[Digestive tract involvement in collagenoses].
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Biomedical subjects
Publications and source records attributed to M Grigorescu.
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In order to define the relationship between cholesterolosis (COL) and cholesterol gallstone disease (CGD), risk factors were comparatively investigated in a great number of patients. Sex, age and metabolic risk factors were the same for both diseases, but gallbladder anomalies and neuroendocrine disturbances were more often associated with COL. The lipid composition of the gallbladder bile was determined in patients with COL. The bile acid decrease and the increase of cholesterol molar concentration (moles %) were found, similar to those known in CGD. The similarity of risk factors and of bile lithogenicity, as well as the frequent association of COL and CGD suggest a pathogenic relationship of both diseases. Local morphological changes in conditions of high biliary cholesterol levels may be responsible for the intraparietal precipitation of cholesterol in COL. Thus, COL seem to be a peculiar variant of CGD and its classification into the heterogeneous group of cholecystoses is at present questionable.
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Fasting and postprandial total bile acid measurements were performed by an enzymatic method in the serum of 12 patients with chronic persistent hepatitis, 8 with chronic active hepatitis, 14 with cirrhosis and 10 with cholestatic chronic hepatitis, as well as in that of 22 normal controls. The results indicated a rise of serum bile acid concentration concomitant with the degree of morphologic liver injury. A significant rise of the fasting concentration of bile acids as compared to the control started with chronic active hepatitis. As postprandial bile acid level was significantly higher in all types of chronic hepatitis and cirrhosis and correlated significantly with most of the usual biochemical liver tests, it could be considered as a test of major diagnostic significance for chronic liver diseases.
Glucose tolerance (75 g OGTT, according WHO) during the third trimester of pregnancy, in 302 women, has formerly been evaluated. Of these, 37 women were reinvestigated, with the same methodology, in absence of pregnancy and lactation, 2 years postpartum. According to oral glucose tolerance three groups were differentiated: group A (n = 14) with normal glucose tolerance (NGT) both in pregnancy and postpartum. Group B1 (n = 12) with impaired glucose tolerance (IGT) in pregnancy but NGT postpartum. Group B2 (n = 11) with IGT both in pregnancy and postpartum. B2 group had increased values (mean + SD) for age (37.0 +/- 6.6 years) versus B1 (30.2 +/- 5.5; p < 0.02) and A (29.5 +/- 5.9); p < 0.02) groups and BMI (32.5 +/- 4.2) versus 26.4 +/- 5.2; p < 0.01 and 23.3 +/- 4.4; p < 0.001 respectively). The ratio between basal insulinogenic indexes (microU IRI/mg BG) during pregnancy and 2 years postpartum has been significantly reduced in B1 (1.4 +/- 0.8) and B2 (1.5 +/- 0.6) as compared to A (2.5 +/- 1.1; p < 0.01) group suggesting, by comparison, the persistence of an increased level of insulin resistance postpartum in B1 and B2 groups. Insulinogenic index, after oral glucose was lower in B2 (34.4 +/- +/- 7.8) versus B1 (53.5 +/- 20.9; p < 0.01) group. These results suggest that, on an increased insulin resistance background, the decrease in glucose induced insulin response and increase in age and BMI are associated to deterioration of glucose tolerance early in the natural history of NIDDM.