1
|
Saucedo-Orozco H, Voorrips SN, Yurista SR, de Boer RA, Westenbrink BD. SGLT2 Inhibitors and Ketone Metabolism in Heart Failure. J Lipid Atheroscler 2022; 11:1-19. [PMID: 35118019 PMCID: PMC8792821 DOI: 10.12997/jla.2022.11.1.1] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 01/06/2022] [Accepted: 01/06/2022] [Indexed: 11/09/2022] Open
Abstract
Sodium-glucose cotransporter-2 (SGLT2) inhibitors have emerged as powerful drugs that can be used to treat heart failure (HF) patients, both with preserved and reduced ejection fraction and in the presence or absence of type 2 diabetes. While the mechanisms underlying the salutary effects of SGLT2 inhibitors have not been fully elucidated, there is clear evidence for a beneficial metabolic effect of these drugs. In this review, we discuss the effects of SGLT2 inhibitors on cardiac energy provision secondary to ketone bodies, pathological ventricular remodeling, and inflammation in patients with HF. While the specific contribution of ketone bodies to the pleiotropic cardiovascular benefits of SGLT2 inhibitors requires further clarification, ketone bodies themselves may also be used as a therapy for HF.
Collapse
Affiliation(s)
- Huitzilihuitl Saucedo-Orozco
- Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Suzanne N. Voorrips
- Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Salva R. Yurista
- Cardiology Division, Cardiovascular Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Rudolf A. de Boer
- Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - B. Daan Westenbrink
- Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| |
Collapse
|
2
|
Barroso Oquendo M, Siegel-Axel D, Gerst F, Lorza-Gil E, Moller A, Wagner R, Machann J, Fend F, Königsrainer A, Heni M, Häring HU, Ullrich S, Birkenfeld AL. Pancreatic fat cells of humans with type 2 diabetes display reduced adipogenic and lipolytic activity. Am J Physiol Cell Physiol 2021; 320:C1000-C1012. [PMID: 33788629 DOI: 10.1152/ajpcell.00595.2020] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Obesity, especially visceral fat accumulation, increases the risk of type 2 diabetes (T2D). The purpose of this study was to investigate the impact of T2D on the pancreatic fat depot. Pancreatic fat pads from 17 partial pancreatectomized patients (PPP) were collected, pancreatic preadipocytes isolated, and in vitro differentiated. Patients were grouped using HbA1c into normal glucose tolerant (NGT), prediabetic (PD), and T2D. Transcriptome profiles of preadipocytes and adipocytes were assessed by RNAseq. Insulin sensitivity was estimated by quantifying AKT phosphorylation on Western blots. Lipogenic capacity was assessed with oil red O staining, lipolytic activity via fatty acid release. Secreted factors were measured using ELISA. Comparative transcriptome analysis of preadipocytes and adipocytes indicates defective upregulation of genes governing adipogenesis (NR1H3), lipogenesis (FASN, SCD, ELOVL6, and FADS1), and lipolysis (LIPE) during differentiation of cells from T2D-PPP. In addition, the ratio of leptin/adiponectin mRNA was higher in T2D than in NGT-PPP. Preadipocytes and adipocytes of NGT-PPP were more insulin sensitive than T2D-PPP cells in regard to AKT phosphorylation. Triglyceride accumulation was similar in NGT and T2D adipocytes. Despite a high expression of the receptors NPR1 and NPR2 in NGT and T2D adipocytes, lipolysis was stimulated by ANP 1.74-fold in NGT cells only. This stimulation was further increased by the PDE5 inhibitor dipyridamole (3.09-fold). Dipyridamole and forskolin increased lipolysis receptor independently 1.88-fold and 1.48-fold, respectively, solely in NGT cells. In conclusion, the metabolic status persistently affects differentiation and lipolysis of pancreatic adipocytes. These alterations could aggravate the development of T2D.
Collapse
Affiliation(s)
- Morgana Barroso Oquendo
- German Center for Diabetes Research (DZD e.V.), Tübingen, Germany.,Division of Endocrinology, Diabetology and Nephrology, Department of Internal Medicine IV, University Hospital of Eberhard-Karls-University Tübingen, Tübingen, Germany
| | - Dorothea Siegel-Axel
- German Center for Diabetes Research (DZD e.V.), Tübingen, Germany.,Division of Endocrinology, Diabetology and Nephrology, Department of Internal Medicine IV, University Hospital of Eberhard-Karls-University Tübingen, Tübingen, Germany
| | - Felicia Gerst
- German Center for Diabetes Research (DZD e.V.), Tübingen, Germany.,Institute for Diabetes Research and Metabolic Diseases, Helmholtz Center Munich, Eberhard-Karls-University of Tübingen, Neuherberg, Germany.,Division of Endocrinology, Diabetology and Nephrology, Department of Internal Medicine IV, University Hospital of Eberhard-Karls-University Tübingen, Tübingen, Germany
| | - Estela Lorza-Gil
- German Center for Diabetes Research (DZD e.V.), Tübingen, Germany.,Institute for Diabetes Research and Metabolic Diseases, Helmholtz Center Munich, Eberhard-Karls-University of Tübingen, Neuherberg, Germany.,Division of Endocrinology, Diabetology and Nephrology, Department of Internal Medicine IV, University Hospital of Eberhard-Karls-University Tübingen, Tübingen, Germany
| | - Anja Moller
- German Center for Diabetes Research (DZD e.V.), Tübingen, Germany.,Institute for Diabetes Research and Metabolic Diseases, Helmholtz Center Munich, Eberhard-Karls-University of Tübingen, Neuherberg, Germany.,Division of Endocrinology, Diabetology and Nephrology, Department of Internal Medicine IV, University Hospital of Eberhard-Karls-University Tübingen, Tübingen, Germany
| | - Robert Wagner
- German Center for Diabetes Research (DZD e.V.), Tübingen, Germany.,Institute for Diabetes Research and Metabolic Diseases, Helmholtz Center Munich, Eberhard-Karls-University of Tübingen, Neuherberg, Germany.,Division of Endocrinology, Diabetology and Nephrology, Department of Internal Medicine IV, University Hospital of Eberhard-Karls-University Tübingen, Tübingen, Germany
| | - Jürgen Machann
- German Center for Diabetes Research (DZD e.V.), Tübingen, Germany.,Institute for Diabetes Research and Metabolic Diseases, Helmholtz Center Munich, Eberhard-Karls-University of Tübingen, Neuherberg, Germany.,Section on Experimental Radiology, Department of Diagnostic and Interventional Radiology, University Hospital of Eberhard-Karls-University Tübingen, Tübingen, Germany
| | - Falko Fend
- Institute of Pathology and Neuropathology, University Hospital of Eberhard-Karls-University Tübingen, Tübingen, Germany
| | - Alfred Königsrainer
- Department of General, Visceral and Transplant Surgery, University Hospital of Eberhard-Karls-University Tübingen, Tübingen, Germany
| | - Martin Heni
- German Center for Diabetes Research (DZD e.V.), Tübingen, Germany.,Institute for Diabetes Research and Metabolic Diseases, Helmholtz Center Munich, Eberhard-Karls-University of Tübingen, Neuherberg, Germany.,Division of Endocrinology, Diabetology and Nephrology, Department of Internal Medicine IV, University Hospital of Eberhard-Karls-University Tübingen, Tübingen, Germany.,Institute for Clinical Chemistry and Pathobiochemistry, Department for Diagnostic Laboratory Medicine, University Hospital of Eberhard-Karls-University Tübingen, Tübingen, Germany
| | - Hans-Ulrich Häring
- German Center for Diabetes Research (DZD e.V.), Tübingen, Germany.,Institute for Diabetes Research and Metabolic Diseases, Helmholtz Center Munich, Eberhard-Karls-University of Tübingen, Neuherberg, Germany.,Division of Endocrinology, Diabetology and Nephrology, Department of Internal Medicine IV, University Hospital of Eberhard-Karls-University Tübingen, Tübingen, Germany
| | - Susanne Ullrich
- German Center for Diabetes Research (DZD e.V.), Tübingen, Germany.,Institute for Diabetes Research and Metabolic Diseases, Helmholtz Center Munich, Eberhard-Karls-University of Tübingen, Neuherberg, Germany.,Division of Endocrinology, Diabetology and Nephrology, Department of Internal Medicine IV, University Hospital of Eberhard-Karls-University Tübingen, Tübingen, Germany
| | - Andreas L Birkenfeld
- German Center for Diabetes Research (DZD e.V.), Tübingen, Germany.,Institute for Diabetes Research and Metabolic Diseases, Helmholtz Center Munich, Eberhard-Karls-University of Tübingen, Neuherberg, Germany.,Division of Endocrinology, Diabetology and Nephrology, Department of Internal Medicine IV, University Hospital of Eberhard-Karls-University Tübingen, Tübingen, Germany
| |
Collapse
|
3
|
The Regulation of Fat Metabolism During Aerobic Exercise. Biomolecules 2020; 10:biom10121699. [PMID: 33371437 PMCID: PMC7767423 DOI: 10.3390/biom10121699] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 12/09/2020] [Accepted: 12/15/2020] [Indexed: 12/19/2022] Open
Abstract
Since the lipid profile is altered by physical activity, the study of lipid metabolism is a remarkable element in understanding if and how physical activity affects the health of both professional athletes and sedentary subjects. Although not fully defined, it has become clear that resistance exercise uses fat as an energy source. The fatty acid oxidation rate is the result of the following processes: (a) triglycerides lipolysis, most abundant in fat adipocytes and intramuscular triacylglycerol (IMTG) stores, (b) fatty acid transport from blood plasma to muscle sarcoplasm, (c) availability and hydrolysis rate of intramuscular triglycerides, and (d) transport of fatty acids through the mitochondrial membrane. In this review, we report some studies concerning the relationship between exercise and the aforementioned processes also in light of hormonal controls and molecular regulations within fat and skeletal muscle cells.
Collapse
|
4
|
Zhu WH, Chen LY, Dai HL, Chen JH, Chen Y, Fang LZ. Correlation between B type natriuretic peptide and metabolic risk factors. Arch Med Sci 2016; 12:334-40. [PMID: 27186177 PMCID: PMC4848355 DOI: 10.5114/aoms.2015.57001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2014] [Accepted: 10/02/2014] [Indexed: 12/05/2022] Open
Abstract
INTRODUCTION It has been shown that B type natriuretic peptide (BNP) level can indicate cardiovascular disease. However, the association between BNP and metabolic risk factors is unknown. The aim of this study was to investigate the correlation between N-terminal pro-B type natriuretic peptide (NT-proBNP) and metabolic risk factors. MATERIAL AND METHODS A total of 11,508 subjects were selected from those who underwent health examinations in our hospital. NT-proBNP, waist circumference, blood pressure, fasting plasma glucose and lipid profile were measured. The level of NT-proBNP was measured and classified into four stratifications (BNP ≥ 20 pg/ml, ≥ 40 pg/ml, ≥ 60 pg/ml, and ≥ 80 pg/ml) to analyze the relationship between BNP and metabolic risk factors. RESULTS B type natriuretic peptide increased gradually with increasing age (p < 0.001). The BNP levels were significantly higher in women than in men (p < 0.001). Multivariate regression analysis showed a positive association between NT-proBNP levels and systolic blood pressure (p < 0.001), fasting plasma glucose (p < 0.05), and total cholesterol (p < 0.001 in women). The NT-proBNP levels were inversely associated with diastolic blood pressure, waist circumference, triglyceride, high-density lipoprotein, and LDL cholesterol. Logistic regression analysis demonstrated a close relationship between NT-proBNP and systolic blood pressure, fasting plasma glucose, and total cholesterol. In the BNP ≥ 60 pg/ml group, odds ratio (OR) values were 1.80, 1.56 and 1.54 (female) and 3.74, 1.59 and 1.51 (male), respectively. In the BNP ≥ 80 pg/ml group, OR values were 2.45, 1.65 and 1.84 (female) and 4.61, 1.66 and 1.75 (male), respectively. CONCLUSIONS NT-proBNP was independently associated with the main metabolic risk factors (systolic blood pressure, fasting plasma glucose, and total cholesterol). These findings suggest that the combined determination of NT-proBNP and the main metabolic risk factors could be important in assessing cardiovascular morbidity.
Collapse
Affiliation(s)
- Wen-Hua Zhu
- Department of General Practice, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Li-Ying Chen
- Department of General Practice, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Hong-Lei Dai
- Department of General Practice, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jian-Hua Chen
- Department of General Practice, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yan Chen
- Department of General Practice, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Li-Zheng Fang
- Department of General Practice, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| |
Collapse
|
5
|
Meroufel DN, Ouhaïbi-Djellouli H, Mediene-Benchekor S, Hermant X, Grenier-Boley B, Lardjam-Hetraf SA, Boulenouar H, Hamani-Medjaoui I, Saïdi-Mehtar N, Amouyel P, Houti L, Goumidi L, Meirhaeghe A. Examination of the brain natriuretic peptide rs198389 single-nucleotide polymorphism on type 2 diabetes mellitus and related phenotypes in an Algerian population. Gene 2015; 567:159-63. [PMID: 25934190 DOI: 10.1016/j.gene.2015.04.073] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2015] [Revised: 04/14/2015] [Accepted: 04/27/2015] [Indexed: 12/24/2022]
Abstract
BACKGROUND In European populations, the NPPB rs198389 single nucleotide polymorphism (SNP) is associated with a reduced risk of type 2 diabetes mellitus (T2DM). We investigated the putative associations between NPPB rs198389, the T2DM risk and quantitative metabolic traits in an Algerian population. METHODS The association analysis was performed as a T2DM case-control study (with 78 cases and 645 controls) nested into the ISOR population-based study. RESULTS The NPPB rs198389 SNP was not associated with T2DM (odds ratio (OR) [95% confidence interval (CI)]=0.73 [0.51-1.04], p=0.08). However, the C allele was associated with lower fasting plasma insulin levels (p=0.05) and a lower homeostatic model assessment insulin resistance index (p=0.05) in non-diabetic individuals. CONCLUSION The NPPB rs198389 SNP might modulate fasting insulin levels in an Algerian population.
Collapse
Affiliation(s)
- Djabaria Naïma Meroufel
- Laboratoire de Génétique Moléculaire et Cellulaire, Université des Sciences et de Technologie d'Oran Mohamed Boudiaf, BP 1505, El M'Naouer, 31000 Oran, Algeria.
| | - Hadjira Ouhaïbi-Djellouli
- Laboratoire de Génétique Moléculaire et Cellulaire, Université des Sciences et de Technologie d'Oran Mohamed Boudiaf, BP 1505, El M'Naouer, 31000 Oran, Algeria; Département de Biotechnologie, Faculté des Sciences de la Nature et de la Vie, Université d'Oran, BP 1524, El M'Naouer, 31000 Oran, Algeria.
| | - Sounnia Mediene-Benchekor
- Laboratoire de Génétique Moléculaire et Cellulaire, Université des Sciences et de Technologie d'Oran Mohamed Boudiaf, BP 1505, El M'Naouer, 31000 Oran, Algeria; Département de Biotechnologie, Faculté des Sciences de la Nature et de la Vie, Université d'Oran, BP 1524, El M'Naouer, 31000 Oran, Algeria.
| | - Xavier Hermant
- INSERM, U1167, Institut Pasteur de Lille, Université de Lille, 1 rue du Pr. Calmette, BP 245, F-59019 Lille cedex, France.
| | - Benjamin Grenier-Boley
- INSERM, U1167, Institut Pasteur de Lille, Université de Lille, 1 rue du Pr. Calmette, BP 245, F-59019 Lille cedex, France.
| | - Sarah Aïcha Lardjam-Hetraf
- Laboratoire de Génétique Moléculaire et Cellulaire, Université des Sciences et de Technologie d'Oran Mohamed Boudiaf, BP 1505, El M'Naouer, 31000 Oran, Algeria.
| | - Houssam Boulenouar
- Laboratoire de Génétique Moléculaire et Cellulaire, Université des Sciences et de Technologie d'Oran Mohamed Boudiaf, BP 1505, El M'Naouer, 31000 Oran, Algeria.
| | - Imane Hamani-Medjaoui
- Laboratoire de Génétique Moléculaire et Cellulaire, Université des Sciences et de Technologie d'Oran Mohamed Boudiaf, BP 1505, El M'Naouer, 31000 Oran, Algeria; Caisse Nationale des Assurances Sociales des travailleurs salariés, Clinique Spécialisée en Orthopédie et Rééducation des Victimes des Accidents de Travail, Hai Bouamama (El Hassi) Oran, Algeria.
| | - Nadhira Saïdi-Mehtar
- Laboratoire de Génétique Moléculaire et Cellulaire, Université des Sciences et de Technologie d'Oran Mohamed Boudiaf, BP 1505, El M'Naouer, 31000 Oran, Algeria.
| | - Philippe Amouyel
- INSERM, U1167, Institut Pasteur de Lille, Université de Lille, 1 rue du Pr. Calmette, BP 245, F-59019 Lille cedex, France.
| | - Leïla Houti
- Laboratoire de Génétique Moléculaire et Cellulaire, Université des Sciences et de Technologie d'Oran Mohamed Boudiaf, BP 1505, El M'Naouer, 31000 Oran, Algeria; Faculté de Médecine, Université Djillali Liabes de Sidi Bel Abbes, BP 89, 22000 Sidi-Bel-Abbès, Algeria; Laboratoire des Systèmes d'Information en Santé, Université d'Oran, BP 1524, El M'Naouer, 31000 Oran, Algeria.
| | - Louisa Goumidi
- INSERM, U1167, Institut Pasteur de Lille, Université de Lille, 1 rue du Pr. Calmette, BP 245, F-59019 Lille cedex, France.
| | - Aline Meirhaeghe
- INSERM, U1167, Institut Pasteur de Lille, Université de Lille, 1 rue du Pr. Calmette, BP 245, F-59019 Lille cedex, France.
| |
Collapse
|
6
|
López-Yoldi M, Fernández-Galilea M, Laiglesia LM, Larequi E, Prieto J, Martínez JA, Bustos M, Moreno-Aliaga MJ. Cardiotrophin-1 stimulates lipolysis through the regulation of main adipose tissue lipases. J Lipid Res 2014; 55:2634-43. [PMID: 25351614 DOI: 10.1194/jlr.m055335] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Cardiotrophin-1 (CT-1) is a cytokine with antiobesity properties and with a role in lipid metabolism regulation and adipose tissue function. The aim of this study was to analyze the molecular mechanisms involved in the lipolytic actions of CT-1 in adipocytes. Recombinant CT-1 (rCT-1) effects on the main proteins and signaling pathways involved in the regulation of lipolysis were evaluated in 3T3-L1 adipocytes and in mice. rCT-1 treatment stimulated basal glycerol release in a concentration- and time-dependent manner in 3T3-L1 adipocytes. rCT-1 (20 ng/ml for 24 h) raised cAMP levels, and in parallel increased protein kinase (PK)A-mediated phosphorylation of perilipin and hormone sensitive lipase (HSL) at Ser660. siRNA knock-down of HSL or PKA, as well as pretreatment with the PKA inhibitor H89, blunted the CT-1-induced lipolysis, suggesting that the lipolytic action of CT-1 in adipocytes is mainly mediated by activation of HSL through the PKA pathway. In ob/ob mice, acute rCT-1 treatment also promoted PKA-mediated phosphorylation of perilipin and HSL at Ser660 and Ser563, and increased adipose triglyceride lipase (desnutrin) content in adipose tissue. These results showed that the ability of CT-1 to regulate the activity of the main lipases underlies the lipolytic action of this cytokine in vitro and in vivo, and could contribute to CT-1 antiobesity effects.
Collapse
Affiliation(s)
- Miguel López-Yoldi
- Departments of Nutrition, Food Science, and Physiology University of Navarra, Pamplona, Navarra, Spain Centre for Nutrition Research, University of Navarra, Pamplona, Navarra, Spain
| | - Marta Fernández-Galilea
- Departments of Nutrition, Food Science, and Physiology University of Navarra, Pamplona, Navarra, Spain
| | - Laura M Laiglesia
- Departments of Nutrition, Food Science, and Physiology University of Navarra, Pamplona, Navarra, Spain Centre for Nutrition Research, University of Navarra, Pamplona, Navarra, Spain
| | - Eduardo Larequi
- Gene Therapy and Hepatology, CIMA, University of Navarra, Pamplona, Navarra, Spain
| | - Jesús Prieto
- Gene Therapy and Hepatology, CIMA, University of Navarra, Pamplona, Navarra, Spain CIBERehd Institute of Health Carlos III, Madrid, Spain
| | - J Alfredo Martínez
- Departments of Nutrition, Food Science, and Physiology University of Navarra, Pamplona, Navarra, Spain Centre for Nutrition Research, University of Navarra, Pamplona, Navarra, Spain CIBERobn, Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain
| | - Matilde Bustos
- Gene Therapy and Hepatology, CIMA, University of Navarra, Pamplona, Navarra, Spain
| | - Maria J Moreno-Aliaga
- Departments of Nutrition, Food Science, and Physiology University of Navarra, Pamplona, Navarra, Spain Centre for Nutrition Research, University of Navarra, Pamplona, Navarra, Spain CIBERobn, Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain
| |
Collapse
|
7
|
Karner-Rezek K, Knechtle B, Fenzl M, Gredig J, Rosemann T. Does continuous endurance exercise in water elicit a higher release of ANP and BNP and a higher plasma concentration of FFAs in pre-obese and obese men than high intensity intermittent endurance exercise? - study protocol for a randomized controlled trial. Trials 2013; 14:328. [PMID: 24112444 PMCID: PMC3852003 DOI: 10.1186/1745-6215-14-328] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2013] [Accepted: 10/01/2013] [Indexed: 11/26/2022] Open
Abstract
Background Atrial natriuretic peptides (ANP) and Brain natriuretic peptides (BNP) stimulate fat cell plasma membrane receptors. They are potent lipolytic agents on isolated fat cells from subcutaneous adipose tissue. The physiological effects of continuous endurance exercise on ANP release and plasma free fatty acids (FFA) concentrations have been well described. The enhancement of fat metabolism using high intensity intermittent exercise protocols has been assessed in more recent investigations. The combined effects of endurance exercise and water immersion on ANP and FFA plasma concentration and the magnitude of excess post-exercise oxygen consumption (EPOC) might be further enhanced by choosing the most effective exercise protocol. Exercise modalities may play a significant role in the future prevention and treatment of obesity. Methods/design The two testing trials will be performed according to a randomized and cross-over design. Twenty healthy sedentary pre-obese and obese class-1 men will be scrutinized with regard to their metabolic responses to continuous exercise in water and to high intensity endurance exercise in water. Both trials will be matched for energy expenditure. After preliminary testing, the tests will be conducted as repeated measurements. The two different exercise protocols will be compared. The aims of the study are to investigate (1) whether continuous endurance exercise or high intensity intermittent endurance exercise in water elicits both a higher release of ANP and BNP and a higher plasma concentration of glycerol and (2) to determine whether continuous endurance exercise in water or a high intensity intermittent endurance exercise in water would lead to a more pronounced short term (two hours) EPOC effect. Discussion If our hypothesis would be confirmed, the most effective exercise protocol based on the combined effects of high intensity endurance exercise and water immersion on ANP and BNP release and glycerol plasma concentrations can be identified. Moreover, the magnitude of the EPOC effect can be augmented. Our study would provide a major contribution for creating optimized exercise modalities in the prevention and treatment of obesity. Trial registration Current controlled trials, ISRCTN95488515
Collapse
Affiliation(s)
- Klaus Karner-Rezek
- Institute of General Practice and for Health Services Research, University of Zurich, Zurich, Switzerland.
| | | | | | | | | |
Collapse
|
8
|
Taner Ertugrul D, Yavuz B, Okhan Akin K, Arif Yalcin A, Ata N, Kucukazman M, Algul B, Dal K, Sinan Deveci O, Tutal E. An obesity drug sibutramine reduces brain natriuretic peptide (BNP) levels in severely obese patients. Int J Clin Pract 2010; 64:518-22. [PMID: 20456197 DOI: 10.1111/j.1742-1241.2009.02197.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVES Sibutramine is a selective inhibitor of the reuptake of monoamines. Plasma levels of brain natriuretic peptide (BNP) appear to be inversely associated with body mass index (BMI) in subjects with and without heart failure for reasons that remain unexplained. The aim of this study was to investigate the possible influence of sibutramine treatment on BNP levels in severely obese patients. METHODS Fifty-two severely obese female patients with BMI > 40 kg/m(2) were included to this study. The women were recommended to follow a weight-reducing daily diet of 25 kcal/kg of ideal body weight. During the treatment period, all patients were to receive 15 mg of sibutramine once a day. Blood chemistry tests were performed before the onset of the medication and after 12 weeks of treatment. RESULTS None of the subjects was withdrawn from the study because of the adverse effects of sibutramine. Body weight (108.8 +/- 13.3 kg vs. 101.7 +/- 15.6 kg, p < 0.001), BMI (44.6 +/- 4.6 kg/m(2) vs. 41.8 +/- 5.7 kg/m(2), p < 0.001) and BNP [8.6 (0.5-49.5) ng/l vs. 3.1 (0.2-28.6) ng/l, p = 0.018] levels were significantly decreased after 12 weeks of sibutramine treatment. Total cholesterol (5.19 +/- 0.90 mmol/l vs. 4.82 +/- 1.05 mmol/l respectively; p < 0.001), low-density lipoprotein-cholesterol (3.26 +/- 0.86 mmol/l vs. 2.99 +/- 0.40 mmol/l respectively; p = 0.008), levels were significantly decreased; however, there was no significant alteration in high-density lipoprotein-cholesterol and triglyceride levels. CONCLUSION This study has shown a decrease in BNP levels which may lead to improvement in cardiac outcome after sibutramine treatment. Further randomised studies are needed to be conducted to clarify the relationship between sibutramine and BNP.
Collapse
Affiliation(s)
- D Taner Ertugrul
- Department of Internal Medicine, Kecioren Teaching and Research Hospital, Ankara, Turkey
| | | | | | | | | | | | | | | | | | | |
Collapse
|
9
|
Abstract
Natriuretic peptides (NP) are essential in mammals to regulate blood volume and pressure. The functional roles of NP are not limited to natriuresis and diuresis. Several peripheral and central actions of the peptides have been characterized. Studies on transgenic mice have revealed their key function in the regulation of cardiomyocyte growth. Plasma NP levels increase in patients with cardiovascular disorders and heart failure. They represent useful clinical markers for clinicians to diagnose heart diseases. The recent discovery of their potent lipolytic action in adipose tissue is a breakthrough in cardiovascular medicine. This new function of NP in the regulation of lipid metabolism offers interesting questions in the field of obesity, diabetes and cardiovascular diseases. This review will briefly describe the effects of NP on the cardiovascular system and lipid metabolism.
Collapse
Affiliation(s)
- Cédric Moro
- Department of Medical and Clinical Pharmacology, Faculty of Medicine, Toulouse, France.
| | | |
Collapse
|
10
|
Daniels LB, Clopton P, Bhalla V, Krishnaswamy P, Nowak RM, McCord J, Hollander JE, Duc P, Omland T, Storrow AB, Abraham WT, Wu AHB, Steg PG, Westheim A, Knudsen CW, Perez A, Kazanegra R, Herrmann HC, McCullough PA, Maisel AS. How obesity affects the cut-points for B-type natriuretic peptide in the diagnosis of acute heart failure. Results from the Breathing Not Properly Multinational Study. Am Heart J 2006; 151:999-1005. [PMID: 16644321 DOI: 10.1016/j.ahj.2005.10.011] [Citation(s) in RCA: 186] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2005] [Accepted: 10/20/2005] [Indexed: 11/16/2022]
Abstract
BACKGROUND B-type natriuretic peptide (BNP) is valuable in diagnosing heart failure (HF), but its utility in obese patients is unknown. Studies have suggested a cut-point of BNP > or = 100 pg/mL for the diagnosis of HF; however, there is an inverse relation between BNP levels and body mass index. We evaluated differential cut-points for BNP in diagnosing acute HF across body mass index levels to determine whether alternative cut-points can improve diagnosis. METHODS The Breathing Not Properly Multinational Study was a 7-center, prospective study of 1586 patients who presented to the Emergency Department with acute dyspnea. B-type natriuretic peptide was measured on arrival. Height and weight data were available for 1368 participants. The clinical diagnosis of HF was adjudicated by 2 independent cardiologists who were blinded to BNP results. RESULTS Heart failure was the final diagnosis in 46.1%. Mean BNP levels (pg/mL) in lean, overweight/obese, and severely/morbidly obese patients were 643, 462, and 247 for patients with acute HF, and 52, 35, and 25 in those without HF, respectively (P < .05 for all comparisons except 35 vs 25). B-type natriuretic peptide cut-points to maintain 90% sensitivity for a HF diagnosis were 170 pg/mL for lean subjects, 110 pg/mL for overweight/obese subjects, and 54 pg/mL in severely/morbidly obese patients. CONCLUSIONS Body mass index influences the selection of cut-points for BNP in diagnosing acute HF. A lower cut-point (BNP > or = 54 pg/mL) should be used in severely obese patients to preserve sensitivity. A higher cut-point in lean patients (BNP > or = 170 pg/mL) could be used to increase specificity.
Collapse
|