Endocrinology and Metabolism

Volume 14(1); March 1999

Review Articles

Insulin Resistance Syndrome in Koreans.: Hyun Chul Lee, Kap Bum Huh, Seok Won Park, Jong Ho Lee; J Korean Endocr Soc. 1999;14(1):1-13. Published online January 1, 2001

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Abstract PDF: No abstract available.

Leptin and Diabetes Mellitus.: Yong Sung Kim; J Korean Endocr Soc. 1999;14(1):14-17. Published online January 1, 2001

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Abstract PDF: BACKGROUND
Leptin secreted from adipose tissue activates not only its receptors expressed abundantly in the brain, including arcuate nucleus but the POMC neurons resulting in secretion of a-MSH. Activation of MC4R by a-MSH increases the energy expenditure and decreases the food intake, and promotes the sympathetic activity. METHODS: To analyze the biologic activity of a-MSH analogues, the rat MC3R DNA and human MC4R DNA were stably and independently expressed in CHO cell lines, and we performed the competitive receptor binding assay with [125I]NDP-MSH as a radioligand and cyclic AMP accumulation assay following treatment with different ligands. a-MSH (Ac-Ser-Tyr-Ser- Met-Glue-His-Phe-Arg-Trp-Gly-Lys-Val-NH2) and its analogue a-MSH-ND (Ac-Nle-Asp-His-Dphe- Arg-Trp-Lys-NH2) were synthesized by Genosys Biotechnologies, Inc. The HPLC purified samples for NMR experiments were dissolved in 90% HO/10% DO or 99.9% DO solutions at pH 7.0 with concentrations of 2 mM in 50 mM sodium phosphate buffer. The NMR spectra were acquired on a Bruker AMX-500 or DMX-600 spectrometer in quadrature detection mode equipped with a triple-resonance probe with an actively shielded pulsed field gradient coil. RESULTS: The preferential order of binding activity for MC3R was NDP-MSH > a-MSH-ND > [Nle4]-MSH with IC50 values (nM) being 0.367 +/- 0.074, 47.20 +/- 9.08 and 106.70 +/- 32.25, respectively. For MC4R, the same preferential order, NDP-MSH (0.566 +/- 0.194) > a-MSH-ND (6.70 +/- 1.07) > [Nle4]a-MSH (238.30 +/- 30.47), were obtained. In c-AMP generation assay, the potency order of peptides was NDP-MSH > a-MSH-ND > a-MSH at both MC3R and MCAR. Accumulated food intake of Sprague Dawley rats was low significantly for six hours after injection of a-MSH-ND into peritoneum. a-MSH forms a hair pin loop conformation, whereas a-MSH-ND, a linear form of MTII, prefers a type I B-turn comprising residues Asp5-His6-DPhe7-Arg8 in NMR study. CONCLUSION: we developed in vitro and in vivo bioassay system to evaluate the biologic activity of a-MSH analogues and we also showed that the type I B-turn structure of a-MSH-ND might enhance the binding activity to MC4R.

Original Articles

Structure and Function Analysis of alpha-MSH Analogues.: Sung Kil Lim, Song Chul Lee, Won Tae Lee, Jung Hoon Lee, Soo Yeon Nam, Kyung Rae Kim, Hyun Chul Lee, Kap Bum Huh; J Korean Endocr Soc. 1999;14(1):18-26. Published online January 1, 2001

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Abstract PDF: No abstract available.

Growth Hormone Therapy with Diet Restriction in Obese Patients with Type 2 Diabetes Mellitus.: Su Youn Nam, Kyung Rae Kim, Young Duk Song, Sung Kil Lim, Hyun Chul Lee, Kap Bum Huh; J Korean Endocr Soc. 1999;14(1):27-39. Published online January 1, 2001

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Abstract PDF: BACKGROUND
Insulin resistance in obesity constitutes an independent risk factor for the development of type 2 diabetes mellitus (DM). Insulin resistance in obese DM can be improved by a decrease in visceral fat and an increase in skeletal muscle which may influence insulin sensitivity via its capacity to uptake glucose load. Diet restriction as a treatment for obesity causes protein catabolism which results in a decrease in muscle mass. Growth hormone (GH) therapy accelerates a lipolysis and promotes protein conservation. We evaluated the effects of GH therapy with diet restriction on lipolysis and anabolism, which can change body composition, insulin resistance and lipid metabolism in obese DM. METHODS: Eighteen newly-diagnosed obese type 2 DM patients (42-56 yrs) were treated with recombinant human GH (GH; 0.06 unit/kg ideal body weight#/day, 3 times/wk) and with diet restriction (25 kcal/kg ideal body weight/day) for 12 weeks. They underwent anthropometric measurement, bioelectrical impedence for total body fat and lean body mass, as well as computed tomography for visceral and subcutaneous fat at the umbilicus level and the muscle area at the mid-thigh level. All subjects underwent a standard oral glucose tolerance test (OGTT) and GH response to L-dopa stimulation. The glucose disposal rate was measured during an euglycemic hyperinsulinemic clamp study. RESULTS: 1. The fraction of body weight lost as fat was significantly greater and the visceral fat area was decreased more in the GH-treated group than in the control group. There was a significant loss of lean body mass and muscle area in the control group, whereas there was an increase in lean body mass and muscle area in GH-treated group. 2. The glucose disposal rate was significantly increased only in the GH-treated group and it was negatively correlated with the ratio of the visceral fat area/muscle area. The serum glucose levels, insulin-area under the curve (AUC) and free fatty acid (FFA)-AUC during OGTT and HbAlc were significantly decreased after GH treatment. The decrease in FFA-AUC was positively correlated with the decrease in the visceral fat area. 3. Total cholesterol and triglyceride were decreased in both groups. LDL-cholesterol was decreased in only the GH-treated group. 4. The GH response to L-dopa stimulatian was blunted in aU subjects and after treatment, the GH response was increased. The insulin-like growth factor-I level was inereased 1.6-fold after the GH treatment. CONCLUSION: This study suggested that in obese DM fed a hypocaloric diet, GH treatment exerted a decrease in visceral fat and an increase in muscle mass via accelerated lipolytic and anabolic effects which could result in the improvement of insulin resistance, glucose metabolism and dyslipidemia.

Cytotoxic T Lymphocyte Antigen-4 (CTla-4) Polymorphism in Korean Autoimmune Thyroid Disease.: Dong Kuen Lee, Young Seol Kim, Jeong Taek Woo, Sung Woon Kim, In Myung Yang, Jin Woo Kim, Young Kil Choi, Jeong Ryung Paeng; J Korean Endocr Soc. 1999;14(1):40-52. Published online January 1, 2001

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Abstract PDF: BACKGROUND
The cause of autoimmune thyroid diseases (AITD), including Graves disease and Hashimotos thyroiditis, is largely unknown. To identify the genes responsible, most attention has been focussed on the HLA regions in the early studies. However, these studies have repeatedly shown a weak association between AITD and the HLA-DR3 in Caucasians. To understand and find out the mechanisms underlying the development of AITD, a search for non-HLA linked susceptibility genes is important. A recent study from American population have indicated an association between a polymorphism of CILA-4 gene and Graves disease. To clarify the relationship of the CTLA-4 polymorphism and AITD, the allele frequency of CTLA-4 gene from the patients with Graves disease and with Hashimotos thyroiditis in Korean papulation were analysed. METHODS: The CTLA-4 exon 1 polymorphism (49, A/G) was analysed by PCR-based, RFLP (Restriction Fragment Length Polymorphism) from 92 women and 37 men with Graves disease and 50 women and 9 men with Hashimotos thyroiditis diagnosed. Also, 287 healthy controls including 155 women and 132 men with no clinical evidence or family history of thyroid disease were enrolled. RESULTS: 1) In the group of Graves disease, there was significantly more patients with alanine homozygote (GG) than in control group (P<0.0005, RR=1.40). However, there was not significant with threonine homozygote (AA) between two groups (P=0.052). In the group of Hashimotos thyroiditis, no significant differences were found between all homozygotes and heterozygote. 2) In the group of Graves disease, there were significantly more patients with alanine homozygote (GG) (P<0.0001, RR=1.85) and significantly fewer patients with threonine homozygote (AA) than in the group of Hashimoto's thyroiditis (P<0.005, RR 0.25). CONCLUSION: Regardless of sex difference, alanine homozygote (GG) at exon 1 (codon 17) of CTLA-4 is associated with Graves disease in Korean population, which suggests genetic susceptibility is some role in the pathogenesis of Graves disease.

ret/PTC-1, -2, and -3 Incogene Rearrangements of Papillary Thyroid Carcinomas in Korea and Its Relevance to Clinical Aggressiveness.: Jong Ryeal Hanhm, Jae Hoon Chung, Byung Joon Kim, Kyoung Ah Kim, Sung Hoon Kim, Dong Jun Kim, Yong Ki Min, Myung Shik Lee, Moon Kyu Lee, Kwang Won Kim, Seok Jin Nam, Jung Hyun Yang, Howe Jung Ree; J Korean Endocr Soc. 1999;14(1):53-62. Published online January 1, 2001

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Abstract PDF: BACKGROUND
The prevalence of ret/PTC rearrangement in papillary thyroid carcinomas has been found to have wide variance in different populations. Recent studies, however, have been reporting no significant geographical difference between Asian and Western countries. In addition, there are some arguments about the correlation of ret/PTC expression with clinical aggressiveness. We have performed this study in order to examine the prevalence of ret/PTC-1, -2 and -3 rearrangements in korean papillary throid carcinomas and to ascertain its clinical relevance. METHODS: Fourteen thyroid tumors histologically confirmed to be papillary carcinomas were included in this study. To find rearrangements, we adopted RT-PCR and automated direct sequencing. Initial and follow-up clinical data were obtained form the patients medical records. The plasmid containing ret/PTC-2, and 3 was kindly provided by Dr. Ahn (Ulsan University, Seoul Choonang Hospital). RESULTS: We identified one tumors containing ret/PTC-1(1/14, 7.1%), and two containing ret/PTC-2 (2/14, 14.2%), and could not find ret/PTC-3 rearrangement in other patients (0/11). There was no significant correlation of ret/PTC with clinical aggressiveness. CONCLUSION: We found that the prevalence of ret/PTC rearrangement (3/14, 21.4%) in papillary thyroid carcinomas from Korea was similar to those recently reported in other nations. ret/PTC rearrangement may not affect biological behaviors of papillary thyroid carcinomas.

Thallium-291 Whole Body Scintigraphy in Postoperative Follow-up of Differentiated Thyroid Carcinoma.: Eun Sook Kim, Hong Kyu Kim, Sung Jin Lee, Jin Sook Ryu, Dae Hyuk Moon, Young Kee Shong; J Korean Endocr Soc. 1999;14(1):63-70. Published online January 1, 2001

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Abstract PDF: BACKGROUND
The advantages of thallium (Tl)-201 whole body scan in follow-up of patients with thyroid carcinoma include no need to discontinue thyroid hormone replacement, a shorter period of time between injection and imaging, a lower radiation dose, and preservation of affinity for subsequent therapeutic dose of 131I. To evaluate the reliability of whole body scintigraphy using Tl-201 in postoperative follow-up of thyroid carcinoma, this procedure was performed in patients after total thyroidectomy for thyroid carcinoma. The results were compared with those of 131I scintigraphy. METHODS: One hundred nineteen cases (119 patients) with a median age of 43 years (range, 20 85 years) were included in the study. After optimal endogenous thyroid-stimulating hormone stimulation (>50 mIU/mL), 131I (4 mCi) scan and Tl 201 (3 mCi) scan were simultaneously performed. Concomitantly serum thyroglobulin and anti-thyroglobulin antibody levels were checked. If abnormal findings on any of the scintigraphic methods or high levels of thyroglobulin (> 10 ng/mL) were detected, high dose (150~200mCi) 131I was administered as therapy and then whole body scans were performed repeatedly after the therapy. The presence or absence of thyroid cancer was established by pathologic, radiologic, and/or high dose 131I scan findings. RESULTS: In 12 patients, ll-201 scan revealed positive accumulations which were not found on 131I scan, of whom 9 had elevated thyroglobulin levels. In these cases, 5 cases were interpreted to have normal thyroid remnant and 7 cases showed pathologic findings (1 lung, 2 lymph node, 1 bone, and 2 lung and lymph node metastasis, and 1 false positive accumulation of thallium). Metastasis were confirmed histologically in 2 and radiologically in 5 cases. Negative Tl-201 scans, despite of positive 131I scans, occurred in 20 patients, of whom 6 had abnormal thyroglobulin levels. Seventeen cases were interpreted to have thyroid remnant, 2 cases were diagnosed to have thyroid carcinoma metastasis (1 lung, 1 lung and lymph node), and 1 case was not confumed. CONCLUSION: These results suggest that 131I scan is superior to 11-201 scan for detection of residual or metastatic differentiated thyroid carcinoma. However, the use of combined modalities may provide a higher diagnostic yield. TI-201 scan can be useful especially in cases in which 'I scan is negative despite of abnormal thyroglobulin levels.

The Diahnostic Value of Ultrasound-Guided Fine Needle Aspiration Cytology in the Thyroid Indedentaloma.: Young Sik Choi, Kibum Kwon, Seong Man Kim, Yo Han Park, Kyung Seung Oh, Ji young Seo, Bong Kwon Chun, Hee Kyung Chang; J Korean Endocr Soc. 1999;14(1):71-80. Published online January 1, 2001

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Abstract PDF: BACKGROUND
The introductian of highly sensitive imaging techniques has made it possible to detect many nonpalpable nodules, or incidentaloma. Because these nodules are small sized or deep seated, the diagnostic approach is difficult with conventional methods but it is easy with ultrasound-guided fine needle aspiration (FNA). However, the role of ultrasound-guided FNA on the incidentalomas has been poorly evaluated, so we tried to assess the diagnostic value of high resolution ultrasound-guided FNA in the incidentalomas. METHODS: One hundred forty-nine patients who underwent high resolution ultrasound-guide FNA for nonpalpable nodules that was smaller than 1.5 cm in diameter at Kosin Medical Center from June, 1996 to April, 1998 were included in the study. Ultrasound-guided FNA was performed with a 22-guage needle attached to 10 mL syringe with 10 MHz linear transducer in a free hand fashion. The aspirated materials were smeared and stained with Papanicolaou stain. For those who underwent surgery histopathologic diagnoses were compared to cytological diagnoses. RESULTS: The mean age of the patients was 45 and most of them were middle aged. Male to female ratio was 1:11.4. Of 149 patients 16 were involutional change, 55 hyperplasia, 42 Hashimotos thyroiditis, 8 follicular neoplasm, 19 papillary carcinoma, 1 subacute thyroiditis, and 6 inadequate specimen. Of the 149 nodules, 123 cases were solid, 11 cystic, and 15 mixed. Malignant nodules were more frequent in the solid nodule, but there was no significant difference between each group. Ten of 93 cases (10.7%) measured less than 1 cm and nine of 56 cases (16.1%) between 1.0 cm to 1,5 cm were malignant nodules. The difference of incidence rate of malignant nodules between each group was not significant. The incidence of malignancy was 13.6% (12/88) in solitary nodule and 11.5% (7/61) in multiple nodules. The difference of incidence rate of malignant nodules between each group was not significant. Eighteen cases including 14 malignancies diagnosed by FNA underwent operation. Of those 13 were papillary carcinoma and 5 adenomatous goiter. Upon the correlation of ultrasound-guided FNA cytology with pathologic diagnosis, the sensitivity of ultrasound-guided FNA cytology in differentiating benign and malignant nodule was 92.3% and overall diagnostic accuracy was 80.0%. The obtainability of adequate cytologic specimen by ultrasound-guided FNA was 95.9%. No complication except pain was noted during this study. CONCLUSION: High resolution ultrasound-guided FNA cytology may be useful for the diagnosis of thyroid cancer in the thyroid incidentalomas and also useful for early detection of recurrence of thyroid cancer .

Anabolic Effects of Recombinant Human Parathyroid Hormone (1-84) on Bone Histomorphometry in Overiectomized Rats.: Young Jun Won, Du Hong Park, Jae Hyun Nam, Jong In Yook, Jin Kim, Kyung Rae Kim, Hyun Chul Lee, Kap Bum Huh, Sung Kil Lim; J Korean Endocr Soc. 1999;14(1):81-90. Published online January 1, 2001

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Abstract PDF: To evaluate the anabolic effects of human recombinant parathyroid hormone [hrPTH(1-84)], we examined effect of low-dose and high-dose of [hrPTH(1-84)] and estradiol on bone histomorphometry in ovariectomized rats. Sixty Sprague-Dawley female rats aged 8~10 weeks were used. Eight weeks after ovariectomy, or sham operation, rats were given daily sc injection of hrPTH (1-84), 30 pg/kg (OVX+L group), 150 pg/kg (OVX+H group), 17-estradiol (30 pg/kg, OVX+E group) or vehicle (OVX+V group) for 4 weeks. After double tetracycline labeling, all rats were killed at day 84. We completed the histomorphometric analysis of distal femoral metaphyseal cancellous bone for trabecular bone volume (TBV), mean trabecular plate thickness (MTPT), mean trabecular plate density (MTPD), mean trabecular plate separation (MTPS), mean osteoid seam width (OSW) and appositional rate (AR). The histomorphometric parameters (TBV, MTPT, OSW and AR) of trabecular bone mass in (OVX+E) group were higher than those in (OVX+V) group. The TBV of trabecular bone in PTH treated groups were higher than that in sham operated, (OVX+V) and (OVX+E) group. The histomorphometric parameters (TBV, MTPD, OSW and AR) of trabecular bone mass in (OVX+H) group showed a tendency to be higher than those in (OVX+L) group, but statistically not significant. In conclusion, Low dose (30 mg/kg) hrPTH (1-84) also shows a sufficient anabolic effect on trabecular bone.

The Repreducitve History and Other Potential Risk Factors as The Determinants of Bone Mineral Density at Postmenopause.: Min Kyung Song, Young Jun Won, Suk Won Park, Young Duk Song, Sung Kil Lim, Jae Jun Oh, Hyun Chul Lee, Kap Bum Huh; J Korean Endocr Soc. 1999;14(1):91-101. Published online January 1, 2001

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Abstract PDF: BACKGROUND
The purpose of this study was to determine the associations of the potential risk factors including reproductive history and lifestyle factors with bone mineral density at postmenopause. METHODS: The bone mineral density of the lumbar spine and proximal femur were measured by dual energy X-ray absorptiometry (DEXA), and physical and anthropometric data were obtained in 187 healthy postmenopausal women aged 45 to 73. Informations about risk factors were assessed by questionairres including medicosurgical and family history, reproductive history and lifestyle factors (dietary calcium intake, past use of oral contraceptives, consumption of alcohol and caffeine, smoking habits and exercise pattern). RESULTS: 1) Each prevalence of osteopenia and osteoporosis was 43.9% and 16.6% in postmenopausal women. 2) In simple correlation analysis between each risk factor and bone mineral density, factors associated with higher level in body mineral density (BMD) were body mass index (BMI)(p<0.01) and reproductive periods (p<0.05) in lumar spine and femur neck, and exerecise strength in femur neck (p<0.05). On the other hand, more aging and longer postmnopausal periods, lower BMD in lumbar spine and femur (p<0.01) and later menarche, lower BMD in lumbar spine (p<0.01) and femur neck (p<0.05) and higher frequencies of parity were influenced on lower BMD in lumbar spine and femur wards (p<0.01) and femur neck (p<0.05). But the other factors had no relation to BMD. 3) There was no significant difference in BMD according to the amount of diet calcium intake, gravity, lactation, the past use of oral contraceptives, the family history of osteoporosis, smoking habits and intake of caffeine and alcohol. 4) No reproductive history and other risk factors were significantly associated with BMD after the influences of age, postmenopausal periods and BMI were adjusted in multiple regression analysis. CONCLUSION: These results show there are no consistent effects on bone mineral density, after adjusting for age and BMI, of reproductive history and any other risk factors in postmenopausal women.

Clonical Experience on Non-Scrotal Testosterone Transdermal Patch in the Middle Aged Male.: Young Chan Kim, Jong Ho Park, Suk Ki Lee, Young Jin Lee, Chul Young Bae, Yong Wook Cho, Myung Seo Kang, Jung Hoon Kim; J Korean Endocr Soc. 1999;14(1):102-121. Published online January 1, 2001

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Abstract PDF: BACKGROUND
To evaluate metabolic effects of testosterone on whole bodily systems, non-scrotal testosterone transdermal patch was given to middle aged men. METHODS: Sixteen impotent patients with serum testosterone levels between 300 and 500 ng/dL, were recruited for 6 month of treatment with non-scrotal testosterone transdermal delivery system, and six patients dropped during the study. All patients have a non-organic impotence (mean age:48 +/- 7). After 1 month placebo patch running period, patients were given 1 or 2 patches. The parameters were evaluated at each stage; before treatment, after placebo patch, and after testosterone patch for 3 months and 6 months. The evaluation parameters included body weight, blood pressure, heart rate, body mass index (BMI), body fat, haemoglobin, haematocrit, RBC, lipid profiles, Prostatic Specific Antigen (PSA), Transrectal Ultrasonography (TRUS), International Prostatic Symptom Score (IPSS), bone markers such as osteocalcin and Deoxypyridinoline (dPyr), Bone Mineral Density (BMD), psychological evaluation with Questionnaire and hormones such as cortisol, Dehydroepiandrosterone sulfate (DHEA-S), Follicle Stimulating Hormone (FSH), Luteinizing Hormone (LH), prolactin, testosterone and Sex Hormone Binding Globulin (SHBG). Sexual functions were evaluated by means of sexual Questionnaire which has grade systems (high grade means good response) on each domain. RESULTS: Hormonal, hematopoietic, lipid and prostatic parametem were not changed with statistical insignificance. There were no significant changes in BMD. But mean osteocalcin values increased about 31.5% (p<0.05). Bone resorption marker, D-Pyr values were also decreased significantly about 18.6% after 4 montbs treatment, but such changes were not shown after 6 months. Tendencies of improvement in all domains of Sexual Questionnaire were noticed, even though they were not statistically significant except in frequency of coitus and satisfaction with ejaculation (p<0.05), CONCLUSION: Decreased bone resorption was noticed while persistent increased bone formation occurred after 4 months treatment of testosterone. Testosterone supplementation has a beneficial effects on mood and sexual function in the impotent patients with lower borderline testosterone level. And it can be concluded that 6 months testosterone treatment dose not produce any adverse reactions on bodily system.

Plasma Leptin, Insulin Resistance, and Obesity Index of Type 2 Diabetics and Normal Subjects among Koreans.: Seong Kyu Lee, Hye Lim Noh, Yoon Jung Oh, Yoon Jung Kim, Eun Gyoung Hong, Bong Nam Chae, Yoon Sok Chung, Kwan Woo Lee, Hyeon Man Kim; J Korean Endocr Soc. 1999;14(1):122-133. Published online January 1, 2001

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Abstract PDF: BACKGROUND
Leptin has been reported to be correlated with the amount of adipose tissue in humans. The plasma leptin concentrations were not different between diabetics and non-diabetics in Mexican-Americans; however, the leptin might stimulate or diminish insulin secretion and induce insulin resistance. Then, it can be postulated that leptin may one of the key factors in the development of insulin resistance. Therefore we were to note any differences in FPL (fasting plasma leptin levels) between diabetics and normal subjects, and to investigate variables such as PBF (percentage body fat), BMI (body mass index), FPI (fasting plasma insulin) to determine their effects on the variation of FPL. We also were to investigate whether FPL influenced the GUR (glucose utilization rate). METHODS: The subjects were 116 type 2 diabetics and 45 normal subjects in Korean. PBF, BMI, WHR (waist hip ratio) were measured. Fasting plasma insulin and leptin levels were measured by radioimmunoassay. Euglycemic and/or hyperglycemic clamp tests were performed in 19 diabetics and 16 normal subjects. RESULTS: 1. There was no difference in FPL between diabetics and normal subjects. 2. A significant difference was found in FPL between female and male subjects. 3. Gender and body composition such as PBF, BMI contributed plasma leptin levels. 4. FPL was associated with GUR (Insulin resiatance) only in male subjects. 5. During 2h clamp tests, the acute increments of insulin or glucose did not change the leptin levels. CONCLUSION: These data suggested that there was no difference in FPL between diabetics and normal subjects, whereas gender, body composition such as PBF, BMI contributed leptin levels.

Total radical TRapping antioxidant parameter, calculated.: Kwan Woo Lee, Hyun Man Kim, Ae Hwa Ha; J Korean Endocr Soc. 1999;14(1):134-141. Published online January 1, 2001

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Abstract PDF: BACKGROUND
It has been suggested that diabetic patients are under high oxidative stress and plasma MDA concentration is a reliable marker for oxidative stress. However, some studies showed that plasma MDA is not a good marker for oxidative stress. Reeently, the total radical-trapping antioxidant parameter (TRAPc) has been proposed as a marker for the overall antioxidant property of plasma samples. Therefore, in this study, we tried to evaluate whether MDA and TRAPc are reliable markers of the oxidative stress-antioxidant system or not. METHODS: The plasma samples from 67 type 2 diabetic patients and 31 normal subjects were collected. The plasma MDA, protein-bound SH groups, uric acid and vitamin C were determined by fluorophotometry or spectrophotometry. Plasma vitamin E concentration was analyzed by HPLC. Calculated TRAP (TRAPc) were determined by the proposed calculation methods. RESULTS: 1. Diabetic patients had significantly lower TRAPc, compared with normal subjects. 2. SH groups, uric acid, vitamin C and vitamin E were not different between the two groups. 3. MDA and MDA/TG were significantly higher in diabetic subjects. CONCLUSION: From the results of this study, TRAPc seems to be a reliable parameter of overall plasma antioxidant system and the plasma MDA may be used as a marker of oxidative stress, but further long-term logitudinal studies are needed.

The Effect of Surgical Stress on Insulin Resistance in Rats.: Soo Bong Choi, Sun Min Park; J Korean Endocr Soc. 1999;14(1):142-146. Published online January 1, 2001

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Abstract PDF: BACKGROUND
It has been reported that surgical stress increased insulin resistance in human. However, there was no research about insulin resistance induced by surgical sttess in Korea. Catheters needed to be inserted in carotid artery and jugular vein of male Sprague Dawley rats to perform euglycemic hyperinsulinemic clamp procedures. The insertion of catheters in rats is a major surgery, which may increase insulin resistance. The purpose of the study is to determine whether surgical stress influence the insulin resistance. METHODS: The euglycemic hyperinsulinemie clamp procedures were performed 5 hours and 7 days after insertion of catheter in carotid artery and jugular vein. A continuous intravenous infusion of insulin was started at a rate of 12 mU/kg/minute and continued for 2 hours. Twenty-five percent glucose solution was infused through the venous line at a various rate to maintain blood glucose at 5.0-5.6 mmol/L and calculated the glucose disposal rate. Blood was collected from arterious line every 5 minutes and measured serum glucose and insulin levels. RESULTS: Prior to the clamp procedures, serum glucose levels of 5 hours and 7 days after catheter insertion were 29.8 +/- 9.8 and 7.8 +/- 0.9mmol/L, respectively. However, basal serum insulin levels were not different between 5 hours and 7 days after surgery. The glucose disposal rates were remarkably higher in rats who recovered from the surgery (22.0 +/- 7.8 mg/kg/minute) than those who did not (2.2 +/- 2.7 mg/kg/minute). Thus, surgical stress increased insulin resistance in male Sprague Dawley rats. CONCLUSION: Since surgery of catheter insertion increased insulin resistance about 10 times, euglycemic hyperinsulinemic clamp study should be performed in rats who completely recovered from the surgical stress.

Case Report

A Case of Acromegaly First Diagnosed in Pregnancy.: Jinny Suh, Hyun Kyung Cho, Yoon Jung Kim, Eun Gyoung Hong, Bong Nam Chae, Seong Kyu Lee, Yoon Sok Chung, Kwan Woo Lee, Kyung Joo Hwang, Hyeon Man Kim; J Korean Endocr Soc. 1999;14(1):148-152. Published online January 1, 2001

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Abstract PDF: Pregnancy in acromegaly is very rare. Amenorrhea and infertility are common manifestations in acromegaly. The pregnancy may be influenced by acromegaly in many ways and pregnancy itself may influence the course of a pituitary tumor. We report of a case of pregnancy in a woman who was diagnosed with acromegaly during the course of pregnancy. Her pregnancy was uneventful and she delivered a healthy baby at 38 weeks by cesarean section. No treatment was undertaken during the pregnancy and transsphenoidal surgery was performed after the delivery.

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