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Iversen KN, Jonsson K, Landberg R. The Effect of Rye-Based Foods on Postprandial Plasma Insulin Concentration: The Rye Factor. Front Nutr 2022; 9:868938. [PMID: 35757252 PMCID: PMC9218669 DOI: 10.3389/fnut.2022.868938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 04/26/2022] [Indexed: 11/15/2022] Open
Abstract
Consumption of whole grain has been associated with lower incidence of type-2 diabetes, cardiovascular disease and their risk factors including improved glycemic control. In comparison with other whole grain products, rye bread has been shown to induce lower insulin response in the postprandial phase, without affecting the glucose response. This phenomenon has been referred to as the “rye factor” and is being explored in this review where we summarize the findings from meal and extended meal studies including rye-based foods. Overall, results from intervention studies showed that rye-based foods vs. (wheat) control foods had positive effect on both insulin and glucose responses in the postprandial phase, rather than on insulin alone. Mechanistic studies have shown that the rye factor phenomenon might be due to slowing of the glucose uptake in the intestine. However, this has also been shown for wheat-based bread and is likely an effect of structural properties of the investigated foods rather than the rye per se. More carefully controlled studies where standardized structural properties of different cereals are linked to the postprandial response are needed to further elucidate the underlying mechanisms and determinants for the effect of specific cereals and product traits on postprandial glycemic control.
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Affiliation(s)
- Kia Nøhr Iversen
- Department of Biology and Biological Engineering, Division of Food and Nutrition Science, Chalmers University of Technology, Gothenburg, Sweden
| | - Karin Jonsson
- Department of Biology and Biological Engineering, Division of Food and Nutrition Science, Chalmers University of Technology, Gothenburg, Sweden
| | - Rikard Landberg
- Department of Biology and Biological Engineering, Division of Food and Nutrition Science, Chalmers University of Technology, Gothenburg, Sweden
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Fu J, Yu MG, Li Q, Park K, King GL. Insulin's actions on vascular tissues: Physiological effects and pathophysiological contributions to vascular complications of diabetes. Mol Metab 2021; 52:101236. [PMID: 33878400 PMCID: PMC8513152 DOI: 10.1016/j.molmet.2021.101236] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 04/07/2021] [Accepted: 04/12/2021] [Indexed: 12/12/2022] Open
Abstract
Background Insulin has been demonstrated to exert direct and indirect effects on vascular tissues. Its actions in vascular cells are mediated by two major pathways: the insulin receptor substrate 1/2-phosphoinositide-3 kinase/Akt (IRS1/2/PI3K/Akt) pathway and the Src/mitogen-activated protein kinase (MAPK) pathway, both of which contribute to the expression and distribution of metabolites, hormones, and cytokines. Scope of review In this review, we summarize the current understanding of insulin's physiological and pathophysiological actions and associated signaling pathways in vascular cells, mainly in endothelial cells (EC) and vascular smooth muscle cells (VSMC), and how these processes lead to selective insulin resistance. We also describe insulin's potential new signaling and biological effects derived from animal studies and cultured capillary and arterial EC, VSMC, and pericytes. We will not provide a detailed discussion of insulin's effects on the myocardium, insulin's structure, or its signaling pathways' various steps, since other articles in this issue discuss these areas in depth. Major conclusions Insulin mediates many important functions on vascular cells via its receptors and signaling cascades. Its direct actions on EC and VSMC are important for transporting and communicating nutrients, cytokines, hormones, and other signaling molecules. These vascular actions are also important for regulating systemic fuel metabolism and energetics. Inhibiting or enhancing these pathways leads to selective insulin resistance, exacerbating the development of endothelial dysfunction, atherosclerosis, restenosis, poor wound healing, and even myocardial dysfunction. Targeted therapies to improve selective insulin resistance in EC and VSMC are thus needed to specifically mitigate these pathological processes. Insulin's actions in vascular cells have a significant influence on systemic metabolism. Insulin exerts its vascular effects through its receptors and signaling cascades. Inhibition or enhancement of different insulin signaling leads to selective insulin resistance. Loss of insulin's actions causes endothelial dysfunction and vascular complications in diabetes.
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Affiliation(s)
- Jialin Fu
- Dianne Nunnally Hoppes Laboratory for Diabetes Complications, Section of Vascular Cell Biology, Joslin Diabetes Center, Harvard Medical School, Boston, MA, 02215, USA
| | - Marc Gregory Yu
- Dianne Nunnally Hoppes Laboratory for Diabetes Complications, Section of Vascular Cell Biology, Joslin Diabetes Center, Harvard Medical School, Boston, MA, 02215, USA
| | - Qian Li
- Dianne Nunnally Hoppes Laboratory for Diabetes Complications, Section of Vascular Cell Biology, Joslin Diabetes Center, Harvard Medical School, Boston, MA, 02215, USA
| | - Kyoungmin Park
- Dianne Nunnally Hoppes Laboratory for Diabetes Complications, Section of Vascular Cell Biology, Joslin Diabetes Center, Harvard Medical School, Boston, MA, 02215, USA
| | - George L King
- Dianne Nunnally Hoppes Laboratory for Diabetes Complications, Section of Vascular Cell Biology, Joslin Diabetes Center, Harvard Medical School, Boston, MA, 02215, USA.
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Postprandial Glycaemic, Hormonal and Satiety Responses to Rice and Kiwifruit Preloads in Chinese Adults: A Randomised Controlled Crossover Trial. Nutrients 2018; 10:nu10081110. [PMID: 30126094 PMCID: PMC6116117 DOI: 10.3390/nu10081110] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Revised: 08/09/2018] [Accepted: 08/14/2018] [Indexed: 11/22/2022] Open
Abstract
Controlling postprandial glycaemia helps to prevent and manage non-communicable diseases. One strategy in controlling glycaemia may be to consume meals in two parts; a preload, followed by the remainder of the meal. Our aim was to test preloading a rice meal given for breakfast and lunch on different days, either by splitting the meal (rice preload followed by rice meal) or by using kiwifruit as a preload compared with consuming the rice meal in one sitting. Primary outcomes were glycaemic and insulinaemic responses with secondary outcomes of other hormonal responses, subjective satiety, and subsequent energy intake. Following breakfast, postprandial glycaemic peak concentration was 0.9 (95% CI: 0.2, 1.6) mmol/L lower for the kiwifruit preload compared with the rice meal eaten in one sitting. Following lunch, glycaemic peak concentrations were 1.0 (0.7, 1.4) and 1.1 (0.5, 1.7) mmol/L lower for the rice-split and kiwifruit preload compared with the rice meal alone, respectively. Postprandial insulinaemia area-under-the-curve was 1385 (87, 2684) mU/L·min less for the kiwifruit preload compared with the rice-split. There were no differences among treatments for subsequent energy intake. Meal splitting is useful for lowering postprandial glycaemia, and replacing part of a meal with kiwifruit may help with insulin efficiency without detriment to subsequent energy intake.
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A Synergistic Formulation of Plant Extracts Decreases Postprandial Glucose and Insulin Peaks: Results from Two Randomized, Controlled, Cross-Over Studies Using Real-World Meals. Nutrients 2018; 10:nu10080956. [PMID: 30044398 PMCID: PMC6115802 DOI: 10.3390/nu10080956] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 07/19/2018] [Accepted: 07/23/2018] [Indexed: 01/21/2023] Open
Abstract
This study investigated the efficacy of a plant-derived dietary supplement with respect to decreasing postprandial glucose and insulin peaks after the intake of real-world meals. Two randomized, double-blind, placebo-controlled, cross-over experiments were conducted on healthy subjects who received a supplement containing extracts of white mulberry, white bean, and green coffee or one containing the three extracts with added fibre before consuming high-GI/GL (glycaemic index/glycaemic load) meals. In study one, 32 subjects received an investigational product/placebo before a standardized meal at two visits. In study two, 150 subjects received an investigational product/placebo before five different standardized meals. Postprandial glucose and insulin concentrations were lower 20–35 min after meal intake among subjects taking the investigational product, and fewer episodes of postprandial reactive hypoglycaemia were noted. For example, after consuming breakfast cereal with milk, lower glucose peaks were observed for the investigational product (vs. placebo) after 20 min (100.2 ± 1.97 vs. 112.5 ± 3.12 mg/dL, respectively; p < 0.01); lower insulin peaks were noted at the same time point (45.9 ± 4.02 IU/mL vs. 68.2 ± 5.53 IU/mL, respectively, p < 0.01). The combined formulation decreases the adverse consequences of high-GI/GL meal consumption. It can be an effective dietary supplement for the management of metabolic syndrome and type 2 diabetes mellitus.
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Al-Waili N, Salom K, Al-Ghamdi A, Ansari MJ, Al-Waili A, Al-Waili T. Honey and cardiovascular risk factors, in normal individuals and in patients with diabetes mellitus or dyslipidemia. J Med Food 2014; 16:1063-78. [PMID: 24328699 DOI: 10.1089/jmf.2012.0285] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Diabetes mellitus, hypercholesteremia, hypertension (HTN), and obesity are well-known risk factors for cardiovascular diseases (CVD). Various medications are currently in use for management of these comorbidities. Undesirable side effects are unavoidable and the ultimate and ideal goal is hardly achieved. Honey and other bee products are widely used in traditional medicine for management of many diseases. Others and the authors have found potent biological activities of these products. Honey is now reintroduced in modern medicine as part of wound and burn management. Honey has antioxidant, anti-inflammatory, and antimicrobial activities. More studies are exploring other aspects of honey activity such as its effect on blood sugar, body weight, lipid profile, C-reactive protein, nitric oxide, proinflammatory prostaglandins, and homocysteine. Growing evidence and scientific data support the use of honey in patients with diabetes, HTN, dyslipidemia, obesity, and CVD. This review discusses clinical and preclinical studies on potential influence of honey on diabetes mellitus and cardiovascular risk factors, and emphasizes the importance of conducting more clinical and controlled studies.
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Zheng JS, Yu Y, Yang J, Xu XJ, Hu XJ, Luo M, Li D. Postprandial effects of two Chinese liquors on selected cardiovascular disease risk factors in young men. ACTA ACUST UNITED AC 2013; 100:302-11. [DOI: 10.1556/aphysiol.100.2013.3.6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Phaseolus vulgaris extract affects glycometabolic and appetite control in healthy human subjects. Br J Nutr 2012; 109:1789-95. [DOI: 10.1017/s0007114512003741] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Extracts of Phaseolus vulgaris (beans) are known to reduce glycaemia and food intake in rodents and humans. The present study evaluated the effects of a new, standardised and purified P. vulgaris extract (PVE), when employed as a supplement in a mixed balanced meal (60 % carbohydrates, 25 % lipids and 15 % protein), on glycometabolic and appetite control. To this end, a randomised, double-blind, placebo-controlled study was performed in twelve volunteers. Plasma glucose, insulin, C-peptide, ghrelin and satiety sensation ratings were assessed at baseline and during 3 h after meal consumption associated with PVE (100 mg) or placebo. Compared with placebo, PVE consumption resulted in lower increments in glucose (+15·4 (sem 5·4) v. 26·1 (sem 7·3) %, P= 0·04 at 30 min), insulin (+981 (sem 115) v. 1325 (sem 240) %, P= 0·04 between 45 and 120 min) and C-peptide (+350 (sem 27) v. 439 (sem 30) %, P= 0·04 between 30 and 90 min). In the first 2 h, plasma ghrelin decreased similarly in both groups but did not rebound as in placebo thereafter (P= 0·04). Correspondingly, satiety sensation in the third hour was significantly reduced in the placebo but not in the PVE condition. PVE induced a lower desire to eat than placebo (P= 0·02) over the 3 h. In conclusion, PVE supplementation reduced postprandial glucose, insulin and C-peptide excursions, suppressed ghrelin secretion and affected satiety sensations, inducing a lower desire to eat. These results support that further studies are needed to prove the concept of employing PVE as a supplement in mixed balanced meals in obese, glucose-intolerant and diabetic subjects.
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Kapur S, Groves MN, Zava DT, Kapur S. Postprandial insulin and triglycerides after different breakfast meal challenges: use of finger stick capillary dried blood spots to study postprandial dysmetabolism. J Diabetes Sci Technol 2010; 4:236-43. [PMID: 20307382 PMCID: PMC2864157 DOI: 10.1177/193229681000400202] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND High levels of insulin and lipids following a meal are recognized risk factors for atherosclerosis. Monitoring such risk factors in the general population is hampered by the inconvenience of venipuncture blood collection, particularly for both premeal and postmeal analyses. This study examined insulin and triglyceride levels in dried blood spots (DBSs) collected after different breakfast meal challenges to assess the potential of this method for risk assessment. METHODS Glucose levels were measured using a glucose meter, and insulin and triglycerides were determined in DBS samples collected from 19 healthy volunteers before and at four time points up to 2.5 h after consuming each of five typical breakfast meals varying in nutritional composition. RESULTS At 2 h, glucose was within normal postprandial values (<140 mg/dl) for all meals; significantly lower glucose was seen after meal 2 (the lowest carbohydrate content) compared to the other meals. Insulin returned to normal fasting levels (<15 microIU/ml) in significantly more subjects (90%) after meal 2 and significantly fewer subjects (31%) after meal 4 (highest carbohydrate content) than the other meals. Triglycerides were elevated to a similar extent in all subjects, with no significant differences between meals; levels were still rising at 2.5 h. CONCLUSIONS Subjects were able to collect blood spots with minimum disruption to their normal daily activities. Relative ease of collection, analyte stability in dried blood, and the close correlation with serum levels that we have previously demonstrated makes DBS a convenient and simple tool for assessing the individual impact of different diets on postprandial dysmetabolism.
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Affiliation(s)
- Sonia Kapur
- ZRT Laboratory, LLC, Beaverton, Oregon, USA.
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Nazare JA, Normand S, Oste Triantafyllou A, Brac de la Perrière A, Desage M, Laville M. Modulation of the postprandial phase by β-glucan in overweight subjects: Effects on glucose and insulin kinetics. Mol Nutr Food Res 2009; 53:361-9. [DOI: 10.1002/mnfr.200800023] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Ahmadani MY, Hakeem R, Fawwad A, Basit A, Shera AS. Determination of reference values for elevated fasting and random insulin levels and their associations with metabolic risk factors among rural Pakistanis from Sindh Province. Metab Syndr Relat Disord 2008; 6:143-8. [PMID: 18484904 DOI: 10.1089/met.2007.0031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
AIM To assess insulin levels and their association with metabolic risk factors (family history of diabetes, abnormal glucose tolerance, hypertension, overweight and android obesity) among a representative group of Pakistan. METHODS The study data was taken from the database of a population-based survey conducted in Sindh Province, Pakistan, in 1994 to assess the prevalence of diabetes mellitus and impaired glucose tolerance (IGT). Through stratified random sampling; oral glucose tolerance tests were performed in 967 adults; every fifth sample was estimated for fasting and random (2-hour post-75 gm glucose load) insulin levels. The total number of metabolic risk factors was counted for each subject, and their association with insulin levels studied. RESULTS Of the 130 subjects, 56.1% were females and 95.4% were Sindhi. The mean age of males and females was 43.84 and 40.61 years, respectively. Family history for diabetes and frequency of overweight had significant positive associations with both fasting and random insulin levels (P < 0.05). Association between hypertension and insulin levels was significant only for random insulin levels, and between android obesity, abnormal glucose tolerance, or male gender and insulin levels only for fasting insulin levels (P < 0.05). Metabolic risk factors had significant positive associations with both fasting (r = 0.351 P = 0.000) as well as random insulin levels (r = 0.364 P = 0.000). CONCLUSION This paper provides baseline pioneering information applicable to the Pakistani population. Furthermore, the observations made in this study about differences in association of fasting or random insulin levels with various metabolic risk factors highlight the possibility of using either of them for risk assessment. This finding needs to be assessed in a larger and nationally representative sample.
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Allison MA, Hiatt WR, Hirsch AT, Coll JR, Criqui MH. A high ankle-brachial index is associated with increased cardiovascular disease morbidity and lower quality of life. J Am Coll Cardiol 2008; 51:1292-8. [PMID: 18371562 DOI: 10.1016/j.jacc.2007.11.064] [Citation(s) in RCA: 104] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2007] [Revised: 11/19/2007] [Accepted: 11/27/2007] [Indexed: 10/22/2022]
Abstract
OBJECTIVES The purpose of this study is to determine if an ankle-brachial index (ABI) >or=1.40 is associated with reduced quality of life (QoL). BACKGROUND Ankle-brachial index values >or=1.40 have been associated with some cardiovascular disease (CVD) risk factors and increased mortality, but the relationship to other disease morbidity such as reduced QoL has not been previously evaluated. METHODS The PARTNERS (PAD Awareness, Risk and Treatment: New Resources for Survival) program was a national cross-sectional study of 7,155 patients age >50 years recruited from 350 primary care sites. All sites performed the ABI using a Doppler device and a standardized technique. RESULTS A total of 296 subjects had an ABI >or=1.40 in at least 1 leg, and 4,420 had an ABI between 0.90 and 1.40. Diabetes, male gender, and waist circumference were positively associated with a high ABI, and smoking and dyslipidemia were inversely associated with a high ABI. After adjustment for age, gender, and the traditional CVD risk factors, and accounting for multiple comparisons, the high ABI group had significantly higher odds for foot ulcers (p < 0.005) and borderline associations with heart failure, stroke, and neuropathy. After the same adjustments and adjusting for patients with other CVD, the high ABI group scored 2.0 points lower on the physical component scale on the Medical Outcomes Study Standard Form-36 and 5.5 points lower on the Walking Impairment Questionnaire walking distance domain (p < 0.05 for both). CONCLUSION Individuals with a high ABI have higher odds for foot ulcers and neuropathy, as well as lower scores on some physical functioning QoL domains.
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Affiliation(s)
- Matthew A Allison
- Department of Family and Preventive Medicine, University of California San Diego, California, USA.
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Nigam A, Bourassa MG, Fortier A, Guertin MC, Tardif JC. Fasting but not postprandial (postmeal) glycemia predicts the risk of death in subjects with coronary artery disease. Can J Cardiol 2007; 23:873-8. [PMID: 17876378 PMCID: PMC2651364 DOI: 10.1016/s0828-282x(07)70842-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
BACKGROUND Chronic hyperglycemia plays a role in the pathogenesis of coronary artery disease (CAD); however, the cut-off level beyond which glycemia becomes detrimental is still controversial. Postprandial glycemia may be a stronger CAD risk factor than fasting glycemia in patients without documented heart disease. OBJECTIVES To identify the contributions of fasting and postprandial glycemia to cardiovascular risk in patients with documented coronary artery disease. METHODS The Coronary Artery Surgery Study (CASS) registry is a database of 24,958 patients with suspected or proven CAD who underwent cardiac catheterization between 1974 and 1979. Median long-term follow up was 14.7 years (interquartile range 9.8 to 16.2 years). Clinical outcomes were evaluated according to fasting glucose levels and 2 h postprandial (postmeal) plasma glucose (2hPG) levels. A total of 13,176 patients with baseline fasting glucose levels and 1691 patients with 2hPG levels were identified. RESULTS Impaired fasting glycemia was associated with a 1.2-fold increase in both all-cause and cardiovascular mortality (adjusted hazard ratio 1.23; 95% CI 1.08 to 1.40 for cardiovascular mortality), while undiagnosed diabetes was associated with a 1.5-fold increased risk for the same end points. Postprandial hyperglycemia (2hPG of 7.8 mmol/L to 11.0 mmol/L following an average meal) was not associated with a significant risk of death after adjustment for traditional risk factors or in the presence of fasting glucose of less than 6.1 mmol/L. CONCLUSIONS In CAD patients, impaired fasting glucose is associated with increased all-cause and cardiovascular mortality, whereas postprandial hyperglycemia following an average meal does not appear to be a risk factor.
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Affiliation(s)
- Anil Nigam
- Department of Medicine
- Research Centre, Montreal Heart Institute and Université de Montréal, Montreal, Quebec
| | - Martial G Bourassa
- Department of Medicine
- Research Centre, Montreal Heart Institute and Université de Montréal, Montreal, Quebec
| | - Annik Fortier
- Biostatistics Department
- Research Centre, Montreal Heart Institute and Université de Montréal, Montreal, Quebec
| | - Marie-Claude Guertin
- Biostatistics Department
- Research Centre, Montreal Heart Institute and Université de Montréal, Montreal, Quebec
| | - Jean-Claude Tardif
- Department of Medicine
- Research Centre, Montreal Heart Institute and Université de Montréal, Montreal, Quebec
- Correspondence: Dr Jean-Claude Tardif, Montreal Heart Institute and Université de Montréal, 5000 Belanger Street, Montreal, Quebec H1T 1C8. Telephone 514-376-3330 ext 3564, fax 514-593-1355, e-mail
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Shadoan MK, Kavanagh K, Zhang L, Anthony MS, Wagner JD. Addition of medroxyprogesterone acetate to conjugated equine estrogens results in insulin resistance in adipose tissue. Metabolism 2007; 56:830-7. [PMID: 17512317 DOI: 10.1016/j.metabol.2007.01.014] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2006] [Accepted: 01/08/2007] [Indexed: 11/24/2022]
Abstract
The purpose of this study was to determine if the insulin resistance we have previously reported in surgically postmenopausal primates treated with combined hormone therapy (HT) is due in part to effects on adipose tissue. Eighty-seven ovariectomized monkeys were fed a moderately atherogenic diet (0.28 mg cholesterol per kilocalorie [0.07 mg/kJ]) and randomized to receive no hormones (control, n = 29), estrogen therapy (ET, conjugated equine estrogens, 0.625 mg/d human equivalent; n = 29), or HT (ET + medroxyprogesterone acetate, 2.5 mg/d human equivalent; n = 29) in the diet for 2 years. Fasting glycemic measures were made at baseline and at the end of treatment. Circulating adiponectin measures, insulin tolerance tests, glucose tolerance tests, and isolated adipocyte glucose uptake assays were performed at the end of the trial. Hormone therapy-treated animals were insulin resistant, as determined by greater fasting insulin concentrations (P = .008), greater homeostasis model assessment of insulin resistance (HOMA-R) value (P = .005) and slower glucose disposal after insulin administration (K(ITT); P = .02) when compared with controls. Subcutaneous adipocytes from HT-treated monkeys had a greater ED(50) for insulin (P = .04) and lower maximal glucose uptake per cell (P < .001) compared with controls, suggesting impaired adipocyte insulin sensitivity. Adipocytes were smaller (P = .001) and adiponectin concentrations were greatest in the ET group (P = .02), with no difference between controls and HT-treated monkeys. In conclusion, estrogen therapy resulted in smaller adipocyte size and greater adiponectin concentrations than control or HT. Hormone therapy resulted in impaired insulin sensitivity and adipocyte glucose uptake compared with controls, whereas there was no difference between ET and controls. Because no adverse effects were found with ET alone, it is likely that the progestin, medroxyprogesterone acetate, resulted in the negative effects of the combined HT regimen on whole-body insulin sensitivity, which were mediated, in part, by reductions in adipose tissue responses to insulin.
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Affiliation(s)
- Melanie K Shadoan
- Department of Endocrinology, Lexicon Pharmaceuticals, The Woodlands, TX 77381, USA
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Englert V, Wells K, Long W, Hickey MS, Melby CL. Effect of Acute Prior Exercise on Glycemic and Insulinemic Indices. J Am Coll Nutr 2006; 25:195-202. [PMID: 16766777 DOI: 10.1080/07315724.2006.10719532] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND Acute exercise is associated with increased insulin sensitivity characterized by increased insulin-induced glucose transport for periods of up to 48 h after the bout of exercise. This suggests that the glycemic response to a meal may be altered by prior exercise. OBJECTIVE We tested the hypothesis that the glycemic and insulinemic responses to a test food consumed following exercise would be lower than when consumed without prior exercise. DESIGN Four lean males (age: 27 +/- 4 y) and 4 females (age: 23 +/- 3 y) completed 3 experimental conditions in random order: ExCHO-Subjects exercised on a cycle ergometer at 70% VO2peak with a net energy cost of 400 kcal, which was followed by consumption of a high carbohydrate (CHO) energy bar; NoExCHO-Same as ExCHO except subjects sat quietly rather than exercised; and NoExGlc-Same as NoExCHO except subjects consumed a 50 g glucose (glc) drink as the reference CHO for GI and insulinemic index (II) determination. For each condition, following exercise or rest, baseline venous blood samples were obtained. Postprandial blood samples were obtained at 15 min intervals for 2 h. RESULTS Neither the 2-h glucose area under the curve (AUC) or the GI were different between ExCHO and NoExCHO. The insulin AUC for ExCHO was 28% lower than the insulin AUC for NoExCHO (p = 0.03). The calculated II for the ExCHO condition was 30% lower than that of NoExCHO (p = 0.05). CONCLUSIONS An acute bout of prior exercise had no effect on the GI of an energy bar compared to that of the same food determined under the standard no-exercise conditions. However, prior exercise resulted in a lower 2-h insulin response to the CHO-rich energy bar.
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Affiliation(s)
- Virginia Englert
- Department of Food Science and Human Nutrition, Nutrition and Metabolic Fitness Laboratory, Colorado State University Fort Collins, CO 80523, USA
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de Ugarte MTO, Portal VL, Dias AA, Schaan BD. Metabolic response to oral lipid overload in diabetes and impaired glucose tolerance. Diabetes Res Clin Pract 2005; 69:36-43. [PMID: 15955386 DOI: 10.1016/j.diabres.2004.11.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2004] [Revised: 10/27/2004] [Accepted: 11/15/2004] [Indexed: 11/18/2022]
Abstract
Post-prandial hyperglycemia and hypertriglyceridemia have been related to atherogenesis. The aim of this study was to evaluate the response of plasma lipoproteins to a lipid overload in subjects with diabetes (DM), impaired glucose tolerance (IGT) and normals (N). Seventy-seven subjects were selected, 36-85 years, plasma glucose (G)<140 mg/dl and triglycerides (TG)<150 mg/dl; those without diabetes underwent a glucose tolerance test (GTT), which classified them into three groups: N, 2h G<140 mg/dl, n=37; IGT, 2h G 140-200mg/dl, n=20; and DM, previous diabetes or 2h G>200mg/dl, n=20. They were submitted to a clinical evaluation and an oral lipid overload (1000 kcal, 58% fat). Fasting, 4 and 6-h blood samples after the meal were collected for G, insulinaemia (I), TG, cholesterol and their fractions, and HOMA-IR. Fasting and post-lipid overload lipoproteins were similar between groups, but 6h TG was still high in DM versus IGT and N as compared to their 4h values. There was a positive correlation between fasting TG versus 6h TG (r=0.78, p<0.001). We conclude that individuals with impaired glucose tolerance and with diabetes mellitus have a slower plasma reduction of triglycerides after lipid overload, as well as an altered glucose and post-prandial insulin response.
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Affiliation(s)
- Maria Teresa O de Ugarte
- Serviço de Epidemiologia da Unidade de Pesquisa do Instituto de Cardiologia do RS/FUC (Fundação Universitária de Cardiologia), Av. Princesa Isabel, 370-Santana-Porto Alegre, RS, Brazil
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Stuveling EM, Bakker SJL, Hillege HL, de Jong PE, Gans ROB, de Zeeuw D. Biochemical risk markers: a novel area for better prediction of renal risk? Nephrol Dial Transplant 2005; 20:497-508. [PMID: 15735241 DOI: 10.1093/ndt/gfh680] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Alssema M, Dekker JM, Nijpels G, Stehouwer CDA, Bouter LM, Heine RJ. Proinsulin concentration is an independent predictor of all-cause and cardiovascular mortality: an 11-year follow-up of the Hoorn Study. Diabetes Care 2005; 28:860-5. [PMID: 15793186 DOI: 10.2337/diacare.28.4.860] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE High proinsulin concentration may be a better predictor for cardiovascular disease (CVD) mortality than insulin concentration. Previous observations may have been confounded by glucose tolerance status or lack of precision because of high intraindividual variability. We investigated the longitudinal relation of means of duplicate measurements of insulin and proinsulin with all-cause and CVD mortality in a population-based cohort taking glucose tolerance status into account. RESEARCH DESIGN AND METHODS Fasting and post-75-g glucose-load (2-h) glucose, insulin, and proinsulin values were determined in duplicate on separate days in 277 participants with normal glucose metabolism, 208 participants with impaired glucose metabolism, and 119 newly detected patients with type 2 diabetes of the Hoorn Study. Insulin resistance and beta-cell function were estimated by homeostasis model assessment (HOMA-IR and HOMA-B, respectively), and the fasting proinsulin-to-insulin ratio was calculated. Subjects were followed with respect to mortality until January 2003. RESULTS Fasting proinsulin levels were significantly associated with all-cause and CVD mortality. The hazard ratios (HRs) per increase in interquartile range adjusted for age and sex were 1.21 (95% CI 1.04-1.42) for all-cause mortality and 1.33 (1.06-1.66) for CVD mortality. Adjustment for glucose tolerance status and HOMA-IR did not substantially change the associations. CONCLUSIONS Fasting proinsulin was associated with all-cause and CVD mortality, independent of glucose tolerance status and insulin resistance and largely independent of other CVD risk factors. Proinsulin might play a role in the relationship between insulin resistance and CVD.
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Affiliation(s)
- Marjan Alssema
- Institute for Research in Extramural Medicine, VU University Medical Center, Van der Boechorststraat 7, 1081 BT Amsterdam, the Netherlands.
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Al-Waili NS. Natural Honey Lowers Plasma Glucose, C-Reactive Protein, Homocysteine, and Blood Lipids in Healthy, Diabetic, and Hyperlipidemic Subjects: Comparison with Dextrose and Sucrose. J Med Food 2004; 7:100-7. [PMID: 15117561 DOI: 10.1089/109662004322984789] [Citation(s) in RCA: 123] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
This study included the following experiments: (1) effects of dextrose solution (250 mL of water containing 75 g of dextrose) or honey solution (250 mL of water containing 75 g of natural honey) on plasma glucose level (PGL), plasma insulin, and plasma C-peptide (eight subjects); (2) effects of dextrose, honey, or artificial honey (250 mL of water containing 35 g of dextrose and 40 g of fructose) on cholesterol and triglycerides (TG) (nine subjects); (3) effects of honey solution, administered for 15 days, on PGL, blood lipids, C-reactive protein (CRP), and homocysteine (eight subjects); (4) effects of honey or artificial honey on cholesterol and TG in six patients with hypercholesterolemia and five patients with hypertriglyceridemia; (5) effects of honey for 15 days on blood lipid and CRP in five patients with elevated cholesterol and CRP; (6) effects of 70 g of dextrose or 90 g of honey on PGL in seven patients with type 2 diabetes mellitus; and (7) effects of 30 g of sucrose or 30 g of honey on PGL, plasma insulin, and plasma C-peptide in five diabetic patients. In healthy subjects, dextrose elevated PGL at 1 (53%) and 2 (3%) hours, and decreased PGL after 3 hours (20%). Honey elevated PGL after 1 hour (14%) and decreased it after 3 hours (10%). Elevation of insulin and C-peptide was significantly higher after dextrose than after honey. Dextrose slightly reduced cholesterol and low-density lipoprotein-cholesterol (LDL-C) after 1 hour and significantly after 2 hours, and increased TG after 1, 2, and 3 hours. Artificial honey slightly decreased cholesterol and LDL-C and elevated TG. Honey reduced cholesterol, LDL-C, and TG and slightly elevated high-density lipoprotein-cholesterol (HDL-C). Honey consumed for 15 days decreased cholesterol (7%), LDL-C (1%), TG (2%), CRP (7%), homocysteine (6%), and PGL (6%), and increased HDL-C (2%). In patients with hypertriglyceridemia, artificial honey increased TG, while honey decreased TG. In patients with hyperlipidemia, artificial honey increased LDL-C, while honey decreased LDL-C. Honey decreased cholesterol (8%), LDL-C (11%), and CRP (75%) after 15 days. In diabetic patients, honey compared with dextrose caused a significantly lower rise of PGL. Elevation of PGL was greater after honey than after sucrose at 30 minutes, and was lower after honey than it was after sucrose at 60, 120, and 180 minutes. Honey caused greater elevation of insulin than sucrose did after 30, 120, and 180 minutes. Honey reduces blood lipids, homocysteine, and CRP in normal and hyperlipidemic subjects. Honey compared with dextrose and sucrose caused lower elevation of PGL in diabetics.
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Affiliation(s)
- Noori S Al-Waili
- Dubai Specialized Medical Center and Medical Research Laboratories, Islamic Establishment for Education, Dubai, United Arab Emirates.
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