neuropeptide-y and Endocrine-System-Diseases

Topics: Adipose Tissue; Animals; Body Weight; Endocrine System Diseases; Homeostasis; Humans; Hypothalamo-Hypophyseal System; Leptin; Neuropeptide Y; Pituitary-Adrenal System; Proteins; Starvation; Wasting Syndrome; Weight Loss

To assess whether endocrine dysfunction may cause derangement in energy homeostasis in patients undergoing hemodialysis (HD), we profiled hormones, during a 3-day period, from the adipose tissue and the gut and the nervous system around the circadian clock in 10 otherwise healthy HD patients and 8 normal controls. The protocol included a 40-h fast. We also measured energy-protein intake and output and assessed appetite and body composition. We found many hormonal abnormalities in HD patients: 1) leptin levels were elevated, due, in part, to increased production, and nocturnal surge in response to daytime feeding, exaggerated. 2) Peptide YY (PYY), an anorexigenic gut hormone, was markedly elevated and displayed an augmented response to feeding. 3) Acylated ghrelin, an orexigenic gut hormone, was lower and did not exhibit the premeal spike as observed in the controls. 4) neuropeptide Y (NPY), a potent orexigenic peptide, was markedly elevated and did not display any circadian variation. 5) Norepinephrine, marginally elevated, did not exhibit the normal nocturnal dip. By contrast, α-melanocyte-stimulating hormone and glucagon-like peptide-1 were not different between the two groups. Despite these hormonal abnormalities, HD patients maintained a good appetite and had normal body lean and fat mass, and there was no evidence of increased energy expenditure or protein catabolism. We explain the hormonal abnormalities as well as the absence of anorexia on suppression of parasympathetic activity (vagus nerve dysfunction), a phenomenon well documented in dialysis patients. Unexpectedly, we noted that the combination of high leptin, PYY, and NPY with suppressed ghrelin may increase arterial blood pressure, impair vasodilatation, and induce cardiac hypertrophy, and thus could predispose to adverse cardiovascular events that are the major causes of morbidity and mortality in the HD population. This is the first report attempting to link hormonal abnormalities associated with energy homeostasis to adverse cardiovascular outcome in the HD patients.

Topics: Adult; Anorexia; Appetite; Body Composition; Cardiovascular Diseases; Circadian Rhythm; Endocrine System Diseases; Energy Metabolism; Fasting; Female; Ghrelin; Homeostasis; Humans; Leptin; Male; Middle Aged; Neuropeptide Y; Norepinephrine; Peptide YY; Protein-Energy Malnutrition; Renal Dialysis; Renal Insufficiency; Risk Factors

Neuropeptide Y (NPY) and its flanking peptide (CPON) were measured in extracts of pheochromocytomas (n = 26), ganglioneuroblastomas (n = 8), and other tumors (n = 95) and plasma (n = 38). NPY was present in high concentrations in the majority of the pheochromocytomas, but was absent in 3 tumors. Similar concentrations of NPY were measured using N- and C-terminal-directed antisera, and there was a good correlation between the concentrations of NPY immunoreactivity and CPON immunoreactivity in the same extracts. Gel permeation chromatography revealed that the separate peptides NPY and CPON were the major products. No significant amounts of a large mol wt precursor containing both immunoreactivities was found. Among the other tumors, 6 of 22 carcinoid tumors, 2 of 2 somatostatinomas, and 3 of 18 insulinomas contained detectable amounts of NPY. Plasma NPY concentrations were very low in normal subjects, and extraction and a 10-fold concentration step were necessary to establish the normal range (0.35-1.25 pmol/L). Plasma NPY concentrations were detectable in unextracted plasma (10 pmol/L) in 50% of patients with pheochromocytomas, but no correlation was found between plasma NPY concentrations and either plasma norepinephrine or epinephrine concentrations. These results indicate that 1) NPY and CPON are present in most, but not all, pheochromocytomas and ganglioneuroblastomas; 2) secretion of NPY immunoreactivity may be independent of that of catecholamines; 3) CPON immunoreactivity is present in plasma of patients with pheochromocytoma; 4) the majority of NPY and CPON immunoreactivities appears to be in the form of the separate free peptide, and there is very little precursor containing both immunoreactivities expressed in these tumors; and 5) NPY immunoreactivity is present in a variety of other endocrine tumors.

Topics: Chromatography, Gel; Chromatography, High Pressure Liquid; Endocrine System Diseases; Humans; Neuropeptide Y; Osmolar Concentration; Pheochromocytoma; Radioimmunoassay; Reference Values