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Littermate dogs were fed from weaning on high-protein diets (HP) or on dietswhich were adequate in calories but marginally deficient in protein (LP). The LP animals grew at a slightly retarded rate but showed no other outward abnormality. In the HP animals, intravenous glucose tolerance (K) increased steadily up to twelve months of age (K = 6) and then declined to the adult value (K = 4.7). These changes were accelerated and exaggerated in LP dogs so that, from seven months onwards, the K values for the LP dogs became progressively lower than those of their HP littermates. Although the LP diet was adequate for adult maintenance and other biochemical signs of proteincalorie deficiency were corrected in the adult, glucose tolerance remained impaired (mean K for HP adults = 4.7 and for LP adults = 3.3). In the LP dog decreasing glucose tolerance was associated with increasing resistance to exogenous insulin. During pregnancy, the HP animals showed an early increase in K followed by a progressive fall. The LP animals showed little change in K during pregnancy, but after lactation both glucose tolerance and sensitivity to insulin increased. Pups born to LP mothers showed signs of congenital malnutrition; they also showed greatly enhanced glucose tolerance in early life. Young dogs, whether fed HP or LP diets, showed rapid impairment of glucosetolerance when acutely infected with toxocara canis. The findings for dogs are compared with those reported in human diabetes mellitus.

Among the difficulties of living with β-thalassemia, patients frequently require blood transfusions and experience iron overload. As serum ferritin (SF) provides an indication of potential iron overload, we conducted a systematic literature review (SLR) to assess whether SF levels are associated with clinical and economic burden and patient-reported outcomes (PROs). The SLR was conducted on 23 April 2020 and followed by analysis of the literature. Dual-screening was performed at the title, abstract, and full-text levels using predefined inclusion and exclusion criteria. Ten studies identified by the SLR were eligible for inclusion in the analysis. Seven studies were conducted in Europe, and most were prospective or retrospective in design. The patient populations had a median age of 20.7–42.6 years, with a percentage of men of 38–80%. Sparse data were found on the correlation between SF levels and mortality, and hepatic, skeletal, and cardiac complications; however, in general, higher SF levels were associated with worsened outcomes. The bulk of the evidence reported on the significant association between higher SF levels and endocrine dysfunction in its many presentations, including a 14-fold increase in the risk of diabetes for patients with persistently elevated SF levels. No studies reporting data on PROs or economic burden were identified by the SLR. SF levels provide another option for prognostic assessment to predict a range of clinical outcomes in patients with β-thalassemia.

The separate effects of insulin and growth hormone on the uptake and incorporation of five amino acids into diaphragm muscle from non-hypophysectomized rabbits has been examined. Both growth hormone and insulin, when present in the medium separately, stimulated the incorporation into protein of the amino acids, leucine, arginine, valine, lysine and histidine. Insulin also stimulated amino acid uptake, but growth hormone did not. When insulin and growth hormone were present in the incubation medium together, the uptake and incorporation of valine, the only amino acid studied under these conditions, tended to be greater than the sum of the separate effects of the two hormones.

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