Detección de cortisol salival nocturno en una muestra de sujetos de Santiago de Chile, mediante la técnica deelectroquimioluminicencia / Night salivary cortisol measurement in a sample of volunteers from Santiago using an electroquimioluminicence technique

Cortisol is a glucocorticoid hormone with circadian cycle, it shows high levels in the morning and lower in the night. The salivary cortisol is the biologically active fraction and night measurement has been very useful for improving the diagnosis of Cushing’s syndrome, an endocrine disorder characterized by high levels of cortisol and loss of their circadian cycle. A disadvantage of this measurement is the establishment of reference ranges, which depends on the population and technique. Therefore the night salivary cortisol values were determined in a sample of 75 healthy volunteers, aged 18-75 years old. Each volunteer collects two samples in consecutive days and these samples were analyzed by electrochemiluminescence. The average of night salivary cortisol of volunteers was 0.165 +/- 0.059 ug/dL with a range from 0.082 to 0.352 ug/dL and no significant differences were found between two samples of cortisol in day 1 and 2. Our results suggest that the proposed cut-off limit 0.32 ug/dL between patients with and without Cushing Syndrome would be suitable for this technique and in our population.

[Normal 131iodine uptake values at 2 and 24 hours]. / Valores normales de captación de 131Yodo de 2 y 24 horas.

BACKGROUND: Radiolabeled iodine uptake is a useful tool in the study of thyroid diseases. AIM: To obtain normal values for 131 Iodine thyroid uptake in healthy volunteers. MATERIAL AND METHODS: A total of 105 subjects were included (52 males and 53 females), with a mean age of 45 years (range: 20 to 68, evenly distributed in decades). A questionnaire was applied and a clinical examination was performed to rule out endocrine diseases. Serum TSH and anti-thyroperoxidase antibodies were also measured. The oral 131I dose was 5-10 microCi, and a Thyrad equipment was used for measurements at 2 and 24 h. RESULTS: Mean global iodine uptake was 5.5%+/-1.8% (range: 2.3-12.0) at 2 h and 16.2+/-4.8% (range: 6.5-30.1) at 24 h. The values at 2 h among women and men were 6.0+/-1.8 and 4.9+/-1.6%, respectively, (p<0.02). At 24 h, the figures were 17.3+/-4.5 and 15.0+/-4.9%, respectively (p=0.01). Compared to their younger counterparts, radioactive iodine uptake was lower among volunteers older than 40 years, at 2 h (5.0+/-1.7 and 6.0+/-1.8, respectively, p<0.02) and at 24 h (14.9+/-4.4 and 17.6+/-4.9%, respectively, p<0.01). CONCLUSIONS: Normal thyroid uptake values in adults are influenced by gender and age. Normal thyroid iodine uptake values are slightly higher in females. Iodine thyroid uptake values decrease slightly in subjects aged more than 40 years.

[Glucose tolerance alterations and frequency of metabolic syndrome among patients with non alcoholic fatty liver disease]. / Alteraciones de la tolerancia a la glucosa y frecuencia de síndrome metabólico en pacientes con enfermedad por hígado graso no alcohólico.

BACKGROUND: Non alcoholic fatty liver disease (NAFLD) is associated to diabetes mellitus, obesity, disturbances in serum lipid levels, insulin resistance and metabolic syndrome. AIM: To assess glucose tolerance and the presence of metabolic syndrome among patients with biopsy proven NAFLD. PATIENTS AND METHODS: Serum lipid levels, hepatic function tests were measured and an oral glucose tolerance test was performed in 46 patients (mean age 45+/-12 years, 36 females) without history of diabetes mellitus and with steatosis in a liver biopsy. RESULTS: Mean body mass index of the sample was 37+/-12 kg/m2. Seventeen percent had pure steatosis, 78% had steatohepatitis with or without fibrosis and 50% had fibrosis in the liver biopsy. Glucose intolerance and diabetes was found in 57% and 15% of cases, respectively. The presence of steatohepatitis was higher in diabetics, compared with subjects with glucose intolerance or a normal glucose response (43, 38 and 8%, respectively, p < 0.0001). Ninety three percent had a metabolic syndrome and the proportion of biopsies with fibrosis was higher among subjects with more than three diagnostic criteria for metabolic syndrome compared with those with three or less criteria (59 and 46%, respectively, p < 0.05). CONCLUSIONS: Glucose intolerance, diabetes and metabolic syndrome are common among patients with NAFLD, even when they are not obese.

Alteraciones de la tolerancia a la glucosa y frecuencia de síndrome metabólico en pacientes con enfermedad por hígado graso no alcohólico / Glucose tolerance alterations and frequency of metabolic syndrome among patients with non alcoholic fatty liver disease

Background: Non alcoholic fatty liver disease (NAFLD) is associated to diabetes mellitus, obesity, disturbances in serum lipid levels, insulin resistance and metabolic syndrome. Aim: To assess glucose tolerance and the presence of metabolic syndrome among patients with biopsy proven NAFLD. Patients and methods: Serum lipid levels, hepatic function tests were measured and an oral glucose tolerance test was performed in 46 patients (mean age 45±12 years, 36 females) without history of diabetes mellitus and with steatosis in a liver biopsy. Results: Mean body mass index of the sample was 37±12 kg/m². Seventeen percent had pure steatosis, 78 percent had steatohepatitis with or without fibrosis and 50 percent had fibrosis in the liver biopsy. Glucose intolerance and diabetes was found in 57 percent and 15 percent of cases, respectively. The presence of steatohepatitis was higher in diabetics, compared with subjects with glucose intolerance or a normal glucose response (43, 38 and 8 percent, respectively, p <0.0001). Ninety three percent had a metabolic syndrome and the proportion of biopsies with fibrosis was higher among subjects with more than three diagnostic criteria for metabolic syndrome compared with those with three or less criteria (59 and 46 percent, respectively, p <0.05). Conclusions: Glucose intolerance, diabetes and metabolic syndrome are common among patients with NAFLD, even when they are not obese.