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Murawska-Ciałowicz E, Kaczmarek A, Kałwa M, Oniszczuk A. Influence of Training and Single Exercise on Leptin Level and Metabolism in Obese Overweight and Normal-Weight Women of Different Age. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12168. [PMID: 36231470 PMCID: PMC9565933 DOI: 10.3390/ijerph191912168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 09/17/2022] [Accepted: 09/19/2022] [Indexed: 06/16/2023]
Abstract
Leptin is one of the important hormones secreted by adipose tissue. It participates in the regulation of energy processes in the body through central and peripheral mechanisms. The aim of this study was to analyse the anthropological and physical performance changes during 9 month training in women of different age and body mass. The additional aim was the analysis of leptin levels in the fasting stage and after a control exercise. Obese (O), overweight (OW), and normal-weight (N) women participated in the study. Additional subgroups of premenopausal (PRE) (<50 years) and postmenopausal (POST) (50+) women were created for leptin level analysis. The main criterion of the division into subgroups was the age of menopause in the population. The control submaximal test and maximal oxygen uptake (VO2max) according to Astrand-Rhyming procedures was performed at baseline and after 3, 6, and 9 months. Before each control test, body weight (BM), body mass index (BMI), percentage of adipose tissue (% FAT), and mass (FAT (kg)) were measured. Moreover, before and after each test, leptin level was measured. After 9 months, there was a significant decrease in BM in the O (p < 0.05) and OW (p < 0.05) groups with no significant changes in the N group. There was a decrease in BMI in both the O (p < 0.05) and the OW (p < 0.05) groups, with no changes in the N group. The % FAT reduction was noted only in the O group (p < 0.05). VO2max increased in each of the measured groups (p < 0.05). The fasting leptin level at 0, 3, 6, and 9 months were the highest in the O group. The fasting leptin level before training was highest in the O group compared to the OW group (p < 0.01) and the N group (p < 0.01). It was also higher in the OW group compared to the N group at baseline (0) (p < 0.01) and after 3 and 6 months (p < 0.01). After 9 months, the leptin concentration decreased by 20.2% in the O group, 40.7% in the OW group, and 33% in the N group. Moreover, the fasting leptin level was higher in the POST subgroup compared to the PRE group in the whole group of women (p < 0.05). After a single exercise, the level of leptin in the whole study group decreased (p < 0.05). This was clearly seen, especially in the POST group. The 9 month training had a reducing effect on the blood leptin concentration in groups O, OW, and N. This may have been a result of weight loss and the percentage of fat in the body, as well as systematically disturbed energy homeostasis.
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Affiliation(s)
- Eugenia Murawska-Ciałowicz
- Physiology and Biochemistry Department, Wroclaw University of Health and Sport Sciences, 51-612 Wroclaw, Poland
| | - Agnieszka Kaczmarek
- Physiology and Biochemistry Department, Wroclaw University of Health and Sport Sciences, 51-612 Wroclaw, Poland
| | - Małgorzata Kałwa
- Sport Didactics Department, Wroclaw University of Health and Sport Sciences, 51-612 Wroclaw, Poland
| | - Anna Oniszczuk
- Physiology and Biochemistry Department, Wroclaw University of Health and Sport Sciences, 51-612 Wroclaw, Poland
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Abdissa D. Purposeful Review to Identify the Benefits, Mechanism of Action and Practical Considerations of Omega-3 Polyunsaturated Fatty Acid Supplementation for the Management of Diabetes Mellitus. NUTRITION AND DIETARY SUPPLEMENTS 2021. [DOI: 10.2147/nds.s298870] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
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Adipokines and Inflammation: Focus on Cardiovascular Diseases. Int J Mol Sci 2020; 21:ijms21207711. [PMID: 33081064 PMCID: PMC7589803 DOI: 10.3390/ijms21207711] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 10/14/2020] [Accepted: 10/16/2020] [Indexed: 02/08/2023] Open
Abstract
It is well established that adipose tissue, apart from its energy storage function, acts as an endocrine organ that produces and secretes a number of bioactive substances, including hormones commonly known as adipokines. Obesity is a major risk factor for the development of cardiovascular diseases, mainly due to a low grade of inflammation and the excessive fat accumulation produced in this state. The adipose tissue dysfunction in obesity leads to an aberrant release of adipokines, some of them with direct cardiovascular and inflammatory regulatory functions. Inflammation is a common link between obesity and cardiovascular diseases, so this review will summarise the role of the main adipokines implicated in the regulation of the inflammatory processes occurring under the scenario of cardiovascular diseases.
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Agostinis-Sobrinho C, Vicente SEDCF, Kievišienė J, Lopes L, Dâmaso AR, Norkiene S, Rosário R, Campos RMDS, Ramirez-Velez R, Mota J, Santos R. High levels of adiponectin attenuate the detrimental association of adiposity with insulin resistance in adolescents. Nutr Metab Cardiovasc Dis 2020; 30:822-828. [PMID: 32278607 DOI: 10.1016/j.numecd.2020.02.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 02/04/2020] [Accepted: 02/15/2020] [Indexed: 12/22/2022]
Abstract
BACKGROUND AND AIM This study aimed to: i) examine the differences in insulin resistance (IR) across adiposity levels; and ii) ascertain whether high levels of adiponectin attenuate the detrimental association of adiposity with IR in adolescents. METHODS AND RESULTS A total of 529 adolescents aged 12-18 years participated in this cross-sectional study (267 girls). Anthropometry and body adiposity parameters [body mass index (BMI), sum of skinfolds, body fat percentage (BF %) by bio-impedance analysis and waist circumference (WC)], were measured according to standardized procedures and categorized into age- and sex-specific quartiles. Socioeconomic status, pubertal stage and lifestyle determinants (Mediterranean diet adherence and cardiorespiratory fitness) were gathered and used as confounders. Serum adiponectin and IR (homeostasis model assessment of insulin resistance [HOMA-IR] estimated from fasting serum insulin and glucose were assessed. Analysis of covariance (ANCOVA) showed that HOMA-IR increased in a linear fashion throughout the quartiles of all adiposity measures (p < 0.001 for all), independently of age, sex, pubertal stage, socioeconomic status, adherence to the Mediterranean diet and cardiorespiratory fitness. Two-way ANCOVA showed that adolescents in the higher quartile of adiposity for BF%, BMI, WC and skinfolds sum (Q4) presented the highest adiponectin levels, and had 0.77 Standard Deviation (SD), 0.8 SD, 0.85 SD and 0.8 SD lower HOMA-IR, respectively (p < 0.01) than their low adiponectin group counterparts, after adjustments for potential confounders. CONCLUSION Higher adiponectin levels may attenuate the detrimental association between adiposity and IR, particularly in subjects with higher adiposity.
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Affiliation(s)
| | | | - Justina Kievišienė
- Faculty of Health Sciences, Klaipeda University, Klaipeda, 92294, Lithuania
| | - Luís Lopes
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Portugal
| | - Ana Raimunda Dâmaso
- Post Graduated Program of Nutrition Paulista Medicine School, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Sigute Norkiene
- Faculty of Health Sciences, Klaipeda University, Klaipeda, 92294, Lithuania
| | - Rafaela Rosário
- Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), School of Nursing, University of Minho, 4710 Braga Portugal
| | - Raquel Munhoz da Silveira Campos
- Department of Physiotherapy, Therapeutic Resources Laboratory, Universidade Federal de São Carlos (UFSCar), São Carlos, SP, 13565-905, Brazil; Department of Biosciences, Universidade Federal de São Paulo (UNIFESP), Campus Baixada Santista - Santos, Brazil
| | - Robinson Ramirez-Velez
- Department of Health Sciences, Public University of Navarra, Pamplona, Navarra, Spain; Navarrabiomed, IdiSNA, Navarra Institute for Health Research, Pamplona, Navarra, Spain
| | - Jorge Mota
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Portugal
| | - Rute Santos
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Portugal
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Castillo‐Armengol J, Fajas L, Lopez‐Mejia IC. Inter-organ communication: a gatekeeper for metabolic health. EMBO Rep 2019; 20:e47903. [PMID: 31423716 PMCID: PMC6726901 DOI: 10.15252/embr.201947903] [Citation(s) in RCA: 67] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 05/21/2019] [Accepted: 05/24/2019] [Indexed: 12/17/2022] Open
Abstract
Multidirectional interactions between metabolic organs in the periphery and the central nervous system have evolved concomitantly with multicellular organisms to maintain whole-body energy homeostasis and ensure the organism's adaptation to external cues. These interactions are altered in pathological conditions such as obesity and type 2 diabetes. Bioactive peptides and proteins, such as hormones and cytokines, produced by both peripheral organs and the central nervous system, are key messengers in this inter-organ communication. Despite the early discovery of the first hormones more than 100 years ago, recent studies taking advantage of novel technologies have shed light on the multiple ways used by cells in the body to communicate and maintain energy balance. This review briefly summarizes well-established concepts and focuses on recent advances describing how specific proteins and peptides mediate the crosstalk between gut, brain, and other peripheral metabolic organs in order to maintain energy homeostasis. Additionally, this review outlines how the improved knowledge about these inter-organ networks is helping us to redefine therapeutic strategies in an effort to promote healthy living and fight metabolic disorders and other diseases.
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Affiliation(s)
| | - Lluis Fajas
- Center for Integrative GenomicsUniversity of LausanneLausanneSwitzerland
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Marinho TDS, Ornellas F, Barbosa-da-Silva S, Mandarim-de-Lacerda CA, Aguila MB. Beneficial effects of intermittent fasting on steatosis and inflammation of the liver in mice fed a high-fat or a high-fructose diet. Nutrition 2019; 65:103-112. [PMID: 31079017 DOI: 10.1016/j.nut.2019.02.020] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Revised: 01/29/2019] [Accepted: 02/23/2019] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Intermittent fasting (IF) is a nutritional intervention with significant metabolic effects on the liver that are not yet fully understood. The aim of this study was to investigate the effects of IF on body mass, lipid profile, glucose metabolism, liver lipogenesis, β-oxidation, and inflammation. METHODS We used cellular and molecular techniques to investigate the effects of IF on 3-mo-old male C57 BL/6 mice that were fed control (10% kcal fat), high-fat (HF; 50% kcal fat), or high-fructose (HFr; 50% kcal fructose) diets for 8 wk. Half of the animals were submitted to IF (1 d fed, 1 d fast) for an additional 4 wk. RESULTS Although food intake on the fed day did not differ between the groups, mice in the HF and HFr groups showed diminished body mass, total cholesterol, and triacylglycerol levels. Also, plasma adiponectin increased in the HFr group and leptin decreased in the HF mice. Oral glucose tolerance test and insulin were ameliorated by IF, regardless of the diet consumed (HF or HFr), and decreased hepatic lipogenesis and increased β-oxidation markers, resulting in a reduction of the hepatic steatosis and inflammation. CONCLUSIONS There were beneficial effects of IF even with the continuity of the obesogenic diet and proinflammatory diet in mice. It is recommended that based on the beneficial effects of IF on glucose and liver metabolism and inflammation that IF be a coadjutant factor in the treatment of hepatic metabolic issues and steatosis.
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Affiliation(s)
- Thatiany de Souza Marinho
- Laboratory of Morphometry, Metabolism, and Cardiovascular Diseases, Biomedical Center, Institute of Biology, The University of the State of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Fernanda Ornellas
- Laboratory of Morphometry, Metabolism, and Cardiovascular Diseases, Biomedical Center, Institute of Biology, The University of the State of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Sandra Barbosa-da-Silva
- Laboratory of Morphometry, Metabolism, and Cardiovascular Diseases, Biomedical Center, Institute of Biology, The University of the State of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Carlos A Mandarim-de-Lacerda
- Laboratory of Morphometry, Metabolism, and Cardiovascular Diseases, Biomedical Center, Institute of Biology, The University of the State of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Marcia Barbosa Aguila
- Laboratory of Morphometry, Metabolism, and Cardiovascular Diseases, Biomedical Center, Institute of Biology, The University of the State of Rio de Janeiro, Rio de Janeiro, Brazil.
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Huang WY, Chang CC, Chen DR, Kor CT, Chen TY, Wu HM. Circulating leptin and adiponectin are associated with insulin resistance in healthy postmenopausal women with hot flashes. PLoS One 2017; 12:e0176430. [PMID: 28448547 PMCID: PMC5407749 DOI: 10.1371/journal.pone.0176430] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Accepted: 04/10/2017] [Indexed: 02/01/2023] Open
Abstract
Introduction Hot flashes have been postulated to be linked to the development of metabolic disorders. This study aimed to evaluate the relationship between hot flashes, adipocyte-derived hormones, and insulin resistance in healthy, non-obese postmenopausal women. Participants and design In this cross-sectional study, a total of 151 women aged 45–60 years were stratified into one of three groups according to hot-flash status over the past three months: never experienced hot flashes (Group N), mild-to-moderate hot flashes (Group M), and severe hot flashes (Group S). Variables measured in this study included clinical parameters, hot flash experience, fasting levels of circulating glucose, lipid profiles, plasma insulin, and adipocyte-derived hormones. Multiple linear regression analysis was used to evaluate the associations of hot flashes with adipocyte-derived hormones, and with insulin resistance. Settings The study was performed in a hospital medical center. Results The mean (standard deviation) of body-mass index was 22.8(2.7) for Group N, 22.6(2.6) for Group M, and 23.5(2.4) for Group S, respectively. Women in Group S displayed statistically significantly higher levels of leptin, fasting glucose, and insulin, and lower levels of adiponectin than those in Groups M and N. Multivariate linear regression analysis revealed that hot-flash severity was significantly associated with higher leptin levels, lower adiponectin levels, and higher leptin-to-adiponectin ratio. Univariate linear regression analysis revealed that hot-flash severity was strongly associated with a higher HOMA-IR index (% difference, 58.03%; 95% confidence interval, 31.00–90.64; p < 0.001). The association between hot flashes and HOMA-IR index was attenuated after adjusting for leptin or adiponectin and was no longer significant after simultaneously adjusting for leptin and adiponectin. Conclusion The present study provides evidence that hot flashes are associated with insulin resistance in postmenopausal women. It further suggests that hot flash association with insulin resistance is dependent on the combination of leptin and adiponectin variables.
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Affiliation(s)
- Wan-Yu Huang
- Institute of Basic Medical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chia-Chu Chang
- Department of Nephrology, Changhua Christian Hospital, Changhua, Taiwan
| | - Dar-Ren Chen
- Comprehensive Breast Cancer Center, Changhua Christian Hospital, Changhua, Taiwan
| | - Chew-Teng Kor
- Internal Medicine Research Center, Changhua Christian Hospital, Changhua, Taiwan
| | - Ting-Yu Chen
- Inflammation Research & Drug Development Center, Changhua Christian Hospital, Changhua, Taiwan
| | - Hung-Ming Wu
- Inflammation Research & Drug Development Center, Changhua Christian Hospital, Changhua, Taiwan
- Department of Neurology, Changhua Christian Hospital, Changhua, Taiwan
- Graduate Institute of Acupuncture Science, China Medical University, Taichung, Taiwan
- * E-mail:
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Derosa G, Maffioli P, Sahebkar A. Improvement of plasma adiponectin, leptin and C-reactive protein concentrations by orlistat: a systematic review and meta-analysis. Br J Clin Pharmacol 2016; 81:819-34. [PMID: 26717446 DOI: 10.1111/bcp.12874] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2015] [Revised: 12/07/2015] [Accepted: 12/14/2015] [Indexed: 12/27/2022] Open
Abstract
AIMS To conduct a systematic review and meta-analysis of relevant randomized clinical trials (RCTs) to ascertain the effect size of orlistat in modulating plasma levels of adipokines, ghrelin and C-reactive protein (CRP). METHODS Medline, SCOPUS, Web of Science and Google Scholar databases were searched. A random-effects model and the generic inverse variance method were used for quantitative data synthesis. Heterogeneity was quantitatively assessed using I(2) index. Sensitivity analyses were conducted using the one-study remove approach. Random-effects meta-regression was performed using unrestricted maximum likelihood method to evaluate the impact of duration of treatment, percentage change in body mass index (BMI) and baseline BMI values as potential confounders of the estimated effect size. RESULTS Meta-analysis suggested a significant increase in plasma levels of adiponectin [weighted mean difference (WMD): 19.18%, 95% confidence interval (CI): 5.80, 32.57, p = 0.005] and significant reductions in plasma levels of leptin (WMD: -13.24%, 95% CI: -20.69, -5.78, p = 0.001) and CRP (WMD: -11.52%, 95% CI: -16.55, -6.49, p < 0.001) following treatment with orlistat. In meta-regression, changes in plasma concentrations of adiponectin, leptin and CRP were associated with duration of treatment, but not with either change in BMI or baseline BMI values. CONCLUSION Orlistat is effective in increasing plasma concentrations of adiponectin and decreasing those of leptin and CRP.
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Affiliation(s)
- Giuseppe Derosa
- Department of Internal Medicine and Therapeutics, University of Pavia and Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy.,Center for the Study of Endocrine-Metabolic Pathophysiology and Clinical Research, University of Pavia, Pavia, Italy.,Molecular Medicine Laboratory, University of Pavia, Pavia, Italy
| | - Pamela Maffioli
- Department of Internal Medicine and Therapeutics, University of Pavia and Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy.,PhD School in Experimental Medicine, University of Pavia, Pavia, Italy
| | - Amirhossein Sahebkar
- Biotechnology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.,Metabolic Research Centre, Royal Perth Hospital, School of Medicine and Pharmacology, University of Western Australia, Perth, Australia
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Chang CC, Wu CL, Su WW, Shih KL, Tarng DC, Chou CT, Chen TY, Kor CT, Wu HM. Interferon gamma-induced protein 10 is associated with insulin resistance and incident diabetes in patients with nonalcoholic fatty liver disease. Sci Rep 2015; 5:10096. [PMID: 25961500 PMCID: PMC4426720 DOI: 10.1038/srep10096] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2014] [Accepted: 03/30/2015] [Indexed: 12/11/2022] Open
Abstract
Nonalcoholic fatty liver disease (NAFLD) is an important risk factor for the development of type 2 diabetes mellitus. Interferon gamma-induced protein 10 (IP-10), a proinflammatory chemokine, plays a crucial role in inflammatory diseases. This cross-sectional pilot study investigated whether circulating IP-10 is associated with the progression of liver disease, and prediabetes in patients with NAFLD. A total of 90 patients with NAFLD alone (n = 48) or NAFLD with incident diabetes (n = 42) and 43 controls participated in this study. Fasting plasma was used to assess metabolic parameters, inflammatory factors, endotoxin levels, and malondialdehyde (MDA) concentrations. Insulin resistance was estimated using homeostatic model assessment (HOMA-IR). IP-10 levels were significantly higher in patients with NAFLD alone (median (interquartile range): 369.44 (309.30-418.97) pg/mL) and in those with incident diabetes (418.99 (330.73-526.04) pg/mL) than in controls (293.37 (214.10-331.57) pg/mL) (P < 0.001). IP-10 levels were positively correlated with levels of alanine aminotransferase, hs-CRP, MDA, MCP-1, and TNF-α as well as HOMA-IR values. Ordinal logistic regression analysis revealed IP-10 was an independent risk factor associated with progressive liver injury, insulin resistance and incident diabetes. Circulating IP-10 may be a non-invasive biomarker for disease progression and subsequent diabetes development of NAFLD.
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Affiliation(s)
- Chia-Chu Chang
- 1] Division of Nephrology, Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan [2] School of Medicine, Chung-Shan Medical University, Taichung, Taiwan
| | - Chia-Lin Wu
- 1] Division of Nephrology, Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan [2] School of Medicine, Chung-Shan Medical University, Taichung, Taiwan [3] Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Wei-Wen Su
- Department of Gastroenterology, Changhua Christian Hospital, Changhua, Taiwan
| | - Kai-Lun Shih
- Department of Gastroenterology, Changhua Christian Hospital, Changhua, Taiwan
| | - Der-Cherng Tarng
- 1] Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan [2] Division of Nephrology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan [3] Department and Institute of Physiology, National Yang-Ming University, Taipei, Taiwan
| | - Chen-Te Chou
- Department of Medical Imaging, Changhua Christian Hospital, Changhua, Taiwan
| | - Ting-Yu Chen
- Inflammation Research &Drug Development Center, Changhua Christian Hospital, Changhua, Taiwan
| | - Chew-Teng Kor
- Internal Medicine Research Center, Changhua Christian Hospital, Changhua, Taiwan
| | - Hung-Ming Wu
- 1] Inflammation Research &Drug Development Center, Changhua Christian Hospital, Changhua, Taiwan [2] Graduate Institute of Acupuncture Science, China Medical University, Taichung, Taiwan [3] Department of Neurology, Changhua Christian Hospital, Changhua, Taiwan
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van Niekerk G, Engelbrecht AM. On the evolutionary origin of the adaptive immune system—The adipocyte hypothesis. Immunol Lett 2015; 164:81-7. [DOI: 10.1016/j.imlet.2015.02.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Revised: 02/03/2015] [Accepted: 02/09/2015] [Indexed: 12/18/2022]
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Mansur RB, Brietzke E, McIntyre RS. Is there a "metabolic-mood syndrome"? A review of the relationship between obesity and mood disorders. Neurosci Biobehav Rev 2015; 52:89-104. [PMID: 25579847 DOI: 10.1016/j.neubiorev.2014.12.017] [Citation(s) in RCA: 193] [Impact Index Per Article: 21.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2014] [Revised: 12/19/2014] [Accepted: 12/31/2014] [Indexed: 12/12/2022]
Abstract
Obesity and mood disorders are highly prevalent and co-morbid. Epidemiological studies have highlighted the public health relevance of this association, insofar as both conditions and its co-occurrence are associated with a staggering illness-associated burden. Accumulating evidence indicates that obesity and mood disorders are intrinsically linked and share a series of clinical, neurobiological, genetic and environmental factors. The relationship of these conditions has been described as convergent and bidirectional; and some authors have attempted to describe a specific subtype of mood disorders characterized by a higher incidence of obesity and metabolic problems. However, the nature of this association remains poorly understood. There are significant inconsistencies in the studies evaluating metabolic and mood disorders; and, as a result, several questions persist about the validity and the generalizability of the findings. An important limitation in this area of research is the noteworthy phenotypic and pathophysiological heterogeneity of metabolic and mood disorders. Although clinically useful, categorical classifications in both conditions have limited heuristic value and its use hinders a more comprehensive understanding of the association between metabolic and mood disorders. A recent trend in psychiatry is to move toward a domain specific approach, wherein psychopathology constructs are agnostic to DSM-defined diagnostic categories and, instead, there is an effort to categorize domains based on pathogenic substrates, as proposed by the National Institute of Mental Health (NIMH) Research Domain Criteria Project (RDoC). Moreover, the substrates subserving psychopathology seems to be unspecific and extend into other medical illnesses that share in common brain consequences, which includes metabolic disorders. Overall, accumulating evidence indicates that there is a consistent association of multiple abnormalities in neuropsychological constructs, as well as correspondent brain abnormalities, with broad-based metabolic dysfunction, suggesting, therefore, that the existence of a "metabolic-mood syndrome" is possible. Nonetheless, empirical evidence is necessary to support and develop this concept. Future research should focus on dimensional constructs and employ integrative, multidisciplinary and multimodal approaches.
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Affiliation(s)
- Rodrigo B Mansur
- Mood Disorders Psychopharmacology Unit (MDPU), University Health Network, University of Toronto, Toronto, Canada; Interdisciplinary Laboratory of Clinical Neuroscience (LINC), Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil.
| | - Elisa Brietzke
- Interdisciplinary Laboratory of Clinical Neuroscience (LINC), Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
| | - Roger S McIntyre
- Mood Disorders Psychopharmacology Unit (MDPU), University Health Network, University of Toronto, Toronto, Canada
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Zanatta LCB, Boguszewski CL, Borba VZC, Kulak CAM. Osteocalcin, energy and glucose metabolism. ACTA ACUST UNITED AC 2014; 58:444-51. [DOI: 10.1590/0004-2730000003333] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2014] [Accepted: 05/15/2014] [Indexed: 01/16/2023]
Abstract
Osteocalcin is a bone matrix protein that has been associated with several hormonal actions on energy and glucose metabolism. Animal and experimental models have shown that osteocalcin is released into the bloodstream and exerts biological effects on pancreatic beta cells and adipose tissue. Undercarboxylated osteocalcin is the hormonally active isoform and stimulates insulin secretion and enhances insulin sensitivity in adipose tissue and muscle. Insulin and leptin, in turn, act on bone tissue, modulating the osteocalcin secretion, in a traditional feedback mechanism that places the skeleton as a true endocrine organ. Further studies are required to elucidate the role of osteocalcin in the regulation of glucose and energy metabolism in humans and its potential therapeutic implications in diabetes, obesity and metabolic syndrome.
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Derosa G, Limas CP, Macías PC, Estrella A, Maffioli P. Dietary and nutraceutical approach to type 2 diabetes. Arch Med Sci 2014; 10:336-44. [PMID: 24904670 PMCID: PMC4042055 DOI: 10.5114/aoms.2014.42587] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2012] [Revised: 11/13/2012] [Accepted: 01/31/2013] [Indexed: 01/11/2023] Open
Abstract
Nutritional medical treatment is the first step to achieve adequate glycemic control and prevent diabetic complications. Lifestyle changes include moderate weight loss (7%) and regular physical activity (150 min/week). The appropriate diet composition is < 30% total fat, < 10% saturated fats, > 15 g/1000 kcal fiber, half soluble, 45-60% of carbohydrates with amoderate intake of sugar (50 g/day) and protein intake of 15-20% of the total calories a day. Patients need to limit the intake of saturated fats to < 7% of the daily calorie intake. Monounsaturated fatty acids such as olive oil and other vegetable oils are recommended. L-carnitine, α-lipoic acid, berberine and ω-3 fatty acids can be useful supplements.
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Affiliation(s)
- Giuseppe Derosa
- Department of Internal Medicine and Therapeutics, University of Pavia and Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy
- Center for the Study of Endocrine-Metabolic Pathophysiology and Clinical Research, University of Pavia, Pavia, Italy
| | - Celina Preciado Limas
- Cardiology Department of the School of Medicine, Universidad Autonoma de Guadalajara, Jalisco, México
| | - Pilar Ceballos Macías
- Cardiology Department of the School of Medicine, Universidad Autonoma de Guadalajara, Jalisco, México
| | - Aceves Estrella
- Cardiology Department of the School of Medicine, Universidad Autonoma de Guadalajara, Jalisco, México
| | - Pamela Maffioli
- Department of Internal Medicine and Therapeutics, University of Pavia and Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy
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Abstract
Obesity currently affects about one-third of the U.S. population, while another one-third is overweight. The importance of obesity for certain conditions such as heart disease and type 2 diabetes is well appreciated. The effects of obesity on the respiratory system have received less attention and are the subject of this article. Obesity alters the static mechanical properties of the respiratory system leading to a reduction in the functional residual capacity (FRC) and the expiratory reserve volume (ERV). There is substantial variability in the effects of obesity on FRC and ERV, at least some of which is related to the location rather than the total mass of adipose tissue. Obesity also results in airflow obstruction, which is only partially attributable to breathing at low lung volume, and can also promote airway hyperresponsiveness and asthma. Hypoxemia is common is obesity and correlates well with FRC, as well as with measures of abdominal obesity. However, obese subjects are usually eucapnic, indicating that hypoventilation is not a common cause of their hypoxemia. Instead, hypoxemia results from ventilation-perfusion mismatch caused by closure of dependent airways at FRC. Many obese subjects complain of dyspnea either at rest or during exertion, and the dyspnea score also correlates with reductions in FRC and ERV. Weight reduction should be encouraged in any symptomatic obese individual, since virtually all of the respiratory complications of obesity improve with even moderate weight loss.
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Derosa G, Cicero AFG, Carbone A, Querci F, Fogari E, D'Angelo A, Maffioli P. Different aspects of sartan + calcium antagonist association compared to the single therapy on inflammation and metabolic parameters in hypertensive patients. Inflammation 2013; 37:154-62. [PMID: 24018781 DOI: 10.1007/s10753-013-9724-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
This study aims to evaluate the effects of an angiotensin receptor blocker (ARB)/calcium channel blocker combination on blood pressure control, lipid profile, insulin sensitivity, and inflammation markers. We randomized 276 hypertensive patients to olmesartan 20 mg, amlodipine 10 mg, or a single pill containing an olmesartan/amlodipine combination 20/5 mg for 12 months. We evaluated the following: body weight, systolic and diastolic blood pressure, fasting plasma glucose, fasting plasma insulin (FPI), M value, lipid profile, adiponectin (ADN), high sensitivity C-reactive protein (Hs-CRP), monocyte chemoattractant protein-1 (MCP-1), and macrophage migration inhibitory factor-1β (MIP-1β). Olmesartan/amlodipine combination better reduced blood pressure, FPI, homeostasis model assessment index, and increased M value and ADN compared to olmesartan and amlodipine monotherapies. Olmesartan/amlodipine significantly decreased Hs-CRP, MCP-1, and MIP-1β. In this multicenter, randomized, double-blind, clinical study, ARB/calcium antagonist combination resulted to be more effective than single monotherapies in reducing blood pressure, in improving insulin sensitivity, and in reducing inflammation parameters in patients with stage I essential hypertension.
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Affiliation(s)
- Giuseppe Derosa
- Department of Internal Medicine and Therapeutics, University of Pavia, Fondazione IRCCS Policlinico S. Matteo, P.le C. Golgi 2, 27100, Pavia, Italy,
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Derosa G, Franzetti IG, Querci F, Carbone A, Ciccarelli L, Piccinni MN, Fogari E, Maffioli P. Variation in Inflammatory Markers and Glycemic Parameters After 12 Months of Exenatide Plus Metformin Treatment Compared with Metformin Alone: A Randomized Placebo-Controlled Trial. Pharmacotherapy 2013; 33:817-26. [DOI: 10.1002/phar.1301] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Affiliation(s)
- Giuseppe Derosa
- Department of Internal Medicine and Therapeutics; University of Pavia; Pavia Italy
- Center for the Study of Endocrine-Metabolic Pathophysiology and Clinical Research; University of Pavia; Pavia Italy
| | | | | | | | | | | | - Elena Fogari
- Department of Internal Medicine and Therapeutics; University of Pavia; Pavia Italy
| | - Pamela Maffioli
- Department of Internal Medicine and Therapeutics; University of Pavia; Pavia Italy
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Derosa G, Fogari E, D’Angelo A, Bianchi L, Bonaventura A, Romano D, Maffioli P. Adipocytokine Levels in Obese and Non-obese Subjects: an Observational Study. Inflammation 2013; 36:914-20. [DOI: 10.1007/s10753-013-9620-4] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Derosa G, Cicero AFG, Carbone A, Querci F, Fogari E, D’Angelo A, Maffioli P. Retracted
: Effects of an olmesartan/amlodipine fixed dose on blood pressure control, some adipocytokines and interleukins levels compared with olmesartan or amlodipine monotherapies. J Clin Pharm Ther 2012; 38:48-55. [DOI: 10.1111/jcpt.12021] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Derosa G, Franzetti IG, Querci F, Carbone A, Ciccarelli L, Piccinni MN, Fogari E, Maffioli P. Exenatide plus metformin compared with metformin alone on β-cell function in patients with Type 2 diabetes. Diabet Med 2012; 29:1515-23. [PMID: 22540883 DOI: 10.1111/j.1464-5491.2012.03699.x] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
AIM To quantify how much exenatide added to metformin improves β-cell function, and to evaluate the impact on glycaemic control, insulin resistance and inflammation compared with metformin alone. METHODS A total of 174 patients with Type 2 diabetes with poor glycaemic control were instructed to take metformin for 8 ± 2 months, then they were randomly assigned to exenatide (5 μg twice a day for the first 4 weeks and forced titration to 10 μg twice a day thereafter) or placebo for 12 months. At 12 months we evaluated anthropometric measurements, glycaemic control, insulin resistance and β-cell function variables, glucagon, adiponectin, high sensitivity-C reactive protein and tumour necrosis factor-α. Before and after 12 months, patients underwent a combined euglycaemic hyperinsulinaemic and hyperglycaemic clamp, with subsequent arginine stimulation. RESULTS Exenatide + metformin gave a greater decrease in body weight, glycaemic control, fasting plasma proinsulin and insulin and their ratio, homeostasis model assessment for insulin resistance (HOMA-IR), and glucagon values and a greater increase in C-peptide levels, homeostasis model assessment β-cell function index (HOMA-β) and adiponectin compared with placebo + metformin. Exenatide + metformin decreased waist and hip circumference, and reduced concentrations of high sensitivity-C reactive protein and tumour necrosis factor-α. Exenatide + metformin gave a greater increase in M value (+34%), and disposition index (+55%) compared with placebo + metformin; first (+21%) and second phase (+34%) C-peptide response to glucose and C-peptide response to arginine (+25%) were also improved by exenatide + metformin treatment, but not by placebo + metformin. CONCLUSION Exenatide is effective not only on glycaemic control, but also in protecting β-cells and in reducing inflammation.
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Affiliation(s)
- G Derosa
- Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy.
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Derosa G, Ragonesi PD, Carbone A, Fogari E, D'Angelo A, Cicero AFG, Maffioli P. Vildagliptin action on some adipocytokine levels in type 2 diabetic patients: a 12-month, placebo-controlled study. Expert Opin Pharmacother 2012; 13:2581-91. [DOI: 10.1517/14656566.2012.734499] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Derosa G, Carbone A, Franzetti I, Querci F, Fogari E, Bianchi L, Bonaventura A, Romano D, Cicero AFG, Maffioli P. Effects of a combination of sitagliptin plus metformin vs metformin monotherapy on glycemic control, β-cell function and insulin resistance in type 2 diabetic patients. Diabetes Res Clin Pract 2012; 98:51-60. [PMID: 22682949 DOI: 10.1016/j.diabres.2012.05.022] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2012] [Revised: 05/09/2012] [Accepted: 05/21/2012] [Indexed: 11/16/2022]
Abstract
AIMS To evaluate the impact on glycemic control, insulin resistance, and insulin secretion of sitagliptin+metformin compared to metformin in type 2 diabetic patients. METHODS Patients were instructed to take metformin for 8 ± 2 months, then they were randomly assigned to sitaglipin 100 mg or placebo for 12 months. We evaluated at 3, 6, 9, and 12 months: body mass index (BMI), glycemic control, fasting plasma insulin (FPI), HOMA-IR, HOMA-β, fasting plasma proinsulin (FPPr), proinsulin/fasting plasma insulin ratio (Pr/FPI ratio), C-peptide, glucagon, adiponectin (ADN), and high sensitivity-C reactive protein (Hs-CRP). Before, and after 12 months since the addition of sitagliptin, patients underwent a combined euglycemic hyperinsulinemic and hyperglycemic clamp, with subsequent arginine stimulation. RESULTS Both treatments similarly decreased body weight, and BMI; on the other hand, they both improved glycemic control, glucagon and HOMA-IR, but sitagliptin+metformin were more effective in reducing these parameters. Sitagliptin+metformin, but not placebo+metformin, decreased FPPr, FPPR/FPI ratio, and increased C-peptide values, even if no differences between the groups were recorded. Sitaglitin+metformin gave also a greater increase of HOMA-β, M value, C-peptide response to arginine and disposition index compared to placebo+metformin group. CONCLUSIONS Other than improving glycemic control, sitagliptin+metformin also improved β-cell function better than metformin alone.
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Affiliation(s)
- Giuseppe Derosa
- Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy.
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Derosa G, Putignano P, Bossi AC, Bonaventura A, Querci F, Franzetti IG, Guazzini B, Testori G, Fogari E, Maffioli P. Exenatide or glimepiride added to metformin on metabolic control and on insulin resistance in type 2 diabetic patients. Eur J Pharmacol 2011; 666:251-6. [DOI: 10.1016/j.ejphar.2011.05.051] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2011] [Revised: 05/03/2011] [Accepted: 05/17/2011] [Indexed: 11/28/2022]
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Derosa G, Maffioli P, D'Angelo A, Fogari E, Bianchi L, Cicero AFG. RETRACTED: Acarbose on insulin resistance after an oral fat load: a double-blind, placebo controlled study. J Diabetes Complications 2011; 25:258-66. [PMID: 21367625 DOI: 10.1016/j.jdiacomp.2011.01.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2010] [Revised: 12/07/2010] [Accepted: 01/18/2011] [Indexed: 10/18/2022]
Abstract
AIM We evaluated the effects of acarbose on insulin resistance parameters in diabetic patients before and after a standardized oral fat load (OFL). MATERIALS AND METHODS Patients were assigned to take acarbose 50 mg three times a day or placebo; after the first month, acarbose was titrated to 100 mg three times a day. We evaluated body mass index, glycemic control, fasting plasma insulin (FPI), post-prandial plasma insulin (PPI), homeostasis model assessment insulin resistance index (HOMA-IR), blood pressure, lipid profile, retinol binding protein-4 (RBP-4), adiponectin (ADN), tumor necrosis factor-α and resistin (r). Furthermore, at the baseline and at the end of the study, all patients underwent an OFL and an euglycemic hyperinsulinemic clamp. RESULTS We observed that acarbose was better than placebo in improving glycemic control and HOMA-IR and that it was also more effective in improving lipid profile, RBP-4 and ADN. Regarding FPI, PPI and r, we did not obtain any significant differences between the two groups. During the second OFL, performed after 7 months of therapy with acarbose, we observed a significant decrease of blood glucose, lipid profile and all insulin resistance parameters peaks compared with the OFL administered at baseline with acarbose, but not with placebo. CONCLUSION Acarbose was more effective than placebo in improving glycemic and lipid profile and in reducing the post-OFL peaks of the various parameters including the insulin resistance biomarkers.
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Affiliation(s)
- Giuseppe Derosa
- Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, PAVIA, Italy.
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Derosa G, Cicero AF, Fogari E, D'Angelo A, Bonaventura A, Maffioli P. Effects of n-3 PUFA on insulin resistance after an oral fat load. EUR J LIPID SCI TECH 2011. [DOI: 10.1002/ejlt.201000504] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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Cancer risk in type 2 diabetes mellitus: metabolic links and therapeutic considerations. J Nutr Metab 2011; 2011:708183. [PMID: 21773024 PMCID: PMC3136221 DOI: 10.1155/2011/708183] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2010] [Revised: 02/10/2011] [Accepted: 03/24/2011] [Indexed: 12/14/2022] Open
Abstract
Type 2 diabetes mellitus (DM2) is increasing in incidence, creating worldwide public health concerns and impacting morbidity and mortality rates. An increasing number of studies have demonstrated shared associations between DM2 and malignancy, including key clinical, biochemical, and metabolic commonalities. This paper will attempt to explore the relationship between the various types of cancer and diabetes, the common metabolic pathways underlying cancer development, and the potential impact of various antidiabetes therapies on cancer risk.
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Derosa G, Maffioli P, Salvadeo SAT, Ferrari I, Gravina A, Mereu R, D'Angelo A, Palumbo I, Randazzo S, Cicero AFG. Effects of combination of sibutramine and L-carnitine compared with sibutramine monotherapy on inflammatory parameters in diabetic patients. Metabolism 2011; 60:421-9. [PMID: 20423740 DOI: 10.1016/j.metabol.2010.03.010] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2010] [Revised: 03/14/2010] [Accepted: 03/17/2010] [Indexed: 10/19/2022]
Abstract
The aim of the study was to evaluate the effects of 12-month treatment with sibutramine plus L-carnitine compared with sibutramine alone on body weight, glycemic control, insulin resistance, and inflammatory state in type 2 diabetes mellitus patients. Two hundred fifty-four patients with uncontrolled type 2 diabetes mellitus (glycated hemoglobin [HbA(1c)] >8.0%) in therapy with different oral hypoglycemic agents or insulin were enrolled in this study and randomized to take sibutramine 10 mg plus L-carnitine 2 g or sibutramine 10 mg in monotherapy. We evaluated at baseline and after 3, 6, 9, and 12 months these parameters: body weight, body mass index, HbA(1c), fasting plasma glucose, postprandial plasma glucose, fasting plasma insulin, homeostasis model assessment of insulin resistance index, total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglycerides, leptin, tumor necrosis factor-α, adiponectin, vaspin, and high-sensitivity C-reactive protein. Sibutramine plus L-carnitine gave a faster improvement of fasting plasma glucose, postprandial plasma glucose, lipid profile, leptin, tumor necrosis factor-α, and high-sensitivity C-reactive protein compared with sibutramine alone. Furthermore, there was a better improvement of body weight, HbA(1c), fasting plasma insulin, homeostasis model assessment of insulin resistance index, vaspin, and adiponectin with sibutramine plus L-carnitine compared with sibutramine alone. Sibutramine plus L-carnitine gave a better and faster improvement of all the analyzed parameters compared with sibutramine alone without giving any severe adverse effect.
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Affiliation(s)
- Giuseppe Derosa
- Department of Internal Medicine and Therapeutics, University of Pavia, 27100 Pavia, Italy.
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Different actions of losartan and ramipril on adipose tissue activity and vascular remodeling biomarkers in hypertensive patients. Hypertens Res 2010; 34:145-51. [DOI: 10.1038/hr.2010.205] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Derosa G, Maffioli P, Ferrari I, D'Angelo A, Fogari E, Palumbo I, Randazzo S, Cicero AFG. Comparison between orlistat plus l-carnitine and orlistat alone on inflammation parameters in obese diabetic patients. Fundam Clin Pharmacol 2010; 25:642-51. [PMID: 21077943 DOI: 10.1111/j.1472-8206.2010.00888.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
To evaluate the effects of 1-year treatment with orlistat plus L-carnitine compared to orlistat alone on body weight, glycemic and lipid control, and inflammatory parameters in obese type 2 diabetic patients. Two hundred and fifty-eight patients with uncontrolled type 2 diabetes mellitus (T2DM) [glycated hemoglobin (HbA(1c)) > 8.0%] in therapy with different oral hypoglycemic agents or insulin were enrolled in this study and randomized to take orlistat 120 mg three times a day plus L-carnitine 2 g one time a day or orlistat 120 mg three times a day. We evaluated the following parameters at baseline and after 3, 6, 9, and 12 months: body weight, body mass index (BMI), glycated hemoglobin (HbA(1c) ), fasting plasma glucose (FPG), postprandial plasma glucose (PPG), fasting plasma insulin (FPI), homeostasis model assessment insulin resistance index (HOMA-IR), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides (Tg), adiponectin (ADN), leptin, tumor necrosis factor-α (TNF-α), vaspin, and high-sensitivity C-reactive protein (Hs-CRP). We observed a better decrease in body weight, glycemic profile, HOMA-IR, LDL-C, and ADN and a faster improvement in FPI, TC, Tg, leptin, TNF-α, Hs-CRP with orlistat plus L-carnitine compared to orlistat alone. We also recorded an improvement in vaspin with orlistat plus l-carnitine not reached with orlistat alone. Orlistat plus L-carnitine gave a better improvement in body weight, glycemic and lipid profile compared to orlistat alone; furthermore, a faster and better improvement in inflammatory parameters was observed with orlistat plus L-carnitine compared to orlistat alone.
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Affiliation(s)
- Giuseppe Derosa
- Fondazione IRCCS Policlinico S. Matteo, Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, P.le C. Golgi, 2-27100 Pavia, Italy.
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Derosa G, Maffioli P, Ferrari I, Palumbo I, Randazzo S, D’Angelo A, Cicero AFG. Variation of inflammatory parameters after sibutramine treatment compared to placebo in type 2 diabetic patients. J Clin Pharm Ther 2010; 36:592-601. [DOI: 10.1111/j.1365-2710.2010.01217.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Derosa G, Maffioli P, Salvadeo SAT, Ferrari I, Gravina A, Mereu R, D'Angelo A, Fogari E, Palumbo I, Randazzo S, Cicero AFG. Comparison of orlistat treatment and placebo in obese type 2 diabetic patients. Expert Opin Pharmacother 2010; 11:1971-82. [DOI: 10.1517/14656566.2010.493557] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Abstract
In the current literature there are different opinions about the use of thiazolidinediones or sulfonylureas. Some authors have reported that thiazolidinediones increase total body glucose disposal and reduce hepatic glucose production, reducing both peripheral and hepatic insulin resistance (or enhances both peripheral and insulin sensitivity). They consider thiazolidinediones a better drug compared to sulfonylureas because they do not induce hypoglycemia and they provide a protection for the pancreatic beta-cell. On the other side, some authors have reported that the improved glycemic control obtained with thiazolidinedione use is associated with an increase in body weight and a worsening of lipid profile, and they also warn providers to consider the potential for serious adverse cardiovascular effects of the treatment with rosiglitazone for type 2 diabetes mellitus, negating some of the benefits of the improved metabolic control. They have also reported that sulfonylureas are safer compared to thiazolidinediones because they give a better and faster improvement of glycated hemoglobin without giving the adverse effects reported with the use of thiazolidinediones. Considering the emerging discrepancies from these studies we decided to undertake a thorough literature search on Medline and Embase to evaluate the effects of thiazolidinediones and sulfonylureas in people with diabetes. In particular, this review examines the effects and the rationale and practicalities for the use of sulfonylureas or thiazolidinediones, alone and in combination therapy with other antidiabetes drugs, to treat type 2 diabetes mellitus considering, as primary end points, glycated hemoglobin, fasting plasma glucose, fasting plasma insulin, homeostasis model assessment indices, body weight, body mass index, blood pressure, and, when available, data on lipid profile. We also evaluated the effects of these two drugs on beta-cell function, insulin resistance, and inflammatory markers, also recording the frequency of adverse events such as edema and heart failure.
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Affiliation(s)
- Giuseppe Derosa
- Department of Internal Medicine and Therapeutics, University of Pavia, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy.
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Derosa G, Maffioli P, Salvadeo SAT, Ferrari I, Ragonesi PD, Querci F, Franzetti IG, Gadaleta G, Ciccarelli L, Piccinni MN, D'Angelo A, Cicero AFG. Effects of sitagliptin or metformin added to pioglitazone monotherapy in poorly controlled type 2 diabetes mellitus patients. Metabolism 2010; 59:887-95. [PMID: 20015525 DOI: 10.1016/j.metabol.2009.10.007] [Citation(s) in RCA: 93] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2009] [Revised: 10/03/2009] [Accepted: 10/13/2009] [Indexed: 12/15/2022]
Abstract
The aim of the study was to compare the effects of the addition of sitagliptin or metformin to pioglitazone monotherapy in poorly controlled type 2 diabetes mellitus patients on body weight, glycemic control, beta-cell function, insulin resistance, and inflammatory state parameters. One hundred fifty-one patients with uncontrolled type 2 diabetes mellitus (glycated hemoglobin [HbA(1c)] >7.5%) in therapy with pioglitazone 30 mg/d were enrolled in this study. We randomized patients to take pioglitazone 30 mg plus sitagliptin 100 mg once a day, or pioglitazone 15 mg plus metformin 850 mg twice a day. We evaluated at baseline and after 3, 6, 9, and 12 months these parameters: body weight, body mass index, HbA(1c), fasting plasma glucose (FPG), postprandial plasma glucose (PPG), fasting plasma insulin (FPI), homeostasis model assessment insulin resistance index (HOMA-IR), homeostasis model assessment beta-cell function index, fasting plasma proinsulin (Pr), Pr/FPI ratio, adiponectin, resistin (R), tumor necrosis factor-alpha (TNF-alpha), and high-sensitivity C-reactive protein. A decrease of body weight and body mass index was observed with metformin, but not with sitagliptin, at the end of the study. We observed a comparable significant decrease of HbA(1c), FPG, and PPG and a significant increase of homeostasis model assessment beta-cell function index compared with baseline in both groups without any significant differences between the 2 groups. Fasting plasma insulin, fasting plasma Pr, Pr/FPI ratio, and HOMA-IR values were decreased in both groups even if the values obtained with metformin were significantly lower than the values obtained with sitagliptin. There were no significant variations of ADN, R, or TNF-alpha with sitagliptin, whereas a significant increase of ADN and a significant decrease of R and TNF-alpha values were recorded with metformin. A significant decrease of high-sensitivity C-reactive protein value was obtained in both groups without any significant differences between the 2 groups. There was a significant correlation between HOMA-IR decrease and ADN increase, and between HOMA-IR decrease and R and TNF-alpha decrease in pioglitazone plus metformin group after the treatment. The addition of both sitagliptin or metformin to pioglitazone gave an improvement of HbA(1c), FPG, and PPG; but metformin led also to a decrease of body weight and to a faster and better improvement of insulin resistance and inflammatory state parameters, even if sitagliptin produced a better protection of beta-cell function.
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Affiliation(s)
- Giuseppe Derosa
- Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy.
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Derosa G, Maffioli P, Salvadeo SAT, Ferrari I, Gravina A, Mereu R, Palumbo I, Fogari E, D'Angelo A, Cicero AFG. Differential effects of candesartan and olmesartan on adipose tissue activity biomarkers in type II diabetic hypertensive patients. Hypertens Res 2010; 33:790-5. [DOI: 10.1038/hr.2010.85] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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Abstract
Epidemiological data indicate that obesity is a risk factor for asthma, but the mechanistic basis for this relationship is not established. Here we review data from human subjects and animal models investigating the relationship between obesity and airway hyperresponsiveness, a characteristic feature of asthma. We discuss obesity as a state of chronic systemic inflammation resulting from interactions between adipocytes and adipose tissue macrophages that are recruited to obese adipose tissue. Finally, we focus on the possibility that aspects of this inflammation, particularly obesity-related changes in TNF-alpha, leptin, and adiponectin, may contribute to airway hyperresponsiveness in obesity. Determining how obesity promotes asthma may uncover novel therapeutic strategies that are effective in the obese asthmatic subject.
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Affiliation(s)
- Stephanie A Shore
- Department of Environmental Health, Harvard School of Public Health, 665 Huntington Ave., Boston, MA 02115, USA.
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Abstract
Epidemiological data indicate that obesity is a risk factor for asthma, but the mechanistic basis for this relationship is not established. Here we review data from human subjects and animal models investigating the relationship between obesity and airway hyperresponsiveness, a characteristic feature of asthma. We discuss obesity as a state of chronic systemic inflammation resulting from interactions between adipocytes and adipose tissue macrophages that are recruited to obese adipose tissue. Finally, we focus on the possibility that aspects of this inflammation, particularly obesity-related changes in TNF-alpha, leptin, and adiponectin, may contribute to airway hyperresponsiveness in obesity. Determining how obesity promotes asthma may uncover novel therapeutic strategies that are effective in the obese asthmatic subject.
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Affiliation(s)
- Stephanie A Shore
- Program in Molecular and Integrative Physiological Sciences, Harvard School of Public Health, 665 Huntington Ave., Boston, MA 02115, USA.
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Derosa G, Salvadeo SA, D'Angelo A, Fogari E, Ragonesi PD, Ciccarelli L, Piccinni MN, Ferrari I, Gravina A, Maffioli P, Cicero AF. Rosiglitazone Therapy Improves Insulin Resistance Parameters in Overweight and Obese Diabetic Patients Intolerant To Metformin. Arch Med Res 2008; 39:412-9. [DOI: 10.1016/j.arcmed.2007.12.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2007] [Accepted: 12/18/2007] [Indexed: 10/22/2022]
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Torsello A, Brambilla F, Tamiazzo L, Bulgarelli I, Rapetti D, Bresciani E, Locatelli V. Central dysregulations in the control of energy homeostasis and endocrine alterations in anorexia and bulimia nervosa. J Endocrinol Invest 2007; 30:962-76. [PMID: 18250619 DOI: 10.1007/bf03349245] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
In the last decades we have come to understand that the hypothalamus is a key region in controlling energy homeostasis. A number of control models have been proposed to explain the regulation of feeding behavior in physiological and pathological conditions, but all those based on imbalances of single factors fail to explain the disrupted regulation of energy supply in eating disorders such as anorexia nervosa and bulimia nervosa, as well as other psychiatric disorders. A growing amount of evidence demonstrates that many signaling molecules originated within the brain or coming from the adipose tissue or the gastro-enteric tract are involved in the highly complex process controlling food intake and energy expenditure. The recent discovery of leptin, ghrelin, and other factors have made it possible to penetrate in the still undefined pathophysiology of eating disorders with the hope of finding effective treatments for such diseases.
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Affiliation(s)
- A Torsello
- Department of Experimental Medicine, University of Milano-Bicocca, 20052 Monza, Italy.
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Juhász A, Katona E, Csongrádi E, Paragh G. The regulation of body mass and its relation to the development of obesity. Orv Hetil 2007; 148:1827-36. [PMID: 17890170 DOI: 10.1556/oh.2007.28085] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
A testtömeg, ezen belül a zsírtömeg regulálása egy visszacsatolásos rendszerben valósul meg, melyben a zsírtömeg nagyságáról adipositasszignálok (leptin, inzulin, amylin), a pillanatnyi tápláltsági állapotról intestinalis peptidhormonok (ghrelin, PYY, PP, GLP-1, OXM, CCK) és a n. vagus informálják a központi idegrendszert mint központi szabályozót. A hypothalamus nucleus arcuatusának két jól elkülöníthető neuroncsoportja fogadja a zsírtömeg nagyságával arányos mennyiségben termelődő leptin közvetítette afferens információt. A leptinkötődés a sejtek felszínén elhelyezkedő leptinreceptorokhoz intracelluláris szignálmechanizmusokon keresztül a targetgének aktiválódását és anorexigén (POMC, CART) neuropeptidek termelését, majd másodlagos központokon keresztül az energiafelvétel és -leadás folyamatainak efferens regulációs mechanizmusait generálja. A testtömeg-szabályozás összetett és redundáns rendszer, számos más neuroendokrin folyamattal (növekedés, mellékvese- és pajzsmirigyműködés, reproduktív funkciók stb.), memória-, valamint jutalmazási és függőségi mechanizmussal áll kapcsolatban, így a szabályozórendszer egyes elemeinek befolyásolása, pl. gyógyszerekkel, más rendszerek működésére is hatással lehet, mellékhatások felléptére lehet számítani. Az obesitas világméretű epidémiája – mely elsősorban a magas energiasűrűségű élelmiszerek bőségével és a mozgásszegény életmóddal áll összefüggésben, melyhez a testtömeg-szabályozó rendszerünk nem tud megfelelően alkalmazkodni – intenzív kutatásokra ösztönzi az akadémiai és gyógyszeripari kutatóközpontokat annak érdekében, hogy új gyógyszerek, hatékony testsúlycsökkentő kezelési eljárások álljanak rendelkezésre az életmód-változtatási stratégiákon (diéta, fizikai aktivitás, magatartásterápia) túlmenően.
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Affiliation(s)
- Attila Juhász
- Sopron MJV Erzsébet Kórház, a DE OEC Oktató Kórháza Belgyógyászat Sopron Gyori.
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Merchant JL. Tales from the crypts: regulatory peptides and cytokines in gastrointestinal homeostasis and disease. J Clin Invest 2007; 117:6-12. [PMID: 17200701 PMCID: PMC1716224 DOI: 10.1172/jci30974] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
The gastrointestinal (GI) tract is composed of a diverse set of organs that together receive extracorporeal nutrition and convert it to energy substrates and cellular building blocks. In the process, it must sort through all that we ingest and discriminate what is useable from what is not, and having done that, it discards what is "junk." To accomplish these many and varied tasks, the GI tract relies on endogenous enteric hormones produced by enteroendocrine cells and the enteric nervous system. In many instances, the mediators of these tasks are small peptides that home to the CNS and accessory gut organs to coordinate oral intake with digestive secretions. As the contents of ingested material can contain harmful agents, the gut is armed with an extensive immune system. A breach of the epithelial barrier of the GI tract can result in local and eventually systemic disease if the gut does not mount an aggressive immune response.
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Affiliation(s)
- Juanita L Merchant
- Division of Gastroenterology, Department of Internal, University of Michigan, Ann Arbor, Michigan, USA.
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Bibliography. Current world literature. Growth and development. Curr Opin Endocrinol Diabetes Obes 2007; 14:74-89. [PMID: 17940424 DOI: 10.1097/med.0b013e32802e6d87] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Abstract
The endocrine functions of the adipose organ are widely studied at this stage. The adipose organ, and in particular adipocytes, communicate with almost all other organs. Although some adipose tissue pads assume the functions as distinct "miniorgans," adipocytes can also be present in smaller numbers interspersed with other cell types. Although fat pads have the potential to have a significant systemic impact, adipocytes may also affect neighboring tissues through paracrine interactions. These local or systemic effects are mediated through lipid and protein factors. The protein factors are commonly referred to as adipokines. Their expression and posttranslational modifications can undergo dramatic changes under different metabolic conditions. Due to the fact that none of the mutations that affect adipose tissue trigger embryonic lethality, the study of adipose tissue physiology lends itself to genetic analysis in mice. In fact, life in the complete absence of adipose tissue is possible in a laboratory setting, making even the most extreme adipose tissue phenotypes genetically amenable to be analyzed by disruption of specific genes or overexpression of others. Here, we briefly discuss some basic aspects of adipocyte physiology and the systemic impact of adipocyte-derived factors on energy homeostasis.
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Affiliation(s)
- Maria E Trujillo
- Departments of Cell Biology and Medicine, Diabetes Research and Training Center, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, New York 10461, USA
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Abstract
There is a widespread epidemic of obesity in the United States, which has been associated with an increased risk of diabetes mellitus, cancer, and cardiovascular diseases. Although lifestyle modifications and long-term dietary vigilance remain cornerstones of weight reduction treatment, the continued availability of U.S. Food and Drug Administration-approved pharmacotherapies has expanded the options available for the management of obesity. These agents include anorexiants, thermogenic drugs, and lipid-partitioning drugs. As knowledge regarding the possible causes of obesity increases, there are new drugs under investigation, which include beta3-adrenergic receptor agonists, modifiers of leptin, and cannabinoid receptor-1 antagonists (rimonabant). Also under investigation are antidiabetic agents (metformin, exenatide), anticonvulsant drugs (topiramate, zonisamide), antidepressants (bupropion, fluoxetine), and growth hormones. New targets for pharmacotherapy include uncoupling proteins, fatty acid synthase, neuropeptide Y, melanocortin, ghrelin, various regulatory gut peptides, and ciliary neurotropic factor. Pharmacologic agents are in clinical development that target these substances.
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Affiliation(s)
- Kerri L Palamara
- Department of Medicine, Harvard Medical School/Massachusetts Medical General Hospital, Boston, Massachusetts, USA
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