Aim:The present study was intended to establish the role of bone in grade III obese women with and without type 2 diabetes mellitus (T2DM). Material & Methods:Serum osteocalcin (OC), Beta Cross-Laps (Beta-CTx), parathormone (PTH) separar and y 25-hydroxyvitamin D (25OHD) concentrations were measured in 48 morbid obesity women (11 with T2DM and 37 control group). Insulin resistance and insulin secretion was assessed by measuring the HOMA-IR and the HOMAβ index and its association with OC and Beta-CTx.Results: Serum OC was signifi cant lower in the diabetic group compared with non-diabetic patients 15.4 ± 3.6 ng/ml vs 22.1 ± 3.5 ng/ml, p<0.001 without signifi cant differences in Beta-CTx (0.24 ± 0.1 vs 0.31 ± 0.2 ng/ml, ns). Both bone biomarkers, OC and Beta-CTx, showed a positive correlation (r=0.76; p<0.01) in the whole group subjects and in the control group (r=0.80, p<0.00), but no in the T2DM group (r=0.50, p ns). In the whole group of patients, OC correlated signifi cantly with HOMA-IR (r=0.36; p<0.01) and HOMA-ß (r=0.36, p<0.01). Beta-CTx also correlated with HOMA-IR (r= 0.40, p<0.01) and HOMA-ß (r= 0.41, p<0.001. OC also signifi cantly correlated with HOMA-IR (r=0.41, p<0.01) in non-diabetic patients and almost reached statistical signifi cance with HOMA-ß (r=0.32, p=0.053), but was not signifi cantly correlated with HOMA-ß (r= -0.53, ns) and with HOMA-IR index (r=0.52, ns) in the T2DM group. When we performed the multivariate logistic regression the serum level of OC was the only covariate found signifi cantly with DM2 with a coefi cient -6.65 , (95% CI, -12.75049 -.5674469 ); p = 0.03). Both groups showed secondary hyperparathyroidism (T2DM, 78.4 ± 19.4 pg/ml vs non-diabetic group, 75.4 ± 35.6 pg/ ml; ns). The majority of the patients showed 25OHD defi ciency 62.5%, followed by 25OHD insuffi ciency 27.1% and normal 25OHD levels in only 10.4%. The 25OHD defi ciency was present in both study groups (T2DM patients, 18.3 ± 7.4 pg/ml and nondiabetic group, 19.7 ± 9.6 pg/ml; ns). Conclusion: OC and Beta-CTx could play a role in glucose metabolism and insulin resistance. Serum OC concentrations are signifi cantly reduced in T2DM morbidily obese women compared with nondiabetic group, and add new evidence on the possible role of bone as an endocrine organ with metabolic implications specially the levels of OC. Citation: Arrieta F, Iglesias P, Piñera M, Arrieta A,Quiñones J, et al. (2017) Serum Concentrations of Osteocalcin (OC) and Beta-Cross Laps (Beta-CTx) and Insulin Resistance in Morbid Obese Women with and without DM2. Glob J Obes Diabetes Metab Syndr 4(3): 072-076.
Based on renal arteriography, hypertensive patients were classified as (1) normal, (2) unilaterally significantly abnormal, and (3) borderline cases. Those who underwent surgery were classified as cured, improved, and unchanged. The results of renograms using iodohippurate sodium I 131 chlormerodrin Hg 197 renograms and renal scans were compared to rapid sequence intravenous pyelography (RSIVP). In group 1 (ten patients), there was one false-positive iodohippurate renogram and two false-positive RSIVPs. Chlormerodrin renograms and scans were normal. In group 2 (13 patients) all iodohippurate renograms and RSIVPs reflected the side of the arteriographic lesion. Of these, 12 were cured or improved surgically. Two false-negative chlormerodrin renograms and scans occurred. In group 3 (six patients), all iodohippurate renograms reflected the side of the lesion while two patients, one cured and one improved, had negative RSIVP. Chlormerodrin renogram and scan were each falsely negative once.It is difficult to know which screening test for renovascular hypertension is most useful. Both renography and rapid sequence pyelography have been favored. While pyelographic criteria suggesting a signifiicant renovascular lesion are well standardized, renographic procedures and interpretations vary widely.1,2 Furthermore, arteriographic criteria of a renal vascular lesion significantly involved in causing hypertension are by no means certain. Surgical success has remained the final arbiter of significance. However, Bookstein3 has recently described certain objective arteriographic measurements which have a high degree of correlation with the final outcome of surgery.Using such criteria and, in most cases, the surgical outcome as evidence of a significant unilateral lesion, we have studied the corresponding preoperative renograms during hydration and have applied new and uniform objective criteria of significance. Thus, it is now possible to estimate the role of the renogram and the intravenous pyelogram as screening tests in the detection of hypertension caused by unilateral renal artery disease. Materials and MethodsClinical Material.\p=m-\Patientsundergoing hypertensive work-up were referred to the Nuclear Medicine Section where renograms and renal scans were performed under the direct supervision of one of us (V.V.) The case material was carefully selected so as to fall into three categories: completely normal arteriogram, unilateral significantly abnormal, and borderline cases. One of us (J.Q.) later read the results without knowledge of whether or not the patient was considered to have renovascular disease. Intravenous pyelograms and aortograms were interpreted in the Radiology Department. The postoperative evaluation was performed in the hypertension clinic and results were classified by the following criteria: cured\p=m-\outpatient blood pressure below 150/95 mm Hg while receiving no drugs; i mproved\p=m-\same result on diuretics alone plus a significant lowering from preoperative levels; and un-changed\p=m-\postoperative b...
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