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Biomedical subjects

S M Joubert

Publications and source records attributed to S M Joubert.

At least 73 records · Page 4Linked to original sources
PubMed1985

The prevalence of diabetes mellitus in a large group of South African Indians.

The prevalences of diabetes mellitus and impaired glucose tolerance (IGT) among 866 Indians living in the Chatsworth area of Durban were determined. The study group was selected by cluster sampling and the participants underwent a modified glucose tolerance test (GTT) (determination of fasting and 2-hour plasma glucose levels after a 75 g glucose load). On the basis of the revised World Health Organization criteria the overall prevalence of diabetes mellitus was 11% and of IGT 5,8%. Of the 368 men, 7,6% were found to have diabetes mellitus and 7,1% IGT; the prevalence of diabetes mellitus was much greater among women (13,5%), while there was less IGT (4,8%). Subjects with diabetes mellitus were significantly older (mean 50,7 years) than those with a normal GTT (mean 30,9 years), but of similar age distribution compared with the IGT group (mean 46 years). Subjects with a normal GTT had a significantly lower mean body mass index (22,1 +/- 2,8) compared with diabetic subjects (26,1 +/- 5,2) or the IGT group (25,8 +/- 6,6). Obesity was commonly associated with both diabetes mellitus and IGT, particularly among women.

Adolescent↗
PubMed1985

A plausible explanation for the aketonuria of young Indian non-insulin-dependent diabetics.

In an attempt to explain the rarity of ketonuria in Indian diabetics, plasma glucose, insulin and free fatty acid (FFA) levels were measured in 35 non-obese patients with non-insulin-dependent diabetes in the young and 35 matched controls during a 100 g oral glucose tolerance test. Compared with the controls, the patients had a severe degree of hyperglycaemia, fasting hyperinsulinism, and an attenuated and delayed insulinaemic response. However, in addition to the fasting plasma FFA levels being similar in the two groups, the decrement in the FFA responses was equivalent. Thus, the hormone-sensitive lipase of the adipose tissue appeared to be sensitive to inhibition by insulin. Also, the fasting insulin:glucagon molar ratios were computed and found to be no different in the two groups. The normal fasting FFA levels, relative sensitivity to insulin of lipolysis in the adipocyte and normal insulin: glucagon molar ratios may help to explain in part the general rarity of ketosis-prone diabetes in the South African Indian population.

Adult↗
PubMed1985

Insulin secretion in healthy Indian volunteers.

The insulin response to a 100 g oral glucose load was studied in 20 non-obese, healthy Indian females and 20 matched Indian males. There were no differences between the mean glucose responses of the two groups. However, early-phase (0-60 minutes) insulin release was significantly greater in the females. While there were no significant differences between the two groups when the total areas under the insulin and glucose curves were computed, the female volunteers had a significantly higher mean insulinogenic index. It therefore appears that healthy Indian females have significantly greater early-phase insulin release than their matched male counterparts.

Adult↗
PubMed1985

Male transmission of the gene for isolated gonadotropin-releasing hormone deficiency.

Three black women, daughters of the same father but three unrelated mothers, presented with isolated gonadotropin deficiency (IGD). Clinically, the patients had no midline defects and intact smell and taste senses. Biochemically, the essential feature was very low unstimulated and stimulated follicle-stimulating hormone and luteinizing hormone levels, even after priming with gonadotropin-releasing hormone over a 5-day period. Growth hormone response to insulin-induced hypoglycemia was somewhat blunted, but prolactin, cortisol, and thyroid-stimulating hormone responses were quite normal. All three patients had the 46,XX karyotype; clinical or biochemical aberrations could not be demonstrated in any of the remaining family members. The disorder was, apparently, transmitted by the deceased father, who manifestly did not have an IGD deficiency nor any of the midline stigmata associated with IGD. The mode of inheritance seems most likely to be autosomal dominant with variable penetrance.

Adolescent↗
PubMed1985

Immunoreactive oestrogens and progesterone in amniotic fluid in twin pregnancies.

Amniotic fluid concentrations of immunoreactive oestrogens and progesterone were measured at the time of caesarean section in 32 twin pregnancies; 25 women had an elective section and seven were in labour at the time of operation. No significant differences between concentrations in the amniotic fluid of the first and second twin were found in respect of conjugated and unconjugated oestrone, oestradiol, oestriol, oestetrol and unconjugated progesterone either before or during labour. It is unlikely that changes in oestrogens or progesterone in the amniotic fluid are responsible for the selective changes seen in prostaglandins and fetal adrenal steroid during labour in the first twin.

Amniotic Fluid↗
PubMed1985

Isolated adrenocorticotrophic hormone (ACTH) deficiency associated with acute adrenal crisis.

A 37 year old black female presented with congestive cardiac failure, 2 months postpartum. She developed spontaneous hypoglycaemia and symptoms of acute adrenal crisis (hypotension, nausea, abdominal pain and tachycardia with small thready pulse), which responded to i.v. dextrose, sodium chloride and hydrocortisone. Biochemical investigations revealed low serum cortisol and plasma adrenocorticotrophic hormone (ACTH) levels. The patient initially showed an impaired cortisol response to intramuscular aqueous tetracosactrin, but an exuberant response after priming with intramuscular tetracosactrin depot. These findings, together with the normal remaining pituitary function, led us to conclude that this patient had isolated ACTH deficiency associated with congestive cardiac failure and acute adrenal crisis.

Acute Disease↗
PubMed1985

The biochemical profile in Indian patients with non-insulin-dependent diabetes in the young with retinopathy.

A comparative study of the biochemical profile in 15 Indian patients with non-insulin-dependent diabetes in the young with retinopathy, and 15 matched patients without vascular disease, was undertaken. There were no significant differences between the lipid, lipoprotein and apoprotein levels between the 2 groups. While the fasting plasma glucose and glycosylated haemoglobin levels were significantly higher in the patients with retinopathy, there were no differences between the groups with regard to their insulin areas, glucose areas and insulinogenic indices. The retinopaths also had significantly lower serum magnesium levels than the patients without detectable retinal vascular disease.

Adult↗
PubMed1984

Adrenal sensitivity to adrenocorticotrophin in twin neonates--effect of birth order and growth retardation.

The sensitivity of the neonatal adrenal gland to injected synthetic adrenocorticotrophin (ACTH) (Synacthen; Ciba-Geigy) 500 micrograms/m2 was assessed in 19 twin pairs by measurement of cortisol and dehydro-epiandrosterone sulphate (DHEAS) before and after injection. Ten of the neonates were growth-retarded with respect to their siblings and 11 pairs were delivered before the onset of labour. The cortisol response to ACTH was not significantly different between labour groups, between the first and second twins or between growth-retarded and non-growth-retarded twins. However, the rise in DHEAS was significantly less in the neonates delivered vaginally after labour. These results suggest that there may be a change in adrenal gland secretion in neonates born after labour compared with those born before the onset of contractions.

Adrenal Glands↗
PubMed1984

The growth hormone responses to L-dopa and TRH in acromegaly.

The GH responses to TRH and L-dopa were investigated in 14 Indian and African patients with untreated acromegaly. A positive response to L-dopa (greater than 50% change from basal) was obtained in 6 of the 14 patients tested while a positive response to TRH (greater than 100% change from basal) was found in 5 of 12 patients tested. While 9 patients responded to at least one agent, only 2 had a positive response to both agents. Positive responders appeared to be hyper-prolactinemic and have evidence of abnormal glucose tolerance as compared to nonresponders.

Acromegaly↗
PubMed1984

Umbilical artery concentrations of androstenedione increased in early labour in the leading twin fetus.

Umbilical artery concentrations of androstenedione, progesterone, pregnenolone, pregnenolone sulphate and dehydroepiandrosterone sulphate were measured at birth in twin pairs, born by caesarean section. In the group born before the onset of labour, there were no significant differences in concentration of any of the steroids between the leading twin (twin I) and the second twin (twin II). In the group born during the latent phase of labour, levels of umbilical artery progesterone were significantly less in twin I (mean 501, SE 112 nmol/l) than in twin II (mean 887, SE 131) (P less than 0.05), while concentrations of androstenedione were increased in twin I [9.9 (SE 1.7) vs 4.7 (SE 0.7) nmol/l, P less than 0.01]. In patients delivered during active labour, androstenedione levels were consistently increased in twin I compared with twin II [11.7 (SE3.4) vs 4.3 (SE 0.7) nmol/l, P less than 0.01]. It is suggested that the rise in umbilical artery levels of androstenedione is derived from the fetal adrenal gland and may have an important role in the onset of labour.

Androstenedione↗
PubMed1984

Abnormal concentrations of prostaglandins in amniotic fluid during delayed labour in multigravid patients.

Concentrations of prostaglandins E (PGE), F2 alpha (PGF), 13,14-dihydro-15-keto prostaglandin F2 alpha (PGFM), 6-keto F1 alpha and thromboxane B2 were measured by specific radioimmunoassay in samples of amniotic fluid from 22 multigravid patients during labour. Normal labour in 10 patients was associated with a significant increase of PGE, PGF and PGFM with close correlation to cervical dilatation (P less than 0.05). In the 12 patients with clinically delayed labour, in the absence of cephalopelvic disproportion, there were significantly lower PGF (P less than 0.002) and PGFM (P less than 0.05) concentrations obtained while no differences were observed in the other prostanoids measured. Administration of oxytocin to the latter group to enhance labour did not have any effect on the concentrations of prostaglandins obtained in spite of an improvement in intrauterine pressures and accelerated progress of labour.

6-Ketoprostaglandin F1 alpha↗
PubMed1984

Pituitary function in Sheehan's syndrome.

The responses of plasma prolactin, follicle-stimulating hormone (FSH), luteinizing hormone (LH), and thyroid-stimulating hormone were measured in ten women with Sheehan's syndrome after intravenous administration of the appropriate releasing hormones. Growth hormone and cortisol responses to insulin-induced hypoglycemia were also measured. It was found that two patients were biochemically borderline euthyroid and eight were probably hypothyroid in the face of thyroid-stimulating hormone values in the reference range; in two patients thyroid-stimulating hormone response to thyrotropin-releasing hormone was appropriate. In no patient were the minimum prolactin levels achieved, in response to thyroid-releasing hormone as established in reference subjects. Growth hormone response to hypoglycemia was inadequate in all patients and only one patient achieved reference range values of cortisol during hypoglycemia. In six patients fasting LH and FSH were in the reference range and the response to gonadotropin-releasing hormone was adequate and appropriate in eight patients. In light of these findings it is suggested that prolactin response to thyrotropin-releasing hormone administration would be a reliable and simple screening procedure for suspected Sheehan's syndrome.

Adult↗
PubMed1983

Beta-2-microglobulin in trophoblastic disease.

Beta-2-microglobulin (BMG) is physically linked to the allo-antigenic HLA chain on the cell surface and is accordingly a marker for the HLA antigens. BMG concentrations were measured in serum and cerebrospinal fluid (CSF) samples from 22 patients with choriocarcinoma, 5 with hydatidiform mole and 17 reference subjects in the first trimester of pregnancy. Serum BMG levels were elevated in the patients with choriocarcinoma, particularly when human chorionic gonadotrophin levels were higher than 50 000 U/l (less than 50 000 U/l--1,6 +/- 0,3 mg/l; greater than 50 000 U/l--2,75 +/- 0,72 mg/l; molar pregnancy--1,42 +/- 0,44 mg/l; reference subjects--1,47 +/- 0,15 mg/l) (mean +/- 1 SD). BMG levels in the serum and CSF were not increased when metastases were present in the cranium. None of the patients had evidence of abnormal renal function as determined by serum urea, electrolyte and creatinine levels and the creatinine clearance rate. These results suggest that BMG and HLA antigens are expressed on the trophoblastic cells in choriocarcinoma, or alternatively that the maternal immunocytes produce increased quantities of BMG.

Beta-Globulins↗
PubMed1983

The sex hormone profile of male patients with breast cancer.

The mean total serum oestradiol level was found to be significantly increased in 8 patients with carcinoma of the breast when compared with 8 healthy reference subjects matched for race, sex and age. The calculated mean free oestradiol index was also higher in these patients. There were no significant differences, however, between the levels of LH, FSH, prolactin. DHEA-S, testosterone and SHGB in the 2 groups. The patients showed a significantly increased LH response to GnRH while there was no difference in the FSH response. Only 1/7 patients had a tumour devoid of steroid hormone receptors. It may be that an increased level of circulating oestradiol-17 beta is an important factor in the aetiology of hormone-dependent male breast cancer.

Adult↗
PubMed1983

Twin pregnancy as a model for studies in fetal cortisol concentrations in labour: relation to prostaglandins, prolactin and ACTH.

Cortisol and prostaglandins were measured in umbilical cord blood obtained from 50 twin pregnancies at caesarean section performed either before or during labour. Umbilical artery cortisol concentrations did not differ between twin I and II before labour or in the latent stage. During active labour cortisol levels were significantly higher in twin I than in twin II. Maternal cortisol levels did not correlate with cord blood cortisol levels in either twin before active labour, nor did the rise in maternal cortisol correlate with the cortisol level in twin I; maternal cortisol levels did, however, correlate with cortisol levels in twin II during active labour. Prostaglandins E(PGE), F 2 alpha (PGF 2 alpha), 13,14-dihydro-15-keto F 2 alpha (PGFM) and ACTH were measured in cord vein blood. PGE values did not differ between twin I and II before active labour. During active labour PGE levels were significantly greater in twin I and correlated with raised cortisol levels. No differences were seen at any stage in PGE and PGFM levels between twins I and II although PGFM levels increased in both twins during active labour. ACTH and prolactin levels did not increase during labour and were similar in twins I and II. The rise in fetal cortisol during active labour is primarily of fetal origin and PGE may be involved in stimulating cortisol production in the fetus.

Adrenocorticotropic Hormone↗
PubMed1983

Amniotic fluid phospholipids and glucocorticoids in multiple pregnancy.

The phospholipid composition of amniotic fluid has been examined in 30 twin pregnancies with a mean gestation of 37.7 weeks. Before the onset of labour there was no difference in ratios of lecithin (L), phosphatidylinositol (PI), phosphatidylethanolamine (PE) and phosphatidylglycerol (PG) to sphingomyelin (S) between the first and second twin. With the start of contractions (6 patients) there was a significant increase in the L/S and PE/S ratios in the first twin (L/S ratio twin I 10.8 +/- 5.2, twin II 7.0 +/- 3.8; PE/S ratio twin I 0.7 +/- 0.2, twin II 0.4 +/- 0.1). Growth retardation of one fetus did not alter the phospholipid profile in the amniotic fluid. Amniotic fluid concentrations of glucocorticoids, measured before and during labour in both twins by specific immunoassay, were the same in both sacs before labour. During labour concentrations of unconjugated and conjugated glucocorticoids were significantly increased in the first sac (twin I unconjugated 113.2 +/- 16.6, conjugated 505.1 +/- 115.9; twin II unconjugated 69.5 +/- 41.4, conjugated 284.3 +/- 124 nmol/l). Amniotic fluid from growth retarded fetuses did not show higher glucocorticoid levels. In subsequent studies the glucocorticoids were separated by chromatography and only cortisol reacted significantly with the antibody used under the conditions of the assay.

Adult↗