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Göran Lindstedt

The introduction of the assay of prolactin in human serum during the 19 70s resulted in the definition of the "hyperprolactinemia syndrome", i.e. menstrual disturbance, infertility and galactorrhea in women, and impotence with loss of libido in men. With the aid of highly effective inhibitors of the secretion of prolactin from the pituitary it then became possible rapidly to restore fertility and sexual function in a number of cases where the etiology of the patient's disorder had eluded the physician.

It was soon found that serum prolactin in some patients is heterogeneous. As regards size heterogeneity, whereas the molecular mass of pituitaryderived prolactin is about 23 kDa (199 amino acids in a single-chain polypeptide), part of the immunoassayable prolactin in some patients is larger, with molecular mass of about 50kDa, 150–170kDa or even more. These entities are sometimes referred to as "big" and "big, big" prolactin, respectively (1–9); also smaller

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Görel Sundbeck, Staffan Edén, Rudolf Jagenburg and Göran Lindstedt


Serum TSH and free T4 were determined by chemiluminometric assays in 601 women and 285 men aged 85 years from the population study "70-year-old people in Gothenburg, Sweden". For individuals with serum TSH concentration above 6.0 mU/l, "antimicrosomal" antibodies were determined, to assess the etiology of the elevated TSH concentration. Clinical follow-up was done of survivors until the age of 88, and records were inspected also for individuals who died before that age. On the basis of these evaluations the prevalence of previously undetected hypothyroidism was estimated to 4.0% in women and 2.5% in men. Previously undetected hyperthyroidism was found in 2, at the most 4, out of 601 women; in one out of 285 men the diagnosis could not be excluded. Possible confounding factors for the evaluation of TSH and/or free T4 concentrations were analysed by permutation t-test followed by multiple regression analysis, which revealed correlations of log TSH concentration to body mass index (p<0.05), serum creatinine concentration (p<0.05), and diabetes mellitus (inverse relationship, p<0.01). Correlation was found of free T4 concentration to treatment with non-selective β-blocking agents (p<0.001) and digitalis glycosides (p<0.01). However, none of the factors influencing TSH and/or free T4 concentrations had any major influence on reference limits, nor could they account for individuals with "outlier" values.

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Penelope Trimpou, Anders Lindahl, Göran Lindstedt, Göran Oleröd, Lars Wilhelmsen and Kerstin Landin-Wilhelmsen


To study secular trends in sex hormones, anthropometry, bone measures and fractures.


A random population sample was studied twice and subjects of similar age group were compared 13 years apart.


X-ray-verified fractures were retrieved from a random population sample of 2400 men and women (participants 1616=67%) aged 25–64 years from the WHO, MONICA Project in Gothenburg, Sweden, in 1995 and 2008. Fasting serum hormones and calcaneal ultrasound were measured in every fourth subject. In fertile women, measurements were performed on cycle day interval 7–9.


In 2008, men had lower serum free testosterone than men of similar age in 1995 (P<0.001). Body composition, physical activity and fracture incidence were similar. In women, hormone replacement therapy (HRT) was lower in 2008, 7 vs 28% (P<0.0001), as was serum oestradiol, although use of tranquilisers and leisure time physical activity were higher. In 2008, the fracture incidence was higher in postmenopausal women, 29 vs 17% (P<0.001), and vertebral crush had increased from 8 to 19% of all fractures (P=0.031). Serum cholesterol and triglycerides were lower in all subjects in 2008 compared with that in 1995.


Secular trends were observed with lower serum testosterone in men in 2008, but no effect was seen on the fracture incidence of these fairly young men. In postmenopausal women in 2008, there was a higher fracture incidence along with more vertebral compressions. Lower HRT use, lower serum oestradiol and higher fall risk exposure due with more tranquilisers and leisure time physical activity in 2008 may explain the results.

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Staffan Edén, Bengt-Åke Bengtsson, Kerstin Albertsson-Wikland, Jörgen Elfversson, Göran Lindstedt, Per-Arne Lundberg, Björn Petruson and Sten Rosberg

Abstract. Profiles of plasma GH, plasma somatomedin-C and serum PRL concentrations as well as serum GH response to iv TRH were determined in 11 patients with acromegaly before and 10 days after surgery. Blood for profile determinations was drawn from a peripheral vein with a continuous withdrawal pump changing the recipient tube at 30-min intervals. Before surgery all patients had high plasma GH concentrations with irregular peaks and somatomedin-C concentrations were elevated. The response to TRH was abnormal in 8 patients. Three patients had slightly elevated PRL concentrations and one had high PRL concentration (6900 mU/l). Ten days after surgery GH concentrations were still high in 2 patients (>5 mU/l), as were somatomedin-C concentrations (3.2 and 2.4 U/l, respectively). In 3 patients basal GH concentrations were <5 mU/l and somatomedin-C concentrations were normal, but there were no major peaks in plasma GH concentrations. In 2 patients major peaks in GH concentrations appeared after surgery, but basal GH concentrations were 1.9 and 0.95 mU/l, respectively. One patient with hyperprolactinemia still had slightly elevated PRL concentration (486 mU/l), but the response to TRH was normalized. Finally, in 4 patients, mean GH concentrations were markedly reduced, somatomedin-C concentrations normalized and apparently normal plasma GH profiles appeared with low or undetectable basal levels separating major peaks. The results indicate that in some patients with acromegaly apparently normal GH secretion can be demonstrated 10 days postoperatively. Characterization of circadian GH rhythms during the early postoperative stage may contribute to the evaluation of the effect of surgery.