12601
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Woolley JD, Lee BS, Kim B, Fields HL. Opposing effects of intra-nucleus accumbens mu and kappa opioid agonists on sensory specific satiety. Neuroscience 2007; 146:1445-52. [PMID: 17445988 DOI: 10.1016/j.neuroscience.2007.03.012] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2007] [Revised: 03/02/2007] [Accepted: 03/07/2007] [Indexed: 11/20/2022]
Abstract
Mu opioid (MOP) agonists acting in the nucleus accumbens (NAcc) robustly enhance consumption of palatable foods. In addition, the effect on consumption of palatable foods produced by MOP agonists acting in the NAcc depends on both recent flavor exposure and the availability of a choice between different-flavored foods. In contrast, kappa opioid (KOP) agonists have variable effects on feeding and KOP agonists have MOP opposing behavioral actions when microinjected at several brain sites. We previously demonstrated that NAcc MOP agonists reverse the devaluation (satiety) effect of pre-feeding for a given flavor; in fact, NAcc MOP agonists selectively increase consumption of a recently sampled food. In contrast, in the present study, we found that the selective KOP agonist U50488 injected into the NAcc of rats reduced consumption of a recently sampled flavor while increasing consumption of the flavor that was not pre-fed. Intra-NAcc U50488 did not affect overall consumption or flavor preference in the absence of pre-feeding. The present data, in conjunction with our previous findings, highlight the robust and opposing role of NAcc MOP and KOP opioid receptors in palatability-based food choice and consumption and raise the possibility that an endogenous KOP agonist acting in the NAcc contributes to the phenomenon of sensory specific satiety.
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MESH Headings
- Analgesics/pharmacology
- Analysis of Variance
- Animals
- Behavior, Animal
- Food Preferences/drug effects
- Male
- Nucleus Accumbens/drug effects
- Rats
- Rats, Long-Evans
- Receptors, Opioid, kappa/agonists
- Receptors, Opioid, kappa/physiology
- Receptors, Opioid, mu/agonists
- Receptors, Opioid, mu/physiology
- Satiety Response/drug effects
- Taste
- Time Factors
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Affiliation(s)
- J D Woolley
- The Ernest Gallo Clinic and Research Center and the Wheeler Center for the Neurobiology of Addiction, Department of Neurology, University of California, San Francisco, San Francisco, CA 94143, USA.
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12602
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12603
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Andersen R, Mølgaard C, Skovgaard LT, Brot C, Cashman KD, Jakobsen J, Lamberg-Allardt C, Ovesen L. Pakistani immigrant children and adults in Denmark have severely low vitamin D status. Eur J Clin Nutr 2007; 62:625-34. [PMID: 17440527 DOI: 10.1038/sj.ejcn.1602753] [Citation(s) in RCA: 67] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To determine vitamin D and bone status in adolescent girls, pre-menopausal women and men of Pakistani origin, to single out determinants of vitamin D status and to determine the association between vitamin D status, bone metabolism and bone status. SUBJECTS/METHODS Cross-sectional study, Copenhagen (55 degrees N), January-November. Serum 25-hydroxyvitamin D (S-25OHD), serum intact parathyroid hormone (S-iPTH), bone turnover markers and whole body and lumbar spine bone mineral density were measured. Sun, smoking and clothing habits, age, body mass index (BMI), and vitamin D and calcium from food and from supplements were recorded. Thirty-seven girls (median age, range: 12.2 years, 10.1-14.7), 115 women (36.2 years, 18.1-52.7) and 95 men (38.3 years, 17.9-63.5) of Pakistani origin (immigrants or descendants with Pakistani parents) took part in the study. RESULTS Median concentration of S-25OHD was 10.9, 12.0 and 20.7 nmol/l for girls, women and men, respectively. Forty-seven per cent of the girls, 37% of the women and 24% of the men had elevated S-iPTH, and there was a negative relationship between S-iPTH and S-25OHD. Use of vitamin D-containing supplements had a positive association with S-25OHD for men (P=0.04) and women (P=0.0008). Twenty-one per cent of the women and 34% of the men had osteopenia. Neither S-25OHD nor S-iPTH was associated with lumbar spine or whole body bone mineral content. CONCLUSIONS Severely low vitamin D status and elevated S-iPTH is common among Pakistani immigrants in Denmark. The low vitamin D status is not associated with bone markers or bone mass among relatively young Pakistanis.
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Affiliation(s)
- R Andersen
- Department of Nutrition, National Food Institute, Technical University of Denmark, Mørkhøj Bygade 19, Søborg, Denmark.
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12604
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Abstract
This article revisits the links between psychopathology and functional gastrointestinal disorders such as irritable bowel syndrome (IBS), discusses the rational use of antidepressants as well as non-pharmacological approaches to the management of IBS, and suggests guidelines for the treatment of IBS based on an interdisciplinary perspective from the present state of knowledge. Relevant published literature on psychiatric disorders, especially somatization disorder, in the context of IBS, and literature providing direction for management is reviewed, and new directions are provided from findings in the literature. IBS is a heterogeneous syndrome with various potential mechanisms responsible for its clinical presentations. IBS is typically complicated with psychiatric issues, unexplained symptoms, and functional syndromes in other organ systems. Most IBS patients have multiple complaints without demonstrated cause, and that these symptoms can involve systems other than the intestine, e.g. bones and joints (fibromyalgia, temporomandibular joint syndrome), heart (non-cardiac chest pain), vascular (post-menopausal syndrome), and brain (anxiety, depression). Most IBS patients do not have psychiatric illness per se, but a range of psychoform (psychological complaints in the absence of psychiatric disorder) symptoms that accompany their somatoform (physical symptoms in the absence of medical disorder) complaints. It is not correct to label IBS patients as psychiatric patients (except those more difficult patients with true somatization disorder). One mode of treatment is unlikely to be universally effective or to resolve most symptoms. The techniques of psychotherapy or cognitive-behavioral therapy can allow IBS patients to cope more readily with their illness. Specific episodes of depressive or anxiety disorders can be managed as appropriate for those conditions. Medications designed to improve anxiety or depression are not uniformly useful for psychiatric complaints in IBS, because the psychoform symptoms that sound similar to those seen in psychiatric disorders may not have the same significance in patients with IBS.
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12605
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Abstract
OBJECTIVES To present an updated review on the etiology, consequences and management of premature ovarian failure. DESIGN A search of the English language literature using the Cochrane Library database and Medline 1966-2006, with a hand search of the references. CONCLUSION Premature ovarian failure is defined as the occurrence of amenorrhea, hypergonadotropinemia and estrogen deficiency in women under the age of 40 years, with the prevalence being 0.9-1.2%. In the majority of cases, the etiology is unknown, but known causes include chemotherapy, radiotherapy, surgery, genetic disorders, particularly involving the X chromosome, associations with autoimmune diseases, infections, smoking and other toxins. The three critical issues of management in these women are the effect of the diagnosis on the psychological health of the patient, the consequent infertility and the long- and short-term effects of estrogen deficiency arising from ovarian decline. Promising methods of screening for premature ovarian failure are being developed.
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Affiliation(s)
- T A Nippita
- Department of Obstetrics and Gynaecology, Royal North Shore Hospital, St Leonards, and The University of Sydney, Australia
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12606
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Almquist M, Manjer J, Bondeson L, Bondeson AG. Serum calcium and breast cancer risk: results from a prospective cohort study of 7,847 women. Cancer Causes Control 2007; 18:595-602. [PMID: 17410477 DOI: 10.1007/s10552-007-9001-0] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2006] [Accepted: 02/21/2007] [Indexed: 12/01/2022]
Abstract
Experimental and epidemiological studies suggest that calcium-regulating hormones--parathyroid hormone (PTH) and vitamin D--may be associated with breast cancer risk. No prospective cohort study has investigated the association between pre-diagnostic calcium levels and subsequent risk of breast cancer. We have examined this in a cohort of 7,847 women where serum calcium levels and established risk factors for breast cancer had been assessed at baseline. During a mean follow-up of 17.8 years, 437 incident breast cancer cases were diagnosed. Incidence of breast cancer was calculated in different quartiles of serum calcium levels and a Cox's proportional hazards analysis was used to obtain corresponding relative risks (RR), with a 95% confidence interval (CI), adjusted for potential confounders. In premenopausal women, serum calcium levels were inversely associated with breast cancer risk in a dose-response manner. The adjusted RR (95% CI) of breast cancer was in the 2nd calcium quartile 0.91 (0.65-1.30), in the 3rd quartile 0.89 (0.60-1.31), and in the 4th quartile 0.56 (0.32-0.98), as compared to the 1st calcium quartile. In postmenopausal overweight women (BMI > 25), breast cancer risk was higher in calcium quartiles 2-4 as compared to the 1st quartile. Our findings may have implications for primary prevention of breast cancer and for the management of asymptomatic primary hyperparathyroidism.
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Affiliation(s)
- Martin Almquist
- Department of Surgery, Malmö University Hospital, 205 02, Malmo, Sweden.
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12607
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Gennari L, De Paola V, Merlotti D, Martini G, Nuti R. Steroid hormone receptor gene polymorphisms and osteoporosis: a pharmacogenomic review. Expert Opin Pharmacother 2007; 8:537-53. [PMID: 17376011 DOI: 10.1517/14656566.8.5.537] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Osteoporosis is a common skeletal disorder with a strong genetic component. In recent years, significant progress has been made in understanding the genetic basis of osteoporosis. Given the biological significance of signalling through steroid hormone receptors, bone biology and calcium homeostasis, alleles of steroid hormone receptor genes have been postulated to contribute to the well-documented genetic predisposition to osteoporosis; and in different studies, these alleles have been associated with variation in bone mass and fracture risk. Even though results are still conflicting and the molecular mechanisms by which these polymorphisms influence receptor activity remain, in part, to be investigated, an additional important issue is represented by potential pharmacogenomic (the investigation of variations of DNA or RNA characteristics as related to drug response) or pharmacogenetic (the influence of variations of DNA sequence on drug response) implications. In fact, steroid hormone receptors actually mediate the action of several compounds known to positively or negatively affect bone homeostasis, such as vitamin D, estrogen and glucocorticoids. This review analyses major pharmacogenetic studies of polymorphisms in steroid hormone receptor genes.
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Affiliation(s)
- Luigi Gennari
- Department of Internal Medicine, Endocrine-Metabolic Sciences and Biochemistry, University of Siena, Viale Bracci 1, 53100 Siena, Italy.
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12608
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Abstract
BACKGROUND Diet and surgically-induced weight loss have been shown to lead to alterations in motor and sensory function of the stomach. We investigated the clinical outcome and gastric emptying of solid foods in morbidly obese (MO) patients following sleeve gastrectomy (SG). METHODS We studied 23 MO patients [(7 males, 16 females), mean age 38.9 +/- 11.0 years (range 20-64 years), mean weight 135.1 +/- 19.0 kg (range 97-167 kg), mean BMI 47.2 +/- 4.8 kg/m(2) (range 39.6-56.0 kg/m(2))] who each underwent a sleeve gastrectomy (SG) for weight reduction. At the monthly follow-up visits, variations in weight and BMI changes, postoperative meal size and frequency, and presence of gastrointestinal symptoms were recorded. 11 patients underwent scintigraphic measurement of the gastric emptying of a solid meal pre- and 6 months postoperatively. RESULTS A significant reduction in patients' weight was evidenced at 6 and 12 months postoperatively [98.6 +/- 11.8 kg and 87.0 +/- 10.7 kg respectively (P=0.001)]. BMI decreased to 35.2 +/- 4.3 kg/m(2) at 6 months and to 31.1 +/- 4.5 kg/m(2) at 12 months, respectively (P=0.001). Although meal size was drastically reduced, meal frequency increased postoperatively in 12 patients (52.2%). Only 5 patients (21.8 %) reported occasional vomiting after meals following SG. The gastric emptying half-time (T1/2) accelerated (47.6 +/- 23.2 vs 94.3 +/- 15.4, P<0.01) and the T-lag phase duration decreased (9.5 +/- 2 min vs 19.2 +/- 2 min, P<0.05) post-operatively. The percentage of the meal emptied from the stomach 90 min after consumption increased significantly after SG (75.4 +/- 14.9% vs 49.2 +/- 8.7%, P<0.01). CONCLUSIONS This study indicates that following SG, the stomach empties its contents rapidly into the small intestine and symptoms of vomiting after eating (characteristic of restrictive procedures) are either absent or very mild. Therefore, the term 'restrictive' is possibly ill-advised for this new bariatric operation. It remains for other mechanisms of energy intake reduction, such as intestinal distension and satiety signals through gut hormones to be investigated, to comprehensively explain precisely how this 'food limiting' procedure results in weight loss.
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Affiliation(s)
- John Melissas
- Bariatric Unit and Department of Surgical Oncology, Heraklion University Hospital, Faculty of Medicine, University of Crete, Greece.
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12609
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TANG S, LO WK, HUI WM, YEUNG H, LAI KC, Po CHENG IK. Gastric emptying in diabetic and non-diabetic patients on continuous ambulatory peritoneal dialysis. Nephrology (Carlton) 2007. [DOI: 10.1111/j.1440-1797.1997.tb00209.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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12610
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Obermayer-Pietsch BM, Gugatschka M, Reitter S, Plank W, Strele A, Walter D, Bonelli C, Goessler W, Dobnig H, Högenauer C, Renner W, Fahrleitner-Pammer A. Adult-type hypolactasia and calcium availability: decreased calcium intake or impaired calcium absorption? Osteoporos Int 2007; 18:445-51. [PMID: 17103297 DOI: 10.1007/s00198-006-0251-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2006] [Accepted: 09/29/2006] [Indexed: 12/14/2022]
Abstract
UNLABELLED Adult-type hypolactasia, as mediated by a widespread genetic predisposition, not only reduces calcium intake but also calcium absorption in the presence of high amounts of lactose and may, therefore, promote osteoporosis. A lactose-reduced diet and lactose-free calcium supplements may reverse this imbalance. INTRODUCTION AND HYPOTHESIS Adult-type hypolactasia (HL) defined by the LCT(-13910) polymorphism may reduce calcium intake by reducing dairy consumption and, therefore, promote osteoporosis. This study aimed to evaluate whether lactose also decreases intestinal calcium absorption in subjects with HL and whether lactose-reduced diet and lactose-free calcium supplementation as recommended could maintain bone mineral density (BMD). METHODS Based on LCT genotyping, 73 postmenopausal women with and without HL underwent a conventional H(2) breath test with a concomitant oral strontium absorption test lasting 150 minutes, which closely reflects intestinal calcium absorption. In addition, we compared bone-specific laboratory parameters, lumbar and femoral BMD, and spinal radiographs to a similar bone assessment 5 years earlier. RESULTS LCT genotyping and functional lactose malabsorption tests were highly correlated. Dairy product consumption was reduced by 80% in HL individuals. During concomitant lactose application, mean strontium absorption was blunted by 54% in HL subjects after 150 minutes (1272 +/- 629 microg/L vs. 2020 +/- 1130 microg/L in lactose tolerant subjects, p=0.001). Nevertheless, BMD in HL subjects remained stable with lactose-free calcium supplements during the observation period. CONCLUSION Both decreased calcium intake as well as lactose-associated impaired calcium absorption may predispose subjects with HL to osteoporosis. Lactose-free calcium supplementation may help to maintain BMD in HL subjects.
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Affiliation(s)
- B M Obermayer-Pietsch
- Division of Endocrinology and Nuclear Medicine, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, A-8036, Graz, Austria.
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12611
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Abstract
PURPOSE OF REVIEW Enteral nutrition is frequently unsuccessful in the critically ill due to gastrointestinal dysfunction. Current treatment strategies are often disappointing. In this article upper gastrointestinal function in health together with abnormalities seen during critical illness are reviewed, and potential therapeutic options summarized. RECENT FINDINGS Reflux oesophagitis occurs frequently due to reduced or absent lower oesophageal sphincter tone. In the stomach a number of motor patterns contribute to slow gastric emptying. The fundus has reduced compliance, there are less frequent contractions in both the proximal and distal stomach, isolated pyloric activity is increased and the organization of duodenal motor activity is abnormal. In response to nutrients, enterogastric feedback is enhanced, fundic relaxation and subsequent recovery is delayed, antral motility is further reduced and localized pyloric contractions stimulated. Elevated concentrations of hormones such as cholecystokinin and peptide YY are potential mediators for these phenomena. Rapid tachyphylaxis occurs with the commonly used prokinetics, metoclopramide and erythromycin, and novel agents are under investigation. Independent of gastric emptying, nutrient absorption is reduced. SUMMARY There has been considerable progress in understanding the pathogenesis of mechanisms causing feed intolerance in critical illness, but this is yet to be translated into therapeutic benefit.
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12612
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Reddy H, Staahl C, Arendt-Nielsen L, Gregersen H, Drewes AM, Funch-Jensen P. Sensory and biomechanical properties of the esophagus in non-erosive reflux disease. Scand J Gastroenterol 2007; 42:432-40. [PMID: 17454852 DOI: 10.1080/00365520600973099] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVES To investigate possible differences between patients with non-erosive gastroesophageal reflux disease (NERD) and controls in a) sensitivity of the distal esophagus after mechanical and thermal stimuli and b) the referred pain areas. MATERIAL AND METHODS Fifteen healthy subjects (mean age 39+/-19.4 years) and 13 NERD patients (mean age 44.4+/-21 years) were enrolled in the study. Pain evoked by mechanical and thermal stimuli was assessed using a newly designed multimodal stimulation probe. RESULTS The patients were less sensitive to mechanical stimulation as assessed by the cross-sectional area (p<0.001) and volume (p=0.007). After thermal stimulation, the patients were hypersensitive to heat stimuli (p=0.04), whereas no significant difference was seen to cold stimuli. The referred pain areas were larger in patients compared with the pain areas in controls after mechanical (p=0.03) and heat stimuli (p=0.01), but not after cold stimuli. Balloon distension resulted in a significant higher number of reactive esophageal contractions in patients as compared with controls (p=0.001). CONCLUSIONS The present study showed that NERD patients were hypersensitive to heat stimuli of the esophagus, with an increase in referred pain to the evoked visceral pain. The data indicate that peripheral sensitization of heat-sensitive pathways together with facilitation of central pain mechanisms are important in the pathogenesis of NERD.
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Affiliation(s)
- Hariprasad Reddy
- Center for Biomechanics and Pain, Department of Gastroenterology, University Hospital Aalborg, Denmark
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12613
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Germain N, Galusca B, Le Roux CW, Bossu C, Ghatei MA, Lang F, Bloom SR, Estour B. Constitutional thinness and lean anorexia nervosa display opposite concentrations of peptide YY, glucagon-like peptide 1, ghrelin, and leptin. Am J Clin Nutr 2007; 85:967-71. [PMID: 17413094 DOI: 10.1093/ajcn/85.4.967] [Citation(s) in RCA: 116] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Food intake is controlled by the arcuate nucleus through integration of peripheral hormonal signals such as leptin, ghrelin, peptide YY (PYY), and glucagon-like peptide 1 (GLP-1). The most common condition resulting in underweight young women in the developed world is restrictive anorexia nervosa (AN). However, constitutional thinness (CT) is also known to exist in the same low-weight range. Women with CT have normal menstrual periods and do not have the psychological or hormonal features of AN. Little is currently known about regulation of food intake in subjects with CT. OBJECTIVE We tested the hypothesis that concentrations of leptin, ghrelin, PYY, and GLP-1 in persons with AN are significantly different from those in persons with CT. DESIGN Concentrations of PYY, GLP-1, ghrelin, and leptin were measured in 3 groups of young women: normal weight (n = 7), CT (n = 10), and AN (n = 12). Samples were collected every 4 h for 24 h. RESULTS PYY concentrations were significantly higher in CT subjects than in AN or control subjects. GLP-1 concentrations were significantly higher in AN than in CT subjects, whereas ghrelin was significantly higher in AN subjects than in control and CT subjects. CT subjects had the lowest ghrelin concentrations. Leptin concentrations were significantly lower in AN subjects. PYY and leptin circadian variations were not significantly different between CT and control subjects, whereas these profiles were blunted in AN subjects. CONCLUSIONS Orexigenic and anorexigenic hormones in CT contrast with an adaptative profile characterizing AN. The hormones appear to be valuable biomarkers for distinguishing these 2 categories of severely underweight subjects.
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Affiliation(s)
- Natacha Germain
- Departments of Endocrinology and Psychiatry, CHU Saint Etienne, St Etienne, France, and Endocrine Unit, Imperial College Faculty of Medicine, Hammersmith Hospital, London, United Kingdom
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12614
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Degen L, Drewe J, Piccoli F, Gräni K, Oesch S, Bunea R, D'Amato M, Beglinger C. Effect of CCK-1 receptor blockade on ghrelin and PYY secretion in men. Am J Physiol Regul Integr Comp Physiol 2007; 292:R1391-9. [PMID: 17138722 DOI: 10.1152/ajpregu.00734.2006] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Cholecystokinin (CCK), peptide YY (PYY), and ghrelin have been proposed to act as satiety hormones. CCK and PYY are stimulated during meal intake by the presence of nutrients in the small intestine, especially fat, whereas ghrelin is inhibited by eating. The sequence of events (fat intake followed by fat hydrolysis and CCK release) suggests that this process is crucial for triggering the effects. The aim of this study was therefore to investigate whether CCK mediated the effect of intraduodenal (ID) fat on ghrelin secretion and PYY release via CCK-1 receptors. Thirty-six male volunteers were studied in three consecutive, randomized, double-blind, cross-over studies: 1) 12 subjects received an ID fat infusion with or without 120 mg orlistat, an irreversible inhibitor of gastrointestinal lipases, compared with vehicle; 2) 12 subjects received ID long-chain fatty acids (LCF), ID medium-chain fatty acids (MCF), or ID vehicle; and 3) 12 subjects received ID LCF with and without the CCK-1 receptor antagonist dexloxiglumide (Dexlox) or ID vehicle plus intravenous saline (placebo). ID infusions were given for 180 min. The effects of these treatments on ghrelin concentrations and PYY release were quantified. Plasma hormone concentrations were measured in regular intervals by specific RIA systems. We found the following results. 1) ID fat induced a significant inhibition in ghrelin levels ( P < 0.01) and a significant increase in PYY concentrations ( P < 0.004). Inhibition of fat hydrolysis by orlistat abolished both effects. 2) LCF significantly inhibited ghrelin levels ( P < 0.02) and stimulated PYY release ( P < 0.008), whereas MCF were ineffective compared with controls. 3) Dexlox administration abolished the effect of LCF on ghrelin and on PYY. ID fat or LCF significantly stimulated plasma CCK ( P < 0.006 and P < 0.004) compared with saline. MCF did not stimulate plasma CCK release. In summary, fat hydrolysis is essential to induce effects on ghrelin and PYY through the generation of LCF, whereas MCF are ineffective. Furthermore, LCF stimulated plasma CCK release, suggesting that peripheral CCK is the mediator of these actions. The CCK-1 receptor antagonist Dexlox abolished the effect of ID LCF, on both ghrelin and PYY. Generation of LCF through hydrolysis of fat is a critical step for fat-induced inhibition of ghrelin and stimulation of PYY in humans; the signal is mediated via CCK release and CCK-1 receptors.
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Affiliation(s)
- Lukas Degen
- Division of Gastroenterology, University Hospital, CH-4031 Basel, Switzerland
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12615
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Provencher V, Bégin C, Tremblay A, Mongeau L, Boivin S, Lemieux S. Short-term effects of a "health-at-every-size" approach on eating behaviors and appetite ratings. Obesity (Silver Spring) 2007; 15:957-66. [PMID: 17426331 DOI: 10.1038/oby.2007.638] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To assess the effects of a "Health-At-Every-Size" (HAES) intervention on eating behaviors and appetite ratings in 144 premenopausal overweight women. RESEARCH METHODS AND PROCEDURES Women were randomly assigned to one of the 3 groups: HAES group, social support (SS) group, and control group (N = 48 in each group). Interventions were conducted over a 4-month period, and measurements were taken before and after this period. Eating behaviors (cognitive dietary restraint, disinhibition, and susceptibility to hunger) were evaluated by the Three-Factor Eating Questionnaire. Appetite ratings (desire to eat, hunger, fullness, and prospective food consumption) were assessed by visual analogue scales before and after a standardized breakfast. RESULTS More important decreases in susceptibility to hunger and external hunger were observed in the HAES group when compared with the SS group (p=0.05, for susceptibility to hunger) and the control group (p=0.02 and p=0.005, for susceptibility to hunger and external hunger, respectively). In addition, women from the HAES group had more important decreases in postprandial area under the curve for desire to eat (p=0.02) and hunger (p=0.04) when compared with the control group. The change in the desire to eat noted in the HAES group was also different from the one observed in SS group (p=0.02). Women from the HAES group experienced significant weight loss at 4 months (-1.6+/-2.5 kg, p<0.0001), which did not differ significantly from the SS and control groups (p=0.09). An increase in flexible restraint was significantly related to a greater weight loss in both HAES and SS groups (r=-0.39, p<0.01; and r=-0.37, p<0.05, respectively). A decrease in habitual susceptibility to disinhibition was also associated with a greater weight loss in HAES and control groups (r=0.31, p<0.05; and r=0.44, p<0.05, respectively). DISCUSSION These results suggest that a HAES intervention could have significant effects on eating behaviors and appetite ratings in premenopausal overweight women, when compared with an SS intervention or a control group.
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Affiliation(s)
- Véronique Provencher
- Institute of Nutraceuticals and Functional Foods, 2440, Hochelaga Blvd., Laval University, Québec, Québec, Canada, G1K 7P4
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12616
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Bolland MJ, Ames RW, Horne AM, Orr-Walker BJ, Gamble GD, Reid IR. The effect of treatment with a thiazide diuretic for 4 years on bone density in normal postmenopausal women. Osteoporos Int 2007; 18:479-86. [PMID: 17120180 DOI: 10.1007/s00198-006-0259-y] [Citation(s) in RCA: 91] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2006] [Accepted: 10/16/2006] [Indexed: 02/07/2023]
Abstract
SUMMARY We performed a 2-year extension of our previous 2-year randomized controlled trial of the effects of hydrochlorothiazide on bone mineral density. The improvements in bone density seen in the first 2 years were sustained throughout the extension study. Thiazides provide a further option in the prevention of postmenopausal bone loss. INTRODUCTION Thiazide diuretics reduce urinary calcium excretion and therefore might prevent osteoporosis. Previously we reported a 2-year randomized controlled trial of hydrochlorothiazide treatment in 185 postmenopausal women that showed positive benefits of hydrochlorothiazide on bone density. Here, we report the results of a 2-year extension to that study. METHODS Of 185 healthy postmenopausal women, 122 agreed to continue in a double-blinded 2-year extension taking 50 mg hydrochlorothiazide or placebo daily. Measurements of bone density occurred every 6 months and of calcium metabolism at 2 and 4 years. RESULTS The improvements in bone density seen in the first 2 years of the trial were sustained throughout the extension. There were significant between-groups differences in the change in bone density over 4 years at the total body (0.9%, P<0.001), legs (1.0%, P=0.002), mid-forearm (1.1%, P=0.03), and ultradistal forearm (1.4%, P=0.04). At the lumbar spine (0.9%, P=0.76) and femoral neck (0.4%, P=0.53) the between-groups differences did not reach statistical significance. CONCLUSIONS Hydrochlorothiazide produces small positive benefits on cortical bone density that are sustained for at least the first 4 years of treatment. They provide a further option in the prevention of postmenopausal bone loss, especially for women with hypertension or a history of kidney stones.
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Affiliation(s)
- M J Bolland
- Department of Medicine, University of Auckland, Auckland, New Zealand.
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12617
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Pittas AG, Harris SS, Stark PC, Dawson-Hughes B. The effects of calcium and vitamin D supplementation on blood glucose and markers of inflammation in nondiabetic adults. Diabetes Care 2007; 30:980-6. [PMID: 17277040 DOI: 10.2337/dc06-1994] [Citation(s) in RCA: 423] [Impact Index Per Article: 24.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE We sought to compare the effects of combined calcium and vitamin D supplementation versus placebo on blood glucose and markers of inflammation in nondiabetic adults aged > or =65 years. RESEARCH DESIGN AND METHODS A total of 314 Caucasian adults without diabetes received either 500 mg calcium citrate and 700 IU vitamin D(3) or placebos daily for 3 years in a double-blind, randomized, controlled trial designed for bone-related outcomes. In a post hoc analysis, fasting plasma glucose (FPG), insulin sensitivity (estimated by homeostasis model assessment of insulin resistance [HOMA-IR]), plasma C-reactive protein, and interleukin-6, were measured at baseline and 3 years. RESULTS The effects of combined calcium-vitamin D supplementation on 3-year change in FPG depended on baseline FPG (P = 0.02 for interaction). Therefore, we conducted analyses separately in participants with normal fasting glucose (NFG) (FPG <5.6 mmol/l, n = 222) and impaired fasting glucose (IFG) (FPG 5.6-6.9 mmol/l, n = 92) at baseline. Among participants with IFG at baseline, those who took combined calcium-vitamin D supplements had a lower rise in FPG at 3 years compared with those on placebo (0.02 mmol/l [0.4 mg/dl] vs. 0.34 mmol/l [6.1 mg/dl], respectively, P = 0.042) and a lower increase in HOMA-IR (0.05 vs. 0.91, P = 0.031). In the NFG subgroup, there was no difference in the change in FPG or HOMA-IR between the two treatment arms. There were no differences in C-reactive protein or interleukin-6 between the two treatment arms in either subgroup. CONCLUSIONS In healthy, older adults with IFG, supplementation with calcium and vitamin D may attenuate increases in glycemia and insulin resistance that occur over time. However, our findings should be considered hypothesis generating and need to be confirmed in randomized trials specifically designed for the outcomes of interest.
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Affiliation(s)
- Anastassios G Pittas
- Department of Endocrinology, Diabetes, and Metabolism, Tufts-New England Medical Center, Boston, MA 02111, USA.
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12618
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Chaikomin R, Wu KL, Doran S, Jones KL, Smout AJPM, Renooij W, Holloway RH, Meyer JH, Horowitz M, Rayner CK. Concurrent duodenal manometric and impedance recording to evaluate the effects of hyoscine on motility and flow events, glucose absorption, and incretin release. Am J Physiol Gastrointest Liver Physiol 2007; 292:G1099-104. [PMID: 17204542 DOI: 10.1152/ajpgi.00519.2006] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Upper gastrointestinal motor function and incretin hormone secretion are major determinants of postprandial glycemia and insulinemia. However, the impact of small intestinal flow events on glucose absorption and incretin release is poorly defined. Intraluminal impedance monitoring is a novel technique that allows flow events to be quantified. Eight healthy volunteers were studied twice, in random order. A catheter incorporating six pairs of electrodes at 3-cm intervals, and six corresponding manometry sideholes, was positioned in the duodenum. Hyoscine butylbromide (20 mg) or saline was given as an intravenous bolus, followed by a continuous intravenous infusion of either hyoscine (20 mg/h) or saline over 60 min. Concurrently, glucose and 3-O-methylglucose (3-OMG) were infused into the proximal duodenum (3 kcal/min), with frequent blood sampling to measure glucose, 3-OMG, insulin, glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP). The frequency of duodenal pressure waves and propagated pressure wave sequences was reduced by hyoscine in the first 10 min (P<0.01 for both), but not after that time. In contrast, there were markedly fewer duodenal flow events throughout 60 min with hyoscine (P<0.005). Overall, blood glucose (P<0.01) and plasma 3-OMG concentrations (P<0.05) were lower during hyoscine than saline, whereas plasma insulin, GLP-1, and GIP concentrations were initially (t=20 min) lower during hyoscine (P<0.05). In conclusion, intraluminal impedance measurement may be more sensitive than manometry in demonstrating alterations in duodenal motor function. A reduction in the frequency of duodenal flow events is associated with a decreased rate of glucose absorption and incretin release in healthy subjects.
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Affiliation(s)
- Reawika Chaikomin
- Discipline of Medicine, Royal Adelaide Hospital, North Terrace, Adelaide, SA, Australia
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12619
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Bibliography. Current world literature. Diabetes and the endocrine pancreas. Curr Opin Endocrinol Diabetes Obes 2007; 14:170-96. [PMID: 17940437 DOI: 10.1097/MED.0b013e3280d5f7e9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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12620
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Karl D, Philis-Tsimikas A, Darsow T, Lorenzi G, Kellmeyer T, Lutz K, Wang Y, Frias JP. Pramlintide as an adjunct to insulin in patients with type 2 diabetes in a clinical practice setting reduced A1C, postprandial glucose excursions, and weight. Diabetes Technol Ther 2007; 9:191-9. [PMID: 17425446 DOI: 10.1089/dia.2006.0013] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE This study was designed to assess the safety and efficacy of pramlintide therapy in patients with type 2 diabetes in a clinical practice setting. METHODS In this open-label study, 166 insulin-treated patients with type 2 diabetes added pramlintide therapy (120 microg) during an initiation period in which mealtime insulin was reduced by 30-50%. Insulin doses were subsequently adjusted to optimize glycemic control. Endpoints included safety, as well as change in A1C, postprandial glucose, weight, insulin dose, and patient satisfaction following 6 months of pramlintide treatment. RESULTS At 6 months, the change in A1C from baseline (8.3%) was -0.56% (P < 0.05; n = 59). Pramlintide treatment significantly reduced mean postprandial glucose excursions (P < 0.05) and weight (-2.8 kg; P < 0.05; n = 125). Glycemic benefits were achieved with lower mealtime insulin doses (-10.3%; P < 0.05; n = 104). Nausea, primarily mild to moderate, was reported by 29.5% of patients (severe nausea in 2.4%). Rates of severe hypoglycemia were low (0.04 events/patient-year). CONCLUSIONS In this uncontrolled, open-label setting, pramlintide initiation while reducing mealtime insulin, followed by insulin dose optimization, resulted in improvements in postprandial glucose excursions and A1C. These improvements in glycemic control were accompanied by weight loss.
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Affiliation(s)
- Diane Karl
- The Endocrine Clinic, Portland, Oregon, USA
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12621
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Genuis SJ, Schwalfenberg GK. Picking a bone with contemporary osteoporosis management: Nutrient strategies to enhance skeletal integrity. Clin Nutr 2007; 26:193-207. [PMID: 17046114 DOI: 10.1016/j.clnu.2006.08.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2006] [Revised: 08/14/2006] [Accepted: 08/27/2006] [Indexed: 12/31/2022]
Abstract
Epidemic rates of osteoporosis in the western world have yielded intense efforts to develop management approaches to combat this potentially devastating disorder; recent research has unveiled innovative strategies which hold considerable promise for prevention of skeletal compromise and amelioration of suboptimal bone health. According to many algorithms and practice directives, the contemporary assessment and management of osteoporosis focuses heavily on determination of fracture risk and pharmaceutical intervention for those patients deemed to be at high risk. While routine recommendations for calcium and vitamin D have been incorporated into most regimens, disproportionately little attention has been given to recent research elucidating improved bone health and diminution in fracture rates experienced by patients receiving specific nutrients. In mainstream medical practice, clinical analysis and management of nutritional or dietary issues is sometimes perceived as unconventional, primitive or unsophisticated health care. Recent evidence-based research, however, supports intervention with adequate amounts of specific nutrients including vitamin D, strontium, vitamin K, and essential fatty acids in the prevention and primary management of osteoporosis.
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Affiliation(s)
- Stephen J Genuis
- University of Alberta, 2935-66 Street, Edmonton, Alberta, Canada T6K 4C1.
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12622
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Abstract
Endocrine emergencies constitute only a small percentage of the emergency workload of general doctors, comprising about 1.5% of all hospital admission in England in 2004-5. Most of these are diabetes related with the remaining conditions totalling a few hundred cases at most. Hence any individual doctor might not have sufficient exposure to be confident in their management. This review discusses the management of diabetic ketoacidosis, hyperosmolar hyperglycaemic state, hypoglycaemia, hypercalcaemia, thyroid storm, myxoedema coma, acute adrenal insufficiency, phaeochromocytoma hypertensive crisis and pituitary apoplexy in the adult population.
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Affiliation(s)
- T Kearney
- Hope Hospital, Stott Lane, Salford M6 8HD, UK.
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12623
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Abstract
OBJECTIVE The purpose of this study was to examine the influence of leptin in women with uterine myoma. MATERIALS AND METHODS In this study, 38 women with myoma uteri and 30 normal women who applied to the Dr Zekai Tahir Burak Woman Health Research and Education Hospital's gynecology clinic were enrolled. Uterine leiomyomas were proved by pathology postoperatively. In all subjects, FSH, LH, E2, prolactin, hemoglobin, hematocrit, blood urea nitrogen, creatinine, fasting glucose, CA125, and leptin were examined, and body mass index (BMI) was calculated. Data were analyzed by Student's t test and Mann-Whitney U test. RESULTS Although leptin level was higher in the myomatic women (5.73 +/- 4.08 ng/mL) than in the normal women, there was no statistically significant difference (p = 0.303). Also, no statistical difference in the ratios of leptin/BMI was found in both groups. A significant correlation was found between high E2 level and myoma uteri (p = 0.021). Hemoglobin levels were significantly lower in the myomatic women (p = 0.044). When we compared the leptin levels according to BMI, leptin levels were higher in patients who had BMI > 30 (p = 0.02). CONCLUSION We did not find any significant difference in serum leptin levels between the two groups. But leptin may have an indirect role in the pathogenesis of uterine leiomyoma. So further research is needed to reveal the role of leptin in myoma uteri pathogenesis.
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Affiliation(s)
- Bihter Senem Dingiloglu
- Department of Obstetrics and Gynecology, Dr Zekai Tahir Burak Woman Health Research and Education Hospital, Ankara, Turkey
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12624
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Sagstetter AM, Camp JJ, Lurken MS, Szurszewski JH, Farrugia G, Gibbons SJ, Robb RA. Computer aided classification of cell nuclei in the gastrointestinal tract by volume and principal axis. ACTA ACUST UNITED AC 2007; 6514:65140E. [PMID: 25301986 DOI: 10.1117/12.710274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Normal function of the gastrointestinal tract involves the coordinated activity of several cell types Human disorders of motor function of the gastrointestinal tract are often associated with changes in the number of these cells. For example, in diabetic patients, abnormalities in gastrointestinal transit are associated with changes in nerves and interstitial cells of Cajal (ICC), two key cells that generate and regulate motility. ICC are cells of mesenchymal origin that function as pacemakers and amplify neuronal signals in the gastrointestinal tract. Quantifying the changes in number of specific cell types in tissues from patients with motility disorders is challenging and requires immunolabeling for specific antigens. The shape of nuclei differs between the cell types in the wall of the gastrointestinal tract. Therefore the objective of this study was to determine whether cell nuclei can be classified by analyzing the 3D morphology of the nuclei. Furthermore, the orientation of the long axis of nuclei changes within and between the muscle layers. These features can be used to classify and differentially label the nuclei in confocal volume images of the tissue by computing the principal axis of the coordinates of the set of voxels forming each nucleus and thereby to identify cells by their nuclear morphology. Using this approach, we were able to separate and quantify nuclei in the smooth muscle layers of the tissue. Therefore we conclude that computer-aided classification of cell nuclei can be used to identify changes in the cell types expressed in gastrointestinal smooth muscle.
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Affiliation(s)
| | - Jon J Camp
- Mayo Clinic/Foundation, 200 1st St. SW, Rochester, MN
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12625
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Knecht KT, Nguyen H, Auker AD, Kinder DH. Effects of extracts of lupine seed on blood glucose levels in glucose resistant mice: antihyperglycemic effects of Lupinus albus (white lupine, Egypt) and Lupinus caudatus (tailcup lupine, Mesa Verde National Park). ACTA ACUST UNITED AC 2007; 6:89-104. [PMID: 17317651 DOI: 10.1080/j157v06n03_04] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Lupine is a medicinal food plant with potential value in the management of diabetes. In white mice, extracts of seeds of the white lupine [Lupinus albus (L. termis L.)] were associated with increased tolerance to an oral glucose bolus. Antihyperglycemic activity was present in extracts of the whole seed but not extracts of the seed coat, and was not detected when glucose was administered intraperitoneally rather than orally. However, in contrast to results seen with the prescription drug, acarbose, lupine extract did not appear to increase the bulk or carbohydrate content of the feces. Antihyperglycemic activity was also seen in extracts of the tailcup lupine (L. caudatus) found in the Four Corners Region of the United States.
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12626
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Wang XY, Liu LWC, Diamant NE, Huizinga JD. Unique distribution of interstitial cells of Cajal in the feline pylorus. Cell Tissue Res 2007; 329:13-24. [PMID: 17384965 DOI: 10.1007/s00441-007-0404-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2006] [Accepted: 02/22/2007] [Indexed: 01/25/2023]
Abstract
The feline gastrointestinal (GI) tract is an important model for GI physiology but no immunohistochemical assessment of interstitial cells of Cajal (ICC) has been performed because of the lack of suitable antibodies. The aim of the present study was to investigate the various types of ICC and associated nerve structures in the pyloric sphincter region, by using immunohistochemistry and electron microscopy to complement functional studies. In the sphincter, ICC associated with Auerbach's plexus (ICC-AP) were markedly decreased within a region of 6-8 mm in length, thereby forming an interruption in this network of ICC-AP, which is otherwise continuous from corpus to distal ileum. In contrast, intramuscular ICC (ICC-IM) were abundant within the pylorus, especially at the inner edge of the circular muscle adjacent to the submucosa. Similar distribution patterns of nerves positive for vesicular acetylcholine transporter (VAChT), nitric oxide synthase (NOS) and substance P (SP) were encountered. Quantification showed a significantly higher number of ICC-IM and the various types of nerves in the pylorus compared with the circular muscle layers in the adjacent antrum and duodenum. Electron-microscopic studies demonstrated that ICC-IM were closely associated with enteric nerves through synapse-like junctions and with smooth muscle cells through gap junctions. Thus, for the first time, immunohistochemical studies have been successful in documenting the unique distribution of ICC in the feline pylorus. A lack of ICC-AP guarantees the distinct properties of antral and duodenal pacemaker activities. ICC-IM are associated with enteric nerves, which are concentrated in the inner portion of the circular muscle layer, being part of a unique innervation pattern of the sphincter.
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Affiliation(s)
- Xuan-Yu Wang
- Intestinal Disease Research Program and Department of Medicine, McMaster University, HSC-3N5C, 1200 Main Street West, Hamilton, ON, L8N 3Z5, Canada
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12627
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Gruendel S, Otto B, Garcia AL, Wagner K, Mueller C, Weickert MO, Heldwein W, Koebnick C. Carob pulp preparation rich in insoluble dietary fibre and polyphenols increases plasma glucose and serum insulin responses in combination with a glucose load in humans. Br J Nutr 2007; 98:101-5. [PMID: 17381962 DOI: 10.1017/s0007114507701642] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Dietary fibre consumption is associated with improved glucose homeostasis. In contrast, dietary polyphenols have been suggested to exert both beneficial and detrimental effects on glucose and insulin metabolism. Recently, we reported that a polyphenol-rich insoluble dietary fibre preparation from carob pulp (carob fibre) resulted in lower postprandial acylated ghrelin levels after a liquid meal challenge test compared with a control meal without supplementation. The effects may, however, differ when a different food matrix is used. Thus, we investigated the effects of carob fibre on glucose, insulin and ghrelin responses in healthy humans in combination with a glucose load. In a randomized single-blind cross-over study involving twenty healthy subjects (aged 22-62 years), plasma glucose, total and acylated ghrelin, and serum insulin were repeatedly assessed before and after the ingestion of 200 ml water with 50 g glucose and 0, 5, 10 or 20 g carob fibre over a period of 180 min. The intake of 5 and 10 g carob fibre increased the plasma glucose by 47 % and 64 % (P < 0.001), and serum insulin by 19.9 and 24.8 % (P < 0.001), compared with the control. Plasma acylated ghrelin concentrations did not change significantly after the consumption of carob-enriched glucose solution. Total ghrelin decreased only after 10 g carob fibre (P < 0.001) compared with control. In conclusion, we showed that polyphenol-rich carob fibre, administered within a water-glucose solution, increases postprandial glucose and insulin responses, suggesting a deterioration in glycaemic control.
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Affiliation(s)
- Sindy Gruendel
- Dietary Fibre and the Metabolic Syndrome Research Group, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
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12628
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Abstract
In patients with diabetes, dysregulation of multiple glucoregulatory hormones results in chronic hyperglycemia and an array of associated microvascular and macrovascular complications. Optimization of glycemic control, both overall (glycosylated hemoglobin [A1C]) and in the postprandial period, may reduce the risk of long-term vascular complications. However, despite significant recent therapeutic advances, most patients with diabetes are unable to attain and/or maintain normal or near-normal glycemia with insulin therapy alone. Pramlintide, an analog of amylin, is the first in a new class of pharmaceutical agents and is indicated as an adjunct to mealtime insulin for the treatment of patients with type 1 and type 2 diabetes. By mimicking the actions of the naturally occurring hormone amylin, pramlintide complements insulin by regulating the appearance of glucose into the circulation after meals via three primary mechanisms of action: slowing gastric emptying, suppressing inappropriate post-meal glucagon secretion, and increasing satiety. In long-term clinical trials, adjunctive pramlintide treatment resulted in improved postprandial glucose control and significantly reduced A1C and body weight compared with insulin alone. The combination of insulin and pramlintide may provide a more physiologically balanced approach to managing diabetes.
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Affiliation(s)
| | - Tamara Darsow
- Amylin Pharmaceuticals Inc.9520 Towne Centre Drive, San Diego, CA, USA
| | - Juan P Frias
- Amylin Pharmaceuticals Inc.9520 Towne Centre Drive, San Diego, CA, USA
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12629
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Abstract
The anesthetic management of the MO patient requires an important focus on a number of issues beginning with a careful preoperative evaluation and synthesizing pre-existing disease processes with the anesthetic management plan. The common misperception that all MO patients are "full stomach" has been challenged and may be a nonissue. New approaches to pre-oxygenation to lessen the likelihood of desaturation during apnea may be a valuable tool if difficulty is encountered in tracheal intubation. In addition, promising results have been demonstrated with the use of the ILMA for ventilation and for blindly establishing tracheal tube placement. Proper patient positioning is essential to aid in successful intubation when a laryngoscope is employed. Intraoperative anesthetic management can be guided with a processed electroencephalogram monitor to help improve emergence and to enhance wakefulness in the PACU. Careful consideration must be given to postoperative analgesic needs by minimizing the use of opioids and employing nonopioid analgesics including NSAIDs, alpha2-adrenergic agonists, and low doses of ketamine.
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Affiliation(s)
- Thomas J Ebert
- The Medical College of Wisconsin, VA Medical Center, Anesthesiology/112A, 5000 W. National Avenue, Milwaukee, WI 53295, USA.
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12630
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Anvari M, Allen C, Marshall J, Armstrong D, Goeree R, Ungar W, Goldsmith C. A randomized controlled trial of laparoscopic nissen fundoplication versus proton pump inhibitors for treatment of patients with chronic gastroesophageal reflux disease: One-year follow-up. Surg Innov 2007; 13:238-49. [PMID: 17227922 DOI: 10.1177/1553350606296389] [Citation(s) in RCA: 66] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
A randomized controlled trial conducted in patients with gastroesophageal reflux disease compared optimized medical therapy using proton pump inhibitor (n = 52) with laparoscopic Nissen fundoplication (n = 52). Patients were monitored for 1 year. The primary end point was frequency of gastroesophageal reflux dis-ease symptoms. Surgical patients had improved symptoms, pH control, and overall quality of life health index after surgery at 1 year compared with the medical group. The overall gastroesophageal reflux disease symptom score at 1 year was unchanged in the medical patients, but improved in the surgical patients. Fourteen patients in the medical arm experienced symptom relapse requiring titration of the proton pump inhibitor dose, but 6 had satisfactory symptom remission. No surgical patients required additional treatment for symptom control. Patients controlled on long-term proton pump inhibitor therapy for chronic gastroesophageal reflux disease are excellent surgical candidates and should experience improved symptom control after surgery at 1 year.
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Affiliation(s)
- Mehran Anvari
- Centre for Minimal Access Surgery, Department of Surgery, St Joseph's Healthcare, 50 Charlton Ave E, Hamilton, ON, L8N 4A6 Canada.
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12631
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Abstract
BACKGROUND AND OBJECTIVE Lead is known to have significant effects on bone metabolism and the immune system. This study tested the hypothesis that lead exposure affects periodontitis in adults. MATERIAL AND METHODS This study used the data from the Third National Health and Nutrition Examination Survey (NHANES III, 1988-94). It analyzed data from 2500 men and 2399 women, 20-56 yr old, who received complete periodontal examination. Periodontitis was defined as the presence of > 20% of mesial sites with >or= 4 mm of attachment loss. Lead exposure was grouped into three categories: < 3; 3-7; and > 7 microg/dL. Covariates were cotinine levels, poverty ratio, race/ethnicity, education, bone mineral density, diabetes, calcium intake, dental visit, and menopause (for women). All analyses were performed separately for men and women and considering the effect design. Univariate, bivariate, and stratified analysis was followed by multivariable analysis by estimating prevalence ratios through poisson regression. RESULTS After adjustment for confounders, the prevalence ratios, comparing those with a lead blood level of > 7 microg/dL to those with a lead blood level of < 3 microg/dL was 1.70 (95% confidence interval (CI): 1.02, 2.85) for men and 3.80 (95% CI: 1.66, 8.73) for women. CONCLUSION The lead blood level was positively and statistically associated with periodontitis for both men and women. Considering the public health importance of periodontitis and lead exposure, further studies are necessary to confirm this association.
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Affiliation(s)
- M C P Saraiva
- Department of Paediatrics and Social Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, SP, Brazil.
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12632
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Civelli M, Preti APM, Cenacchi V, Rondelli I, Guastalla D, Tarral A, Dostert P, Guillevic Y, Homery MC. Single and multiple ascending dose studies of a novel tissue-selective oestrogen receptor modulator, CHF 4227, in healthy postmenopausal women. Br J Clin Pharmacol 2007; 64:304-16. [PMID: 17367495 PMCID: PMC2000661 DOI: 10.1111/j.1365-2125.2007.02870.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
AIMS We evaluated the tolerability, adverse events profile, pharmacokinetics, and pharmacodynamics of CHF 4227, a new selective oestrogen receptor modulator (SERM), in healthy postmenopausal women. METHODS Two phase I studies were conducted according to a double-bind, placebo-controlled design. Subjects were randomized to receive six single (5-400 mg) or five multiple oral doses of CHF 4227 for 28 days (5-100 mg). RESULTS No vaginal bleeding and no changes in either endometrial thickness or the placenta protein 14 marker were found after 4 weeks of treatment. The compound did not induce negative effects on the fibrinolytic system. After 28 days of treatment, CHF 4227 decreased both total and LDL cholesterol concentrations (maximum decreases from baseline of 17.4% (95% CI 7.0, 27.7) and 27.6% (95% CI 9.0, 46.3), respectively). Decreases in both serum and urinary type-I C-terminal collagen telopeptide were also observed producing maximum changes of 40.6% (95% CI 29.5, 51.7), and 41.7% (95% CI 20.3, 56.8), respectively. CHF4227 (5 and 10 mg) induced near maximal oestrogen-like effects on bone markers and serum lipids without causing hot flushes. The pharmacokinetics of CHF 4227 were characterized by a slow absorption, a long elimination half-life (31-42 h after single administration) and dose linearity with respect to C(max) and AUC up to 100 mg. CONCLUSIONS CHF 4227 is a well-tolerated SERM when administered once daily for 28 days. It is potentially active on bone resorption and serum lipids, without affecting the endometrium and without worsening hot flushes. CHF 4227 is a promising agent for the treatment of several conditions in postmenopausal women.
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Affiliation(s)
- Maurizio Civelli
- Research & Development Division, Chiesi Farmaceutici S.p.A.Via Palermo 26/A, 43100 Parma, Italy
| | | | - Valentina Cenacchi
- Research & Development Division, Chiesi Farmaceutici S.p.A.Via Palermo 26/A, 43100 Parma, Italy
| | - Ivano Rondelli
- Research & Development Division, Chiesi Farmaceutici S.p.A.Via Palermo 26/A, 43100 Parma, Italy
| | - Daniele Guastalla
- Research & Development Division, Chiesi Farmaceutici S.p.A.Via Palermo 26/A, 43100 Parma, Italy
| | - Antoine Tarral
- Biotrial, Technopole Atalante Villejean7–9 rue Jean-Louis Bertrand, 35000 Rennes, France
| | - Philippe Dostert
- Biotrial, Technopole Atalante Villejean7–9 rue Jean-Louis Bertrand, 35000 Rennes, France
| | - Yann Guillevic
- Biotrial, Technopole Atalante Villejean7–9 rue Jean-Louis Bertrand, 35000 Rennes, France
| | - Marie-Claude Homery
- Biotrial, Technopole Atalante Villejean7–9 rue Jean-Louis Bertrand, 35000 Rennes, France
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12633
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Zhou W, Heist RS, Liu G, Asomaning K, Neuberg DS, Hollis BW, Wain JC, Lynch TJ, Giovannucci E, Su L, Christiani DC. Circulating 25-hydroxyvitamin D levels predict survival in early-stage non-small-cell lung cancer patients. J Clin Oncol 2007; 25:479-85. [PMID: 17290055 DOI: 10.1200/jco.2006.07.5358] [Citation(s) in RCA: 159] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Our previous analyses suggested that surgery in the summertime with higher vitamin D intake is associated with improved survival in patients with early-stage non-small-cell lung cancer (NSCLC). We further investigated the results of circulating 25-hydroxyvitamin D (25[OH]D) levels on overall survival (OS) and recurrence-free survival (RFS) in NSCLC patients. PATIENTS AND METHODS Among 447 patients with early-stage NSCLC, data were analyzed using Cox proportional hazards models, adjusting for age, sex, stage, smoking, and treatment. RESULTS The median follow-up time was 72 months (range, 0.2 to 141), with 161 recurrences and 234 deaths. For OS, the adjusted hazard ratio (AHR) was 0.74 (95% CI, 0.50 to 1.10; Ptrend = .07) for the highest versus lowest quartile of 25(OH)D levels. Stratified by stage, a strong association was observed among stage IB-IIB patients (AHR, 0.45; 95% CI, 0.24 to 0.82; Ptrend = .002), but not among stage IA patients (AHR, 1.10; 95% CI, 0.62 to 1.96; Ptrend = .53). Similar effects of 25(OH)D levels were observed among the 309 patients with dietary information (AHR, 0.74; 95% CI, 0.46 to 1.17; Ptrend = .19). For the joint effects of 25(OH)D level and vitamin D intake, the combined high 25(OH)D levels and high vitamin D intake (by median) were associated with better survival than the combined low 25(OH)D levels and low vitamin D intake (AHR, 0.64; 95% CI, 0.42 to 0.98; Ptrend = .06). Again, stronger associations were observed among stage IB-IIB than IA patients. Similar effects of 25(OH)D levels and vitamin D intake were observed for RFS. CONCLUSION Vitamin D may be associated with improved survival of patients with early-stage NSCLC, particularly among stage IB-IIB patients.
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Affiliation(s)
- Wei Zhou
- Departments of Environmental Health, Harvard School of Public Health, Boston, MA 02115, USA.
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12634
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Sanggaard KM, Holst JJ, Rehfeld JF, Sandström B, Raben A, Tholstrup T. Different effects of whole milk and a fermented milk with the same fat and lactose content on gastric emptying and postprandial lipaemia, but not on glycaemic response and appetite. Br J Nutr 2007; 92:447-59. [PMID: 15469648 DOI: 10.1079/bjn20041219] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Longitudinal studies indicate that milk and fermented milk products lower basal plasma cholesterol concentrations, despite their high content of saturated fat, and therefore have favourable health effects. However, there have been few studies on the postprandial effects of milk products. The present study compared the effect of whole milk with a fermented milk, A-38, on postprandial carbohydrate and lipid metabolism, gastric emptying and appetite. Eight healthy young men participated. On the two test days, they arrived fasting for collection of baseline values before consuming the meals, which for a 75 kg subject consisted of 1·4 litre milk or fermented milk, plus 165 mg [13C]acetate (for later determination of gastric emptying by a [13C]acetate breath test). Lactose (15 g) was added to the A-38 meal to equalize the lactose content. Postprandially the A-38 meal resulted in a slower gastric emptying rate than milk (P>0·001). Furthermore, the A-38 meal resulted in a greater increase and a quicker decrease of the triacylglycerol content in all lipoprotein fractions (LDL-fraction,P>0·05; other fractions,P>0·001) and of the gastrointestinal hormones (cholecystokinin and peptide YY,P>0·05; gastric inhibitory polypeptide and glucagon-like polypeptide-1,P>0·001). There were no significant differences in appetite sensations (measured by visual analogue scale) or in the glucose and insulin response (P<0·10). The slower emptying rate of the liquid phase after the A-38 meal is probably due to the higher viscosity of A-38. The lower and more prolonged triacylglycerol response after the milk meal might be caused by coagulation of milk in the stomach.
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Affiliation(s)
- K M Sanggaard
- Research Department of Human Nutrition, the Royal Veterinary and Agricultural University, DK-1958 Frederiksberg, Denmark
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12635
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Creedon A, Cashman KD. The effect of high salt and high protein intake on calcium metabolism, bone composition and bone resorption in the rat. Br J Nutr 2000; 84:49-56. [DOI: 10.1017/s0007114500001227] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The effects of salt (NaCl) supplementation of rat diets (50 g/kg diet),
with normal (200 g/kg) or high (500 g/kg) dietary casein content, were
studied in 3-week-old male rats over a 3-week period. Weight gain was
reduced by dietary salt but was unaffected by dietary casein.
Salt-supplemented rats exhibited a two-and three-fold increase in urinary Mg
and Ca excretion respectively, irrespective of dietary casein content.
Dietary casein had no effect on urinary Ca or Mg. Salt reduced femoral mass
but not femoral mass expressed relative to body weight, but neither variable
was affected by dietary casein. Femoral Mg and P contents and concentrations
were unaffected by dietary salt or casein. While femoral Ca concentration
was unaffected by dietary salt, the Ca content was reduced by salt
supplementation, irrespective of dietary casein content. Neither the content
nor concentration of Ca in femora was affected by dietary casein. Urinary
pyridinoline and deoxypyridinoline levels were increased by salt
supplementation, irrespective of dietary casein content, but were unaffected
by casein. Net Ca absorption was unaffected by dietary salt or casein. In
conclusion, these results show that salt supplementation over the short-term
increased the rate of bone resorption in rats. This was as a consequence of
Na-induced calciuria. On the other hand, a high dietary protein intake had
no effect on Ca metabolism, bone composition or bone resorption, nor did it
augment the Na-induced calciuria or increased rate of bone
resorption.
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12636
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Abstract
The present review summarises the effects of different carbohydrate and fat structures on food intake and appetite and the differences in response at various levels of processing of macronutrients. Several physico-chemical properties of carbohydrate and fat molecules appear to influence the short-term satiating properties. However, long-term substantiation of these findings expressed in terms of food intake or body weight is not currently available. Such studies will be required to make clear recommendations regarding dietary composition to aid satiety.
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Affiliation(s)
- Stephen French
- Masterfoods (Division of Mars UK Ltd), Dundee Road, Slough, Berkshire SL1 4JX, UK.
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12637
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Boudry G, Guérin S, Henri Malbert C. Effect of an abrupt switch from a milk-based to a fibre-based diet on gastric emptying rates in pigs: difference between origins of fibre. Br J Nutr 2007; 92:913-20. [PMID: 15613253 DOI: 10.1079/bjn20041271] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
A characteristic dietary feature at weaning is a switch from a milk-based to plant-based diet, i.e. from a non-fibrous to a fibrous diet. The present study aimed to evaluate the effects of such an abrupt dietary switch on gastric emptying rate in pigs maintained on a milk substitute after weaning. Eighteen piglets were kept on a milk substitute for 5 weeks after weaning and were then switched to wheat-based or barley-based diets or kept on the milk substitute (six piglets per group). All piglets were fasted for 1d before the switch and daily food intake was then increased linearly to reach initial values within 3d. The gastric emptying rate was measured by γ-scintigraphy before and after the switch. Corpo-antral peristalsis was also evaluated by the use of high-frequency scintigraphic frames. The gastric emptying rate of the wheat-based diet was accelerated on days 1 to 3 after the switch, but was similar to that in the milk-substitute group thereafter. This acceleration was concomitant with an enhanced frequency of corpo-antral waves on days 2 and 3. Conversely, the gastric emptying rate of the barley-based diet tended to be enhanced on day 2, but was delayed on days 4 and 5, without any change in frequency of corpo-antral waves. We conclude that a switch from a non-fibrous to a fibrous diet alters the gastric emptying rate differently depending on the type of dietary fibre.
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12638
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Abstract
An adequate level of protein intake is required to limit the gradual body protein loss observed during ageing. Different factors (cohort age, sex, life conditions) may modify protein intake and distribution. However the precise amounts, as well as their daily distribution which affects protein utilisation and N retention, are unknown in both young and elderly individuals. The hypothesis was tested that protein intake and its distribution over daily meals could be different between the young and elderly. The consumption of six different protein-rich food groups by 292 healthy individuals aged 20–30 and 65–75 years was determined throughout each day for 1 week. The data of the total protein intake and protein intakes at each meal were analysed by ANOVA for each sex separately, using age group as the independent factor. The average protein intake of men was lower in the older age group whilst the opposite trend was seen in women. The distribution of protein intake was different between the two age groups: 56·5 % of the daily protein was eaten at lunch by the elderly but only 47 % (P<0·0001) by the younger subjects. In the elderly subjects, those eating larger amounts consumed a greater proportion of protein-rich foods at dinner than those eating small amounts (30·4 v. 26·2 %, P=0·05). A high level of protein intake was related to a higher meat-product consumption in both the elderly and young individuals. In conclusion, the pattern of protein intake differs significantly between age groups and sexes.
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Affiliation(s)
- Sylvie Rousset
- Institut National de la Recherche Agronomique, Station de Recherches sur la Viande, Equipe Propriétés Sensorielles et Préférences, Theix, 63 122 Saint Genès Champanelle, France.
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12639
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Marciani L, Wickham MSJ, Bush D, Faulks R, Wright J, Fillery-Travis AJ, Spiller RC, Gowland PA. Magnetic resonance imaging of the behaviour of oil-in-water emulsions in the gastric lumen of man. Br J Nutr 2007; 95:331-9. [PMID: 16469150 DOI: 10.1079/bjn20051628] [Citation(s) in RCA: 65] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Pre-processed foods often contain a high percentage of lipid, present as emulsions stabilised with various surface-active agents. The acidic gastric environment can affect the behaviour of such emulsions, modifying the lipid spatial distribution and, in turn, the rate of gastric emptying and nutrient delivery to the gut. The aim of the present study was to use echo-planar magnetic resonance imaging (EPI) to determine the behaviour of model olive oil emulsions during gastric processing. Six healthy male volunteers were intubated nasogastrically on two separate occasions and fed 500ml 15% (w/w) olive oil-in-water, surfactant-stabilised emulsions designed to have identical droplet size distribution and which were either stable or unstable under gastric acid conditions. EPI was used to assess the oil fraction of the intragastric emulsions, gastric emptying and to visualise the spatial distribution of the oil at 10, 30 and 50min postprandially. The in vivo imaging measurements of the oil volume fraction of the emulsions correlated well (r 0·66, acid-stable; r 0·52, acid-unstable) with that assayed in the gastric aspirates. Compared with the acid-stable emulsion, the acid-unstable emulsion in the gastric lumen rapidly separated into lipid-depleted ‘aqueous’ and lipid layers. Phase separation in the acid-unstable meal allowed the oil-depleted component to empty first and more rapidly than the stable emulsion as determined by the gastric emptying curves. These pilot data suggest that gastric processing and emptying of high-fat foods could be manipulated by careful choice of emulsifier.
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Affiliation(s)
- Luca Marciani
- Wolfson Digestive Diseases Centre, Queen's Medical Centre, University Hospital, Nottingham NG7 2RD, UK
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12640
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Abstract
Physical activity (PA) is a popular therapy for the prevention and treatment of bone loss and osteoporosis because it has no adverse side effects, it is low cost, and it confers additional benefits such as postural stability and fall prevention. Bone mass is regulated by mechanical loading, and is limited but not controlled by diet. The mechanism by which strain thresholds turn bone remodelling ‘on’ and ‘off ’ is known as the mechanostat theory. Research in animals has shown that optimal strains are dynamic, with a high change rate, an unusual distribution and a high magnitude of strain, but the results of randomized controlled trials in human subjects have been somewhat equivocal. In the absence of weight-bearing activity nutritional or endocrine interventions cannot maintain bone mass. Biochemical markers of bone turnover predict bone mass changes, and findings from our research group and others have shown that both acute and chronic exercise can reduce bone resorption. Similarly, Ca intervention studies have shown that supplementation can reduce bone resorption. Several recent meta-analytical reviews concur that changes in bone mass with exercise are typically 2–3%. Some of these studies suggest that Ca intake may influence the impact of PA on bone, with greater effects in Ca-replete subjects. Comparative studies between Asian (high PA, low Ca intake) and US populations (low PA, high Ca intake) suggest that PA may permit an adaptation to low Ca intakes. Whether Ca and PA interact synergistically is one of the most important questions unanswered in the area of lifestyle-related bone health research.
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Affiliation(s)
- Niamh M Murphy
- Centre for Health Behaviour Research, Waterford Institute of Technology, Waterford, Republic of Ireland.
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12641
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Abstract
After a meal the activity of the gut increases markedly as digestion takes place. Associated with this increase in activity is an increase in blood flow, which has been shown to be dependent on factors such as caloric content and constitution of the meal. Much qualitative work has been carried out regarding mechanisms for the presence of food in a section of gut producing increased blood flow to that section, but there are still many aspects of this process that are not fully understood. In this paper we briefly review current knowledge on several relevant areas relating to gut blood flow, focusing on quantitative data where available and highlighting areas where further research is needed. We then present new data on the effect of feeding on flow in the superior mesenteric artery. Finally, we describe a framework for combining this data to produce a single model describing the mechanisms involved in postprandial hyperaemia. For a section of the model, where appropriate data are available, preliminary results are presented.
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12642
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Abstract
There is compelling evidence to suggest that both the development of bone to peak bone mass at maturity and subsequent loss depend on the interaction between genetic, hormonal, environmental and nutritional factors. The major part (≤80%) of the age-specific variation in bone turnover and bone density is genetically determined. However, the notion of genetic determinant is of little value unless the specific genes that are involved can be identified. Most work in this area of osteoporosis research has focused on the candidate gene approach, which has identified several candidate genes for osteoporosis, including genes encoding the vitamin D receptor (VDR), oestrogen receptors (α and β), apolipoprotein E, collagen type I α 1 and methylenetetrahydrofolate reductase, amongst many others. However, in general, findings from numerous studies of the association between such genes and various bone variables have been inconsistent. In addition to possible gene—gene interactions it is likely that there are interactions between these genes and certain environmental factors, especially nutrition, that may mediate expression of bone-related phenotypes. While these potential interactions add a level of complexity to our understanding of these apparent genetic effects on bone, identification of a role for genetic factors without knowledge of their interaction with nutrients can do little to advance prevention and treatment of osteoporosis. This information is especially important because, unlike genotype, diet and nutrition can be modified. The aim of the present review is to critically evaluate current knowledge relating to candidate genes for osteoporosis, with particular emphasis on their interaction with nutrients and dietary factors in determining bone health.
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Affiliation(s)
- Siobhán Cusack
- Department of Food and Nutritional Sciences, University College, Cork, Republic of Ireland
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12643
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Abstract
Vitamin D is produced endogenously when the skin is exposed to sunlight and can be obtained exogenously from a few natural food sources, from food fortification and from supplements. Generally, vitamin D intake is low ≤2–3 μg/d in Europe. Casual exposure to sunlight is thought to provide most of the vitamin D requirement of the human population. However, skin synthesis of vitamin D may not compensate for the low nutritional intake in Europe, even in countries with high supplies from food fortification and supplements. For assessment of vitamin D nutritional status the concentration of 25-hydroxyvitamin D (25(OH)D) in serum is considered to be an accurate integrative measure reflecting an individual's dietary intake and cutaneous production. A substantial percentage of the elderly and adolescents in Europe have a low concentration of 25(OH)D; in the elderly this percentage ranges from approximately 10 in the Nordic countries to approximately 40 in France. Low vitamin D status seems to be aggravated by disease and immobility, and by a low frequency of supplement use.
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Affiliation(s)
- Lars Ovesen
- Institute of Food Safety and Nutrition, The Danish Veterinary and Food Administration, 30A Sydmarken, 2860 Søborg, Denmark.
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12644
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Abstract
Osteoporosis is an important contributor to the global burden of disease, and in the UK alone results in one in three women and one in twelve men aged >50 years experiencing a fragility fracture. Optimising peak bone mass in early adulthood is thought to reduce osteoporosis risk by offsetting bone losses in later life. Ensuring sufficient vitamin D status (measured as 25-hydroxyvitamin D (25OHD) in plasma), among other factors, is believed to facilitate the achievement of optimum peak bone mass. Lower 25OHD is associated with a higher plasma concentration of parathyroid hormone (PTH). As PTH is associated with increased bone turnover and bone loss, maintenance of sufficient 25OHD is thought to have a protective effect on bone health. However, there is a lack of consensus internationally on what constitutes an optimum 25OHD concentration, and values between 30 and 80 nmol/l have been suggested. These values have been based on findings from various studies in adults in which PTH has been observed to plateau at a 25OHD concentration of >30 nmol/l; however, not all studies have found such a plateau. Although studies in younger adolescents (14–16 years) have shown an inverse relationship between PTH and 25OHD, the concentration of 25OHD required for achievement of optimum peak bone mass is unknown. The present review examines the evidence defining vitamin D insufficiency thresholds, and the relevance of such thresholds to adolescent bone health.
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Affiliation(s)
- Alexis M Willett
- MRC Human Nutrition Research, Elsie Widdowson Laboratory, Cambridge, UK.
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12645
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Van Walleghen EL, Orr JS, Gentile CL, Davy KP, Davy BM. Habitual physical activity differentially affects acute and short-term energy intake regulation in young and older adults. Int J Obes (Lond) 2007; 31:1277-85. [PMID: 17342074 DOI: 10.1038/sj.ijo.0803579] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Energy intake (EI) regulation is impaired in older adults, but it is not known if habitual physical activity affects accuracy of EI regulation in older compared with young adults. OBJECTIVE We hypothesized that the ability to compensate for a high-energy yogurt preload beverage at a subsequent ad libitum meal (i.e. acute compensation) and over the course of the testing day (i.e. short-term compensation) would decrease with age, but the magnitude of the decline would be smaller in physically active compared with sedentary older adults. DESIGN On two occasions, young active (n=15), young sedentary (n=14), older active (n=14) and older sedentary (n=11) subjects consumed either a high-energy yogurt preload beverage (YP: 500 ml, 1988 kJ, men; 375 ml, 1507 kJ, women), or no preload (NP), 30 min before an ad libitum test meal. EI at both ad libitum meals was measured, and total daily EI was determined on both testing days. Percent EI compensation for the YP was calculated for the test meal and testing day to determine acute and short-term compensation. RESULTS Percent EI compensation at the test meal was significantly lower in the older compared with the young subjects (65+/-4 vs 81+/-4%, P=0.005). There was no effect of habitual physical activity level on acute compensation, and no age by physical activity level interaction (P=0.60). In contrast, short-term compensation was not different with age (87+/-5 vs 93+/-6%, older vs young, P=0.45), but was more accurate in active vs sedentary subjects (100+/-5 vs 79+/-6%, P=0.01). As with acute compensation, there was no age by physical activity interaction (P=0.39). CONCLUSION Acute EI regulation is impaired in older adults, which is not attenuated by physical activity status. However, EI regulation over the course of a day is more accurate in active vs sedentary adults, which may facilitate long-term energy balance. Future work is needed to determine if higher energy expenditure in older active vs older sedentary adults improves long-term EI regulation.
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Affiliation(s)
- E L Van Walleghen
- Department of Human Nutrition, Foods and Exercise, Virginia Tech, Blacksburg, VA 24061, USA
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12646
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Abstract
Bone growth and turnover results from the coordinated activities of two key cell types. Bone matrix is deposited and mineralised by osteoblasts and it is resorbed by osteoclasts, multinucleate cells that excavate pits on bone surfaces. It has been known since the early 20th century that systemic acidosis causes depletion of the skeleton, an effect assumed to result from physico-chemical dissolution of bone mineral. However, our own work has shown that resorption pit formation by cultured osteoclasts was absolutely dependent on extracellular acidification; these cells are inactive at pH levels above about 7·3 and show maximum stimulation at a pH of about 6·9. Bone resorption is most sensitive to changes in H+concentration at a pH of about 7·1 (which may be close to the interstitial pH in bone). In this region pH shifts of <0·05 units can cause a doubling or halving of pit formation. In whole-bone cultures, chronic HCO3-acidosis results in similar stimulations of osteoclast-mediated Ca2+release, with a negligible physico-chemical component.In vivo, severe systemic acidosis (pH change of about –0·05 to –0·20) often results from renal disease; milder chronic acidosis (pH change of about –0·02 to –0·05) can be caused by excessive protein intake, acid feeding, prolonged exercise, ageing, airway diseases or the menopause. Acidosis can also occur locally as a result of inflammation, infection, wounds, tumours or diabetic ischaemia. Cell function, including that of osteoblasts, is normally impaired by acid; the unusual stimulatory effect of acid on osteoclasts may represent a primitive ‘fail-safe’ that evolved with terrestrial vertebrates to correct systemic acidosis by ensuring release of alkaline bone mineral when the lungs and kidneys are unable to remove sufficient H+equivalent. The present results suggest that even subtle chronic acidosis could be sufficient to cause appreciable bone loss over time.
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Affiliation(s)
- Tim Arnett
- Department of Anatomy and Developmental Biology, University College London, Gower Street, London WC1E 6BT, UK.
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12647
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Rosa-E-Silva L, Troncon LEA, Gallo L, Foss MC, Passos ADC, Perdoná GC, Achcar JA, Oliveira RB. Factors associated with abnormal gastric emptying in alcohol-related chronic pancreatitis. J Clin Gastroenterol 2007; 41:306-11. [PMID: 17426472 DOI: 10.1097/01.mcg.0000225582.55459.dd] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Patients with alcohol-related chronic pancreatitis (ARCP) may present with abnormal gastric emptying (GE), which has been ascribed mainly to nutrient maldigestion. Nevertheless, many patients also have diabetes with autonomic dysfunction and malnutrition and the role of these factors on abnormal GE has not been investigated. GOALS To determine the influences of malabsorption, diabetes, malnutrition, and autonomic dysfunction on GE abnormalities in patients with ARCP. STUDY Forty ARCP outpatients and 18 healthy controls were studied. GE was measured by scintigraphy after a standard, liquid, nutrient meal labeled with Technetium-phytate. Autonomic function was evaluated by cardiovascular tests. The influence of each factor on abnormal GE was assessed by Bayesian multiple regression analysis. RESULTS In the ARCP group, GE was abnormal in 19 patients (47.5%), who showed either accelerated (N=12) or delayed emptying (N=7). Diabetes was highly prevalent (P<0.01) in ARCP patients with either rapid or delayed GE (18/19). Multiple regression analysis showed that not only diabetes, but also autonomic dysfunction has significant effects on abnormal GE, whereas malabsorption and malnutrition seemed not to be associated to abnormal emptying. CONCLUSIONS A substantial proportion of patients with ARCP may have abnormal GE. Either delayed or accelerated GE seem to be related to underlying diabetes mellitus and autonomic neuropathy rather than to nutrient malabsorption and malnutrition.
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Affiliation(s)
- Lucilene Rosa-E-Silva
- Department of Medicine, Londrina School of Medicine, State University of Londrina, Londrina, State of Paraná, Brazil
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12648
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Brennan IM, Otto B, Feltrin KL, Meyer JH, Horowitz M, Feinle-Bisset C. Intravenous CCK-8, but not GLP-1, suppresses ghrelin and stimulates PYY release in healthy men. Peptides 2007; 28:607-11. [PMID: 17129639 DOI: 10.1016/j.peptides.2006.10.014] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2006] [Revised: 10/20/2006] [Accepted: 10/20/2006] [Indexed: 02/07/2023]
Abstract
We have investigated the effects of exogenous CCK-8 and GLP-1, alone and in combination, on ghrelin and PYY secretion. Nine healthy males were studied on four occasions. Plasma ghrelin and PYY concentrations were measured during 150 min intravenous infusions of: (i) isotonic saline, (ii) CCK-8 at 1.8 pmol/kg/min, (iii) GLP-1 at 0.9 pmol/kg/min or (iv) CCK-8 and GLP-1 combined. CCK-8 markedly suppressed ghrelin and stimulated PYY when compared with control between t=0-120 min (P<0.001 for both). GLP-1 had no effect on ghrelin, but decreased PYY slightly at 120 min (P<0.05). During infusion of CCK-8+GLP-1, there was comparable suppression of ghrelin (P<0.001), but the stimulation of PYY was less (P<0.001), than that induced by CCK-8, between t=20-120 min. In conclusion, in healthy subjects, in the doses evaluated, exogenous CCK-8 suppresses ghrelin and stimulates PYY, and exogenous GLP-1 has no effect on ghrelin and attenuates the effect of CCK-8 on PYY.
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Affiliation(s)
- Ixchel M Brennan
- University of Adelaide Discipline of Medicine, Royal Adelaide Hospital, Adelaide, SA 5000, Australia
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12649
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Kalaitzakis E, Bosaeus I, Ohman L, Björnsson E. Altered postprandial glucose, insulin, leptin, and ghrelin in liver cirrhosis: correlations with energy intake and resting energy expenditure. Am J Clin Nutr 2007; 85:808-15. [PMID: 17344504 DOI: 10.1093/ajcn/85.3.808] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Liver cirrhosis is associated with reduced energy intake and increased resting energy expenditure. OBJECTIVE We aimed to investigate the possible role of glucose, insulin, leptin, and ghrelin in the pathogenesis of these alterations. DESIGN Nutritional status, energy intake, resting energy expenditure, and fasting glucose, insulin, and leptin were assessed in 31 patients with cirrhosis. Postprandial glucose, insulin, C-peptide, leptin, and ghrelin responses were studied in a subgroup of patients after a standard meal. Ten healthy subjects served as controls. RESULTS Patients with cirrhosis had a lower energy intake (P < 0.05), higher resting energy expenditure (P < 0.05), higher fasting leptin (P < 0.05), and higher insulin resistance (P < 0.001) than did the healthy control subjects. In the patients with cirrhosis, fasting leptin was negatively correlated with resting energy expenditure (r = -0.38, P < 0.05) but not with energy intake. In control subjects, leptin was negatively correlated with energy intake (r = -0.72, P < 0.05) but not with resting energy expenditure. The patients with cirrhosis had higher postprandial glucose (P < 0.001) and lower ghrelin (P < 0.05) concentrations at 4 h postprandially than did the control subjects. The increase in ghrelin from its minimal postmeal value to 4 h postmeal was negatively correlated (r = -0.66, P = 0.014) with weight loss in the patients with cirrhosis. Energy intake was negatively correlated (r = -0.42, P < 0.01) with the postprandial increase in glucose. CONCLUSIONS In cirrhosis, altered postprandial glucose and ghrelin are associated with reduced energy intake and weight loss, respectively, and the effects of leptin on energy intake and expenditure seem to be altered. Insulin resistance might be involved in these altered postprandial responses.
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Affiliation(s)
- Evangelos Kalaitzakis
- Department of Internal Medicine, Faculty of Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden.
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Abstract
We tested the hypothesis that low vitamin D receptor (VDR) level causes intestinal vitamin D resistance and intestinal calcium (Ca) malabsorption. To do so, we examined vitamin D regulated duodenal Ca absorption and gene expression [transient receptor potential channel, vallinoid subfamily member 6 (TRPV6), 24-hydroxylase, calbindin D(9k) (CaBP) mRNA, and CaBP protein] in wild-type mice and mice with reduced tissue VDR levels [i.e. heterozygotes for the VDR gene knockout (HT)]. Induction of 24-hydroxylase mRNA levels by 1,25 dihydroxyvitamin D(3) [1,25(OH)(2) D(3)] injection was significantly reduced in the duodenum and kidney of HT mice in both time-course and dose-response experiments. TRPV6 and CaBP mRNA levels in duodenum were significantly induced after 1,25(OH)(2) D(3) injection, but there was no difference in response between wild-type and HT mice. Feeding a low-calcium diet for 1 wk increased plasma PTH, renal 1alpha-hydroxylase (CYP27B1) mRNA level, and plasma 1,25(OH)(2) D(3), and this response was greater in HT mice (by 88, 55, and 37% higher, respectively). In contrast, duodenal TRPV6 and CaBP mRNA were not higher in HT mice fed the low-calcium diet. However, the response of duodenal Ca absorption and CaBP protein to increasing 1,25(OH)(2) D(3) levels was blunted by 40% in HT mice. Our data show that low VDR levels lead to resistance of intestinal Ca absorption to 1,25(OH)(2) D(3), and this resistance may be due to a role for the VDR (and VDR level) in the translation of CaBP.
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Affiliation(s)
- Yurong Song
- Interdepartmental Nutrition Program and Department of Foods and Nutrition, Purdue University, 700 West State Street, West Lafayette, IN 47906-2059, USA
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