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L Escobar,
J M Freire,
R Espinosa,
M Pajares,
J A Girón,
J M Vázquez,
A Chover,
M Carrasco,
J Ortero, I Gavilán,
E Segura,
M Aguilar
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ABSTRACT: The present study was conducted in order to analyze the relationship existing between leptin, insulin and neuropeptide Y (NPY) levels in massive weight loss and weight recovery. Twenty-three patients with severe obesity, 23 patients with anorexia nervosa and 28 healthy control subjects were studied. Patients with severe obesity underwent a vertical banded gastroplasty followed by an 800 kcal/day diet during 16 weeks, with evaluation taking place before (Body mass index, BMI, 52,1 8 Kg/m2) and after the drastic weight loss (BMI 39,2 6,2 Kg/m2). Patients with anorexia nervosa were treated with nutritional therapy exclusively during 16 weeks, and they were evaluated in the low weight situation (BMI 15,3 1,7 Kg/m2) and after weight recovery (BMI 18,9 2,8 Kg/m2). Normal subjects had a normal BMI from 20 to 27 (average 21,8 2 Kg/m2). BMI, percentage of body fat, and serum levels of leptin, insulin, and NPY, were determined in each patient and normal subjects. In severe obese patients serum leptin and insulin decreased significantly after drastic weight reduction (leptin: from 48,8 19,2 to 24,3 9,8 ng/ml; insulin: from 26,2 10,8 to 18 6 U/ml). In patients with anorexia nervosa serum leptin mean levels were significantly higher after weight recovery (3,7 1,9 vs 9,2 5,1 ng/ml). In subjects with morbid obesity NPY levels decreased after weight loss below those of control group (43,5 16,1 vs 57,3 12,8 pmol/l). On the other hand, patients with anorexia nervosa had NPY levels superior to those of control group. In subjects with anorexia, NPY levels decreased after weight recovery (69,1 16,7 a 59,1 20,3 pmol/l). In the whole population, Leptin and NPY plasma levels were correlated with body fat percentage. Leptin was positively correlated with BMI and body fat percentage in obese and anorectic subjects after weight loss or recovery, respectively. NPY was inversely correlated with body fat percentage in controls and obese subjects before treatment. These data reveal that the concentration of serum leptin and NPY correlates significantly with the total adiposity in subjects with a wide weight range and caloric intake. Leptin plasma levels are proportional to fat stores in patients with severe obesity and anorexia nervosa after drastic weight loss or recovery, respectively. NPY serum levels are negatively correlated with de total body fat in normal weight subjects and obese patients in their initial weight.
Revista Española de Medicina Nuclear 03/2002; 21(1):3-11. · 0.89 Impact Factor
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ABSTRACT: B lymphocytes that infiltrate the thyroid (Thy-B cells) in Graves' patients appear to be implicated in the pathophysiology of this disorder. The goal of the present study was to examine the nature of these Thy-B cells. To this end, Thy-B lymphocytes were isolated from surgical thyroidal samples, and their phenotype was determined by using mouse monoclonal antibodies (mAb) directed against a wide variety of surface markers, followed by flow cytometry multicolor analysis. The results show that most Thy-B cells (approximately 60%) exhibited IgM(+) IgD(low to -) surface immunoglobulin (Ig) profile, whereas the minor cell fraction (approximately 30%) consisted of switched IgG(+) memory B lymphocytes. Thy-B cells expressed low levels of CD5, CD23, and CD62L, which distinguished them from the resting B-cell pool, the major B-cell subset in the blood. In addition, they lacked CD38, CD10, and CD71, characteristic molecules for the germinal center B lymphocytes. In addition, Thy-B lymphocytes showed peculiar patterns both of adhesion molecules (CD62L(-), CD44(intermediate)), and of activation molecules (CD69(+), CD80(+), and, in part, CD95(+)). Taken together, these results suggest that the Thy-B lymphocyte subset consists of a combination of IgM(+) B cells resembling marginal zone B lymphocytes, and isotype-switched memory B cells.
Thyroid 07/2001; 11(6):525-30. · 4.79 Impact Factor
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ABSTRACT: To evaluate the T helper 1 (T(H)1)/T helper 2 (T(H)2) lymphocyte cytokine profiles in women and men and to study the in vitro effects of sex hormones on lymphocyte secretion of cytokines.
Analysis of serum concentration and lymphocyte synthesis of T(H)1 (gamma interferon (INF-gamma) and interleukin 2 (IL-2)) and T(H)2 (interleukin 4 (IL-4) and interleukin 10 (IL-10)) cytokines was performed in 20 women and 15 men. Analysis of modifications in cytokine secretion induced by supplementation of lymphocyte culture with increasing concentrations of sex hormones was carried out.
Higher levels of INF-gamma and IL-2 and lower levels of IL-4 and IL-10 were detected in the phytohemagglutinin-stimulated lymphocyte culture supernatants of men compared with women; the INF-gamma:IL-4 ratio was significantly higher in men. In women, similar concentrations of all the cytokines were detected in culture supernatants obtained during the follicular and the luteal phases. The addition of sex hormones did not modify the concentration of cytokines in supernatants of phytohemagglutinin-stimulated T-cell cultures.
Women present a predominant T(H)2 cytokine profile, which could be involved in immune responses characterized principally by the secretion of antibodies. This could be a factor implicated in the higher concentration of immunoglobulins or the increased prevalence of autoimmune diseases detected in females.
European Journal of Endocrinology 08/2000; 143(1):31-6. · 3.42 Impact Factor
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L Escobar,
J M Freire,
J A Girón,
J M Vázquez,
M Pajares,
J Ortego, I Gavilán,
A J Chover,
M Carrasco,
R Epinosa,
F Marín,
M Aguilar
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ABSTRACT: The present study was conducted in order to analyze the relationship existing between leptin and insulin levels in massive weight loss and weight recovery. Thirteen patients with severe obesity, 14 patients with anorexia nervosa and 13 healthy control subjects were studied. The patients with severe obesity underwent a vertical banded gastroplasty followed by an 800 kcal/day diet for 12 weeks. They were evaluated prior to (body mass index [BMI] 51.2 +/- 8.8 Kg/m2) and after drastic weight loss (BMI 40.6 +/- 6.7 Kg/m2). Patients with anorexia nervosa were treated exclusively with nutritional therapy during 12 weeks, and they were evaluated at their lowest weight status (BMI 16.2 +/- 2.2 Kg/m2) and after weight recovery (BMI 17.9 +/- 2.3 Kg/m2). The BMI of the normal subjects was in the normal range of 20 to 27 Kg/m2 (average 22.8 +/- 2.6 Kg/m2). BMI, percentage of body fat, waist circumference, and serum levels of leptin, insulin, and C-peptide were determined in each patient and normal subject. In severely obese patients, serum leptin and insulin decreased significantly after drastic weight reduction (leptin: from 51.8 +/- 22.3 to 23.7 +/- 10.2 ng/ml; insulin: from 27.1 +/- 13.3 to 17.2 +/- 7.2 mU/ml). In patients with anorexia nervosa, the mean serum leptin levels were significantly higher after weight recovery (5.5 +/- 3.2 vs 7.6 +/- 6 ng/ml). Serum leptin in the severe obesity group correlated positively with BMI, percentage body fat and waist circumference before and after weight loss. In those patients suffering from anorexia nervosa, serum leptin correlated positively with the BMI, percentage of body fat, and waist circumference in the low weight state and after weight recovery. In addition, their serum insulin correlated with BMI and waist circumference after weight recovery. These data reveal that serum leptin concentration correlates significantly with the BMI and body fat content 1) in subjects with a range of weight and caloric intake, 2) in obese patients after drastic weight loss; 3) in anorexic patients after weight gain; and that hyper- or normoinsulinemia do not seem to have any influence on the leptin changes caused by weight loss or gain.
Revista Española de Medicina Nuclear 07/2000; 19(3):199-206. · 0.89 Impact Factor
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ABSTRACT: We have prospectively examined the percentage of peripheral blood lymphocytes which expressed adhesion molecules in untreated Graves' disease patients. Eighteen patients with Graves' disease, twenty-four patients with Hashimoto's thyroiditis and thirty-two sex- and age-matched healthy control subjects were studied. The expression of the lymphocyte adhesion molecules beta-1 integrin CD29, beta-2 integrin CD11b and L-selectin Leu8 (CD62L) was analyzed by cytofluorometry. A decreased percentage of CD29+ and CD11b+ lymphocytes was observed in hyperthyroid patients in comparison with Hashimoto's thyroiditis patients and healthy controls. However, there was no difference in the percentage of CD62L+ lymphocytes in the three groups. Percentages of lymphocyte activation markers, hyperthyroid status, presence or absence of ophthalmopathy or serum levels of antithyroid antibodies were not related to the proportions of CD29+ or CD11b+ lymphocytes. Four Graves' patients required radical therapy but after the treatment, there was no modification in the percentages of CD29+ and CD11b+ lymphocytes compared with those determined at diagnosis. Our findings suggest that the decrease in beta-1 and beta-2 integrins could be a predisposing marker of development of Graves' disease.
European Journal of Endocrinology 10/1998; 139(3):349-54. · 3.42 Impact Factor
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ABSTRACT: The distribution of peripheral blood CD16/56 cytotoxic T and natural killer (NK) cells in Graves' disease patients is analyzed in order to correlate them with disease activity and with prognosis. Eighteen patients with Graves' disease, twenty-four patients with Hashimoto's thyroiditis and thirty-two sex- and age-matched healthy control subjects were studied. Peripheral blood CD16/56 (cytotoxic T and NK) cells were analyzed by cytofluorometry. A decreased proportion of CD16/56+ and CD16/ 56+CD3+ cells were detected in Graves' disease patients when compared with thyroiditis patients and healthy control groups. No correlation was detected with serum free thyroxine. On diagnosis, patients who would require a radical treatment for thyrotoxicosis control showed a significant decrease of cytotoxic CD56+ T (CD3+) and NK (CD3-) cells compared with those who would maintain the euthyroid state after methimazole. These results suggest that the cytotoxic compartment, both T and NK cells, of the immune system is altered in patients with Graves' disease, independently of the functional thyroid status. Changes in peripheral blood lymphocytes in Graves' disease patients could be useful as predictive markers of an unfavorable outcome.
European Journal of Endocrinology 10/1998; 139(3):314-6. · 3.42 Impact Factor
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ABSTRACT: In the present paper the distribution of peripheral blood T gamma/delta lymphocytes in Graves' disease patients is analyzed in order to correlate them with disease activity and with prognosis. Eighteen patients with Graves' disease, 24 patients with Hashimoto's thyroiditis and 32 sex- and age-matched healthy control subjects were studied. Peripheral blood CD3+ alpha/beta and gamma/delta T lymphocytes as well as CD4+ and CD8+ T cells, and CD19 (B) lymphocytes were analyzed by cytofluorometry. At diagnosis, patients who required a radical treatment for thyrotoxicosis control showed a significant decrease of T gamma/delta lymphocytes and an increase of B cells when compared with those who maintained the euthyroid state after methimazole. No correlation was detected between the percentages of these subpopulations and serum free thyroxine. This decreased proportion did not normalize after methimazole or radical treatments. These results suggest that the cytotoxic T gamma/delta compartment of the immune system is altered in patients with Graves' disease.
Endocrine Research 06/1998; 24(2):285-95. · 0.97 Impact Factor
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ABSTRACT: To analyze the clinical features and possible prognostic factors involved in the clinical course of a series of 26 patients with the diagnosis of thyroid medullar carcinoma (TMC).
An analysis was made of the variables age, sex, clinical course to diagnosis, paraneoplastic manifestations (flush, diarrhoea), clinical type (sporadic, non-associated, familial MEN IIa associated TMC, familial MEN IIb associated TMC), histologic uni or multicentricity, and stage of disease as possible predictive factors for the evolution.
The most remarkable prognostic factor was tumoral stage. The likelihood of a patient diagnosed with stage I or II being free of metastatic disease was 1, 0.66 and 0.33 at 15, 16 and 17 years, respectively. In contrast, those patients in stage III at diagnosis had a likelihood of being free from metastasis 5 years after diagnosis and therapy of 0. With regard to sex, a better clinical course was observed among males than among females, statistically significant at 3 and 5, but not at 10 years. No statistical significance was reached with the other possible prognostic factors investigated.
Given the obvious influence of tumoral stage of disease on prognosis, an early access to medical attention is desirable for diagnosis and treatment of TMC, as well as an early detection of family cases by a screening test.
Revista Clínica Española 03/1996; 196(2):92-8. · 2.01 Impact Factor
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ABSTRACT: The results of two acute treatment tests using SMS 201-995 (SMS), over a 24 hour period in acromegalic patients are presented. Test number 1: Seventeen cases with a mean age of 44.3 +/- 11.9 (21/71) years with an evolution of 9.2 +/- 6.5 (2/20) years and GH of 30.1 +/- 21.1 (5.2/96.4) ng/ml were treated with 50 micrograms/8 hours (8, 16, and 24 hours) of subcutaneous SMS. Test number 2: 26 cases with a mean age of 45.5 +/- 15.5 (21/71) years with an evolution of 9.1 +/- 7.9 (2/35) years and GH of 28.6 +/- 22.2 (5.2/96.4) ng/ml were treated with 100 micrograms/8 hours (8, 16, and 24 hours) of subcutaneous SMS. Ten point GH profile in 24 hours is evaluated in both tests and in number 2 insulin and blood sugar levels are measured at the same time points. In both tests GH is significantly reduced being the 100 micrograms/8 hour treatment schedule more efficient. The results in the decrease of GH in test number two are related to those obtained using SMS in prolonged treatments. Inspire of the reducing effect that SMS has on insulin levels, its influence on the blood sugar profile is scare.
Revista Clínica Española 08/1991; 189(3):110-4. · 2.01 Impact Factor
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ABSTRACT: During the past 17 years (1972-89) 55 transsphenoidal surgery (TSS) interventions were performed in our Hospital in 53 cases of acromagaly (2 cases underwent surgery twice). Results: 22 were cured (40%); 15 partial efficacy (27%) and 18 negative efficacy (33%). Mean GH values (ngr/ml) before surgery were: Cured cases 15.8 + 12.9 (p = 0.0015). Basal GH values above 40 ngr/ml obscure the prognosis of TSS in acromegaly. Cure was perfectly achieved in smaller size hypophysis adenomas (Hardy Grade land 11 in CT scan). The complications in the early post-surgery were rare and transient. Chronic sequelae due to TSS occurred in 7 cases (13.5%), as complete or partial anterior hypophysis failure. TSS is the treatment of choice of acromegaly in our environment, however a significant number of cases do not achieve cure and need to complete treatment with hypophyseal radiotherapy.
Revista Clínica Española 03/1991; 188(2):76-80. · 2.01 Impact Factor
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Revista Clínica Española 04/1988; 182(4):187-91. · 2.01 Impact Factor
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Medicina Clínica 12/1985; 85(18):733-6. · 1.38 Impact Factor
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Medicina Clínica 11/1985; 85(12):486-90. · 1.38 Impact Factor
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ABSTRACT: To determine the accuracy of fine needle aspiration (FNA) and intraoperative frozen section examination (IFSE) on thyroid nodules.
The study group consisted of 470 patients who underwent thyroidectomy. FNA was performed on 289 patients and IFSE on 326. The FNA and IFSE results were compared with the final histologic diagnosis obtained after examination of permanent sections.
The overall FNA sensitivity was 65%, specificity 88% and positive predictive value 61%. The IFSE sensitivity was 50%, and the specificity and positive predictive value were 100%. When both procedures were used together, FNA identified 16 of 45 (36%) carcinomas as malignant and an additional 13 (29%) as follicular proliferative lesions; IFSE correctly identified only 23 of 45 (51%) carcinomas.
FNA provides enough information for determining the extent of thyroid surgery when a diagnosis of cancer is made. However, IFSE should be considered a supplementary procedure when FNA is not positive for cancer.
Acta cytologica 41(3):677-82. · 0.49 Impact Factor
