Scandinavian Journal of Clinical and Laboratory Investigation最新文献

{"title":"High expression of CD7 on CD34+ cells is not linked to deletion of derivative chromosome 9 or lack of dendritic cells in chronic myeloid leukaemia.","authors":"Y Fløisand,&nbsp;A P Normann,&nbsp;S Heim,&nbsp;F Lund-Johansen,&nbsp;G E Tjønnfjord","doi":"10.1080/00365510701558477","DOIUrl":"https://doi.org/10.1080/00365510701558477","url":null,"abstract":"<p><strong>Objective: </strong>High expression of CD7 on CD34+ cells (>20 %) has been shown to be associated with inferior prognosis in chronic myeloid leukaemia (CML), but the reason has not been unravelled. We set out to investigate whether lack of dendritic cells or der(9)t(9;22)(q34;q11) deletions might be correlated with increased CD7 expression on CD34+ cells in CML.</p><p><strong>Material and methods: </strong>We identified 43 patients in our cohort of CML patients in the first chronic phase in whom we were able to assess the expression of CD7 on CD34+ cells. der(9)t(9;22) deletions were evaluated by FISH (fluorescent in situ hybridization) analyses and the proportions of plasmacytoid and myeloid dendritic cells were assessed by flow cytometry.</p><p><strong>Results: </strong>High and low expressions of CD7 on CD34+ cells were found in 19 and 24 patients, respectively. Two out of 20 patients examined had a der(9)t(9;22)(q34;11) deletion, one patient with high expression and one with low expression of CD7 on CD34+ cells. The proportions of plasmacytoid dendritic cells (PDCs) and myeloid dendritic cells (MDCs) were reduced in a majority of patients in our cohort, but no correlation was found between high or low expression of CD7 on CD34+ cells and the proportion of dendritic cells.</p><p><strong>Conclusions: </strong>A high proportion of CD34+CD7+ cells in patients with CML is not associated with der(9)t(9;22)(q34;q11) deletions. Nor did we find any correlation between CD7 expression on CD34+ cells and lack of dendritic cells. High expressions of CD7 on CD34+ cells and der(9)t(9;22)(q34;q11) deletions seem to be independent prognostic markers in CML.</p>","PeriodicalId":501634,"journal":{"name":"Scandinavian Journal of Clinical and Laboratory Investigation","volume":" ","pages":"93-8"},"PeriodicalIF":2.1,"publicationDate":"2008-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/00365510701558477","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40960546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biomarkers of alcoholism: an updated review.","authors":"S K Das,&nbsp;L Dhanya,&nbsp;D M Vasudevan","doi":"10.1080/00365510701532662","DOIUrl":"https://doi.org/10.1080/00365510701532662","url":null,"abstract":"<p><p>Alcoholic beverages, and the problems they engender, have been familiar in human societies since the beginning of recorded history. Among a variety of blood tests used to aid the diagnosis of alcohol consumption and related disorders, laboratory tests are particularly useful in settings where cooperativeness is suspected or when a history is not available. Biochemical and haematological tests, such as gamma-glutamyltransferase activity, aspartate aminotransferase activity and erythrocyte mean corpuscular volume, are established markers of alcohol intake. Carbohydrate-deficient transferrin is the only test approved by the FDA for the identification of heavy alcohol use. Total serum sialic acid and sialic acid index of Apolipoprotein J have the potential to be included in a combination of measurements providing an accurate, more exact, assessment of alcohol consumption in a variety of clinical and research settings. Several other markers with considerable potential for measuring recent alcohol intake include beta-hexosaminidase, acetaldehyde adducts and the urinary ratio of serotonin metabolites, 5-hydroxytryptophol and 5-hydroxyindoleacetic acid. These markers provide hope for more sensitive and specific aids to diagnosis and improved monitoring of alcohol intake.</p>","PeriodicalId":501634,"journal":{"name":"Scandinavian Journal of Clinical and Laboratory Investigation","volume":" ","pages":"81-92"},"PeriodicalIF":2.1,"publicationDate":"2008-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/00365510701532662","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40959664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Renal effects of urodilatin in healthy subjects are independent of blockade of the cyclooxygenase and angiotensin II receptor.","authors":"Jan Carstens,&nbsp;Erling Bjerregaard Pedersen","doi":"10.1080/00365510701504257","DOIUrl":"https://doi.org/10.1080/00365510701504257","url":null,"abstract":"<p><strong>Objective: </strong>Little is known about the role of the renin-angiotensin-aldosterone system and the renal prostaglandins in modulating the renal vasoconstrictive and natriuretic effects of synthetic urodilatin (URO) in healthy humans.</p><p><strong>Material and methods: </strong>Twelve volunteers were pretreated in a randomized, single-blind, crossover study with losartan 50 mg a day or placebo for 5 days. Another 12 healthy subjects received indomethacin 25 mg three times a day or placebo for 4 days and a single dose on day 5. All subjects received a URO infusion (15 ng kg(-1) min(-1)) on day 5. Radioactive tracers and the lithium clearance technique were used.</p><p><strong>Results: </strong>The effective renal plasma flow (ERPF) decreased significantly during URO infusion: losartan pretreatment 573+/-63 to 461+/-76 mL/min versus placebo 540+/-89 to 432+/-90 mL/min. The urinary sodium excretion rate (UNa) increased significantly during URO infusion: losartan 335+/-115 to 502+/-134 umol/min (micromol/min) (UNa) versus placebo 386+/-142 to 476+/-137 umol/min (micromol/min) (UNa). In the indomethacin pretreated subjects, ERPF decreased significantly from 530+/-109 to 446+/-55 mL/min versus 533+/-89 to 449+/-69 mL/min in the placebo group. UNa increased significantly from 395+/-142 to 768+/-254 umol/min (micromol/min) (UNa) in the indomethacin group versus 282+/-117 to 552+/-242 umol/min (micromol/min) (UNa) in placebo.</p><p><strong>Conclusion: </strong>The renal vasoconstrictive and natriuretic effects of synthetic URO are not modified by sustained inhibition of the angiotensin II receptor or the cyclooxygenase in man in a sodium replete state.</p>","PeriodicalId":501634,"journal":{"name":"Scandinavian Journal of Clinical and Laboratory Investigation","volume":" ","pages":"2-10"},"PeriodicalIF":2.1,"publicationDate":"2008-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/00365510701504257","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40959665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Butyrylcholinesterase K variants increase the risk of coronary artery disease in the population of western Iran.","authors":"A Vaisi-Raygani,&nbsp;Z Rahimi,&nbsp;H Entezami,&nbsp;H Kharrazi,&nbsp;F Bahrhemand,&nbsp;H Tavilani,&nbsp;M Rezaei,&nbsp;A Kiani,&nbsp;B Nomanpour,&nbsp;T Pourmotabbed","doi":"10.1080/00365510701576180","DOIUrl":"https://doi.org/10.1080/00365510701576180","url":null,"abstract":"<p><p>The conflicting results of several studies suggest that there is an association between the butyrylcholinesterase-K variant (BCHE-K, G1615A/Ala539Thr) and the risk of developing coronary artery disease (CAD) in diabetes and non-diabetic subjects. The objective of this study was to determine whether the presence of the BCHE-K variant exacerbates the risk of CAD in patients from western Iran with and without type 2 diabetes mellitus (T2DM). This case-control study comprised 464 subjects undergoing their first coronary angiography. They were matched and randomly assigned into four groups: CAD+T2DM+ (CAD/T2DM), CAD+DM(-) (CAD/ND), CAD(-)DM+ (T2DM/NCAD) and CAD(-)DM(-)(control). The BCHE-K variant was detected by PCR-RFLP. The BCHE-K allele frequency in CAD patients with and without T2DM [total CAD (TCAD)] and separately for each group (CAD/T2DM and CAD/ND) was significantly higher than in the control group (21.1 % versus 13.3 % (p = 0.001), 22.4 % versus 13.3 % (p = 0.001) and 19.7 % versus 13.3 % (p = 0.015), respectively). The odds ratios (ORs) for the BCHE-K heterozygous and homozygous variants in TCAD subjects were 1.65 (95 % CI 1.17-2.3; p = 0.004) and 4.3 (1.05-19.4; p = 0.048); for CAD/T2DM individuals 1.76 (1.2-2.6; p = 0.004) and 4.73 (0.96-23.3; p = 0.052); and for CAD/ND patients 1.53 (1.05-2.3; p = 0.029) and 3.88 (0.8-19.7; p = 0.7), respectively. The OR of the BCHE-K allele was found to be 1.74 (1.1-2.4; p = 0.001) in TCAD subjects, 1.87 (1.12-1.48; p = 0.001) in the CAD/T2DM group and 1.59 (1.04-1.4; p = 0.016) in CAD/ND subjects. These data suggest that the BCHE-K allele increases the risk of CAD in the population (with and without DM) in western parts of Iran, and its presence intensifies the risk of CAD in T2DM. The fact that the BCHE-K allele, even in the heterozygous form, exacerbates the risk of CAD in this population, suggests that a specific therapeutic intervention should be considered for this particular group of patients.</p>","PeriodicalId":501634,"journal":{"name":"Scandinavian Journal of Clinical and Laboratory Investigation","volume":" ","pages":"123-9"},"PeriodicalIF":2.1,"publicationDate":"2008-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/00365510701576180","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40960452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dramatic reduction of erythrocyte glucose-6-phosphate dehydrogenase activity in athletes participating in the ultradistance foot race \"Spartathlon\".","authors":"K H Schulpis,&nbsp;M Tsironi,&nbsp;K Skenderi,&nbsp;C Lazaropoulou,&nbsp;N Parthimos,&nbsp;G Reclos,&nbsp;E Goussetis,&nbsp;S Tsakiris,&nbsp;I Papassotiriou","doi":"10.1080/00365510701604610","DOIUrl":"https://doi.org/10.1080/00365510701604610","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the effect of a long-distance endurance exercise \"Spartathlon\" on erythrocyte glucose-6-phosphate dehydrogenase (G(6)PD) activity.</p><p><strong>Material and methods: </strong>The study comprised 15 male runners, median age 36.5 years. Blood samples were obtained in the 15 min before the race and again within 15 min after the end of the race. Erythrocyte glutathione (GSH and GSSG) and plasma malonyldialdehyde were measured with HPLC methods, and total antioxidant capacity (TAC), total hyperoxides and G(6)PD activity with commercial kits. Lipids, uric acid and total bilirubin were determined with a clinical chemistry analyser.</p><p><strong>Results: </strong>Total hyperoxides were found statistically reduced, whereas total bilirubin was measured elevated post-race. Interestingly, GSSG levels were found increased (167.3+/-12.0 versus 219.5+/-20.3 micromol/L; p<0.005) as well as GSSG/GSH ratio (16.0+/-1.3 versus 20.60+/-1.65; p<0.05) post-race. In contrast, G(6)PD activity was found remarkably decreased (8.72+/-3.10 versus 3.8+/-2.5 U/g Hb; p<0.0001) pre versus post the event.</p><p><strong>Conclusion: </strong>Red blood cell G(6)PD activity in athletes may be reduced post-race as a consequence of the modulation of NADP/NADPH levels and elevation of the erythrocyte GSSG, and especially GSSG/GSH ratio, resulting in an impairment of the hexose monophosphate shunt.</p>","PeriodicalId":501634,"journal":{"name":"Scandinavian Journal of Clinical and Laboratory Investigation","volume":" ","pages":"228-32"},"PeriodicalIF":2.1,"publicationDate":"2008-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/00365510701604610","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40960541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality specifications for seminal parameters based on clinicians' opinions.","authors":"J Aguilar,&nbsp;C Alvarez,&nbsp;J Morancho-Zaragoza,&nbsp;R Prats-Gimenez,&nbsp;J P Ramírez,&nbsp;E Fernández-Pardo,&nbsp;L Martínez,&nbsp;R Calafell,&nbsp;I Duran,&nbsp;J A Castilla","doi":"10.1080/00365510701496470","DOIUrl":"https://doi.org/10.1080/00365510701496470","url":null,"abstract":"<p><strong>Background: </strong>The aim of this study was to identify analytical quality specifications for seminal parameters based on clinicians' opinions, and to compare with those based on biological variability and state of the art.</p><p><strong>Material and methods: </strong>Two questionnaires with case histories were sent to laboratories participating in the Spanish programme of external quality on semen analysis for distribution to as many specialist clinicians as possible. Our intention was to determine the critical difference (CD), defined as the difference needed between two consecutive results obtained from semen analysis to be 95 % confident that the two results actually are different. Subsequently, we calculated the specifications of analytical quality in accordance with the clinicians' opinions.</p><p><strong>Results: </strong>The CDs obtained from the median value of the differences between the initial value and that given in the clinicians' replies were similar in clinical situations of improvement or worsening in the infertile normozoospermic male, and also in worsening situations for male patients presenting a significant alteration in seminal parameters. For improvement in this latter case, the CD cited as necessary in the clinicians' opinion was much higher than that for the other clinical situations. At a desirable level of quality, for concentration and total motility the coefficients of variation in the clinicians' opinion were below those based on biological variability and the state of the art. However, for type \"a+b\" motility, type \"a\" motility, morphology and vitality the coefficients of variation based on the clinicians' opinions were higher than those based on biological variability and lower than those based on the state of the art.</p><p><strong>Conclusions: </strong>Quality specifications for seminal parameters based on clinicians' opinions depend to a large extent on the clinical situation and on the seminal parameter being analysed.</p>","PeriodicalId":501634,"journal":{"name":"Scandinavian Journal of Clinical and Laboratory Investigation","volume":" ","pages":"68-76"},"PeriodicalIF":2.1,"publicationDate":"2008-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/00365510701496470","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40959662","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genotyping of the reduced folate carrier-1 c.80G>A polymorphism by pyrosequencing technology: importance of PCR and pre-PCR optimization.","authors":"T K Nilsson,&nbsp;Z M Löf-Ohlin,&nbsp;A K Böttiger","doi":"10.1080/00365510701570118","DOIUrl":"https://doi.org/10.1080/00365510701570118","url":null,"abstract":"<p><p>When developing a genotyping assay by Pyrosequencing(trade mark) technology for the RFC1 (SLC19A1) c.80G>A polymorphism (rs1051266), unequal peak heights in the pyrograms were observed, probably due to unequal amplification of the mutated and wild-type alleles. This rarely occurring problem could potentially render assignment of heterozygous genotypes uncertain. When the PCR conditions were studied, it was found that substitution of the dGTP nucleotide in the master mix by dGTP and dITP in proportion 1:1 largely overcame this problem. Heat denaturation of the DNA at 95 degrees C before PCR also counteracted the problem. A combination of these two modifications of the standard pyrosequencing PCR protocol gave the best results. We conclude that, with these modifications, the RFC1 c.80G>A SNP can be reliably assayed by pyrosequencing.</p>","PeriodicalId":501634,"journal":{"name":"Scandinavian Journal of Clinical and Laboratory Investigation","volume":" ","pages":"166-70"},"PeriodicalIF":2.1,"publicationDate":"2008-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/00365510701570118","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40960447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post-ischaemic restituted intestinal mucosa is more resistant to further ischaemia than normal mucosa in the pig.","authors":"Ingebjørg S Juel,&nbsp;Erik Solligård,&nbsp;Kåre E Tvedt,&nbsp;Eirik Skogvoll,&nbsp;Per Jynge,&nbsp;Vidar Beisvag,&nbsp;Sten Even Erlandsen,&nbsp;Arne K Sandvik,&nbsp;Petter Aadahl,&nbsp;Jon Erik Grønbech","doi":"10.1080/00365510701534833","DOIUrl":"https://doi.org/10.1080/00365510701534833","url":null,"abstract":"<p><strong>Objective: </strong>Ischaemic preconditioning may protect the intestine from subsequent prolonged ischaemia. This study evaluates whether a much longer initial ischaemia, encountered clinically, may modify intestinal resistance to further ischaemia in a pig model.</p><p><strong>Material and methods: </strong>After cross-clamping of the superior mesenteric artery for 1 h, the intestine was either reperfused for 8 h or a second cross-clamping for 1 h was performed at 4 h of reperfusion. Based on microarray analysis of intestinal samples at 1, 4 and 8 h of reperfusion, mRNA of selected genes was measured with QRT-PCR.</p><p><strong>Results: </strong>The first ischaemic period caused exfoliation of surface epithelial cells from the basement membrane comprising about 90 % of the villi tips, a marked increase in permeability and depletion of ATP. The second ischaemic challenge caused about 30 % less denudation of the basement membrane (p = 0.008), no increase in permeability (p = 0.008) and less depletion of ATP (p = 0.039). mRNAs for superoxide dismutase 2, heat shock proteins and signal transducer and activator of transcription 3, which may protect against ischaemia/reperfusion injury, were up-regulated throughout the reperfusion period. mRNAs for matrix metalloproteinase 1, connexin 43 and peripheral myelin 22, which may be associated with cell migration or tight junctions, showed a particular up-regulation at 4 h of reperfusion.</p><p><strong>Conclusion: </strong>One hour of initial ischaemia followed by 4 h of reperfusion is associated with increased intestinal resistance to further ischaemia. The differential regulation of genes identified in this study provides working hypotheses for mechanisms behind this observation.</p>","PeriodicalId":501634,"journal":{"name":"Scandinavian Journal of Clinical and Laboratory Investigation","volume":" ","pages":"106-16"},"PeriodicalIF":2.1,"publicationDate":"2008-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/00365510701534833","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40960449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association of HDL cholesterol concentration with the -629C>A CETP promoter polymorphism is not fully explained by its relationship with plasma cholesteryl ester transfer.","authors":"R P F Dullaart,&nbsp;S E Borggreve,&nbsp;H L Hillege,&nbsp;G M Dallinga-Thie","doi":"10.1080/00365510701519719","DOIUrl":"https://doi.org/10.1080/00365510701519719","url":null,"abstract":"<p><strong>Objective: </strong>HDL cholesterol is associated with the -629C>A cholesteryl ester transfer protein (CETP) promoter polymorphism. This relationship may in part be explained via effects on plasma cholesteryl ester transfer (CET), which reflects the activity of CETP in the context of endogenous lipoproteins, but also via CET independent pathways involved in HDL metabolism. In this study, we determined the contributions of the CETP -629 C>A genotype, plasma CETP mass and cholesteryl ester transfer to HDL cholesterol.</p><p><strong>Material and methods: </strong>The -629 C>A CETP gene promoter polymorphism, plasma CETP mass, CET, HDL cholesterol, lipids and apolipoprotein (apo) A-I were measured in 220 non-diabetic men without cardiovascular disease.</p><p><strong>Results: </strong>Plasma CETP mass (p<0.001) and CET (p<0.001) were higher, whereas HDL cholesterol (p<0.05) and plasma apo A-I levels (p<0.05) were lower in CC compared to AA carriers. Univariate regression analysis showed that plasma CET was related to the CETP genotype (p = 0.004), plasma CETP mass (p<0.001) and triglycerides (p<0.001). In a multiple linear regression model, HDL cholesterol was related to CETP genotype (p = 0.04) and plasma triglycerides (p<0.001) without independent contributions of plasma CETP mass and CET (p>0.20 for both).</p><p><strong>Conclusions: </strong>This study suggests that, despite a relationship between a common CETP gene variation and plasma cholesteryl ester transfer, the association between CETP gene and HDL cholesterol appears to be at least in part unexplained by the plasma cholesteryl ester transfer process.</p>","PeriodicalId":501634,"journal":{"name":"Scandinavian Journal of Clinical and Laboratory Investigation","volume":" ","pages":"99-105"},"PeriodicalIF":2.1,"publicationDate":"2008-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/00365510701519719","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40960601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The osmotic link between hypoglycaemia and hypovolaemia.","authors":"F Sjöstrand,&nbsp;D Berndtson,&nbsp;J Olsson,&nbsp;P Strandberg,&nbsp;R G Hahn","doi":"10.1080/00365510701541036","DOIUrl":"https://doi.org/10.1080/00365510701541036","url":null,"abstract":"<p><strong>Objective: </strong>Hypoglycaemia is regularly accompanied by hypovolaemia. To suggest a mechanism for this phenomenon, we reviewed data from eight studies conducted by our group and examined the circumstances under which rebound hypoglycaemia develops after intravenous infusion of glucose solutions.</p><p><strong>Material and methods: </strong>Forty healthy volunteers and 40 patients received a total of 122 infusions of glucose solutions at different rates, volumes and concentrations. Plasma glucose and the haemodilution were measured repeatedly during and for at least 2 h after the infusions ended. Glucose kinetics was calculated using a one-compartment turnover model and the plasma volume expansion was estimated from changes in Hb.</p><p><strong>Results: </strong>A strong linear correlation was found between the glucose level and the plasma volume expansion in all series of experiments (p<0.001). After infusion, there was a risk of hypoglycaemia and hypovolaemia developing in healthy volunteers with a high glucose clearance and when infusing glucose solutions of higher concentrations than 2.5 %. Few and mild hypoglycaemic events occurred in patients with insulin resistance, such as in diabetics and in those undergoing surgery. The immediate linear relationship between hypoglycaemia and hypovolaemia suggests an osmotic link between the two parameters. More specifically, infused fluid accompanies glucose during uptake into the cells, while volume expansion by the same fluid has already elicited an effective diuretic response.</p><p><strong>Conclusion: </strong>Hypovolaemia is a consequence of hypoglycaemia after intravenous infusion of glucose solution and is caused by the osmotic translocation of fluid from the extracellular to the intracellular fluid space that occurs despite effective renal elimination.</p>","PeriodicalId":501634,"journal":{"name":"Scandinavian Journal of Clinical and Laboratory Investigation","volume":" ","pages":"117-22"},"PeriodicalIF":2.1,"publicationDate":"2008-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/00365510701541036","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40960803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}