of the stimuli were evaluated by measuring the expression of five key genes involved in carbohydrate utilization: alpha-amylase, maltase (digestion), sodium-dependent glucose cotransporter (SGLT1; intestinal glucose transport), and glucokinase and glucose-6-phosphatase, involved in the utilization and production of glucose, respectively. The hyperglucidic diet rapidly increased expressions of maltase, alpha-amylase, and glucokinase in stimulus 1 fish and only of maltase in stimulus 2 fish, probably because of a lower plasticity at this later stage of development. In the final challenge test with juveniles fed a 25% dextrin diet, both digestive enzymes were upregulated in fish that had experienced the hyperglucidic stimulus at first feeding, confirming the possibility of modification of some long-term physiological functions in rainbow trout. In contrast, no persistent molecular adaptations were found for the genes involved in glucose transport or metabolism. In addition, growth and postprandial glycemia were unaffected by the stimuli. In summary, our data show that a short hyperglucidic stimulus during early trout life may permanently influence carbohydrate digestion.

Utilidad diagnóstica de la determinación del antígeno de helicobacter pylori en heces / Helycobacter pylori antigen in stool. Diagnostic utility

Se estudia la utilidad clínica de la determinación del Antígeno de Helicobacter pylori (Hp) en heces (HpSA), tanto en el diagnóstico inicial, como en el control de erradicación postratamiento. Para ello estudian 58 pacientes (28 mujeres y 30 hombres) de edades comprendidas entre 15 y 80 años, durante un periodo de tiempo de 1,5 años; con sintomatología compatible con úlcera gastro-duodenal y/o síndrome dispéptico. Se realiza estudio endoscópico, con determinación de presencia de Hp mediante cultivo y/o test de ureasa, como método de referencia, y estudio del Ag. de Hp en heces mediante el ELISA (HpSA).Los pacientes con endoscopia positiva, fueron tratados con la pauta O.C.A. Después de 1-2 meses del tratamiento, se realiza el test del aliento como método de referencia de erradicación y el test HpSA. Los resultados fueron: Pretratamiento.- La prevalencia de infección por Hp fue del 84,4 por ciento. La Sensibilidad (S), Especificidad (E), Valor Predictivo Positivo (VPP) y Valor Predictivo Negativo (VPN) fueron: 89,79 por ciento, 55,55 por ciento, 91,96 por ciento y 50 por ciento. El Likelihood ratio Positivo (LRP) 1,97 y el Likelihood ratio Negativo(LRN) 0.2. Postratamiento.-La prevalencia de infección fue del 22.7 por ciento, con un porcentaje de erradicación del 77.2 por ciento. La S, E, VPP, VPN, LRP y LRN fue: 100 por ciento, 85,29 por ciento, 66,66 por ciento, 100 por ciento, 6,66 y 0. El test HpSA es útil para descartar el diagnóstico de infección por Hp y en el control de erradicación postratamiento (AU)

¿Es correcto realizar el control de T.A.O. en sangre capilar, siguiendo los criterios de INR en sangre venosa? / Is correct to achieve the control of O. A. T. in capillary blood with INR criteria in Plasme

Se analizan los resultados obtenidos en el control de anticoagulación oral en sangre capilar y venosa. Se estudian 155 pacientes a los que se determina INR en plasma en el Hospital 12 de Octubre y en el C.E.P. Pontones e INR en sangre capilar. El INR en H. 12 de Octubre y C.E.P. Pontones se realizó en el autoanalizador CA6.000 (DADE-Berhing), y en sangre capilar en el sistema Trombotrack (Nycomed). Los coeficientes de correlación de Pearson obtenidos fueron: r= 0.93 entre INR capilar y H. 12 de Octubre; r= 0.92 entre INR capilar y C.E.P. Pontones y r= 0.97 entre H. 12 de Octubre y C.E.P. Pontones. El grado de acuerdo entre los métodos fue: 0.34 entre INR capilar y C.E.P. Pontones, 0.24 entre INR capilar y H. 12 de Octubre y 0.71 entre C.E.P. Pontones y H. 12 de Octubre. La actitud terapeútica fue discordante en más del 50 por ciento Los resultados de INR en sangre venosa y capilar no son intercambiables por lo que no se pueden comparar (AU)