A practical reference on visceral adiposity: what it is, how it behaves, what the literature reports, and where the honest uncertainties sit.
Reviewed 2025-10-24. Anything still debated is marked as such rather than presented as settled.
Whether the drug improves hard clinical outcomes is not settled. No completed trial has shown a reduction in heart attacks or strokes among treated patients, although a dedicated cardiovascular outcomes study has been discussed in the literature. Investigators have also examined hepatic fat in people with HIV and fatty liver disease, cognitive measures in small cohorts, and changes in bone density. Regulatory labeling emphasizes monitoring of insulin-like growth factor 1 because supraphysiologic levels raise questions about tissue growth, and the clinical significance of that signal remains an open question rather than a demonstrated harm.
Binding of tesamorelin to the growth hormone-releasing hormone receptor on anterior pituitary somatotrophs activates a Gs protein pathway, raises cyclic AMP, and triggers release of stored growth hormone into the bloodstream. Because the analogue resists dipeptidyl peptidase-4, its plasma residence time exceeds that of native GHRH, producing a larger and more sustained secretory signal. The released growth hormone then acts on the liver and peripheral tissues to raise insulin-like growth factor 1, which feeds back on the hypothalamus and pituitary. This axis explains both the intended effects on fat distribution and the biological markers used to track them.
A Phase 3 program led to regulatory approval in the United States in 2010 for reduction of excess visceral abdominal fat in adults with HIV and lipodystrophy. Subsequent studies examined effects on liver fat, muscle area, and metabolic markers, with mixed findings for some endpoints. Long-term cardiovascular outcomes and effects on mortality remain uncertain because most trials were relatively short and focused on imaging-based fat measurements. Use in populations without HIV has been studied experimentally but is not part of the approved indication.
Tesamorelin is a synthetic analog of growth hormone-releasing hormone, a peptide hormone produced by the hypothalamus. The molecule retains the 44-amino-acid sequence of human GHRH and carries a trans-3-hexenoyl modification at its N-terminus. This modification increases resistance to enzymatic degradation and extends the peptide's functional stability relative to native GHRH. The compound is supplied as a lyophilized powder for reconstitution and subcutaneous administration in clinical settings. Its development code was TH9507, and it belongs to the GHRH analog class. It is not a growth hormone product; instead, it acts upstream to stimulate endogenous growth hormone release.
Clinical interest in tesamorelin arose from the need to address visceral adiposity in people living with HIV. Antiretroviral therapy improved survival but was associated in some patients with central fat accumulation, altered lipid profiles, and metabolic complications. This condition, often called HIV-associated lipodystrophy, involves excess visceral adipose tissue that is difficult to manage through diet and exercise alone. Investigators evaluated tesamorelin because GHRH analogs can stimulate growth hormone secretion and influence fat distribution without direct liposuction or invasive procedures.
| Property | Value | Notes |
|---|---|---|
| Appearance | White to off-white powder | Lyophilized cake in single-use vials |
| Solubility class | Freely soluble in water | Reconstituted with sterile diluent before injection |
| Typical storage temperature | 2 to 8 degrees Celsius | Before reconstitution; protect from light |
| Typical analytical method | Reversed-phase high-performance liquid chromatography | Purity and related-substance testing |
| Identity confirmation | Mass spectrometry | Observed mass near 5.1 kDa for the intact peptide |
Pharmacodynamic studies show that tesamorelin reduces visceral adipose tissue more than subcutaneous adipose tissue in the studied population. This selectivity may relate to differences in blood flow and hormone sensitivity between fat depots. Effects on glucose metabolism and insulin sensitivity have been investigated, with some trials reporting modest changes and others showing stability. The precise relationship between growth hormone exposure, IGF-1 levels, and visceral fat loss remains an active area of analysis.
Tesamorelin binds to growth hormone-releasing hormone receptors on somatotroph cells in the anterior pituitary. Receptor activation increases intracellular cyclic AMP and promotes synthesis and secretion of growth hormone. Because the peptide mimics endogenous GHRH, it amplifies the normal pulsatile release of growth hormone rather than providing exogenous growth hormone directly. This upstream action distinguishes tesamorelin from recombinant growth hormone preparations and from growth hormone secretagogues that act at different receptors.
Stimulated growth hormone release leads to hepatic production of insulin-like growth factor 1, a key mediator of many growth hormone effects. In clinical studies, tesamorelin increased IGF-1 levels in a dose-dependent manner, although the response varies among individuals. The drug's effect on visceral fat is thought to involve growth hormone-mediated lipolysis and altered adipocyte metabolism. Muscle mass and lean body mass have also been assessed as secondary outcomes, but changes are generally smaller and less consistent than fat reductions.
监管记录显示，特沙莫瑞林于 2010 年在美国首次获得批准，用于人类免疫缺陷病毒感染相关的脂肪营养不良患者。批准依据来自降低内脏脂肪的临床试验，而非体重或瘦体重的普遍改善。后续出现了不同制剂版本，但其核心适应症保持一致。关于长期心血管结局和死亡率影响，现有证据仍不充分。
在临床研究之外，特沙莫瑞林常被讨论为生长激素分泌促进剂，但这一说法需要限定。它并不等同于生长激素本身，也不属于普通减重药物。部分研究关注其减少腹部脂肪和改善脂质谱的潜力，另一些研究则关注胰岛素抵抗和 IGF-1 升高等信号。这些效应的临床意义仍在评估中，尚未形成统一结论。
特沙莫瑞林是一种合成肽，其序列与人生长激素释放激素的 44 个氨基酸形式相关。它在 N 端带有反式-3-己烯酰基修饰，这一改动可减缓二肽基肽酶 IV 的降解。该化合物属于生长激素释放激素受体激动剂，可刺激垂体释放生长激素。研究文献通常将其归入合成肽类药物，而非小分子化合物。
质量控制项目一般包括外观、身份、纯度、含量、有关物质、水分和微生物限度。身份确认可通过肽图谱、氨基酸分析和质谱完成，纯度则用面积归一化法计算。研究级材料与药品级材料的要求不同，前者常缺少完整药典验证。不同批次间杂质谱是否影响活性，仍是一个需要具体数据回答的问题。
特沙莫瑞林的检测通常依赖反相高效液相色谱和质谱联用。反相色谱可分离肽主峰与缺失序列、氧化产物等杂质，质谱则提供精确质量以确认身份。对于复杂基质中的定量，常采用液相色谱-串联质谱，并配合固相萃取或蛋白沉淀。生物样品中的肽易降解，因此采集和处理条件会影响结果。
=== Internment camps and Polish refugees === Thousands of Axis POWs and people described as "enemy aliens" were held in Southern Rhodesia during the conflict. These were mainly Italians and Germans, but there were also a handful from Iraq and the Levant; the colony furthermore hosted nearly 7,000 refugees from Poland. Britain delegated responsibility for co-ordinating investigation into enemy aliens in central Africa to the Southern Rhodesian government, which set up a system whereby the Criminal Investigation Department (CID) identified potential detainees while a body called the Internment Camps Corps oversaw the camps. Many of those held in Southern Rhodesia were sent there by Britain or authorities elsewhere in the Empire. Five internment camps were set up in two waves. No. 1 (General) Internment Camp opened to the north-east of Salisbury in October 1939 and No. 2 (Tanganyika) Internment Camp, just south of the city, opened the following year, mostly housing Germans formerly resident in Tanganyika. The first two camps together had less than 800 inmates. The third, fourth and fifth camps were set up near Gatooma, Umvuma and Fort Victoria in 1941–42 to accommodate roughly 5,000 Italians from Somaliland and Abyssinia. The Internment Camps Corps' reliance on the elderly, the infirm and so-called "friendly aliens" to staff the three new camps led to indiscipline, poor living conditions and dozens of escapes. A 1943 government commission into the quality of the internment camps reported the second wave camps to be of far worse quality than those of the first wave.
Statistical Coupling Analysis (SCA) is a method used in bioinformatics to study how pairs of amino acids in a protein sequence evolve together. It analyzes a multiple sequence alignment (MSA), which is a display of the sequences of many related proteins arranged to highlight similarities and differences. SCA measures how much the amino acid makeup at one position in the protein changes when the amino acid makeup at another position is altered. This relationship is quantified as statistical coupling energy. A higher coupling energy indicates that the amino acids at both positions are more likely to have co-evolved and are therefore functionally or structurally linked. In simpler terms, it helps scientists understand which parts of a protein are working together and how they have changed over evolutionary time.
After the breakup, Bare embarked on a successful solo career, releasing his first album, "Izgubljen I Nađen", in 2001, recorded with his backing band Plaćenici. Meanwhile, Čalić and Kilmister formed the band Elektrobuda, releasing an album titled "Sveti Zvuk" in 2005.
== Clinical significance == Pathogenic variants in SLC39A13 cause spondylodysplastic Ehlers–Danlos syndrome type 3, an autosomal recessive connective tissue disorder characterized by short stature, skeletal abnormalities, thin wrinkled skin, joint hypermobility, and dental abnormalities. A reported missense variant, Gly74Asp, occurs within a transmembrane region of ZIP13 and has been associated with disease. Disease-associated ZIP13 variants may be degraded by the cell’s protein quality-control machinery, leading to impaired zinc homeostasis.
Berkelium-242 was synthesized in 1979 by bombarding 235U with 11B, 238U with 10B, 232Th with 14N or 232Th with 15N. It converts by electron capture to 242Cm with a half-life of 7.0±1.3 minutes. A search for an initially suspected isotope 241Bk was then unsuccessful; 241Bk has since been synthesized.
Sources: en.wikipedia.org
Glycyrrhizin (glycyrrhizic acid or glycyrrhizinic acid) is the chief sweet-tasting constituent of Glycyrrhiza glabra (liquorice) root. Structurally, it is a saponin used as an emulsifier and gel-forming agent in foodstuffs and cosmetics. Its aglycone is enoxolone.
==== UK and European Union export ban ==== Due to its use for executions in the US, the UK introduced a ban on the export of sodium thiopental in December 2010, after it was established that no European supplies to the US were being used for any other purpose. The restrictions were based on "the European Union Torture Regulation (including licensing of drugs used in execution by lethal injection)." From December 21, 2011, the European Union extended trade restrictions to prevent the export of certain medicinal products for capital punishment, stating, "The Union disapproves of capital punishment in all circumstances and works towards its universal abolition."
The sermon images were "of pure Gandhara style". Their style was very close to those of the "Cave of the Painters (Cave 207)", and, according to Grünwedel, "they seem to have been executed by the same hand". Albert Grünwedel attributed both caves to the same "Stage I" period (500–600 CE). Several fine fragments of very fine painting have reached us, which are attributed to the Cave of the Statues. Grünwedel explained that only three paintings remained in the cella, all scenes of the sermon of the Buddha: 1) On the right wall of the cella, Grünwedel described the picture of a sermon, with "a youth in light undergarment praying in front of Buddha", corresponding to the picture now described as the "cowherd Nanda", known to have come from the Cave of the Statues. 2) In the opposite location, on the left wall, Grünwedel described a sermon scene in which the Buddha "only had his feet remaining", corresponding to the panel photographed by Charles Nouette in-situ in 1907. 3) Finally Grünwedel described a sermon scene with only a "kneeling adorant" remaining, corresponding to the kneeling Vajrapani, known to have come from the Cave of the Statues. The style of these panels from the main cella is markedly different from the refined, "classical" style of the side corridor vaults and the back corridor. They suggests different painters and different schools of art. In the cella, the paintings are much bolder, using intense colors, thicker lines and simpler patterns, as in the "Cowherd Nanda".
Ornstein commented that "no speaker did more to relegate the regular order to the sidelines than Hastert. ... The House is a very partisan institution, with rules structured to give even tiny majorities enormous leverage. But Hastert took those realities to a new and more tribalized, partisan plane." Despite this shift, Hastert was widely seen as "affable" and low-key; he did not seek the limelight, "become a regular on Sunday talk shows or anything close to a household word or figure", or "openly exhibit the kind of snarling or mean partisan demeanor that made Tom DeLay such a mark of hatred for Democrats". Hastert adopted a much lower profile in the media than conventional wisdom would suggest for a Speaker. This led to accusations that he was only a figurehead for DeLay. In 2005, DeLay was indicted by a Texas grand jury on charges of campaign finance violations. DeLay stepped down as majority leader and was replaced in that post by Roy Blunt; DeLay resigned from Congress the following year. Throughout his term, Hastert was a strong supporter of President George W. Bush's foreign and domestic policies. Hastert was described as a Bush loyalist who worked closely with the White House to shepherd Bush's agenda through Congress, The two frequently praised each other, expressed mutual respect, and had a close working relationship, even during the controversy over Representative Mark Foley sending sexually explicit text messages to teenage male [[Page of the United States House of Representatives
== Mechanism of action, metabolic end-products, and metabolic rate == [18F]FDG, as a glucose analog, is taken up by high-glucose-using cells such as brain, brown adipocytes, kidney, and cancer cells, where phosphorylation prevents the glucose from being released again from the cell, once it has been absorbed. The 2-hydroxyl group (–OH) in normal glucose is needed for further glycolysis (metabolism of glucose by splitting it), but [18F]FDG is missing this 2-hydroxyl. Thus, in common with its sister molecule 2-deoxy-D-glucose, FDG cannot be further metabolized in cells. The [18F]FDG-6-phosphate formed when [18F]FDG enters the cell cannot exit the cell before radioactive decay. As a result, the distribution of [18F]FDG is a good reflection of the distribution of glucose uptake and phosphorylation by cells in the body. The fluorine in [18F]FDG decays radioactively via beta-decay to 18O−. After picking up a proton H+ from a hydronium ion in its aqueous environment, the molecule becomes glucose-6-phosphate labeled with harmless nonradioactive "heavy oxygen" in the hydroxyl at the C-2 position. The new presence of a 2-hydroxyl now allows it to be metabolized normally in the same way as ordinary glucose, producing non-radioactive end-products. Although in theory all [18F]FDG is metabolized as above with a radioactivity elimination half-life of 110 minutes (the same as that of fluorine-18), clinical studies have shown that the radioactivity of [18F]FDG partitions into two major fractions.
Sources: en.wikipedia.org
It mimics a natural hypothalamic signal that tells the pituitary to release growth hormone. The result is a rise in circulating growth hormone and, indirectly, in insulin-like growth factor 1. Over weeks of treatment this shift is associated with a selective decrease in fat stored inside the abdomen.
The primary measure is usually a cross-sectional abdominal scan that separates internal fat from fat just under the skin. Waist circumference and body weight are recorded as secondary measures because they are easy to obtain but do not distinguish the two fat compartments. Hormone and metabolic blood tests are collected alongside the imaging.
Available follow-up data indicate that visceral fat drifts back toward pretreatment levels once injections stop. The change is therefore best described as treatment-dependent rather than permanent. Investigators continue to debate whether intermittent or repeated courses would preserve any benefit.
It is a synthetic peptide analog of human growth hormone-releasing hormone. It is used clinically to reduce excess visceral abdominal fat in adults with HIV-associated lipodystrophy. It works by stimulating pituitary growth hormone release.