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Biomedical subjects

I Bosaeus

Publications and source records attributed to I Bosaeus.

At least 73 records · Page 4Linked to original sources
PubMed1993

Treatment of adults with growth hormone (GH) deficiency with recombinant human GH.

In a double blind, cross-over placebo-controlled trial, we studied the effects of 26 weeks of replacement therapy with recombinant human GH on body composition, metabolic parameters, and well-being in 10 patients with adult-onset GH deficiency (GHD). All patients received appropriate thyroid, adrenal, and gonadal replacement therapy. The dose of recombinant human GH was 0.25-0.5 U/kg.week (0.013-0.026 mg/kg.day) and was administered sc daily at bedtime. One patient was withdrawn from the study because of edema and atrial fibrillation. Body composition was estimated with three independent methods: computed tomography, bioelectric impedance, and total body potassium combined with total body water assessments. The Comprehensive Psychological Rating Scale and the Symptom Check List-90 were used to assess any change in psychopathology. After 26 weeks of treatment, adipose tissue (AT) mass decreased 4.7 kg (P < 0.001). Subcutaneous AT decreased by an average of 13%, whereas visceral AT was reduced by 30%. Muscle volume increased by 2.5 kg (5%; P < 0.05). According to the four-compartment model derived from assessments of total body potassium and total body water, body cell mass and extracellular fluid volume increased significantly by 1.6 and 3.0 kg, whereas body fat decreased by 6.1 kg. Results obtained by the bioelectric impedance technique were similar. The mean (+/- SD) concentrations of insulin-like growth factor-I increased from 0.26 (0.06) at baseline to 2.56 (1.55) and 2.09 (1.03) kU/L after 6 and 26 weeks of treatment. Calcium and serum phosphate, osteocalcin, and procollagen-III concentrations were significantly higher, and intact PTH concentrations were reduced after 6 and 26 weeks of treatment, respectively. Total and free T3 concentrations were significantly increased after 6 and 26 weeks of treatment, whereas free T4 concentrations were reduced at 6 weeks, but after 26 weeks, free T4 concentrations had returned to pretreatment values. Finally, after 26 weeks of treatment, there was a decrease in the Comprehensive Psychological Rating Scale score (P < 0.05). The results show that GH replacement in GHD adults results in marked alterations in body composition, fat distribution, and bone and mineral metabolism and reduces psychiatric symptoms. Finally, we conclude that the observed beneficial effects of replacement therapy with GH are of sufficient magnitude to consider treatment of GHD adults.

Adipose Tissue↗
PubMed1992

Sodium and potassium excretion before and after conversion from conventional to reservoir ileostomy.

Sodium and potassium in the ileostomy output and urine were determined in 28 patients with ulcerative colitis on a free diet and in eight patients on a defined constant diet, before and after conversion from a conventional ileostomy (CI) to a continent reservoir ileostomy (RI). Feces and urine were collected both in the hospital and at home. Patients with CI on free diet had a median intestinal loss of 62 mmol sodium and those with RI 74 mmol/24 h collected in the hospital (p < 0.05). The figures for at home was 79 and 81 mmol/24 respectively, and were larger than in the hospital (p < 0.01). Sodium loss in the urine (U-Na) and the intake of sodium did not change significantly after conversion. Patients with a low U-Na before conversion also had a low U-Na after, in a few almost nil, implying a need for increased intake of sodium. Patients with a CI and low urinary output of sodium should be carefully studied with respect to their sodium balance before accepting them for conversion to RI. The ileostomy output of potassium increased after conversion (4.3 vs. 6.8 mmol/24 h; p < 0.01) in the hospital (5.3 vs 7.1 mmol/24 h; p < 0.01) at home. Patients on a defined constant diet before and after conversion did not show any significant differences in absorption of sodium, potassium, magnesium or calcium after conversion, but did show a reduced dry weight of the ileostomy output, indicating an increased degradation of intestinal contents in RI patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

Effect of oat bran on plasma cholesterol and bile acid excretion in nine subjects with ileostomies.

A higher excretion of dry matter, fat, nitrogen, energy, and total bile acids in ileal effluents; a lower plasma low-density-lipoprotein (LDL) and total cholesterols (12.1% and 9.0% lower respectively); but no change in plasma high-density-lipoprotein (HDL) cholesterol or apolipoproteins A-I and B were observed in nine subjects with ileostomies when they consumed an oat-bran, bread-based, high-fiber diet (HFD) as compared with a wheat-flour, bread-based, low-fiber diet (LFD) for 3 wk with a crossover design. Of the nine subjects only the subjects with a low daily excretion of bile acids had an elevated excretion of total bile acids during the HFD compared with the LFD. Total cholesterol, LDL cholesterol, and apolipoprotein B in plasma also decreased by 11.3%, 15.3%, and 10.7%, respectively, after consumption of the HFD for 3 wk.

Adult↗
PubMed1992

Validation of body composition determination by bioelectrical impedance analysis in acromegaly.

Body composition determination by bioelectrical impedance analysis (BIA) has been compared with measurement of total body water (TBW) by tritiated water dilution and estimation of body fat (BF) by measurement of TBW and total body potassium (TBK) in a four-compartment model, in patients with acromegaly. This disorder is accompanied by a profound aberration in body composition. Furthermore TBW and BF were predicted on the basis of anthropometric variables alone. Paired comparisons of TBW estimations by isotope dilution and BIA showed good correlation (Spearman's rank correlation 0.95, P less than 0.01). Isotope dilution resulted in a mean of 1.7 liter (standard deviation 1.87) higher values. Comparison of BF estimations showed also a significant correlation (Spearman's rank correlation 0.75, P less than 0.01), with slightly higher values for BIA (mean 1.4 kg; standard deviation 2.99). BIA improved the prediction of TBW and BF compared with predictions based on anthropometric variables. In a population of acromegalic patients, BIA seemed to be a useful method to estimate TBW and BF.

Acromegaly↗
PubMed1992

Olive oil instead of butter increases net cholesterol excretion from the small bowel.

Butter was replaced by olive oil in a controlled 100 g fat diet in order to study the effect of saturated fats (SAFA) versus monounsaturated fats (MUFA) on small-bowel sterol excretion in eleven healthy ileostomates. Bile acids and neutral sterols were measured by gas-liquid chromatography. Net cholesterol excretion (excretion minus intake) was 84 +/- 25 mg/24 h (mean +/- SE) on the SAFA diet and increased to 218 +/- 32 mg/24 h on the MUFA diet (P less than 0.01). The bile acid excretion tended to be somewhat lower on the MUFA diet, but this was significant only for chenodeoxycholic acid. Net sterol excretion (the sum of excretion of net cholesterol and bile acids) was significantly lower on the SAFA diet than on the MUFA diet (443 +/- 60 and 529 +/- 58 mg/24 h, respectively). The immediately increased excretion of cholesterol from the small bowel could thus explain the serum cholesterol-lowering effect of a change from a SAFA-rich to a MUFA-rich diet, though the mechanism for this change is still unclear.

Adult↗
PubMed1991

Brewer's spent grain, serum lipids and fecal sterol excretion in human subjects with ileostomies.

A crossover design studying lipid and apoprotein levels in serum and excretion of sterol, nitrogen and fat in ileostomy effluent was performed in 10 subjects fed diets with or without supplementation with brewer's spent grain, which is the residue of barley after the brewing of beer. More cholesterol, nitrogen, fat and energy were excreted in the ileostomy effluents when the subjects consumed a brewer's spent grain supplemented, high fiber diet than when they consumed a low fiber diet. No significant change was found in the daily net sterol excretion. The six subjects with low daily excretion of bile acids (less than 1000 mg/24 h) had increased cholesterol and net cholesterol and decreased bile acid excretion per day, and lowered serum LDL-cholesterol and apoprotein B levels after supplementation with brewer's spent grain. We propose that subjects with low daily bile acid excretion are suitable models for studying the effect of dietary changes on sterol excretion and serum lipid levels. Increased fecal cholesterol excretion is suggested to be the primary mechanism for the serum LDL-cholesterol lowering effect of brewer's spent grain.

Adult↗
PubMed1991

Sterol and nutrient excretion in ileostomists on prudent diets.

Nine ileostomists eating three diets (STAND, RESAT and EXFIB) were investigated in order to quantify the changes in sterol and nutrient excretion when shifting between a standard Western diet and two prudent diets. The RESAT diet had a moderate reduction in fat content to 30 per cent of energy, mainly through a reduction in saturated fat. The EXFIB diet had the same fat modification but in addition the dietary fibre content was raised to 3g/MJ according to current Swedish nutrition recommendations. The RESAT diet resulted in a lowered excretion of fat, but the excretion of nitrogen, energy, cholesterol and bile acids did not change compared with the STAND diet. The EXFIB diet resulted in a higher excretion of fat, nitrogen, energy and cholesterol compared with both the STAND and the RESAT diets (P less than 0.01). Bile acids showed no consistent excretion changes. Thus, a prudent diet, with moderate restricted total and saturated fat content, and a moderate increase in dietary fibre from natural food items, increased the excretion of cholesterol and fat from the small bowel when given to healthy ileostomists. A solely fat-modified prudent diet did not significantly change the pattern of excretion compared with a standard diet.

Adult↗
PubMed1990

Elevation of retinol levels and suppression of alanine aminotransferase activity in the liver of taurine-deficient kittens.

In taurine-deficient cats, the secretion of bile acids is impaired, and this impairment may reduce intestinal uptake of lipophilic vitamins. It was therefore hypothesized that retinol deficiency is involved in the generation of retinal lesions in taurine-deficient kittens. To this end, the concentration of retinol in plasma and liver was determined in taurine-deficient kittens. Further, the effects of taurine deficiency on amino acid concentrations of heart, liver and kidney were investigated. To see whether taurine deficiency adversely affects the liver, hepatic enzymes were measured in plasma and liver of kittens suffering from taurine deficiency. In addition, liver morphology, growth and food intake were studied. Taurine was the only amino acid whose concentration was consistently decreased in plasma of the experimental group. Unexpectedly, retinol level was increased in plasma and liver from taurine-depleted kittens. Several alterations were noted in amino acid concentrations in liver and kidney, but not in heart. Plasma alanine aminotransferase activity was diminished, probably reflecting decreased activity in the liver. Perivenular steatosis was found in both groups. Controls grew linearly, in contrast to deficient animals, which nevertheless consumed more food. The results demonstrate that retinol deficiency is not involved in taurine-deficiency retinopathy. Moreover, taurine is required for linear growth of juvenile cats and for the maintenance of hepatic and renal pools of certain amino acids.

Alanine Transaminase↗
PubMed1990

Growth hormone and body composition.

Through its anabolic, lipolytic and antinatriuretic actions, GH has profound effects on body composition. In untreated acromegaly, body weight, body cell mass and extracellular water are increased simultaneously with a decrease of body fat. After successful treatment, extracellular water and body fat normalize, but cell mass remains high. The changes in cell mass, body fat and extracellular water observed in acromegaly suggest different dose-response relationships between GH and these parameters. The relationship between GH concentration and the lipolytic actions of GH is more linear, while the relationship between GH and excess extracellular water is more curvilinear. The sodium-retaining effect of GH seems to be mediated by stimulation of the Na(+)-K+ pump. At higher GH levels, the pump activity is counteracted by an alleged sodium transport inhibitor. In GH-deficient children, GH treatment is followed by rapid loss of adipose tissue and muscular gain. The influence of GH on body composition in GH-deficient adults has recently received attention. Compared to normal subjects, these patients are overweight and have decreased cell mass. Replacement treatment with GH restores body composition towards normal.

Acromegaly↗
PubMed1990

Total body potassium, skeletal muscle potassium and magnesium in patients with Bartter's syndrome.

In 20 patients with Bartter's syndrome, who had a serum potassium concentration of 2.75 +/- 0.29 mmol/l (mean +/- SD), the total body potassium (TBK) was measured and compared with a predicted value obtained from regression equations based on age, sex, body height and weight. A significant difference was found between the observed and predicted TBK (mean -320 +/- 306 mmol, p less than 0.01). A positive correlation existed between the serum potassium concentration and the ratio observed TBK/predicted TBK. However, the average fractional reduction in TBK (-11%) was less than the average fractional decrease in serum potassium concentration (-32%). Muscle biopsy specimens were obtained from four patients with Bartter's syndrome and 10 control subjects for analyses of potassium and magnesium. The serum concentrations of potassium and magnesium were decreased in these patients. The potassium content in muscle tissue was lower in two of four patients, but no difference in the amount of magnesium was observed.

Adult↗
PubMed1990

Hepatobiliary compensation for the loss of gallbladder function after cholecystectomy. An experimental study in the cat.

The side effects of the removal of a functioning gallbladder are surprisingly few, and it has been suggested, but never demonstrated, that the hepatobiliary tract then adjusts to compensate for the loss of gallbladder function. In this study the effects of cholecystectomy on bile acid kinetics, bile flow, and biliary clearance of mannitol were studied in cats 6-8 weeks after cholecystectomy. An enhanced recycling rate of a diminished bile acid pool was found. The bile flow was reduced and the bile acid concentration in hepatic bile was increased, but fasting bile acid secretion rate was not changed. Both when the bile acid secretion rate was reduced by drainage via an acute bile fistula and when it was enhanced by intravenous infusion of glycocholic acid, there was a lower bile acid-independent flow in the cholecystectomy group. This reduced bile flow after cholecystectomy was not explained by the higher proportion of deoxycholic acid present in the bile of the cholecystectomized animals. Biliary clearance of mannitol, which is supposed to reflect the canalicular inflow, was not reduced, indicating that the reduction in bile flow is explained by a reduced fluid secretion or an enhanced fluid reabsorption in the bile ductules and ducts after cholecystectomy. In this manner the bile ducts compensate for the loss of the absorptive function of the gallbladder after cholecystectomy.

Animals↗
PubMed1990

Selenium status and absorption of zinc (65Zn), selenium (75Se) and manganese (54Mn) in patients with short bowel syndrome.

Selenium level and activity of glutathione peroxidase in plasma were studied in seven patients with extensive short bowel resection due to Crohn's disease, before and during 27-54 weeks of intake of a vitamin and trace element supplement containing 50 micrograms of selenium as sodium selenite. Initial levels of selenium were normal in all except one of the patients. The supplementation had no or minor effects on plasma selenium levels and glutathione peroxidase activity. The absorption of zinc, manganese and selenium was measured with a radionuclide technique before and/or after the supplementation period in five of the patients. The absorption of zinc and manganese was similar to that observed earlier in healthy subjects, while the absorption of selenium was significantly lower. The results indicate that a higher selenium intake or a different form of selenium is needed in these patients to compensate for the impaired bowel function.

Adult↗
PubMed1989

Body composition in acromegaly: the effect of treatment.

Total body water (TBW) and total potassium (TBK) were measured in patients participating in a follow-up investigation of all acromegalic patients seen between 1956 and 1984. The results were compared with population-based estimates of TBK and TBW calculated from height (BH), weight (BW) age and sex, using data from a large number of healthy subjects (n = 476). The findings were compared with values obtained at diagnosis and were also related to growth hormone (GH) and IGF-I/SmC concentrations at follow-up. BW at follow-up was unchanged compared to BW at diagnosis and was 9.7 and 10.0 kg higher in males and females, respectively, than in healthy subjects of the same BH (BWnorm). Growth hormone concentration at follow-up correlated directly with excess extracellular fluid volume (ECW%) (P less than 0.001) and inversely with the ratio observed/predicted body fat (BF%) (P less than 0.001) as well as with BW/BWnorm (P less than 0.05). On the other hand, GH concentration did not correlate with excess body cell mass (BCM%) estimated from TBK. IGF-I/SmC concentration correlated with GH concentration at follow-up (P less than 0.001) and with ECW% (P less than 0.01) but not with BCM% or BF%. In 39 patients, data on body composition were also available at diagnosis. Of these, three males had developed gonadal insufficiency and their BCM had decreased markedly. One patient had suffered from hemiplegia. Five patients had not received any treatment. In the remaining 30 treated patients, those with a post-treatment GH concentration below 5 mU/l were normalized with respect to ECW and BF. BCM, however, was unchanged. In contrast, patients with GH concentration greater than or equal to mU/l displayed unchanged body composition. Furthermore, BH decreased significantly in successfully treated patients.

Acromegaly↗
PubMed1989

Body composition in acromegaly.

Total body water (TBW) and potassium (TBK) were measured in untreated acromegalic patients seen between 1956 and 1984 and the results were compared to values predicted from height (BH), weight (BW), age and sex, using data from a large number of healthy subjects (n = 476). Normal body weight for each patient (BWnorm) was predicted from BH and sex, the regression equations being derived from a representative population sample (n = 4017). The BH for each patient was compared with data on BH in 15,000 Swedes. The patients were significantly taller than the control population (P less than 0.001). In 107 (70%) of the 156 patients BH was above the median. Patients with an early onset of the disease were taller than those with a later onset. TBK and TBW were significantly higher than predicted from observed BW (P less than 0.001) and so was the quotient extracellular water (ECW)/intracellular water (ICW). Body fat (BF), on the other hand, was lower than predicted (P less than 0.001). Observed BW in male acromegalics was 8.1 kg higher than predicted from healthy subjects of the same BH (BWnorm), a difference explained by an average increase of 4.7 kg in body cell mass (BCM) (P less than 0.001) and 7.1 kg in extracellular water (P less than 0.001) simultaneously with a mean decrease of 3.7 kg in BF (P less than 0.01). Female acromegalics weighed on average 6.4 kg more than healthy women, a difference explained by an increase in BCM of 3.3 kg (P less than 0.001) and in ECW of 4.6 kg (P less than 0.001) concomitantly with a decrease in BF of 1.5 kg. Mean hGH concentration at diagnosis correlated inversely with the quotients observed/predicted BF (P less than 0.01) and BW/BWnorm (P less than 0.05) but not with the quotients observed/predicted TBK, TBW or ECW/ICW.

Acromegaly↗
PubMed1988

Bile acid and cholesterol excretion in human beings given soya-bean- and meat-protein-based diets: a study in ileostomy subjects.

1. The effect of partial replacement of meat protein with three different soya-bean-protein products on bile acid and cholesterol excretion was studied in seven ileostomy subjects. Four different tests diets containing 60 g meat, rice and bread protein, or a replacement of 250 g protein/kg total dietary protein by soya-bean protein from soya-bean flour, soya-bean concentrate or soya-bean isolate, were randomly assigned to the subjects in 2-d periods. 2. Ileostomy contents were collected at 2-h intervals during the day and in one portion during the night, and immediately deep-frozen to avoid bacteriological degradation. Bile acids and cholesterol were quantified by gas-liquid chromatography. 3. No difference in daily excretion of bile acids and cholesterol was noted between test diets. Ileostomy sterol concentrations were lower when soya-bean products were fed. 4. Incorporation of moderate amounts of soya-bean products in solid diets does not seem to affect short-term sterol balance in man.

Adult↗
PubMed1988

Total body water and total body potassium in ileostomy patients before and after conversion to the continent ileostomy.

Total body water (TBW) and total body potassium (TBK) were studied in 40 ileostomists before (with conventional ileostomy) and one year after conversion to a continent ileostomy. Each patient acted as his own control. Total body water was determined by using an isotope dilution technique and TBK by counting the gamma radiation from the naturally present nuclide 40K in a whole body counter. Measured values of TBW and TBK were compared intraindividually (conventional versus continent ileostomy) and also with 'normal values' obtained from the same laboratory and based on a multiple regression analysis of data from 476 healthy controls. There was no evidence of water or potassium depletion in ileostomy patients, neither before nor after construction of the continent ileostomy.

Adult↗