This issue brings a review by the first winner of the Acta Endocrinologica Prize, Professor Bengt Westermark. The prize has been founded by Acta Endocrinologica, owned by the Endocrine Societies of Denmark, Finland, the Federal Republic of Germany, the Netherlands, Norway, Sweden and Switzerland. The prize is presented at the Congress of the European Federation of Endocrine Societies (EFES) to emphasize and further the already significant endocrine research in Europe.
The prize should be awarded to a young European scientist, basic or clinical, for distinction manifested by publications that have contributed to the advancement of knowledge in the field of endocrinology.
The jury is made up of seven members, with the President of EFES as the chairman and the Chief Editor of the journal as Secretary and Vicechairman. The other five members are elected at the discretion of the Editorial Board and the President of EFES upon the advice of
Jørn Nerup and Christian Binder
The clinical association between diabetes mellitus and auto-immune diseases of the thyroid, the adrenals and the gastric mucosa occurs more frequently than could be expected by chance. Sera from 133 patients with diabetes mellitus and 128 controls were therefore investigated for the presence of organ-specific auto-antibodies. Thyroid microsomal antibody and gastric-parietal-cell antibody were demonstrated with significantly increased frequency – 20% and 16% respectively – in sera from patients with diabetes mellitus. Antibodies reacting specifically with tissue components of the endocrine pancreas could not be demonstrated.
From the data presented and from a review of the literature it is concluded that evidence is accumulating pointing to a disorder of the immunological system in patients with diabetes mellitus with regard to the formation of organ-specific humoral and cellular auto-immunity, and the occurrence of organ-specific auto-immune diseases.
Inger Bendtson, Anne Mette Rosenfalck and Christian Binder
Asymptomatic hypoglycemia in IDDM patients seems to be more frequent during the night than during the day, with reported frequencies as high as 56%. Hormonal counterregulation to diurnal and nocturnal hypoglycemia was studied in 10 insulin-dependent diabetic patients without diabetic complications in order to test whether hormonal responses were lower at night than during daytime. A lower catecholamine response might imply less marked symptoms and therefore one reason why patients are not awakened by hypoglycemia. Blood glucose was stabilized to around 6 mmol/1 by iv insulin infusion and hypoglycemia was induced by increasing the insulin infusion rate—in the night studies at 01.30, in the day studies at 08.00. Blood glucose nadirs were 1.5±0.4 (1.2–1.9) mmol/1 at night and 1.9±0.3 (1.3–2.2) mmol/l during the day; in three patients the nadirs were identical during both the night and day. One patient had no adrenaline response to daytime hypoglycemia. In general, nocturnal hypoglycemia elicited greater catecholamine responses correlated to the duration of hypoglycemia. Glucagon responses showed a great heterogeneity independently of diabetes duration and hypoglycemic level. Growth hormone secretion was reduced during the night study; however, no refractory periods were found after sleep-related growth hormone secretion. In conclusion: counter-regulatory hormonal responses tend to be greater at night than during the day and do not explain why patients are not awakened by nocturnal hypoglycemia.
Henrik Kehlet, Christian Binder and Christen Engbæk
The concentration of plasma corticosteroids was followed during major surgery and during the infusion of synthetic human ACTH at dose rates varying from 2400 ng to 15 000 ng per hour.
The results showed that the time course of plasma corticosteroids during major surgery was intermediate between that obtained during the infusion of 7500 and 15 000 ng synthetic human ACTH per hour.
This gives an estimated ACTH secretion rate during major surgery of between 7500 ng and 15 000 ng per hour.
Christian Binder, Albert G Burger and René Mornex
In 1993, Acta Endocrinologica enters a new era as the Official Journal of the Federation of European Societies of Endocrinology (EFES), and will change its title to the European Journal of Endocrinology as of January 1994.
This event represents an important milestone for this venerable journal of Northern European origins which, over the years, has acquired an international reputation within the scientific community. The new title reflects an awareness of the future and, also, the primary objective of the journal's founders: to promote increased communication and understanding between scientists in Europe and elsewhere in the field of endocrinology.
The journal was founded in 1948 by a group of Scandinavian endocrinologists who realized that the need for a greater cohesion of regional and national scientists should be encouraged by the creation of a scientific journal. Acta Endocrinologica, sponsored by the National Endocrine Societies of Denmark, Finland, Germany, Holland, Norway, Sweden and
Henrik Kehlet, Christian Binder and Christen Engbæk
The transcortin binding capacity and cortisol binding to albumin were determined before and after induction of anaesthesia and also post-operatively in 14 normal subjects undergoing major surgery. Plasma non-protein-bound (free) cortisol and total cortisol in the plasma were measured by an ultrafiltration technique and a competetive protein-binding technique, respectively.
The results showed that the anaesthetics caused a decreased (0.05 < P < 0.1) binding of cortisol to albumin, while the transcortin binding capacity was unchanged. Post-operatively the mean transcortin binding capacity decreased from 24.6 to 20.4 μg cortisol per 100 ml (P < 0.01) and the cortisol binding to albumin returned to pre-anaesthetic values. These findings could not be related to changes in the concentration of albumin, α2-protein and total protein in plasma.
Claus Hagen, Henrik Kehlet and Christian Binder
To evaluate the relationship between plasma prolactin and cortisol in patients with Cushing's syndrome, the 24 h pattern of these hormones was measured in normal subjects and in 5 patients with pituitary dependent Cushing's syndrome and 2 patients with Cushing's syndrome due to an adrenocortical adenoma and ectopic secretion of ACTH.
The normal subjects showed an increase in plasma prolactin during late sleep without correlation (P > 0.05) to changes in plasma cortisol. All patients had normal basal levels (between 10 a. m. and 12 p. m.) of plasma prolactin. Four of 5 patients with pituitary dependent Cushing's syndrome had an absent diurnal rhythm of plasma prolactin. One patient classified as pituitary dependent Cushing's syndrome on the basis of adrenal pathology, but pituitary independent on the basis of the dexamethasone suppression test had a normal circadian rhythm of plasma prolactin suggesting that the disease is not pituitary dependent at this stage. Two patients with pituitary independent Cushing's syndrome, one with adrenocortical adenoma and one with an oat cell carcinoma of the lung and the ectopic ACTH syndrome and very elevated plasma cortisol levels showed a normal and an absent diurnal rhythm of prolactin, respectively.
Margrethe E. Olsen, Ole K. Faber and Christian Binder
Peripheral venous plasma insulin and C-peptide concentrations during oral glucose tolerance tests were measured in 7 normal weight non-diabetic subjects before and after 7 days of sucrose hyperalimentation. This induced a deterioration of the glucose tolerance with higher levels of glucose, insulin and C-peptide.
The C-peptide to insulin molar ratio as well as the relation between incremental areas under the plasma curves of the two peptides were used as relative measures of the hepatic insulin extraction.
Both estimates of hepatic insulin extraction were unchanged by hyperalimentation, suggesting that the induced decreases in glucose tolerance and insulin receptor function are not followed by a decrease in hepatic insulin extraction as found in obese subjects with similar changes in glucose tolerance and insulin receptor function.