V. Anyaoku

Postprandial thermogenesis is reduced in polycystic ovary syndrome and is associated with increased insulin resistance.

OBJECTIVE In order to investigate the possible causes and effects of obesity in polycystic ovary syndrome resting energy expenditure, postprandial thermogenesis and insulin resistance were measured in 14 polycystic ovary syndrome subjects and in 14 controls.

Smoking is associated with increased hepatic lipase activity, insulin resistance, dyslipidaemia and early atherosclerosis in Type 2 diabetes

We have studied the relationships between hepatic lipase activity, smoking, dyslipidaemia insulin resistance, and early atherosclerosis in 67 Type 2 diabetic subjects, 47 non-smokers and 20 smokers. Insulin resistance was measured using an insulin modified frequently sampled intravenous glucose tolerance test. Early atherosclerosis was assessed using high-resolution ultrasound to measure carotid intima media thickness (IMT) and an arterial ultrasonic score (AUS). Smokers had higher serum cholesterol and triglyceride, lower HDL and HDL2 cholesterol as well as increased hepatic lipase activity. They were also more insulin resistant than non-smokers. Smokers also had higher patient AUS scores. On multiple regression analysis, hepatic lipase activity emerged as the most significant variable affecting patient AUS. We suggest that smoking accentuates the dyslipidaemia of Type 2 diabetic subjects and this is associated with increased hepatic lipase activity. This may be one mechanism whereby smoking further increases the risk of cardiovascular disease in Type 2 diabetes.

Effects of four years' treatment with biosynthetic human growth hormone (GH) on glucose homeostasis, insulin secretion and lipid metabolism in GH‐deficient adults

To study the effects of long‐term growth hormone (GH) treatment on lipid metabolism and carbohydrate tolerance in GH‐deficient adults.

Correlation of plasma insulin and insulin‐like growth factor‐I with indices of androgen transport and metabolism in women with polycystic ovary syndrome

Summary. objective Polycystic ovary syndrome (PCOS) Is said to be associated with hyperinsulinaemia. Insulin stimulates androgen production by ovarian tissue in vitro and previous studies have identified a positive correlation of Insulin with androstenedione. The aim of the present study was to discover whether insulin levels correlate with clinical presentation and with markers of androgen trans‐port and metabolism In women with PCOS.

Elevated leptin concentrations in growth hormone-deficient hypopituitary adults.

Hypopituitarism with growth hormone (GH) deficiency is associated with obesity characterized by central (abdominal) distribution of fat. Recent work has demonstrated that leptin, a product of obese gene, is raised in obesity.

Response of sex hormone binding globulin and insulin‐like growth factor binding protein‐1 to an oral glucose tolerance test in obese women with polycystic ovary syndrome before and after calorie restriction

OBJECTIVE We determined the relationship of short‐term changes in circulating insulin concentrations, resulting from an oral glucose load, to those in both sex hormone binding globulin (SHBG) and insulin‐like growth factor binding protein 1 (IGFBP‐1) and assessed the effect of a short‐term low calorie diet on the levels of SHBG and IGFBP‐1 during an oral glucose tolerance test.

Overnight metabolic fuel deficiency in patients treated conventionally for hypopituitarism

BACKGROUND Hormone replacement in hypopituitary adults attempts to reproduce normal physiology. Conventional regimens fail to mimic normal hormone profiles over 24 hours.

The effect of subcutaneous injection site on absorption of human growth hormone: abdomen versus thigh

To investigate whether growth hormone (GH) absorption is site dependent.

Insulin resistance with respect to lipolysis in non-diabetic relatives of European patients with type 2 diabetes

Type 2 diabetes is characterized by resistance to insulin action of glucose metabolism and lipolysis. First‐degree relatives of diabetic patients are at increased risk of developing diabetes themselves and early metabolic abnormalities in these relatives may represent primary defects in the pathogenesis of diabetes. Our previous work has demonstrated impaired suppression of lipolysis after an oral glucose load in glucose‐tolerant relatives of Asian origin, but not in European relatives. To investigate whether a more subtle defect exists in the European population we studied 8 first‐degree relatives of European patients and 9 matched control subjects. All had normal glucose tolerance. Glycerol and glucose turnovers were measured using a primed constant infusion of the stable isotopic tracers [1, 1, 1, 2, 32H5] glycerol and [6, 62H] glucose, basally and in response to a very low dose insulin infusion (0.005 units kg‐1 h‐1). The relatives had higher basal insulin concentrations (median (range): 49 (30 to 113) vs 28 (18 to 66) pmol 1‐1, p < 0.05) compared to controls, but basal glycerol and glucose turnovers and plasma concentrations of glycerol, glucose, and non‐esterifed fatty acids (NEFA) were similar. Following insulin, the suppression of glycerol appearance in the circulation measured isotopically was significantly less complete in the relatives compared with controls (mean change ± SEM: + 0.06 ± 0.21 vs ‐0.51 ± 0.16 μmol kg‐1 min‐1, p < 0.05). Plasma glycerol concentration decreased to a similar extent in relatives and controls, as did glucose and NEFA levels (mean change ± SEM: glycerol ‐12 ± 3 vs ‐8 ± 4 μmol 1‐1; glucose ‐0.37 ± 0.06 vs ‐0.30 ± 0.10 mmol.l‐1; NEFA ‐152 ± 48 vs ‐130 ± 32 μmol.1‐1). The change in glucose turnover was not different in relatives and controls (change ‐0.10 ± 0.03 vs ‐0.07 ± 0.06 mg kg‐1 min‐1). We conclude that glucose‐tolerant relatives of European origin exhibit subtle defects in insulin sensitivity with respect to lipolysis.

Diurnal variation of sex hormone binding globulin and insulin-like growth factor binding protein-1 in women with polycystic ovary syndrome

OBJECTIVES The aim of this study was to examine (1) the diurnal variation In SHBG and (2) the Inter‐relatlonshlps of Insulin, IGF‐I, SHBG and IGFBP‐1 over 24 hours In 10 women with anovulatory PCOS and compare them with weight‐matched ovulatory controls.