Smeets PA, Vidarsdottir S, de Graaf C, Stafleu A, van Osch MJ, Viergever MA, Pijl H, van der Grond J. Oral glucose intake inhibits hypothalamic neuronal activity more effectively than glucose infusion. Am J Physiol Endocrinol Metab 293: E754-E758, 2007. First published June 12, 2007; doi:10.1152/ajpendo.00231.2007.-We previously showed that hypothalamic neuronal activity, as measured by the blood oxygen level-dependent (BOLD) functional MRI signal, declines in response to oral glucose intake. To further explore the mechanism driving changes in hypothalamic neuronal activity in response to an oral glucose load, we here compare hypothalamic BOLD signal changes subsequent to an oral vs. an intravenous (iv) glucose challenge in healthy humans. Seven healthy, normal-weight men received four interventions in random order after an overnight fast: 1) ingestion of glucose solution (75 g in 300 ml) or 2) water (300 ml), and 3) iv infusion of 40% glucose solution (0.5 g/kg body wt, maximum 35 g) or 4) infusion of saline (0.9% NaCl, equal volume). The BOLD signal was recorded as of 8 min prior to intervention (baseline) until 30 min after. Glucose infusion was associated with a modest and transient signal decline in the hypothalamus. In contrast, glucose ingestion was followed by a profound and persistent signal decrease despite the fact that plasma glucose levels were almost threefold lower than in response to iv administration. Accordingly, glucose ingestion tended to suppress hunger more than iv infusion (P Ͻ 0.1). We infer that neural and endocrine signals emanating from the gastrointestinal tract are critical for the hypothalamic response to nutrient ingestion. functional magnetic resonance imaging; glucose homeostasis; insulin; incretins THE BLOOD OXYGEN LEVEL-DEPENDENT (BOLD) signal, produced by functional magnetic resonance imaging (fMRI), is a noninvasive measure of neuronal activity (19, 30,35). We (36, 37) have recently shown that the BOLD signal in the upper part of the hypothalamus of healthy, normal-weight humans consistently declines in response to an oral glucose load, which strongly suggests that glucose ingestion blunts hypothalamic neuronal activity in these subjects. The hypothalamus plays a critical role in the control of energy balance. Neural circuits in hypothalamic nuclei perceive and integrate endocrine and metabolic cues reflecting bodily energy content to coordinate behavior and fuel flux so as to maintain energy homeostasis (28, 34). Thus, adaptations of hypothalamic neuronal activity driven by nutrient ingestion may serve to guard energy equilibrium in the face of an environmental challenge.The mechanism linking glucose intake and changes in hypothalamic neuronal activity in humans is currently unknown. Various metabolic and endocrine cues are worthwhile to consider. Circulating levels of glucose can be sensed by specialized neurons in the arcuate and ventromedial nuclei of the hypothalamus, and these neurons project to other key nuclei (21). Alternatively, insulin inhibits NPY neuronal activit...

Short-term treatment with olanzapine reduces fasting plasma free fatty acid concentrations and hampers insulin action on glucose disposal in healthy men, whereas haloperidol has less clear effects. Moreover, olanzapine, but not haloperidol, blunts the insulin-induced decline of plasma free fatty acids and triglyceride concentrations. Notably, these effects come about without a measurable change of body fat mass.

This report confirms the essential role of STAT5b in GH signaling in the human. We show for the first time that immunological or pulmonary problems or elevated GH secretion are not obligatory signs of STAT5b deficiency, whereas hyperprolactinemia appears to be part of the syndrome. Therefore, in patients with severe short stature, signs of GH insensitivity, and a normal GHR, analysis of the STAT5b gene is recommended.

OBJECTIVE-The hypothalamus plays a critical role in the regulation of energy balance and fuel flux. Glucose ingestion inhibits hypothalamic neuronal activity in healthy humans. We hypothesized that hypothalamic neuronal activity in response to an oral glucose load would be altered in patients with type 2 diabetes.RESEARCH DESIGN AND METHODS-In this randomized, single blind, case-control study, 7 type 2 diabetic men (BMI 27.9 Ϯ 2.0 kg/m 2 ) and 10 age-matched healthy men (BMI 26.1 Ϯ 3.2 kg/m 2 ) were scanned twice for 38 min on separate days using functional magnetic resonance imaging. After 8 min, they ingested either a glucose solution (75 g in 300 ml water) or water (300 ml).RESULTS-Glucose ingestion resulted in a prolonged significant blood oxygen level-dependent signal decrease in the upper and lower hypothalamus in healthy subjects but not in diabetic patients.CONCLUSIONS-Glucose ingestion fails to inhibit hypothalamic neuronal activity in patients with type 2 diabetes. Failure of neural circuits to properly adapt to nutrient ingestion may contribute to metabolic imbalance in type 2 diabetic patients.

Objective: STAT5b is a component of the GH signaling pathway. Recently, we described a 31-year-old male patient (height, K5.9 SDS) with a novel homozygous inactivating mutation in the STAT5b gene. The purpose of this study is to describe the phenotype in detail, including GH secretion and immunological function. In addition, we report four family members of this patient, all heterozygous carriers of the mutation. Design and methods: Twenty-four hour GH and prolactin secretion characteristics were assessed by blood sampling at 10-min intervals. An IGF-I generation test was performed. Monocyte function was tested by stimulation of whole blood with lipopolysaccharide (LPS) in the presence or absence of Interferon-g (IFN-g). In addition, T cell function was determined by measuring proliferative responses of peripheral blood mononuclear cells (PBMC) after stimulation by various polyclonal activators and Interleukin-2 (IL-2). Clinical and biochemical characteristics were determined in the carriers of the mutation. Results: GH secretory parameters were comparable with that of healthy male controls (mean fat percentage 25), but likely increased in relation to the patient's 40% body fat. The regularity of GH secretion was diminished. Prolactin secretion was increased by sixfold. The IGF-I generation test showed a small increase in IGF-I and IGF-binding protein-3 on lower GH doses and an increase in IGF-I to K2.4 SDS on the highest dose of GH. In vitro, IL-12p40, IL 10, and tumour necrosis factor-a (TNF-a) production rates by PBMC increased to values within the normal range upon stimulation of LPS. Heterozygous carriers of the mutation did not show abnormalities, although the height of the males was below the normal range. Conclusions: This report shows that GH and prolactin secretion were increased in this patient homozygous for a new STAT5b mutation. Although STAT5b plays a role in signaling within immune cells, clinical immunodeficiency is not an obligatory phenomenon of STAT5b deficiency per se. Heterozygous carriers of a STAT5b mutation show no signs of GH insensitivity. 156 155-165 European Journal of Endocrinology