Changes In Basal Metabolism Research Articles

Algorithm for personalization of diet therapy in patients with atrial fibrillation and obesity based on metabolic status assessment

Aim: To develop an algorithm for personalizing the diet therapy of patients with obesity and atrial fibrillation (AF) based on the assessment of the metabolic status.Material and Methods. The study included 100 patients with grade III obesity and paroxysmal AF. All subjects had nonvalvular AF. Anthropometric parameters, actual nutrition, bioimedance analysis of body composition, basal metabolic rate (BMR) were assessed.Results. Changes in basal metabolism by gender were identified. In women – a decrease in the rate of carboydrate oxidation (CHO) (by 27 ± 12.2%, p < 0.05), an increase in fat oxidation (by 48,58 ± 14.6%, p < 0.01). In men – a decrease in BMR (by 26,23 ± 13.6%, p < 0.05), CHO (by 57,18 ± 18.1%, p < 0.01) and protein (by 28,06 ± 12.9%, p < 0.05), increased rate of fat oxidation (by 31,42 ± 10.0%, p <0.05). A hyperphagic pattern of actual nutrition has been established: excess daily energy intensity (by 16–44%), excess of daily intake of proteins (by 34–54%), fats (by 17% in women) and carbohydrates (by 57–72%, p < 0.05). An excessive amount of saturated fat, cholesterol, and added sugar was revealed in the diet. A deficiency in vitamin D intake was found (by 8–16%, p < 0.05). The maximum daily energy requirement for 95% of women is within 2250 kcal/day, for men – 2950 kcal/day.Conclusion. Metabolic status disorders serve as factors of hemodynamic overload, humoral and electrical dysfunction of the heart. Diet therapy is a powerful component in the treatment and prevention of AF. It is advisable to carry out an algorithm for individual correction of the chemical composition and energy value of diet therapy taking into account the optimal metabolic corridor of needs, enriching the diet with vitamin D, eliminating added sugar, cholesterol, sodium, phosphorus, and sources of vitamin K.

Single-Cell Transcriptomics Identifies Pituitary Gland Changes in Diet-Induced Obesity in Male Mice.

Obesity is a chronic disease with increasing prevalence worldwide. Obesity leads to an increased risk of heart disease, stroke, and diabetes, as well as endocrine alterations, reproductive disorders, changes in basal metabolism, and stress hormone production, all of which are regulated by the pituitary. In this study, we performed single-cell RNA sequencing of pituitary glands from male mice fed control and high-fat diet (HFD) to determine obesity-mediated changes in pituitary cell populations and gene expression. We determined that HFD exposure is associated with dramatic changes in somatotrope and lactotrope populations, by increasing the proportion of somatotropes and decreasing the proportion of lactotropes. Fractions of other hormone-producing cell populations remained unaffected. Gene expression changes demonstrated that in HFD, somatotropes became more metabolically active, with increased expression of genes associated with cellular respiration, and downregulation of genes and pathways associated with cholesterol biosynthesis. Despite a lack of changes in gonadotrope fraction, genes important in the regulation of gonadotropin hormone production were significantly downregulated. Corticotropes and thyrotropes were the least affected in HFD, while melanotropes exhibited reduced proportion. Lastly, we determined that changes in plasticity and gene expression were associated with changes in hormone levels. Serum prolactin was decreased corresponding to reduced lactotrope fraction, while lower luteinizing hormone and follicle-stimulating hormone in the serum corresponded to a decrease in transcription and translation. Taken together, our study highlights diet-mediated changes in pituitary gland populations and gene expression that play a role in altered hormone levels in obesity.

P.31 A multiparametric quantitative NMR study at rest and during exercise in subjects between 22 and 65 years of age: Preliminary results

The progressive decline in muscle strength and performance during ageing negatively affects the quality of life in the elderly and increases the risk of falls, disability and frailty. The age-related loss of muscle mass, strength and quality is a multifactorial process whose mechanisms are incompletely understood. Nuclear magnetic resonance (NMR) allows evaluating anatomical, structural and physiological aspects of muscle tissue non-invasively. Functional NMR also enables, for instance, to image during an exercise paradigm the tissue blood flow (BF) or energy metabolism using ³¹P MR spectroscopy (MRS). Here, we designed a protocol where multiple quantitative and complementary biomarkers were acquired in the lower leg in a single exam. Acquisitions were done at 3 T (Siemens Prisma) on 26 subjects (22 to 65 y.o., 15 women). Variables studied were muscle-specific cross-sectional area (CSA), intramuscular fat fraction (FF), muscle water T1 (T1_H2O) and T2 (T2_H2O ) values; and pH and concentrations of phosphocreatine (PCr), inorganic phosphate (Pi), phosphodiesters (PDE) and phosphomonoesters (PME) in the triceps. Dynamic simultaneous BF, T2* and 31P MRS measurements were done during a 13-min plantar flexion exercise. A linear model and ANOVA using gender and age as fixed factors were used for analysis. Preliminary results showed several statistically significant (p < 0.05) changes related to age: increased T1_H2O and FF in all the lower leg muscles (gastroc. med. & lat., soleus, tibial. ant. & post, peron.); increased PDE/ATP and PME/ATP ratios; and a modest CSA increase of the extensor and fibular muscles (unlike the quadriceps muscles). Pi/PCr at the end of exercise increased with age in male subjects. No other age-related changes were found for functional NMR variables, grip strength or triceps maximal contraction force. Our results show that age-related structural and basal metabolic changes can be observed with a multiparametric NMR approach in the muscle. The ongoing recruitment of additional subjects will allow us to confirm our findings.

Housing conditions modify seasonal changes in basal metabolism and body mass of the Siberian hamster, Phodopus sungorus

Proper housing conditions are important aspects of animal welfare. Animals housed in enriched environments show less stereotypic behaviours than animals kept in barren cages. However, different types of cage enrichment may affect the results of experimental studies and hinder comparative analyses of animal physiology and behaviour. We investigated whether access to a running wheel, availability of nesting material, and pair housing affect basal metabolic rate (BMR) of Siberian hamsters (Phodopus sungorus) under various acclimation conditions. We used 70 adult hamsters (35 males and 35 females) divided into five groups housed under different cage conditions. All individuals experienced the same acclimation procedure: first a winter (L8:D16) then a summer (L16:D8) photoperiod, at air temperatures of first 20 °C then 7 °C under both photoperiods. We found that nesting material and pair housing did not affect hamster BMR, while access to a running wheel increased BMR and body mass regardless of photoperiod and ambient temperature. Thus, we suggest that cage enrichment should be applied with caution, especially in studies on energetics or thermoregulation, particularly in seasonal animals.

Seasonally related metabolic changes and energy allocation associated with growth and reproductive phases in the liver of male goldfish (Carassius auratus)

Reproduction and growth follow a seasonal pattern in many fish species involving changes in gonadal development, growth, and metabolism. Significant metabolic energy is needed during gametogenesis in both female and male to produce hundreds of eggs and billions of sperms. Seasonal variations are controlled by the hormones of brain-pituitary-peripheral axis and are accompanied by significant metabolic changes. There is evidence that GnRH and GnIH are among the key neurohormones that regulate the reciprocal control of growth and reproduction. The objective of this study was to investigate changes in metabolic profile and energy allocation patterns at different stages of reproduction, using goldfish as a model organism and LC-MS as analytical platform for metabolic analysis. Goldfish undergoes a clear seasonal cycle of growth and reproduction. In vivo experiments were conducted at three different time point of the annual cycle: regressed gonadal phase (peak growth phase), mid gametogenesis and late gametogenesis. Emphasis is placed on changes in liver metabolic pathways to energetically sustain the physiological processes related to growth and reproduction. Moreover, we tested the hypothesis that GnRH and GnIH may play a role in the regulation of metabolism by investigating acute effects of these peptides at different stages of reproductive cycle. SignificanceThe findings in this paper provide novel information on the seasonal changes in basal metabolism during different stages of reproductive cycle, and evidence for differential allocation of energy during reciprocal control of reproduction and growth in goldfish. Chemometrics combined with pathway-driven bioinformatics elucidated a shift in the metabolic profile, indicating distinct patterns of energy allocation in the reproductive and growth seasons. Furthermore, to our knowledge this is the first study to provide evidence for a possible regulatory role of GnRH and GnIH in liver metabolism and energy allocation patterns associated with growth and reproductive processes. Together our findings present a framework for better understanding of the hormonally induced changes in metabolism to energetically sustain growth and reproduction in fish and other oviparous species undergoing seasonal cycle.

Influence of cytoskeleton organization on recombinant protein expression by CHO cells.

In this study, we assessed the importance of cytoskeleton organization in the mammalian cells used to produce therapeutic proteins. Two cytoskeletal genes, Actin alpha cardiac muscle 1 (ACTC1) and a guanosine triphosphate GTPase‐activating protein (TAGAP), were found to be upregulated in highly productive therapeutic protein‐expressing Chinese hamster ovary (CHO) cells selected by the deprivation of vitamin B5. We report here that the overexpression of the ACTC1 protein was able to improve significantly recombinant therapeutic production, as well as to decrease the levels of toxic lactate metabolic by‐products. ACTC1 overexpression was accompanied by altered as well as decreased polymerized actin, which was associated with high protein production by CHO cell cultured in suspension. We suggest that the depolymerization of actin and the possible modulation of integrin signaling, as well as changes in basal metabolism, may be driving the increase of protein secretion by CHO cells.

Energy regulation in context: Free-living female arctic ground squirrels modulate the relationship between thyroid hormones and activity among life history stages

Thyroid hormones (THs), key regulators of lipid and carbohydrate metabolism, are likely modulators of energy allocation within and among animal life history stages. Despite their role in modulating metabolism, few studies have investigated whether THs vary among life history stages in free-living animals or if they exhibit stage-specific relationships to total energy expenditure and activity levels. We measured plasma total triiodothyronine (tT3) and thyroxine (tT4) at four, discrete life history stages of female arctic ground squirrels from two different populations in northern Alaska to test whether plasma THs correlate with life history stage-specific changes in metabolic rate and energy demand. We also tested whether THs explained individual variation in aboveground activity levels within life history stages. T3 peaked during lactation and was lowest during pre-hibernation fattening, consistent with known changes in basal metabolism and core body temperature. In contrast, T4 was elevated shortly after terminating hibernation but remained low and stable across other life-history stages in the active season. THs were consistently higher in the population that spent more time above-ground but the relationship between THs and activity varied among life history stages. T3 was positively correlated with activity only during lactation (r2=0.50) whereas T4 was positively correlated with activity immediately following lactation (r2=0.48) and during fattening (r2=0.53). Our results support the hypothesis that THs are an important modulator of basal metabolism but also suggest that the relationship between THs and activity varies among life history stages.

Does near-roadway air pollution contribute to childhood obesity?

Exposure to man-made combustion products, including secondhand tobacco smoke, maternal smoking during pregnancy, and near-roadway air pollution (NRAP), have been associated with increased body mass index and obesity in children and have been shown to result in excess weight gain in animal models. Potential mechanisms include pro-inflammatory central nervous system effects of airborne particles on appetite control, resulting in increased caloric intake, or changes in basal metabolism due to effects on mitochondria and brown adipose tissue. Combustion-derived polyaromatic hydrocarbons have also been linked to altered lipid metabolism, epigenetic effects on PPARγ expression, particle-induced estrogenic effects, and alterations in the distribution of visceral fat. Emerging evidence that a broad spectrum of environmental chemicals have “obesogenic” properties and alter the metabolic profile of adipose tissue challenges the prevailing model that the childhood obesity epidemic is explained solely by increased caloric density of food and decreased physical activity. Research on environmental obesogens could identify novel targets for intervention and yield public health benefits, since NRAP and SHS exposure are both common in populations most at-risk for development of obesity.

Metabolic Profiling Reveals Differences in Concentrations of Oxylipins and Fatty Acids Secreted by the Infrapatellar Fat Pad of Donors With End‐Stage Osteoarthritis and Normal Donors

The infrapatellar fat pad (IPFP) in the knee joint is hypothesized to contribute to osteoarthritis (OA) development by the IFPF possibly by influencing inflammatory processes. Oxylipins are essential mediators in the inflammatory process. We undertook this study to investigate secretion by the IFPF of fatty acids and oxylipins derived from those fatty acids. IPFP explants from 13 OA donors undergoing joint replacement surgery and from 10 normal donors postmortem were cultured for 24 hours, and supernatants (fat-conditioned medium [FCM]) were collected. Liquid chromatography tandem mass spectrometry detected fatty acids and oxylipins in FCM samples. Univariate and multivariate (partial least-squares discriminant analysis [PLS-DA]) analyses were performed, followed by pathway analysis. To validate these outcomes, a second set of OA FCM samples was measured (n=23). Twenty-nine oxylipins and fatty acids could be detected in FCM. Univariate analysis showed no differences between normal donor and OA donor FCM; however, PLS-DA revealed an oxylipin/fatty acid profile consisting of 14 mediators associated with OA (accuracy rate 72%). The most important contributors to the model were lipoxin A4 (decreased), thromboxane B2 (increased), and arachidonic acid (increased). The statistical model predicted 64% of the second set of OA FCM samples correctly. Pathway analysis indicated differences in individual mediators rather than in complete pathways. The IPFP secretes multiple and different oxylipins, and a subset of these oxylipins provides a distinctive profile for OA donors. It is likely that the observed changes are regulated by the OA process rather than being a consequence of basal metabolism changes, as an increase in fatty acid levels was not necessarily associated with an increase in oxylipins derived from that fatty acid.

(+)-Z-Bisdehydrodoisynolic Acid Enhances Basal Metabolism and Fatty Acid Oxidation in Female Obese Zucker Rats

We have previously reported that the synthetic estrogen, (+)-Z-bisdehydrodoisynolic Acid [(+)-Z-BDDA], attenuated weight gain and cardiovascular risk in obese rodents. To determine if these antiobesity effects were attributed to changes in basal metabolism, we assessed indirect calorimetry and metabolic profile in female obese Zucker (OZR) rats provided (+)-Z-BDDA (0.0002% food admixture) for 11 weeks. Similar to our previous findings, (+)-Z-BDDA reduced weight gain and improved lipid and glucose homeostasis in OZR rats. Furthermore, resting energy expenditure was increased by (+)-Z-BDDA, as evident by heat production and oxygen consumption. We also observed a marked reduction in respiratory quotient (RQ) along with a corresponding induction of hepatic AMPK in rodents provided (+)-Z-BDDA. Collectively, these findings indicate that (+)-Z-BDDA partially attenuated obesity and associated pathologies through increased resting energy expenditure and fatty acid utilization. Further investigation is required to fully elucidate the mechanisms involved as well as to determine the potential therapeutic implications for (+)-Z-BDDA on obesity and its related pathologies.

Metabolic activity in the brain of juvenile and adult rats with a neonatal ventral hippocampal lesion

Longitudinal studies on patients for schizophrenia suggest that functional brain perturbations precede the onset of symptoms. Rats with a neonatal ventral hippocampal lesion (NVHL) are considered as a heuristic neurodevelopmental model of schizophrenia. We characterized basal metabolic changes observed in NVHL rats before and after the age when known behavioral alterations have been reported. Male pups were lesioned with ibotenic acid at postnatal day 7 (PD7). We measured local cerebral metabolic rates for glucose (LCMRglc) by the quantitative autoradiographic [(14)C]2-deoxyglucose technique at pre- (PD21) and postpubertal (PD42) ages when NVHL rats do not express abnormal dopamine related behaviors, and at adulthood (PD70). We observed a widespread increase in LCMRglcs in PD21 NVHL indicative of an ongoing intense reorganization of the brain while at PD42, increases were less extended. At PD70, changes in glucose metabolism were restricted to specific systems, such as the auditory system, the cerebellum, the serotonergic median raphe, and median septum. These data show in a heuristic animal model of schizophrenia that functional metabolic changes within the brain could precede the onset of dopamine-related behavioral alterations and lead to a distinct ensemble of functional changes in adulthood in systems that may be relevant to schizophrenia.

Effects of Isoflurane on Coronary Blood Flow Velocity in Young, Old and ApoE −/− Mice Measured by Doppler Ultrasound

The commonly used anesthetic agent isoflurane (ISO) is a potent coronary vasodilator that could potentially be used in the assessment of coronary reserve, but its effects on coronary blood flow in mice are unknown. Coronary reserve is reduced by age, coronary artery disease and other cardiac pathologies in man, and some of these conditions can now be modeled in mice. Accordingly, we used Doppler ultrasound to measure coronary flow velocity in mice anesthetized with low (1%) and high (2.5%) levels of ISO to generate baseline (B) and elevated hyperemic (H) coronary flows, respectively. A 20-MHz Doppler probe was mounted in a micromanipulator and pointed transthoracically toward the origin of the left main coronary arteries of 10 6-wk (Young [Y]), 10 2-y (Old [O]) and 20 2-y apolipoprotein-E null (ApoE −/−) atherosclerotic (A) mice. In each mouse, we measured (B) and (H) peak diastolic velocities. B was 35.4 ± 1.4 cm/s (Y), 24.8 ± 1.6 (O) and 51.7 ± 6.4 (A); H was 83.5 ± 1.3 (Y), 86.5 ± 1.9 (O) and 120 ± 16.9 (A) and H/B was 2.4 ± 0.1 (Y), 3.6 ± 0.2 (O) and 2.5 ± 0.2 (A). The differences in baseline velocities and H/B between O and Y and between A and O were significant ( p < 0.01), whereas the differences in hyperemic velocities were not ( p > 0.05). H/B was higher in old mice as a result of decreased baseline flow rather than increased hyperemic flow velocity. In contrast, ApoE −/− mice have increased baseline and hyperemic velocities, perhaps because of coronary lesions. The differences in baseline velocities between young and old mice could be the result of age-related changes in basal metabolism or to differential sensitivity to isoflurane. We conclude that Doppler ultrasound combined with coronary vasodilation via isoflurane could provide a convenient and noninvasive method to estimate coronary reserve in mice, but also that care must be taken when assessing coronary flow in mice under isoflurane anesthesia because of its potent coronary vasodilator properties. (E-mail: chartley@bcm.edu)

Leptin stimulates gonadotropin releasing hormone release from cultured intact hemihypothalami and enzymatically dispersed neurons.

Leptin is a peptide released by adipocytes that has profound effects on central regulation of body metabolism. The present study represents an investigation into leptin effects on hypothalamic control of reproductive function, specifically on GnRH release. Adult male rats (gonadectomized or sham-operated) were used as donors of hypothalamic tissue that was used as intact hemihypothalami or as enzymatically dispersed hemihypothalami in a perifusion culture system. Continuous samples were collected at 10-min intervals for 8 to 10 hr and were assayed to measure temporal changes in GnRH release in response to various doses of leptin infused into the perifusion chambers. Leptin at the highest dose (10(-8) M) resulted in consistent and significant stimulation of GnRH release. There were no effects of treatment for surgical preparation (gonadectomy versus sham) or tissue preparation (intact versus dispersed hemihypothalami). The results of this study support the hypothesis that leptin plays a direct stimulatory role in the regulation of GnRH release. This study describes an important step in our understanding of the mechanism that connects changes in basal metabolism with reproductive function. These results indicate an intact interneuronal network is unnecessary for these leptin effects, but does not exclude a role for interneuronal networks in this regulatory pathway.

Mechanisms of changes in basal metabolism during ageing.

A considerable number of physiological functions are known to show a gradual decline with increasing age. However, the effects of ageing differ widely between organ systems. It is believed that basal metabolic rate (BMR) falls dramatically with age. These observations, largely based on cross-sectional surveys, are discussed in light of our present understanding of the biology of ageing. This paper reviews both the longitudinal and cross-sectional studies of BMR and presents evidence that the fall in BMR with ageing may be less dramatic than previously perceived. Indeed, some subjects may show an increase in BMR with ageing. The mechanism of changes in BMR during ageing will be discussed. Organ weight changes appear to have a profound impact on BMR. The use of BMR to predict total energy expenditure in the 'old elderly' (>75 y) is unlikely to be of any practical use due to wide intra- and inter-individual variation in BMR. This wide intra- and inter-individual variation in BMR is due to illness, disease and other metabolic disorders seen in the elderly. Finally, the importance of measuring BMR in elderly populations for its use in clinical medicine will be discussed.

Mouse strain differences in ozone dosimetry and body temperature changes.

Strain differences in susceptibility to inhaled ozone (O3) have been observed in mice, with C57BL/6J (B6) mice reported to be more sensitive than C3H/HEJ (C3) mice when exposed to equal concentrations of O3. To determine whether differences in the delivered dose of O3 to the lung could help explain these differences, C3 and B6 mice were exposed to 18O-labeled ozone (18O3), and the resulting 18O concentrations in pulmonary tissues were monitored as an indicator of O3 delivered dose. Body core temperatures (Tco) of similarly treated mice were measured during O3 exposures (using surgically implanted temperature probes) in an effort to correlate lung O3 dose to changes in basal metabolism. Immediately after exposure to 18O3, C3 mice had 46% less 18O (per mg dry wt) in lungs and 61% less in tracheas than B6 mice. Nasal 18O tended to be lower in the C3 mice, but these differences were not significant. Although both strains responded to the O3 exposure with significant decreases in Tco, C3 mice had a 70% greater mean temperature x time product decrease during the exposure than B6 mice. These results suggest that the strain differences in O3 susceptibility may be due to differences in O3 dose to the lung, which may be related to differences in the ability of the mice to lower their Tco in response to O3 exposure.

Predicting White-Tailed Deer Habitat Use in Northern Idaho

Winter habitat use patterns of white-tailed deer (Odocoileus virginianus) have been studied extensively across their northern distribution. However, previous research has contributed little to predicting habitat use of unstudied populations. Thus, we evaluated winter habitat use of white-tailed deer in the Priest River drainage of northern Idaho and developed a predictive model of winter habitat selection. Our findings suggest that winter habitat selection is predictable given seasonal changes in basal metabolism and the effects of snow accumulation on forage availability and energy expenditure. During early (18 Nov-8 Jan) and late (3 Mar-2 Apr) winter, when basal metabolic rates were elevated and snow depths did not exceed 30 cm, white-tailed deer selected lodgepole pine (Pinus contorta) and Douglas-fir (Pseudotsuga menziesii) pole timber stands that provided the greatest availability of preferred forage species

A Nutritional Explanation for Body-Size Patterns of Ruminant and Nonruminant Herbivores

The gut capacity of mammalian herbivores increases linearly with body weight. This relationship, coupled with the change in basal metabolism with weight, produces an MR/GC ratio (metabolic requirement/gut capacity) that decreases with increasing body size. Since the retention of a food particle within the gut is proportional to this ratio, the extent to which food particles are digested will be related to body size. Plant material is made up of chemical components that react differently to digestive enzymes. The fiber fraction of plant material (i.e., cell wall) is digested slowly and exclusively by microbial symbiotes. A positive relationship probably exists between the fiber content of plant parts and their biomass in the environment. This relationship is used to describe a resource axis on which digestion rate is the scaling variable. In response to this resource axis and metabolic requirements, the fiber content of the diet of herbivores increases with body size. Ruminants are the predominant medium-s...

Enteral and Parenteral Feeding to Evaluate Malabsorption in Intestinal Parasitism *

General evidence of malnutrition such as loss in body weight associated with intestinal parasitism has been attributed to decreased food intake, to intestinal malabsorption, and to change in host basal metabolism. To establish the relative importance of these factors in this regard, rats with trichinosis were studied. The weights of infected and uninfected animals were followed after being placed on one of three feeding regimens for 1 week--stock diet ad libitum, intraduodenal nutrition, and intravenous nutrition. Infected rats on a stock diet lost weight whereas those on the other two regimens maintained the same weight pattern as uninfected counterparts. The maintainance of body weight occurred despite alterations at the level of the intestinal brush border as indicated by a depression of intestinal disaccharidase activities (sucrase and lactase) and by reduction of monosaccharide absorption (measured as accumulation of beta-methyl glucoside) in the proximal, heavily infected region of the small intestine. There was no compensatory increase in enzyme activity nor in the absorptive capacity in the distal gut. Results support the conclusion that inadequate oral food intake rather than changes in basal metabolism or intestinal pathophysiology accounts for weight loss during the intestinal phase of infection.

Basal metabolism and age of adult man

Basal metabolism measurements made on young men were repeated after 19 yr. Basal metabolism was repeatedly measured over a period of 22 yr on men initially aged 44–56 yr. In the younger men the basal metabolic rate per individual man decreased by an average of only 3% in 19 yr but during this period these men had an average gain of 10.6 kg so there was a decrease of 9% in the average metabolic rate per unit of body weight. In the older men, average weight gain over 22 yr was only 1 kg, and there was not any significant decrease in individual oxygen consumption with age. The commonly cited figures on age changes in basal metabolism in adults, derived from cross-sectional surveys, much overestimate the true age effect.

Changes in basal metabolism, serumprotein-bound iodine, and cholesterol during treatment of hypothyroidism with oral thyroid and L-thyroxine sodium.

Changes in basal metabolism, serumprotein-bound iodine, and cholesterol during treatment of hypothyroidism with oral thyroid and L-thyroxine sodium.