ABSTRACT
Using the determination of thyroxine (T4) hair content, we studied 16 hypothyroid newborns diagnosed by means of our regional screening program, and five hypothyroid infants, undetected at birth, at diagnosis and after 3 months of substitutive therapy (8-10 microg/kg/day L-thyroxine in newborns; 15 microg/kg/day in infants), and 13 hyperthyroid adults. Hair T4 content was similar at diagnosis in hypothyroid newborns (2.6 +/- 2.3 pg/mg hair) and in infants undetected at birth (2.4 +/- 1.7 microg/mg hair), but very high only in the latter after therapy (23.2 +/- 3.9 microg/mg hair). Untreated hyperthyroid adults surprisingly evidenced lower hair T4 (0.4 +/- 0.2 microg/mg hair) than controls (1.5 +/- 0.3 microg/mg hair). We suggest these findings are due to differential tissue storage of thyroid hormone, related to the different blood T4 concentration. Therefore, T4 hair assay could be a non-invasive method to further assess thyroid status.
Subject(s)
Congenital Hypothyroidism , Hair/chemistry , Hyperthyroidism/congenital , Hyperthyroidism/metabolism , Hypothyroidism/metabolism , Thyroxine/analysis , Adult , Hair/metabolism , Humans , Infant , Infant, Newborn , Radioimmunoassay/methods , Reference ValuesABSTRACT
Pituitary height, volume and morphology were investigated by MRI in patients aged 3.5-24.9 years with growth hormone deficiency (GHD) in relation to birth history and hormonal findings. Three groups with comparable age, sex and pubertal stage were studied: group I (n=42)--patients with isolated growth hormone deficiency (IGHD); group II (n=22)-- patients with multiple pituitary hormone deficiency (MPHD); and group III (n=30)--healthy controls. Pituitary height and volume differed significantly between the three groups, with the smallest in group II and largest in group III (p <0.001 for both). Both variables correlated significantly with peak GH value in the patient groups (p <0.001). The specificity of pituitary dysmorphology in the determination of GHD was 100% and its sensitivity in differentiation of IGHD and MPHD was 95%. Ectopic neurohypophysis was present in 75% of breech births and 27% of head-presenting patients (p <0.01). This study emphasizes the differential diagnostic value of pituitary MRI and its contribution to the understanding of the pathogenesis and prognosis in GHD.
Subject(s)
Human Growth Hormone/deficiency , Human Growth Hormone/metabolism , Magnetic Resonance Imaging , Pituitary Gland/pathology , Pituitary Hormones/deficiency , Adolescent , Breech Presentation , Child , Choristoma/complications , Choristoma/epidemiology , Diagnosis, Differential , Female , Human Growth Hormone/blood , Humans , Labor Presentation , Male , Organ Size , Pituitary Gland, Posterior , Pregnancy , Reference Values , Sensitivity and SpecificityABSTRACT
The aim of this study was to evaluate the occurrence of gallbladder dysfunction in children with type 1 diabetes mellitus using real-time ultrasonography. The study population consisted of 20 diabetic children (11 male, 9 female; age 11.7+/-2.8 years; diabetes duration 0.5-7 years) with clinically negative neuropathy findings and 15 healthy controls (11 male, 4 female; age 10.5+/-3.7 years). Three-dimensional measurements of the gallbladder were made before and 15, 30, 45, 60 min after intake of diet chocolate. Gallbladder volumes were calculated by the ellipsoid formula. Fasting gallbladder volume of diabetic children (16.9+/-9.5 ml) was significantly greater than that of the controls (10.6+/-5.3 ml; p=0.017). Ejection fraction and maximal contraction showed no significant difference between the two groups. Diabetic patients with multiple microvascular complications had diminished gallbladder motility. There was a negative correlation between BMI and maximal contraction (p<0.05). Nerve conduction velocity was diminished in 45% of the diabetic patients. In conclusion, gallbladder function is preserved in pediatric type 1 diabetic patients with a disease duration less then 10 years, but dilated gallbladder at rest may be an early sign of gastrointestinal autonomic neuropathy and a risk factor for gallstone formation.
Subject(s)
Diabetes Mellitus, Type 1/complications , Gallbladder Diseases/diagnostic imaging , Adolescent , Autonomic Nervous System Diseases/complications , Body Mass Index , Cacao , Child , Cholelithiasis/etiology , Diabetic Angiopathies/complications , Diabetic Neuropathies/complications , Diet , Fasting , Female , Gallbladder/diagnostic imaging , Gallbladder/innervation , Gallbladder/physiopathology , Gallbladder Diseases/physiopathology , Humans , Kinetics , Male , Muscle Contraction , Neural Conduction , Risk Factors , UltrasonographyABSTRACT
BACKGROUND: The aim of the present study was to investigate the controversial role of growth hormone (GH) therapy in lipid regulation. METHODS: We studied serum levels of cholesterol and subgroups, triglyceride and apolipoprotein A-1 and B in 41 GH-deficient children (with subgroups of untreated and short- and long-term treated subjects) and 20 healthy controls. RESULTS: Cholesterol and low-density lipoprotein cholesterol levels (in mmol/L) were found to be 4.92 +/- 1.34 and 3.02 +/- 1.58 in untreated, 4.15 +/- 0.72 and 2.46 +/- 0.65 in short-term (3 month) treated, 4.93 +/- 1.39 and 3.15 +/- 1.38 in long-term (> 1 year) treated and 4.11 +/- 0.5 and 2.0 +/- 0.74 in control subjects, respectively. The apolipoprotein A-1:B ratio was 1.98 +/- 0.5 in long-term treated and 1.6 +/- 0.6 in control subjects. CONCLUSIONS: The improvement of lipid composition with short-term GH therapy is temporary, but the increase in apo A-1:B is not and seems to be the particular benefit of this therapy.
