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Lee S, Bae J, Jo DR, Lee M, Lee YH, Kang ES, Cha BS, Lee BW. Impaired ketogenesis is associated with metabolic-associated fatty liver disease in subjects with type 2 diabetes. Front Endocrinol (Lausanne) 2023; 14:1124576. [PMID: 36896171 PMCID: PMC9989459 DOI: 10.3389/fendo.2023.1124576] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 02/09/2023] [Indexed: 02/23/2023] Open
Abstract
AIMS The ketogenic pathway is an effective mechanism by which the liver disposes of fatty acids (FAs) to the peripheral tissues. Impaired ketogenesis is presumed to be related to the pathogenesis of metabolic-associated fatty liver disease (MAFLD), but the results of previous studies have been controversial. Therefore, we investigated the association between ketogenic capacity and MAFLD in subjects with type 2 diabetes (T2D). METHODS A total of 435 subjects with newly diagnosed T2D was recruited for the study. They were classified into two groups based on median serum β-hydroxybutyrate (β-HB) level: intact vs. impaired ketogenesis groups. The associations of baseline serum β-HB and MAFLD indices of hepatic steatosis index, NAFLD liver fat score (NLFS), Framingham Steatosis index (FSI), Zhejian University index, and Chinese NAFLD score were investigated. RESULTS Compared to the impaired ketogenesis group, the intact ketogenesis group showed better insulin sensitivity, lower serum triglyceride level, and higher low-density lipoprotein-cholesterol and glycated hemoglobin levels. Serum levels of liver enzymes were not different between the two groups. Of the hepatic steatosis indices, NLFS (0.8 vs. 0.9, p=0.045) and FSI (39.4 vs. 47.0: p=0.041) were significantly lower in the intact ketogenesis group. Moreover, intact ketogenesis was significantly associated with lower risk of MAFLD as calculated by FSI after adjusting for potential confounders (adjusted odds ratio 0.48, 95% confidence interval 0.25-0.91, p=0.025). CONCLUSIONS Our study suggests that intact ketogenesis might be associated with decreased risk of MAFLD in T2D.
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Affiliation(s)
- Sejeong Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, CHA Gangnam Medical Center, CHA University School of Medicine, Seoul, Republic of Korea
| | - Jaehyun Bae
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Catholic Kwandong University College of Medicine, International St. Mary’s Hospital, Incheon, Republic of Korea
| | - Doo Ri Jo
- Department of diabetes mellitus, Biomedical Research Center, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Minyoung Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Yong-ho Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Eun Seok Kang
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Bong-Soo Cha
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Byung-Wan Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
- *Correspondence: Byung-Wan Lee,
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Postprandial lipaemia following consumption of a meal enriched with medium chain saturated and/or long chain omega-3 polyunsaturated fatty acids. A randomised cross-over study. Clin Nutr 2020; 40:420-427. [PMID: 32684486 DOI: 10.1016/j.clnu.2020.06.027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 05/22/2020] [Accepted: 06/19/2020] [Indexed: 11/23/2022]
Abstract
BACKGROUND & AIMS Postprandial lipaemic response has emerged as a risk factor for cardiovascular disease. Dietary fats such as medium-chain saturated fatty acids (MCSFA) and long-chain omega-3 polyunsaturated fatty acids (LCn-3PUFA) are known to reduce postprandial lipaemic responses. The combination of the two could potentially have complementary and/or synergistic effects for optimising cardiovascular health. This study aims to investigate the effects of MCSFA (coconut oil) with or without LCn-3PUFA (fish oil) inclusion in the test meal on postprandial blood lipids in healthy adults. METHODS In a randomised, double-blinded, placebo-controlled, 2 × 2 factorial cross-over study, participants (n = 15) were randomised to receive four standardised isocaloric test meals. Test meals include: placebo [PL, containing no fish oil (0 g EPA & DHA) or coconut oil (0 g MCSFA)], fish oil [FO, 6 g fish oil (3.85 g EPA & DHA), containing no coconut oil (0 g MCSFA)], coconut oil [CO, 18.65 g coconut oil (15 g MCSFA), containing no fish oil (0 g EPA & DHA)] and coconut oil + fish oil [COFO, 18.65 g coconut oil (15 g MCSFA) + 6 g fish oil (3.85 g EPA & DHA)]; all providing a total fat content of 33.5 g. Participants received all four treatments on four separate test days with at least 3 days washout in between. Blood parameters were measured by finger pricks at 7 timepoints between 0 and 300min. The primary outcome of this study was the change in postprandial triglycerides (TG) concentrations with secondary outcomes as total cholesterol, high-density lipoprotein cholesterol and blood glucose concentrations. RESULTS TG area under the curve (AUC) (mmol/L/min) was significantly lower for FO (383.67, p = 0.0125) and COFO (299.12, p = 0.0186) in comparison to PL (409.17) only. TG incremental area under the curve (iAUC) (mmol/L/min) was significantly lower with COFO (59.67) in comparison to CO (99.86), (p = 0.0480). Compared to PL, the change in absolute TG concentrations (mmol/L) from baseline to post TG peak time (180min) after FO were significantly less at 240min (0.39 vs 0.15), 270min (0.2 vs 0.1), and 300min (0.28 vs 0.06), and after COFO was significantly less at 300min (0.28 vs 0.16) (p < 0.05). No significant differences in postprandial AUC and iAUC for any other blood parameters were reported. CONCLUSIONS Our study demonstrated that LCn-3PUFA with or without MCSFA but not MCSFA alone are effective in reducing postprandial TG in healthy individuals.
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Yao Y, Pek SX, Toh DWK, Xia X, Kim JE. Effects of fatty acids composition in a breakfast meal on the postprandial lipid responses: a systematic review and meta-analysis of randomised controlled trials. Int J Food Sci Nutr 2020; 71:793-803. [PMID: 32223451 DOI: 10.1080/09637486.2020.1744534] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Replacement of food rich in saturated fatty acids (SFAs) with unsaturated fatty acids (UFAs) is a well-known dietary strategy to reduce the risk of cardiovascular disease while its impact on postprandial blood lipids is less examined. This study assessed the effects of fatty acids composition on the postprandial triglycerides and cholesterol responses. Seventeen randomised controlled trials were identified and pooled analysis results revealed that consumption of a UFAs-rich or an SFAs-rich breakfast meal did not acutely affect postprandial triglycerides and cholesterol responses. However, subgroup analysis observed that triglycerides incremental area under the curve was lower with an SFAs-rich meal (SMD: -0.36; 95% CI: -0.57, -0.15) over a less than 8 h duration, while was higher (SMD: 0.59; 95% CI: 0.05, 1.23) over a longer postprandial duration. It suggests that the postprandial duration is of importance when evaluating the effects of fatty acids composition on blood lipid responses.
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Affiliation(s)
- Yuanhang Yao
- Department of Food Science and Technology, Faculty of Science, National University of Singapore, Singapore
| | - Sheri Xueqi Pek
- Department of Food Science and Technology, Faculty of Science, National University of Singapore, Singapore
| | - Darel Wee Kiat Toh
- Department of Food Science and Technology, Faculty of Science, National University of Singapore, Singapore
| | - Xuejuan Xia
- Department of Food Science and Technology, Faculty of Science, National University of Singapore, Singapore
| | - Jung Eun Kim
- Department of Food Science and Technology, Faculty of Science, National University of Singapore, Singapore
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Joung KH, Kim JM, Choung S, Lee JH, Kim HJ, Ku BJ. Association between IL-1beta and cardiovascular disease risk in patients with newly diagnosed, drug-naïve type 2 diabetes mellitus: a cross-sectional study. ANNALS OF TRANSLATIONAL MEDICINE 2020; 8:225. [PMID: 32309372 PMCID: PMC7154468 DOI: 10.21037/atm.2020.01.17] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Background To determine whether the pro-inflammatory cytokine interleukin (IL)-1beta, as a marker of the nucleotide binding and oligomerization domain-like receptor family pyrin domain-containing 3 (NLRP3) inflammasome activation, can be used to predict cardiovascular disease (CVD) risk in patients with newly diagnosed, drug-naïve type 2 diabetes mellitus (T2DM). Methods A total of 110 subjects with no history of diabetes were enrolled and divided into control subjects (non-DM group, n=52) and patients with newly diagnosed, drug-naïve T2DM (DM group, n=58). Results Serum IL-1beta levels were not different between the two groups. The Framingham CVD risk score (F-score) was positively correlated with the serum IL-1beta level in the DM group. Multivariate regression analyses showed that the F-score was independently associated with the serum IL-1beta level in the DM group. Patients with an intermediate to high CVD risk (F-score ≥10%) also had significantly higher serum IL-1beta levels than did those with a low CVD risk (F-score <5%). Smokers in the DM group had higher IL-1beta levels than did those in the non-DM group, regardless of the F-score. Conclusions These results suggest that serum IL-1beta levels might be useful as an independent risk factor predicting CVD risk in patients with newly diagnosed, drug naïve T2DM, particularly those who smoke.
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Affiliation(s)
- Kyong Hye Joung
- Department of International Medicine, Chungnam National University College of Medicine, Daejeon, Republic of Korea
| | - Ji Min Kim
- Department of International Medicine, Chungnam National University College of Medicine, Daejeon, Republic of Korea
| | - Sorim Choung
- Department of Medical Science, Chungnam National University College of Medicine, Daejeon, Republic of Korea
| | - Ju Hee Lee
- Department of International Medicine, Chungnam National University College of Medicine, Daejeon, Republic of Korea
| | - Hyun Jin Kim
- Department of International Medicine, Chungnam National University College of Medicine, Daejeon, Republic of Korea
| | - Bon Jeong Ku
- Department of International Medicine, Chungnam National University College of Medicine, Daejeon, Republic of Korea
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Tarigan TJE, Khumaedi AI, Wafa S, Johan M, Abdullah M, Surono IS, Tahapary DL. Determinant of postprandial triglyceride levels in healthy young adults. Diabetes Metab Syndr 2019; 13:1917-1921. [PMID: 31235115 DOI: 10.1016/j.dsx.2019.04.027] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Accepted: 04/21/2019] [Indexed: 11/20/2022]
Abstract
BACKGROUND Fasting lipid profile does not necessarily illustrate the exact lipid dynamic in 24 h as human spends most of their time in postprandial state. Postprandial triglyceride (TG) has been reported to have advantages compared to fasting TG in terms of practicality and ability to predict cardiovascular events. This study aims to assess the determinant of postprandial TG in healthy young adults. METHODS This is a quasy-experimental study that involved 200 healthy young adults. This study compared fasting with postprandial TG and analyzed the relationship between postprandial TG with various demographic and metabolic parameters after ingestion of standardized high fat liquid meal. RESULT There was an upward trend from fasting TG to 2 h postprandial TG and 4 h postprandial TG. There was strong correlation between fasting TG and 2 h postprandial TG with 4 h postprandial TG (r = 0.731; p < 0.0001 dan r = 0.669; p < 0.0001, respectively). Whereas body mass index (BMI) and age showed weak correlation with 4 h postprandial TG (r = 0.141; p < 0.0001 dan r = 0.0747; p < 0.0001), fasting TG was the strongest predictor of 4 h postprandial TG (r = 0.669, B = 1.722 (95% CI 1.552 to 1.892), p < 0.0001). CONCLUSION Fasting TG was the strongest determinant of 4 h postprandial TG in healthy young adults. We also observed strong correlation between 4 h postprandial TG and fasting TG. Hence, 4 h postprandial TG might potentially replaced fasting TG when measurement of fasting TG is not feasible.
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Affiliation(s)
- Tri J E Tarigan
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Dr. Ciptomangunkusumo National General Hospital, Faculty of Medicine Universitas Indonesia, Indonesia; Metabolic, Cardiovascular, and Aging Cluster, The Indonesian Medical Education and Research Institute, Faculty of Medicine, Universitas Indonesia, Indonesia.
| | - Anandhara I Khumaedi
- Department of Internal Medicine, Dr. Ciptomangunkusumo National General Hospital, Faculty of Medicine Universitas Indonesia, Indonesia
| | - Syahidatul Wafa
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Dr. Ciptomangunkusumo National General Hospital, Faculty of Medicine Universitas Indonesia, Indonesia
| | - Michael Johan
- Metabolic, Cardiovascular, and Aging Cluster, The Indonesian Medical Education and Research Institute, Faculty of Medicine, Universitas Indonesia, Indonesia
| | - Murdani Abdullah
- Division of Gastroenterology, Department of Internal Medicine, Dr. Ciptomangunkusumo National General Hospital, Faculty of Medicine Universitas Indonesia, Indonesia
| | - Ingrid S Surono
- Department of Food Technology, Bina Nusantara University, Indonesia
| | - Dicky L Tahapary
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Dr. Ciptomangunkusumo National General Hospital, Faculty of Medicine Universitas Indonesia, Indonesia; Metabolic, Cardiovascular, and Aging Cluster, The Indonesian Medical Education and Research Institute, Faculty of Medicine, Universitas Indonesia, Indonesia
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Sandesara PB, Virani SS, Fazio S, Shapiro MD. The Forgotten Lipids: Triglycerides, Remnant Cholesterol, and Atherosclerotic Cardiovascular Disease Risk. Endocr Rev 2019; 40:537-557. [PMID: 30312399 PMCID: PMC6416708 DOI: 10.1210/er.2018-00184] [Citation(s) in RCA: 258] [Impact Index Per Article: 51.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Accepted: 10/08/2018] [Indexed: 12/11/2022]
Abstract
Atherosclerotic cardiovascular disease (ASCVD) remains the leading cause of death worldwide. Low-density lipoprotein cholesterol (LDL-C) is a well-established mediator of atherosclerosis and a key target for intervention for the primary and secondary prevention of ASCVD. However, despite substantial reduction in LDL-C, patients continue to have recurrent ASCVD events. Hypertriglyceridemia may be an important contributor of this residual risk. Observational and genetic epidemiological data strongly support a causal role of triglycerides (TGs) and the cholesterol content within triglyceride-rich lipoproteins (TGRLs) and/or remnant cholesterol (RC) in the development of ASCVD. TGRLs are composed of hepatically derived very low-density lipoprotein and intestinally derived chylomicrons. RC is the cholesterol content of all TGRLs and plasma TGs serve as a surrogate measure of TGRLs and RC. Although lifestyle modification remains the cornerstone for management of hypertriglyceridemia, many novel drugs are in development and have shown impressive efficacy in lowering TG levels. Several ongoing, randomized controlled trials are underway to examine the impact of these novel agents on ASCVD outcomes. In this comprehensive review, we provide an overview of the biology, epidemiology, and genetics of TGs and ASCVD; we discuss current and novel TG-lowering therapies under development.
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Affiliation(s)
- Pratik B Sandesara
- Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Salim S Virani
- Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas.,Baylor College of Medicine, Houston, Texas
| | - Sergio Fazio
- Center for Preventive Cardiology, Knight Cardiovascular Institute, Oregon Health & Science University, Portland, Oregon
| | - Michael D Shapiro
- Center for Preventive Cardiology, Knight Cardiovascular Institute, Oregon Health & Science University, Portland, Oregon
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Khan HA, Sobki SH, Ekhzaimy A, Khan I, Almusawi MA. Biomarker potential of C-peptide for screening of insulin resistance in diabetic and non-diabetic individuals. Saudi J Biol Sci 2018; 25:1729-1732. [PMID: 30591792 PMCID: PMC6303159 DOI: 10.1016/j.sjbs.2018.05.027] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Revised: 05/28/2018] [Accepted: 05/31/2018] [Indexed: 02/05/2023] Open
Abstract
Insulin resistance is a hallmark feature of type-2 diabetes mellitus (T2DM). We determined the homeostatic model assessment insulin resistance (HOMA-IR) and evaluated its association with C-peptide, insulin, fasting blood glucose (FBG) and glycated hemoglobin (HbA1c) in T2DM patients and non-diabetic subjects. This study comprised a total of 47 T2DM patients and 38 non-diabetic controls. Venous blood samples from all the subjects were collected and sera were analyzed for FBG, HbA1c, insulin and C-peptide using an autoanalyzer. HOMA-IR was calculated using the following equation: HOMA-IR = fasting insulin (µU/ml) × fasting glucose (mmol/L)/22.5. There was a significant increase in the levels of FBG and HbA1c in diabetic patients. Although the levels of C-peptide and insulin did not differ significantly between the two groups, a significant increase in HOMA-IR was observed in T2DM patients. Both insulin and C-peptide were significantly correlated with HOMA-IR. In conclusion, C-peptide may serve as a simple and convenient predictor of HOMA-IR.
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Affiliation(s)
- Haseeb A. Khan
- Department of Biochemistry, College of Science, King Saud University, Riyadh 11451, Saudi Arabia
- Corresponding author at: Department of Biochemistry, College of Science, Bldg. 5, King Saud University, P.O. Box 2455, Riyadh 11451, Saudi Arabia.
| | - Samia H. Sobki
- Department of Central Military Laboratory and Blood Bank, Prince Sultan Military Medical City, Riyadh 11159, Saudi Arabia
| | - Aishah Ekhzaimy
- Division of Endocrinology, Department of Medicine, King Khalid University Hospital, Riyadh 12372, Saudi Arabia
| | - Isra Khan
- Rohilkhand Medical College and Hospital, Bareilly 243006, India
| | - Mona A. Almusawi
- Department of Family and Community Medicine, Faculty of Medicine, King Saud University, Riyadh 12372, Saudi Arabia
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Impact of the triglyceride level on coronary plaque components in female patients with coronary artery disease treated with statins. Heart Vessels 2018; 33:1175-1184. [PMID: 29696358 DOI: 10.1007/s00380-018-1173-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Accepted: 04/20/2018] [Indexed: 01/13/2023]
Abstract
Several studies have reported that elevated triglyceride (TG) levels may be more strongly associated with an increased risk of coronary artery disease (CAD) in females than in males. We examined gender differences in the relationship between TG levels and coronary atherosclerosis using integrated backscatter intravascular ultrasound (IB IVUS) in CAD patients treated with statins. Three hundred seventy-eight CAD patients (105 females and 273 males) who underwent percutaneous coronary intervention using IB IVUS, and who were already receiving statin treatment, were included. Gray-scale and IB IVUS examinations were performed for the non-culprit segment of a coronary artery and fasting serum TG concentrations were measured. We found that TG levels were significantly correlated with increased lipid (r = 0.40, p < 0.001) and decreased fibrous (r = - 0.37, p < 0.001) plaque components in females, but not in males. Low-density lipoprotein cholesterol and high-density lipoprotein cholesterol levels were not related to either the gray-scale or IB IVUS parameters in both genders. After adjustment for conventional coronary risk factors by a multivariate stepwise regression analysis, higher TG levels in females were independently associated with increased lipid (β = 0.31, p< 0.001) contents in coronary plaques. In conclusion, among CAD patients treated with statins, TG levels were associated with lipid-rich coronary plaques in females, but not in males. TG levels may be more important indicators of residual risk after statin treatment in females than in males.
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Rosenson RS, Davidson MH, Hirsh BJ, Kathiresan S, Gaudet D. Genetics and causality of triglyceride-rich lipoproteins in atherosclerotic cardiovascular disease. J Am Coll Cardiol 2015; 64:2525-40. [PMID: 25500239 DOI: 10.1016/j.jacc.2014.09.042] [Citation(s) in RCA: 168] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2014] [Revised: 09/18/2014] [Accepted: 09/21/2014] [Indexed: 12/31/2022]
Abstract
Triglycerides represent 1 component of a heterogeneous pool of triglyceride-rich lipoproteins (TGRLs). The reliance on triglycerides or TGRLs as cardiovascular disease (CVD) risk biomarkers prompted investigations into therapies that lower plasma triglycerides as a means to reduce CVD events. Genetic studies identified TGRL components and pathways involved in their synthesis and metabolism. We advocate that only a subset of genetic mechanisms regulating TGRLs contribute to the risk of CVD events. This "omic" approach recently resulted in new targets for reducing CVD events.
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Affiliation(s)
- Robert S Rosenson
- Mount Sinai Heart, Cardiometabolic Disorders, Icahn School of Medicine at Mount Sinai, New York, New York.
| | - Michael H Davidson
- Division of Cardiology, Pritzker School of Medicine, University of Chicago, Chicago, Illinois
| | | | - Sekar Kathiresan
- Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Daniel Gaudet
- ECOGENE-21 and Lipid Clinic, Department of Medicine, Université de Montreal, Chicoutimi, Quebec, Canada
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Gutiérrez-Salmeán G, Ortiz-Vilchis P, Vacaseydel CM, Rubio-Gayosso I, Meaney E, Villarreal F, Ramírez-Sánchez I, Ceballos G. Acute effects of an oral supplement of (-)-epicatechin on postprandial fat and carbohydrate metabolism in normal and overweight subjects. Food Funct 2014; 5:521-7. [PMID: 24458104 DOI: 10.1039/c3fo60416k] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Postprandial hyperglycemia, in particular when accompanied by excessive hypertriglyceridemia, is associated with increased cardiovascular risk, mainly in overweight or obese subjects, as it favors oxidative stress, systemic inflammation and endothelial dysfunction. Thus, treatments that favorably modulate metabolism by reducing steep increases in postprandial serum glucose and triglycerides, are of considerable interest. Evidence suggests that (-)-epicatechin (EPI) is responsible for reductions in cardiometabolic risk associated with chocolate consumption; these effects may be associated with favorable effects of EPI on postprandial metabolism. The aims of this study were to assess the effects of EPI on postprandial metabolism in normal-weight and overweight/obese subjects. Twenty adult volunteers (normal and overweight) underwent oral metabolic tolerance tests in the absence and presence of oral EPI (1 mg kg(-1)). Metabolic responses were examined using indirect calorimetry and determining blood glucose and triglycerides at 0, 2 and 4 hours after metabolic load ingestion. Results show that EPI increased postprandial lipid catabolism, as evidenced by a significant decrease in the respiratory quotient, which implies an increase in fat oxidation. The effect was associated with significantly lower postprandial plasma glucose and triglycerides concentrations. The effects were more prominent in overweight subjects. In conclusion, EPI modulates postprandial metabolism by enhancing lipid oxidation accompanied by reductions in glycemia and triglyceridemia.
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Affiliation(s)
- Gabriela Gutiérrez-Salmeán
- Laboratorio de Investigación Integral Cardiometabólica, Escuela Superior de Medicina, Instituto Politécnico Nacional, Plan de San Luis y Díaz Mirón s/n. Casco de Santo Tomás, Miguel Hidalgo. C.P. 11340, Mexico City, Mexico.
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Mirmiran P, Bahadoran Z, Golzarand M, Zojaji H, Azizi F. A comparative study of broccoli sprouts powder and standard triple therapy on cardiovascular risk factors following H.pylori eradication: a randomized clinical trial in patients with type 2 diabetes. J Diabetes Metab Disord 2014; 13:64. [PMID: 24940565 PMCID: PMC4060758 DOI: 10.1186/2251-6581-13-64] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2014] [Accepted: 05/03/2014] [Indexed: 12/30/2022]
Abstract
Background In this clinical trial we compared the effects of broccoli sprouts powder, as an alternative and complementary treatment, to those of standard triple therapy, as a common medical treatment, on cardiovascular risk factors following the H.pylori eradication in patients with type 2 diabetes. Methods Eighty-six type 2 diabetic patients with positive H.pylori stool antigen test (HpSAg) were randomized to receive one of the three following regimens: STT) Standard triple therapy (omeprazole 20 mg, clarithromycin 500 mg, amoxicillin 1000 mg, twice a day for 14 days), BSP) 6 g/d broccoli sprouts powder for 28 days, and combination of these as STT + BSP. After 4 weeks of treatment, H.pylori eradication rates were assessed by HpSAg. Anthropometric measures, blood pressure, serum lipids and lipoproteins as well as serum high sensitive- C reactive protein were also assessed at baseline and at the second examination. Results Seventy-seven participants completed the study [STT (n = 28), BSP (n = 25), STT + BSP (n = 24)]. The H.pylori eradication rates were 89.3%, 56.0% and 91.7% in STT, BSP and STT + BSP groups, respectively. After the treatment, both systolic and diastolic blood pressure significantly decreased in STT + BSP group (P < 0.05). Serum triglycerides and TG/HDL-C ratio increased in STT patients group (<0.05). Serum hs-CRP levels significantly decreased in the patients who were treated with BSP per se (3.0 ± 2.5 at baseline vs. 2.3 ± 2.1 after the treatment, P < 0.05). Conclusion Compared to standard triple therapy, BSP regimen in addition to considerable effects on H.pylori eradication had also favorable properties on cardiovascular risk factors following the H.pylori eradication.
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Affiliation(s)
- Parvin Mirmiran
- Nutrition and Endocrine Research Center, and Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran ; Department of Clinical Nutrition and Diet Therapy, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zahra Bahadoran
- Nutrition and Endocrine Research Center, and Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahdieh Golzarand
- Nutrition and Endocrine Research Center, and Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Homayoun Zojaji
- Research Center for Gastroenterology and Liver Disease, Department of Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O.Box: 19395-4763, Tehran, Iran
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Lee EY, Hwang S, Lee SH, Lee YH, Choi AR, Lee Y, Lee BW, Kang ES, Ahn CW, Cha BS, Lee HC. Postprandial C-peptide to glucose ratio as a predictor of β-cell function and its usefulness for staged management of type 2 diabetes. J Diabetes Investig 2014; 5:517-24. [PMID: 25411619 PMCID: PMC4188109 DOI: 10.1111/jdi.12187] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2013] [Revised: 09/24/2013] [Accepted: 10/20/2013] [Indexed: 11/28/2022] Open
Abstract
Aims/Introduction Type 2 diabetes is characterized by progressive deterioration of β‐cell function. Recently, it was suggested that the C‐peptide‐to‐glucose ratio after oral glucose ingestion is a better predictor of β‐cell mass than that during fasting. We investigated whether postprandial C‐peptide‐to‐glucose ratio (PCGR) reflects β‐cell function, and its clinical application for management of type 2 diabetes. Materials and Methods We carried out a two‐step retrospective study of 919 Korean participants with type 2 diabetes. In the first step, we evaluated the correlation of PCGR level with various markers for β‐cell function in newly diagnosed and drug‐naïve patients after a mixed meal test. In the second step, participants with well‐controlled diabetes (glycated hemoglobin <7%) were divided into four groups according to treatment modality (group I: insulin, group II: sulfonylurea and/or dipeptityl peptidase IV inhibitor, group III: metformin and/or thiazolidinedione and group IV: diet and exercise group). Results In the first step, PCGR was significantly correlated with various insulin secretory indices. Furthermore, PCGR showed better correlation with glycemic indices than homeostatic model assessment of β‐cell function (HOMA‐β). In the second step, the PCGR value significantly increased according to the following order: group I, II, III, and IV after adjusting for age, sex, body mass index and duration of diabetes. The cut‐off values of PCGR for separating each group were 1.457, 2.870 and 3.790, respectively (P < 0.001). Conclusions We suggest that PCGR might be a useful marker for β‐cell function and an ancillary parameter in the choice of antidiabetic medication in type 2 diabetes.
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Affiliation(s)
- Eun Young Lee
- Department of Internal Medicine Yonsei University College of Medicine Seoul Korea
| | - Sena Hwang
- Department of Internal Medicine Yonsei University College of Medicine Seoul Korea ; International Health Care Center Yonsei Medical Health System Seoul Korea
| | - Seo Hee Lee
- Department of Internal Medicine Yonsei University College of Medicine Seoul Korea
| | - Yong-Ho Lee
- Department of Internal Medicine Yonsei University College of Medicine Seoul Korea
| | - A Ra Choi
- Department of Internal Medicine Yonsei University College of Medicine Seoul Korea
| | - Youngki Lee
- Department of Internal Medicine Yonsei University College of Medicine Seoul Korea
| | - Byung-Wan Lee
- Department of Internal Medicine Yonsei University College of Medicine Seoul Korea
| | - Eun Seok Kang
- Department of Internal Medicine Yonsei University College of Medicine Seoul Korea
| | - Chul Woo Ahn
- Department of Internal Medicine Yonsei University College of Medicine Seoul Korea
| | - Bong Soo Cha
- Department of Internal Medicine Yonsei University College of Medicine Seoul Korea
| | - Hyun Chul Lee
- Department of Internal Medicine Yonsei University College of Medicine Seoul Korea
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Park KH, Kim KJ, Lee BW, Kang ES, Cha BS, Lee HC. The effect of insulin resistance on postprandial triglycerides in Korean type 2 diabetic patients. Acta Diabetol 2014; 51:15-22. [PMID: 22854916 DOI: 10.1007/s00592-012-0420-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2012] [Accepted: 07/16/2012] [Indexed: 11/29/2022]
Abstract
We hypothesized that the influence of metabolic parameters depends on metabolic syndrome (MetS) status. The clinical and metabolic implications of postprandial triglyceride (ppTG) in Korean type 2 diabetes were investigated in the presence or absence of MetS, MetS+, or MetS-. To investigate the relationship between ppTG and metabolic parameters, we analyzed plasma TG levels in 126 newly diagnosed, drug-naïve diabetic patients after ingestion of a standardized low calorie and fat (500 kcal, 17.5 g fat) liquid meal formula. We report that MetS+ patients have significantly higher BMI, waist/hip ratio, HOMA-IR, and HOMA-β, but insignificantly higher fasting TG, ppTG, and ΔTG than MetS- patients. In the MetS+ patients, ppTG correlated with fasting TG and non-HDL, but was not related to HOMA-IR. In MetS- patients, ppTG correlated with fasting TG, non-HDL, blood pressure, waist/hip ratio, fasting C-peptide and insulin levels, and HOMA-IR. Multivariate analysis showed HOMA-IR to be a predictive factor for ppTG in MetS- patients but not in MetS+ patients. ppTG correlated with IR in MetS- type 2 diabetic patients but not in MetS+. This unexpected result implies that MetS+ diabetic patients already have high fasting TG and that IR influences fasting TG more dominantly than ppTG.
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Affiliation(s)
- Kyeong Hye Park
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Republic of Korea
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Kim HM, Kim KJ, Lee HJ, Yu HT, Moon JH, Kang ES, Cha BS, Lee HC, Lee BW, Kim YJ. Epicardial adipose tissue thickness is an indicator for coronary artery stenosis in asymptomatic type 2 diabetic patients: its assessment by cardiac magnetic resonance. Cardiovasc Diabetol 2012; 11:83. [PMID: 22809408 PMCID: PMC3461492 DOI: 10.1186/1475-2840-11-83] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2012] [Accepted: 07/05/2012] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND We used cardiovascular magnetic resonance (CMR) to investigate the association between epicardial adipose tissue (EAT) thickness and silent myocardial ischemia, as well as coronary artery stenosis, in asymptomatic type 2 diabetic patients. METHODS The study included 100 type 2 diabetic subjects (51 male and 49 female; mean age: 56 ± 7 years). Silent myocardial ischemia, as determined by CMR, was defined as evidence of inducible ischemia or myocardial infarction. Signal reduction or stenosis of ≥ 50% in the vessel diameter was used as the criteria for significant coronary artery stenosis on coronary magnetic resonance (MR) angiography. RESULTS EAT thickness was positively correlated with body mass index (BMI), waist-to-hip ratio, systolic blood pressure, postprandial glucose, fasting/postprandial triglyceride (TG), serum glycated hemoglobin (HbA1c) level, and homeostasis model assessment of insulin resistance (HOMA-IR) score. Significant coronary artery stenosis was found in 24 patients, while 14 patients had silent myocardial ischemia in CMR (1 with silent myocardial infarction, 11 with inducible ischemia, and 2 with both). EAT thickness was greater in patients who had coronary artery stenosis (13.0 ± 2.6 mm vs. 11.5 ± 2.1 mm, p = 0.01), but did not differ between the subjects with or without silent myocardial ischemia on CMR images (12.8 ± 2.1 vs. 11.7 ± 2.3 mm, p = 0.11). Multivariate logistic regression analysis indicated that EAT thickness was an independent indicator for significant coronary artery stenosis after adjusting for traditional risk factors (OR 1.403, p = 0.026). CONCLUSIONS Increased EAT thickness assessed by CMR is an independent risk factor for significant coronary artery stenosis in asymptomatic type 2 diabetes. However, EAT thickness was not associated with silent myocardial ischemia.
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Affiliation(s)
- Hyun Min Kim
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea
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