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Fulltext The Association Between Salivary Ghrelin Levels with Anthropometric Measures in Underweight, Normal, Overweight and Obese Healthy Adult Males

Abdalla MMI, Choo SS

Eur Endocrinol, 2020 Apr;16(1):49-53.
PMID: 32595769 DOI: 10.17925/EE.2020.16.1.49

OBJECTIVES: The study aimed to measure salivary ghrelin levels in healthy adult males and investigate their association with age, weight, height, total as well as regional body fat and muscle mass. The study also aimed to investigate the relative contribution of body mass index (BMI), waist circumference (WC), hip circumference (HC), waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR) in predicting salivary ghrelin levels in the studied groups.
METHODS: A sample of young adult males was divided into underweight, normal weight, overweight, and obese groups, according to their BMI. Standardised methods were used to measure height, WC and HC. Total body fat, visceral fat, subcutaneous fat, total and regional muscle mass were assessed by bioelectrical impedance technique utilising Karada scan. Salivary ghrelin concentrations were assessed using enzyme-linked immunosorbent assay.
RESULTS: A total of 90 adult males were included in the analysis (underweight n=9, normal weight n=41, overweight n=22, and obese n=18). One-way ANOVA test revealed significant differences among the groups in all of the variables except height and salivary ghrelin levels. Multiple linear regression revealed a significant association between salivary ghrelin levels with total fat, subcutaneous fat, visceral fat and muscle mass in the obese group. The analysis also revealed that BMI, WC, HC, WHR and WHtR were reliable predictors for salivary ghrelin levels in the obese group but not in other groups.
CONCLUSIONS: Anthropometric measures can be used as predictors for salivary ghrelin levels in healthy obese adults. However, they are poor predictors for salivary ghrelin levels in healthy lean, normal and overweight adults.
Fulltext Ghrelin - Physiological Functions and Regulation

Ibrahim Abdalla MM

Eur Endocrinol, 2015 Aug;11(2):90-95.
PMID: 29632576 DOI: 10.17925/EE.2015.11.02.90

Ghrelin is an orexigenic peptide predominantly secreted from the stomach and stimulates appetite and growth hormone (GH) release. Studies have provided evidence that ghrelin exercises a wide range of functions, including regulation of food intake and energy metabolism, modulation of cardiovascular function, stimulation of osteoblast proliferation and bone formation and stimulation of neurogenesis and myogenesis. In the gastrointestinal system, ghrelin affects multiple functions, including secretion of gastric acid, gastric motility and pancreatic protein output. Most of these functions have been attributed to the actions of acylated ghrelin. The balance among its secretion rate, degradation rate and clearance rate determines the circulating level of ghrelin. This review explains what ghrelin is, its physiological functions and the factors that influence its level.
Fulltext Ischaemic haemorrhagic stroke in a child with new onset type 1 diabetes mellitus

Mohd Nor NS, Fong CY, Rahmat K, Vanessa Lee WM, Zaini AA, Jalaludin MY

Eur Endocrinol, 2018 Apr;14(1):59-61.
PMID: 29922355 DOI: 10.17925/EE.2018.14.1.59

Cerebral oedema is the most common neurological complication of diabetic ketoacidosis (DKA). However, ischaemic and haemorrhagic brain injury has been reported infrequently. A 10-year old girl who was previously well presented with severe DKA. She was tachycardic with poor peripheral perfusion but normotensive. However, two fast boluses totalling 40 ml/kg normal saline were given. She was transferred to another hospital where she was intubated due to drowsiness. Rehydration fluid (maintenance and 48-hour correction for 7.5% dehydration) was started followed by insulin infusion. She was extubated within 24 hours of admission. Her ketosis resolved soon after and subcutaneous insulin was started. However, about 48 hours after admission, her Glasgow Coma Scale score dropped to 11/15 (E4M5V2) with expressive aphasia and upper motor neuron signs. One dose of mannitol was given. Her symptoms improved gradually and at 26-month follow-up she had a near-complete recovery with only minimal left lower limb weakness. Serial magnetic resonance imaging brain scans showed vascular ischaemic injury at the frontal-parietal watershed regions with haemorrhagic transformation. This case reiterates the importance of monitoring the neurological status of patient's with DKA closely for possible neurological complications including an ischaemic and haemorrhagic stroke.
Salivary Leptin Level in Young Adult Males and its Association with Anthropometric Measurements, Fat Distribution and Muscle Mass

Ibrahim Abdalla MM, Siew Choo S

Eur Endocrinol, 2018 Sep;14(2):94-98.
PMID: 30349601 DOI: 10.17925/EE.2018.14.2.94

Aims: 1) To assess salivary leptin levels in normal-underweight versus overweight and obese healthy adult males aged 18-25 years old. 2) The relative contribution of anthropometric measurements, fat percentage, fat distribution (visceral versus subcutaneous) and total as well as regional muscle mass in arms, trunk and legs respectively in predicting salivary leptin levels. Methods: A total of 92 adult males were classified into two groups based on their body mass index (BMI): normal-underweight, BMI <24.9 kg/m2 (n=51); overweight-obese, BMI >25 kg/m2 (n=41). Anthropometric measurements such as BMI, waist circumference (WC), hip circumference (HC) and waist-hip ratio (WHR) were measured through standardised methods. Fat percentage, visceral fat level, subcutaneous fat and muscle mass (total and regional) were measured using Karada scan bioelectrical impedance method. Fasting saliva samples were collected and used for assessing salivary leptin concentrations using enzyme-linked immunosorbent assay. Results: Statistical analysis of the data showed a significant difference between the two groups in all of the parameters measured except height and salivary leptin levels. Multiple regression analysis showed that HC, WC and WHR were good predictors for salivary leptin levels in normal-underweight group. However, in the overweight-obese group, height was the most important independent variable that could predict salivary leptin levels as a dependent variable. Conclusions: Predictors for salivary leptin levels in adult healthy males are different in normal-underweight subjects from overweight-obese subjects. The most important predictor for salivary leptin levels is HC in normal weight subjects, while it is height in overweight and obese healthy adult males.
Fulltext Defining Disease Progression and Drug Durability in Type 2 Diabetes Mellitus

Kalra S, Kamaruddin NA, Visvanathan J, Santani R

Eur Endocrinol, 2019 Aug;15(2):67-69.
PMID: 31616495 DOI: 10.17925/EE.2019.15.2.67

This communication shares insights into the definition of disease progression and drug durability in type 2 diabetes. Disease progression may be defined as gradual worsening of beta-cell function, clinically observed as an increase in drug dosage, drug frequency or number of glucose lowering drugs needed to maintain HbA1c control; and/or a ≥0.5% rise in HbA1c, unexplained by acute, modifiable factors, while using the same drug regimen; and/or as the occurrence or worsening of cardiovascular or microvascular complications, in spite of standard care, over a pre-specified time period. Durability of a drug or a drug combination may be defined as its ability to postpone or delay progression of disease, in a safe and well tolerated manner. Thus, all drugs that are able to prevent disease progression (i.e., postpone loss of glycaemic control, need for intensification of therapy or onset or worsening of complications) may be termed 'durable'.
Fulltext Idiopathic Thyroid Abscess - A Rare Occurrence

Chainchel Singh MK, Vijayanathan A

Eur Endocrinol, 2019 Apr;15(1):42-43.
PMID: 31244909 DOI: 10.17925/EE.2019.15.1.42

Thyroid abscesses are rare as the gland has a rich blood supply, well-developed capsule and is high in iodine. However, clinicians must be aware of this fact and make an early diagnosis as it can lead to serious morbidity if left untreated. Infection may involve one or both lobes of the thyroid gland, although the left lobe is more often affected and is successfully treated with surgery and antibiotics. This case study involves a 22-year-old woman with a history of painful swelling over the neck accompanied by low-grade fever without any underlying cause. Both the ultrasound and computed tomography revealed a heterogeneous mass within the left lobe of the thyroid gland. Fine needle aspiration revealed an abscess collection and culture Staphylococcus aureus had grown. She was successfully treated with intravenous and oral amoxicillin clavulanate and no surgical treatment was carried out. In conclusion, thyroid abscesses are rare as the gland is resistant to infection and must be differentiated from an infected branchial cleft cyst or sinus, infected thyroid tumour or lymphadenitis in the region of the thyroid in order to avoid serious morbidity if left untreated.