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205. Dietary carbohydrate restriction in type 2 diabetes mellitus and metabolic syndrome: time for a critical appraisal

Author

Accurso, Anthony, primary, Bernstein, Richard K, additional, Dahlqvist, Annika, additional, Draznin, Boris, additional, Feinman, Richard D, additional, Fine, Eugene J, additional, Gleed, Amy, additional, Jacobs, David B, additional, Larson, Gabriel, additional, Lustig, Robert H, additional, Manninen, Anssi H, additional, McFarlane, Samy I, additional, Morrison, Katharine, additional, Nielsen, Jørgen Vesti, additional, Ravnskov, Uffe, additional, Roth, Karl S, additional, Silvestre, Ricardo, additional, Sowers, James R, additional, Sundberg, Ralf, additional, Volek, Jeff S, additional, Westman, Eric C, additional, Wood, Richard J, additional, Wortman, Jay, additional, and Vernon, Mary C, additional

Published
2008
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207. 44

Author

Boss, Thad J., primary, Peters, Jeffrey, additional, Patti, Marco G., additional, Lustig, Robert H., additional, and Kral, John G., additional

Published
2007
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210. Childhood Obesity

Author

Speiser, Phyllis W., primary, Rudolf, Mary C. J., additional, Anhalt, Henry, additional, Camacho-Hubner, Cecilia, additional, Chiarelli, Francesco, additional, Eliakim, Alon, additional, Freemark, Michael, additional, Gruters, Annette, additional, Hershkovitz, Eli, additional, Iughetti, Lorenzo, additional, Krude, Heiko, additional, Latzer, Yael, additional, Lustig, Robert H., additional, Pescovitz, Ora Hirsch, additional, Pinhas-Hamiel, Orit, additional, Rogol, Alan D., additional, Shalitin, Shlomit, additional, Sultan, Charles, additional, Stein, Daniel, additional, Vardi, Pnina, additional, Werther, George A., additional, Zadik, Zvi, additional, Zuckerman-Levin, Nehama, additional, and Hochberg, Zeev, additional

Published
2005
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212. Chapter 25: Obesity and Cancer.

Author

Lustig, Robert H. and Bradlow, H. Leon

Subjects
*CANCER patient medical care, *HOSPITAL care for cancer patients
Abstract

Chapter 25 of the book "Medical Care of Cancer Patients" is presented. It explores both the condition of having excessive energy storage being regarded as a risk factor for cancer and the considered risk factors for developing excessive energy storage after cancer therapy or treatment. It also discusses the correlation of obesity to different metabolic diseases including cancer, its management, diagnosis and treatment.

Published
2009

213. The Efferent Arm of the Energy Balance Regulatory Pathway: Neuroendocrinology and Pathology.

Author

Conn, P. Michael, Donohoue, Patricia A., and Lustig, Robert H.

Abstract

The regulation of energy balance is unique among neuroendocrine homeostatic systems, as it does not involve the pituitary gland. It is accomplished through afferent neural and hormonal signals reaching the hypothalamus, with resultant efferent projections of the autonomic nervous system innervating the muscles, viscera, and adipose tissue. The efferent system is of particular interest, as it has its own pathologies, which can be modulated to achieve weight loss. The sympathetic nervous system promotes energy expenditure by increasing movement and thermogenesis and inhibiting insulin secretion. The vagus nerve promotes energy storage by increasing alimentary tract digestion and absorption, adipose tissue insulin sensitivity, and insulin secretion. These two pathways are clearly demonstrated in the starvation response, in which sympathetic activity decreases to conserve energy, and vagal activity increases to store energy. Hypothalamic obesity, an example of "organic" leptin resistance, manifests similarly. Finally, anorexia nervosa is an example of dissociation between weight loss, but with increased sympathetic modulation. Understanding the relationship between these two efferent arms is essential to treatment of energy balance disorders. [ABSTRACT FROM AUTHOR]

Published
2008
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217. Exercise Type in Dieting Obese Older Adults.

Author

Stigler, Florian L., Lustig, Robert H., Rezende, Leandro F. M., Matsudo, Victor K. R., Villareal, Dennis T., Waters, Debra L., and Qualls, Clifford

Subjects
*OVERWEIGHT persons, *HEALTH of older people, *PHYSICAL activity
Published
2017
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221. Diagnosis of ACTH Deficiency

Author

Rose, Susan R., primary, Lustig, Robert H., additional, Burstein, Stephen, additional, Pitukcheewanont, Pisit, additional, Broome, Dean C., additional, and Burghen, George A., additional

Published
1999
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224. Papillary thyroid carcinoma: Demographics, treatment, and outcome in eleven pediatric patients treated at a single institution

Author

Kuefer, Martin U., primary, Moinuddin, Mohammed, additional, Heideman, Richard L., additional, Lustig, Robert H., additional, Rose, Susan R., additional, Burstein, Stephen, additional, VanMiddlesworth, Lester, additional, Fleming, Irvin, additional, Jenkins, Jesse J., additional, and Shearer, Patricia D., additional

Published
1997
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232. Metformin Extended Release Treatment of Adolescent Obesity A 48-Week Randomized, Double-Blind, Placebo-Controlled Trial With 48-Week Follow-up.

Author

Wilson, Darrell M., Abrams, Stephanie H., Aye, Tandy, Lee, Phillip D. K., Lenders, Carine, Lustig, Robert H., Osganian, Stavroula V., and Feldman, Henry A.

Abstract

Background: Metformin has been proffered as a therapy for adolescent obesity, although long-term controlled studies have not been reported. Objective: To test the hypothesis that 48 weeks of daily metformin hydrochloride extended release (XR) therapy will reduce body mass index (BMI) in obese adolescents, as compared with placebo. Design: Multicenter, randomized, double-blind, placebocontrolled clinical trial. Setting: The 6 centers of the Glaser Pediatric Research Network from October 2003 to August 2007. Participants: Obese (BMI⩾95th percentile) adolescents (aged 13-18 years) were randomly assigned to the intervention (n=39) or placebo groups. Intervention: Following a 1-month run-in period, subjects following a lifestyle intervention program were randomized 1:1 to 48 weeks' treatment with metformin hydrochloride XR, 2000mgonce daily, or an identical placebo. Subjects were monitored for an additional 48 weeks. Main Outcome Measure: Change in BMI, adjusted for site, sex, race, ethnicity, and age and metformin vs placebo. Results: After 48 weeks, mean (SE) adjusted BMI increased 0.2 (0.5) in the placebo group and decreased 0.9 (0.5) in the metformin XR group (P=.03). This difference persisted for 12 to 24 weeks after cessation of treatment. No significant effects of metformin on body composition, abdominal fat, or insulin indices were observed. Conclusion: Metformin XR caused a small but statistically significant decrease in BMI when added to a lifestyle intervention program. Trial Registration: clinicaltrials.gov Identifiers: NCT00209482 and NCT00120146. [ABSTRACT FROM AUTHOR]

Published
2010

233. Insulin Resistance is Improved in Overweight African American Boys but Not in Girls Following a One-Year Multidisciplinary Community Intervention Program.

Author

Raman, Aarthi, Ritchie, Lorrene D., Lustig, Robert H., Fitch, Mark D., Hudes, Mark L., and Fleming, Sharon E.

Abstract

The article discusses findings of a study which evaluated the impact of a one-year community-based lifestyle intervention program on overweight African-American (AA) children. A total of 165 AA children with body mass index (BMI) higher than the 85th percentile were asked to choose between a 2-week summer camp or a 2-week conventional Young Men's Christian Association (YMCA) summer camp. After one year, the study confirmed that community-based exercise and nutrition programs reduced the risk for type 2 diabetes mellitus in overweight AA boys.

Published
2010
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235. A Clinic-Based Lifestyle Intervention for Pediatric Obesity: Efficacy and Behavioral and Biochemical Predictors of Response.

Author

Madsen, Kristine A., Garber, Andrea K., Mietus-Snyder, Michele L., Orrell-Valente, Joan K., Cam-Tu Tran, Wlasiuk, Lidya, Matos, Renee I., Neuhaus, John, and Lustig, Robert H.

Abstract

The article examines the effectiveness of a multidisciplinary lifestyle intervention for obese children and adolescents. It provides an overview of the behavioral, socio-economic, genetic and biochemical factors contributing to the development of obesity in childhood and adolescence. It relates some of the recommendations from a registered dietitian to reduce the body mass index (BMI) and fat mass among the patients. It has revealed that clinic-based interventions were effective in improving the weight status of obese children and adolescents.

Published
2009
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236. Accuracy of Self-assessed Tanner Staging Against Hormonal Assessment of Sexual Maturation in Overweight African-American Children.

Author

Raman, Aarthi, Lustig, Robert H., Fitch, Mark, and Fleming, Sharon E.

Abstract

The article discusses a study of the accuracy of self-reported Tanner (SRT) staging against hormonal sexual maturation assessment in overweight African-American (AA) children, 9-11 years old. It is stated that 15-20% agreement was found in SRT stages of assessments in boys' genital and pubic hair and girls' breast and pubic hair relative to their hormone-derived pubertal stages. SRT staging in such children was reportedly not accurate when compared with a hormone-derived method.

Published
2009
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239. Effect of Growth Hormone-Releasing Factor on Growth Hormone Release in Children with Radiation-Induced Growth Hormone Deficiency.

Author

Lustig, Robert H., Schriock, Elizabeth A., Kaplan, Selna L., and Grumbach, Melvin M.

Subjects
*LEUKEMIA treatment, *PITUITARY dwarfism, *GROWTH hormone releasing factor
Abstract

Abstract. Five male children who received cranial irradiation for extrahypothalamic intracranial neoplasms or leukemia and subsequently developed severe growth hormone (GH) deficiency were challenged with synthetic growth hormone-releasing factor (GRF-44), in an attempt to distinguish hypothalamic from pituitary dysfunction as a cause of their GH deficiency, and to assess the readily releasable GH reserve in the pituitary. In response to a pulse of GRF-44 (5 micro g/kg intravenously), mean peak GH levels rose to values higher than those evoked by the pharmacologic agents L-dopa or arginine (6.4 +/- 1.3 ng/mL v 1.5 +/- 0.4 ng/mL, P < .05). The peak GH value occurred at a mean of 26.0 minutes after administration of GRF-44. These responses were similar to those obtained in children with severe GH deficiency due to other etiologies (peak GH 6.3 +/- 1.7 ng/mL, mean 28.0 minutes). In addition, there was a trend toward an inverse relationship between peak GH response to GRF44 and the postirradiation interval. Prolactin and somatomedin-C levels did not change significantly after the administration of a single dose of GRF-44. The results of this study support the hypothesis that cranial irradiation in children can lead to hypothalamic GRF deficiency secondary to radiation injury of hypothalamic GRF-secreting neurons. This study also lends support to the potential therapeutic usefulness of GRF-44 or an analog for GH deficiency secondary to cranial irradiation. [ABSTRACT FROM AUTHOR]

Published
1985

242. Management of Postoperative and PostTmumaticDiabetes Insipidus inChildren

Author

Pitukcheewanont, Pisit, Burstein, Stephen, Rose, Susan R., Lustig, Robert H., and Burghen, George A.

Abstract

Endocrinologists are increasingly confronted by central diabetes insipidus (DI) in children who have had neurosurgical procedures or head injuries. The severity of the disorder depends on the anatomic level of the injury, the degree of hypo-thalamic-pituitary gland damage, and the number and distribution of residual magnocellular neurons that secrete vasopressin. The course of DI may be transient or permanent. The “triphasic” pattern is the most complex and potentially the most dangerous, because the diagnosis can be delayed or even missed. Before diagnosing DI, it is important to evaluate all of the other possible causes of postoperative and post-traumatic polyuria, including fluid overload, osmotic diuresis, hyperglycemia, hypokalemia, and hypercalcemia. The treatment of DI is especially difficult when consciousness is impaired, the thirst mechanism is not intact, or the child is very young. In the patient without an intact thirst mechanism, a daily fluid prescription and frequent checks on serum sodium levels are needed for appropriate home therapy. l-Desamino-8-D-arginine vasopressin is the preferred antidiuretic agent, with the subcutaneous route suggested by us in children younger than 3 years. This article focuses on the pathophysiology, presentation, and diagnosis of postoperative and post-traumatic DI and suggests guidelines for the management of this condition in children.

Published
1996

243. Ontogeny of Gonadotropin Secretion in Congenital Anorchism: Sexual Dimorphism Versus Syndrome of Gonadal Dysgenesis and Diagnostic Considerations

Author

Lustig, Robert H., Conte, Felix A., Kogan, Barry A., and Grumbach, Melvin M.

Abstract

The hormonal characteristics of anorchism are elevated basal levels of gonadotropins, especially follicle-stimulating hormone and a low concentration of plasma testosterone that fails to increase after the administration of human chorionic gonadotropin. However, little is known about the dynamics of plasma gonadotropin secretion in infants and children with anorchism. We analyzed plasma gonadotropin concentrations and their responses to luteinizing hormone releasing factor, along with plasma testosterone responses to human chorionic gonadotropin, in 9 children with surgically proved bilateral anorchism. Basal concentrations of gonadotropins, especially plasma follicle-stimulating hormone, are elevated above normal during the first 3 to 4 years of life, decrease gradually to normal prepubertal levels and then increase again after age 9 years. This age-dependent diphasic pattern of gonadotropin secretion is comparable to that described previously in patients with the syndrome of gonadal dysgenesis and it is consistent with steroid-independent central nervous system inhibition of pulsatile luteinizing hormone releasing factor secretion during mid childhood. Moreover, a sex difference in follicle-stimulating hormone and luteinizing hormone values was observed; the mean follicle-stimulating hormone and luteinizing hormone concentrations in anorchid boys less than 3 years old were lower than in patients with Turner’s syndrome. We suggest that this sex dichotomy is a consequence, at least in part, of the actions of testosterone derived from the fetal testis on the fetal hypothalamus.

Published
1987
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244. An in VitroModel for the Effects of Androgen on Neurons Employing Androgen Receptor-Transfected PC12 Cells

Author

Lustig, Robert H., Hua, Ping, Smith, Lincoln S., Wang, Chihuei, and Chang, Chawnshang

Abstract

Androgen alters neurite outgrowth, synaptic organization, and cell survival in various portions of the brain and spinal cord. However, examination of the specific effects of androgen on neurons in vivohas been difficult. Previously, an in vitromodel for the effects of estrogen on neurons was developed and characterized, using an estrogen receptor (ER)-transfected PC12 rat pheochromocytoma cell line. This model demonstrated estrogenic regulation of neurite outgrowth, spine formation, and gap junction formation. Similarly, an in vitromodel for the effects of androgen on neurons is now described. Wild-type cells (PC12-WT) were stably transfected with an expression vector coding for the full-length cDNA for the human androgen receptor (AR). Resultant clones were isolated, screened for incorporation of vector and expression of AR mRNA and protein, and analyzed for morphologic responses to androgen. PC12-WT, NE09 (ER-negative, AR-negative), SER8 (ER-positive, AR-negative), and AR8 (ER-negative, AR-positive) cells were exposed to 10 ng/ml nerve growth factor (NGF), along with 0-10-7Mdihydrotestosterone (DHT) for 2 days. AR8 cells demonstrated an androgen dose-dependent increase in mean neurite length, branch order, and neurite field area, whereas neurite branch segment length and soma area were not affected by androgen. PC12-WT, NE09, and SER8 cells exhibited no alterations in cell morphology with DHT exposure. Because of the synergistic effects of DHT and NGF, the regulation of NGF receptor mRNA by DHT was evaluated; however, no significant induction of either trkAor p75 mRNA expression by androgen was documented. The results suggest that in AR-positive PC12 cells, androgen acts additively with NGF to increase neurite outgrowth; but androgen effects are mediated specifically through branching and arborization. These responses are similar to developmental studies of androgen effects in vivo. Thus, androgen appears to induce an inherent neural morphologic program in AR-containing cells, which increases the receptive field of these cells, increasing the likelihood for interneural communication, although not promoting communication itself. These cell lines will provide a unique in vitrosystem for studying mechanisms of androgen-neuron interactions.

Published
1994
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