[Multiple Endocrine Neoplasia Type 1(MEN1)Presenting with Hypoglycemic Attacks - A Case Report].

A woman in her 60s visited our hospital because of frequent hypoglycemia and episodes of unconsciousness over the last 6 years. A 4 cm tumor was detected on the pancreatic tail using abdominal computed tomography and ultrasonography. An insulinoma was strongly suspected from the results of the fasting test and glucagon load test, and a distal pancreatectomy with splenectomy was performed. Pathological examination indicated an insulinoma and neuroendocrine tumor(NET)G2 based on the WHO 2010 classification. The patient's blood sugar and insulin levels returned to normal, and hypoglycemic attacks disappeared postoperatively. Six months later, a total parathyroidectomy was performed because of primary hyperparathyroidism with hypertrophy of the parathyroid glands. Furthermore, pituitary swellingwas also detected usinghead MRI. However, the patient has been under observation because the tumor was non-functional without any associated symptoms. Thus, we diagnosed the patient with multiple endocrine neoplasia type 1(MEN1). In patients with pancreatic NET, it is necessary to consider the possibility of MEN1.

Circulating adiponectin levels and their associated factors in young lean healthy Japanese women.

AIM: The aim of the current study was to investigate circulating adiponectin levels and their associated factors in young lean healthy Japanese women. METHODS: We recruited 82 healthy Japanese women in their twenties and thirties with their body mass index <25 kg/m(2), and performed anthropometric, sphygmomanometric, and laboratory examinations. Laboratory examinations included adiponectin levels, as well as lipid profiles, glucose, hemoglobin A1c, transaminase, and creatinine levels, from which the glomerular filtration rate was estimated (eGFR). RESULTS: The median and interquartile range of circulating adiponectin levels were 8.1 (6.2-10.0) µg/ mL. HDL cholesterol levels and eGFR, but not the other examined clinical parameters, were significantly correlated with log-transformed adiponectin levels; their correlation coefficients were 0.323 (p<0.01) and -0.311 (p<0.01), respectively. Statistical significance was still observed even after adjustment for each other (both p= 0.02). In adjusted models, subjects with HDL cholesterol levels ≥80 mg/dL had 1.3 times higher adiponectin levels than those with 40-60 mg/dL, whereas eGFR ≥110 mL/min/1.73m(2) and 60-90 mL/min/1.73m(2) showed a 1.5-fold difference in adiponectin levels. CONCLUSIONS: Adiponectin levels of young lean healthy Japanese women had significant associations with HDL cholesterol levels and eGFR, even though their HDL cholesterol levels and eGFR were distributed within normal ranges. It seems important to take into account these two variables in evaluating adiponectin levels of these subjects, even if the two variables are within normal ranges.