PCT may be a better marker to rule out bacterial infection in lupus flare but not in remission or general screening.

No abstract

The reversal of glucocorticoid-induced negative nitrogen balance by GH supports a possible therapeutic role for GH treatment in patients receiving these catabolic steroids. A GH secretagogue might be of similar utility. However, stimulated GH secretion is generally suppressed by glucocorticoids. To test whether L-692,429, a nonpeptide mimic of GH-releasing peptide-6, can overcome such suppression, a double blind, placebo-controlled, three-period, cross-over study was performed in nine healthy young men who received 0.2 mg/kg L-692,429, i.v., preceded by 4 days of prednisolone (20 mg, orally, three times daily) or placebo, and 0.75 mg/kg L-692,429 preceded by prednisolone only. The mean (SE) GH peak and area under the curve between 0-240 min after administration of 0.2 mg/kg L-692,429 in the absence of steroid were 53.8 (7.2) micrograms/L and 3481 (1005) micrograms/min.L, which were reduced to 25.1 (3.4) micrograms/L and 1342 (285) micrograms/min.L (P < or = 0.01) when treatment was preceded by 4 days of prednisolone. However, the suppressive influence of the steroid was attenuated by the high dose of L-692,429, which achieved a GH peak and area under the curve between 0-240 min of 42.6 (5.8) micrograms/L and 2298 (425) micrograms/min.L, respectively (P < 0.01 vs. 0.2 mg/kg L-692,429 plus prednisolone). L-692,429 stimulates GH secretion even in the setting of short term, high dose, concomitant glucocorticoid treatment, suggesting that such compounds might provide an alternative means of increasing circulating GH and reversing the catabolic effects of these steroids.

No abstract

Background: Serum glycated albumin (GA) is a marker of glycemic control in diabetic renal patients, but studies were limited by the use of few random glucose values to define glycemic control. Objectives: To determine whether GA correlated with self blood glucose monitoring is better than HbA1c in hemodialyzed diabetic patients taking erythropoietin. Methods: This was a cross-sectional study of diabetic patients on hemodialysis with and without erythropoietin. GA was measured by ELISA and HbA1c by ion-exchange HPLC. GA was reported as the GA/albumin ratio where albumin was measured using bromocresol green. The average capillary blood glucose level over the preceding three months (CBG) was calculated from self-reported daily prebreakfast, prelunch, and prebed glucose meter readings. Results: Thirty-four patients were recruited; 18 were taking erythropoietin (6000 units per week) and 16 had never received erythropoietin. HbA1c correlated poorly with CBG in patients taking erythropoietin (r = -0.014, P = 0.96) compared with patients without erythropoietin (r = 0.579, P = 0.02). The correlation of GA/albumin ratio with CBG in the erythropoietin group (r = 0.612, P = 0.007) was similar to the nonerythropoietin group (r = 0.854, P < 0.001). The slope for HbA1c versus CBG was 2.8-fold greater in patients without erythropoietin compared with those taking erythropoietin. There was no significant difference in the slopes for GA/albumin ratio versus CBG between the two patient groups (P > 0.05). Conclusion:In diabetic patients on hemodialysis and taking low doses of erythropoietin, GA/albumin is a better marker of glycemic control than HbA1c.