Insulin sensitivity, metabolic clearance rate of insulin (MCR-I) and basal posthepatic insulin delivery rate (BIDR) were investigated by means of euglycemic clamp technique in 8 normal subjects and 8 patients with hyperthyroid Graves' disease. The mean (±SD) steady-state glucose infusion rate (SSGIR) was lower in hyperthyroid Graves' patients than in normal subjects (228.9±57.0 vs. 290.9±49.4 mg/m2/min, p<0.05). Both MCR-I and BIDR were higher in hyperthyroid Graves' patients than in normal subjects (1162.9+517.1 vs. 463.5±103.9 ml/m2/min, p<0.005; 17.7+12.6 vs. 3.6±0.9 mU/m2/min, p<0.01, respectively).Plasma free T4 levels showed a close correlation with MCR-I (r=0.77, p<0.05) and BIDR (r=0.81, p<0.05), respectively, in Graves' patients. These findings indicate that hyperthyroidism is characterized by not only a decrease in insulin sensitivity, but also an increase in basal insulin secretion and the metabolic clearance rate of insulin, which are correlated with plasma free T4 levels. (Internal Medicine 34: 339-341, 1995)

Abstract.The causes of hyperprolactinemia, the correlation between serum levels of PRL and thyroid function and magnetic resonance imaging (MRI) of the pituitary were studied in patients with chronic thyroiditis.Seventy

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Aims Hb Toranomon [b112 (G14) Cys ? Try] was the variant hemoglobin first reported by Harano et al. (Hemoglobin 20:361-369, 1996). Since 2004 there have been successive reports of Hb Toranomon based on abnormal HbA1c levels measured by high-performance liquid chromatography (HPLC). HbA1c levels are known to vary depending on the HPLC model used. We compared the HbA1c measured by new and old HPLC models in patients with Hb Toranomon. Method Eight patients with Hb Toranomon (5 men, 3 women; 4 with diabetes and 4 without diabetes; 7 heterozygotes, 1 homozygote) were studied. HbA1c levels measured using the old HPLC models (Arkray HA-8150 and Tosoh GHb III) and the new HPLC models (Arkray HA-8160 or later, Tosoh GHbV or later) were compared with the results of immunoassay, enzymatic assay, affinity assay of HbA1c, and glycated albumin (GA). Results HbA1c levels measured by the old and new Arkray models were 10 and 30% lower, respectively, and those measured by the new Tosoh models were 30% higher than the results of immunoassay. The same trends were found in comparisons with the HbA1c results of enzymatic and affinity assays or GA. Conclusion Glycated variant hemoglobins, such as Hb Toranomon, may have previously been measured as HbA1c and are difficult to identify because of the low divergence from other glycemic control indicators in the old HPLC models. The recent detection of successive Hb Toranomon patients is likely due to the abnormally low or high HbA1c levels by the upgraded measuring models.