Regional variation in adipose tissue metabolism of severely obese premenopausal women

Lipolytic and lipoprotein lipase (LPL) activities were studied in isolated human adipocytes obtained from two intraabdominal depots (round ligament and omental) and from the subcutaneous abdominal region of nine severely obese premenopausal women (with body mass indices ranging from 37 to 51 kg/m2), aged 36 +/- 3 yr, undergoing gastrointestinal surgery. Both fat cell weight and LPL activity were significantly greater in round ligament adipose cells than in subcutaneous abdominal or in omental adipocytes (P < 0.05). The antilipolytic effect of insulin and the sensitivity to this hormone were also higher in round ligament adipose cells than in omental adipocytes (P < 0.05). Although epinephrine initiated a similar biphasic profile of response in all cell types, the catecholamine promoted a weaker inhibition of lipolysis in omental adipocytes than in subcutaneous abdominal adipose cells (P < 0.05). In addition, a lack of regional variation was found in the maximal antilipolysis initiated by UK 14304 and the alpha 2-adrenoceptors was higher in both subcutaneous abdominal and round ligament fat cells than in omental adipocytes. Moreover, the maximal lipolytic response to isoproterenol or to agents acting at post-receptor levels was not different among fat depots. Finally, a lower beta-adrenergic lipolytic sensitivity associated with a reduced beta-adrenoceptor density was observed in round ligament as compared to omental adipose cells. These data suggest that in massively obese premenopausal women, omental and round ligament adipose tissues show distinct metabolic properties that may contribute to limit the impact of intraabdominal obesity.

Hyperinsulinemia and regulation of energy balance

Recent data suggest that hyperinsulinemia with euglycemia may favor the restoration of energy balance when one gains body weight. To test the validity of this concept in humans, the data of 24 young men who had been exposed to a 353-MJ overfeeding protocol for 100 d and who were remeasured after a 4-mo follow-up were analyzed. The sample was subdivided in two groups on the basis of the overfeeding-induced change in postprandial plasma insulin. The increase in postprandial energy expenditure induced by overfeeding was significantly greater in high than in low postprandial insulin responders (P < 0.05) but not after body fat gain was controlled for. After the overfeeding protocol, the loss of subcutaneous adiposity was greater in high than in low postprandial insulin responders. However, this difference was no more significant after the gain in fat mass was controlled for. There was no difference between the two groups in post-overfeeding loss of body weight, fat mass, or fat-free mass. These results partly agree with the idea that hyperinsulinemia resulting from a long-term positive energy balance and its associated fat gain exert a regulatory role promoting the restoration of energy balance.

Effects of different training intensities on the cardiopulmonary baroreflex control of forearm vascular resistance in hypertensive subjects

We recently reported that ambulatory blood pressure decreased during the awake period after training at low intensity but not after training at moderate intensity in subjects with mild to moderate hypertension. The reasons for the failure of moderate-intensity training to reduce blood pressure are not clear. In the present article, we report the effects of different training intensities on cardiopulmonary baroreflex control of forearm vascular resistance, left ventricular function, vascular reactivity, and resistive vessel structure. After moderate-intensity training, the cardiopulmonary baroreflex control of forearm vascular resistance was significantly attenuated, left ventricular performance was enhanced, and vascular reactivity and resistive vessel wall thickness in the calf were reduced compared with values after the control sedentary period. No significant changes in these indexes were found after low-intensity training compared with sedentary values. These results indicate that attenuation of the cardiopulmonary baroreflex control of skeletal muscle vascular resistance after training at moderate intensity may contribute to the lack of antihypertensive effects, as seen from unchanged ambulatory blood pressure levels during the awake period, after training at this intensity. A decreased vascular smooth muscle response to sympathetic nervous stimulation appears to be partly involved in the alteration in the baroreflex control of forearm vascular resistance after moderate-intensity training. Although these findings should be confirmed in a greater number of subjects, the present results point to a key mechanism that might explain why moderate endurance exercise training fails to lower arterial blood pressure in hypertensive subjects.

Relation of steroid hormones to glucose tolerance and plasma insulin levels in men. Importance of visceral adipose tissue

OBJECTIVE

Low plasma testosterone levels are associated with hyperinsulinemia and glucose intolerance in men. However, it is unclear whether these abnormalities are related to the concomitant alteration in regional adipose tissue (AT) accumulation associated with reduced androgen levels.

RESEARCH DESIGN AND METHODS

We measured plasma steroid levels in a sample of 79 men, ranging from lean to obese (aged 29-42 years), for whom an oral glucose tolerance test (OGTT), anthropometric and computed tomography (CT) measurements of body fatness, and AT distribution were performed. Sex hormone binding globulin (SHBG) and the following steroids were measured after extraction from plasma and chromatography: dehydroepiandrosterone, androstenedione, androst-5-ene-3 beta,17 beta-diol, testosterone, estrone, and estradiol (E2).

RESULTS

Several significant negative correlations were found between adrenal C19 steroid precursors, testosterone, SHBG, and fasting insulin levels, as well as between plasma glucose and insulin concentrations measured during the OGTT (-0.25 < or = r < or = -0.35, 0.05 > or = P > or = 0.001). The best steroid correlate of plasma glucose and insulin homeostasis indexes was the E2: testosterone ratio (0.34 < or = r < or = 0.42, 0.005 > or = P > or = 0.001). However, after correction of steroid levels for either fat mass, body mass index (BMI), or visceral AT area, as measured by CT, no significant residual associations were noted between testosterone, adrenal C19 steroid, SHBG, and estrogen levels and indexes of plasma glucose-insulin homeostasis, although the positive association between the E2: testosterone ratio and glucose area remained significant after adjustment for total body fat mass and BMI. Furthermore, 15 pairs of obese subjects, matched for visceral AT area, showing either low or high levels of the steroids studied, did not differ in fasting insulin and postglucose plasma insulin levels or in glucose tolerance.

CONCLUSIONS

These results suggest that the previously reported relationships between androgen levels and indexes of plasma glucose-insulin homeostasis are mediated, to a large extent, by concomitant alterations in levels of total body fat and visceral AT in men.

Plasma glucose, insulin, and glucagon before and after long-term overfeeding in identical twins

Plasma glucose, insulin, and glucagon levels were measured before and after long-term overfeeding (4.2 MJ/d during a 100-day period) in 24 lean adults (12 pairs of monozygotic twins). Fasting plasma glucose, insulin, and glucagon were significantly increased by overfeeding. During a 75-g oral glucose tolerance test (OGTT), no major alteration in glucose tolerance was observed and insulin area under the curve was increased. During a meal test, insulin and glucagon areas under the curve were increased. The pre-overfeeding values for glucose, insulin, and glucagon (fasting and areas) were not correlated with the gains in body weight and in fat mass. However, fasting glucagon before overfeeding was positively correlated with the gains in abdominal visceral fat and in femoral fat. The changes with overfeeding in insulin area during the OGTT were positively correlated with the changes in total subcutaneous fat, even after adjustment for total body fat gain. Significant twin intrapair similarity was observed for fasting plasma glucagon before overfeeding and for the changes in fasting insulin and glucagon with overfeeding. These results indicate that (1) in response to long-term overfeeding, both fasting insulin and glucagon are increased; (2) initial levels of glucose, insulin, and glucagon do not predict the gains in body weight and total body fat during overfeeding, but are related to changes in indicators of fat topography; (3) the changes in total subcutaneous fat represent an important correlate of insulin changes with overfeeding; and (4) the genotype could be an important determinant of insulin and glucagon responses to a prolonged positive-energy-balance period.

Diminished diabetogenic effect of streptozotocin in adrenodemedullated rats

Although stress is suspected to play a role in the development of diabetes mellitus, no direct experimental evidence for involvement of the adrenal medullae in onset of the disease has yet been found. We recently observed that, in comparison with sham-operated rats, fewer adrenodemedullated rats become diabetic after an i.v. injection of streptozotocin (STZ); thus, the present study examined the role of the adrenal medullae in the development of experimental diabetes. Male Wistar rats were surgically adrenodemedullated (ADM) or sham-operated (SHAM). After a 3-week recovery period, they were injected with 40 mg STZ/kg freshly dissolved in citrate buffer or buffer alone. A 1-mL arterial blood sample was withdrawn 12 days later in previously cannulated animals; then the rats were killed and their pancreas was removed. The plasma glucose levels were lower in ADM rats injected with buffer alone than in their SHAM counterparts (7.7 +/- 0.1 vs. 8.5 +/- 0.1 mmol/L; p < 0.05). The glucose levels were higher (p < 0.001) in both groups of STZ-treated rats, with values 28% lower in ADM than in SHAM rats (14.7 +/- 1.6 vs. 18.8 +/- 1.2 mmol/L; p < 0.03). Whereas plasma insulin levels did not differ between ADM and SHAM rats injected with buffer alone (431 +/- 38 vs. 428 +/- 35 pmol/L; p > 0.05), they were diminished in SHAM animals injected with STZ (292 +/- 37 vs. 428 +/- 35 pmol/L; p < 0.02).(ABSTRACT TRUNCATED AT 250 WORDS)

Are gender differences in cardiovascular disease risk factors explained by the level of visceral adipose tissue?

It has been suggested that the lower prevalence of cardiovascular disease in women before menopause in comparison with men may be explained by differences in body fat distribution, plasma lipoprotein levels and indices of plasma glucose-insulin homeostasis. Thus, gender differences in visceral adipose tissue accumulation measured by computed tomography and metabolic variables were studied in 80 men and 69 pre-menopausal women, aged 23-50 years. Despite the fact that women had higher levels of total body fat (p < 0.0001), they displayed lower areas of abdominal visceral adipose tissue (p < 0.06) and a lower ratio of abdominal visceral to mid-thigh adipose tissue areas than men (p < 0.0001). After adjustment for body fat mass, women generally displayed a more favourable risk profile than men which included higher plasma HDL2-cholesterol and lower plasma insulin, apolipoprotein B and triglyceride levels (p < 0.01). Metabolic variables adjusted for body fat mass were then compared between genders after control for differences in abdominal visceral adipose tissue area. After such controls, variables related to plasma glucose-insulin homeostasis were no longer significantly different between men and women. Gender differences for plasma concentrations of triglyceride, apolipoprotein B and the ratio of HDL2-cholesterol/HDL3-cholesterol also disappeared, whereas plasma concentrations of HDL-cholesterol, HDL2-cholesterol as well as the ratio of HDL-cholesterol/total cholesterol remained significantly higher in women than in men (p < 0.01). These results suggest that abdominal visceral adipose tissue is an important correlate of gender differences in cardiovascular disease risk. However, additional factors are likely to be involved in gender differences in plasma HDL-cholesterol levels.

The pattern of catecholamine response to burst activity in leopard frogs, Rana pipiens

It is well known that burst activity causes a rapid breakdown of muscle glycogen and extensive accumulation of lactate in frogs. During recovery, it has been shown that lactate is nearly totally recycled into muscle glycogen. Since catecholamines are likely to play some role in the regulation of postexercise repletion of muscle glycogen, the pattern of catecholamine response was assessed in frogs during intense physical activity and the ensuing recovery period. Chronically cannulated frogs were forced to swim until exhaustion, and serial blood samples were taken at regular time intervals for the measurements of catecholamines. The pattern of changes in plasma and muscle lactate and glucose and muscle glycogen during and after burst activity is similar to that reported in previous studies using noncannulated frogs, a result which indicates that the animals recover well from the surgical trauma associated with cannulation. The concentrations of plasma catecholamines in frogs at rest are comparable to those measured in other amphibians, and the levels of plasma epinephrine in resting frogs are much higher than those of norepinephrine. Burst activity causes a marked increase in plasma catecholamines, with higher levels reached by epinephrine. During recovery, the concentration of plasma catecholamines returns to normal within 30 min. Although this pattern of catecholamine response to intense physical activity may be favorable to the repletion of muscle glycogen postexercise, it remains to be clarified how critical the low levels and fast reduction in plasma catecholamines are for optimum glycogen resynthesis.

Waist circumference and abdominal sagittal diameter: best simple anthropometric indexes of abdominal visceral adipose tissue accumulation and related cardiovascular risk in men and women

The amount of abdominal visceral adipose tissue measured by computed tomography is a critical correlate of the potentially "atherogenic" metabolic disturbances associated with abdominal obesity. In this study conducted in samples of 81 men and 70 women, data are presented on the anthropometric correlates of abdominal visceral adipose tissue accumulation and related cardiovascular disease risk factors (triglyceride and high-density lipoprotein cholesterol levels, fasting and postglucose insulin and glucose levels). Results indicate that the waist circumference and the abdominal sagittal diameter are better correlates of abdominal visceral adipose tissue accumulation than the commonly used waist-to-hip ratio (WHR). In women, the waist circumference and the abdominal sagittal diameter also appeared more closely related to the metabolic variables than the WHR. When the samples were divided into quintiles of waist circumference, WHR or abdominal sagittal diameter, it was noted that increasing values of waist circumference and abdominal sagittal diameter were more consistently associated with increases in fasting and postglucose insulin levels than increasing values of WHR, especially in women. These findings suggest that the waist circumference or the abdominal sagittal diameter, rather than the WHR, should be used as indexes of abdominal visceral adipose tissue deposition and in the assessment of cardiovascular risk. It is suggested from these data that waist circumference values above approximately 100 cm, or abdominal sagittal diameter values > 25 cm are most likely to be associated with potentially "atherogenic" metabolic disturbances.

Systolic blood pressure during submaximal exercise: an important correlate of cardiovascular disease risk factors in normotensive obese women

Body fatness, plasma lipids, lipoproteins, indicators of glucose metabolism, and resting as well as submaximal treadmill exercise systolic blood pressures (BPs) were measured in a sample of 25 normotensive obese premenopausal women. No association was observed between body fatness, risk factors for cardiovascular disease, and resting BP. However, body fatness and plasma cholesterol, low-density lipoprotein cholesterol (LDL-CHOL), LDL apolipoprotein B (apo B), and apo B concentrations, as well as the high-density lipoprotein cholesterol to cholesterol (HDL-CHOL/CHOL) ratio, showed significant correlations with systolic BP measured during submaximal exercise. In addition, fasting plasma insulin concentrations and the glucose and insulin areas under the oral glucose tolerance test (OGTT) curve were both significantly associated with systolic BP during submaximal exercise. Partial correlation analyses revealed that the associations between submaximal exercise systolic BP and plasma apo B and LDL apo B levels were in part independent from the level of obesity. These results indicate that plasma concentrations of lipoproteins and insulin are important correlates of the systolic BP during submaximal exercise in obese premenopausal women. Further analyses performed on two subgroups indicated that women with high exercise systolic BP values exhibited significant differences in their metabolic profile in comparison to women with low BP during exercise. These results suggest that the absolute systolic BP recorded during submaximal exercise may be useful in the early detection of individuals at risk for the development of cardiovascular disease in resting normotensive obese women.

Components of postprandial thermogenesis in relation to meal frequency in humans

Experiments on dogs have shown that the size of the meal has no effect on the early cephalic postprandial thermogenesis, and that four small meals are more thermogenic than a larger meal with the same total caloric content as the four meals. A study was repeated on human subjects who were fed during alternating weeks either one large meal (653 kcal (1 kcal = 4.1855 kJ)) or four small meals (163 kcal) at 40-min intervals. Oxygen consumption and respiratory exchange ratio determinations indicated (i) larger overall increase in postprandial thermogenesis with the four meals than with one meal and (ii) an enhancement of glucose utilization with the large meal compared with greater lipid utilization with the four meals. On the basis of indirect evidence from previous investigations it is suggested that the enhanced thermogenesis observed in the four-meal experiment is due to lipid mobilization caused by repeated stimulation of the sympathetic nervous system with palatable food. Blood analysis indicated a reduced elevation of plasma glucose in the four-meal experiment. The variations of insulin and C-peptide exactly paralleled those observed for glucose. It is concluded that the increased frequency of feeding significantly reduces insulin secretion in subjects fed a relatively high carbohydrate meal. In addition to this beneficial effect, increasing the number of meals increased thermogenesis and fat utilization.

Effect of adrenal demedullation and (or) physical training on glucose tolerance in the rat

Physical training increases insulin sensitivity by mechanisms not yet fully understood. Because exercise also modulates adrenergic system activity, the present study was designed to ascertain whether the improved glucose homeostasis observed in trained rats is influenced by epinephrine secretion from the adrenal medullae. Male Wistar rats previously submitted to adrenal demedullation or sham operated were kept sedentary or trained on a treadmill over a 10-week period. An intravenous glucose tolerance test (IVGTT) was done 64 h after the last bout of exercise. Basal plasma glucose levels were reduced by physical training (p < 0.005) and by adrenal demedullation (p < 0.001). Adrenodemedullated rats had lower (p < 0.005) plasma glucose levels than sham-operated animals over the whole glucose tolerance curve. Trained animals had lower (p < 0.01) plasma glucose levels than sedentary rats throughout the IVGTT, except at 45 min. The glucose disappearance rate measured after the glucose bolus injection was increased by training (p < 0.05), whereas it was not modified by adrenal demedullation. Basal plasma insulin levels were reduced (p < 0.001) by physical training but unaffected by adrenal demedullation. During the IVGTT, adrenodemedullated rats had higher (p < 0.01) plasma insulin levels at 2, 4, and 6 min, whereas trained animals had lower (p < 0.05) plasma insulin levels throughout the test. Moreover, insulin in adrenodemedullated and trained rats had returned to basal levels at 30 min. The area under the curve for insulin was diminished by physical training (p < 0.001) but was not modified by adrenal demedullation.(ABSTRACT TRUNCATED AT 250 WORDS)

Abdominal and femoral adipose tissue lipolysis and cardiovascular disease risk factors in men

The relationships between subcutaneous abdominal and femoral fat cell lipolyses, plasma free-fatty acid (FFA) levels and metabolic variables considered as risk factors for cardiovascular disease (CVD) (plasma glucose, insulin and lipoprotein levels) were investigated in 54 men, aged 36 +/- 3 (SD) years, covering a wide range of body fatness values (body mass indices from 19 to 34 kg m-2). Although there were no consistent relationships between femoral fat cell weight and the metabolic profile, positive and significant associations were found between abdominal fat cell weight and most of the metabolic indices. However, abdominal fat cell lipolysis measured with an alpha 2-(clonidine) or a beta-agonist (isoproterenol) was unrelated to metabolic variables. In contrast, femoral fat cell lipolysis measured in the presence of clonidine was positively associated with fasting plasma insulin, cholesterol (CHOL) and apolipoprotein (apo) B levels, as well as with LDL-CHOL and LDL-apo B concentrations. No association was found between isoproterenol-stimulated lipolysis of femoral adipocytes and the metabolic profile. Comparison of two subgroups of men with either low or high femoral residual lipolysis with clonidine revealed that subjects with the lowest femoral alpha 2-adrenergic component (i.e. the highest residual lipolysis) displayed significant alterations in both plasma lipid-lipoprotein and glucose-insulin levels which could be predictive of an increased risk of CVD. Free fatty acid (FFA) levels measured in the fasting state and during an oral glucose tolerance test (OGTT) were positively associated with fasting plasma insulin and triglyceride levels as well as with both glucose and insulin areas measured during the OGTT. However, regional adipose tissue lipolysis measured in vitro was unrelated to plasma FFA levels. These results support the view that both femoral adipose tissue lipolysis and plasma FFA levels are significant correlates of plasma glucose-insulin homeostasis and lipoprotein-lipid levels, in men. However, as adipose tissue lipolysis and plasma FFA are unrelated to each other, they may be associated with risk variables through independent mechanisms.

Post-exercise reduction in blood pressure in hypertensive subjects: effects of angiotensin converting enzyme inhibition

1. Much attention has been given to the effects of various classes of antihypertensive drugs on blood pressure and haemodynamics. The effects of a single bout of exercise on post-exercise blood pressure have also been studied by several investigators. However, the combined effects of prior exercise and antihypertensive medication has drawn less attention. 2. We examined the separate and combined effects of a single bout of exercise and of angiotensin converting enzyme (ACE) inhibition with a new ACE inhibitor (fosinopril, 20 mg day(-1)) on post-exercise blood pressure and systemic and regional haemodynamics. Ten patients with mild-to-moderate hypertension were studied with a double-blind, randomized crossover, placebo- and rest period-controlled study design. 3. At rest, mean arterial pressure (MAP, -10 +/- 2 mm Hg), total peripheral resistance (TPR, -11 +/- 5%) and forearm vascular resistance (FVR, -17 +/- 8%) were significantly (P < 0.05) reduced during ACE inhibition as compared with the placebo phase. 4. During the placebo phase, MAP (-3 +/- 1 mm Hg), TPR (-10 +/- 4%) and FVR (-9 +/- 4%) were lower after exercise as compared with the control rest period. 5. During ACE inhibition, MAP (-3 +/- 1 mm Hg) and TPR (-8 +/- 4%) were lower, but FVR (+32 +/- 15%) was increased after exercise as compared with the control rest period. 6. Thus, blood pressure and TPR decreased similarly after exercise during the placebo phase and during ACE inhibition. However, differences in post-exercise forearm haemodynamics during the placebo phase and during ACE inhibition indicate that underlying regional haemodynamics are modified.

Apolipoprotein E polymorphism modifies relation of hyperinsulinemia to hypertriglyceridemia

The effect of apolipoprotein E polymorphism on the established relationships between glucose tolerance, plasma insulin levels, and plasma lipoprotein concentrations were investigated in a sample of women defined on the basis of apolipoprotein E phenotypes. In women with the apolipoprotein E epsilon 2 allele (n = 22), fasting plasma insulin and glucose and insulin areas under the curve measured during an oral glucose tolerance test were positively correlated with plasma triglyceride levels (0.48 < or = r < or = 0.70; P < 0.05). In this group, very-low-density lipoprotein cholesterol and very-low-density lipoprotein triglyceride concentrations were positively correlated with fasting insulin levels, the insulin area, and with the ratio of insulin area to glucose area. In women (n = 24) homozygous for the apolipoprotein E epsilon 3 allele (the most common allele), essentially similar associations were found. In contrast, in women (n = 17) with the apolipoprotein E epsilon 4 allele, no association was found between glucose tolerance, fasting and postglucose plasma insulin levels, and plasma lipid and lipoprotein levels. These results suggest that apolipoprotein E polymorphism substantially modifies the associations between glucose tolerance, plasma insulin levels, and plasma lipoprotein concentrations. Additional analysis of the data revealed that apolipoprotein E polymorphism did not alter the relationships between body fat distribution and fasting insulin and postglucose insulin levels, but no correlation was observed between fatness indexes and glucose tolerance among apolipoprotein E epsilon 2 carriers.(ABSTRACT TRUNCATED AT 250 WORDS)

Captopril or conventional therapy in hypertensive type II diabetics. Three-year analysis

The effects of long-term treatment with captopril and conventional therapy on albuminuria and metabolic parameters were compared in 74 hypertensive type II diabetics with normal serum creatinine. Patients were treated double-blind with either captopril monotherapy or combined with hydrochlorothiazide or therapy with metoprolol, hydrochlorothiazide, or both for 36 months. The treatment was titrated to achieve goal diastolic blood pressure of < or = 85 mm Hg. The reductions in blood pressures during treatment were similar in patients with (n = 21) and without (n = 53) microalbuminuria treated with either captopril or conventional therapy. No significant changes in albuminuria occurred in normoalbuminuric patients with either therapy. Although albuminuria fell in nearly all patients with microalbuminuria treated with captopril, it rose in eight of 12 patients on conventional therapy, with macroalbuminuria developing in two of them. Renal function was preserved by both types of treatment in both patient groups. Long-term treatment with either conventional therapy or captopril did not alter metabolic variables. We conclude that captopril alone or in combination decreases albuminuria and prevents the development of macroalbuminuria in hypertensive type II diabetics with persistent microalbuminuria. The renoprotective effect of this agent, however, remains to be demonstrated with longer term data on renal function. Aggressive antihypertensive treatment with either captopril or conventional therapy appears to be effective in preventing the onset of microalbuminuria in most normoalbuminuric patients. In contrast, with previous short-term studies, the use of converting enzyme inhibitors or conventional therapy did not cause adverse metabolic effects.

Physical training reverses defect in mitochondrial energy production in heart of chronically diabetic rats

This study examined the impact of physical training on cardiac mitochondrial respiration of rats with chronic diabetes mellitus. Diabetes was induced by an intravenous injection of STZ (50 mg/kg) and only rats with a blood glucose level between 14 and 22 mM 1 wk later were kept in the protocol. Exercise training was conducted on a treadmill with a progressive 10-wk program. Animals were killed at the end of the training program, and mitochondria were isolated from ventricular tissue by differential centrifugation. Both state 3 respiration and oxidative phosphorylation rates were depressed significantly in the mitochondria of diabetic rats. These alterations were reversed completely to normal by physical training, without any significant changes in plasma glucose or insulin levels. The activity of ANT was not affected by diabetes or training. These results indicate that the depressed OPR present in isolated heart mitochondria from chronically diabetic rats is reversed to normal by physical training, apparently by mechanisms independent of blood glucose control. This correction in mitochondrial energy production may explain the improvement in cardiac function previously reported in trained diabetic rats.

Evidence for a role of insulin in the regulation of abdominal adipose tissue lipoprotein lipase response to exercise training in obese women

Abdominal and femoral adipose tissue lipoprotein lipase (AT-LPL) activities were measured in ten obese premenopausal women (mean age 35 +/- 5 years) who took part in a six month endurance exercise training programme. The programme involved four to five 90 min training sessions per week at about 50 to 55% of maximal endurance power (VO2max). Before training, the ratio of insulin to glucose area measured during an oral glucose tolerance test (OGTT) was significantly correlated with fat mass (r = 0.72, P < 0.05) as well as with abdominal AT-LPL activity (r = 0.69, P < 0.05). The training programme induced a significant increase in VO2max (P < 0.05) whereas no significant change in the mean body composition was observed. Abdominal as well as femoral AT-LPL activities were significantly reduced after the exercise training programme (P < 0.05) whereas plasma post-heparin (PH) LPL activity was significantly increased by training (P < 0.05). No significant association was observed between changes in VO2max and in body composition parameters and changes in abdominal or femoral AT-LPL activities. However, changes in insulin sensitivity, as estimated by changes in the insulin area/glucose area ratio were positively correlated with changes in abdominal AT-LPL activity expressed on a per cell (r = 0.72, P < 0.05) or per surface area (r = 0.81, P < 0.01) basis. These results suggest that the reduction in AT-LPL activity in both fat depots following endurance training in obese women can occur despite the lack of significant decrease in body weight and average fat cell size.(ABSTRACT TRUNCATED AT 250 WORDS)

Effect of endurance training on beta-adrenergic system in three different skeletal muscles

The beta-adrenergic receptor density (Bmax) and adenylate cyclase (AC) activity in the soleus muscle and deep red and white superficial portions of the vastus lateralis muscle were evaluated in a group of rats submitted to a progressive 10-wk treadmill running program (n = 19) and compared with a group of rats kept sedentary (n = 17) during the same period of time.(ABSTRACT TRUNCATED AT 250 WORDS)

Physical training attenuates phosphocreatine and long-chain acyl-CoA alterations in diabetic rat heart

This study was designed to assess the effect of physical training on high-energy phosphate levels in the heart of diabetic rats. Diabetes was induced with streptozocin (50 mg/kg), and exercise training was carried out on a treadmill with a progressive 10-wk program. Plasma glucose levels at the end of the training program showed only a small improvement of the diabetic state in trained animals (21.7 +/- 1.3 vs. 24.4 +/- 0.8 mmol/l; P < 0.05). The lower heart rate observed in sedentary diabetic rats (279 +/- 6 vs. 356 +/- 5 beats/min; P < 0.001) was improved by physical training (301 +/- 8 beats/min; P < 0.05 vs. sedentary diabetics). Significantly lower phosphocreatine levels were found in sedentary diabetic rats (12.0 +/- 0.7 mumol/g dry wt) than in sedentary control rats (15.0 +/- 0.9 mumol/g dry wt; P < 0.05) but not in trained diabetic rats (13.7 +/- 0.7 mumol/g dry wt). ATP levels were not affected by diabetes but were increased by training. The increased long-chain acyl-CoA levels in sedentary diabetic rats (146 +/- 7 vs. 119 +/- 8 mumol/g dry wt in sedentary control rats; P < 0.05) were improved by training (138 +/- 6 mumol/g dry wt; P > 0.05 vs. sedentary control rats). These data indicate that the diminution in phosphocreatine levels observed in the heart tissue of chronically diabetic rats can be attenuated by an exercise training program.

Metabolic heterogeneity associated with high plasma triglyceride or low HDL cholesterol levels in men

To further understand the factors involved in the regulation of high plasma triglyceride (TG) or low plasma high density lipoprotein cholesterol (HDL-C) levels, three groups of male subjects (normal TG with low HDL-C levels, high TG with normal HDL-C levels, and high TG with low HDL-C levels) were compared with a sample of normolipemic men with normal TG and HDL-C plasma levels. Mean age was 34 years (range, 20-42 years), and none of the subjects had plasma TG levels > 4.0 mmol/l or familial hypercholesterolemia. Both groups of subjects with high TG levels had a higher body mass index, waist circumference, waist-to-hip circumferences ratio, and a higher ratio of abdominal to femoral adipose tissue areas as measured by computed tomography when compared with normolipemic control subjects. However, during an oral glucose tolerance test only high TG-low HDL-C men had fasting hyperinsulinemia and higher plasma insulin levels compared with normolipemic subjects. In addition, the high TG-low HDL-C group showed reduced HDL apoprotein (apo) A-I levels and a low HDL2-C/HDL3-C ratio. These changes were observed along with a nonsignificant trend for a lower plasma postheparin lipoprotein lipase activity. However, among subjects with high TG and normal HDL-C levels, no evidence of insulin resistance or of a reduction in postheparin lipoprotein lipase activity was observed, suggesting that the high plasma TG levels could be attributed to an increased production of apo B-containing lipoproteins, as high plasma apo B and low density lipoprotein (LDL)-apo B levels were observed in this group.(ABSTRACT TRUNCATED AT 250 WORDS)

Physical training increases beta-adrenoceptor density and adenylate cyclase activity in high-oxidative skeletal muscle of diabetic rats

The effects of physical training on beta-adrenergic-receptor density (Bmax) and adenylate cyclase (AC) activity in soleus muscles (type I) and the deep red portion (type IIa) and superficial white portion (type IIb) of vastus lateralis muscles in diabetic rats were investigated. Rats were rendered diabetic with streptozotocin ([STZ] 45 mg/kg intravenously [IV]) and were either kept sedentary ([SD] n = 12) or submitted to a progressive 10-week treadmill running program ([TD] n = 13). A group of normal sedentary rats served as controls ([SC] n = 13). Plasma glucose levels were increased in SD rats in comparison with SC rats (21.3 +/- 1.4 mmol/L v 7.7 +/- 0.2; mean +/- SE, P < .001), but levels were partially reversed to normal by training (10.7 +/- 1.7; P < .01 v SD). The gastrocnemius nicotinamide adenine dinucleotide (NAD)-isocitrate dehydrogenase (ICDH) activity was significantly increased in TD rats in comparison to SC or SD rats (P < .001). The Bmax and antagonist affinity (Kd) determined with 125iodocyanopindolol (ICYP) were not affected by diabetes in any of the three types of muscle. In type I muscle, TD rats showed a significant 67% increase in Bmax compared with that of SD rats (TD 26.7 +/- 2.0 v SD 16.0 +/- 1.0; P < .001). In type IIa muscle, Bmax was significantly higher by 68% in TD rats as compared with SD rats (TD 16.5 +/- 1.7 v SD 9.8 +/- 0.9 fmol/mg protein; P < .01).(ABSTRACT TRUNCATED AT 250 WORDS)

Relation of abdominal obesity to hyperinsulinemia and high blood pressure in men

The relationships between body fatness, adipose tissue distribution, plasma glucose, insulin levels, lipoprotein levels, and resting blood pressure were studied in 81 men aged 36.0 +/- 3.3 years (mean +/- s.d.) (body mass index (BMI): 27.4 +/- 3.8 kg/m2, percentage body fat: 26.4 +/- 6.6%). Systolic and diastolic blood pressures (BP) were significantly associated with the BMI (r = 0.31, r = 0.33, P < 0.01), the waist circumference (r = 0.33, r = 0.27; P < 0.01) as well as with adipose tissue areas measured by computerized tomography (CT) (0.27 < or = r < or = 0.36, P < 0.01). Furthermore, the relative accumulation of subcutaneous abdominal fat, as estimated by the ratio of abdominal to femoral adipose tissue areas measured by CT, was positively correlated with systolic and diastolic BP (P < 0.01). Fasting plasma insulin level (r = 0.30, P < 0.01) as well as the insulin area measured during an oral glucose tolerance test (0.34 < or = r < or = 0.37, P < 0.01) were significantly correlated with blood pressure. Systolic and diastolic BP were significantly associated with HDL2-cholesterol (C) as well as with the HDL2-C/HDL3-C ratio (-0.24 < or = r < or = -0.34), whereas triglycerides (r = 0.23) and the HDL-C/C ratio (r = -0.23) were significantly correlated with diastolic BP only (P < 0.05). Multivariate analysis indicated that the insulin area was the most important variable associated with blood pressure and that this association was independent of total body fatness and regional adipose tissue distribution. Plasma insulin levels explained 14% and 11% of the variance observed in the systolic and diastolic blood pressures respectively. These results suggest that most of the association between abdominal obesity and high blood pressure is mediated by the hyperinsulinemia and/or the related insulin resistant state.

Is body fat loss a determinant factor in the improvement of carbohydrate and lipid metabolism following aerobic exercise training in obese women?

Thirty-one obese, premenopausal women aged 35.4 +/- 5.1 (SD) years exercised for 90 minutes at approximately 55% of maximal aerobic power (VO2max) four to five times a week for a period of 6 months. The training program induced a significant increase in VO2max (P < .001) and significant improvements in carbohydrate and lipid metabolism, as reflected by decreased plasma insulin (INS) concentrations measured in the fasting state and after glucose (GLU) ingestion (INS area, P < .001), by reduced plasma cholesterol (C) and low-density lipoprotein cholesterol (LDL-C) levels (P < .001), and by increased ratios of high-density lipoprotein cholesterol (HDL-C)/LDL-C and HDL2-C/HDL3-C (P < .05 and P < .001, respectively). Changes in body fat mass were positively associated with changes in the INS area/GLU area ratio (r = .49, P < .05) and with changes in very-low-density lipoprotein triglycerides ([VLDL-TG] r = .49, P < .05). Furthermore, changes in the INS area were positively associated with changes in VLDL-TG (r = .51, P < .05). Although no significant mean change in body composition was observed, important individual variation was noted. Twenty women showed a reduction in body fat mass (mean reduction, 2.63 +/- 2.2 kg), whereas 11 women showed an increase in adipose mass (mean increase, 2.79 +/- 2.36 kg). Comparable increases in VO2max were observed between the two groups. The group that showed a decrease in body fat mass with exercise also had significant improvements in carbohydrate and lipid metabolism.(ABSTRACT TRUNCATED AT 250 WORDS)

Baroreflex regulation of forearm vascular resistance after exercise in hypertensive and normotensive humans

The mechanisms underlying the antihypertensive period following a bout of exercise are not well understood. We examined the aftereffects of exercise on the linear relationship between forearm vascular resistance (FVR) and estimated central venous pressure (CVP) during leg raising and lower body negative pressure to determine whether an alteration of the baroreflex control of FVR was associated with the decreased blood pressure. Blood pressure, forearm blood flow (FBF), and estimated CVP were obtained in 13 hypertensive and 9 normotensive subjects evaluated in a randomized crossover fashion after 30 min of cycle ergometer exercise and after a nonexercise control period. In hypertensive subjects, the reduced blood pressure was accompanied by an increased baseline FBF after exercise. This resulted in a downward shift of the FVR-CVP relationship, while the slope was unchanged. In normotensive subjects, blood pressure and baroreflex control of FVR were unaffected by prior exercise. Four of the hypertensive subjects performed an additional study in which forearm skin was vasodilated with local heating to FVR levels similar to those observed after exercise. Results suggested that the aftereffects of exercise could not be attributed to changes in cutaneous blood flow. We speculate that modulation of the baroreflex control of FVR after exercise contributes to its antihypertensive effect.

Increased resting metabolic rate and lipid oxidation in exercise-trained individuals: evidence for a role of beta-adrenergic stimulation

This study investigated the contribution of beta-adrenergic stimulation to the increase in resting metabolic rate (RMR) and lipid oxidation observed in exercise-trained individuals. Nine trained and eight sedentary men were subjected to two testing sessions, during which these variables were measured before and for 3 h after the oral administration of propranolol or placebo. As expected, RMR and lipid oxidation were significantly higher in the trained subjects before the administration of propranolol and throughout the placebo test in comparison with sedentary controls. A significant decrease in RMR and lipid oxidation was induced by propranolol in the trained subjects, whereas no change was observed in the untrained group, and this effect of propranolol was sufficient to abolish the difference between the two groups at baseline and under the placebo condition. Propranolol also induced a significant reduction in heart rate and systolic blood pressure, but the response was comparable in the two groups. In conclusion, the results of this study show that beta-adrenergic stimulation is involved in the increase in RMR and lipid oxidation observed in highly trained individuals. Moreover, the absence of a training-propranolol interaction effect on heart rate and systolic blood pressure suggests the existence of some dissociation between the metabolic and cardiovascular effects of prolonged exercise training.

Partial correction of impaired creatine kinase activity in diabetic rat heart by physical training

The effect of physical training on total creatine kinase (CK), CK-MM, and CK-MB isoenzyme activity was studied in hearts of diabetic and control rats. Diabetes was induced with streptozotocin (50 mg/kg), and only rats with blood glucose levels between 14 and 22 mmol/L 1 week later were kept in the protocol. Exercise training was performed on a treadmill in a progressive 10-week program. Physical training did not induce any significant changes in plasma glucose or insulin levels in diabetic rats. Total CK, CK-MM, and CK-MB activity was decreased in diabetic rat heart by 27%, 22%, and 56%, respectively. Physical training did not induce any important changes in CK activity in heart of nondiabetic rats. However, in diabetic rat heart, training increased total CK activity by 13%, CK-MM activity by 12%, and CK-MB activity by 31%. We conclude that the decrease in cardiac CK activity observed in chronic experimental diabetes mellitus can be partly alleviated by a program of physical training. This may be one of the mechanisms whereby physical conditioning improves cardiac function in experimental diabetes.

Genetic aspects of susceptibility to obesity and related dyslipidemias

Obesity has a multifactorial origin. However, although environmental variables undoubtedly play a role in the development of obesity, it is now clear that genetic variation is also involved in the determination of an individual's susceptibility to body fat accumulation. In addition, it is also widely accepted that obesity is not a single homogeneous phenotype. It is also heterogeneous regarding its causes and metabolic complications. The regional distribution of body fat appears to be an important correlate of the metabolic complications that have been related to obesity. Due to their higher accumulation of abdominal fat, men are generally more at risk for the metabolic complications of obesity than women whereas some obese women, with large gluteal-femoral adipose depots may have a cosmetic problem which may not necessarily require medical intervention. Several studies have been conducted to understand the mechanisms by which abdominal obesity is related to diabetes, hypertension and cardiovascular disease. It appears that the increased risk of abdominal obesity is the result of complex hormonal and metabolic interactions. Studies in genetic epidemiology have shown that both total body fatness and the regional distribution of body fat have a significant genetic component. Standardized intervention studies using an identical twin design have shown that individuals that have the same genetic background tend to show similar changes in body fat and in plasma lipoprotein levels when exposed to standardized caloric excess or energy restriction. Finally, although abdominal obesity is a significant risk factor for cardiovascular disease, not every abdominal obese subject will experience metabolic complications, suggesting that some obese individuals may be more susceptible than others. Variation in several genes relevant to lipid and lipoprotein metabolism may alter the relation of abdominal obesity to dyslipoproteinemias. Abdominal obesity should therefore be considered as a factor that exacerbates an individual's susceptibility to cardiovascular disease.

Visceral obesity in men. Associations with glucose tolerance, plasma insulin, and lipoprotein levels

The relations of regional adipose tissue (AT) distribution measured by computed tomography (CT) to plasma insulin-glucose homeostasis and lipoprotein-lipid levels were studied in 58 obese and 29 lean control men. In the group of obese men, the visceral AT area measured by CT was positively correlated with fasting plasma triglyceride and insulin levels and with glucose and insulin areas under the curves measured during a 75-g oral glucose tolerance test. Visceral AT area was also negatively associated with plasma high-density lipoprotein (HDL) and HDL2 cholesterol levels. The relative accumulation of abdominal fat, estimated by the ratio of abdominal to femoral AT areas obtained by CT, was also a significant correlate of indices of carbohydrate metabolism and was the best univariate correlate of plasma lipoprotein levels. No significant associations were observed between the visceral AT area, the ratio of abdominal to femoral AT areas, and indices of carbohydrate and lipoprotein metabolism in the group of lean men. On the other hand, the subcutaneous abdominal AT area was a significant correlate of the glucose area under the curve in both groups of men, but this association was not independent from the percentage of total body fat. No relationship was observed between the femoral AT area and indices of carbohydrate metabolism in either lean or obese groups. In obese men, however, the femoral AT area was negatively correlated with plasma triglyceride concentration and positively correlated with plasma HDL and HDL2 cholesterol levels.(ABSTRACT TRUNCATED AT 250 WORDS)

Heterogeneous glycaemic and insulinaemic responses to oral glucose in non-diabetic men: interactions between duration of obesity, body fat distribution and family history of diabetes mellitus

The interaction between environmental and genetic factors in the alterations of glucose-insulin homeostasis was studied in 104 non-diabetic men. Family history of diabetes mellitus was used as an index of genetic predisposition to diabetes. Body composition was measured by underwater weighing whereas subcutaneous and visceral adipose tissue areas were measured at the abdominal and femoral levels by computed tomography. The sample was first divided into two groups. The first group included subjects with "normal" glycaemic and insulinaemic responses during a 75 g oral glucose tolerance test. The second group was composed of subjects either with a high glucose response or high insulin response or both. Men included in the second group were different from the "normal" subjects for almost all body fatness variables. They also presented a prevalence of a positive family history of diabetes which was significantly higher than "normal" subjects. The second group was then divided into three distinct subgroups based on insulin and glucose responses of the subjects during the oral glucose tolerance test. Subjects with high insulin but "normal" glucose responses were characterized by significantly higher levels of total body fat and deep abdominal adipose tissue when compared to the "normal" group (p less than 0.05). Men with both high insulinaemic and glycaemic responses displayed higher body fatness values and higher deep and subcutaneous abdominal adipose tissue areas (p less than 0.05) in comparison with "normal" subjects. They also had a higher body mass index at age 20 years than control subjects and subjects with high insulin but "normal" glucose responses.(ABSTRACT TRUNCATED AT 250 WORDS)

Drug-dispensing errors: one more case

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Adrenodemedullation does not impair the beneficial effect of physical training in streptozotocin-diabetic rats

This study was designed to ascertain if the improvement in glucose homeostasis found in diabetic animals submitted to physical training is due to an increased secretion of epinephrine by the adrenal medullae. Male Wistar rats were surgically adrenodemedullated (ADM group) or sham-operated (SHAM group). After a 3-week recovery period, a bolus of streptozotocin (40 mg/kg) was injected intravenously (IV), and the animals presenting 1 week later with a blood glucose value between 14 and 22 mmol/L were retained in the protocol and randomly assigned to a sedentary (SHAM-DS and ADM-DS) or trained (SHAM-DT and ADM-DT) group. Physical training was done on a treadmill according to a 10-week progressive program. An IV glucose tolerance test (0.5 g/kg) was performed in previously cannulated rats, 64 hours after the last bout of exercise. Pancreatic insulin and glucagon content was also determined. In sedentary diabetic rats, adrenodemedullation had no effect on plasma glucose, insulin, or glucagon levels, neither in the basal state nor following the glucose load. Basal glucose levels were diminished by training in both SHAM (16.1 +/- 1.5 v 21.8 +/- 0.4 mmol/L; P less than .01) and ADM (12.4 +/- 1.7 v 21.1 +/- 1.2 mmol/L; P less than .01) groups, with values lower in ADM-DT than in SHAM-DT rats (P less than .05). After glucose loading, the glucose levels were significantly lower (P less than .01) throughout the test in both SHAM-DT and ADM-DT rats than in their sedentary counterparts.(ABSTRACT TRUNCATED AT 250 WORDS)

Adipose tissue lipolysis after long-term overfeeding in identical twins

Ten pairs of young male sedentary, non-obese, monozygotic (MZ) twins, aged 21 +/- 2 years (mean +/- s.d.), were overfed for a period of 100 days during which they ingested 4.2 MJ (1000 kcal) per day above their individual energy needs, 6 days per week. There was a mean 8.4 kg increase in body weight and the average gain in body fat reaches 5.6 kg (P less than 0.0001). A biopsy of subcutaneous abdominal fat was performed, before and after the treatment, to determine fat cell weight as well as basal and catecholamine stimulated lipolyses from collagenase isolated adipocytes. Although analysis of variance revealed an increase in abdominal fat cell weight, no significant changes were noted in basal and catecholamine-stimulated lipolyses, due to large variation among individuals, results being expressed either per cell number or corrected for cell surface area. However, significant intrapair resemblance was observed in the changes of basal and epinephrine stimulated lipolyses (ri of about 0.60 in both cases), suggesting a concordant within-pair response, despite large between-pair variation. These results support the notion that the genotype may play an important role in regulating the response of abdominal adipose cells lipolytic activity to caloric excess.

Aftereffects of exercise on regional and systemic hemodynamics in hypertension

Several studies have indicated that a single bout of physical exercise induced a significant antihypertensive effect during the hours after the activity. However, little information is presently available on the underlying hemodynamic changes. We examined 13 essential hypertensive patients and nine normotensive subjects in a randomized, crossover study design during 3 hours after a 30-minute period of upright leg cycling at 50% of peak aerobic capacity and during 3 hours after a 30-minute control period of rest. Blood pressure, heart rate, cardiac output, total peripheral resistance, and regional vascular resistance in the forearm as well as venous plasma catecholamine concentrations were measured repeatedly. After exercise, systolic (-11 +/- 2 mm Hg) and diastolic (-4 +/- 1 mm Hg) blood pressures, total peripheral resistance (-27 +/- 5%), forearm vascular resistance (-25 +/- 6%), and plasma norepinephrine levels (-21 +/- 7%) were significantly (p less than or equal to 0.05) decreased, and cardiac output was increased (+31 +1- 8%) compared with control in hypertensive subjects. In contrast, in normotensive subjects blood pressure, forearm vascular resistance, and plasma norepinephrine were unchanged, and systemic hemodynamics changed to a lesser extent than in hypertensive subjects after exercise. It is concluded that a decrease in regional vascular resistance in skeletal muscles and possibly in the skin in hypertensive patients may contribute importantly to the antihypertensive effect of prior exercise. A decreased sympathetic nervous activity, as seen from lower plasma norepinephrine levels, may be involved in this effect.

A study of some potential correlates of the hypotensive effects of prolonged submaximal exercise in normotensive men

This study was undertaken (1) to examine the relation of plasma catecholamine and insulin levels to the blood pressure response during and after submaximal exercise, (2) to verify whether the blood pressure response to an epinephrine infusion is associated with the blood pressure response to a prolonged submaximal exercise, and (3) to study some potential correlates of the hypotensive effect of prolonged aerobic exercise. Nine normotensive young men (mean age 22.0 +/- 1.4 years) were subjected to a 1-h epinephrine infusion protocol and a 1-h submaximal exercise test on a cycle ergometer. The two tests were performed 1 week apart. The physiological and hormonal responses observed during the submaximal exercise test were generally greater than those observed during the epinephrine infusion test. Blood pressure responses in both tests showed no significant association with changes in plasma insulin levels. Changes in plasma norepinephrine concentration were positively correlated with changes in systolic blood pressure during the submaximal exercise test but not during the epinephrine infusion. Results also showed that the blood pressure response to epinephrine infusion was not correlated with the blood pressure response to submaximal exercise. However, post-exercise and post-infusion systolic blood pressure responses (differences between "post-test" and "resting" values) were significantly associated (r = 0.81, p less than 0.01). In addition, a significant hypotensive effect of submaximal exercise was observed for both systolic and diastolic blood pressure.(ABSTRACT TRUNCATED AT 250 WORDS)

Comparative effects of converting enzyme inhibition and conventional therapy in hypertensive non-insulin dependent diabetics with normal renal function

The effects of long-term reduction in blood pressure by the angiotensin converting enzyme inhibitor captopril, as single therapy or in combination with hydrochlorothiazide (HCTZ), were compared with those of metoprolol and/or hydrochlorothiazide in 91 hypertensive non insulin-dependent diabetics with normal renal function. Following a single-blind placebo run-in period of 4 weeks, treatments were assigned randomly in a double-blind fashion. During the study, weight and glycosylated hemoglobin remained elevated. After 9 months of treatment, blood pressure fell significantly (p less than 0.0001) in all treatment groups, with most patients achieving goal supine diastolic blood pressure of less than or equal to 85 mmHg. Whereas urinary albumin excretion (UAE) did not change in patients given metoprolol and/or HCTZ, captopril monotherapy (p = 0.0021) or captopril given in combination with HCTZ (p = 0.0002) decreased UAE without affecting glomerular filtration rate. These data are in favour of a renal beneficial effect of angiotensin converting enzyme inhibitors distinct from their effects on systemic blood pressure. Further studies are needed to determine whether this effect persists with longer treatment, and whether it would lead to better preservation of kidney function than other antihypertensive agents.

Normalization of the metabolic profile in obese women by exercise and a low fat diet

This study was performed to evaluate the additive effect of exercise and a low fat diet on body weight, body composition, and the metabolic profile in four obese women who were previously exercise-trained for 15 months. This study therefore included regular aerobic exercise for 15 months and a low fat diet plus exercise for an additional period of 14 months. After 15 months, mean body weight and fat losses corresponded to 6.4 and 8.4 kg, respectively. Significant reductions (P less than 0.05) in plasma insulin, cholesterol, apo B, and LDL-C were also observed. Following the second part of the study, mean cumulative body weight and fat losses were 11.0 and 11.3 kg, respectively. At this time, the subjects were still overweight, but their plasma glucose and insulin during an oral glucose tolerance test were essentially similar to values obtained in a sample of 22 nonobese women. With the exception of plasma apo B and HDL-C levels, plasma lipid and lipoprotein levels were also comparable to those observed in nonobese controls. These results thus indicate that aerobic exercise-training and a low fat diet can normalize the metabolic profile of obese women, even if their adiposity remains higher than that of lean women.

Contribution of glucose tolerance and plasma insulin levels to the relationships between body fat distribution and plasma lipoprotein levels in women

Numerous interrelated metabolic and morphological variables such as plasma insulin levels, glucose tolerance and abdominal obesity are associated with changes in plasma lipoprotein levels. The present study was undertaken to differentiate, using a multivariate approach, the respective contributions of plasma glucose and insulin levels, obesity and regional adipose tissue distribution to the variance in plasma lipoproteins. The study group was composed of 69 healthy premenopausal women (age 35.4 +/- 5.0 years (mean +/- s.d.); percent body fat 40.7 +/- 10.1). Indices of carbohydrate metabolism showed significant univariate correlations with triglyceride (TG) and/or cholesterol (CHOL) content of plasma VLDL, LDL and HDL (P less than 0.05). Multivariate analyses indicated that the explained variance in plasma VLDL-TG (R2 x 100 = 44 percent, P less than 0.05) and LDL-apoprotein (apo) B levels (R2 x 100 = 33.1 percent, P less than 0.08) was entirely accounted for by indices of carbohydrate metabolism and body fat distribution, whereas total body fatness added no significant contribution to these models. Multivariate analyses also revealed that the best possible regression model to predict the variation in plasma HDL2-CHOL levels only included computed tomography-derived deep abdominal adipose tissue area (P less than 0.0001). All other variables were unable to further improve the explained variance in plasma HDL2-CHOL levels. In partial correlation analyses, indices of carbohydrate metabolism and the waist-to-hip circumference ratio (WHR) remained significantly correlated with plasma VLDL-TG and LDL-apo B levels after adjustment of VLDL-TG and LDL-apo B for either insulin and glucose levels, or for the WHR (P less than 0.08). After correcting for deep abdominal fat accumulation, no significant correlation was observed between indices of carbohydrate metabolism and plasma HDL2-CHOL levels whereas deep abdominal fat showed significant correlations with HDL2-CHOL levels (P less than 0.05) after correction for indices of carbohydrate metabolism. These results suggest that both disturbances in glucose-insulin homeostasis and abdominal obesity are significantly associated with changes in plasma VLDL-TG and LDL-apo B levels and that these associations are partly independent from each other. These results also indicate that mechanisms other than disturbances in glucose homeostasis and hyperinsulinemia are responsible for the association between the level of deep abdominal fat and plasma HDL2-CHOL levels.

Human resting energy expenditure in relation to dietary potassium

This study investigates the putative effect of potassium on energy expenditure. Eight young adult men were submitted to two different normocaloric mixed diets in a randomized order, containing either 163 +/- 9 or 69 +/- 2 mmol potassium/d. On the fifth day of each diet, after an overnight fast, resting metabolic rate (RMR) was measured over a 1-h period. After these measurements, either a potassium load (50 mmol) or a placebo were given to subjects submitted to the low- or the high-potassium diet, respectively. RMR was then measured again for 3 h and the last hour was kept for further analysis. Results showed that acute and chronic variations in potassium intake do not induce significant changes in RMR, and chronic but not acute changes in serum potassium concentration were significantly correlated with changes in energy expenditure (r = 0.74, P less than 0.05) by mechanisms that remain to be elucidated.

Plasma epinephrine in chronically adrenodemedullated rats: lack of response to acute or chronic exercise

Even if it is well established that epinephrine is a hormone originating from the adrenal medullae, the reappearance of circulating epinephrine has been reported in rats a few days after adrenodemedullation. To verify if the extra-adrenal tissue responsible for this epinephrine production can be stimulated, sham-operated or adrenodemedullated rats, either trained or kept sedentary, were submitted to an acute exercise stimulation test. Blood sampling was done before and after the test in precannulated rats for the determination of plasma epinephrine, norepinephrine, and corticosterone levels. Basal epinephrine levels were significantly reduced in trained and sedentary adrenodemedullated rats compared with their sham-operated counterparts. In response to exercise, there was no significant rise in epinephrine levels in both groups of adrenodemedullated rats. The norepinephrine levels in the basal state and in response to exercise were not altered by adrenodemedullation nor by physical conditioning. Basal corticosterone levels were similar between adrenodemedullated and sham-operated animals, either trained or kept sedentary. In response to exercise, corticosterone levels increased significantly in each group of rats but to a lesser extent in both groups of adrenodemedullated animals. These data indicate that the extra-adrenal epinephrine secretion that develops in the absence of adrenal medullae is not influenced by acute exercise nor by physical training.

Regional variation in adipose tissue lipoprotein lipase activity: association with plasma high density lipoprotein levels

The associations of adipose tissue lipoprotien lipase (AT-LPL) activity with body fatness and plasma lipoprotein levels were studied in the light of the recently described regional differences in AT-LPL activity. In this regard, heparin-releasable LPL activity was measured in abdominal and femoral adipose tissues of 29 pre-menopausal women. Body fatness variables were all positively correlated with abdominal and femoral AT-LPL activities expressed per 10(6) cells. However, abdominal and femoral AT-LPL activities expressed per unit of cell surface displayed divergent association patterns with body fatness and plasma lipoprotein levels. Indeed, only abdominal AT-LPL activity remained significantly correlated with body fatness variables after adjustment for fat cell surface. Furthermore, whereas abdominal AT-LPL activity tended to be negatively correlated with plasma HDL-cholesterol levels, femoral AT-LPL activity was positively correlated with plasma HDL2-cholesterol (r = 0.40, P less than 0.05) concentration and with the HDL2-cholesterol/HDL3-cholesterol ratio (r = 0.49, P less than 0.01). These results demonstrate the importance of taking into account the regional variation in metabolic activity of adipose tissue when studying its associations with body fatness, and with plasma lipoprotein levels. The lack of association between abdominal AT-LPL activity and plasma HDL2-cholesterol levels lead us to suggest that AT-LPL activity may not be causally related with plasma HDL levels.