Arquivos Brasileiros de Endocrinologia & Metabologiahttps://www.scielo.br/feed/abem/2011.v55n4/2022-08-06T14:17:38.680000ZVol. 55 No. 4 - 2011WerkzeugThe role of uncoupling protein 2 (UCP2) on the development of type 2 diabetes mellitus and its chronic complications10.1590/S0004-273020110004000012022-08-06T14:17:38.680000Z2020-08-09T06:48:11.828000ZSouza, Bianca Marmontel deAssmann, Taís SilveiraKliemann, Lúcia MariaGross, Jorge LuizCanani, Luís HenriqueCrispim, Daisy
<em>Souza, Bianca Marmontel De</em>;
<em>Assmann, Taís Silveira</em>;
<em>Kliemann, Lúcia Maria</em>;
<em>Gross, Jorge Luiz</em>;
<em>Canani, Luís Henrique</em>;
<em>Crispim, Daisy</em>;
<br/><br/>
It is well established that genetic factors play an important role in the development of type 2 diabetes mellitus (DM2) and its chronic complications, and that genetically susceptible subjects can develop the disease after being exposed to environmental risk factors. Therefore, great efforts have been made to identify genes associated with DM2. Uncoupling protein 2 (UCP2) is expressed in several tissues, and acts in the protection against oxidative stress; in the negative regulation of insulin secretion by beta cells, and in fatty acid metabolism. All these mechanisms are associated with DM2 pathogenesis and its chronic complications. Therefore, UCP2 is a candidate gene for the development of these disorders. Indeed, several studies have reported that three common polymorphisms in UCP2 gene are possibly associated with DM2 and/or obesity. Only a few studies investigated these polymorphisms in relation to chronic complications of diabetes, with inconclusive results.Transitory increase in creatinine levels after parathyroidectomy: evidence of another action of the parathyroid glands?10.1590/S0004-273020110004000022022-08-06T14:17:38.680000Z2020-08-09T06:48:11.828000ZMontenegro, Fábio M.Brandão, Lenine G.Ferreira, Gustavo F.Lourenço Jr., Delmar M.Martin, Regina M.Cunha-Neto, Malebranche B.Helou, Claudia B.Toledo, Sergio A.Cordeiro, Anói C.Ianhez, Luiz E.
<em>Montenegro, Fábio M.</em>;
<em>Brandão, Lenine G.</em>;
<em>Ferreira, Gustavo F.</em>;
<em>Lourenço Jr., Delmar M.</em>;
<em>Martin, Regina M.</em>;
<em>Cunha-Neto, Malebranche B.</em>;
<em>Helou, Claudia B.</em>;
<em>Toledo, Sergio A.</em>;
<em>Cordeiro, Anói C.</em>;
<em>Ianhez, Luiz E.</em>;
<br/><br/>
OBJECTIVE: Little information is available on glomerular function changes after surgical treatment of primary hyperparathyroidism. The acute effects of some head and neck operations on renal function were studied. MATERIAL AND MATHODS: Retrospective analysis of changes in creatinine levels and estimated glomerular filtration rate (eGFR) after surgery. Preoperative values were compared with values available until 72 hours after the operation. RESULTS: In tertiary hyperparathyroidism, mean preoperative and postoperative eGFR values were 57.7 mL/min and 40.8 mL/min (p < 0.0001), respectively. A similar decrease was observed after parathyroidectomy for primary hyperparathyroidism, from 85.4 mL/min to 64.3 mL/min (p < 0.0001). After major head and neck procedures, there was a slight increase in eGFR (from 94.3 mL/min to 105.4 mL/min, p = 0.002). CONCLUSION: Parathyroidectomy may be followed by a transient decrease in eGFR that is not often observed in other head and neck operations.Diabetic ketoacidosis: difference between potassium determined by blood gas analysis versus plasma measurement10.1590/S0004-273020110004000032022-08-06T14:17:38.680000Z2020-08-09T06:48:11.828000ZRobles, Fernando CésarLaguna Neto, DanielDias, Fábio GuiradoSpressão, MárciaMatos, Priscila NascimbeniCordeiro, José AntônioPires, Antônio Carlos
<em>Robles, Fernando César</em>;
<em>Laguna Neto, Daniel</em>;
<em>Dias, Fábio Guirado</em>;
<em>Spressão, Márcia</em>;
<em>Matos, Priscila Nascimbeni</em>;
<em>Cordeiro, José Antônio</em>;
<em>Pires, Antônio Carlos</em>;
<br/><br/>
OBJECTIVE: To evaluate the accuracy of potassium concentrations measured by blood gas analysis (PBG) compared with laboratory serum potassium (LSP), in the initial care of patients with diabetic ketoacidosis (DKA). SUBJECTS AND METHODS: Fifty three patients with diabetes mellitus were evaluated in a retrospective analysis. PBG was carried out using the Radiometer ABL 700 (Radiometer Copenhagen®), and results were compared with LSP ADVIA 1650 Chemistry system (Siemens®), the gold standard method. Both methods are based on potentiometry. RESULTS: Mean PBG was 3.66 mmol/L and mean LSP was 4.79 mmol/L. Mean difference between PBG and LSP was -1.13 mmol/L (p < 0.0005, 95% CI, -1.39 to -0,86). Lin concordance correlation coefficient was rc = 0.28 (95% CIb, 0.10 to 0.45), demonstrating low concordance between the methods. CONCLUSION: Although PBG measurement is faster and easier, it should not be used as a surrogate for LSP in the clinical treatment of DKA.Effectiveness of adding vildagliptin to the treatment of diabetic patients nonresponsive to the combination of metformin and a sulphonylurea10.1590/S0004-273020110004000042022-08-06T14:17:38.680000Z2020-08-09T06:48:11.828000ZVilar, LucioGusmão, AmaroAlbuquerque, José LucianoPontes, LiseteMontenegro, LarissaPontes, SorayaIbiapina, George RobsonCunha, Rodrigo AndradeAlves, Gercivan dos SantosCanadas, VivianeFerreira, Vera Maria Santos G.Nóbrega, Lucia Helena CoelhoLima, Josivan Gomes de
<em>Vilar, Lucio</em>;
<em>Gusmão, Amaro</em>;
<em>Albuquerque, José Luciano</em>;
<em>Pontes, Lisete</em>;
<em>Montenegro, Larissa</em>;
<em>Pontes, Soraya</em>;
<em>Ibiapina, George Robson</em>;
<em>Cunha, Rodrigo Andrade</em>;
<em>Alves, Gercivan Dos Santos</em>;
<em>Canadas, Viviane</em>;
<em>Ferreira, Vera Maria Santos G.</em>;
<em>Nóbrega, Lucia Helena Coelho</em>;
<em>Lima, Josivan Gomes De</em>;
<br/><br/>
OBJECTIVE: To evaluate the effectiveness of adding vildagliptin to the treatment of patients with inadequately controlled type 2 diabetes mellitus (T2DM) treated with a combination of metformin and a sulphonylurea. SUBJECTS AND METHODS: 37 T2DM patients with HbA1c ranging from 7.7% to 12.4% (mean of 9.30 ± 1.38), despite the use of metformin in combination with a sulphonylurea, were additionally treated with vildagliptin (100 mg/day) for at least 6 months. RESULTS: During triple oral therapy (TOT) HbA1c levels < 7% were achieved in 11 patients (29.7%), whereas levels of fasting plasma glucose (FPG) < 120 mg/dL were observed in 12 patients (32.4%). Both findings were observed in 10 patients (27.0%). Compared to nonresponsive subjects, lower mean baseline HbA1c and FPG levels were seen in responsive patients, but the difference was only statistically significant for fasting plasma glucose (FPG). Moreover, there was considerable overlap between the two groups. CONLUSION: Our preliminary results suggest that TOT with metformin, a sulphonylurea and vildagliptin may be useful for some T2DM patients nonresponsive to combination therapy with metformin and sulphonylurea.Clomiphene fails to revert hypogonadism in most male patients with conventionally treated nonfunctioning pituitary adenomas10.1590/S0004-273020110004000052022-08-06T14:17:38.680000Z2020-08-09T06:48:11.828000ZRibeiro, Rogerio SilicaniAbucham, Julio
<em>Ribeiro, Rogerio Silicani</em>;
<em>Abucham, Julio</em>;
<br/><br/>
OBJETIVE: To evaluate the effect of clomiphene in men with hypogonadism and conventionally treated nonfunctioning pituitary adenomas (NFPA). PATIENTS AND METHODS: Open label, single-arm, prospective trial. Nine hypogonadal men (testosterone < 300 ng/dL and low/normal LH) with previously treated NFPA. Clomiphene (50 mg/day orally) for 12 weeks. Testosterone, estradiol, LH, FSH, prolactin and erectile function were evaluated before and after 10 days, 4, 8 and 12 weeks of clomiphene treatment. RESULTS: After clomiphene treatment, testosterone and erectile function improved in only one patient. In the remaining eight patients, testosterone levels decreased whereas LH, FSH, and estradiol remained unchanged. Insulin sensitivity increased in unresponsive patients. CONCLUSIONS: Compared with hypogonadal men with prolactinomas under dopaminergic therapy, clomiphene treatment failed to restore normal testosterone levels in most patients with conventionally treated NFPA.The effects of discontinuing long term alendronate therapy in a clinical practice setting10.1590/S0004-273020110004000062022-08-06T14:17:38.680000Z2020-08-09T06:48:11.828000ZSilva, André Gonçalves daVieira, José Gilberto H.Kunii, Ilda SizueLana, Janaína Martins deLazaretti-Castro, Marise
<em>Silva, André Gonçalves Da</em>;
<em>Vieira, José Gilberto H.</em>;
<em>Kunii, Ilda Sizue</em>;
<em>Lana, Janaína Martins De</em>;
<em>Lazaretti-Castro, Marise</em>;
<br/><br/>
OBJECTIVE: To assess bone turnover markers (BTM) and bone mineral density (BMD) after discontinuation of alendronate treatment used for five or more years. SUBJECTS AND METHODS: 40 patients (pt) with post-menopausal osteoporosis treated with alendronate (10 mg/d) for at least five years (Group 1, G1) had their medication discontinued. Group 2 (G2): 25 pt treated with alendronate for at least one year. Group 3 (G3): 23 treatment-naïve osteoporotic pt. BMD was evaluated in G1 and G2 at baseline and after 12 months. Collagen type I cross-linked C-telopeptide (CTX) and procollagen type 1 N-terminal propeptide (P1NP) levels were measured in all pt at baseline, and in G1 and G2 every three months for 12 months. Data were analyzed using ANOVA on ranks and Mann-Whitney tests. RESULTS: Mean BMD values in G1 and G2 did not differ during follow-up. However, 16 pt (45.7%) in G1 and one (5.2%) in G2 lost BMD (P < 0.001). BTM at baseline was not different between G1 and G2, and both were lower than G3. A significant increase in BTM levels was detected in G1 pt after three months, but not in G2. CONCLUSION: Observed BMD loss and BTM rise after alendronate withdrawal imply that bone turnover was not over suppressed, and alendronate discontinuation may not be safe.Serum retinol binding protein 4 is not decreased in congenital generalized lipodystrophy: a case series10.1590/S0004-273020110004000072022-08-06T14:17:38.680000Z2020-08-09T06:48:11.828000ZGodoy-Matos, Amélio F.Moreira, Rodrigo O.MacDowell, RenataBendet, Izidro
<em>Godoy-Matos, Amélio F.</em>;
<em>Moreira, Rodrigo O.</em>;
<em>Macdowell, Renata</em>;
<em>Bendet, Izidro</em>;
<br/><br/>
INTRODUCTION: Previous studies have suggested that Retinol Binding Protein 4 (RPB4), a protein produced by the adipose tissue, is associated with insulin resistance (IR). Congenital Generalized Lipodystrophy (CGL) is a rare disease characterized by IR and paucity of adipose tissue. Our objective was to determine RBP4 levels in patients with CGL. SUBJECTS AND METHODS: Six (6) patients with CGL and a healthy control group were selected to participate in the study. Anthropometric and biochemical variables were compared between groups. RESULTS: No difference was observed in RBP4 levels between the two groups (CGL 42.5 [12.5 - 127] vs. control 57.4 [15.9 - 165]; p = 0.78). On the other hand, leptin levels were significantly lower in CGL patients (CGL 0.65 [0.2 - 0.7] vs. control 10.9 [0.9 - 38.6]; p = 0.015). No correlation was found between RBP-4 and waist circunference (r = 0.18, p = 0.57), or BMI (r = 0.24, p = 0.45). CONCLUSION: RBP4 is not decreased in CGL. These results suggest that adipose tissue may not be the main source of RBP4.Pseudotumor cerebri during Cushing's disease treatment with ketoconazole10.1590/S0004-273020110004000082022-08-06T14:17:38.680000Z2020-08-09T06:48:11.828000ZCostenaro, FabiolaRodrigues, Ticiana C.Ferreira, Nelson P.Costa, Tiago G. daSchuch, TiagoBoschi, VitorCzepielewski, Mauro A.
<em>Costenaro, Fabiola</em>;
<em>Rodrigues, Ticiana C.</em>;
<em>Ferreira, Nelson P.</em>;
<em>Costa, Tiago G. Da</em>;
<em>Schuch, Tiago</em>;
<em>Boschi, Vitor</em>;
<em>Czepielewski, Mauro A.</em>;
<br/><br/>
Benign intracranial hypertension (Pseudotumor cerebri) has been described as related to the reduction in steroid levels in Cushing's disease (CD), especially after surgical remission. Ketoconazole is a common and effective adjuvant therapy for hypercortisolism, but the major concern is liver enzyme dysfunction. We describe here the case of a 12-year old girl with CD who developed benign intracranial hypertension during treatment with ketoconazole. She presented headache, vomiting, a black spot on her right temporal visual field, and signs of elevated intracranial pressure. Pituitary image was normal on magnetic resonance image (MRI), and all symptoms improved after treatment with acetazolamide. We call attention to the diagnosis of this disorder in CD patients, especially children on ketoconazole treatment, because it could be confounded with adrenal insufficiency and lead to definitive severe visual impairment.Cerebrovascular complications of diabetic ketoacidosis in children10.1590/S0004-273020110004000092022-08-06T14:17:38.680000Z2020-08-09T06:48:11.828000ZSiqueira, Luis Felipe Mendonça de
<em>Siqueira, Luis Felipe Mendonça De</em>;
<br/><br/>
Neurological deterioration in children with diabetic ketoacidosis (DKA) is commonly caused by cerebral edema. However, subtle cerebral injuries including strokes should also be suspected, since children with hyperglycemia and DKA are prone to thrombosis. In this paper, a case involving a 2 month-old patient that presented cerebral edema and stroke as complications of DKA is reported. In the discussion, the literature on neurological complications of DKA in children is briefly reviewed, emphasizing the prothrombotic tendency of these patients.Spontaneous pregnancy in a patient with a combination of ovarian and thyroid failure10.1590/S0004-273020110004000102022-08-06T14:17:38.680000Z2020-08-09T06:48:11.828000ZLaway, Bashir AhmadTufail, SyedBashir, Mir IftikharGanie, Mohd AshrafZargar, Abdul Hamid
<em>Laway, Bashir Ahmad</em>;
<em>Tufail, Syed</em>;
<em>Bashir, Mir Iftikhar</em>;
<em>Ganie, Mohd Ashraf</em>;
<em>Zargar, Abdul Hamid</em>;
<br/><br/>
Premature ovarian failure has an overall prevalence of 0.3% to 0.9% in general population. If fertility is a concern, treatment usually consists of estrogen therapy as hormone replacement and oocyte donation. Spontaneous pregnancy in affected women is uncommon. We report a case of a 34-year old woman, who had premature ovarian failure and primary hypothyroidism, and conceived spontaneously eleven years after the development of premature ovarian failure and correction of hypothyroidism.