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Weicht J, Mai K, Arafat AM, Bobbert T, Ruhla S, Weickert MO, Spranger J, Pfeiffer AFH, Möhlig M. Akute Effekte auf die Subendokardiale Viability Ratio während Lipid-induzierter Insulinresistenz. DIABETOL STOFFWECHS 2009. [DOI: 10.1055/s-0029-1222069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Arafat AM, Möhlig M, Weickert MO, Perschel FH, Purschwitz J, Spranger J, Strasburger CJ, Schöfl C, Pfeiffer AFH. A comparison between three automated chemiluminescence assays for growth hormone: on the use of recombinant hGH as a primary calibrant. Exp Clin Endocrinol Diabetes 2008. [DOI: 10.1055/s-0028-1096361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Mai K, Bobbert T, Reinecke F, Andres J, Maser-Gluth C, Wudy SA, Möhlig M, Weickert MO, Hartmann MF, Schulte HM, Diederich S, Pfeiffer AFH, Spranger J. Intravenous lipid and heparin infusion-induced elevation in free fatty acids and triglycerides modifies circulating androgen levels in women: a randomized, controlled trial. J Clin Endocrinol Metab 2008; 93:3900-6. [PMID: 18664538 DOI: 10.1210/jc.2008-0714] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND The polycystic ovarian syndrome (PCOS) is characterized by hyperandrogenism and associated with obesity and impaired glucose metabolism. Despite the high prevalence of PCOS and the considerable clinical impact, the precise interplay between metabolism and hyperandrogenemia is not entirely clear. OBJECTIVE The objective of the study was to analyze the effects of iv lipid and heparin infusion on circulating androgen levels in healthy women. DESIGN This was a randomized, controlled, crossover trial. SETTING The study was conducted at an endocrinology center. PATIENTS Patients included 12 healthy young women during the early follicular phase of two subsequent cycles. INTERVENTION After an overnight fast, a 20% lipid/heparin or a saline/heparin infusion was administered in random order for 330 min. MAIN OUTCOME MEASURES A detailed characterization of androgen metabolism was performed. RESULTS Elevations in free fatty acids and triglycerides, induced by lipid/heparin infusion, elevates the levels of androstenedione, dehydroepiandrosterone (DHEA), dehydroepiandrosterone sulfate (DHEAS), testosterone, 5alpha-dihydrotestosterone, estrone, and 17beta-estradiol. Urinary excretion of DHEA, DHEAS, 5-androstene-3beta,17beta-diol, and the sum of urinary excreted DHEA and its 16-hydroxylated downstream metabolites, 16alpha-hydroxy-DHEA and 5-androstene-3beta,16alpha,17beta-triol, were reduced. CONCLUSION The mechanism of iv lipid and heparin infusion-induced elevation of circulating androgens described here might contribute to the development of hyperandrogenism in women with PCOS and suggests that lowering of hyperlipidemia might be a potential therapeutic target in patients with PCOS to treat hyperandrogenemia.
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Arafat AM, Adamidou A, Otto B, Weickert MO, Perschel FH, Spranger J, Schöfl C, Möhlig M, Pfeiffer AFH. Glucagon suppression of total but not of acylated ghrelin is preserved in obesity; the impact on appetite control. Exp Clin Endocrinol Diabetes 2008. [DOI: 10.1055/s-0028-1096335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Weickert MO, Möhlig M, Spranger J, Schöfl C, Loeffelholz CV, Riepl RL, Otto B, Pfeiffer AFH. Effects of euglycemic hyperinsulinemia and lipid infusion on circulating cholecystokinin. J Clin Endocrinol Metab 2008; 93:2328-33. [PMID: 18364380 DOI: 10.1210/jc.2007-2787] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
AIMS Functions of the gut hormone cholecystokinin (CCK) include an important role in the regulation of gastric emptying, postprandial glucose homeostasis, and postmeal satiety. Postprandial CCK responses are significantly blunted in type 2 diabetic patients by unknown mechanisms. We hypothesized that hyperinsulinemia and lipid infusion influence circulating levels of biologically active CCK. METHODS Eleven healthy subjects were studied in a cross-over design after 10-h overnight fasts, using euglycemic-hyperinsulinemic clamps for 443 min, with an additional infusion of lipid-heparin (1.25 ml.min(-1)) or saline (1.25 ml.min(-1)) for the last 300 min after constant plasma glucose levels were achieved. RESULTS Euglycemic-hyperinsulinemia resulted in a sustained, up to 5-fold increase of plasma CCK (P < 0.001). When adding lipid infusion instead of saline, CCK concentrations rapidly declined and returned to baseline levels (CCK(300 min) 1.1 +/- 0.2 vs. 3.3 +/- 0.3 pmol/liter, P < 0.001). Partial intraclass correlation showed an independent correlation of plasma CCK with free fatty acids (r(ic) = -0.377, P < 0.001) but not with serum insulin (r(ic) = 0.077, P = 0.32). Whole-body insulin sensitivity decreased in lipid-exposed subjects (M value 7.1 +/- 0.7 vs. 5.6 +/- 0.9 mg.kg.min(-1), P = 0.017) but was not independently correlated with CCK (r(ic) = 0.040, P = 0.61). CONCLUSIONS We report novel findings showing that circulating CCK markedly increased in the euglycemic-hyperinsulinemic state, possibly as a result of near-complete suppression of circulating free fatty acids. Moreover, raising blood lipids even moderately by lipid infusion rapidly and significantly interfered with this effect, suggesting that a negative feedback mechanism of blood lipids on circulating CCK might exist.
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Spranger J. Zellen, Feten, Menschenwürde. Monatsschr Kinderheilkd 2008. [DOI: 10.1007/s00112-008-1751-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Greinacher I, Weitzel D, Spranger J. Die Bedeutung von Stigmata für die Erkennung von Fehlbildungen der Nieren und Harnwege. Aktuelle Urol 2008. [DOI: 10.1055/s-2008-1062905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Weickert MO, Loeffelholz CV, Arafat AM, Schöfl C, Otto B, Spranger J, Möhlig M, Pfeiffer AF. Euglycemic hyperinsulinemia differentially modulates circulating total and acylated-ghrelin in humans. J Endocrinol Invest 2008; 31:119-24. [PMID: 18362502 DOI: 10.1007/bf03345577] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Ghrelin is a powerful orexigenic gut hormone. Circulating concentrations of total ghrelin are downregulated by food intake in both acute and chronic hyperinsulinemic states. However, in blood des-acylated (des-acyl) ghrelin is the predominant form that has no orexigenic effects in humans. Circulating acyl-ghrelin has been shown to be suppressed post-prandially and by pharmacological hyperinsulinemia. However, up to now responses of circulating acyl-ghrelin to moderate hyperinsulinemic and hyperinsulinemic-hyperlipidemic clamp conditions have not been reported. Fourteen healthy subjects were investigated using two-stepped euglycemic-hyperinsulinemic clamps (40 mU insulin/ m2/min; mean 148+/-7 min till steady state, followed by 300 min lipid/heparin infusion). Responses of total ghrelin and acyl-ghrelin were measured at timed intervals throughout the clamps. Des-acyl-ghrelin concentrations were calculated by subtraction. Total ghrelin significantly decreased vs baseline concentrations (819+/-92 vs 564+/-58 pg/ml, p<0.001), thereby confirming previous observations. Des-acyl ghrelin closely followed total ghrelin concentrations and significantly decreased vs baseline (772+/-92 vs 517+/-56 pg/ml, p<0.001). In contrast, neither euglycemichyperinsulinemia nor euglycemic-hyperinsulinemic- hyperlipidemia suppressed acyl-ghrelin below baseline concentrations throughout the clamps (46+/-3 vs 47+/-8 pg/ml, p=0.90). In conclusion, moderate hyperinsulinemic and hyperinsulinemic- hyperlipidemic clamp conditions differentially modulated circulating total ghrelin and acylghrelin in humans. Factors other than changes in insulin and lipid concentrations are likely to contribute to the previously reported post-prandial reduction of circulating acyl-ghrelin.
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Göhring I, Catchpole G, Eckardt Ä, Fischer A, Pfeiffer AFH, Willmitzer L, Spranger J. Beteiligung des Pentosephosphatweges an der Hyperglykämie-induzierten Verminderung der Insulingenexpression? DIABETOL STOFFWECHS 2008. [DOI: 10.1055/s-2008-1076416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Andres J, Mai K, Pfeiffer AFH, Spranger J. Gesättigte Fettsäuren steigern die Promotoraktivität und mRNA-Expression der11beta-Hxdroxysteroid Dehydrogenase Typ 1. DIABETOL STOFFWECHS 2008. [DOI: 10.1055/s-2008-1076339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Fischer A, Weickert MO, Osterhoff M, Möhlig M, Pfeiffer AFH, Boeing H, Spranger J. Der Effekt des rs10882278 Polymorphismus des RBP4-Gens auf anthropometrische Parameter, Indizes des Glucosestoffwechsels und kardiovaskuläre Endpunkte in zwei unabhängigen Kohorten. DIABETOL STOFFWECHS 2008. [DOI: 10.1055/s-2008-1076329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Huth C, Illig T, Herder C, Gieger C, Grallert H, Vollmert C, Rathmann W, Martin S, Hamid YH, Pedersen O, Hansen T, Thorand B, Meisinger C, Döring A, Klopp N, Gohlke H, Langer B, Lieb W, Hengstenberg C, Lyssenko V, Groop L, Irland H, Stephens JW, Wernstedt I, Niklason A, Jansson JO, Boeing H, Möhlig M, Spranger J, Pfeiffer AFH, Stringham HM, Boehnke M, Tuomilehto J, Fernandez-Real JM, Lopez-Bermejo A, Gallart L, Vendrell J, Tsiavou A, Hatziagelaki E, Hanson RL, Wolford JK, Humphries SE, Kronenberg F, Wichmann HE, Heid IM. Assoziation zwischen IL6–174G>C und Diabetes mellitus Typ 2 sowie quantitativen Nüchternglucosespiegeln – Eine Individualdatenanalyse 21 internationaler Studien. DIABETOL STOFFWECHS 2008. [DOI: 10.1055/s-2008-1076379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Mai K, Andres J, Bobbert T, Pfeiffer AFH, Spranger J. Rosiglitazon vermindert die 11β-HSD1 Expression in humanem Sklettmuskel. DIABETOL STOFFWECHS 2008. [DOI: 10.1055/s-2008-1076337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Ruhla S, Spranger J, Weickert MO, Arafat AM, Schöfl C, Pfeiffer AFH, Möhlig M. Schilddrüsenhormonlage und Insulinempfindlichkeit: Höherer T3/rT3-Quotient bei Insulinresistenz. DIABETOL STOFFWECHS 2008. [DOI: 10.1055/s-2008-1076448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Rudovich N, Pivovarova O, Fisher E, Osterhof M, Moehlig M, Spranger J, Slominsky P, Boeing H, Schulze M, Pfeiffer AFH. The genetic variation in the IDE (insulin degrading enzyme) gene is associated with impaired insulin metabolism and increased risk of type 2 diabetes. DIABETOL STOFFWECHS 2008. [DOI: 10.1055/s-2008-1076445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Raila J, Henze A, Spranger J, Möhlig M, Pfeiffer AFH, Schweigert FJ. Microalbuminuria is a major determinant of elevated plasma retinol-binding protein 4 in type 2 diabetic patients. Kidney Int 2007; 72:505-11. [PMID: 17568782 DOI: 10.1038/sj.ki.5002372] [Citation(s) in RCA: 74] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Plasma retinol-binding protein 4 (RBP4) may be a new adipokine linked to obesity-induced insulin resistance and type 2 diabetes. The impact of diabetic nephropathy on plasma RBP4 levels, however, is not known. We tested the hypothesis that microalbuminuria is associated with elevated plasma concentrations of RBP4 in type 2 diabetic subjects. Retinol, its binding protein and transthyretin (TTR) were measured in the plasma and urine of 62 type 2 diabetic subjects, 26 of whom had microalbuminuria. The results were compared to 35 healthy control subjects. Despite no differences in plasma retinol, concentrations of the RBP4 were significantly elevated in plasma of diabetic patients and significantly higher in those with microalbuminuria. The higher plasma levels of the binding protein in subjects with microalbuminuria were accompanied by both significantly elevated plasma TTR and increased urinary levels of RBP4. There were no correlations of plasma-binding protein levels and parameters of insulin resistance. Our study suggests that plasma RBP4 levels in type 2 diabetic patients are affected by incipient nephropathy. Therefore, further studies evaluating RBP4 as a regulator of systemic insulin resistance and type 2 diabetes will need to take renal function into consideration.
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Beulens JWJ, van Loon LJC, Kok FJ, Pelsers M, Bobbert T, Spranger J, Helander A, Hendriks HFJ. The effect of moderate alcohol consumption on adiponectin oligomers and muscle oxidative capacity: a human intervention study. Diabetologia 2007; 50:1388-92. [PMID: 17492425 PMCID: PMC1914282 DOI: 10.1007/s00125-007-0699-8] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2007] [Accepted: 04/02/2007] [Indexed: 12/30/2022]
Abstract
AIMS/HYPOTHESIS The aim of this study was to investigate whether moderate alcohol consumption increases plasma high molecular weight (HMW) adiponectin and/or muscle oxidative capacity. MATERIALS AND METHODS Eleven lean (BMI 18-25 kg/m(2)) and eight overweight (BMI >or=27 kg/m(2)) men consumed 100 ml whisky ( approximately 32 g alcohol) or water daily for 4 weeks in a randomised, controlled, crossover trial. After each treatment period, muscle biopsies and fasting blood samples were collected. RESULTS Adiponectin concentrations increased (p < 0.001) by 12.5% after 4 weeks of moderate alcohol consumption. Moderate alcohol consumption tended to increase HMW adiponectin by 57% (p = 0.07) and medium molecular weight adiponectin by 12.5% (p = 0.07), but not low molecular weight (LMW) adiponectin. Skeletal muscle citrate synthase, cytochrome c oxidase and beta-3-hydroxyacyl coenzyme A dehydrogenase (beta-HAD) activity were not changed after moderate alcohol consumption, but an interaction between alcohol consumption and BMI was observed for cytochrome c oxidase (p = 0.072) and citrate synthase (p = 0.102) activity. Among lean men, moderate alcohol consumption tended to increase cytochrome c oxidase (p = 0.08) and citrate synthase activity (p = 0.12) by 23 and 26%, respectively, but not among overweight men. In particular, plasma HMW adiponectin correlated positively with activities of skeletal muscle citrate synthase (r = 0.64, p = 0.009), cytochrome c oxidase (p = 0.59, p = 0.009) and beta-HAD (r = 0.46, p = 0.056), while such correlation was not present for LMW adiponectin. Whole-body insulin sensitivity and intramyocellular triacylglycerol content were not affected by moderate alcohol consumption. CONCLUSIONS/INTERPRETATION Moderate alcohol consumption increases adiponectin concentrations, and in particular HMW adiponectin. Concentrations of HMW adiponectin in particular were positively associated with skeletal muscle oxidative capacity.
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Otto C, Otto B, Frost RJA, Vogeser M, Pfeiffer AFH, Spranger J, Parhofer KG. Short-term therapy with atorvastatin or fenofibrate does not affect plasma ghrelin, resistin or adiponectin levels in type 2 diabetic patients with mixed hyperlipoproteinaemia. Acta Diabetol 2007; 44:65-8. [PMID: 17530469 DOI: 10.1007/s00592-007-0244-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2006] [Accepted: 02/23/2007] [Indexed: 01/27/2023]
Abstract
Lipid-lowering therapy is associated with reduced cardiovascular risk. The aim of the present study was to investigate whether lipid-lowering therapy might be associated with changes in the concentrations of metabolically important hormone concentrations. We performed a randomised cross-over open-label trial with atorvastatin (10 mg/day) and fenofibrate (200 mg/day), each for 6 weeks separated by a 6-week washout period in 13 patients (5 men, 8 women, age 60.0+/-6.8 years, body mass index 30.0+/-3.0 kg/m2) with type 2 diabetes mellitus and mixed hyperlipoproteinaemia. Plasma ghrelin (RIA, Phoenix Pharmaceuticals, Mountain View, CA, USA), adiponectin (ELISA, Biovendor, Heidelberg, Germany) as well as resistin (ELISA, Linco Research, St. Charles, MO, USA) concentrations were measured before and after atorvastatin as well as before and after fenofibrate. Ghrelin (462+/-84 pg/ml before vs. 464+/-102 pg/ml after atorvastatin, n.s.; 454+/-85 pg/ml before vs. 529+/-266 pg/ml after fenofibrate, n.s.), resistin (24.4+/-7.4 pg/ml before vs. 23.7+/-9.1 pg/ml after atorvastatin, n.s.; 23.4+/-8.2 pg/ml before vs. 19.9+/-5.5 pg/ml after fenofibrate, n.s.), adiponectin (10.89+/-5.33 pg/ml before vs. 12.41+/-5.75 pg/ml after atorvastatin, n.s.; 12.58+/-9.87 pg/ml before vs. 10.27+/-5.23 pg/ml after fenofibrate, n.s.) and insulin levels did not change significantly during lipid-lowering therapy. In patients with type 2 diabetes and mixed hyperlipoproteinaemia, short-term atorvastatin as well as fenofibrate therapy had no significant effects on adiponectin, ghrelin or resistin levels.
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Arafat AM, Frystyk J, Weickert MO, Spranger J, Schöfl C, Möhlig M, Pfeiffer AFH. Insulin decreases IGF-I bioactivity in patients with impaired glucose tolerance and in healthy subjects. Exp Clin Endocrinol Diabetes 2007. [DOI: 10.1055/s-2007-972399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Fischer A, Möhlig M, Osterhoff M, Weickert MO, Pfeifer AFH, Spranger J. The KCNJ11 E23K polymorphism is associated with impaired glucose metabolism and affects the disposition index. Exp Clin Endocrinol Diabetes 2007. [DOI: 10.1055/s-2007-972436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Möhlig M, Weickert MO, Arafat AM, Spranger J, Pfeiffer AFH, Schöfl C. Case report: Bilateral adrenal macronodular hyperplasia. Exp Clin Endocrinol Diabetes 2007. [DOI: 10.1055/s-2007-972239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Weickert MO, Löffelholz CV, Roden M, Chandramouli V, Brehm A, Nowotny P, Osterhoff MA, Isken F, Spranger J, Landau BR, Pfeiffer AFH, Möhlig M. A common Thr94Ala replacement in liver-fatty-acid-binding-protein contributes to improved glucose metabolism upon lipid challenge. Exp Clin Endocrinol Diabetes 2007. [DOI: 10.1055/s-2007-972374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Möhlig M, Spranger J, Weickert MO, Arafat AM, Pfeiffer AFH, Schöfl C. The impact of testosterone and the androgen receptor (AR) CAG length polymorphism on insulin resistance in men. Exp Clin Endocrinol Diabetes 2007. [DOI: 10.1055/s-2007-972381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Andres J, Mai K, Bumke-Vogt C, Bähr V, Pfeiffer AFH, Spranger J. Fatty acids regulate the promoter activity of the 11beta-hydroxysteroid dehydrogenase type 1. Exp Clin Endocrinol Diabetes 2007. [DOI: 10.1055/s-2007-972376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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