Abstract
Objective: There is an increasing evidence that glucagon and growth hormone (GH)-insulin-like growth factor (IGF) axis may play an important role in glucose metabolism since early stages of glucose intolerance. Carotid intima media thickness is a marker for subclinical atherosclerosis. We aimed to evaluate glucagon, GH and IGF-1 in prediabetic states and their relationship with carotid intima media thickness. Methods: One hundred subjects underwent a 75 gr oral glucose tolerance test and were divided into 4 groups according to their state of glucose tolerance: (i) normal glucose tolerance (NGT)/Controls (n=21), (ii) impaired glucose tolerance (IGT) (n=35), (iii) impaired fasting glucose (IFG) (n=22), (iv) type 2 diabetes mellitus (n=22). Insulin, glucagon and GH were measured at 0, 60 and 120. minutes of OGTT and their area under the curve (AUC) were calculated. Fasting IGF-1 levels and carotid intima media thickness were determined in all participants. Results: AUC for Glucagon was significantly higher in subjects with IGT, IFG and type 2 diabetes mellitus compared to NGT subjects. AUC for GH was significantly higher in subjects with IFG compared to subjects with IGT, type 2 diabetes mellitus and NGT. Plasma IGF-1 levels were significantly lower in subjects with abnormal glucose tolerance. CIMT was significantly higher in IFG group and CIMT was found to be negatively correlated with IGF-1 levels in subjects with IFG. Conclusion: There are pathological alterations of glucagon, GH-IGF-1 and insulin in prediabetic stages. Among these alterations insulin resistance and IGF-1 are associated with CIMT. Further studies needed to investigate the role of treatments targeting insulin sensitivity will have an impact on the association between insulin and early atherogenesis
Highlights
Hereditary spastic paraplegia (HSP) is a clinically and genetically heterogeneous neurodegenerative disorders
Herditary spastic paraplegia with thin corpus callosum (HSP-TCC) (MIM 604360) is the most common type of complicated HSP characterized by slowly progressive spastic paraparesis and cognitive decline (2)
Remarkable thinning corpus callosum is detectable in brain magnetic resonance imaging (MRI)
Summary
Hereditary spastic paraplegia (HSP) is a clinically and genetically heterogeneous neurodegenerative disorders. Remarkable thinning corpus callosum is detectable in brain magnetic resonance imaging (MRI) We report a 16 years old male patient presented with weakness and paraplegia of lower limbs and mental retardation and had SPG11 mutation. A sixteen year old boy born to a second degree consanguineous marriage was admitted to our clinic because of progressive bilateral weakness in lower extremities and cognitive impairment. He had near normal motor and mental development until the age of 11, afterwards he had progressive cognitive impairment, learning and walking difficuties which led him to walking with aid. For spasticity of lower extremities baclofen treatment has been started and an exercise programme planned by a physiotherapist
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