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  • 1
    Electronic Resource
    Electronic Resource
    Assessment of insulin sensitivity in glucokinase-deficient subjects (1996)
    Springer
    Diabetologia 39 (1996), S. 82-90 
    Details
    ISSN: 1432-0428
    Keywords: Insulin resistance ; glucokinase mutation ; MODY ; glucose clamp
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The chronic hyperglycaemia of glucokinase-deficient diabetes results from a glucose-sensing defect in pancreatic beta cells and abnormal hepatic glucose phosphorylation. We have evaluated the contribution of insulin resistance to this form of chronic hyperglycaemia. Insulin sensitivity, assessed by the homeostasis model assessment (HOMA) method in 35 kindreds with glucokinase mutations, was found to be significantly decreased in 125 glucokinase-deficient subjects as compared to 141 unaffected first-degree relatives. Logistic regression analysis showed that in glucokinase-deficient subjects a decrease in insulin sensitivity was associated with deterioration of the glucose tolerance status. A euglycaemic hyperin-sulinaemic clamp was performed in 14 glucokinase-deficient subjects and 12 unrelated control subjects. In six patients and six control subjects the clamp was coupled to dideutero-glucose infusion to measure glucose turnover. Average glucose infusion rates (GIR) at 1 and 5 mU · kg body weight · min−1 insulin infusion rates were significantly lower in (the glucokinase-deficient) patients than in control subjects. Although heterogeneous results were observed, in 8 out of the 14 patients GIRs throughout the experiment were lower than 1 SD below the mean of the control subjects. Hepatic glucose production at 1 mU · kg body weight−1 · min−1 insulin-infusion rate was significantly higher in patients than in control subjects. In conclusion, insulin resistance correlates with the deterioration of glucose tolerance and contributes to the hyperglycaemia of glucokinase-deficient diabetes. Taken together, our results are most consistent with insulin resistance being considered secondary to the chronic hyperglycaemia and/or hypoinsulinaemia of glucokinase-deficiency. Insulin resistance might also result from interactions between the unbalanced glucose metabolism and susceptibility gene(s) to low insulin sensitivity likely to be present in this population.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00400417
    Library Location Call Number Volume/Issue/Year Availability
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    Paper (German National Licenses)
    Fulltext
  • 2
    Electronic Resource
    Electronic Resource
    Detection of coronary artery disease in diabetic patients (1995)
    Springer
    Diabetologia 38 (1995), S. 726-731 
    Details
    ISSN: 1432-0428
    Keywords: Key words Non-invasive test ; detection ; coronary artery disease ; diabetic patients.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Coronary artery disease may be difficult to detect in diabetic patients. This study was designed to determine the specificity and sensitivity of three non-invasive tests. Accordingly, the results of 48-h ambulatory electrocardiogram (ECG) monitoring, maximal ECG exercise test, and intravenous dipyridamole myocardial thallium scintigraphy were compared in 59 middle-aged diabetic patients who were consecutively selected for suspected coronary artery disease. All patients also underwent coronary angiography, which was performed regardless of the results of the non-invasive tests. Twenty patients (34 %) had significant coronary lesions, i. e. stenosis equal to or greater than 70 %, and 16 of these 20 patients (80 %) had double or triple vessel disease. Sensitivity and specificity were, respectively, 25 % and 88 % for ambulatory ECG monitoring, 75 % and 77 % for the exercise test and 80 % and 87 % for thallium myocardial scintigraphy. This observation strongly supports the use of non-invasive tests for the detection of coronary artery disease in those diabetic patients at high risk of such disease. As the exercise test is cheaper and more widely available than thallium myocardial scintigraphy it should be used as a first line examination. Dipyridamole myocardial scintigraphy may provide an alternative solution for those patients who cannot perform maximal exercise, or with atypical clinical presentation. [Diabetologia (1995) 38: 726–731]
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00401847
    Library Location Call Number Volume/Issue/Year Availability
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    Paper (German National Licenses)
    Fulltext
  • 3
    Electronic Resource
    Electronic Resource
    Association of elevated lipoprotein(a) levels and coronary heart disease in NIDDM patients. Relationship with apolipoprotein(a) phenotypes (1994)
    Springer
    Diabetologia 37 (1994), S. 585-591 
    Details
    ISSN: 1432-0428
    Keywords: NIDDM ; lipoprotein(a) ; apo(a) isoforms ; coronary heart disease ; lipids ; lipoproteins ; cardiovascular risk factors
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Non-insulin-dependent diabetes mellitus (NIDDM) is a strong and independent risk factor for coronary heart disease. We assessed the potential relationship between plasma Lp(a) levels, apo(a) phenotypes and coronary heart disease in a population of NIDDM patients. Seventy-one patients with coronary heart disease, who previously have had transmural myocardial infarction, or significant stenosis on coronary angiography, or positive myocardial thallium scintigraphy, or in combination, were compared with 67 patients without coronary heart disease, who tested negatively upon either coronary angiography, myocardial thallium scintigraphy or a maximal exercise test. The prevalence of plasma Lp(a) levels elevated above the threshold for increased cardiovascular risk (〉0.30 g/l) was significantly higher (p=0.005) in patients with coronary heart disease (33.8%) compared to the control group (13.4%). The relative risk (odds ratio) of coronary heart disease among patients with high Lp(a) concentrations was 3.1 (95% confidence interval, 1.31–7.34;p=0.01). The overall frequency distribution of apo(a) phenotypes differed significantly between the two groups (p=0.043). However, the frequency of apo(a) isoforms of low apparent molecular mass (≤700 kDa) was of borderline significance (p=0.067) between patients with or without coronary heart disease (29.6% and 16.4%, respectively). In this Caucasian population of NIDDM patients, elevated Lp(a) levels were associated with coronary heart disease, an association which was partially accounted for by the higher frequency of apo(a) isoforms of small size. In multivariate analyses, elevated levels of Lp(a) were independently associated with coronary heart disease (odds ratio 3.48, p=0.0233).
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00403377
    Library Location Call Number Volume/Issue/Year Availability
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    Paper (German National Licenses)
    Fulltext
  • 4
    Electronic Resource
    Electronic Resource
    Detection of coronary artery disease in diabetic patients (1995)
    Springer
    Diabetologia 38 (1995), S. 726-731 
    Details
    ISSN: 1432-0428
    Keywords: Non-invasive test ; detection ; coronary artery disease ; diabetic patients
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Coronary artery disease may be difficult to detect in diabetic patients. This study was designed to determine the specificity and sensitivity of three non-invasive tests. Accordingly, the results of 48-h ambulatory electrocardiogram (ECG) monitoring, maximal ECG exercise test, and intravenous dipyridamole myocardial thallium scintigraphy were compared in 59 middle-aged diabetic patients who were consecutively selected for suspected coronary artery disease. All patients also underwent coronary angiography, which was performed regardless of the results of the non-invasive tests. Twenty patients (34%) had significant coronary lesions, i.e. stenosis equal to or greater than 70%, and 16 of these 20 patients (80%) had double or triple vessel disease. Sensitivity and specificity were, respectively, 25% and 88% for ambulatory ECG monitoring, 75% and 77% for the exercise test and 80% and 87% for thallium myocardial scintigraphy. This observation strongly supports the use of non-invasive tests for the detection of coronary artery disease in those diabetic patients at high risk of such disease. As the exercise test is cheaper and more widely available than thallium myocardial scintigraphy it should be used as a first line examination. Dipyridamole myocardial scintigraphy may provide an alternative solution for those patients who cannot perform maximal exercise, or with atypical clinical presentation.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00401847
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 5
    Electronic Resource
    Electronic Resource
    Association of elevated lipoprotein(a) levels and coronary heart disease in NIDDM patients. Relationship with apolipoprotein(a) phenotypes (1994)
    Springer
    Diabetologia 37 (1994), S. 585-591 
    Details
    ISSN: 1432-0428
    Keywords: Key words NIDDM, lipoprotein(a), apo(a) isoforms, coronary heart disease, lipids, lipoproteins, cardiovascular risk factors.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Non-insulin-dependent diabetes mellitus (NIDDM) is a strong and independent risk factor for coronary heart disease. We assessed the potential relationship between plasma Lp(a) levels, apo(a) phenotypes and coronary heart disease in a population of NIDDM patients. Seventy-one patients with coronary heart disease, who previously have had transmural myocardial infarction, or significant stenosis on coronary angiography, or positive myocardial thallium scintigraphy, or in combination, were compared with 67 patients without coronary heart disease, who tested negatively upon either coronary angiography, myocardial thallium scintigraphy or a maximal exercise test. The prevalence of plasma Lp(a) levels elevated above the threshold for increased cardiovascular risk (〉0.30 g/l) was significantly higher (p =0.005) in patients with coronary heart disease (33.8 %) compared to the control group (13.4 %). The relative risk (odds ratio) of coronary heart disease among patients with high Lp(a) concentrations was 3.1 (95 % confidence interval, 1.31–7.34; p =0.01). The overall frequency distribution of apo(a) phenotypes differed significantly between the two groups (p =0.043). However, the frequency of apo(a) isoforms of low apparent molecular mass (≤ 700 kDa) was of borderline significance (p =0.067) between patients with or without coronary heart disease (29.6 % and 16.4 %, respectively). In this Caucasian population of NIDDM patients, elevated Lp(a) levels were associated with coronary heart disease, an association which was partially accounted for by the higher frequency of apo(a) isoforms of small size. In multivariate analyses, elevated levels of Lp(a) were independently associated with coronary heart disease (odds ratio 3.48, p =0.0233). [Diabetologia (1994) 37: 585–591]
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00403377
    Library Location Call Number Volume/Issue/Year Availability
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    Paper (German National Licenses)
    Fulltext
  • 6
    Electronic Resource
    Electronic Resource
    Close linkage of glucokinase locus on chromosome 7p to early-onset non-insulin-dependent diabetes mellitus (1992)
    [s.l.] : Nature Publishing Group
    Nature 356 (1992), S. 162-164 
    Details
    ISSN: 1476-4687
    Source: Nature Archives 1869 - 2009
    Topics: Biology , Chemistry and Pharmacology , Medicine , Natural Sciences in General , Physics
    Notes: [Auszug] Although clinical and metabolic profiles of families with maturity-onset diabetes of the young (MODY) are diverse5, most MODY patients present a decreased insulin response to glucose, suggesting a primary pancreatic /3-cell defect6. Genes whose products seem to be involved in insulin secretion ...
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1038/356162a0
    Library Location Call Number Volume/Issue/Year Availability
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    Paper (German National Licenses)
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  • 7
    Electronic Resource
    Electronic Resource
    Nonsense mutation in the glucokinase gene causes early-onset non-insulin-dependent diabetes mellitus (1992)
    [s.l.] : Nature Publishing Group
    Nature 356 (1992), S. 721-722 
    Details
    ISSN: 1476-4687
    Source: Nature Archives 1869 - 2009
    Topics: Biology , Chemistry and Pharmacology , Medicine , Natural Sciences in General , Physics
    Notes: [Auszug] The gene encoding the enzyme glucokinase in humans spans a region of 〉20 kilobases (kb) and consists of 12 exons (M.S., J.T., N.V. and G.I.B., manuscript in preparation). The exon-intron organization of the human glucokinase gene is similar to that of the rat4. The regions of the exons were ...
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1038/356721a0
    Library Location Call Number Volume/Issue/Year Availability
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    Paper (German National Licenses)
    Fulltext
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