Ml In Women Research Articles

Renal outcomes of gout and hyperuricemia

Azotemia and urolithiasis as outcomes of gout or hyperuricemia were examined in several ways. Azotemia occurred in two (1.8 per cent) of 113 patients with asymptomatic hyperuricemia followed for eight years and in four (2.1 per cent) of 193 normouricemic control subjects; it was mild in all instances. Azotemia was also mild when it occurred in 168 patients with gout followed for 10 years and was unrelated to the degree of control of serum uric acid levels in these patients. Projected degrees of azotemia after 40 years of sustained hyperuricemia were mild and probably of no clinical significance until levels of serum uric acid reached 10 mg/100 ml in women and 13 mg/100 ml in men. Among 1,356 men, aged 60 to 69 years when serum uric acid was measured, follow-up for 10 years showed no death from renal failure that was attributable to hyperuricemia. Risks of urolithiasis were small; approximately one stone per 295 patients per year in those with asymptomatic hyperuricemia compared with one stone per 852 patients per year in normouricemic control subjects, and one stone per 114 patients per year in those with established gout. Among the gouty patients, initial level of serum uric acid was not a predictor of stone; significantly more of those in whom urolithiasis developed were taking medication to lower serum uric acid levels than in those not taking such medicine, but the differences between those taking probenecid and those taking allopurinol were not significant. Also, among the gouty patients, the control of serum uric acid levels was similar in those in whom stones developed and in those in whom they did not. It is concluded that (1) azotemia attributable to hyperuricemia is generally mild and probably of no clinical importance until serum uric acid levels reach 13 mg/100 ml in men and 10 mg/100 ml in women; and (2) the risk of urolithiasis is sufficiently low to justify awaiting the occurrence of the first stone before commencing drug therapy to lower serum uric acid levels.

PLASMA LIPOPROTEIN DISTRIBUTIONS IN MALE AND FEMALE RUNNERS *

Recent studies have shown a consistent association between relatively low plasma concentrations of high-density lipoprotein (HDL) cholesterol and increased risk of coronary heart disease. A cross-sectional comparison was made of the distribution of plasma lipids and lipoproteins in groups of 41 male and 43 female long distance runners versus larger control groups matched for age and sex, randomly selected from northern California towns. The runners showed modestly lower total cholesterol concentrations, while their triglyceride levels were only 50% of control. HDL-cholesterol was higher in runners than controls (75 +/- 14 vs 56 +/- 14 mg/100 ml for women; 64 +/- 13 vs 43 +/- 10 for men), while low-density lipoprotein cholesterol was lower (113 +/- 33 vs 124 +/- 34 for women; 125 +/- 21 vs 139 +/- 32 for men). All differences were statistically significant (p less than 0.05), and only partially attributable to known factors other than high physical activity level. Since the runners were predominantly normotensive, relatively lean, and exclusively nonsmokers, they appear to constitute a remarkably favored group with respect to risk of cardiovascular disease.

SERUM THYROXINE-BINDING GLOBULIN: DETERMINATION BY COMPETITIVE LIGAND-BINDING ASSAY IN THYROID DISEASE AND PREGNANCY

Serum thyroxine-binding globulin (TBG) concentrations were measured by competitive ligand-binding assay in normal subjects and patients with a variety of abnormalities of thyroid hormone production or TBG production. The mean serum TBG concentration in 73 normal adults was 3.4 +/- 0.6 mg/100 ml. No correlations with age, sex or serum thyroxine (T4) or triiodothyronine (T3) concentrations were found. Serum TBG concentrations were normal in patients with hyperthyroidism. They were significantly elevated in hypothyroid patients, and fell to normal with thyroxine treatment. In pregnant women, serum TBG concentrations were markedly increased, being 7.1 +/- 1.2 (mean +/- SD) mg/100 ml in women in their first trimester, 9.0 +/- 1.0 mg/100 ml in the second trimester and 8.9 +/- 1.6 mg/100 ml in the third trimester. There was a positive correlation between serum TBG concentration and both serum T4 and serum T3 concentrations in pregnant women. Competitive ligand-binding assay is a simple and reliable method for TBG asay and yields results similar to those of electrophoretic saturation techniques.

Stabilization of plasma glucose during fasting; Normal variations in two separate studies.

To establish more reliable criteria for the diagnosis of hypoglycemia during fasting, studies of plasma glucose concentrations during 72 hours of fasting were conducted independently at two institutions. Premenopausal women did not stabilize glucose at a level comparable to men. Twenty-four subjects, both men and women, were fasted in Study I. The mean (± S.E.M.) lowest glucose recorded was 66.4 ± 2.9 mg per 100 ml in men of normal weight and 47.8 ± 2.9 mg per 100 ml in women. In Study II the mean lowest glucose in 40 fasts by women was 41.3 ± 1.9 mg per 100 ml. No variation was noted in the early and late phases of the menstrual cycle. Three prepubertal children had glucose responses during fasting comparable to those of women. To be considered abnormal, plasma glucose must decrease in women to less than 35 mg per 100 ml within 24 hours, and in men,55 mg per 100 ml. After 36 hours of fasting, it is virtually impossible to judge the diagnostic implications of plasma or blood glucose values in premenopausal women. (N Engl J Med 291:1275–1278, 1974)

Serum α2-macroglobulin levels in normal chinese

Serum α 2-macroglobulin levels were measured in normal healthy Chinese subjects by the antibody-agar radial immunodiffusion technique. The values for males were 278 ± 63 mg/100 ml and for females 234 ± 51 mg/100 ml. After six cycles of freeze-thawing the values were reduced to 190 ± 38 mg/100 ml for men but remained the same at 235 ± 52 mg/100 ml for women. It is tentatively suggested that additionally bound proteins and hormones may afford the female α 2-macroglobulin greater protection against denaturation. It appears that fresh serum samples only should be used for α 2-macroglobulin determinations.

Aminocaproic acid for bleeding associated with intrauterine devices?

Menstrual cycle irregularities and menorrhagia are the most common complications of the intrauterine device as a contraceptive method. In a recent study of menstrual loss, women with an IUCD had a mean loss of 56 ml, compared with 13 ml for women on the pill and 38 ml for women using other forms of contraception.1 Suggested causes for this increased loss include traumatic, chronic inflammatory and functional effects on the endometrium. Other possible causes of excessive bleeding are perforation of the uterus and abortion with the device still present.

Direct estimation of copper in serum and urine by atomic absorption spectroscopy

Methods are described for the estimation of copper directly in acidified urine and after twentyfold dilution of serum with 0.1 N HCl using a sensitive atomic absorption spectrophotometer. Suppression of up to 10% of the apparent copper content was found to arise due to the inorganic components of urine. This effect was overcome by the addition of inorganic salts to the standard used for urine estimation. The organic components of serum and urine had no significant effect on the apparent copper content. An analytical rate of 10 samples per hour can be achieved. Random contamination presents a serious problem and is best detected by replicate analyses. A study of the serum copper level of 24 normal subjects (12 men, 12 women) gave a range of 78–111 μg/100 ml for men (mean 95 μg/100 ml) and 70–165 μg/100 ml for women (mean 122 μg/100 ml). The 24-h urine excretion of copper from 10 normal subjects (5 men, 5 women) had a mean of 52 μg/24 h and a range from 26–64 μg/24 h.

Vitamin A and Carotene in Serum from Healthy Danish Subjects

Seventy-nine adults were examined with a few diurnal and seasonal repeats showing no significant changes with regard to vitamin A.In males an average of 60.4 μg/100 ml of vitamin A was found expressed as axerophtol, the coefficient of variation being 22.4 per cent. In females corresponding figures are 49.9 μg/100 ml and 27.3 per cent.Carotene mean was 59.6 μg/100 ml for men with actual ranges observed 21–123, and 71.6 μg/100 ml for women, ranges 30–143.In males vitamin A is significantly higher and carotene is on the average slightly lower than in females.Influence of age is discussed with no certain trend either for vitamin A or for carotene.The results are compared with other studies and it is concluded that axerophtol values in the present material largely correspond with results found in recent studies from other countries.