Bone mass after long-term euthyroidism in former hyperthyroid women treated with (131)I influence of menopausal status.

The objective of this study was to assess bone mineral density (BMD) and bone markers in former hyperthyroid females after long-term euthyroidism (>4 yr) following (131)I therapy, as well as the potential influence of the timing of menopause. Twenty-six females ages 57 +/- 8 yr previously diagnosed with hyperthyroidism and treated with (131)I who were euthyroid for a minimum of the last 4 yr (10 +/- 5 yr) were studied. Eighteen patients (69%) were on levothyroxine (LT(4)) replacement therapy for 9 +/- 4 yr. BMD (g/cm(2) and Z-score) was measured by dual X-ray absorptiometry in the lumbar spine, femoral neck, and Ward's triangle. BMD (Z-score) was lower than the normal reference values for the Spanish population in all sites (lumbar spine: -0.65 +/- 1.13; femoral neck: -0.47 +/- 0.95; Ward's triangle: -0.37 +/- 0.88). No differences were found between BMD values according to the etiology of the hyperthyroidism or current LT(4) therapy. Current postmenopausal patients (n = 21) showed lower BMD than current premenopausal patients in the lumbar spine and femoral neck (p < 0.05). Those women who were postmenopausal at the time of the (131)I therapy (n = 15) also had lower lumbar spine BMD than premenopausal patients (p = 0.01), while no significant difference in BMD was seen according to the menopausal status when hyperthyroidism was diagnosed. Former hyperthyroid patients after long-term euthyroidism following (131)I therapy showed reduced BMD at the lumbar spine and proximal femur. Menopausal women showed a greater reduction in bone density. The menopausal status at the time of diagnosis did not seem to have long-term effects in bone density; nevertheless, an early therapeutic intervention in premenopause is suggested to reduce bone loss.

Factors associated with microalbuminuria in type 1 diabetes mellitus: a cross-sectional study.

In order to determine the prevalence of microalbuminuria in people with Type 1 diabetes mellitus (Type 1 DM) and identify factors associated with microalbuminuria, we studied 312 Type 1 DM patients attending in three hospitals in two Spanish regions over 6 months. Clinical characteristics, micro- and macro-vascular complications, blood pressure, 24-h urine albumin excretion, lipid profile, HbA1(c) levels, smoking habits, and family history of hypertension and diabetic nephropathy were recorded. Univariate analysis and multiple logistic regression were used to examine associations between these variables and the prevalence of microalbuminuria. We detected microalbuminuria in 29% of the patients. The prevalence of microalbuminuria was high during the second decade of diabetes and declined thereafter. Univariate analysis showed dyslipidaemia (P<0. 002), previously diagnosed hypertension (P<0.001), family history of hypertension (sibling alone P<0.006; mother alone P<0.05), family history of diabetic nephropathy (P<0.001), and laser-treated retinopathy (P<0.03) to be factors associated with the presence of microalbuminuria. Multiple logistic regression revealed an association between microalbuminuria and family history of nephropathy (OR 7.6, 3.6-16). In conclusion, in our sample the frequency of microalbuminuria seems to be related to the presence of dyslipidaemia, hypertension, and to a family history of hypertension or nephropathy.

Hypoglycemic action of an oral fig-leaf decoction in type-I diabetic patients.

The effect of a decoction of fig leaves (Ficus carica), as a supplement to breakfast, on diabetes control was studied in insulin-dependent diabetes mellitus (IDDM) patients (six men, four women, age 22-38 years, body mass index (BMI): 20.8 +/- 3.0 kg/m2, HbA1c 7.6 +/- 0.9% with a mean duration of diabetes of 9 +/- 6.3 years). The patients were managed with their usual diabetes diet and their twice-daily insulin injection. During the first month, patients were given a decoction of fig leaves (FC) and during the next month a non-sweet commercial tea (TC). The patients were divided into two groups (n = 5) with random allocation and cross-over design. A standard breakfast was given at the beginning and end of each month-run. C-peptide, 2 h pre- and post-prandial glycemia, HbA1c, cholesterol, lipid fractions and hematology data, were analyzed during each visit. Glycemic profiles (7/day per week) were recorded by patients. Only two patients had intolerance dropout. Post-prandial glycemia was significantly lower during supplementation with FC 156.6 +/- 75.9 mg/dl versus TC 293.7 +/- 45.0 mg/dl (P < 0.001) without pre-prandial differences 145.0 +/- 41.5 and 196.6 +/- 43.2 mg/dl, respectively. Medium average capillary profiles were also lower in the two sub-groups of patients during FC 166.7 +/- 23.6 mg/dl, P < 0.05 and 157.1 +/- 17.0 mg/dl versus TC 245.8 +/- 14.2 mg/dl and 221.4 +/- 27.3 mg/dl. Average insulin dose was 12% lower during FC in the total group. The addition of FC to diet in IDDM could be of help to control postprandial glycemia.