Carbohydrate metabolism in subacute thyroiditis: effect of acute elevation of thyroid hormones

Carbohydrate metabolism was studied in nine patients with subacute thyroiditis before treatment and after recovery. The mean fasting free fatty acid level before treatment was significantly higher than that after the recovery, although the mean fasting blood glucose and insulin levels were not significantly different. Seven out of nine patients showed glucose intolerances. They returned to normal after the recovery except two cases with family histories of diabetes mellitus, whose glucose intolerances remained even 6 months after the recovery. Glucose area during oral glucose tolerance test was significantly correlated with the elevated thyroxine (r = 0.8, p less than 0.01), and triidothyronine (r = 0.66, p less than 0.05). The results indicated the importance of follow-up study of glucose tolerance in subacute thyroiditis as well as similarity of carbohydrate metabolism abnormalities in hyperthyroidism.

Carbohydrate metabolism in Down's syndrome

Carbohydrate metabolism was studied in eight patients with Down's syndrome, aged 8 to 18 years. Diabetic glucose tolerance was observed in only one patient with obesity. This impaired glucose tolerance was improved with the weight reduction due to diet restriction. The flat glucose tolerance curves with low peak values were also observed in the other two patients. In the remaining five patients, normal glucose tolerance was obtained. Insulin response and free fatty acid levels during oral glucose load were not characteristic except for the diabetic patient with obesity. The sera of Down's syndrome showed normal binding capacity for insulin. These results suggest that obesity might partly participate in the impaired glucose tolerance in Down's syndrome.

Human lymphocyte antigen, HL-A27, in Japanese patients with ankylosing spondylitis

A high association of HL-A27 specificity with ankylosing spondylitis was found in Japanese patients in spite of a very low frequency of this specificity in a normal Japanese population. These findings coincide well with those in Caucasian patients, and indicate the strong relationship between the susceptibility to ankylosing spondylitis and HL-A27 specificity beyond racial differences. No particular HL-A patterns were noted in patients with the ossification of the posterior longitudinal ligament of the cervical vertebrae. This observation provides an evidence that this disease is etiologically different from ankylosing spondylitis.

Glucose tolerance and insulin secretion in patients with parathyroid disorders. Effect of serum calcium on insulin release

To evaluate the role of serum calcium in human insulin secretion, insulin responses after a 100-g oral glucose load were studied in nine patients with primary hyperparathyroidism, five with idiopathic hypoparathyroidism, three with pseudohypoparathyroidism and one with normocalcemic secondary hyperparathyroidism. Glucose tolerance values in these disorders were almost normal. Insulin responses in primary hyperparathyroidism were increased, and those in idiopathic hypoparathyroidism and pseudohypoparathyroidism were reduced significantly as compared to normal subjects. Isulin response in secondary hyperparathyroidism was normal. The calculated insulin area during an oral glucose load was significantly correlated with serum calcium (5.1 to 12.2 mg per deciliter), and a linear relation was obtained (y = 1.59x - 3.3, r = 0.81, p less than 0.001), although a relation with the glucose area was not found. These observations indicate that serum calcium has an important effect on insulin secretion in parathyroid disorders.