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Jolanta U Weaver

Publications and source records attributed to Jolanta U Weaver.

10 recordsLinked to original sources
PubMed2006

Association of glucocorticoid receptor polymorphism A3669G in exon 9beta with reduced central adiposity in women.

The glucocorticoid receptor (GR) may be a common link between human obesity/metabolic syndrome and Cushing's syndrome. The effects of glucocorticoids are mediated through the functional isoform, GRalpha. An alternative isoform, GRbeta, behaves as a dominant negative inhibitor of GRalpha and has been implicated as a contributing factor to glucocorticoid resistance. A naturally occurring ATTTA to GTTTA single nucleotide polymorphism (A3669G) located in the 3' end of exon 9beta results in increased stability of GRbeta mRNA and increased GRbeta protein expression. Enhanced GRbeta expression may result in greater inhibition of GRalpha transcriptional activity, resulting in glucocorticoid insensitivity. To test the hypothesis that the 3669G allele would result in a phenotype less likely to express features of glucocorticoid excess, we studied the prevalence of this polymorphism and its relationship with obesity and features of the metabolic syndrome in 322 Europid and 262 South-Asian subjects in northeast England. We report evidence that 3669G allele is associated with reduced central obesity in Europid women and a more favorable lipid profile in Europid men. These data suggest that the 3669G allele may attenuate the undesirable effects of glucocorticoids on fat distribution and lipid metabolism, although its penetrance may vary in different ethnic groups.

Adiposity↗
PubMed2005

Instruments used in measuring symptoms, health status and quality of life in hypothyroidism: a systematic qualitative review.

BACKGROUND: Symptoms of hypothyroidism are varied and nonspecific, thereby making clinical diagnosis impossible. Some patients report ongoing symptoms despite treatment. Measuring symptoms, health status and quality of life by using appropriate instruments, in addition to biochemical tests, is therefore vital to quantify disease severity and assess response to treatment. A number of instruments have been used in hypothyroidism, leading to lack of clarity about what exactly is being measured, and the rationale for the inclusion of particular measures is often uncertain. OBJECTIVES: To evaluate and compare instruments used in hypothyroidism in assessing patient-reported outcomes. DATA SOURCES AND STUDY SELECTION: All published literature on MEDLINE until March 2005 was searched using the keywords 'hypothyroidism', 'symptoms', 'quality of life' and 'health status'. Articles reporting controlled trials or instrument design and development were analysed to assess the instruments used and to ascertain whether they were measuring the stated outcome. DATA SYNTHESIS: Available tools to measure symptoms, health status and quality of life in diagnosis and management of hypothyroidism are discussed. We also describe how these tools have been described in published clinical trials along with the advantages and possible pitfalls of each of the commonly used tools. CONCLUSIONS: Some instruments reviewed have not been suited to the outcome being studied, thereby giving rise to questionable results. This review should be useful for clinicians, researchers and patient-support groups in understanding the principles behind these tools and the results obtained from their use in clinical practice, and in selecting measures for their own use.

Biomarkers↗
PubMed2005

Health status in patients with sub-clinical hypothyroidism.

OBJECTIVE: Sub-clinical hypothyroidism (SCH) is a common disorder. People with this condition may have symptoms which could affect their perception of health. Therefore, the perceived health status of people with SCH was assessed and compared with population-matched norms. DESIGN: A prospective cross-sectional survey. METHODS: Seventy-one adults with SCH, age range 18-64 years were studied. Perceived health status was measured by the Short Form-36 (SF-36) version 2 questionaire, which has been validated in a UK population setting. The SF-36 has eight scales measuring physical functioning, role physical, bodily pain, general health, vitality, social functioning, role emotional and mental health. Their SF-36 scores were compared with UK normative data after matching for age and sex and are reported as z-scores. RESULTS: Scores of all eight SF-36 scales were significantly lower in people with SCH compared with the normative population. A negative score (compared with zero of the normative population) indicates worse health status. The most significantly impaired aspects of health status were vitality and role limitations due to physical problems (role physical scale) with z-scores (95% confidence intervals) of -1.01 (-0.74 to -1.29) and -0.73 (-0.43 to -1.04) respectively. Thyroid autoimmunity did not influence the results. CONCLUSION: Perceived health status is significantly impaired in people with SCH when compared with UK normative population scores. This needs to be taken into consideration by clinicians when managing patients with this disease.

Adult↗
PubMed2004

Fasting homocysteine levels in adults with type 1 diabetes and retinopathy.

BACKGROUND AND METHODS: Whether hyperhomocysteinemia is associated with diabetic retinopathy is still being debated. We measured homocysteine and thrombomodulin, a marker of endothelial cell damage, in patients with type 1 diabetes mellitus and retinopathy (n=25) and in a well-matched group of diabetic patients without retinopathy (n=23). All patients had normal serum creatinine and no macroalbuminuria. RESULTS: Fasting homocysteine levels were higher in the group with retinopathy than in the group without retinopathy (8.75+/-1.9 vs. 7.69+/-1.6 micromol/l, P<0.05). Microalbuminuria was more prevalent in the group with diabetic retinopathy and it correlated with homocysteine levels in this group (p<0.05). Microalbuminuria was the most powerful independent determinant of homocysteine levels in multiple regression analysis in the group with retinopathy (p<0.01). Thrombomodulin levels were not different in the two groups (36.6+/-9.7 vs. 34.9+/-11.1, p>0.1) and there was no correlation between homocysteine and thrombomodulin levels in either group. CONCLUSIONS: The slight rise in homocysteine levels in patients with diabetic retinopathy was possibly caused by the early nephropathy as indicted by microalbuminuria. This small rise in homocysteine levels was not associated with endothelial dysfunction, as measured by serum thrombomodulin levels.

Aged↗
PubMed2004

Low prevalence of the N363S polymorphism of the glucocorticoid receptor in South Asians living in the United Kingdom.

Similarities between clinical states of glucocorticoid excess and obesity have raised suspicion of a link between the two conditions. An Asn363Ser (N363S) polymorphism in exon 2 of the glucocorticoid receptor has been associated with glucocorticoid sensitivity and excess adiposity in people of European origin. Compared with Europid populations, South Asians have a higher prevalence of cardiovascular risk factors, including type 2 diabetes and central obesity. The aim of this study was to determine the prevalence of the 363S allele in people of South Asian origin living in northeast England in relation to obesity and other cardiovascular risk factors. DNA from 142 males and 153 females was characterized for 363S allele status. Two N363S heterozygotes were identified; both subjects had raised body mass index and central obesity. Despite a higher prevalence of overweight (body mass index >/==" BORDER="0"> 25 kg/m(2)) people in the South Asian group compared with the Europid population in the same geographical area (66 vs. 56%, respectively), the 363S allele frequency was significantly lower in the South Asian group (0.3 vs. 3%, respectively). Therefore, the N363S polymorphism is unlikely to be an important factor in obesity and/or dysmetabolic traits in people of South Asian origin living in the United Kingdom.

Adult↗