In cirrhotics, the hypothalamic-pituitary-adrenal and -gonadal axes and prolactin secretion are impaired. Growth hormone response to growth hormone-releasing hormone (GHRH) is accelerated in cirrhotics. Thus, elevated basal and stimulated levels of growth hormone probably reflect compensation for low levels of IGF-1, which are associated with deteriorating liver function. The aetiology of cirrhosis was found to have no influence on the degree of alteration of the hypothalamic-pituitary-glandular axes.

Low levels of high-density lipoprotein (HDL)-cholesterol represent an independent cardiovascular risk factor and, besides reduced physical activity, mechanisms leading to decreased HDL-cholesterol levels are not known. We aimed to test the hypothesis, that adiponectin provides a missing link between type 2 diabetes and low levels of HDL-cholesterol, independent from common metabolic risk factors. 523 patients with type 2 diabetes were investigated for adiponectin serum levels and parameters of lipid metabolism. Even after correction for age, gender, BMI and fasting insulin concentration, serum levels of adiponectin were highly signi¢cant (P 6 0.0001) and positively (regression analysis: r = 0.86) associated with HDLcholesterol levels in type 2 diabetes. Conclusion: adiponectin seems to predict HDL-cholesterol levels in patients with diabetes mellitus type 2. Low levels of adiponectin are associated with low levels of HDL-cholesterol independently from common metabolic risk factors and therefore represent an independent cardiovascular risk factor in type 2 diabetes. Thus, adiponectin is a potentially new drug target in the treatment of dyslipidaemia. ß 2003 Published by Elsevier Science B.V. on behalf of the Federation of European Biochemical Societies.Key words: Diabetes; Adiponectin; Adipocyte; High-density lipoprotein-cholesterol ; Lipid metabolism High-density lipoprotein (HDL)-cholesterol represents a common and independent protective cardiovascular risk factor. Cardiovascular risk increases with decreasing levels of HDL-cholesterol. While lipid lowering and antidiabetic drugs such as statins, ¢brates, and PPARQ agonists as well as diet alone have only marginal e¡ects on serum HDL-cholesterol levels, physical activity is able to elevate e¡ectively HDL levels. Since type 2 diabetes mellitus and obesity are associated with low levels of HDL-cholesterol, a reduced physical activity has been regarded as the main mechanism standing behind these low levels. Adiponectin [1^4] represents a newly discovered adipocyte-speci¢c secretory protein. Its expression is highly restricted to terminally di¡erentiated adipocytes. Adiponectin is secreted into the plasma and represents a new member of the recently described C1q/TNF molecular superfamily [3]. Since adiponectin is the only known adipocyte-speci¢c secretory protein in the human system, that is exclusively and paradoxically decreased in obesity and type 2 diabetes [1,4], we aimed to test the hypothesis that adiponectin might in£uence HDL-cholesterol levels. For that purpose, a large cohort of Caucasian patients with type 2 diabetes was investigated for serum adiponectin levels and parameters of lipid metabolism. Human adiponectin serum concentrations were measured by enzyme-linked immunosorbent assay (ELISA) according to the protocol provided by the manufacturer (human adiponectin ELISA kit, Biocat, Heidelberg, Germany). 523 subjects, 296 males (56.6%) and 227 females (43.4%), were included in the study. The main question was whether adiponectin serum levels ...

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To evaluate possible pathophysiologic links between cerebral changes in diabetic patients detected by proton magnetic resonance spectroscopy and clinical as well as laboratory parameters. The brains of 30 patients with diabetes mellitus and 30 healthy volunteers were examined using a STEAM sequence (TR 1500 ms, TE 20 ms). We measured in occipital gray matter and parietal white matter in a 1.5-Tesla magnet. Laboratory parameters were acquired before and after the examination. In diabetic patients a significant elevation of the myo-inositol/creatine ratio in gray and white matter was present (p = 0.006). Choline/creatine ratio in gray matter was elevated compared to normal controls (p = 0.002). No correlation with laboratory parameters was detected. Myo-inositol was even more elevated in patients with polyneuropathy (p = 0.024). No correlation with age or sex was detected. The changes found in diabetes are similar to those found in patients with Alzheimer's disease, dialysis, and after renal transplant, suggesting a similar etiology. Elevated myo-inositol may not only indicate osmolar changes in glial cells but also glial cell alteration due to amyloid or amylin deposition with formation of neurofibrillary tangles, especially as these changes are found in all of these diseases and no correlation to osmolar deterioration exists.