Diurnal variation in the glycogen content of the human liver using 13 C MRS

Heat stress increases carbohydrate oxidation rates and oxygen uptake during prolonged load carriage exercise

Military missions are conducted in a multitude of environments including heat and may involve walking under load following severe exertion, the metabolic demands of which may have nutritional implications for fueling and recovery planning. Ten males equipped a military pack loaded to 30% of their body mass and walked in 20°C/40% relative humidity (RH) (TEMP) or 37°C/20% RH (HOT) either continuously (CW) for 90 min at the first ventilatory threshold or mixed walking (MW) with unloaded running intervals above the second ventilatory threshold between min 35 and 55 of the 90 min bout. Pulmonary gas, thermoregulatory, and cardiovascular variables were analyzed following running intervals. Final rectal temperature (MW: p < 0.001, g = 3.81, CW: p < 0.001, g = 4.04), oxygen uptake, cardiovascular strain, and energy expenditure were higher during HOT trials (p ≤ 0.05) regardless of exercise type. Both HOT trials elicited higher final carbohydrate oxidation (CHOox) than TEMP CW at min 90 (HOT MW: p < 0.001, g = 1.45, HOT CW: p = 0.009, g = 0.67) and HOT MW CHOox exceeded TEMP MW at min 80 and 90 (p = 0.049, g = 0.60 and p = 0.024, g = 0.73, respectively). There were no within-environment differences in substrate oxidation indicating that severe exertion work cycles did not produce a carryover effect during subsequent loaded walking. The rate of CHOox during 90 minutes of load carriage in the heat appears to be primarily affected by accumulated thermal load.

Attention to Innate Circadian Rhythm and the Impact of Its Disruption on Diabetes

Novel strategies are required to reduce the risk of developing diabetes and/or clinical outcomes and complications of diabetes. In this regard, the role of the circadian system may be a potential candidate for the prevention of diabetes. We reviewed evidence from animal, clinical, and epidemiological studies linking the circadian system to various aspects of the pathophysiology and clinical outcomes of diabetes. The circadian clock governs genetic, metabolic, hormonal, and behavioral signals in anticipation of cyclic 24-hour events through interactions between a "central clock" in the suprachiasmatic nucleus and "peripheral clocks" in the whole body. Currently, circadian rhythmicity in humans can be subjectively or objectively assessed by measuring melatonin and glucocorticoid levels, core body temperature, peripheral blood, oral mucosa, hair follicles, rest-activity cycles, sleep diaries, and circadian chronotypes. In this review, we summarized various circadian misalignments, such as altered light-dark, sleep-wake, rest-activity, fasting-feeding, shift work, evening chronotype, and social jetlag, as well as mutations in clock genes that could contribute to the development of diabetes and poor glycemic status in patients with diabetes. Targeting critical components of the circadian system could deliver potential candidates for the treatment and prevention of type 2 diabetes mellitus in the future.

Day-to-day variability in euvolemic body mass

Short-term variability in body mass is a common, everyday phenomenon; however, data on body mass variability are scarce. While the physiological variability of body mass is negligible in healthy individuals, it could have implications for therapy in patients with impaired volume homeostasis, for example, patients with kidney failure undergoing kidney replacement therapy. We analyzed a long-term dataset comprising 9521 days of standardized body mass measurements from one healthy male individual and assessed the variability in body mass as a positive or negative relative difference in body mass measured on subsequent days. The average and median relative differences were zero, with a standard deviation (SD) of 0.53% for the one-day interval, increasing to 0.69% for the 7-day interval, and this variability was constant throughout the observation period. A body mass variability of approximately 0.6% (±450 mL in a 75-kg patient) should be taken into consideration when weight-dependent treatment prescriptions, e.g. the ultrafiltration rates in patients on hemodialysis, are being set. Consequently, a "soft target weight", considering the longitudinal variation of volume markers, such as body mass, might improve treatment quality.

Exercise Timing Matters for Glycogen Metabolism and Accumulated Fat Oxidation over 24 h

Due to increasingly diverse lifestyles, exercise timings vary between individuals: before breakfast, in the afternoon, or in the evening. The endocrine and autonomic nervous systems, which are associated with metabolic responses to exercise, show diurnal variations. Moreover, physiological responses to exercise differ depending on the timing of the exercise. The postabsorptive state is associated with greater fat oxidation during exercise compared to the postprandial state. The increase in energy expenditure persists during the post-exercise period, known as "Excess Post-exercise Oxygen Consumption". A 24 h evaluation of accumulated energy expenditure and substrate oxidation is required to discuss the role of exercise in weight control. Using a whole-room indirect calorimeter, researchers revealed that exercise performed during the postabsorptive state, but not during the postprandial state, increased accumulated fat oxidation over 24 h. The time course of the carbohydrate pool, as estimated by indirect calorimetry, suggests that glycogen depletion after postabsorptive exercise underlies an increase in accumulated fat oxidation over 24 h. Subsequent studies using ¹³C magnetic resonance spectroscopy confirmed that the variations in muscle and liver glycogen caused by postabsorptive or postprandial exercise were consistent with indirect calorimetry data. These findings suggest that postabsorptive exercise alone effectively increases 24 h fat oxidation.

Liver glycogen stores via 13C magnetic resonance spectroscopy in healthy children: randomized, controlled study

BACKGROUND

Owing to its role in glucose homeostasis, liver glycogen concentration ([LGly]) can be a marker of altered metabolism seen in disorders that impact the health of children. However, there is a paucity of normative data for this measure in children to allow comparison with patients, and time-course assessment of [LGly] in response to feeding has not been reported. In addition, carbon-13 magnetic resonance spectroscopy (¹³C-MRS) is used extensively in research to assess liver metabolites in adult health and disease noninvasively, but similar measurements in children are lacking.

OBJECTIVES

The main objectives were to quantify the depletion of [LGly] after overnight fasting and the subsequent response to feeding.

METHODS

In a randomly assigned, open-label, incomplete block design study, healthy, normal-weight children (8-12 y) attended 2 evening visits, each separated by ≥5 d and directly followed by a morning visit. An individually tailored, standardized meal was consumed 3-h prior to evening assessments. Participants then remained fasted until the morning visit. [LGly] was assessed once in the fed (20:00) and fasted state (08:00) using ¹³C-MRS. After the 8:00 assessment, 200 ml of a mixed-macronutrient drink containing 15.5 g (402 kJ) or 31 g carbohydrates (804 kJ), or water only, was consumed, with ¹³C-MRS measurements then performed hourly for 4 h. Each child was randomly assigned to 2 of 3 drink options across the 2 mornings. Data are expressed as mean (SD).

RESULTS

Twenty-four children including females and males (13F:11M) completed the study [9.9 (1.1) y, BMI percentile 45.7 (25.9)]. [LGly] decreased from 377.9 (141.3) to 277.3 (107.4) mmol/L overnight; depletion rate 0.14 (0.15) mmol/L min. Incremental responses of [LGly] to test drinks differed (P < 0.001), with incremental net area under the curve of [LGly] over 4 h being higher for 15.5 g [-67.1 (205.8) mmol/L·240 min; P < 0.01] and 31 g carbohydrates [101.6 (180.9) mmol/L·240 min; P < 0.005] compared with water [-253.1 (231.2) mmol/L·240 min].

CONCLUSIONS

After overnight fasting, [LGly] decreased by 22.9 (25.1)%, and [LGly] incremental net area under the curve over 4 h was higher after subsequent consumption of 15.5 g and 31 g carbohydrates, compared to water. Am J Clin Nutr 20XX;xx:xx-xx.

Muscle Glycogen Assessment and Relationship with Body Hydration Status: A Narrative Review

Muscle glycogen is a crucial energy source for exercise, and assessment of muscle glycogen storage contributes to the adequate manipulation of muscle glycogen levels in athletes before and after training and competition. Muscle biopsy is the traditional and gold standard method for measuring muscle glycogen; alternatively, ¹³C magnetic resonance spectroscopy (MRS) has been developed as a reliable and non-invasive method. Furthermore, outcomes of ultrasound and bioimpedance methods have been reported to change in association with muscle glycogen conditions. The physiological mechanisms underlying this activity are assumed to involve a change in water content bound to glycogen; however, the relationship between body water and stored muscle glycogen is inconclusive. In this review, we discuss currently available muscle glycogen assessment methods, focusing on ¹³C MRS. In addition, we consider the involvement of muscle glycogen in changes in body water content and discuss the feasibility of ultrasound and bioimpedance outcomes as indicators of muscle glycogen levels. In relation to changes in body water content associated with muscle glycogen, this review broadens the discussion on changes in body weight and body components other than body water, including fat, during carbohydrate loading. From these discussions, we highlight practical issues regarding muscle glycogen assessment and manipulation in the sports field.

Magnetic Resonance Imaging and Spectroscopy Methods to Study Hepatic Glucose Metabolism and Their Applications in the Healthy and Diabetic Liver

The liver plays an important role in whole-body glucose homeostasis by taking up glucose from and releasing glucose into the blood circulation. In the postprandial state, excess glucose in the blood circulation is stored in hepatocytes as glycogen. In the postabsorptive state, the liver produces glucose by breaking down glycogen and from noncarbohydrate precursors such as lactate. In metabolic diseases such as diabetes, these processes are dysregulated, resulting in abnormal blood glucose levels. Magnetic resonance imaging (MRI) and magnetic resonance spectroscopy (MRS) are noninvasive techniques that give unique insight into different aspects of glucose metabolism, such as glycogenesis, glycogenolysis, and gluconeogenesis, in the liver in vivo. Using these techniques, liver glucose metabolism has been studied in regard to a variety of interventions, such as fasting, meal intake, and exercise. Moreover, deviations from normal hepatic glucose metabolism have been investigated in both patients with type 1 and 2 diabetes, as well as the effects of antidiabetic medications. This review provides an overview of current MR techniques to measure hepatic glucose metabolism and the insights obtained by the application of these techniques in the healthy and diabetic liver.

Circadian clock, diurnal glucose metabolic rhythm, and dawn phenomenon

The circadian clock provides cue-independent anticipatory signals for diurnal rhythms of baseline glucose levels and glucose tolerance. The central circadian clock is located in the hypothalamic suprachiasmatic nucleus (SCN), which comprises primarily GABAergic neurons. The SCN clock regulates physiological diurnal rhythms of endogenous glucose production (EGP) and hepatic insulin sensitivity through neurohumoral mechanisms. Disruption of the molecular circadian clock is associated with the extended dawn phenomenon (DP) in type 2 diabetes (T2D), referring to hyperglycemia in the early morning without nocturnal hypoglycemia. The DP affects nearly half of patients with diabetes, with poorly defined etiology and a lack of targeted therapy. Here we review neural and secreted factors in physiological diurnal rhythms of glucose metabolism and their pathological implications for the DP.

Diurnal variations in muscle and liver glycogen differ depending on the timing of exercise

It has been suggested that glycogen functions not only in carbohydrate energy storage, but also as molecular sensors capable of activating lipolysis. This study aimed to compare the variation in liver and muscle glycogen during the day due to different timing of exercise. Nine healthy young men participated in two trials in which they performed a single bout of exercise at 70% of their individual maximal oxygen uptake for 60 min in the post-absorptive (morning) or post-prandial (afternoon) state. Liver and muscles glycogen levels were measured using carbon magnetic resonance spectroscopy (13C MRS). Diurnal variations in liver and muscle glycogen compared to baseline levels were significantly different depending on the timing of exercise. The effect of the timing of exercise on glycogen fluctuation is known to be related to a variety of metabolic signals, and the results of this study will be useful for future research on energy metabolism.

Effects of exercise before breakfast on plasma free fatty acid profile and 24-h fat oxidation

Background

Free fatty acids (FFAs) are an important source of energy, and also serve as signaling molecules to regulate gene expression. Exercise performed in a post-absorptive state, in contrast to that performed in a postprandial state, increases 24-h fat oxidation under an energy-balanced condition. The primary aim of the present study was to clarify whether the effects of exercise on the concentration and composition of plasma FFAs, which may underlie distinct effects of exercise on 24-h fat oxidation, depend on the nutritional state of the individual when performing the exercise.

Methods

Ten healthy young men underwent 3 trials of indirect calorimetry in a metabolic chamber. The subjects performed exercise at 60% of VO_2max for 60 min in either a post-absorptive or postprandial state, or remained sedentary without an exercise session (control). All trials were designed to be energy balanced over 24 h. Blood samples were collected immediately before and after exercise.

Results

Fat oxidation over 24 h was increased only when exercise was performed in a post-absorptive state (control, 531 ± 60; post-absorptive, 779 ± 70; postprandial, 569 ± 37 kcal/24 h). The increase in the 24-h fat oxidation was related to the magnitude of the transient carbohydrate deficit after exercise. The plasma FFA concentration after exercise was higher in the post-absorptive trial (0.38 ± 0.04) than in the control (0.13 ± 0.01) and postprandial (0.15 ± 0.02 mM) trials. The ratio of unsaturated to saturated (U/S) fatty acids after exercise was higher in the post-absorptive trial (1.76 ± 0.06) than in the control (1.56 ± 0.07) and postprandial (1.53 ± 0.08) trials. On the other hand, the plasma FFA concentration after exercise in a postprandial state did not differ significantly from that in the control trial.

Conclusion

Exercise performed in a post-absorptive state effectively increased the plasma FFA concentration and U/S ratio to a greater degree than exercise performed in a postprandial state, underlying the increase in the 24-h fat oxidation. The increase in the plasma FFA concentration was related to the transient carbohydrate deficit after exercise.

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Exercise performed in post-absorptive state increases 24-h fat oxidation.

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Exercise performed in a post-absorptive state increased the ratio of U/S ratio.

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The plasma FFA concentration was related to the transient carbohydrate deficit.