17-ketosteroids and Diabetes-Mellitus--Type-2

The purpose of the study was to analyse bone density in patients with noninsulin-dependent diabetes mellitus with respect to such factors as the magnitude of obesity, serum cortisol concentration and 17-ketosteroid excretion and insulinemia level. Bone density was measured by ultrasonography, insulin was determined by radioimmunoassay, and steroid level by using the method of Zimmerman. The patients had imminent and overt osteoporosis. The highest serum cortisol concentration was in groups with lower T-score significant negative correlation between cortisol and SOS index. The lowest 17-ketosteroid level was detected in the patients with the lowest T-score; a significant correlation was observed between 17-ketosteroids and BUA index. The present findings indicate an imbalance between bone protective and resorptive factors. This leads to osteopenia in patients with noninsulin-dependent diabetes mellitus despite a protective effect of obesity.

Topics: 17-Ketosteroids; Aged; Body Mass Index; Bone Density; Diabetes Mellitus, Type 2; Female; Humans; Hydrocortisone; Male; Middle Aged; Obesity; Osteoporosis

We devised a clinical test of renal metabolism based on the synthesis of guanidinoacetic acid from citrulline in the proximal convoluted tubule. Intravenous administration of a citrulline/creatine solution to rats with modified levels of renal glycine amidinotransferase activity revealed a strong correlation (r = 0.921) between this activity and urinary guanidinoacetic acid excretion. Citrulline (1.75 g) and creatine (1.50 g) were administered orally to healthy individuals and patients with chronic glomerulonephritis. In the healthy individuals, urinary guanidinoacetic acid excretion increased 5-fold by 2 h after dosing (15.1 +/- 2.2 vs. 2.8 +/- 1.1 mg/h). In the glomerulonephritis patients, blood clearance of citrulline decreased as the creatinine clearance decreased and urinary guanidinoacetic acid excretion also decreased. Of 56 patients with glomerulonephritis or diabetes mellitus, one had increased urinary guanidinoacetic acid excretion associated with an excess of adrenal androgens. This test appears a useful, noninvasive and simple method for examining the metabolic activity of the renal proximal convoluted tubules.

Topics: 17-Ketosteroids; Amidinotransferases; Animals; Chronic Disease; Citrulline; Creatine; Diabetes Mellitus, Type 2; Female; Glomerulonephritis; Glycine; Humans; Kidney; Kidney Tubules, Proximal; Middle Aged; Ovariectomy; Rats; Rats, Inbred WKY