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Biomedical subjects

B I Joffe

Publications and source records attributed to B I Joffe.

At least 127 records · Page 7Linked to original sources
PubMed1976

Hyperlipidaemia in renal transplant patients.

The prevalence, nature and possible aetiology of post-transplantation hyperlipidaemia were studied in 94 renal allograft recipients. Sixty-five per cent of the group had hypercholesterolaemia or hypertriglyceridaemia, and types IIb and IV were the commonest forms of hyperlipoproteinaemia encountered. The pathogenesis of post-transplantation hyperlipidaemia is complex. Hypertriglyceridaemia was maximal in the first year after transplantation and could be correlated with high corticosteroid dosage during this period. Thereafter hypertriglyceridaemia was less marked and was related to obesity, corbohydrate intolerance and basal insulin levels. Mean cholesterol levels were elevated throughout the post-transplantation period, varied little and could not be related to corticosteroid dosage, body weight, carbohydrate intolerance, basal insulin levels or renal dysfunction.

Adolescent↗
PubMed1976

Clinical aspects of monocomponent insulins in the treatment of diabetes.

Conventional insulins, even if recrystallised many times, are found to contain several peptides on gel electrophoresis and are immunogenic. Antibody formation, insulin allergy, fat atrophy, fat hypertrophy and insulin bumps are thought to be largely caused by the impurities rather than by the insulin itself. 'Monocomponent' insulin has recently been prepared in the laboratories of Novo industries Ltd. Theoretically, this insulin should not cause the above complications. A combined clinical trial of monocomponent insulin has been carried out in Johannesburg and Cape Town on 24 patients with diabetes of diverse aetiology, who required insulin. The results of the trial may be summarised as follows: Monocomponent insulin appears to be very effective in patients with insulin allergy, adipopathy, and possibily in some patients in whom diabetes is not controlled with large doses of insulin. The monocomponent insulins deteriorate on storage at room temperature and yield monodesamido insulin. This de-amidation may be associated with persistent circulating antibodies to insulin and pro-insulin and with failure to reduce insulin requirements, but does not interfere with improvement in allergy or adipopathy. Long-standing diabetic patients, who are qell controlled with conventional insulin, are unlikely to gain therapeutic benefit from monocomponent insulin, and may even deteriorate or lose smooth metabolic control.

Adolescent↗
PubMed1976

Some metabolic relationships in young patients with ischemic heart disease.

The interrelationships between body weight, insulin secretion and serum lipids were studied in 40 young white patients (mean age 37 years) with established ischemic heart disease (IHD), living in Johannesburg. None was severely obese, hypertensive or overtly diabetic. In general, strong positive correlations were found between body weight and insulin concentrations and between insulin levels and fasting serum triglycerides. However, insulin levels were relatively low in 4 patients with marked hypertriglyceridemia (above 350 mg/dl). These data are consistent with the postulate that insulin promotes (hepatic) triglyceride synthesis, but when there is gross hypertriglyceridemia peripheral triglyceride clearance becomes defective. Insignificant correlations were observed between body weight and serum lipids and between cholesterol and other metabolic variables. We conclude that there is a sequential link between increasing body weight, insulin secretion and triglyceride levels in young patients with IHD, but that cholesterolemia is independent of this axis.

Adult↗
PubMed1976

Prevalence of hepatitis B surface antigen and antibody in white and black patients with diabetes mellitus.

The prevalence of hepatitis B surface antigen (HBSAg) and antibody (anti-HBS) was determined in 531 white and 519 black diabetic outpatients and in appropriate white and black control populations. There was no difference between the prevalence of either HBSAg or anti-HBS in either the white or black diabetics and that in the white and black controls. These findings make it unlikely that the vast majority of patients with diabetes mellitus have either an increased susceptibility to infection by the hepatitis B virus or an impaired ability to clear the virus once they are infected.

Adolescent↗
PubMed1975

Metabolic bone disease in the elderly. Biochemical studies in three different racial groups living in South Africa.

In an attempt to detect biochemical evidence of metabolic bone disease in the aged, we measured plasma parathyroid hormone (PTH) concentrations, in addition to plasma calcium, phosphorus, alkaline phosphatase and creatinine levels, in elderly White, Black and Indian women. All three ethnic groups demonstrated raised mean PTH concentrations. The Black patients, however, showed the greatest mean PTH elevation and the lowest plasma calcium level. Increased PTH secretion in elderly females may reflect either an age-related decline in renal function or subclinical osteomalacia. Elderly Black women seem particularly susceptible to the latter disorder, probably because of dietary and environmental factors.

Black or African American↗
PubMed1975

Pathogenesis of nonketotic hyperosmolar diabetic coma.

Two concepts are advanced to explain some fo the puzzling biochemical features found in nonketotic hyperosmolar diabetic coma. It is firstly suggested that an insulinised liver (reflecting residual beta-cell secretory activity) coexists with a diabetic periphery, thereby inactivating intrahepatic oxidation of incoming free fatty acids, which are directed largly along nonketogenic metabolic pathways such as triglyceride synthesis. This could account for the lack of hyperketonaemia. Secondly, it is hypothesised that within the liver enhanced neoglucogenesis occurs, due to the prevailing portal-vein into ratio of glucagon to insulin, and is mainly responsible for the development of massive hyperglycaemia.

Animals↗
PubMed1975

Insulin, glucose and triglyceride relationships in obese African subjects.

Aspects of carbohydrate and lipid metabolism were studied in 50 nondiabetic African subjects living in Johannesburg. Twenty-six of them were overweight, invariably associated with a high-carbohydrate intake. In general, the obese group demonstrated significantly raised serum insulin levels, normal glucose tolerance, normal fasting serum triglycerides, and significantly elevated serum cholesterol concentrations. However, the degree of obesity was not significantly correlated with any of these metabolic variables--notably basal or stimulated insulin levels. This suggests that the obese state, per se, was not the major cause of the hyperinsulinemia, and that other factors influenced individual insulin responses or sensitivity. Inconsistently excessive dietary carbohydrate ingestion and an unusual degree of physical activity may have been important. A striking correlation emerged between fasting serum triglycerides and insulin concentrations (both basal and stimulated); the possibility that this reflects acceleration of hepatic triglyceride synthesis by insulin is discussed. The concept of obesity invariably producing insulin resistance and progressive compensatory hyperinsulinism may not apply in all environmental conditions.

Adult↗
PubMed1975

Hormonal responses in ethanol-induced hypoglycemia.

Seven patients with clinical alcoholic hypoglycemia showed suppressed pretreatment plasma insulin levels and raised concentrations of somatotropin, hydrocortisone and pancreatic glucagon. A prolonged intravenous glucose infusion failed to elicit adequate insulin output and marked hyperglycemia supervened.

Blood Glucose↗
PubMed1973

Evolution of diabetes mellitus in a case of Friedreich's ataxia.

A 12 year old girl with Friedreich's ataxia, in whom progression from chemical to severe insulin-dependent diabetes mellitus occurred over a two year period, is presented. During the phase of subclinical diabetes her plasma immunoreactive insulin response to oral glucose was markedly increased, but when she became symptomatic gross insulin deficiency had supervened. This report draws attention to the unusual disorders of carbohydrate metabolism and insulin secretion that may occur in a variety of neurological conditions.

Blood Glucose↗