Oral glucose tolerance tests (OGTT) were performed on eighteen patients with suspected obstructive sleep apnoea who also completed a whole-night polygraphic recording with oximetry. Insulin resistance indices (IRI) were calculated as the product of areas under glucose and insulin curves. In the resulting multiple regression analysis the dependent variable was IRI and the independent variables were age, body mass index (BMI) and the number of nocturnal hypoxic episodes with over 4% desaturation per hour (ODI4). ODI4 was between 4.6 and 70 (median 22.3); IRI ranged from 2.20 to 33.55 (median 7.50). In the regression model the coefficient of determination (R2) for IRI was 0.441 (F-ratio = 3.681, P = 0.038). The strongest determinant of IRI was ODI4 and the regression coefficient of BMI was not significantly different from zero even when possible outliers were excluded. It was found that insulin resistance is related to the severity of sleep anoea. This may be due to a hypoxia-induced hormonal stress reaction which decreases tissue insulin sensitivity. Since upper body obesity is associated with both insulin resistance and sleep apnoea, the distribution of fat should be taken into account in future studies.

Insulin activity in plasma and the concentrations of tryptophan and serotonin were measured during the glucose tolerance test (GTT) in habitually violent and impulsive male offenders and in psychiatric personnel as controls. Insulin was enhanced in the intermittent explosive disorder; at the same time the concentration of plasma tryptophan and the ratio of tryptophan to large neutral amino acids were on a high level and tryptophan even increased in many cases during GTT. Serotonin values did not differ. Many offenders with enhanced insulin secretion displayed abnormal neuroglycopenic symptoms during GTT.

Salivary diagnosis is a developing area in clinical chemistry and dentistry. Cortisol analyses from saliva have been used in pediatric practice and as doping tests. Growth hormone (hGH), also a stress hormone, has not been analyzed from saliva. We studied the serum and saliva of 51 healthy subjects. The samples were taken at 8:00 in the morning after 12 h fasting. Cortisol concentrations were analyzed using RIA. An immunoradiometric assay was applied for analyzing serum and salivary hGH. The validity of this method developed in our laboratory was found to be good. The results showed correlation of salivary cortisol with that of serum (r = 0.47, P < 0.001). Salivary hGH concentrations were 1000-fold lower than the respective values in serum, but a clear correlation was found between salivary and serum hGH levels (r = 0.59, P < 0.001).

View related articles Citing articles: 28 View citing articles I'ro1n the Cliiiir for 0rtllop:irtlics and l'raiimattrlogg, llrncl : Profcssor I<. 15. I(allio, and the Chilclrrii's Clinic, Hrad : IBrofrssor Niilo Hallmaii, of tlic lliiivrrsity Crntral Hospital, Hclsiiilti.

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