The diagnosis of diabetic cardiovascular autonomic neuropathy (DCVAN) is based on evaluation of baroreflex arc function (BRAF) by measuring R-R variability at rest and the R-R response to exercises such as the Valsalva manoeuvre, deep breathing, standing up, etc. Using an original computerized technique, we have studied 178 normal subjects (79 males and 99 females uniformly distributed between the ages of 16 and 88 years) so as to determine ages defining natural divisions into 'old' and 'young' groups as regards the values of various BRAF parameters, and simultaneously to determine the natural ranges for each age group so defined. For most of the 32 parameters considered the dividing ages obtained lay between 43 and 55 years. No dividing age could be determined for the response of arterial pressure to the Valsalva manoeuvre or standing up, nor for the mean heart rate while resting in a recumbent position, and in these cases normal ranges were determined for the age range of the whole sample. The effects of aging were not the same for all parameters. Thus instantaneous heart rate variability while sitting at rest and the response to deep breathing (maximum heart rate minus minimum heart rate) both decreased considerably with age, whereas the responses to the Valsalva manoeuvre (PV10) and to standing up (maximum heart rate/minimum heart rate) diminished less markedly. In conclusion, we consider that the reported results accurately establish the normal ranges of the BRAF parameters considered, whose reliability for individual diagnosis of DCVAN is thereby increased.

Adolescent↗

PubMedDate not supplied

Insulin sensitivity and metabolic clearance rate of insulin in familial multiple lipomatosis.

Intolerance to glucose in certain kinds of lipomatosis is well documented. This article describes a euglucaemic hyperinsulinaemic clamp study of alterations in glucose and/or insulin metabolism in four members of a single family with familial multiple lipomatosis. Fifteen normal subjects were studied as controls. The four patients exhibited no alteration in tolerance to orally administered glucose. When a Biostator Glucose-Controlled Insulin Infusion System (GCIIS) was used to clamp glycaemia at 4.44 mmol/L with successive insulin infusion rates of (a) 0.5 (b) 1.0 or (c) 5.0 mU/kg/min, there was no difference between patients and controls as regards the value of M, the rate of glucose infusion, but the concentrations of immunoreactive insulin recorded during the last 40 minutes of each phase of the clamp were greater in patients than in controls (45 +/- 2 vs 27 +/- 2 uU/mL (p less than 0.01), 83 +/- 2 vs 60 +/- 5 uU/mL (p less than 0.05) and 537 +/- 48 vs 377 +/- 25 uU/mL (p less than 0.05) for insulin infusion rates (a), (b) and (c) respectively), and the ratio M/IRI was consequently smaller for patients than controls (1.92 +/- 0.41 vs 3.06 +/- 0.19 (p less than 0.05) for an insulin infusion rate of 5 mU/kg/min). The metabolic clearance rate of insulin was likewise slower in patients than controls (p less than 0.01). It is concluded that the four patients studied (all members of the same family) have sub-normal sensitivity to insulin secondary to a sub-normal metabolic clearance rate for insulin.

Blood Glucose↗

PubMedDate not supplied

[Lack of activity of diphenhydramine in the secretion of prolactin and insulin induced by arginine].

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Adult↗

PubMedDate not supplied

[Protein-energy malnutrition: its effects on 4 metabolic parameters].

The usefulness of cholinesterase (CS) and cholesterol (CO) in evaluating the nutritional state has been studied, comparing them to two classic parameters: albumin (ALB) and transferrin (TF). The study was done on 73 patients between the ages of 17 and 93, suffering from different afflictions, all of whom were suffering from energy-protein malnutrition (EPM). The patients were divided according to whether the EPM was predominantly visceral (V) or non-visceral (NV), based on the following parameters: ALB, TF, total lymphocytes (TL), cellular immunity test (CIT), triceps skin fold (TSF) and muscular circumference (MC). Our results show significant differences between the V and NV groups for the 4 studied parameters, obtaining lower values for each in the V group. There were significant differences between the ages of both groups, while these did not have any influence on any of the parameters. We found a positive and significant correlation when comparing TF and ALB, TF and CO, TF and CS, CS and ALB, and lastly, CS and CO. There was no correlation between ALB and COO. From our data we concluded that serum cholinesterase is a useful parameter for evaluating the nutritional state of the hospitalized patients.

Adolescent↗