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Metabolic and Endocrine Studies in Identical Diabetic Twins

Metabolic and Endocrine Studies in Identical Diabetic Twins Abstract A set of identical twins with diabetes mellitus underwent serial endocrine and metabolic studies. Both twins had diabetes mellitus. One of the twins was euthyroid during both study periods while the other twin was hyperthyroid during the first study period and euthyroid during the second study period. The hyperthyroid twin had greater sensitivity to insulin than did the euthyroid twin. Both twins had persistent hypocholesterolemia with concordant pertubations in their polyarcylamide gel lipoprotein electrophoresis patterns. Following the development of hyperthyroidism, one of the twins developed symptomatic sarcoidosis. The sarcoidosis resolved when she later became euthyroid. This study illustrates some of the complex interactions between a disease process and the patient's genetic characteristics. References 1. Kreines F, Jett M, Knowles HC: Observations in hyperthyroidism of abnormal glucose tolerance and other traits related to diabetes mellitus. Diabetes 14:740-744, 1965. 2. Houssay BO: The action of the thyroid on diabetes. Recent Prog Horm Res 2:277-291, 1948. 3. Marecek RL, Feldman JM: Effect of hyperthyroidism on insulin and glucose dynamics in rabbits. Endocrinology 92:1604-1611, 1973.Crossref 4. Marecek RL, Feldman JM: Steady state glucose dynamics in hyperthyroid rabbits. Res Commun Chem Pathol Pharmacol 5:493-504, 1973. 5. Cerasi E, Luft R: "What is inherited—what is added": Hypothesis for the pathogenesis of diabetes mellitus. Diabetes 16:615-627, 1967. 6. New weight standards for men and women. Stat Bull Metropol Life Ins Co 40:1-4, 1959. 7. Saifer A, Gerstenfeld S: The photometric microdetermination of blood glucose with glucose oxidase. J Lab Clin Med 51:448-460, 1958. 8. Frohman L, Horton ES, Lebovitz HE: Growth hormone releasing action of a Pseudomonas endotoxin (Piromen). Metabolism 16:57-62, 1967.Crossref 9. Moran RF, Castelli WP, Moran MV: Quantitation of β lipoprotein (LDL) cholesterol by densitometric evaluation of disc electropherograms. Clin Chem 18:217-221, 1972. 10. Noble PR, Campbell FM: Improved accuracy in automated fluorometric determination of plasma triglycerides. Clin Chem 16:166-170, 1970. 11. Levine J, Morgenstern S, Vlastelica D: A direct Lieberman-Burchard method for serum cholesterol , in Automation in Analytical Chemistry-Technicon Symposia, 1967. New York, Medidad Inc., 1968, vol 1, pp 25-28. 12. Kessler G, Lederer H: Fluorometric measurement of triglycerides , in Skeggs LT Jr (ed): Automation in Analytical Chemistry, Technicon Symposia 1965 . New York, Medidad Inc., 1965, pp 341-345. 13. Murphy BEP: Some studies on the protein-binding of steroids and their application to the routine micro and ultramicro measurement of various steroids in body fluids by competitive protein-binding radioassay. J Clin Endocrinol Metab 27:973-990, 1967.Crossref 14. Odell WD, Wilber JF, Utiger RD: Studies of thyrotropin physiology by means of radioimmunoassay. Recent Prog Horm Res 23:47-85,1967. 15. Murphy BEP, Pattee CJ: Determination of thyroxine utilizing the property of protein binding. J Clin Endocrinol Metab 24:187-196, 1964.Crossref 16. Sterling K, Milch PO: Thermal inactivation of thyroxine-binding globulin for direct radioimmunoassay of triiodothyronine in serum, abstracted. J Clin Invest 52:82a, 1973. 17. Sisson JC: Principles of, and pitfalls in, thyroid function tests. J Nucl Med 6:853-901, 1965. 18. Williams T, Besser GM: Effects of treatment on tyrosine tolerance in thyroid disease. Clin Chem 17:148-151, 1971. 19. Williams CH, King DJ, Cairns J: Microestimation of tryptophan in plasma by a fluorometric procedure. Biochem Med 6:504-507, 1972.Crossref 20. Davis RB: The concentration of serotonin in normal human serum as determined by an improved method. J Lab Clin Med 54:344-351, 1959. 21. Sinha YN, et al: A homologous radioimmunoassay for human prolactin. J Clin Endocrinol Metab 36:509-516, 1973.Crossref 22. Fulthorpe AJ, et al: A stable sheep cell preparation for detecting thyroglobulin auto-antibodies and its clinical application. J Clin Pathol 14:654-660, 1961.Crossref 23. Peterson JJ: The physiological disposition and metabolic fate of hydrocortisone in man. J Clin Invest 34:1779-1794, 1955.Crossref 24. Drekter IJ, et al: A rapid method for the determination of total urinary 17-ketosteroids. J Clin Endocrinol Metab 7:795-800, 1947.Crossref 25. Von Euler VS, Floding I: A fluorometric estimation of noradrenalin and adrenalin in urine. Acta Physiol Scand ( (suppl 118) ) 33:57-62, 1955. 26. Anton AH, Sayre DF: A study of the factors affecting the aluminum oxide trihydroxyindole procedure for the analysis of catecholamines. J Pharmacol Exp Ther 138:360-375, 1962. 27. Pisano JJ, Crout JR, Abraham D: Determination of 3-methoxy-4-hydroxymandelic acid in urine. Clin Chem Acta 7:285-290, 1962.Crossref 28. Sankoff I, Sourkes TL: Determination by thinlayer chromatography of urinary homovanillic acid in normal and disease states. Can J Biochem 41:13811388, 1963.Crossref 29. Udenfriend S, Titus E, Weissbach H: The identification of 5-hydroxy-3-indoleacetic acid in normal urine and a method for its assay. J Biol Chem 216:499-505, 1955. 30. Anker RM: The determination of creatine and creatinine in urine: A correction factor for the determination of 24-hour urinary excretion values. J Lab Clin Med 43:798-802, 1954. 31. Gibson WE: Achilles-reflex recording with a simple photomotograph. N Engl J Med 260:1027-1028, 1959.Crossref 32. Werner SC, Quimby EH, Schmidt C: Clinical experience in diagnosis and treatment of thyroid disorders with radioactive iodine, eight-day half life. Radiology 51:564-578, 1948.Crossref 33. Kessler G: Automated techniques in lipid chemistry. Adv Clin Chem 10:45-64, 1967. 34. Trout DL, Estes EH, Friedberg SS: Titration of free fatty acids in plasma: A study of current methods and a new modification. J Lipid Res 1:199202, 1960. 35. Peterson RE: The miscible pool and turnover rate of adrenocortical steroids in man. Recent Prog Horm Res 15:231-274, 1959. 36. Hilton JC, et al: Increased ACTH-like activity in plasma of patient with thyrotoxicosis. J Clin Endocrinol Metab 22:900-905, 1962.Crossref 37. Harrison TS: Adrenal medullary and thyroid relationships. Physiol Rev 44:161-185, 1964. 38. Levine RJ, et al: Studies in the metabolism of aromatic amines in relation to altered thyroid function in man. J Clin Endocrinol Metab 22:1242-1250, 1962.Crossref 39. Palmer WW, Carson DA, Sloan LW: The influence of iodine on the excretion of creatine in exophthalmic goiter. J Clin Invest 6:597-608, 1928.Crossref 40. Sierbaek-Nielsen K: Determination of plasma tyrosine in thyroid disorders. Acta Med Scand 179:417-426, 1966.Crossref 41. Skanse B, Hanson A: Increased thyroid function and the urinary excretion of 5-hydroxyindoleacetic acid. Lancet 1:1072, 1962.Crossref 42. Brauman H, Smets P, Corvilain J: Comparative study of growth hormone response to hypoglycemia in normal subjects and in patients with primary myxedema or hyperthyroidism before and after treatment. J Clin Endocrinol Metab 36:11621174, 1973.Crossref 43. Mann EB, Bildea EF, Peters JP: Serum lipids and proteins in hyperthyroidism. J Clin Invest 19:4359, 1940.Crossref 44. Wayne EJ: Clinical and metabolic studies in thyroid disease. Br Med J 1:78-90, 1960.Crossref 45. Fredrickson DS, Levy RI: Familial hyperlipoproteinemia , in Stanbury JB, Wyngaarden JB, Fredrickson DS (eds): The Metabolic Basis of Inherited Disease , ed 3. New York, McGraw-Hill, 1972, pp 545-614. 46. Sheba CH, Bank H: Thyrotoxicosis simulating lymphoma. Isr J Med Sci 1:818-819, 1965. 47. Winterbauer RH, Belic N, Moores KD: A clinical interpretation of bilateral hilar adenopathy. Ann Intern Med 78:65-71, 1973.Crossref 48. Turkington RW, Macindoe JH: Hyperprolactinemia in sarcoidosis. Ann Intern Med 76:545549, 1972.Crossref 49. Karlish AJ, MacGregor GA: Sarcoidosis, thyroiditis and Addison's Disease. Lancet 2:330-333, 1970.Crossref 50. Elgee NJ: Medical aspects of oral contraceptives. Ann Intern Med 72:409-418, 1970.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Metabolic and Endocrine Studies in Identical Diabetic Twins

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References (53)

Publisher
American Medical Association
Copyright
Copyright © 1974 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1974.00320220041003
Publisher site
See Article on Publisher Site

Abstract

Abstract A set of identical twins with diabetes mellitus underwent serial endocrine and metabolic studies. Both twins had diabetes mellitus. One of the twins was euthyroid during both study periods while the other twin was hyperthyroid during the first study period and euthyroid during the second study period. The hyperthyroid twin had greater sensitivity to insulin than did the euthyroid twin. Both twins had persistent hypocholesterolemia with concordant pertubations in their polyarcylamide gel lipoprotein electrophoresis patterns. Following the development of hyperthyroidism, one of the twins developed symptomatic sarcoidosis. The sarcoidosis resolved when she later became euthyroid. This study illustrates some of the complex interactions between a disease process and the patient's genetic characteristics. References 1. Kreines F, Jett M, Knowles HC: Observations in hyperthyroidism of abnormal glucose tolerance and other traits related to diabetes mellitus. Diabetes 14:740-744, 1965. 2. Houssay BO: The action of the thyroid on diabetes. Recent Prog Horm Res 2:277-291, 1948. 3. Marecek RL, Feldman JM: Effect of hyperthyroidism on insulin and glucose dynamics in rabbits. Endocrinology 92:1604-1611, 1973.Crossref 4. Marecek RL, Feldman JM: Steady state glucose dynamics in hyperthyroid rabbits. Res Commun Chem Pathol Pharmacol 5:493-504, 1973. 5. Cerasi E, Luft R: "What is inherited—what is added": Hypothesis for the pathogenesis of diabetes mellitus. Diabetes 16:615-627, 1967. 6. New weight standards for men and women. Stat Bull Metropol Life Ins Co 40:1-4, 1959. 7. Saifer A, Gerstenfeld S: The photometric microdetermination of blood glucose with glucose oxidase. J Lab Clin Med 51:448-460, 1958. 8. Frohman L, Horton ES, Lebovitz HE: Growth hormone releasing action of a Pseudomonas endotoxin (Piromen). Metabolism 16:57-62, 1967.Crossref 9. Moran RF, Castelli WP, Moran MV: Quantitation of β lipoprotein (LDL) cholesterol by densitometric evaluation of disc electropherograms. Clin Chem 18:217-221, 1972. 10. Noble PR, Campbell FM: Improved accuracy in automated fluorometric determination of plasma triglycerides. Clin Chem 16:166-170, 1970. 11. Levine J, Morgenstern S, Vlastelica D: A direct Lieberman-Burchard method for serum cholesterol , in Automation in Analytical Chemistry-Technicon Symposia, 1967. New York, Medidad Inc., 1968, vol 1, pp 25-28. 12. Kessler G, Lederer H: Fluorometric measurement of triglycerides , in Skeggs LT Jr (ed): Automation in Analytical Chemistry, Technicon Symposia 1965 . New York, Medidad Inc., 1965, pp 341-345. 13. Murphy BEP: Some studies on the protein-binding of steroids and their application to the routine micro and ultramicro measurement of various steroids in body fluids by competitive protein-binding radioassay. J Clin Endocrinol Metab 27:973-990, 1967.Crossref 14. Odell WD, Wilber JF, Utiger RD: Studies of thyrotropin physiology by means of radioimmunoassay. Recent Prog Horm Res 23:47-85,1967. 15. Murphy BEP, Pattee CJ: Determination of thyroxine utilizing the property of protein binding. J Clin Endocrinol Metab 24:187-196, 1964.Crossref 16. Sterling K, Milch PO: Thermal inactivation of thyroxine-binding globulin for direct radioimmunoassay of triiodothyronine in serum, abstracted. J Clin Invest 52:82a, 1973. 17. Sisson JC: Principles of, and pitfalls in, thyroid function tests. J Nucl Med 6:853-901, 1965. 18. Williams T, Besser GM: Effects of treatment on tyrosine tolerance in thyroid disease. Clin Chem 17:148-151, 1971. 19. Williams CH, King DJ, Cairns J: Microestimation of tryptophan in plasma by a fluorometric procedure. Biochem Med 6:504-507, 1972.Crossref 20. Davis RB: The concentration of serotonin in normal human serum as determined by an improved method. J Lab Clin Med 54:344-351, 1959. 21. Sinha YN, et al: A homologous radioimmunoassay for human prolactin. J Clin Endocrinol Metab 36:509-516, 1973.Crossref 22. Fulthorpe AJ, et al: A stable sheep cell preparation for detecting thyroglobulin auto-antibodies and its clinical application. J Clin Pathol 14:654-660, 1961.Crossref 23. Peterson JJ: The physiological disposition and metabolic fate of hydrocortisone in man. J Clin Invest 34:1779-1794, 1955.Crossref 24. Drekter IJ, et al: A rapid method for the determination of total urinary 17-ketosteroids. J Clin Endocrinol Metab 7:795-800, 1947.Crossref 25. Von Euler VS, Floding I: A fluorometric estimation of noradrenalin and adrenalin in urine. Acta Physiol Scand ( (suppl 118) ) 33:57-62, 1955. 26. Anton AH, Sayre DF: A study of the factors affecting the aluminum oxide trihydroxyindole procedure for the analysis of catecholamines. J Pharmacol Exp Ther 138:360-375, 1962. 27. Pisano JJ, Crout JR, Abraham D: Determination of 3-methoxy-4-hydroxymandelic acid in urine. Clin Chem Acta 7:285-290, 1962.Crossref 28. Sankoff I, Sourkes TL: Determination by thinlayer chromatography of urinary homovanillic acid in normal and disease states. Can J Biochem 41:13811388, 1963.Crossref 29. Udenfriend S, Titus E, Weissbach H: The identification of 5-hydroxy-3-indoleacetic acid in normal urine and a method for its assay. J Biol Chem 216:499-505, 1955. 30. Anker RM: The determination of creatine and creatinine in urine: A correction factor for the determination of 24-hour urinary excretion values. J Lab Clin Med 43:798-802, 1954. 31. Gibson WE: Achilles-reflex recording with a simple photomotograph. N Engl J Med 260:1027-1028, 1959.Crossref 32. Werner SC, Quimby EH, Schmidt C: Clinical experience in diagnosis and treatment of thyroid disorders with radioactive iodine, eight-day half life. Radiology 51:564-578, 1948.Crossref 33. Kessler G: Automated techniques in lipid chemistry. Adv Clin Chem 10:45-64, 1967. 34. Trout DL, Estes EH, Friedberg SS: Titration of free fatty acids in plasma: A study of current methods and a new modification. J Lipid Res 1:199202, 1960. 35. Peterson RE: The miscible pool and turnover rate of adrenocortical steroids in man. Recent Prog Horm Res 15:231-274, 1959. 36. Hilton JC, et al: Increased ACTH-like activity in plasma of patient with thyrotoxicosis. J Clin Endocrinol Metab 22:900-905, 1962.Crossref 37. Harrison TS: Adrenal medullary and thyroid relationships. Physiol Rev 44:161-185, 1964. 38. Levine RJ, et al: Studies in the metabolism of aromatic amines in relation to altered thyroid function in man. J Clin Endocrinol Metab 22:1242-1250, 1962.Crossref 39. Palmer WW, Carson DA, Sloan LW: The influence of iodine on the excretion of creatine in exophthalmic goiter. J Clin Invest 6:597-608, 1928.Crossref 40. Sierbaek-Nielsen K: Determination of plasma tyrosine in thyroid disorders. Acta Med Scand 179:417-426, 1966.Crossref 41. Skanse B, Hanson A: Increased thyroid function and the urinary excretion of 5-hydroxyindoleacetic acid. Lancet 1:1072, 1962.Crossref 42. Brauman H, Smets P, Corvilain J: Comparative study of growth hormone response to hypoglycemia in normal subjects and in patients with primary myxedema or hyperthyroidism before and after treatment. J Clin Endocrinol Metab 36:11621174, 1973.Crossref 43. Mann EB, Bildea EF, Peters JP: Serum lipids and proteins in hyperthyroidism. J Clin Invest 19:4359, 1940.Crossref 44. Wayne EJ: Clinical and metabolic studies in thyroid disease. Br Med J 1:78-90, 1960.Crossref 45. Fredrickson DS, Levy RI: Familial hyperlipoproteinemia , in Stanbury JB, Wyngaarden JB, Fredrickson DS (eds): The Metabolic Basis of Inherited Disease , ed 3. New York, McGraw-Hill, 1972, pp 545-614. 46. Sheba CH, Bank H: Thyrotoxicosis simulating lymphoma. Isr J Med Sci 1:818-819, 1965. 47. Winterbauer RH, Belic N, Moores KD: A clinical interpretation of bilateral hilar adenopathy. Ann Intern Med 78:65-71, 1973.Crossref 48. Turkington RW, Macindoe JH: Hyperprolactinemia in sarcoidosis. Ann Intern Med 76:545549, 1972.Crossref 49. Karlish AJ, MacGregor GA: Sarcoidosis, thyroiditis and Addison's Disease. Lancet 2:330-333, 1970.Crossref 50. Elgee NJ: Medical aspects of oral contraceptives. Ann Intern Med 72:409-418, 1970.Crossref

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Oct 1, 1974

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