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Rejeski JJ, Fanning J, Nicklas BJ, Rejeski WJ. Six-month changes in ghrelin and glucagon-like peptide-1 with weight loss are unrelated to long-term weight regain in obese older adults. Int J Obes (Lond) 2021; 45:888-894. [PMID: 33526855 PMCID: PMC8005376 DOI: 10.1038/s41366-021-00754-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 11/19/2020] [Accepted: 01/12/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND OBJECTIVE Weight loss (WL) and subsequent regain are complex physiologic processes, and our understanding of the hormonal changes associated with these processes continues to evolve. We aimed to examine the effects of behavioral WL on 6-month changes in ghrelin and GLP-1 and evaluate the effects of these changes in gut hormones on weight regain among older adults. SUBJECTS AND METHODS One hundred seventy-seven obese (BMI: 33.5 (3.5) kg/m2) older adults (66.9 ± 4.7 years, 71.2% female, 67.6% white) were randomized to WL (WL; n = 68), WL plus aerobic training (n = 79), or WL plus resistance training (n = 75) for 18 months. Ghrelin, GLP-1, power of food scale (PFS), and weight were measured at baseline, 6 months, and 18 months. RESULTS There was no differential treatment effect on change in either gut hormone, however, there was a significant time effect across all groups (p < 0.001), with increases in ghrelin (∆ = +106.77 pg/ml; 95% CI = + 84.82, +128.71) and decreases in GLP-1 (∆ = -4.90 pM; 95% CI = -6.27, -3.51) at 6-month. Ratings on the PFS decreased from baseline to 6-month and there was significant loss of weight from baseline to either 6- or 18-month, ∆ = -7.96 kg; 95% CI = -7.95, -8.78 and ∆ = -7.80 kg; 95% CI = -8.93, -6.65, respectively (p < 0.001). Changes in ghrelin and GLP-1 at 6-month did not predict weight regain from 6- to 18-month. DISCUSSION AND CONCLUSION Among older adults with obesity and cardiometabolic disease, the intensive phase of dietary WL results in increasing levels of ghrelin and decreasing levels of GLP-1 that are unrelated to weight regain a year later. Registered with ClinicalTrials.gov (NCT01547182).
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Affiliation(s)
- Jared J Rejeski
- Department of Internal Medicine, Section on Gastroenterology, Wake Forest School of Medicine, Winston-Salem, NC, USA.
| | - Jason Fanning
- Department of Health & Exercise Science, Wake Forest University, Winston-Salem, NC, USA
| | - Barbara J Nicklas
- Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - W Jack Rejeski
- Department of Health & Exercise Science, Wake Forest University, Winston-Salem, NC, USA
- Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
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Abstract
There are numerous treatment options currently available for patients with type 2 diabetes mellitus; however, a multitude of patients continue to have inadequately controlled glycemic levels with their current antihyperglycemic regimen. Furthermore, the American Diabetes Association guidelines increasingly highlight the importance of multifactorial management and optimizing medication regimens that include cardiovascular, renal, and/or weight benefits in patients with type 2 diabetes mellitus. Glucagon-like peptide-1 receptor agonists belong to a novel class of type 2 diabetes mellitus agents that are becoming increasingly prevalent owing to their ability to improve glycemic status without the risk of hypoglycemia. Currently, there are three US Food and Drug Administration-approved glucagon-like peptide-1 receptor agonists, subcutaneous semaglutide, dulaglutide, and liraglutide, that also have an indication for reducing major adverse cardiovascular events in patients with type 2 diabetes mellitus and established cardiovascular disease. However, these agents are not often the first options because of their subcutaneous administration. Nevertheless, co-formulation of oral semaglutide with an absorption enhancer has shown to increase its bioavailability and has made its oral absorption possible. In the PIONEER trials, oral semaglutide effectively lowered blood glucose levels, and showed benefits on weight and cardiovascular outcomes; however, there is no Food and Drug Administration indication approved yet as the SOUL trial is still ongoing. Such characteristics of oral semaglutide may improve and increase its use compared to subcutaneous agents and possibly lead to earlier cardiovascular protection in addition to achieving glycemic control.
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Martínez-Gómez MG, Roberts BM. Metabolic Adaptations to Weight Loss: A Brief Review. J Strength Cond Res 2021; 36:2970-2981. [PMID: 33677461 DOI: 10.1519/jsc.0000000000003991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
ABSTRACT Martínez-Gómez, MG and Roberts, BM. Metabolic adaptations to weight loss: A brief review. J Strength Cond Res XX(X): 000-000, 2021-As the scientific literature has continuously shown, body mass loss attempts do not always follow a linear fashion nor always go as expected even when the intervention is calculated with precise tools. One of the main reasons why this tends to happen relies on our body's biological drive to regain the body mass we lose to survive. This phenomenon has been referred to as "metabolic adaptation" many times in the literature and plays a very relevant role in the management of obesity and human weight loss. This review will provide insights into some of the theoretical models for the etiology of metabolic adaptation as well as a quick look into the physiological and endocrine mechanisms that underlie it. Nutritional strategies and dietetic tools are thus necessary to confront these so-called adaptations to body mass loss. Among some of these strategies, we can highlight increasing protein needs, opting for high-fiber foods or programming-controlled diet refeeds, and diet breaks over a large body mass loss phase. Outside the nutritional aspects, it might be wise to increase the physical activity and thus the energy flux of an individual when possible to maintain diet-induced body mass loss in the long term. This review will examine these protocols and their viability in the context of adherence and sustainability for the individual toward successful body mass loss.
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Affiliation(s)
- Mario G Martínez-Gómez
- CarloSportNutrition, Spain; and University of Alabama at Birmingham, Birmingham, Alabama
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Ozgen Saydam B, Yildiz BO. Weight management strategies for patients with PCOS: current perspectives. Expert Rev Endocrinol Metab 2021; 16:49-62. [PMID: 33719818 DOI: 10.1080/17446651.2021.1896966] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Accepted: 02/25/2021] [Indexed: 12/26/2022]
Abstract
INTRODUCTION Polycystic ovary syndrome (PCOS) is the most common endocrine disorder of reproductive-aged women. Overweight and obesity commonly accompany the syndrome at the clinic and are significant concerns for women with PCOS. AREAS COVERED Herein, we provide an overview of the relevant literature on weight management strategies in women with PCOS. We performed an electronic-based search using PubMed until February 2021. We aimed to summarize available evidence of different weight-reducing interventions in PCOS and outline the gaps in our current knowledge and recommend areas for further research. EXPERT OPINION PCOS is closely linked to obesity and increased adiposity enhances severity and expression of PCOS phenotype. Current data suggest that weight loss is associated with improved metabolic, endocrine, reproductive, cardiovascular and psychological features in overweight and obese women with PCOS. Lifestyle interventions including diet and exercise, anti-obesity medications and bariatric surgery have been used as therapeutic approaches for short-term management of obesity in PCOS with varying success rates. Large and sufficiently powered studies are required in order to determine long-term effects of weight management strategies and potential benefits beyond weight loss in the syndrome. This would allow informing the guidelines to make PCOS specific evidence-based recommendations.
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Affiliation(s)
- Basak Ozgen Saydam
- Yildirim Beyazit University, Yenimahalle Training and Research Hospital, Division of Endocrinology and Metabolism, Ankara, Turkey
| | - Bulent Okan Yildiz
- Hacettepe University School of Medicine, Division of Endocrinology and Metabolism, Ankara, Turkey
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105
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Risdon S, Battault S, Romo-Romo A, Roustit M, Briand L, Meyer G, Almeda-Valdes P, Walther G. Sucralose and Cardiometabolic Health: Current Understanding from Receptors to Clinical Investigations. Adv Nutr 2021; 12:1500-1513. [PMID: 33578411 PMCID: PMC8321845 DOI: 10.1093/advances/nmaa185] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 10/26/2020] [Accepted: 12/31/2020] [Indexed: 12/15/2022] Open
Abstract
The excess consumption of added sugar is consistently found to be associated with weight gain, and a higher risk of type 2 diabetes mellitus, coronary heart disease, and stroke. In an effort to reduce the risk of cardiometabolic disease, sugar is frequently replaced by low- and null-calorie sweeteners (LCSs). Alarmingly, though, emerging evidence indicates that the consumption of LCSs is associated with an increase in cardiovascular mortality risk that is amplified in those who are overweight or obese. Sucralose, a null-caloric high-intensity sweetener, is the most commonly used LCS worldwide, which is regularly consumed by healthy individuals and patients with metabolic disease. To explore a potential causal role for sucralose in increased cardiovascular risk, this present review summarizes the preclinical and clinical data from current research detailing the effects of sucralose on systems controlling food intake, glucose homeostasis, and gut microbiota.
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Affiliation(s)
| | | | - Alonso Romo-Romo
- Department of Endocrinology and Metabolism, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, México City, México
| | - Matthieu Roustit
- Université Grenoble Alpes, Inserm U1042, Grenoble, France,Grenoble Alpes University Hospital, Clinical Pharmacology, Inserm CIC1406, Grenoble, France
| | - Loic Briand
- AgroSup Dijon, INRAE, Université de Bourgogne Franche-Comté, CNRS, Centre des Sciences du Goût et de l'Alimentation, Dijon, France
| | | | - Paloma Almeda-Valdes
- Department of Endocrinology and Metabolism, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, México City, México
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Millman JF, Okamoto S, Teruya T, Uema T, Ikematsu S, Shimabukuro M, Masuzaki H. Extra-virgin olive oil and the gut-brain axis: influence on gut microbiota, mucosal immunity, and cardiometabolic and cognitive health. Nutr Rev 2021; 79:1362-1374. [PMID: 33576418 PMCID: PMC8581649 DOI: 10.1093/nutrit/nuaa148] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Extra-virgin olive oil (EVOO), a popular functional food and major source of fat in the Mediterranean diet, possesses a variety of healthful components, including monounsaturated fatty acids and bioactive phenolic compounds that, individually and collectively, exert beneficial effects on cardiometabolic markers of health and act as neuroprotective agents through their anti-inflammatory and antioxidant activities. The gut microbiota and health of the intestinal environment are now considered important factors in the development of obesity, metabolic disease, and even certain neurodegenerative conditions via the gut-brain axis. Recently, data are emerging which demonstrate that the health-promoting benefits of EVOO may also extend to the gut microbiota. In this review, we aimed to examine findings from recent studies regarding the impact of EVOO on gut microbiota and intestinal health and explore how modulations in composition of gut microbiota, production of microbially produced products, and activity and functioning of the mucosal immune system may lead to favorable outcomes in cardiovascular, metabolic, and cognitive health.
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Affiliation(s)
- Jasmine F Millman
- J.F. Millman, S. Okamoto, T. Taiki, T. Uema, and H. Masuzaki are with the Division of Endocrinology, Diabetes and Metabolism, Hematology, Rheumatology (Second Department of Internal Medicine), Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan. S. Ikematsu is with the Department of Bioresources Engineering, National Institute of Technology, Okinawa College, Okinawa, Japan. M. Shimabukuro is with the Department of Diabetes, Endocrinology and Metabolism, Fukushima Medical University, Fukushima, Japan
| | - Shiki Okamoto
- J.F. Millman, S. Okamoto, T. Taiki, T. Uema, and H. Masuzaki are with the Division of Endocrinology, Diabetes and Metabolism, Hematology, Rheumatology (Second Department of Internal Medicine), Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan. S. Ikematsu is with the Department of Bioresources Engineering, National Institute of Technology, Okinawa College, Okinawa, Japan. M. Shimabukuro is with the Department of Diabetes, Endocrinology and Metabolism, Fukushima Medical University, Fukushima, Japan
| | - Taiki Teruya
- J.F. Millman, S. Okamoto, T. Taiki, T. Uema, and H. Masuzaki are with the Division of Endocrinology, Diabetes and Metabolism, Hematology, Rheumatology (Second Department of Internal Medicine), Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan. S. Ikematsu is with the Department of Bioresources Engineering, National Institute of Technology, Okinawa College, Okinawa, Japan. M. Shimabukuro is with the Department of Diabetes, Endocrinology and Metabolism, Fukushima Medical University, Fukushima, Japan
| | - Tsugumi Uema
- J.F. Millman, S. Okamoto, T. Taiki, T. Uema, and H. Masuzaki are with the Division of Endocrinology, Diabetes and Metabolism, Hematology, Rheumatology (Second Department of Internal Medicine), Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan. S. Ikematsu is with the Department of Bioresources Engineering, National Institute of Technology, Okinawa College, Okinawa, Japan. M. Shimabukuro is with the Department of Diabetes, Endocrinology and Metabolism, Fukushima Medical University, Fukushima, Japan
| | - Shinya Ikematsu
- J.F. Millman, S. Okamoto, T. Taiki, T. Uema, and H. Masuzaki are with the Division of Endocrinology, Diabetes and Metabolism, Hematology, Rheumatology (Second Department of Internal Medicine), Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan. S. Ikematsu is with the Department of Bioresources Engineering, National Institute of Technology, Okinawa College, Okinawa, Japan. M. Shimabukuro is with the Department of Diabetes, Endocrinology and Metabolism, Fukushima Medical University, Fukushima, Japan
| | - Michio Shimabukuro
- J.F. Millman, S. Okamoto, T. Taiki, T. Uema, and H. Masuzaki are with the Division of Endocrinology, Diabetes and Metabolism, Hematology, Rheumatology (Second Department of Internal Medicine), Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan. S. Ikematsu is with the Department of Bioresources Engineering, National Institute of Technology, Okinawa College, Okinawa, Japan. M. Shimabukuro is with the Department of Diabetes, Endocrinology and Metabolism, Fukushima Medical University, Fukushima, Japan
| | - Hiroaki Masuzaki
- J.F. Millman, S. Okamoto, T. Taiki, T. Uema, and H. Masuzaki are with the Division of Endocrinology, Diabetes and Metabolism, Hematology, Rheumatology (Second Department of Internal Medicine), Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan. S. Ikematsu is with the Department of Bioresources Engineering, National Institute of Technology, Okinawa College, Okinawa, Japan. M. Shimabukuro is with the Department of Diabetes, Endocrinology and Metabolism, Fukushima Medical University, Fukushima, Japan
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107
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Subba R, Sandhir R, Singh SP, Mallick BN, Mondal AC. Pathophysiology linking depression and type 2 diabetes: Psychotherapy, physical exercise, and fecal microbiome transplantation as damage control. Eur J Neurosci 2021; 53:2870-2900. [PMID: 33529409 DOI: 10.1111/ejn.15136] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 01/10/2021] [Accepted: 01/28/2021] [Indexed: 02/06/2023]
Abstract
Diabetes increases the likelihood of developing depression and vice versa. Research on this bidirectional association has somewhat managed to delineate the interplay among implicated physiological processes. Still, further exploration is required in this context. This review addresses the comorbidity by investigating suspected common pathophysiological mechanisms. One such factor is psychological stress which disturbs the hypothalamic-pituitary-adrenal axis causing hormonal imbalance. This includes elevated cortisol levels, a common biomarker of both depression and diabetes. Disrupted insulin signaling drives the hampered neurotransmission of serotonin, dopamine, and norepinephrine. Also, adipokine hormones such as adiponectin, leptin, and resistin and the orexigenic hormone, ghrelin, are involved in both depression and T2DM. This disarray further interferes with physiological processes encompassing sleep, the gut-brain axis, metabolism, and mood stability. Behavioral coping mechanisms, such as unhealthy eating, mediate disturbed glucose homeostasis, and neuroinflammation. This is intricately linked to oxidative stress, redox imbalance, and mitochondrial dysfunction. However, interventions such as psychotherapy, physical exercise, fecal microbiota transplantation, and insulin-sensitizing agents can help to manage the distressing condition. The possibility of glucagon-like peptide 1 possessing a therapeutic role has also been discussed. Nonetheless, there stands an urgent need for unraveling new correlating targets and biological markers for efficient treatment.
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Affiliation(s)
- Rhea Subba
- School of Life Sciences, Jawaharlal Nehru University, New Delhi, India
| | - Rajat Sandhir
- Dept. of Biochemistry, Panjab University, Chandigarh, Punjab, India
| | - Surya Pratap Singh
- Dept. of Biochemistry, Banaras Hindu University, Varanasi, Uttar Pradesh, India
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Freynhagen R, Baron R, Kawaguchi Y, Malik RA, Martire DL, Parsons B, Rey RD, Schug SA, Jensen TS, Tölle TR, Ushida T, Whalen E. Pregabalin for neuropathic pain in primary care settings: recommendations for dosing and titration. Postgrad Med 2021; 133:1-9. [PMID: 33423590 DOI: 10.1080/00325481.2020.1857992] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Pregabalin is one of the first-line treatments approved for the management of neuropathic pain (NeP). While many patients benefit from treatment with pregabalin, they are often treated with suboptimal doses, possibly due to unfamiliarity around prescribing the drug and/or side effects that can occur with up-titration. This narrative review discusses key aspects of initiating, titrating, and managing patients prescribed pregabalin therapy, and addresses concerns around driving and the potential for abuse, as well as when to seek specialist opinion. To ensure that patients derive maximum therapeutic benefit from the drug, we suggest a 'low and slow' dosing approach to limit common side effects and optimize tolerability alongside patients' expectations. When requiring titration to higher doses, we recommend initiating 'asymmetric dosing,' with the larger dose in the evening. Fully engaging patients in order for them to understand the expected timeline for efficacy and side effects (including their resolution), can also help determine the optimal titration tempo for each individual patient. The 'low and slow' approach also recognizes that patients with NeP are heterogeneous in terms of their optimal therapeutic dose of pregabalin. Hence, it is recommended that general practitioners closely monitor patients and up-titrate according to pain relief and side effects to limit suboptimal dosing or premature discontinuation.
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Affiliation(s)
- Rainer Freynhagen
- Center for Anaesthesiology, Intensive Care, Pain Medicine & Palliative Medicine, Benedictus Hospital, Feldafing, Germany
| | - Ralf Baron
- Department of Anaesthesiology, Technische Universtät München, Munich, Germany
| | - Yoshiharu Kawaguchi
- Division of Neurological Pain Research and Therapy, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Rayaz A Malik
- Department of Orthopaedic Surgery, Toyama University Hospital, Toyama, Japan; eWeill Cornell Medicine, Qatar, Doha, Qatar
| | | | | | | | - Stephan A Schug
- Argentine Institute for Neurological Research (IADIN), Buenos Aires, Argentina
| | | | - Thomas R Tölle
- Anaesthesiology and Pain Medicine, Medical School, University of Western Australia, Perth, WA, Australia
| | - Takahiro Ushida
- Department of Neurology and Diabetic Neuropathy Consortium, Aarhus University Hospital, Aarhus, Denmark
| | - Ed Whalen
- Department of Neurology, Technische Universität München, Munich, Germany.,Multidisciplinary Pain Center, Aichi Medical University Hospital, Nagakute, Japan
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Yamada T, Wakabayashi M, Bhalla A, Chopra N, Miyashita H, Mikami T, Ueyama H, Fujisaki T, Saigusa Y, Yamaji T, Azushima K, Urate S, Suzuki T, Abe E, Wakui H, Tamura K. Cardiovascular and renal outcomes with SGLT-2 inhibitors versus GLP-1 receptor agonists in patients with type 2 diabetes mellitus and chronic kidney disease: a systematic review and network meta-analysis. Cardiovasc Diabetol 2021; 20:14. [PMID: 33413348 PMCID: PMC7792332 DOI: 10.1186/s12933-020-01197-z] [Citation(s) in RCA: 65] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 12/14/2020] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Emerging evidence suggests that sodium-glucose cotransporter-2 (SGLT-2) inhibitors and glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are associated with decreased risk of cardiovascular and renal events in type 2 diabetes mellitus (DM) patients. However, no study to date has compared the effect of SGLT-2 inhibitors with that of GLP-1 RAs in type 2 DM patients with chronic kidney disease (CKD). We herein investigated the benefits of SGLT-2 inhibitors and GLP-1 RAs in CKD patients. METHODS We performed a systematic literature search through November 2020. We selected randomized control trials that compared the risk of major adverse cardiovascular events (MACE) and a composite of renal outcomes. We performed a network meta-analysis to compare SGLT-2 inhibitors with GLP-1 RAs indirectly. Risk ratios (RRs) with corresponding 95% confidence intervals (CI) were synthesized. RESULTS Thirteen studies were selected with a total of 32,949 patients. SGLT-2 inhibitors led to a risk reduction in MACE and renal events (RR [95% CI]; 0.85 [0.75-0.96] and 0.68 [0.59-0.78], respectively). However, GLP-1 RAs did not reduce the risk of cardiovascular or renal adverse events (RR 0.91 [0.80-1.04] and 0.86 [0.72-1.03], respectively). Compared to GLP-1 RAs, SGLT-2 inhibitors did not demonstrate a significant difference in MACE (RR 0.94 [0.78-1.12]), while SGLT-2 inhibitors were associated with a lower risk of renal events compared to GLP-1 RAs (RR 0.79 [0.63-0.99]). A sensitivity analysis revealed that GLP-1 analogues significantly decreased MACE when compared to placebo treatment (RR 0.81 [0.69-0.95]), while exendin-4 analogues did not (RR 1.03 [0.88-1.20]). CONCLUSIONS In patients with type 2 DM and CKD, SGLT-2 inhibitors were associated with a decreased risk of cardiovascular and renal events, but GLP-1 RAs were not. SGLT-2 inhibitors significantly decreased the risk of renal events compared to GLP-1 RAs. Among GLP-1 RAs, GLP-1 analogues showed a positive impact on cardiovascular and renal outcomes, while exendin-4 analogues did not.
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Affiliation(s)
- Takayuki Yamada
- Department of Medicine, Mount Sinai Beth Israel, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, 3 Chome-9 Fukuura, Kanazawa Ward, Yokohama, Kanagawa, 236-0004, Japan
| | - Mako Wakabayashi
- Department of Medicine, Nippon Medical School Hospital, Tokyo, Japan
| | - Abhinav Bhalla
- Department of Medicine, Mount Sinai Beth Israel, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Nitin Chopra
- Department of Medicine, Mount Sinai Beth Israel, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Hirotaka Miyashita
- Department of Medicine, Mount Sinai Beth Israel, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Takahisa Mikami
- Department of Neurology, Tufts Medical Center, Boston, MA, USA
| | - Hiroki Ueyama
- Department of Medicine, Mount Sinai Beth Israel, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Tomohiro Fujisaki
- Department of Medicine, Mount Sinai Morningside and West, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Yusuke Saigusa
- Department of Biostatistics, Yokohama City University School of Medicine, Yokohama, Japan
| | - Takahiro Yamaji
- Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, 3 Chome-9 Fukuura, Kanazawa Ward, Yokohama, Kanagawa, 236-0004, Japan
| | - Kengo Azushima
- Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, 3 Chome-9 Fukuura, Kanazawa Ward, Yokohama, Kanagawa, 236-0004, Japan
| | - Shingo Urate
- Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, 3 Chome-9 Fukuura, Kanazawa Ward, Yokohama, Kanagawa, 236-0004, Japan
| | - Toru Suzuki
- Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, 3 Chome-9 Fukuura, Kanazawa Ward, Yokohama, Kanagawa, 236-0004, Japan
| | - Eriko Abe
- Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, 3 Chome-9 Fukuura, Kanazawa Ward, Yokohama, Kanagawa, 236-0004, Japan
| | - Hiromichi Wakui
- Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, 3 Chome-9 Fukuura, Kanazawa Ward, Yokohama, Kanagawa, 236-0004, Japan.
| | - Kouichi Tamura
- Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, 3 Chome-9 Fukuura, Kanazawa Ward, Yokohama, Kanagawa, 236-0004, Japan
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Isaacs DM, Kruger DF, Spollett GR. Optimizing Therapeutic Outcomes With Oral Semaglutide: A Patient-Centered Approach. Diabetes Spectr 2021; 34:7-19. [PMID: 33627989 PMCID: PMC7887531 DOI: 10.2337/ds20-0016] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
In September 2019, the U.S. Food and Drug Administration approved oral semaglutide as the first orally administered glucagon-like peptide 1 (GLP-1) receptor agonist for treating people with type 2 diabetes. Although injectable GLP-1 receptor agonists are well-established treatment options for people with type 2 diabetes, clinical experience with an oral formulation in this class is limited. This article provides practical guidance for diabetes care and education specialists on how to effectively counsel patients initiating therapy with oral semaglutide on appropriate administration of the treatment and its possible effects on glycemic control, body weight, and quality of life. Strategies for mitigating potential side effects typical of the GLP-1 receptor agonist class, namely nausea, vomiting, and diarrhea, are also provided. Involving patients in treatment decisions and educating them about available and prescribed medications are key strategies for encouraging treatment adherence and ensuring optimal therapeutic outcomes.
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Zhao N, Wang X, Wang Y, Yao J, Shi C, Du J, Bai R. The Effect of Liraglutide on Epicardial Adipose Tissue in Type 2 Diabetes. J Diabetes Res 2021; 2021:5578216. [PMID: 34825006 PMCID: PMC8610652 DOI: 10.1155/2021/5578216] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 10/18/2021] [Accepted: 10/23/2021] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE To study the effect of liraglutide on the thickness of epicardial adipose tissue (EAT) in type 2 diabetes mellitus (T2DM) patients with abdominal obesity. METHODS Abdominal obesity T2DM patients with poor glycemic control were collected and treated with liraglutide. The changes of blood glucose, blood lipid, waist circumference, body mass index (BMI), and EAT thickness were compared after 3 months of treatment with liraglutide. Cardiac magnetic resonance imaging (MRI) was used to measure EAT thickness. RESULTS After 3 months of treatment with liraglutide, glycosylated hemoglobin (HbA1c) decreased from 9.81 ± 1.46% to 6.94 ± 1.29% (95%CI = 2.14-3.59, p < 0.001). The weight decreased from 91.67 ± 16.29 kg to 87.29 ± 16.43 kg (95%CI = 2.97-5.79, p < 0.001). Waist circumference before treatment was 103.69 ± 9.14 cm, and after treatment was 96.42 ± 8.42 cm (95%CI = 5.04-9.50, p < 0.001). Total cholesterol (TC), triglyceride (TG), and low-density lipoprotein cholesterol (LDL-C) were significantly lower than those before treatment. TC decreased from 5.34 ± 1.05 mmol/L to 4.86 ± 0.97 mmol/L (95%CI = 0.15-0.82, p < 0.001). TG was 1.89 (1.48-3.17) and then to 1.92 ± 0.69 (p = 0.03). LDL-C decreased from 3.39 ± 0.84 mmol/L to 3.01 ± 0.74 mmol/L (95%CI = 0.17-0.59, p = 0.001). HDL-C increased by 1.7% after treatment, with no significant difference (p = 0.062). More importantly, the thickness of EAT decreased from 5.0 (5.0-7.0) mm to 3.95 ± 1.43 mm (p < 0.001) after liraglutide administered for 3 months. CONCLUSION Liraglutide significantly reduces EAT thickness in T2DM with abdominal obesity, which provides theoretical support for the cardiovascular benefits of liraglutide.
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Affiliation(s)
- Na Zhao
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning Province, China
| | - Xiaoying Wang
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning Province, China
| | - Yongbo Wang
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning Province, China
| | - Junjie Yao
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning Province, China
| | - Chunhong Shi
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning Province, China
| | - Jianling Du
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning Province, China
| | - Ran Bai
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning Province, China
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Mohammed I, Hollenberg MD, Ding H, Triggle CR. A Critical Review of the Evidence That Metformin Is a Putative Anti-Aging Drug That Enhances Healthspan and Extends Lifespan. Front Endocrinol (Lausanne) 2021; 12:718942. [PMID: 34421827 PMCID: PMC8374068 DOI: 10.3389/fendo.2021.718942] [Citation(s) in RCA: 105] [Impact Index Per Article: 35.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 07/15/2021] [Indexed: 12/11/2022] Open
Abstract
The numerous beneficial health outcomes associated with the use of metformin to treat patients with type 2 diabetes (T2DM), together with data from pre-clinical studies in animals including the nematode, C. elegans, and mice have prompted investigations into whether metformin has therapeutic utility as an anti-aging drug that may also extend lifespan. Indeed, clinical trials, including the MILES (Metformin In Longevity Study) and TAME (Targeting Aging with Metformin), have been designed to assess the potential benefits of metformin as an anti-aging drug. Preliminary analysis of results from MILES indicate that metformin may induce anti-aging transcriptional changes; however it remains controversial as to whether metformin is protective in those subjects free of disease. Furthermore, despite clinical use for over 60 years as an anti-diabetic drug, the cellular mechanisms by which metformin exerts either its actions remain unclear. In this review, we have critically evaluated the literature that has investigated the effects of metformin on aging, healthspan and lifespan in humans as well as other species. In preparing this review, particular attention has been placed on the strength and reproducibility of data and quality of the study protocols with respect to the pharmacokinetic and pharmacodynamic properties of metformin. We conclude that despite data in support of anti-aging benefits, the evidence that metformin increases lifespan remains controversial. However, via its ability to reduce early mortality associated with various diseases, including diabetes, cardiovascular disease, cognitive decline and cancer, metformin can improve healthspan thereby extending the period of life spent in good health. Based on the available evidence we conclude that the beneficial effects of metformin on aging and healthspan are primarily indirect via its effects on cellular metabolism and result from its anti-hyperglycemic action, enhancing insulin sensitivity, reduction of oxidative stress and protective effects on the endothelium and vascular function.
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Affiliation(s)
- Ibrahim Mohammed
- Department of Medical Education, Weill Cornell Medicine-Qatar, Al-Rayyan, Qatar
- *Correspondence: Chris R. Triggle, ; Ibrahim Mohammed,
| | - Morley D. Hollenberg
- Inflammation Research Network and Snyder Institute for Chronic Diseases, Department of Physiology & Pharmacology, University of Calgary Cumming School of Medicine, Calgary, AB, Canada
- Department of Medicine, University of Calgary Cumming School of Medicine, Calgary, AB, Canada
| | - Hong Ding
- Department of Medical Education, Weill Cornell Medicine-Qatar, Al-Rayyan, Qatar
- Departments of Medical Education and Pharmacology, Weill Cornell Medicine-Qatar, Al-Rayyan, Qatar
| | - Chris R. Triggle
- Department of Medical Education, Weill Cornell Medicine-Qatar, Al-Rayyan, Qatar
- Departments of Medical Education and Pharmacology, Weill Cornell Medicine-Qatar, Al-Rayyan, Qatar
- *Correspondence: Chris R. Triggle, ; Ibrahim Mohammed,
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Eslam M, Sarin SK, Wong VWS, Fan JG, Kawaguchi T, Ahn SH, Zheng MH, Shiha G, Yilmaz Y, Gani R, Alam S, Dan YY, Kao JH, Hamid S, Cua IH, Chan WK, Payawal D, Tan SS, Tanwandee T, Adams LA, Kumar M, Omata M, George J. The Asian Pacific Association for the Study of the Liver clinical practice guidelines for the diagnosis and management of metabolic associated fatty liver disease. Hepatol Int 2020; 14:889-919. [PMID: 33006093 DOI: 10.1007/s12072-020-10094-2] [Citation(s) in RCA: 405] [Impact Index Per Article: 101.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 09/06/2020] [Indexed: 02/06/2023]
Abstract
Metabolic associated fatty liver disease (MAFLD) is the principal worldwide cause of liver disease and affects nearly a quarter of the global population. The objective of this work was to present the clinical practice guidelines of the Asian Pacific Association for the Study of the Liver (APASL) on MAFLD. The guidelines cover various aspects of MAFLD including its epidemiology, diagnosis, screening, assessment, and treatment. The document is intended for practical use and for setting the stage for advancing clinical practice, knowledge, and research of MAFLD in adults, with specific reference to special groups as necessary. The guidelines also seek to improve patient care and awareness of the disease and assist stakeholders in the decision-making process by providing evidence-based data. The guidelines take into consideration the burden of clinical management for the healthcare sector.
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Affiliation(s)
- Mohammed Eslam
- Storr Liver Centre, Westmead Institute for Medical Research, Westmead Hospital and University of Sydney, Westmead, NSW, 2145, Australia.
| | - Shiv K Sarin
- Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India.
| | - Vincent Wai-Sun Wong
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China
| | - Jian-Gao Fan
- Center for Fatty Liver, Department of Gastroenterology, Xin Hua Hospital Affiliated To Shanghai Jiao Tong University School of Medicine, Shanghai Key Lab of Pediatric Gastroenterology and Nutrition, Shanghai, China
| | - Takumi Kawaguchi
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Sang Hoon Ahn
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Ming-Hua Zheng
- Department of Hepatology, MAFLD Research Center, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
- Institute of Hepatology, Wenzhou Medical University, Wenzhou, China
| | - Gamal Shiha
- Hepatology and Gastroenterology Unit, Internal Medicine Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt
- Egyptian Liver Research Institute and Hospital (ELRIAH), Sherbin, El Mansoura, Egypt
| | - Yusuf Yilmaz
- Department of Gastroenterology, School of Medicine, Marmara University, Istanbul, Turkey
- Institute of Gastroenterology, Marmara University, Istanbul, Turkey
| | - Rino Gani
- Department of Internal Medicine, Hepatobiliary Division, Dr. Cipto Mangunkusumo National General Hospital, Universitas Indonesia, Pangeran Diponegoro Road No. 71st, Central Jakarta, 10430, Indonesia
| | - Shahinul Alam
- Department of Hepatology, Bangabandhu Sheikh Mujib Medical University, Shahbag, Dhaka, Bangladesh
| | - Yock Young Dan
- Department of Medicine, Yong Loo Lin School of Medicine, National University Singapore, Singapore, Singapore
| | - Jia-Horng Kao
- Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, National Taiwan University, 1 Chang-Te Street, Taipei, 10002, Taiwan
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
- Hepatitis Research Center, National Taiwan University, National Taiwan University Hospital, Taipei, Taiwan
- Department of Medical Research, National Taiwan University, National Taiwan University Hospital, Taipei, Taiwan
| | - Saeed Hamid
- Department of Medicine, Aga Khan University, Karachi, Pakistan
| | - Ian Homer Cua
- Institute of Digestive and Liver Diseases, St. Luke's Medical Center, Global City, Philippines
| | - Wah-Kheong Chan
- Gastroenterology and Hepatology Unit, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Diana Payawal
- Department of Medicine, Cardinal Santos Medical Center, Mandaluyong, Philippines
| | - Soek-Siam Tan
- Department of Hepatology, Selayang Hospital, Batu Caves, Malaysia
| | - Tawesak Tanwandee
- Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Leon A Adams
- Medical School, Faculty of Medicine and Health Sciences, The University of Western Australia, Nedlands, WA, Australia
| | - Manoj Kumar
- Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Masao Omata
- Department of Gastroenterology, Yamanashi Central Hospital, Yamanashi, Japan
- University of Tokyo, Tokyo, Japan
| | - Jacob George
- Storr Liver Centre, Westmead Institute for Medical Research, Westmead Hospital and University of Sydney, Westmead, NSW, 2145, Australia.
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114
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Gupta A, Osadchiy V, Mayer EA. Brain-gut-microbiome interactions in obesity and food addiction. Nat Rev Gastroenterol Hepatol 2020; 17:655-672. [PMID: 32855515 PMCID: PMC7841622 DOI: 10.1038/s41575-020-0341-5] [Citation(s) in RCA: 114] [Impact Index Per Article: 28.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/24/2020] [Indexed: 12/13/2022]
Abstract
Normal eating behaviour is coordinated by the tightly regulated balance between intestinal and extra-intestinal homeostatic and hedonic mechanisms. By contrast, food addiction is a complex, maladaptive eating behaviour that reflects alterations in brain-gut-microbiome (BGM) interactions and a shift of this balance towards hedonic mechanisms. Each component of the BGM axis has been implicated in the development of food addiction, with both brain to gut and gut to brain signalling playing a role. Early-life influences can prime the infant gut microbiome and brain for food addiction, which might be further reinforced by increased antibiotic usage and dietary patterns throughout adulthood. The ubiquitous availability and marketing of inexpensive, highly palatable and calorie-dense food can further shift this balance towards hedonic eating through both central (disruptions in dopaminergic signalling) and intestinal (vagal afferent function, metabolic endotoxaemia, systemic immune activation, changes to gut microbiome and metabolome) mechanisms. In this Review, we propose a systems biology model of BGM interactions, which incorporates published reports on food addiction, and provides novel insights into treatment targets aimed at each level of the BGM axis.
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Affiliation(s)
- Arpana Gupta
- G. Oppenheimer Family Center for Neurobiology of Stress and Resilience, Ingestive Behavior and Obesity Program, University of California Los Angeles, Los Angeles, CA, USA
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
- Vatche and Tamar Manoukian Division of Digestive Diseases, University of California Los Angeles, Los Angeles, CA, USA
| | - Vadim Osadchiy
- G. Oppenheimer Family Center for Neurobiology of Stress and Resilience, Ingestive Behavior and Obesity Program, University of California Los Angeles, Los Angeles, CA, USA
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Emeran A Mayer
- G. Oppenheimer Family Center for Neurobiology of Stress and Resilience, Ingestive Behavior and Obesity Program, University of California Los Angeles, Los Angeles, CA, USA.
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.
- Vatche and Tamar Manoukian Division of Digestive Diseases, University of California Los Angeles, Los Angeles, CA, USA.
- Ahmanson-Lovelace Brain Mapping Center at University of California Los Angeles, University of California Los Angeles, Los Angeles, CA, USA.
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115
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Jafari-Vayghan H, Varshosaz P, Hajizadeh-Sharafabad F, Razmi HR, Amirpour M, Tavakoli-Rouzbehani OM, Alizadeh M, Maleki V. A comprehensive insight into the effect of glutamine supplementation on metabolic variables in diabetes mellitus: a systematic review. Nutr Metab (Lond) 2020; 17:80. [PMID: 32983244 PMCID: PMC7517657 DOI: 10.1186/s12986-020-00503-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 09/10/2020] [Indexed: 12/14/2022] Open
Abstract
Diabetes mellitus is one of the most important threats to human health in the twenty-first century.
The use of complementary and alternative medicine to prevent, control, and reduce the complications of diabetes mellitus is increasing at present. Glutamine amino acid is known as a functional food.
The purpose of this systematic review is to determine the potential role of glutamine supplementation on metabolic variables in diabetes mellitus. For this review, PubMed, SCOPUS, Embase, ProQuest, and Google Scholar databases were searched from inception through April 2020. All clinical trial and animal studies assessing the effects of glutamine on diabetes mellitus were eligible for inclusion. 19 studies of 1482 articles met the inclusion criteria. Of the 19 studies, nine studies reported a significant increase in serum GLP-1 levels. Also, eight studies showed reducing in serum levels of fasting blood sugar, four studies reducing in postprandial blood sugar, and triglyceride after glutamine supplementation. Although glutamine resulted in a significant increase in insulin production in seven studies, the findings on Hb-A1c levels were inconclusive. In addition to, despite of the results was promising for the effects of glutamine on weight changes, oxidative stress, and inflammation, more precise clinical trials are needed to obtain more accurate results. In conclusion, glutamine supplementation could improve glycemic control and levels of incretins (such as GLP-1 and GIP) in diabetes mellitus. However, more studies are needed for future studies.
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Affiliation(s)
- Hamed Jafari-Vayghan
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran.,Faculty of Health, Arak University of Medical Sciences, Arak, Iran
| | - Parisa Varshosaz
- Departments of Chemistry and Biochemistry, and Biology and Biomolecular Sciences Program, Laurentian University, Sudbury, ON Canada
| | - Fatemeh Hajizadeh-Sharafabad
- Department of Clinical Nutrition, Faculty of Nutrition and Food Science, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hamid Reza Razmi
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mahdi Amirpour
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Mohammad Alizadeh
- Nutrition Research Center, Faculty of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Vahid Maleki
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
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116
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Kittah E, Camilleri M, Jensen MD, Vella A. A Pilot Study Examining the Effects of GLP-1 Receptor Blockade Using Exendin-(9,39) on Gastric Emptying and Caloric Intake in Subjects With and Without Bariatric Surgery. Metab Syndr Relat Disord 2020; 18:406-412. [PMID: 32833560 DOI: 10.1089/met.2020.0049] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Background: Obesity causes significant morbidity and mortality and continues to be a significant public health concern. Unfortunately, lifestyle modification and pharmacotherapy do not produce durable results. This has led to bariatric surgical procedures playing an increasingly prominent role in the management of medically complicated obesity. Roux-en-Y gastric bypass and sleeve gastrectomy are the most commonly performed bariatric surgeries in North America and produce mechanical restriction with accelerated gastrointestinal transit accompanied by increased postprandial secretion of glucagon-like peptide-1 (GLP-1). GLP-1 is a gastrointestinal hormone that delays gastric emptying and causes satiety and weight loss. This raises the possibility that the postprandial rise in GLP-1 might affect feeding behavior over and above the mechanical restriction produced by bariatric surgery. Methods: We, therefore, sought to determine the effects of GLP-1 receptor blockade using exendin-9,39-a competitive antagonist of the actions of GLP-1 at its receptor-on caloric intake and gastrointestinal transit in subjects after sleeve gastrectomy and after Roux-en-Y gastric bypass compared with weight-matched controls. Results: GLP-1 receptor blockade did not alter caloric intake in people after bariatric surgery. However, caloric intake was decreased in age-, weight- and sex-matched control subjects, and the mechanisms require further study. Conclusions: Given the known effects of GLP-1 on gastric accommodation, future studies should ascertain effects of GLP-1 receptor blockade on gastric accommodation, which might be a useful and novel strategy to decrease caloric intake in humans with an intact upper gastrointestinal tract. The Clinical Trial Resigtration number is NCT02779075.
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Affiliation(s)
- Esi Kittah
- Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic, Rochester, Minnesota, USA
| | - Michael Camilleri
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA
| | - Michael D Jensen
- Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic, Rochester, Minnesota, USA
| | - Adrian Vella
- Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic, Rochester, Minnesota, USA
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117
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The Potential Role of Fish-Derived Protein Hydrolysates on Metabolic Health, Skeletal Muscle Mass and Function in Ageing. Nutrients 2020; 12:nu12082434. [PMID: 32823615 PMCID: PMC7468851 DOI: 10.3390/nu12082434] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 08/11/2020] [Accepted: 08/11/2020] [Indexed: 02/07/2023] Open
Abstract
Fish protein represents one of the most widely consumed dietary protein sources by humans. The processing of material from the fishing industry generates substantial unexploited waste products, many of which possess high biological value. Protein hydrolysates, such as fish protein hydrolysates (FPH), containing predominantly di- and tripeptides, are more readily absorbed than free amino acids and intact protein. Furthermore, in animal models, FPH have been shown to possess numerous beneficial properties for cardiovascular, neurological, intestinal, renal, and immune health. Ageing is associated with the loss of skeletal muscle mass and function, as well as increased oxidative stress, compromised vascularisation, neurological derangements, and immunosenescence. Thus, there appears to be a potential application for FPH in older persons as a high-quality protein source that may also confer additional health benefits. Despite this, there remains a dearth of information concerning the impact of FPH on health outcomes in humans. The limited evidence from human interventional trials suggests that FPH may hold promise for supporting optimal body composition and maintaining gut integrity. FPH also provide a high-quality source of dietary protein without negatively impacting on subjective appetite perceptions or regulatory hormones. Further studies are needed to assess the impact and utility of FPH on skeletal muscle health in older persons, ideally comparing FPH to ‘established’ protein sources or a non-bioactive, nitrogen-matched control. In particular, the effects of acute and chronic FPH consumption on post-exercise aminoacidaemia, skeletal muscle protein synthesis, and intramyocellular anabolic signalling in older adults are worthy of investigation. FPH may represent beneficial and sustainable alternative sources of high-quality protein to support skeletal muscle health and anabolism in ageing, without compromising appetite and subsequent energy intake.
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118
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Supplementation with Low Doses of a Cod Protein Hydrolysate on Glucose Regulation and Lipid Metabolism in Adults with Metabolic Syndrome: A Randomized, Double-Blind Study. Nutrients 2020; 12:nu12071991. [PMID: 32635503 PMCID: PMC7400914 DOI: 10.3390/nu12071991] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 06/26/2020] [Accepted: 07/01/2020] [Indexed: 02/06/2023] Open
Abstract
The risk of cardiovascular diseases and type 2 diabetes mellitus are increased in subjects with metabolic syndrome (MetS), and hydrolyzed fish protein may have favorable effects on metabolic health. Here, we investigated the effect of 8 weeks supplementation with 4 g of cod protein hydrolysate (CPH) on glucose metabolism, lipid profile and body composition in individuals with MetS in a double-blind, randomized intervention study with a parallel-group design. Subjects received a daily supplement of CPH (n = 15) or placebo (n = 15). Primary outcomes were serum fasting and postprandial glucose levels. Secondary outcomes were fasting and postprandial insulin and glucagon-like peptide 1 (GLP-1), fasting lipid concentrations and body composition. No difference was observed between CPH and placebo for insulin, glucose or GLP-1 after 8 weeks intervention. Fasting triacylglycerol decreased in both the CPH group and placebo group, with no change between groups. Fasting total cholesterol and low-density lipoprotein cholesterol decreased significantly within both groups from baseline to study end, but no difference was observed between the two groups. In conclusion, supplementing with a low dose of CPH in subjects with MetS for 8 weeks had no effect on fasting or postprandial levels of insulin, glucose or GLP-1, lipid profile or body composition.
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119
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Jalleh R, Pham H, Marathe CS, Wu T, Buttfield MD, Hatzinikolas S, Malbert CH, Rigda RS, Lange K, Trahair LG, Feinle-Bisset C, Rayner CK, Horowitz M, Jones KL. Acute Effects of Lixisenatide on Energy Intake in Healthy Subjects and Patients with Type 2 Diabetes: Relationship to Gastric Emptying and Intragastric Distribution. Nutrients 2020; 12:nu12071962. [PMID: 32630191 PMCID: PMC7400134 DOI: 10.3390/nu12071962] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Revised: 06/24/2020] [Accepted: 06/29/2020] [Indexed: 02/07/2023] Open
Abstract
Glucagon-like peptide-1 receptor agonists induce weight loss, which has been suggested to relate to the slowing of gastric emptying (GE). In health, energy intake (EI) is more strongly related to the content of the distal, than the total, stomach. We evaluated the effects of lixisenatide on GE, intragastric distribution, and subsequent EI in 15 healthy participants and 15 patients with type 2 diabetes (T2D). Participants ingested a 75-g glucose drink on two separate occasions, 30 min after lixisenatide (10 mcg) or placebo subcutaneously, in a randomised, double-blind, crossover design. GE and intragastric distribution were measured for 180 min followed by a buffet-style meal, where EI was quantified. Relationships of EI with total, proximal, and distal stomach content were assessed. In both groups, lixisenatide slowed GE markedly, with increased retention in both the proximal (p < 0.001) and distal (p < 0.001) stomach and decreased EI (p < 0.001). EI was not related to the content of the total or proximal stomach but inversely related to the distal stomach at 180 min in health on placebo (r = -0.58, p = 0.03) but not in T2D nor after lixisenatide in either group. In healthy and T2D participants, the reduction in EI by lixisenatide is unrelated to changes in GE/intragastric distribution, consistent with a centrally mediated effect.
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Affiliation(s)
- Ryan Jalleh
- Endocrine and Metabolic Unit, Royal Adelaide Hospital, Adelaide SA 5000, Australia; (R.J.); (C.S.M.); (T.W.); (M.H.)
| | - Hung Pham
- Adelaide Medical School, Centre of Research Excellence in Translating Nutritional Science to Good Health, The University of Adelaide, Adelaide SA 5000, Australia; (H.P.); (S.H.); (R.S.R.); (K.L.); (L.G.T.); (C.F.-B.); (C.K.R.)
| | - Chinmay S. Marathe
- Endocrine and Metabolic Unit, Royal Adelaide Hospital, Adelaide SA 5000, Australia; (R.J.); (C.S.M.); (T.W.); (M.H.)
- Adelaide Medical School, Centre of Research Excellence in Translating Nutritional Science to Good Health, The University of Adelaide, Adelaide SA 5000, Australia; (H.P.); (S.H.); (R.S.R.); (K.L.); (L.G.T.); (C.F.-B.); (C.K.R.)
| | - Tongzhi Wu
- Endocrine and Metabolic Unit, Royal Adelaide Hospital, Adelaide SA 5000, Australia; (R.J.); (C.S.M.); (T.W.); (M.H.)
- Adelaide Medical School, Centre of Research Excellence in Translating Nutritional Science to Good Health, The University of Adelaide, Adelaide SA 5000, Australia; (H.P.); (S.H.); (R.S.R.); (K.L.); (L.G.T.); (C.F.-B.); (C.K.R.)
| | - Madeline D. Buttfield
- School of Health Sciences, University of South Australia, Adelaide SA 5001, Australia;
| | - Seva Hatzinikolas
- Adelaide Medical School, Centre of Research Excellence in Translating Nutritional Science to Good Health, The University of Adelaide, Adelaide SA 5000, Australia; (H.P.); (S.H.); (R.S.R.); (K.L.); (L.G.T.); (C.F.-B.); (C.K.R.)
| | - Charles H. Malbert
- Aniscan, Institut National de la Rechercher Agronomique, 35590 Saint-Gilles, France;
| | - Rachael S. Rigda
- Adelaide Medical School, Centre of Research Excellence in Translating Nutritional Science to Good Health, The University of Adelaide, Adelaide SA 5000, Australia; (H.P.); (S.H.); (R.S.R.); (K.L.); (L.G.T.); (C.F.-B.); (C.K.R.)
| | - Kylie Lange
- Adelaide Medical School, Centre of Research Excellence in Translating Nutritional Science to Good Health, The University of Adelaide, Adelaide SA 5000, Australia; (H.P.); (S.H.); (R.S.R.); (K.L.); (L.G.T.); (C.F.-B.); (C.K.R.)
| | - Laurence G. Trahair
- Adelaide Medical School, Centre of Research Excellence in Translating Nutritional Science to Good Health, The University of Adelaide, Adelaide SA 5000, Australia; (H.P.); (S.H.); (R.S.R.); (K.L.); (L.G.T.); (C.F.-B.); (C.K.R.)
| | - Christine Feinle-Bisset
- Adelaide Medical School, Centre of Research Excellence in Translating Nutritional Science to Good Health, The University of Adelaide, Adelaide SA 5000, Australia; (H.P.); (S.H.); (R.S.R.); (K.L.); (L.G.T.); (C.F.-B.); (C.K.R.)
| | - Christopher K. Rayner
- Adelaide Medical School, Centre of Research Excellence in Translating Nutritional Science to Good Health, The University of Adelaide, Adelaide SA 5000, Australia; (H.P.); (S.H.); (R.S.R.); (K.L.); (L.G.T.); (C.F.-B.); (C.K.R.)
- Department of Gastroenterology and Hepatology, Royal Adelaide Hospital, Adelaide SA 5000, Australia
| | - Michael Horowitz
- Endocrine and Metabolic Unit, Royal Adelaide Hospital, Adelaide SA 5000, Australia; (R.J.); (C.S.M.); (T.W.); (M.H.)
- Adelaide Medical School, Centre of Research Excellence in Translating Nutritional Science to Good Health, The University of Adelaide, Adelaide SA 5000, Australia; (H.P.); (S.H.); (R.S.R.); (K.L.); (L.G.T.); (C.F.-B.); (C.K.R.)
| | - Karen L. Jones
- Endocrine and Metabolic Unit, Royal Adelaide Hospital, Adelaide SA 5000, Australia; (R.J.); (C.S.M.); (T.W.); (M.H.)
- Adelaide Medical School, Centre of Research Excellence in Translating Nutritional Science to Good Health, The University of Adelaide, Adelaide SA 5000, Australia; (H.P.); (S.H.); (R.S.R.); (K.L.); (L.G.T.); (C.F.-B.); (C.K.R.)
- Correspondence: ; Tel.: +61-8-83137821
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Da Porto A, Casarsa V, Colussi G, Catena C, Cavarape A, Sechi L. Dulaglutide reduces binge episodes in type 2 diabetic patients with binge eating disorder: A pilot study. Diabetes Metab Syndr 2020; 14:289-292. [PMID: 32289741 DOI: 10.1016/j.dsx.2020.03.009] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 03/19/2020] [Accepted: 03/19/2020] [Indexed: 12/22/2022]
Abstract
AIMS Binge eating disorder (BED) is the most common eating disorder in the United States and Europe and is associated with obesity and type 2 diabetes (T2D). Presence and severity of BED have been associated with worse metabolic control and greater BMI in T2D patients. Glucagon Like Peptide-1 (GLP1) receptors are present in central nervous system areas involved in appetite regulation and treatment with GLP-1 receptor agonists modulates appetite and reward-related brain areas in humans. We evaluated the effects of treatment with dulaglutide on eating behavior in T2D outpatients with BED. METHODS This was a pilot open label, prospective controlled study. Inclusion criteria were: Age ≤65, HbA1c between 7.5 and 9% on metformin therapy alone, normal renal function and diagnosis of BED. Patients were randomly assigned to receive either Dulaglutide 1,5 mg/sett or Gliclazide 60 mg for 12 weeks. We evaluated baseline binge eating scale score (BES), weight, BMI, percentage fat mass, HbA1c and their changes after treatment. A multivariate linear regression model was used to verify the association between Δ BES from baseline with Δ Hba1c and variation of anthropometric parameters after treatment. RESULTS After 12 weeks patients treated with dulaglutide had grater reduction of binge eating behaviour (p < 0.0001), body weight (p < 0,0001), BMI (p < 0.0001), percentage fat mass (p < 0.0001) and HbA1c (p = 0.009) than patients treated with gliclazide. Reduction in BES was associated with reduction in body weight (p < 0.0001) and HbA1c (p = 0.033). CONCLUSION Dulaglutide treatment reduces binge eating behaviour in T2D patients with BED.
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Santella C, Yin H, Hicks BM, Yu OHY, Bouganim N, Azoulay L. Weight-lowering Effects of Glucagon-like Peptide-1 Receptor Agonists and Detection of Breast Cancer Among Obese Women with Diabetes. Epidemiology 2020; 31:559-566. [PMID: 32282437 DOI: 10.1097/ede.0000000000001196] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND It has been proposed that the weight loss associated with glucagon-like peptide-1 receptor agonists (GLP-1 RAs) may improve detection of breast cancer in patients undergoing this treatment. We aimed to determine whether the weight-lowering effects of GLP-1 RAs are associated with an increased detection of breast cancer among obese women with type 2 diabetes. METHODS Using the UK Clinical Practice Research Datalink, we conducted a propensity score-matched cohort study among female obese patients with type 2 diabetes newly treated with antidiabetic drugs between 1 January 2007 and 31 January 2018. New users of GLP-1 RAs (n = 5,510) were matched to new users of second- to third-line noninsulin antidiabetic drugs (n = 5,510). We used time-dependent Cox proportional hazards models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of breast cancer associated with different GLP-1 RA maximal weight loss categories (<5%, 5%-10%, >10%). RESULTS Breast cancer incidence gradually increased with GLP-1 RA maximal weight loss categories, with the highest HR observed for patients achieving at least 10% weight loss (HR = 1.8, 95% CI = 1.1, 2.8). In secondary analyses, the HR for >10% weight loss was highest in the 2-3 years since treatment initiation (HR = 2.9, 95% CI = 1.2, 6.9). CONCLUSIONS In this population-based study, the detection of breast cancer gradually increased with GLP-1 RA weight loss categories, particularly among those achieving >10% weight loss. These results are consistent with the hypothesis that substantial weight loss with GLP-1 RAs may improve detection of breast cancer among obese patients with type 2 diabetes.
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Affiliation(s)
- Christina Santella
- From the Centre for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital, Montreal, Quebec, Canada
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada
| | - Hui Yin
- From the Centre for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital, Montreal, Quebec, Canada
| | - Blánaid M Hicks
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, United Kingdom
| | - Oriana H Y Yu
- From the Centre for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital, Montreal, Quebec, Canada
- Division of Endocrinology, Jewish General Hospital, Montreal, Quebec, Canada
| | - Nathaniel Bouganim
- Department of Oncology, McGill University Health Centre, Montreal, Quebec, Canada
- Gerald Bronfman Department of Oncology, McGill University, Montreal, Quebec, Canada
| | - Laurent Azoulay
- From the Centre for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital, Montreal, Quebec, Canada
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada
- Gerald Bronfman Department of Oncology, McGill University, Montreal, Quebec, Canada
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Zaher S, Branco R, Meyer R, White D, Ridout J, Pathan N. Relationship between inflammation and metabolic regulation of energy expenditure by GLP-1 in critically ill children. Clin Nutr 2020; 40:632-637. [PMID: 32646758 DOI: 10.1016/j.clnu.2020.06.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 05/28/2020] [Accepted: 06/14/2020] [Indexed: 12/21/2022]
Abstract
BACKGROUND & AIMS Critical illness is associated with derangement in the metabolic and inflammatory response. Previous investigators have highlighted the cross-link between feeding, inflammation and gut homeostasis. Glucagon like peptide-1 (GLP-1) is a gut derived hormone that plays an important role in the modulation of energy metabolism through appetite regulation and promotion of gastric motility. Growing evidence suggests that GLP-1 might influence energy expenditure. The aim of this study was to assess the relationship between inflammatory activation and metabolic regulation of energy expenditure by assessing cytokine release, levels of GLP-1 and energy expenditure in a cohort of critically ill children. METHOD This is a prospective study conducted in critically ill children. A blood sample was collected from each child during the first few days of critical illness, for the analysis of serum inflammatory cytokines (TNF-α, IL-10, IL-6 and IL-1β) and GLP-1 in 42 children. Indirect calorimetry (IC) measurements were performed concurrently in a subset of 21 children. The metabolic index was determined using the ratio of Measured Resting Energy Expenditure (MREE)/Predicted Resting Energy Expenditure (PREE) based on the Schofield equation. Correlation analysis was performed, followed by a stepwise linear regression analysis to assess factors affecting GLP-1 and the metabolic index. RESULTS A total of 42 children (0-14 years) were included in this study. The regression analysis indicated that CRP, TNF-α, IL-6 and IL-1β statistically influenced GLP-1 concentrations (p < 0.01). Where IC measurements were performed (N = 21), GLP-1 showed a statistically significant association with the metabolic index (p < 0.01). No evidence of statistical association was recorded between the inflammatory mediators and the metabolic index. Overall the results showed that circulating GLP-1 was increased in response to inflammatory stimuli in critically ill children. GLP-1 contributed to the changes observed in MREE induced by critical illness in our cohort. CONCLUSION Energy expenditure is extremely variable in critically ill children, our study suggests that changes in GLP-1 might contribute to a significant amount of this variation. If confirmed in larger studies, GLP-1 could be used as a correction factor for REE predictive equations in critically ill children.
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Affiliation(s)
- Sara Zaher
- Clinical Nutrition Department, Faculty of Applied Medical Sciences, Taibah University, Saudi Arabia; Department of Paediatrics, University of Cambridge, Hills Road, Cambridge, UK.
| | - Ricardo Branco
- Division of Pediatric Critical Care, Sidra Medicine, Doha, Qatar
| | - Rosan Meyer
- Department of Paediatrics, Imperial College London, Praed Street, London, UK
| | - Deborah White
- Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge, UK
| | - Jenna Ridout
- Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge, UK
| | - Nazima Pathan
- Department of Paediatrics, University of Cambridge, Hills Road, Cambridge, UK; Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge, UK
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Dhindsa DS, Sandesara PB, Shapiro MD, Wong ND. The Evolving Understanding and Approach to Residual Cardiovascular Risk Management. Front Cardiovasc Med 2020; 7:88. [PMID: 32478100 PMCID: PMC7237700 DOI: 10.3389/fcvm.2020.00088] [Citation(s) in RCA: 82] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Accepted: 04/22/2020] [Indexed: 12/21/2022] Open
Abstract
Despite unprecedented advances in treatment of atherosclerotic cardiovascular disease, it remains the leading cause of death and disability worldwide. Treatment of major traditional risk factors, including low-density lipoprotein-cholesterol, serves as the foundation of atherosclerotic risk reduction. However, there remains a significant residual risk of cardiovascular events despite optimal risk factor management. Beyond traditional risk factors, other drivers of residual risk have come to the forefront, including inflammatory, pro-thrombotic, and metabolic pathways that contribute to recurrent events and are often unrecognized and not addressed in clinical practice. This review will explore the evidence linking these pathways to atherosclerotic cardiovascular disease and potential future therapeutic options to attenuate residual cardiovascular risk conferred by these pathways.
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Affiliation(s)
- Devinder S. Dhindsa
- Division of Cardiology, Department of Medicine, Emory Clinical Cardiovascular Research Institute, Atlanta, GA, United States
| | - Pratik B. Sandesara
- Division of Cardiology, Department of Medicine, Emory Clinical Cardiovascular Research Institute, Atlanta, GA, United States
| | - Michael D. Shapiro
- Section on Cardiovascular Medicine, Center for the Prevention of Cardiovascular Disease, Wake Forest Baptist Medical Center, Winston-Salem, NC, United States
| | - Nathan D. Wong
- Heart Disease Prevention Program, Division of Cardiology, University of California, Irvine, Irvine, CA, United States
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Binou P, Yanni AE, Stergiou A, Karavasilis K, Konstantopoulos P, Perrea D, Tentolouris N, Karathanos VT. Enrichment of bread with beta-glucans or resistant starch induces similar glucose, insulin and appetite hormone responses in healthy adults. Eur J Nutr 2020; 60:455-464. [PMID: 32385687 DOI: 10.1007/s00394-020-02265-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2019] [Accepted: 04/28/2020] [Indexed: 11/24/2022]
Abstract
PURPOSE β-Glucans (βG) and resistant starch (RS) are known for their effects on the improvement of glucose tolerance and enhancement of insulin sensitivity. Enrichment of bread with βG or RS was performed to examine potential postprandial benefits regarding gastrointestinal hormone responses. METHODS Ten healthy normoglycaemic adults participated in the study and were provided with either a glucose solution (reference food, GS) or bread enriched with β-glucans (βGB) (3.6 g/30 g available CHO) or bread enriched with resistant starch (RSB) (15% of total starch), with 1-week intervals in amounts that yielded 50 g of available carbohydrates. Venous blood samples were collected before consumption and at 15, 30, 45, 60, 90, 120 and 180 min postprandially. Glucose, insulin, ghrelin, glucagon-like peptide-1 (GLP-1) and peptide YY (PYY) responses as well as glycaemic index (GI) and subjective appetite ratings were evaluated. RESULTS Ingestion of βGB and RSB elicited lower incremental area under the curve (iAUC) for glycaemic response compared to GS (P < 0.05). Both breads demonstrated a low GI (βGB: 48, RSB: 40). There were no significant differences in insulin response, ghrelin, GLP-1 or PYY between the two breads. A significantly lower desire to eat and higher fullness were detected 15 min after βGB and RSB consumption and until 180 min (P < 0.05 compared to GS). CONCLUSION Enrichment of bread with either βG or RS produced a low GI product but the two breads were not significantly different in relation to insulin, ghrelin, GLP-1 and PYY responses. The development of bread products which cause improved metabolic effects is of great importance for the promotion of public health.
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Affiliation(s)
- Panagiota Binou
- Laboratory of Chemistry, Biochemistry, Physical Chemistry of Foods, Department of Nutrition and Dietetics, Harokopio University, 70 El. Venizelou Ave, 17671, Athens, Greece
| | - Amalia E Yanni
- Laboratory of Chemistry, Biochemistry, Physical Chemistry of Foods, Department of Nutrition and Dietetics, Harokopio University, 70 El. Venizelou Ave, 17671, Athens, Greece.
| | - Athena Stergiou
- Laboratory of Chemistry, Biochemistry, Physical Chemistry of Foods, Department of Nutrition and Dietetics, Harokopio University, 70 El. Venizelou Ave, 17671, Athens, Greece.,1st Department of Propaedeutic Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Konstantinos Karavasilis
- ELBISCO S.A., Industrial and Commercial Food Company, 21st Km Marathonos Ave, Pikermi, Attica, Greece
| | - Panagiotis Konstantopoulos
- Laboratory of Experimental Surgery and Surgery Research, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Despoina Perrea
- Laboratory of Experimental Surgery and Surgery Research, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Nikolaos Tentolouris
- 1st Department of Propaedeutic Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Vaios T Karathanos
- Laboratory of Chemistry, Biochemistry, Physical Chemistry of Foods, Department of Nutrition and Dietetics, Harokopio University, 70 El. Venizelou Ave, 17671, Athens, Greece
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Paolacci S, Kiani AK, Manara E, Beccari T, Ceccarini MR, Stuppia L, Chiurazzi P, Dalla Ragione L, Bertelli M. Genetic contributions to the etiology of anorexia nervosa: New perspectives in molecular diagnosis and treatment. Mol Genet Genomic Med 2020; 8:e1244. [PMID: 32368866 PMCID: PMC7336737 DOI: 10.1002/mgg3.1244] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Accepted: 03/19/2020] [Indexed: 12/12/2022] Open
Abstract
Background Anorexia nervosa is a multifactorial eating disorder that manifests with self‐starvation, extreme anxiety, hyperactivity, and amenorrhea. Long‐term effects include organ failure, disability, and in extreme cases, even death. Methods Through a literature search, here we summarize what is known about the molecular etiology of anorexia nervosa and propose genetic testing for this condition. Results Anorexia nervosa often has a familial background and shows strong heritability. Various genetic studies along with genome‐wide association studies have identified several genetic loci involved in molecular pathways that might lead to anorexia. Conclusion Anorexia nervosa is an eating disorder with a strong genetic component that contributes to its etiology. Various genetic approaches might help in the molecular diagnosis of this disease and in devising novel therapeutic options. Anorexia nervosa is a multifactorial eating disorder with a strong genetic component that manifests with self‐starvation, extreme anxiety, hyperactivity, and amenorrhea. Through a literature search, here we summarize what is known about the molecular etiology of anorexia nervosa and propose genetic testing for this condition.
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Affiliation(s)
| | | | | | - Tommaso Beccari
- Department of Pharmaceutical Sciences, University of Perugia, Perugia, Italy
| | | | - Liborio Stuppia
- Department of Psychological, Health and Territorial Sciences, School of Medicine and Health Sciences, "G. d'Annunzio" University, Chieti, Italy
| | - Pietro Chiurazzi
- Istituto di Medicina Genomica, Università Cattolica del Sacro Cuore, Rome, Italy.,UOC Genetica Medica, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
| | - Laura Dalla Ragione
- Center for the Treatment of Eating Disorders, Residenza Palazzo Francisci, Todi, Perugia, Italy
| | - Matteo Bertelli
- MAGI'S LAB, Rovereto, Trento, Italy.,MAGI EUREGIO, Bolzano, Italy.,EBTNA-LAB, Rovereto, Trento, Italy
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Aroda VR, Capehorn MS, Chaykin L, Frias JP, Lausvig NL, Macura S, Lüdemann J, Madsbad S, Rosenstock J, Tabak O, Tadayon S, Bain SC. Impact of baseline characteristics and beta-cell function on the efficacy and safety of subcutaneous once-weekly semaglutide: A patient-level, pooled analysis of the SUSTAIN 1-5 trials. Diabetes Obes Metab 2020; 22:303-314. [PMID: 31608552 PMCID: PMC7065219 DOI: 10.1111/dom.13896] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 10/01/2019] [Accepted: 10/08/2019] [Indexed: 01/09/2023]
Abstract
AIM To evaluate the impact of relevant patient-level characteristics on the efficacy and safety of subcutaneous, once-weekly semaglutide in subjects with type 2 diabetes. MATERIALS AND METHODS Exploratory post hoc analyses of pooled SUSTAIN 1-5 (phase 3a) randomized, controlled trials examined the change from baseline in HbA1c and body weight (BW), and the proportions of subjects achieving the composite endpoint (HbA1c < 7.0% [53 mmol/mol]), without weight gain or severe/blood glucose-confirmed symptomatic hypoglycaemia at week 30 with semaglutide (0.5/1.0 mg) across clinically relevant patient subgroups: baseline HbA1c (≤7.5%, >7.5%-8.0%, >8.0%-8.5%, >8.5%-9.0% and > 9.0%), background medications, diabetes duration and pancreatic beta-cell function. RESULTS Mean HbA1c (% point) reductions increased from lowest to highest HbA1c subgroups (-0.9%, -1.2%,-1.5%, -1.7% and -2.3% [effect of subgroup within treatment: P = 0.247] for semaglutide 0.5 mg, and -1.1%, -1.4%, -1.9%, -2.1% and -2.7% [P = 0.045] for semaglutide 1.0 mg), with mean HbA1c ranges at week 30 of 6.3%-7.3% and 6.1%-6.9%, respectively. The corresponding BW reductions generally decreased with increasing baseline HbA1c (-4.4, -3.9, -3.9, -3.3 and -2.9 kg [P = 0.004], and -6.4, -5.9, -5.2, -4.5 and -4.8 kg [P < 0.001], respectively). HbA1c and BW reductions were consistently greater for semaglutide 1.0 mg versus 0.5 mg across background medication, diabetes duration and pancreatic beta-cell function subgroups. Adverse events with semaglutide were consistent with the glucagon-like peptide-1 receptor agonist class, with gastrointestinal events the most common. CONCLUSIONS Semaglutide was consistently efficacious across the continuum of diabetes care in a broad spectrum of patient subgroups with a range of clinical characteristics.
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Affiliation(s)
| | | | | | | | | | | | - Jörg Lüdemann
- Diabetes‐Falkensee, Diabetes‐Centre and Centre for Clinical StudiesFalkenseeGermany
| | | | | | - Omur Tabak
- Istanbul Kanuni Sultan Suleyman Education and Research HospitalIstanbulTurkey
| | | | - Stephen C. Bain
- Diabetes Research Unit Cymru, Swansea University Medical SchoolSwanseaUK
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Patel H, Munir K, Sutherland S, Karanikas CA, Konig M. Efficacy of Dulaglutide as a First Injectable Option for Patients with Type 2 Diabetes: A Post-Hoc Pooled Analysis. Diabetes Ther 2019; 10:2321-2330. [PMID: 31605302 PMCID: PMC6848683 DOI: 10.1007/s13300-019-00709-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Indexed: 12/17/2022] Open
Abstract
INTRODUCTION The ADA-EASD consensus report recommends using glucagon-like peptide-1 receptor agonists (GLP-1RAs) as the first injectable therapy prior to basal insulin in most patients with type 2 diabetes (T2D) not at glycemic goals after oral anti-hyperglycemia medications (OH). The objective of this analysis was to assess the glycemic efficacy of once-weekly dulaglutide 1.5 mg in patients with T2D when added on a background of commonly used OH regimens. METHODS Patients from seven phase 3 AWARD [Assessment of Weekly AdministRation of LY2189265 (Dulaglutide) in Diabetes] trials, where once-weekly dulaglutide 1.5 mg was added to OHs, were pooled into the following categories based on OH regimens: metformin (MET), sulfonylurea (SU), MET + SU, MET + pioglitazone, and MET + SGLT2i. Change from baseline in glycated hemoglobin A1c (HbA1c), fasting serum glucose and body weight, proportion of patients reaching target HbA1c < 7%, and safety parameters were assessed. RESULTS A total of 1784 patients treated with once-weekly dulaglutide 1.5 mg were included in this analysis. Baseline characteristics of the overall population were (mean ± standard deviation): age, 55.4 ± 9.8 years, HbA1c: 8.2 ± 1.0%, body mass index: 31.4 ± 5.4 kg/m2, duration of diabetes: 8.0 ± 5.6 years, and 878 (49.2%) were female. At 6 months, the addition of once-weekly dulaglutide 1.5 mg to various OH regimens significantly reduced HbA1c (- 1.3 to - 1.6%) and fasting blood glucose (- 29 to - 45 mg/dl) from baseline in all groups (p < 0.001), with 39-61% and 52-76% of these patients achieving HbA1c targets of ≤ 6.5% and < 7%, respectively. Significant reductions in body weight (- 0.8 to - 2.9 kg) were also observed in all groups (p < 0.001). Nausea, vomiting, and diarrhea were reported by 10-35%, 4-19%, and 6-28% of patients, respectively. Severe hypoglycemia occurred in one patient (MET + SU). CONCLUSION The addition of a once-weekly GLP-1RA, dulaglutide, demonstrated clinically meaningful HbA1c reduction in patients with T2D on different background OH regimens, making it an effective first injectable option. FUNDING Eli Lilly and Company.
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Affiliation(s)
- Hiren Patel
- Eli Lilly and Company, Indianapolis, IN, USA.
| | - Kashif Munir
- Division of Endocrinology, Diabetes and Nutrition, University of Maryland School of Medicine, Baltimore, MD, USA
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Kokkinos A, Tsilingiris D, le Roux CW, Rubino F, Mantzoros CS. Will medications that mimic gut hormones or target their receptors eventually replace bariatric surgery? Metabolism 2019; 100:153960. [PMID: 31412266 DOI: 10.1016/j.metabol.2019.153960] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Revised: 07/31/2019] [Accepted: 08/05/2019] [Indexed: 02/07/2023]
Abstract
Bariatric surgery is currently the most effective therapeutic modality through which sustained beneficial effects on weight loss and metabolic improvement are achieved. During recent years, indications for bariatric surgery have been expanded to include cases of poorly controlled type 2 (T2DM) diabetes mellitus in lesser extremes of body weight. A spectrum of the beneficial effects of surgery is attributed to robust changes of postprandial gut peptide responses that are observed post operatively. Consolidated knowledge regarding gut peptide physiology as well as emerging new evidence shedding light on the mode of action of previously overlooked gut hormones provide appealing potential obesity and T2DM therapeutic perspectives. The accumulation of evidence from the effect of exogenous administration of native gut peptides alone or in combinations to humans as well as the development of mimetic agents exerting agonistic effects on combinations of gut hormone receptors pave the way for future integrated gut peptide-based treatments, which may mimic the effects of bariatric surgery.
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Affiliation(s)
- Alexander Kokkinos
- First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, Athens, Greece.
| | - Dimitrios Tsilingiris
- First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, Athens, Greece
| | - Carel W le Roux
- Diabetes Complications Research Centre, University College Dublin, Dublin, Ireland
| | - Francesco Rubino
- Department of Metabolic and Bariatric Surgery, Diabetes and Nutritional Science Division, King's College Hospital, London, United Kingdom
| | - Christos S Mantzoros
- Division of Endocrinology, Diabetes and Metabolism, Beth Israel Deaconess Medical Center, Harvard Medical School, USA
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Epicardial adipose tissue GLP-1 receptor is associated with genes involved in fatty acid oxidation and white-to-brown fat differentiation: A target to modulate cardiovascular risk? Int J Cardiol 2019; 292:218-224. [DOI: 10.1016/j.ijcard.2019.04.039] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Revised: 04/04/2019] [Accepted: 04/10/2019] [Indexed: 12/14/2022]
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Martins LB, Monteze NM, Calarge C, Ferreira AVM, Teixeira AL. Pathways linking obesity to neuropsychiatric disorders. Nutrition 2019; 66:16-21. [DOI: 10.1016/j.nut.2019.03.017] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 03/25/2019] [Accepted: 03/25/2019] [Indexed: 01/10/2023]
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Joksić G, Tričković JF, Joksić I. Potential of Gentiana lutea for the Treatment of Obesity-associated Diseases. Curr Pharm Des 2019; 25:2071-2076. [PMID: 31538881 DOI: 10.2174/1381612825666190708215743] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Accepted: 06/24/2019] [Indexed: 12/25/2022]
Abstract
BACKGROUND Obesity, diabetes, and associated diseases are increasing all over the world, and pose a great burden on public health. According to the latest reports, 440 million people are suffering from diabetes. Diabetes is caused by impaired ability to produce or respond to the hormone insulin consequently resulting in hyperglycemia. METHODS Data used for this review was obtained by using PUBMED/MEDLINE (1987-2018). The main data search terms were: Gentiana lutea, Gentiana lutea extract, Gentiana lutea constituents, obesity, diabetes mellitus, diabetic complications. RESULTS In the present review, we describe the potential of root powder of yellow gentian (Gentiana lutea) for the prevention of obesity and diabetes including complications related to this disease. CONCLUSION Reasonably effective, low-cost alternatives could fulfill an important role for a large part of the human population and could be of great value for the food market. Even a modest reduction of morbidity and mortality with respect to this disease translates into millions of lives saved.
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Affiliation(s)
- Gordana Joksić
- Vinca Institute of Nuclear Science, University of Belgrade, M.Petrovica Alasa 12-14, 11000 Belgrade, Serbia
| | - Jelena Filipović Tričković
- Vinca Institute of Nuclear Science, University of Belgrade, M.Petrovica Alasa 12-14, 11000 Belgrade, Serbia
| | - Ivana Joksić
- Vinca Institute of Nuclear Science, University of Belgrade, M.Petrovica Alasa 12-14, 11000 Belgrade, Serbia.,Clinic for Gynecology and Obstetrics Narodni Front, Kraljice Natalije 62, 11000, Belgrade, Serbia
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Dhindsa DS, Mehta A, Sandesara PB, Thobani A, Brandt S, Sperling LS. Strategies for Appropriate Selection of SGLT2-i vs. GLP1-RA in Persons with Diabetes and Cardiovascular Disease. Curr Cardiol Rep 2019; 21:100. [PMID: 31352613 DOI: 10.1007/s11886-019-1197-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
PURPOSE OF REVIEW This review will serve to highlight the clinical rationale used in the selection of sodium-glucose cotransporter 2 inhibitors (SGLT2-i) or glucagon-like peptide 1 receptor agonists (GLP1-ra). RECENT FINDINGS SGLT2-i and GLP1-ra are the first anti-hyperglycemics to demonstrate significant cardiovascular benefit in multiple cardiovascular outcomes trials (CVOTs), with benefits that are consistent across class of medication. Diabetes is a major risk factor for morbidity and mortality from cardiovascular disease. Sodium-glucose cotransporter 2 inhibitors (SGLT2-i) and glucagon-like peptide 1 receptor agonists (GLP1-ra) are the first anti-hyperglycemics to demonstrate significant cardiovascular benefit. Given the unique side effect and benefit profiles, appropriate consideration of these agents with a focus on cardiovascular risk reduction requires an individualized approach.
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Affiliation(s)
- Devinder S Dhindsa
- Emory Clinical Cardiovascular Research Institute, Division of Cardiology, Department of Medicine, Emory University School of Medicine, 1365 Clifton Road, NE, Building A, Suite 2200, Atlanta, GA, 30322, USA
| | - Anurag Mehta
- Emory Clinical Cardiovascular Research Institute, Division of Cardiology, Department of Medicine, Emory University School of Medicine, 1365 Clifton Road, NE, Building A, Suite 2200, Atlanta, GA, 30322, USA
| | - Pratik B Sandesara
- Emory Clinical Cardiovascular Research Institute, Division of Cardiology, Department of Medicine, Emory University School of Medicine, 1365 Clifton Road, NE, Building A, Suite 2200, Atlanta, GA, 30322, USA
| | - Aneesha Thobani
- Department of Internal Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Stephen Brandt
- Division of Endocrinology, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Laurence S Sperling
- Emory Clinical Cardiovascular Research Institute, Division of Cardiology, Department of Medicine, Emory University School of Medicine, 1365 Clifton Road, NE, Building A, Suite 2200, Atlanta, GA, 30322, USA.
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Ren L, Cui Q, Liu W, Wang L, Liao Y, Feng Y, Sun W, Yang Y, Zhang Z, Jin T, Prud'homme GJ, Zhang L, Li Y, Leng Y, Wang Q. Novel GLP-1 Analog Supaglutide Stimulates Insulin Secretion in Mouse and Human Islet Beta-Cells and Improves Glucose Homeostasis in Diabetic Mice. Front Physiol 2019; 10:930. [PMID: 31404283 PMCID: PMC6670290 DOI: 10.3389/fphys.2019.00930] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Accepted: 07/09/2019] [Indexed: 12/11/2022] Open
Abstract
Glucagon-like peptide-1 (GLP-1), an incretin hormone plays an important role in regulating glucose homeostasis. The therapeutic use of native GLP-1 is inadequate due to its short in vivo half-life. We recently developed a novel GLP-1 mimetics supaglutide, and demonstrated that this formulation retained native GLP-1 biological activities and possessed long-lasting GLP-1 actions. In this study, we further examined its abilities in regulating blood glucose in diabetic mice. We found that supaglutide stimulated insulin secretion in both mouse and human islets in a dose-dependent fashion. Oral glucose tolerance test conducted in normal ICR mice showed that supaglutide significantly decreased postprandial glucose excursions in a dose-dependent fashion. In type 2 diabetic db/db mice, a single-dose injection of supaglutide significantly decreased blood glucose levels, and this efficacy was lasted for at least 72 h in a dose-dependent fashion. During a 4-weeks intervention course supaglutide (twice injections per week) dose-dependently and significantly decreased fasting and random blood glucose levels in hyperglycemic db/db mice. Supaglutide, at a dose of 1.2 mg/kg, significantly reduced serum fructosamine levels. This was associated with significant enlargement of beta-cell mass, increased pancreatic insulin content, and increased plasma insulin level. Notably, during the intervention course supaglutide significantly reduced body-weight gain in these obese diabetic mice, associated with reduced fat mass (but not the lean mass), improved lipid profile, i.e., declined serum triglyceride, and free fatty acid levels compared to the placebo control. These finding reveals that supaglutide exerts beneficial effects in regulating blood glucose and lipid homeostasis in diabetic db/db mice.
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Affiliation(s)
- Liwei Ren
- Department of Endocrinology and Metabolism, Huashan Hospital, Fudan University, Shanghai, China
| | - Qiaoli Cui
- Department of Endocrinology and Metabolism, Huashan Hospital, Fudan University, Shanghai, China
| | - Wenjuan Liu
- Department of Endocrinology and Metabolism, Huashan Hospital, Fudan University, Shanghai, China
| | - Liqian Wang
- Shanghai Yinuo Pharmaceutical Co., Ltd., Shanghai, China
| | - Yijing Liao
- Department of Endocrinology and Metabolism, Huashan Hospital, Fudan University, Shanghai, China
| | - Ying Feng
- Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, China
| | - Wanwan Sun
- Department of Endocrinology and Metabolism, Huashan Hospital, Fudan University, Shanghai, China
| | - Yehong Yang
- Department of Endocrinology and Metabolism, Huashan Hospital, Fudan University, Shanghai, China
| | - Zhaoyun Zhang
- Department of Endocrinology and Metabolism, Huashan Hospital, Fudan University, Shanghai, China
| | - Tianru Jin
- Division of Advanced Diagnostics, Toronto General Research Institute, University Health Network, Toronto, ON, Canada.,Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Gerald J Prud'homme
- Department of Laboratory Medicine and Pathobiology, Keenan Research Centre for Biomedical Science, St. Michael's Hospital, Toronto, ON, Canada
| | - Lina Zhang
- Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, China
| | - Yiming Li
- Department of Endocrinology and Metabolism, Huashan Hospital, Fudan University, Shanghai, China
| | - Ying Leng
- Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, China
| | - Qinghua Wang
- Department of Endocrinology and Metabolism, Huashan Hospital, Fudan University, Shanghai, China
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135
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Afrasyabi S, Marandi SM, Kargarfard M. The effects of high intensity interval training on appetite management in individuals with type 2 diabetes: influenced by participants weight. J Diabetes Metab Disord 2019; 18:107-117. [PMID: 31275881 PMCID: PMC6582123 DOI: 10.1007/s40200-019-00396-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Accepted: 02/28/2019] [Indexed: 12/19/2022]
Abstract
Background and purpose The connection between exercise and appetite has ramifications for acute energy balance and weight-management. Research would suggest that exercise training can transiently suppress appetite, particularly in overweight and T2D, healthy-weight individuals. However, the effect of such a transient appetite suppression on subsequent food intake may be restricted. The aim of this thesis was to investigate appetite responses to HIIT in obesity with T2D and to assess the effect of other exercise characteristics, as well as exercise intensity, in mediating these responses especially appetite hormones. Materials and methods Eighty individuals with type 2 diabetes (forty normal and forty obesity weight) performed HIIT trials, all in arandomly divided, in 8 groups (10 in each group) which included, obesity non-diabetic control, obesity diabetic control, normal weight diabetic control, obesity non-diabetic training, obesity diabetic training, normal weight, non-diabetic training, and normal weight diabetic training. Twelve-weeks HIIT sessions (each session of an interval training includes 60 s of high intensity training (85-95% of reserve heart rate)) + running for 60 s at low intensity (55-60% of reserve heart rate) were applied. Blood samples were taken at the beginning and after the fourth, eighth and twelfth week of the training. Data were analyzed using repeated variance analysis and Pearson correlation coefficient. Results The results showed that training reduced ghrelin plasma levels in obese diabetic subjects (P < 0.05). Training has reduced PYY plasma in healthy subjects (non-diabetic) with normal weight (P < 0.05). Training reduced plasma levels of PYY in diabetic patients with normal weight and increased it in obese diabetic and healthy subjects (P < 0.05). Training has increased GLP-1 plasma in obese diabetic and diabetic with normal weight groups (P < 0.05). Training reduced TNF-α in normal (non-diabetic) subjects with normal weight and diabetic and non-diabetic obese subjects. Conclusion Collectively, the studies reported here suggest that appetite hormones differ between lean and obesity participants. The finding also suggested HIIT is more likely to elicit appetite hormones responses in obesity than in lean individuals with type 2 diabetes. Therefore, with caution, it is recommended that the high intensity interval training can be beneficial for these patients.
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Affiliation(s)
- Saleh Afrasyabi
- Department of Exercise Physiology, Faculty of Sport Sciences, University of Isfahan, Hezar Jerib Street, P.O. Box 81746-7344, Isfahan, Iran
| | - Syed Mohamad Marandi
- Department of Exercise Physiology, Faculty of Sport Sciences, University of Isfahan, Hezar Jerib Street, P.O. Box 81746-7344, Isfahan, Iran
| | - Mehdi Kargarfard
- Department of Exercise Physiology, Faculty of Sport Sciences, University of Isfahan, Hezar Jerib Street, P.O. Box 81746-7344, Isfahan, Iran
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136
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Wollam J, Riopel M, Xu YJ, Johnson AMF, Ofrecio JM, Ying W, El Ouarrat D, Chan LS, Han AW, Mahmood NA, Ryan CN, Lee YS, Watrous JD, Chordia MD, Pan D, Jain M, Olefsky JM. Microbiota-Produced N-Formyl Peptide fMLF Promotes Obesity-Induced Glucose Intolerance. Diabetes 2019; 68:1415-1426. [PMID: 31010956 PMCID: PMC6609982 DOI: 10.2337/db18-1307] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Accepted: 04/08/2019] [Indexed: 12/14/2022]
Abstract
The composition of the gastrointestinal microbiota and associated metabolites changes dramatically with diet and the development of obesity. Although many correlations have been described, specific mechanistic links between these changes and glucose homeostasis remain to be defined. Here we show that blood and intestinal levels of the microbiota-produced N-formyl peptide, formyl-methionyl-leucyl-phenylalanine, are elevated in high-fat diet-induced obese mice. Genetic or pharmacological inhibition of the N-formyl peptide receptor Fpr1 leads to increased insulin levels and improved glucose tolerance, dependent upon glucagon-like peptide 1. Obese Fpr1 knockout mice also display an altered microbiome, exemplifying the dynamic relationship between host metabolism and microbiota. Overall, we describe a new mechanism by which the gut microbiota can modulate glucose metabolism, providing a potential approach for the treatment of metabolic disease.
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Affiliation(s)
- Joshua Wollam
- Division of Endocrinology and Metabolism, Department of Medicine, University of California, San Diego, La Jolla, CA
| | - Matthew Riopel
- Division of Endocrinology and Metabolism, Department of Medicine, University of California, San Diego, La Jolla, CA
| | - Yong-Jiang Xu
- Division of Endocrinology and Metabolism, Department of Medicine, University of California, San Diego, La Jolla, CA
- Department of Pharmacology, University of California, San Diego, La Jolla, CA
| | - Andrew M F Johnson
- Division of Endocrinology and Metabolism, Department of Medicine, University of California, San Diego, La Jolla, CA
| | - Jachelle M Ofrecio
- Division of Endocrinology and Metabolism, Department of Medicine, University of California, San Diego, La Jolla, CA
| | - Wei Ying
- Division of Endocrinology and Metabolism, Department of Medicine, University of California, San Diego, La Jolla, CA
| | - Dalila El Ouarrat
- Division of Endocrinology and Metabolism, Department of Medicine, University of California, San Diego, La Jolla, CA
| | | | | | | | | | - Yun Sok Lee
- Division of Endocrinology and Metabolism, Department of Medicine, University of California, San Diego, La Jolla, CA
| | - Jeramie D Watrous
- Division of Endocrinology and Metabolism, Department of Medicine, University of California, San Diego, La Jolla, CA
- Department of Pharmacology, University of California, San Diego, La Jolla, CA
| | - Mahendra D Chordia
- Department of Radiology and Medical Imaging, University of Virginia, Charlottesville, VA
| | - Dongfeng Pan
- Department of Radiology and Medical Imaging, University of Virginia, Charlottesville, VA
| | - Mohit Jain
- Division of Endocrinology and Metabolism, Department of Medicine, University of California, San Diego, La Jolla, CA
- Department of Pharmacology, University of California, San Diego, La Jolla, CA
| | - Jerrold M Olefsky
- Division of Endocrinology and Metabolism, Department of Medicine, University of California, San Diego, La Jolla, CA
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137
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Santoso P, Amelia A, Rahayu R. Jicama ( Pachyrhizus erosus) fiber prevents excessive blood glucose and body weight increase without affecting food intake in mice fed with high-sugar diet. J Adv Vet Anim Res 2019; 6:222-230. [PMID: 31453195 PMCID: PMC6702872 DOI: 10.5455/javar.2019.f336] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Revised: 03/24/2019] [Accepted: 03/24/2019] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE Jicama (Pachyrhizus erosus) fiber has been documented to exert an immunomodulatory effect both in vitro and in vivo. However, its beneficial effect against metabolic syndrome remains unknown. This study aimed to reveal whether the jicama fiber (JF) could prevent the development of diabetes and obesity caused by a high-sugar diet (HSD). MATERIALS AND METHODS The JF was isolated from its tuberous part and subsequently used as a supplemental diet for adult male Bagg and Albino (BALB)/c mice fed with a HSD. Four different diet paradigms including normal diet, HSD (30% sucrose), and HSD in combination with 10% and 25% of JF, respectively, were deployed continuously for 8 weeks. Furthermore, the blood glucose level, glucose tolerance, body weight, food and water consumption as well as epididymal white adipose tissue (WAT) and interscapular brown adipose tissue (BAT) mass were determined. RESULTS Our results revealed that supplementation of 25% JF could significantly prevent the blood glucose increase, excessive body weight gain, and glucose intolerance in mice fed with HSD. Moreover, 10% and 25% JF blunted the HSD-induced WAT mass gain but failed to counteract the depletion of BAT mass. Furthermore, the fiber supplementation elicited a minimum effect on rhythm and total food and water intake. CONCLUSION The JF could effectively sustain blood glucose homeostasis as well as improve body weight and WAT mass profile against the development of diabetes and obesity caused by HSD.
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Affiliation(s)
- Putra Santoso
- Biology Department, Faculty of Mathematics and Natural Sciences, Andalas University, Padang, Indonesia
| | - Astri Amelia
- Biology Department, Faculty of Mathematics and Natural Sciences, Andalas University, Padang, Indonesia
| | - Resti Rahayu
- Biology Department, Faculty of Mathematics and Natural Sciences, Andalas University, Padang, Indonesia
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138
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He YL, Haynes W, Meyers CD, Amer A, Zhang Y, Mahling P, Mendonza AE, Ma S, Chutkow W, Bachman E. The effects of licogliflozin, a dual SGLT1/2 inhibitor, on body weight in obese patients with or without diabetes. Diabetes Obes Metab 2019; 21:1311-1321. [PMID: 30724002 DOI: 10.1111/dom.13654] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Revised: 01/31/2019] [Accepted: 02/02/2019] [Indexed: 01/11/2023]
Abstract
BACKGROUND There is an unmet need for a safer and more effective treatment for obesity. This study assessed the effects of licogliflozin, a dual inhibitor of sodium-glucose co-transporter (SGLT) 1/2, on body weight, metabolic parameters and incretin hormones in patients with type 2 diabetes mellitus (T2DM) and/or obesity. METHODS Patients with obesity (BMI, 35-50 kg/m2 ) were enrolled into a 12-week study (N = 88; licogliflozin 150 mg q.d.). Patients with T2DM were enrolled into a second, two-part study, comprising a single-dose cross-over study (N = 12; 2.5 - 300 mg) and a 14-day dosing study (N = 30; 15 mg q.d). Primary endpoints included effects on body weight, effects on glucose, safety and tolerability. Secondary endpoints included urinary glucose excretion (UGE24 ) and pharmacokinetics, while exploratory endpoints assessed the effects on incretin hormones (total GLP-1, PYY3-36 , and GIP), insulin and glucagon. RESULTS Treatment with licogliflozin 150 mg q.d. for 12 weeks in patients with obesity significantly reduced body weight by 5.7% vs placebo (P < 0.001) and improved metabolic parameters such as significantly reduced postprandial glucose excursion (21%; P < 0.001), reduced insulin levels (80%; P < 0.001) and increased glucagon (59%; P < 0.001). In patients with T2DM, a single dose of licogliflozin 300 mg in the morning prior to an oral glucose tolerance test (OGTT) remarkably reduced glucose excursion by 93% (P < 0.001; incremental AUC0-4h ) and suppressed insulin by 90% (P < 0.01; incremental AUC0-4h ). Treatment with licogliflozin 15 mg q.d. for 14 days reduced 24-hour average glucose levels by 26% (41 mg/dL; P < 0.001) and increased UGE24 to 100 g (P < 0.001) in patients with T2DM. In addition, this treatment regimen significantly increased total GLP-1 by 54% (P < 0.001) and PYY3-36 by 67% (P < 0.05) post OGTT vs placebo, while significantly reducing GIP levels by 53% (P < 0.001). Treatment with licogliflozin was generally safe and well tolerated. Diarrhea (increased numbers of loose stool) was the most common adverse event in all studies (90% with licogliflozin vs 25% with placebo in the 12-week study), while a lower incidence of flatulence, abdominal pain and abdominal distension (25%-43% with licogliflozin vs 9%-11% with placebo in the 12-week study) were among the other gastrointestinal events reported. CONCLUSION Licogliflozin treatment (1-84 days) leads to significant weight loss and favourable changes in a variety of metabolic parameters and incretin hormones. Dual inhibition of SGLT1/2 with licogliflozin in the gut and kidneys is an attractive strategy for treating obesity and diabetes.
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Affiliation(s)
- Yan-Ling He
- Translational Medicine, Novartis Institutes for BioMedical Research, Cambridge, Massachusetts
| | - William Haynes
- Translational Medicine, Novartis Institutes for BioMedical Research, Cambridge, Massachusetts
- Novo Nordisk Research Centre Oxford, UK
| | - Charles D Meyers
- Translational Medicine, Novartis Institutes for BioMedical Research, Cambridge, Massachusetts
- Chief Medical Office, Anji Pharmaceuticals, Cambridge, Massachusetts
| | - Ahmed Amer
- CMO and Patient Safety, Novartis Pharmaceuticals Corporation, East Hanover, New Jersey
| | - Yiming Zhang
- Early Development Biostatistics, Biostatistics and Pharmacometrics, Novartis Institutes for BioMedical Research, East Hanover, New Jersey
| | - Ping Mahling
- DEV B&SS, CM/Global Health, Novartis Institutes for BioMedical Research, Cambridge, Massachusetts
| | - Anisha E Mendonza
- Translational Medicine, Novartis Institutes for BioMedical Research, Cambridge, Massachusetts
| | - Shenglin Ma
- Translational Medicine, Novartis Institutes for BioMedical Research, Cambridge, Massachusetts
| | - William Chutkow
- Cardiovascular and Metabolism Disease Area, Novartis Institutes for BioMedical Research, Cambridge, Massachussets
| | - Eric Bachman
- Translational Medicine, Novartis Institutes for BioMedical Research, Cambridge, Massachusetts
- Vertex Pharmaceuticals, Boston, Massachusetts
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139
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Christou GA, Katsiki N, Blundell J, Fruhbeck G, Kiortsis DN. Semaglutide as a promising antiobesity drug. Obes Rev 2019; 20:805-815. [PMID: 30768766 DOI: 10.1111/obr.12839] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 01/15/2019] [Accepted: 01/20/2019] [Indexed: 12/16/2022]
Abstract
Semaglutide is a glucagon-like peptide-1 receptor agonist (GLP-1 RA) with a long elimination half-life, allowing subcutaneous (sc) administration once per week. Both the European Medicines Agency (EMA) and the Food and Drug Administration (FDA) recently approved once-weekly sc semaglutide for the treatment of type 2 diabetes mellitus (T2DM). The weight loss efficacy of once-weekly sc semaglutide appears to be superior compared with the other once-weekly GLP-1 RAs in patients with T2DM. Semaglutide was recently evaluated as an antiobesity drug in a phase II dose-finding trial, which demonstrated superior weight loss efficacy of once daily sc semaglutide compared with both placebo and once daily 3.0 mg liraglutide in patients with obesity but without T2DM. The magnitude of semaglutide-induced weight loss in this study exceeded the criteria of both the EMA and FDA for antiobesity drugs, and there were no safety concerns, indicating the eligibility of once daily sc semaglutide as a future antiobesity drug.
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Affiliation(s)
| | - Niki Katsiki
- Second Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippocration Hospital, Thessaloniki, Greece
| | - John Blundell
- Institute of Psychological Sciences, Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | - Gema Fruhbeck
- Metabolic Research Laboratory, Clinica Universidad de Navarra, CIBEROBN, Pamplona, Spain
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Payahoo L, Khajebishak Y, Alivand MR, Soleimanzade H, Alipour S, Barzegari A, Ostadrahimi A. Investigation the effect of oleoylethanolamide supplementation on the abundance of Akkermansia muciniphila bacterium and the dietary intakes in people with obesity: A randomized clinical trial. Appetite 2019; 141:104301. [PMID: 31132422 DOI: 10.1016/j.appet.2019.05.032] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2019] [Revised: 05/22/2019] [Accepted: 05/24/2019] [Indexed: 12/31/2022]
Abstract
Akkermansia muciniphila bacterium is one of the inhabitant gut microbiota involving in the energy homeostasis and inhibition of the inflammations. The present study was designed to evaluate the effects of Oleoylethanolamide (OEA) supplementation on the abundance of A. muciniphila and the dietary intakes in obese people. In this randomized, double-blind, controlled clinical trial, 60 eligible obese people were selected and divided randomly into two groups including OEA group (received two capsules containing 125 mg of OEA daily) and placebo group (received two capsules containing 125 mg of starch daily). The treatment lasted for 8 weeks. Dietary intakes were evaluated according to the three -day food record and, were analyzed by the Nutritionist 4 software. In order to evaluate the changes in the abundance of A. muciniphila bacterium, faeces samples were collected at baseline and at the end of study. The targeting of the 16S rRNA gene in A. muciniphila was measured by the quantitative real-time PCR analysis. For OEA group, the energy and carbohydrate intakes decreased significantly after adjusting for baseline values and confounder factors; (p = 0.035), the amount of carbohydrate was reported as 422.25 (SD = 103.11) gr and 368.44 (SD = 99.08) gr; (p = 0.042)), before and after the treatment, respectively. The abundance of A. muciniphila bacterium increased significantly in OEA group compared to placebo group (p < 0.001). Considering the accumulating evidence identified OEA as a novel, safe, and efficacious pharmaceutical agent increasing the abundance of A. muciniphila bacterium and modifying the energy balance, therefore it is suggested to use its supplement for treatment of the obese people. However, future studies are needed to confirm the positive results obtained in this study.
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Affiliation(s)
- Laleh Payahoo
- Assistant Professor of Nutrition Sciences, Maragheh University of Medical Sciences, Maragheh, Iran
| | - Yaser Khajebishak
- Assistant Professor of Nutrition Sciences, Maragheh University of Medical Sciences, Maragheh, Iran
| | - Mohammad Reza Alivand
- Department of Medical Genetics, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hamid Soleimanzade
- Department of Applied Biochemistry, Faculty of Chemistry, Tabriz University, Tabriz, Iran
| | - Shahriar Alipour
- Department of Biochemistry, Faculty of Medicine, Urmia University of Medical Sciences, Urmia, Iran
| | - Abolfazl Barzegari
- Student Research Committee, School of Advanced Biomedical Sciences, Research Center for Pharmaceutical Nanotechnology, Tabriz University of Medical Science, Tabriz, Iran
| | - Alireza Ostadrahimi
- Nutrition Research Center, Faculty of Nutrition and Food Science, Tabriz University of Medical Sciences, Tabriz, Iran.
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141
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Lew KN, Starkweather A, Cong X, Judge M. A Mechanistic Model of Gut-Brain Axis Perturbation and High-Fat Diet Pathways to Gut Microbiome Homeostatic Disruption, Systemic Inflammation, and Type 2 Diabetes. Biol Res Nurs 2019; 21:384-399. [PMID: 31113222 DOI: 10.1177/1099800419849109] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Type 2 diabetes (T2D) is a highly prevalent metabolic disease, affecting nearly 10% of the American population. Although the etiopathogenesis of T2D remains poorly understood, advances in DNA sequencing technologies have allowed for sophisticated interrogation of the human microbiome, providing insight into the role of the gut microbiome in the development and progression of T2D. An emerging body of research reveals that gut-brain axis (GBA) perturbations and a high-fat diet (HFD), along with other modifiable and nonmodifiable risk factors, contribute to gut microbiome homeostatic imbalance. Homeostatic imbalance or disruption increases gut wall permeability and facilitates translocation of endotoxins (lipopolysaccharides) into the circulation with resultant systemic inflammation. Chronic, low-grade systemic inflammation ensues with pro-inflammatory pathways activated, contributing to obesity, insulin resistance (IR), pancreatic β-cell decline, and, thereby, T2D. While GBA perturbations and HFD are implicated in provoking these conditions, prior mechanistic models have tended to examine HFD and GBA pathways exclusively without considering their shared pathways to T2D. Addressing this gap, this article proposes a mechanistic model informed by animal and human studies to advance scientific understanding of (1) modifiable and nonmodifiable risk factors for gut microbiome homeostatic disruption, (2) HFD and GBA pathways contributing to homeostatic disruption, and (3) shared GBA and HFD pro-inflammatory pathways to obesity, IR, β-cell decline, and T2D. The proposed mechanistic model, based on the extant literature, proposes a framework for studying the complex relationships of the gut microbiome to T2D to advance study in this promising area of research.
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Affiliation(s)
| | | | - Xiaomei Cong
- 1 School of Nursing, University of Connecticut, Storrs, CT, USA
| | - Michelle Judge
- 1 School of Nursing, University of Connecticut, Storrs, CT, USA
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Suarez AN, Noble EE, Kanoski SE. Regulation of Memory Function by Feeding-Relevant Biological Systems: Following the Breadcrumbs to the Hippocampus. Front Mol Neurosci 2019; 12:101. [PMID: 31057368 PMCID: PMC6482164 DOI: 10.3389/fnmol.2019.00101] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Accepted: 04/03/2019] [Indexed: 12/15/2022] Open
Abstract
The hippocampus (HPC) controls fundamental learning and memory processes, including memory for visuospatial navigation (spatial memory) and flexible memory for facts and autobiographical events (declarative memory). Emerging evidence reveals that hippocampal-dependent memory function is regulated by various peripheral biological systems that are traditionally known for their roles in appetite and body weight regulation. Here, we argue that these effects are consistent with a framework that it is evolutionarily advantageous to encode and recall critical features surrounding feeding behavior, including the spatial location of a food source, social factors, post-absorptive processing, and other episodic elements of a meal. We review evidence that gut-to-brain communication from the vagus nerve and from feeding-relevant endocrine systems, including ghrelin, insulin, leptin, and glucagon-like peptide-1 (GLP-1), promote hippocampal-dependent spatial and declarative memory via neurotrophic and neurogenic mechanisms. The collective literature reviewed herein supports a model in which various stages of feeding behavior and hippocampal-dependent memory function are closely linked.
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Affiliation(s)
| | | | - Scott E. Kanoski
- Human and Evolutionary Biology Section, Department of Biological Sciences, University of Southern California, Los Angeles, CA, United States
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143
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Hervik AK, Svihus B. The Role of Fiber in Energy Balance. J Nutr Metab 2019; 2019:4983657. [PMID: 30805214 PMCID: PMC6360548 DOI: 10.1155/2019/4983657] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Revised: 12/10/2018] [Accepted: 12/23/2018] [Indexed: 12/25/2022] Open
Abstract
Excessive energy intake is linked with obesity and subsequent diet-related health problems, and it is therefore a major nutritional challenge. Compared with the digestible carbohydrates starch and sugars, fiber has a low energy density and may have an attenuating effect on appetite. This narrative review attempts to clarify the net energy contributions of various fibers, and the effect of fiber on satiety and thus appetite regulation. Fibers, broadly defined as nonstarch polysaccharides, are a varied class of substances with vastly different physicochemical properties depending on their chemical arrangement. Thus, net energy content can vary from more than 10 kJ/g for soluble, nonviscous, and easily fermentable fibers such as those in many fruits, to less than zero for viscous fibers with anti-nutritive properties, such as certain types of fibers found in rye and other cereals. Likewise, some fibers will increase satiety by being viscous or contribute to large and/or swollen particles, which may facilitate mastication and increase retention time in the stomach, or potentially through fermentation and an ensuing satiety-inducing endocrine feedback from the colon. Thus, fibers may clearly contribute to energy balance. The metabolizable energy content is very often considerably lower than the commonly used level of 8 kJ per g fiber, and some fibers may reduce energy intake indirectly through satiety-inducing effects. A more precise characterization of fiber and its physicochemical effects are required before these beneficial effects can be fully exploited in human nutrition.
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Affiliation(s)
- Astrid Kolderup Hervik
- Inland Norway University of Applied Sciences and University of South-Eastern Norway, P.O. Box 4, 3199 Borre, Norway
| | - Birger Svihus
- Norwegian University of Life Sciences, P.O. Box 5003, 1432 Aas, Norway
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144
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Niccolai E, Boem F, Russo E, Amedei A. The Gut⁻Brain Axis in the Neuropsychological Disease Model of Obesity: A Classical Movie Revised by the Emerging Director "Microbiome". Nutrients 2019; 11:E156. [PMID: 30642052 PMCID: PMC6356219 DOI: 10.3390/nu11010156] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Revised: 12/21/2018] [Accepted: 01/08/2019] [Indexed: 02/06/2023] Open
Abstract
The worldwide epidemic of obesity has become an important public health issue, with serious psychological and social consequences. Obesity is a multifactorial disorder in which various elements (genetic, host, and environment), play a definite role, even if none of them satisfactorily explains its etiology. A number of neurological comorbidities, such as anxiety and depression, charges the global obesity burden, and evidence suggests the hypothesis that the brain could be the seat of the initial malfunction leading to obesity. The gut microbiome plays an important role in energy homeostasis regulating energy harvesting, fat deposition, as well as feeding behavior and appetite. Dietary patterns, like the Western diet, are known to be a major cause of the obesity epidemic, probably promoting a dysbiotic drift in the gut microbiota. Moreover, the existence of a "gut⁻brain axis" suggests a role for microbiome on hosts' behavior according to different modalities, including interaction through the nervous system, and mutual crosstalk with the immune and the endocrine systems. In the perspective of obesity as a real neuropsychological disease and in light of the discussed considerations, this review focuses on the microbiome role as an emerging director in the development of obesity.
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Affiliation(s)
- Elena Niccolai
- Department of Experimental and Clinical Medicine, University of Florence, Largo Brambilla 3, 50134 Florence, Italy.
| | - Federico Boem
- Department of Experimental and Clinical Medicine, University of Florence, Largo Brambilla 3, 50134 Florence, Italy.
| | - Edda Russo
- Department of Experimental and Clinical Medicine, University of Florence, Largo Brambilla 3, 50134 Florence, Italy.
| | - Amedeo Amedei
- Department of Experimental and Clinical Medicine, University of Florence, Largo Brambilla 3, 50134 Florence, Italy.
- Department of Biomedicine, Azienda Ospedaliera Universitaria Careggi (AOUC), Largo Brambilla 3, 50134 Florence, Italy.
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145
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Huang H, Meegalla SK, Lanter JC, Winters MP, Zhao S, Littrell J, Qi J, Rady B, Lee PS, Liu J, Martin T, Lam WW, Xu F, Lim HK, Wilde T, Silva J, Otieno M, Pocai A, Player MR. Discovery of a GPR40 Superagonist: The Impact of Aryl Propionic Acid α-Fluorination. ACS Med Chem Lett 2019; 10:16-21. [PMID: 30655940 PMCID: PMC6331191 DOI: 10.1021/acsmedchemlett.8b00444] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Accepted: 12/03/2018] [Indexed: 12/11/2022] Open
Abstract
GPR40 is a G-protein-coupled receptor which mediates fatty acid-induced glucose-stimulated insulin secretion from pancreatic beta cells and incretion release from enteroendocrine cells of the small intestine. GPR40 full agonists exhibit superior glucose lowering compared to partial agonists in preclinical species due to increased insulin and GLP-1 secretion, with the added benefit of promoting weight loss. In our search for potent GPR40 full agonists, we discovered a superagonist which displayed excellent in vitro potency and superior efficacy in the Gαs-mediated signaling pathway. Most synthetic GPR40 agonists have a carboxylic acid headgroup, which may cause idiosyncratic toxicities, including drug-induced-liver-injury (DILI). With a methyl group and a fluorine atom substituted at the α-C of the carboxylic acid group, 19 is not only highly efficacious in lowering glucose and body weight in rodent models but also has a low DILI risk due to its stable acylglucuronide metabolite.
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Affiliation(s)
- Hui Huang
- Departments
of Medicinal Chemistry, Cardiovascular & Metabolism in Vitro Biology, Cardiovascular &
Metabolism in Vivo Pharmacology, andPreclinical Drug Safety, Janssen Research & Development, Welsh and McKean Roads,Spring House, Pennsylvania 19477-0776, United States
| | - Sanath K. Meegalla
- Departments
of Medicinal Chemistry, Cardiovascular & Metabolism in Vitro Biology, Cardiovascular &
Metabolism in Vivo Pharmacology, andPreclinical Drug Safety, Janssen Research & Development, Welsh and McKean Roads,Spring House, Pennsylvania 19477-0776, United States
| | - James C. Lanter
- Departments
of Medicinal Chemistry, Cardiovascular & Metabolism in Vitro Biology, Cardiovascular &
Metabolism in Vivo Pharmacology, andPreclinical Drug Safety, Janssen Research & Development, Welsh and McKean Roads,Spring House, Pennsylvania 19477-0776, United States
| | - Michael P. Winters
- Departments
of Medicinal Chemistry, Cardiovascular & Metabolism in Vitro Biology, Cardiovascular &
Metabolism in Vivo Pharmacology, andPreclinical Drug Safety, Janssen Research & Development, Welsh and McKean Roads,Spring House, Pennsylvania 19477-0776, United States
| | - Shuyuan Zhao
- Departments
of Medicinal Chemistry, Cardiovascular & Metabolism in Vitro Biology, Cardiovascular &
Metabolism in Vivo Pharmacology, andPreclinical Drug Safety, Janssen Research & Development, Welsh and McKean Roads,Spring House, Pennsylvania 19477-0776, United States
| | - James Littrell
- Departments
of Medicinal Chemistry, Cardiovascular & Metabolism in Vitro Biology, Cardiovascular &
Metabolism in Vivo Pharmacology, andPreclinical Drug Safety, Janssen Research & Development, Welsh and McKean Roads,Spring House, Pennsylvania 19477-0776, United States
| | - Jenson Qi
- Departments
of Medicinal Chemistry, Cardiovascular & Metabolism in Vitro Biology, Cardiovascular &
Metabolism in Vivo Pharmacology, andPreclinical Drug Safety, Janssen Research & Development, Welsh and McKean Roads,Spring House, Pennsylvania 19477-0776, United States
| | - Brian Rady
- Departments
of Medicinal Chemistry, Cardiovascular & Metabolism in Vitro Biology, Cardiovascular &
Metabolism in Vivo Pharmacology, andPreclinical Drug Safety, Janssen Research & Development, Welsh and McKean Roads,Spring House, Pennsylvania 19477-0776, United States
| | - Paul S. Lee
- Departments
of Medicinal Chemistry, Cardiovascular & Metabolism in Vitro Biology, Cardiovascular &
Metabolism in Vivo Pharmacology, andPreclinical Drug Safety, Janssen Research & Development, Welsh and McKean Roads,Spring House, Pennsylvania 19477-0776, United States
| | - Jianying Liu
- Departments
of Medicinal Chemistry, Cardiovascular & Metabolism in Vitro Biology, Cardiovascular &
Metabolism in Vivo Pharmacology, andPreclinical Drug Safety, Janssen Research & Development, Welsh and McKean Roads,Spring House, Pennsylvania 19477-0776, United States
| | - Tonya Martin
- Departments
of Medicinal Chemistry, Cardiovascular & Metabolism in Vitro Biology, Cardiovascular &
Metabolism in Vivo Pharmacology, andPreclinical Drug Safety, Janssen Research & Development, Welsh and McKean Roads,Spring House, Pennsylvania 19477-0776, United States
| | - Wing W. Lam
- Departments
of Medicinal Chemistry, Cardiovascular & Metabolism in Vitro Biology, Cardiovascular &
Metabolism in Vivo Pharmacology, andPreclinical Drug Safety, Janssen Research & Development, Welsh and McKean Roads,Spring House, Pennsylvania 19477-0776, United States
| | - Fran Xu
- Departments
of Medicinal Chemistry, Cardiovascular & Metabolism in Vitro Biology, Cardiovascular &
Metabolism in Vivo Pharmacology, andPreclinical Drug Safety, Janssen Research & Development, Welsh and McKean Roads,Spring House, Pennsylvania 19477-0776, United States
| | - Heng Keang Lim
- Departments
of Medicinal Chemistry, Cardiovascular & Metabolism in Vitro Biology, Cardiovascular &
Metabolism in Vivo Pharmacology, andPreclinical Drug Safety, Janssen Research & Development, Welsh and McKean Roads,Spring House, Pennsylvania 19477-0776, United States
| | - Thomas Wilde
- Departments
of Medicinal Chemistry, Cardiovascular & Metabolism in Vitro Biology, Cardiovascular &
Metabolism in Vivo Pharmacology, andPreclinical Drug Safety, Janssen Research & Development, Welsh and McKean Roads,Spring House, Pennsylvania 19477-0776, United States
| | - Jose Silva
- Departments
of Medicinal Chemistry, Cardiovascular & Metabolism in Vitro Biology, Cardiovascular &
Metabolism in Vivo Pharmacology, andPreclinical Drug Safety, Janssen Research & Development, Welsh and McKean Roads,Spring House, Pennsylvania 19477-0776, United States
| | - Monicah Otieno
- Departments
of Medicinal Chemistry, Cardiovascular & Metabolism in Vitro Biology, Cardiovascular &
Metabolism in Vivo Pharmacology, andPreclinical Drug Safety, Janssen Research & Development, Welsh and McKean Roads,Spring House, Pennsylvania 19477-0776, United States
| | - Alessandro Pocai
- Departments
of Medicinal Chemistry, Cardiovascular & Metabolism in Vitro Biology, Cardiovascular &
Metabolism in Vivo Pharmacology, andPreclinical Drug Safety, Janssen Research & Development, Welsh and McKean Roads,Spring House, Pennsylvania 19477-0776, United States
| | - Mark R. Player
- Departments
of Medicinal Chemistry, Cardiovascular & Metabolism in Vitro Biology, Cardiovascular &
Metabolism in Vivo Pharmacology, andPreclinical Drug Safety, Janssen Research & Development, Welsh and McKean Roads,Spring House, Pennsylvania 19477-0776, United States
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146
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Gentilella R, Pechtner V, Corcos A, Consoli A. Glucagon-like peptide-1 receptor agonists in type 2 diabetes treatment: are they all the same? Diabetes Metab Res Rev 2019; 35:e3070. [PMID: 30156747 DOI: 10.1002/dmrr.3070] [Citation(s) in RCA: 140] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Revised: 07/30/2018] [Accepted: 08/18/2018] [Indexed: 02/06/2023]
Abstract
Glucagon-like peptide-1 (GLP-1) receptor agonists (RAs) are an important class of drugs with a well-established efficacy and safety profile in patients with type 2 diabetes mellitus. Agents in this class are derived from either exendin-4 (a compound present in Gila monster venom) or modifications of human GLP-1 active fragment. Differences among these drugs in duration of action (ie, short-acting vs long-acting), effects on glycaemic control and weight loss, immunogenicity, tolerability profiles, and administration routes offer physicians several options when selecting the most appropriate agent for individual patients. Patient preference is also an important consideration. The aim of this review is to discuss the differences between and similarities of GLP-1 RAs currently approved for clinical use, focusing particularly on the properties characterising the single short-acting and long-acting GLP-1 RAs rather than on their individual efficacy and safety profiles. The primary pharmacodynamic difference between short-acting (ie, exenatide twice daily and lixisenatide) and long-acting (ie, albiglutide, dulaglutide, exenatide once weekly, liraglutide, and semaglutide) GLP-1 RAs is that short-acting agents primarily delay gastric emptying (lowering postprandial glucose) and long-acting agents affect both fasting glucose (via enhanced glucose-dependent insulin secretion and reduced glucagon secretion in the fasting state) and postprandial glucose (via enhanced postprandial insulin secretion and inhibition of glucagon secretion). Other advantages of long-acting GLP-1 RAs include smaller fluctuations in plasma drug concentrations, improved gastrointestinal tolerability profiles, and simpler, more convenient administration schedules (once daily for liraglutide and once weekly for albiglutide, dulaglutide, the long-acting exenatide formulation, and semaglutide), which might improve treatment adherence and persistence.
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Affiliation(s)
| | - Valeria Pechtner
- Lilly Diabetes, Eli Lilly and Company, Neuilly-sur-Seine, France
| | | | - Agostino Consoli
- Department of Medicine and Ageing Sciences and CeSI-Met, University D'Annunzio, Chieti, Italy
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147
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Abstract
We describe a case of liraglutide-induced acute gastroparesis in a 52-year-old man with a history of well-controlled type 2 diabetes who presented with symptoms of gastric outlet obstruction. The patient responded markedly to conservative treatment with gastric suctioning, antiemetic and prokinetic therapy, and discontinuation of liraglutide with a resolution of his symptoms. This case highlights the importance of considering drug-induced gastroparesis as an etiology of unexplained upper abdominal pain, nausea, and early satiety, especially in the absence of mechanical obstruction.
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Affiliation(s)
- Puja Rai
- Internal Medicine, Tufts Medical Center, Boston, USA
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148
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Kaneko S, Ueda Y, Tahara Y. GLP1 Receptor Agonist Liraglutide Is an Effective Therapeutic Option for Perioperative Glycemic Control in Type 2 Diabetes within Enhanced Recovery After Surgery (ERAS) Protocols. Eur Surg Res 2018; 59:349-360. [PMID: 30537714 DOI: 10.1159/000494768] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2018] [Accepted: 10/23/2018] [Indexed: 11/19/2022]
Abstract
BACKGROUND Enhanced Recovery After Surgery (ERAS) protocols are multimodal perioperative care pathways designed to achieve early recovery after surgical procedures by maintaining preoperative organ function and reducing profound stress responses following surgery [Wilmore and Kehlet: BMJ 2001; 322(7284): 473-6]. Glucagon-like peptide-1 receptor agonists (GLP-1RAgs), such as liraglutide, have recently been widely used as antidiabetic agents in patients with type 2 diabetes (T2D) because they maintain blood glucose at an ideal level throughout the day, including during postprandial periods, thereby improving hypoglycemia and body weight more than insulin therapies. Additionally, the administration of liraglutide may exert cardiovascular, renal, and cerebral protective effects in T2D patients. The use of GLP-1RAgs for perioperative glycemic control is sometimes considered to be controversial. METHODS The efficacy and safety of liraglutide therapy during perioperative glycemic control in elective surgery patients within ERAS protocols were compared with those of insulin therapy. Ninety adult T2D patients scheduled to undergo elective surgery within ERAS protocols were randomized and analyzed. Forty-nine subjects were prescribed liraglutide and 41 insulin therapy. Procedures comprised orthopedic, thoracic, urological, otolaryngological, hepatic resection, and gynecological breast surgeries. RESULTS Liraglutide was shown to be a more effective option than insulin therapy because (1) glycemic levels were more stable; (2) the number of patients requiring additional insulin according to the insulin sliding scale was significantly smaller (Fisher's exact test, p = 0.005); (3) the insulin dosage required on the day of surgery was significantly smaller (Fisher's exact, p = 0.004); (4) the additional insulin volume required was significantly less for patients throughout the perioperative period (Fisher's exact test, p = 0.001); and (5) while lean body mass remained the same, body fat measurements, particularly visceral fat, tended to decrease. CONCLUSIONS Based on the results of the present study and a recent large-scale clinical study showing cardiovascular and renal protective effects in T2D patients, we consider the administration of liraglutide within ERAS protocols for T2D patients to represent a more comprehensive suite of patient protection measures as a perioperative non-insulin agent, particularly in patients with limited exercise ability and those at risk of hypoglycemia.
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Affiliation(s)
- Shizuka Kaneko
- Division of Diabetes/Endocrinology/Lifestyle-Related Disease, Takatsuki Red Cross Hospital, Takatsuki, Japan,
| | - Youhei Ueda
- Division of Diabetes/Endocrinology/Lifestyle-Related Disease, Takatsuki Red Cross Hospital, Takatsuki, Japan
| | - Yumiko Tahara
- Division of Diabetes/Endocrinology/Lifestyle-Related Disease, Takatsuki Red Cross Hospital, Takatsuki, Japan
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149
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Dhindsa DS, Sandesara PB, Shapiro MD. The Intersection of Diabetes and Cardiovascular Disease-A Focus on New Therapies. Front Cardiovasc Med 2018; 5:160. [PMID: 30555833 PMCID: PMC6282028 DOI: 10.3389/fcvm.2018.00160] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Accepted: 10/18/2018] [Indexed: 01/14/2023] Open
Abstract
Diabetes is a leading cause of cardiovascular disease and its associated morbidity. While the medical community has had access to numerous glucose lowering therapies over the last decades, it was not until recently that newer agents demonstrated improvement in cardiovascular outcomes. In particular, diabetes care and management of its attendant cardiovascular risk is now being revolutionized with the development and provision of the SGLT-2 inhibitors and GLP1-receptor agonists. Given the exciting data with these new classes of diabetes therapeutics, there is a clear need to improve education and utilization of these evidence-based medications across a wide spectrum of clinicians, including cardiologists. The aim of this review is to familiarize the cardiovascular specialist with the benefits and harms of the most commonly used oral anti- hyperglycemic medications, with an emphasis on SGLT-2 inhibitors and GLP-1 receptor agonists.
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Affiliation(s)
- Devinder S. Dhindsa
- Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, GA, United States
| | - Pratik B. Sandesara
- Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, GA, United States
| | - Michael D. Shapiro
- Center for Preventive Cardiology, Knight Cardiovascular Institute, Oregon Health & Science University, Portland, OR, United States
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150
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Ma J, Vella A. What Has Bariatric Surgery Taught Us About the Role of the Upper Gastrointestinal Tract in the Regulation of Postprandial Glucose Metabolism? Front Endocrinol (Lausanne) 2018; 9:324. [PMID: 29997575 PMCID: PMC6028568 DOI: 10.3389/fendo.2018.00324] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Accepted: 05/31/2018] [Indexed: 02/06/2023] Open
Abstract
The interaction between the upper gastrointestinal tract and the endocrine system is important in the regulation of metabolism and of weight. The gastrointestinal tract has a heterogeneous cellular content and comprises a variety of cells that elaborate paracrine and endocrine mediators that collectively form the entero-endocrine system. The advent of therapy that utilizes these pathways as well as the association of bariatric surgery with diabetes remission has (re-)kindled interest in the role of the gastrointestinal tract in glucose homeostasis. In this review, we will use the changes wrought by bariatric surgery to provide insights into the various gut-pancreas interactions that maintain weight, regulate satiety, and limit glucose excursions after meal ingestion.
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Affiliation(s)
- Jing Ma
- Division of Endocrinology and Metabolism, Shanghai Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
- Division of Endocrinology, Diabetes and Metabolism, Mayo Clinic College of Medicine, Rochester, NY, United States
| | - Adrian Vella
- Division of Endocrinology, Diabetes and Metabolism, Mayo Clinic College of Medicine, Rochester, NY, United States
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