The beta3-adrenergic receptor (3-BAR) is assumed to play a role in the regulation of energy balance by increasing lipolysis and thermogenesis. A recently detected allelic polymorphism (Trp64Arg polymorphism) has been suggested to contribute to the development of obesity and non-insulin-dependent diabetes mellitus. We examined the prevalence of the two 3-BAR alleles in Germany and looked for associations between 3-BAR genotype and metabolic disorders (obesity and type 2 diabetes mellitus). From over 6450 participants in the Diabetomobile Study, a nationwide epidemiologic study on the prevalence of metabolic disorders (carried out from 1993 to 1996 in Germany), 1259 participants were randomly chosen. The 3-BAR genotype status was determined by 3-BAR gene-specific genomic PCR and consecutive restriction fragment length polymorphism analysis. The frequencies of the different genotypes in the examined cohort were as follows: Trp64/Trp64, 88.3%; Trp64/Arg64, 10.8%; and Arg64/ Arg64, 0.8%. No significant differences between the different genotypes were found when comparing age, body mass index, weight, total and high-density lipoprotein (HDL) cholesterol, fasting insulin, HbA11, and blood pressure; neither did the type 2 diabetes mellitus participants in the different genotype groups differ significantly in terms of age of diabetes onset or HbA11. This is the largest population-based study on the Trp64Arg polymorphism reported yet. The Arg64 allele of the 3-BAR gene was found commonly in Germany. In our cohort, no significant associations between the Arg64 allele and metabolic disorders (e.g. obesity, type 2 diabetes mellitus, dyslipidemia, or hypertension) were detected.
AbstractA 53-year old female patient, who presented with retrosternal pain, which could be ascribed to reflux oesophagitis and gastritis, furthermore stated recurrent palpitations, sweating and the feeling of uneasiness. In routine laboratory investigation hyperthyroidism and hypercalcaemia were detected. Further testing revealed elevated TSH receptor antibodies and a parathyroid hormone level within the normal range. Scintigraphically a homogeneous, but increased uptake was found. In ultrasonography guided fine needle aspiration biopsy of a nodule parathyroid hormone was verifiable by immunochemical means.Under thyrostatic treatment with carbimazole the patient became euthyroid, simultaneous a decrease of serum calcium levels could be observed. Parathyroid hormone level remained in normal range. After confirmation of Graves’ disease and adenoma of the parathyroid gland parathyroidectomy in combination with near total resection of the thyroid gland was performed. In conclusions concomitant Graves’ disease and primary hyperparathyroidism is rare, but should be considered in case of persisting hypercalcaemia after the patient became euthyroid again, when parathyroid hormone level is in normal range or elevated. Thus a potentially required second operation can be avoided. By ultrasonography guided fine needle aspiration biopsy and immunochemical processing adenomas of parathyroid glands can be localized preoperatively.
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