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Abstract: Cadmium (Cd) is a persistent environmental and occupational contaminant that accumulates in humans and shows adverse effects on health. Accumulating evidence reveals that environmental Cd exposure is associated with hepatic lipid accumulation and metabolic alterations in adult male mice. However, whether Cd exposure induces hepatic lipid accumulation and metabolic alterations in female mice remains poorly understood. In the present study, we aimed to investigate the effects of Cd exposure on insulin resistance, hepatic lipid accumulation and associated metabolic pathways. Female CD1 mice were administrated with CdCl2 (10 and 100 mg l–1) by drinking water. We found that Cd exposure did not induce obesity, insulin resistance and hepatic lipid accumulation. By contrary, mice in the Cd‐100 mg l–1 group presented a significant reduction of the glucose area under the curve during the glucose tolerance test. However, there was a significant elevation in the mRNA level of Fasn and Scd‐1, which were critical genes during hepatic fatty acid synthesis. Moreover, hepatic Fabp1 and Fabp4, two genes for hepatic fatty acid uptake were upregulated in Cd‐treated mice. Of interest, Lpl, a key gene for hepatic lipoprotein lysis, was also upregulated in Cd‐treated mice. Collectively, our results suggest that Cd exposure upregulated mRNA level of genes related to hepatic lipid metabolism although there was no insulin resistance and hepatic lipid accumulation shown in the present study. [ABSTRACT FROM AUTHOR]

Background: Gestational diabetes mellitus (GDM) is recognised as a significant problem in pregnancy. Changes to GDM diagnostic criteria have been proposed following analysis of data from the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) study. We sought to assess the impact on the workload for GDM management in Australia that would occur if these changes were adopted. Aim: To assess the impact on health professional workload, specifically management of the number of additional women who would be diagnosed with GDM, should the newly recommended diagnostic criteria be adopted in Australia. Methods: We analysed oral glucose tolerance test results undertaken in pregnant women at two large pathology services in South West and Northern Sydney. We calculated GDM rates using current Australasian Diabetes in Pregnancy Society (ADIPS) Australian Criteria and the rates using the proposed new criteria. Results: These workload data compare ADIPS and proposed International Association of Diabetes and Pregnancy Study Groups Criteria. In a high-risk population examined in two time periods, the estimated increase in workload was 29.0% (based on November 2005 to August 2007 data) and 31.9% (based on September 2007 to August 2009 data). Data from Northern Sydney indicated a 21.7% increased workload (based on September 1998 to July 2009 data). Conclusions: If the newly recommended changes to the diagnostic criteria for GDM are implemented in Australia, we may need to change the way we currently structure our services to manage GDM, to cope with the workload impact of the significantly increased number of women who would require management. In some units this change will be substantial. [ABSTRACT FROM AUTHOR]

Study Objectives. To determine if subjects with chronic alcoholism are predisposed to acetaminophen-induced hepatotoxicity, and to determine the contributing factors. Design. Prospective cohort study. Setting. Community-based crisis intervention center. Subjects. One hundred eighty-eight subjects who answered "yes" to at least one of the four questions on the CAGE (Cut down-Annoyed-Guilty-Eye-opener) questionnaire for identifying alcoholism, and 10 healthy volunteers (controls). Intervention. A history, physical examination, urine toxicologic analysis, ethanol and drug therapy history, and venous blood samples were collected on all subjects. Measurements and Main Results. Venous blood was analyzed for a liver profile, prothrombin time, and total and oxidized glutathione concentrations. A significantly higher proportion of daily drinkers were regular daily users (29.2% [45/154] vs 11.8% [4/34], p=0.0497) as well as abusers (35.7% [55/154] vs 14.7% [5/34], p=0.0237) of acetaminophen compared with nondaily drinkers. Alcoholic subjects with elevated γ-glutamyl transferase (GGT ≥ 51 U/L) levels had significantly lower median plasma glutathione concentrations (2.33 µmol/L, 95% confidence interval [CI] 1.74-2.69 µmol/L) compared with those of alcoholic subjects with normal GGT concentrations (5.97 µmol/L, 95% CI 4.39-7.03 µmol/L, p<0.0001) and healthy volunteers (6.59 µmol/L, 95% CI 4.79-9.65 µmol/L, p=0.0002). A significant inverse correlation was also noted between the GGT concentration and the plasma total glutathione concentration (r = -0.62, p<0.0001). None of the 188 subjects met all preset criteria for hepatotoxicity. Conclusions. Daily drinkers were more than twice as likely as nondaily drinkers to be regular daily acetaminophen users and abusers. Alcoholic subjects with elevated GGT concentrations had significantly lower plasma total glutathione concentrations, and plasma total glutathione concentrations inversely correlated with GGT concentrations. Elevated GGT concentrations may be a clinical marker of depleted glutathione in alcoholic subjects. Acetaminophen-induced hepatotoxicity appears to be uncommon in alcoholic subjects, despite the 31.9% (60/188 patients) who took doses that are potentially hepatotoxic. [ABSTRACT FROM AUTHOR]