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Wachter H, von Loeffelholz C, Thomas-Rüddel DO, Bargenda S, Birkenfeld AL, Bauer M, Ehler J. [Life-threatening euglycemic ketoacidosis under treatment with empagliflozin in cardiac surgery patients: rare isolated case or a frequent problem in the future?]. Anaesthesiologie 2024; 73:336-339. [PMID: 38635034 PMCID: PMC11076387 DOI: 10.1007/s00101-024-01406-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 02/19/2024] [Accepted: 03/12/2024] [Indexed: 04/19/2024]
Affiliation(s)
- H Wachter
- Klinik für Anästhesiologie und Intensivmedizin, Universitätsklinikum Jena, Am Klinikum 1, 07749, Jena, Deutschland
| | - C von Loeffelholz
- Klinik für Anästhesiologie und Intensivmedizin, Universitätsklinikum Jena, Am Klinikum 1, 07749, Jena, Deutschland
| | - D O Thomas-Rüddel
- Klinik für Anästhesiologie und Intensivmedizin, Universitätsklinikum Jena, Am Klinikum 1, 07749, Jena, Deutschland
| | - S Bargenda
- Klinik für Herz- und Thoraxchirurgie, Universitätsklinikum Jena, Jena, Deutschland
| | - A L Birkenfeld
- Klinik für Diabetologie, Endokrinologie, Nephrologie, Innere Medizin IV, Universitätsklinikum Tübingen, Tübingen, Deutschland
- Deutsches Zentrum für Diabetesforschung (DZD e. V.), Neuherberg, Deutschland
| | - M Bauer
- Klinik für Anästhesiologie und Intensivmedizin, Universitätsklinikum Jena, Am Klinikum 1, 07749, Jena, Deutschland
| | - J Ehler
- Klinik für Anästhesiologie und Intensivmedizin, Universitätsklinikum Jena, Am Klinikum 1, 07749, Jena, Deutschland.
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Laufs U, Birkenfeld AL, Fraass U, Hohenstein B, Siegert C, Klotsche J, Parhofer KG, Pittrow D, Dexl S, Salmen S, Schettler VJJ, Steinhagen-Thiessen E. Novel insights into the management of German patients with very high cardiovascular risk eligible for PCSK9 inhibitor treatment: baseline characteristics from the PERI-DYS study. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
The reasons why patients are treated or not with PCSK9 inhibitors (PCSK9i) are incompletely understood. In Germany, access to PCSK9i is limited by local regulations and many high-risk cardiovascular patients do not receive these therapies. The PERI-DYS study aims to describe and compare two groups of dyslipidaemia patients at very high CV risk: those treated with PCSK9i compared with patients qualifying for but not treated with PCSK9i.
Methods
Observational study with up to 2000 consented patients, documented mainly by office-based cardiologists or physicians in lipid ambulances with data extracted from patient charts. Lipid lowering treatment (LLT) at enrolment includes ongoing PCSK9i use, newly initiated PCSK9i, statins, ezetimibe, and lipoprotein apheresis. Patients are followed for up to 3 years, with visits every 6±2 months to record LLT (drugs, dosing), other CV medications, lipid and glucose values, blood pressure, clinical events (major adverse cardiac and cerebrovascular events) and adverse drug reactions.
Results
As of 05 March 2021, 1488 patients have been enrolled across 70 sites. The majority of patients (91.5%) had heterozygous familial or non-familial hypercholesterolemia or mixed dyslipidaemia. At enrolment, 49.4% of patients were receiving PCSK9i (35.4% ongoing and 14.0% newly treated). Among PCSK9i users, the majority were receiving evolocumab 140 mg (n=567, 38.1% of all enrolled patients). There were no major differences in demographics and non-lipid lowering medication, with the exception of more females in the PCSK9i group.
The estimated untreated LDL-C based on “back-calculation” was higher in patients who were on ongoing PCSK9i therapy than in those not on PCSK9i or newly treated with PCSK9i (Table 1). Physician-reported statin intolerance was much more common in the two PCSK9i groups compared with the non-PCSK9i group (67% versus 14%). Patients in the PCSK9i groups received fewer concomitant statins. Mean on-treatment total cholesterol and LDL-C were considerably lower in patients who were on ongoing PCSK9i compared to non-PCSK9i. Overall, nicotinic acid, fibrates, cholestagel, and omega-3 fatty acids were rarely used (data not shown).
Conclusions
Patients treated with PCSK9i and those qualifying for but not treated with PCSK9i had similar baseline characteristics, but the former had higher estimated untreated LDL-C values and a higher rate of statin intolerance. Ongoing follow-up will determine the prognostic importance of these findings.
Funding Acknowledgement
Type of funding sources: Private company. Main funding source(s): Amgen GmbH Germany
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Affiliation(s)
- U Laufs
- Leipzig University Hospital, Department of Cardiology, Leipzig, Germany
| | - A L Birkenfeld
- University hospital Tübingen, Internal Medicine IV, Tuebingen, Germany
| | | | - B Hohenstein
- Nephrologisches Zentrum, Villingen-Schwenningen, Germany
| | | | - J Klotsche
- Deutsches Rheumaforschungszentrum, Epidemiologie, Berlin, Germany
| | - K G Parhofer
- Ludwig-Maximilians University, Medizinische Klinik und Poliklinik IV, Munich, Germany
| | - D Pittrow
- University Hospital Carl Gustav Carus, Dresden, Germany
| | - S Dexl
- Amgen GmbH, Munich, Germany
| | | | | | - E Steinhagen-Thiessen
- Charite Universitatsmedizin Berlin, Department of Endocrinology and Metabolism, Berlin, Germany
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Capristo E, Panunzi S, De Gaetano A, Raffaelli M, Guidone C, Iaconelli A, L'Abbate L, Birkenfeld AL, Bellantone R, Bornstein S, Mingrone G. Corrigendum to "Intensive lifestyle modifications with or without liraglutide 3mg vs. sleeve gastrectomy: A three-arm non-randomised, controlled, pilot study" [Diabetes Metab. 44 (2018) 235-242]. Diabetes Metab 2019; 46:179. [PMID: 30857948 DOI: 10.1016/j.diabet.2019.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- E Capristo
- Department of Internal Medicine, Catholic University, Rome, Italy; Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - S Panunzi
- CNR-Institute of Systems Analysis and Computer Science (IASI), BioMatLab, Rome, Italy
| | - A De Gaetano
- CNR-Institute of Systems Analysis and Computer Science (IASI), BioMatLab, Rome, Italy
| | - M Raffaelli
- Department of Surgery, Catholic University, Rome, Italy
| | - C Guidone
- Department of Internal Medicine, Catholic University, Rome, Italy
| | - A Iaconelli
- Department of Internal Medicine, Catholic University, Rome, Italy
| | - L L'Abbate
- CNR-Institute of Systems Analysis and Computer Science (IASI), BioMatLab, Rome, Italy
| | - A L Birkenfeld
- Department of Medicine III, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden, Dresden, Germany; Diabetes and Nutritional Sciences, Hodgkin Building, Guy's Campus, King's College London, London, United Kingdom; Paul Langerhans Institute Dresden of the Helmholtz Centre Munich at University Hospital Dresden, a member of the German Centre for Diabetes Research, Dresden, Germany
| | - R Bellantone
- Department of Surgery, Catholic University, Rome, Italy
| | - S Bornstein
- Department of Medicine III, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden, Dresden, Germany; Diabetes and Nutritional Sciences, Hodgkin Building, Guy's Campus, King's College London, London, United Kingdom
| | - G Mingrone
- Department of Internal Medicine, Catholic University, Rome, Italy; Diabetes and Nutritional Sciences, Hodgkin Building, Guy's Campus, King's College London, London, United Kingdom; Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
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Tofte N, Lindhardt M, Adamova K, Beige J, Beulens JWJ, Birkenfeld AL, Currie G, Delles C, Dimos I, Francová L, Frimodt-Møller M, Girman P, Göke R, Havrdova T, Kooy A, Mischak H, Navis G, Nijpels G, Noutsou M, Ortiz A, Parvanova A, Persson F, Ruggenenti PL, Rutters F, Rychlík I, Spasovski G, Speeckaert M, Trillini M, von der Leyen H, Rossing P. Characteristics of high- and low-risk individuals in the PRIORITY study: urinary proteomics and mineralocorticoid receptor antagonism for prevention of diabetic nephropathy in Type 2 diabetes. Diabet Med 2018; 35:1375-1382. [PMID: 29781558 DOI: 10.1111/dme.13669] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/10/2018] [Indexed: 12/13/2022]
Abstract
AIM To compare clinical baseline data in individuals with Type 2 diabetes and normoalbuminuria, who are at high or low risk of diabetic kidney disease based on the urinary proteomics classifier CKD273. METHODS We conducted a prospective, randomized, double-blind, placebo-controlled international multicentre clinical trial and observational study in participants with Type 2 diabetes and normoalbuminuria, stratified into high- or low-risk groups based on CKD273 score. Clinical baseline data for the whole cohort and stratified by risk groups are reported. The associations between CKD273 and traditional risk factors for diabetic kidney disease were evaluated using univariate and logistic regression analysis. RESULTS A total of 1777 participants from 15 centres were included, with 12.3% of these having a high-risk proteomic pattern. Participants in the high-risk group (n=218), were more likely to be men, were older, had longer diabetes duration, a lower estimated GFR and a higher urinary albumin:creatinine ratio than those in the low-risk group (n=1559, P<0.02). Numerical differences were small and univariate regression analyses showed weak associations (R2 < 0.04) of CKD273 with each baseline variable. In a logistic regression model including clinical variables known to be associated with diabetic kidney disease, estimated GFR, gender, log urinary albumin:creatinine ratio and use of renin-angiotensin system-blocking agents remained significant determinants of the CKD273 high-risk group: area under the curve 0.72 (95% CI 0.68-0.75; P<0.01). CONCLUSIONS In this population of individuals with Type 2 diabetes and normoalbuminuria, traditional diabetic kidney disease risk factors differed slightly between participants at high risk and those at low risk of diabetic kidney disease, based on CKD273. These data suggest that CKD273 may provide additional prognostic information over and above the variables routinely available in the clinic. Testing the added value will be subject to our ongoing study. (European Union Clinical Trials Register: EudraCT 2012-000452-34 and Clinicaltrials.gov: NCT02040441).
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Affiliation(s)
- N Tofte
- Steno Diabetes Centre Copenhagen, Gentofte, Denmark
| | - M Lindhardt
- Steno Diabetes Centre Copenhagen, Gentofte, Denmark
| | - K Adamova
- University Clinic of Endocrinology, Diabetes and Metabolic Disorders, Skopje, Macedonia
| | - J Beige
- Klinikum St. Georg, Nephrology and KfH Renal Unit, Leipzig, Martin-Luther University Halle, Wittenberg, Germany
| | - J W J Beulens
- Amsterdam Public Health Research Institute, VU University Medical Centre, Amsterdam, The Netherlands
- Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - A L Birkenfeld
- Clinical Study Centre Metabolic Vascular Medicine, GWT TU-Dresden GmbH, Dresden, Germany
- Paul Langerhans Institute Dresden of the Helmholtz Centre Munich at University Hospital, and Faculty of Medicine, TU Dresden, Dresden, Germany
- German Centre for Diabetes Research (DZD e.V.), Neuherberg, Germany
| | - G Currie
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - C Delles
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - I Dimos
- Diabetespraxis, Leipzig, Germany
| | - L Francová
- 1st Department, Charles University, Third Faculty of Medicine, Prague, Czech Republic
| | | | - P Girman
- Diabetes Centre, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - R Göke
- Diabetologische Schwerpunktpraxis, Diabetologen Hessen, Marburg, Germany
| | - T Havrdova
- Diabetes Centre, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - A Kooy
- Bethesda Diabetes Research Centre, Hoogeveen and University Medical Centre Groningen, Netherlands
| | - H Mischak
- Mosaiques Diagnostics, Hannover, Germany
| | - G Navis
- Division of Nephrology, Department of Internal Medicine, University Medical Centre Groningen, Groningen, Netherlands
| | - G Nijpels
- Department General Practice and Elderly Care, Amsterdam Public Health VU University Medical Centre, Amsterdam, The Netherlands
| | - M Noutsou
- Diabetes Centre and 2nd Department of Internal Medicine, National and Kapodistrian University of Athens, Hippokratio General Hospital, Athens, Greece
| | - A Ortiz
- Instituto de Investigacion Sanitaria de la Fundacion Jiménez Díaz UAM, Madrid, Spain
| | - A Parvanova
- Istituto di Richerche Farmacologiche Mario Negri, Bergamo, Italy
| | - F Persson
- Steno Diabetes Centre Copenhagen, Gentofte, Denmark
| | - P L Ruggenenti
- Istituto di Richerche Farmacologiche Mario Negri, Bergamo, Italy
| | - F Rutters
- Amsterdam Public Health Research Institute, VU University Medical Centre, Amsterdam, The Netherlands
| | - I Rychlík
- 1st Department, Charles University, Third Faculty of Medicine, Prague, Czech Republic
- Faculty Hospital Královské Vinohrady, Prague, Czech Republic
| | - G Spasovski
- Department of Nephrology, Cyril and Methodius University in Skopje, Skopje, Macedonia
| | - M Speeckaert
- Ghent University Hospital, Department of Nephrology, Ghent, Belgium
| | - M Trillini
- Istituto di Richerche Farmacologiche Mario Negri, Bergamo, Italy
| | | | - P Rossing
- Steno Diabetes Centre Copenhagen, Gentofte, Denmark
- University of Copenhagen, Copenhagen, Denmark
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Capristo E, Panunzi S, De Gaetano A, Raffaelli M, Guidone C, Iaconelli A, L'Abbate L, Birkenfeld AL, Bellantone R, Bornstein SR, Mingrone G. Intensive lifestyle modifications with or without liraglutide 3mg vs. sleeve gastrectomy: A three-arm non-randomised, controlled, pilot study. Diabetes Metab 2017; 44:235-242. [PMID: 29398254 DOI: 10.1016/j.diabet.2017.12.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2017] [Revised: 12/04/2017] [Accepted: 12/19/2017] [Indexed: 12/14/2022]
Abstract
BACKGROUND/OBJECTIVES As only 1% of clinically eligible subjects choose to undergo surgical treatment for obesity, other options should be investigated. This study aimed to assess the effects of intensive lifestyle modification (ILM) with or without 3-mg liraglutide daily vs. sleeve gastrectomy (SG) on BMI after 1 year. SUBJECTS/METHODS In this study performed at an Italian university hospital, non-diabetic patients eligible for bariatric surgery were recruited from a weight-loss clinic and had the option to choose from three possible weight-loss programmes up to an allocation of 25 subjects in each arm matched by BMI and age. ILM consisted in 813kcal of a very low-calorie diet (VLCD) for 1 month, followed by a diet of 12kcal/kg body weight of high protein and high fat for 11 months plus 30min of brisk walking daily and at least 3h of aerobic exercise weekly. SG patients followed a VLCD for 1 month and a free diet thereafter. Patients were evaluated at baseline and at 1, 3, 6, 9 and 12 months. RESULTS A total of 75 patients were enrolled; retention was 100% in the SG and 85% in the two medical arms. SG reduced BMI by 32% (P<0.001 vs. medical arm), while ILM+liraglutide and ILM led to BMI reductions of 24% and 14%, respectively (P<0.001). More women allocated themselves to the ILM+liraglutide group. Weight loss was 43kg with SG, 26kg with ILM+liraglutide and 15kg with ILM alone. Lean body mass reductions were -11.6kg with SG, -6.3kg with ILM and -8.3kg with ILM+liraglutide. Prevalence of prediabetes was significantly lower with ILM+liraglutide, and insulin resistance was reduced by about 70% by both ILM+liraglutide and SG vs. 39% by ILM alone. Cardiometabolic risk factors were greatly reduced in all three groups. DISCUSSION At least in the short-term, liraglutide 3.0mg once daily associated with drastic calorie-intake restriction and intensive physical activity promoted a 24% weight loss, which was almost two times greater than ILM alone and only about 25% less than with SG, while preserving lean body mass. Although this study was non-randomised, it was designed to explore the efficacy of medical treatments for obesity in everyday clinical practice.
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Affiliation(s)
- E Capristo
- Department of Internal Medicine, Catholic University, Rome, Italy
| | - S Panunzi
- CNR-Institute of Systems Analysis and Computer Science (IASI), BioMatLab, Rome, Italy
| | - A De Gaetano
- CNR-Institute of Systems Analysis and Computer Science (IASI), BioMatLab, Rome, Italy
| | - M Raffaelli
- Department of Surgery, Catholic University, Rome, Italy
| | - C Guidone
- Department of Internal Medicine, Catholic University, Rome, Italy
| | - A Iaconelli
- Department of Internal Medicine, Catholic University, Rome, Italy
| | - L L'Abbate
- CNR-Institute of Systems Analysis and Computer Science (IASI), BioMatLab, Rome, Italy
| | - A L Birkenfeld
- Department of Medicine III, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden, Dresden, Germany; Diabetes and Nutritional Sciences, Hodgkin Building, Guy's Campus, King's College London, London, United Kingdom; Paul Langerhans Institute Dresden of the Helmholtz Centre Munich at University Hospital Dresden, a member of the German Centre for Diabetes Research (DZD e.V.), Dresden, Germany
| | - R Bellantone
- Department of Surgery, Catholic University, Rome, Italy
| | - S R Bornstein
- Department of Medicine III, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden, Dresden, Germany; Diabetes and Nutritional Sciences, Hodgkin Building, Guy's Campus, King's College London, London, United Kingdom
| | - G Mingrone
- Department of Internal Medicine, Catholic University, Rome, Italy; Diabetes and Nutritional Sciences, Hodgkin Building, Guy's Campus, King's College London, London, United Kingdom.
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Gardemann P, Pistrosch F, Henkel E, Hanefeld M, Birkenfeld AL. Hypoglycemia is associated with acute changes in the QTc interval and reduced heart rate in type 2 diabetic patients with cardiovascular disease in a real world setting. DIABETOL STOFFWECHS 2017. [DOI: 10.1055/s-0037-1601762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- P Gardemann
- Universitätsklinikum Dresden, Studienzentrum für Metabolisch Vaskuläre Medizin GWT-TUD, Dresden, Germany
| | - F Pistrosch
- Universitätsklinikum Dresden, Studienzentrum für Metabolisch Vaskuläre Medizin GWT-TUD, Dresden, Germany
| | - E Henkel
- Universitätsklinikum Dresden, Studienzentrum für Metabolisch Vaskuläre Medizin GWT-TUD, Dresden, Germany
| | - M Hanefeld
- Universitätsklinikum Dresden, Studienzentrum für Metabolisch Vaskuläre Medizin GWT-TUD, Dresden, Germany
| | - AL Birkenfeld
- Universitätsklinikum Dresden, Studienzentrum für Metabolisch Vaskuläre Medizin GWT-TUD, Dresden, Germany
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Henke C, Willmes DM, Kurzbach A, Schumann T, Birkenfeld AL. The role of aging in glucose homeostasis. DIABETOL STOFFWECHS 2017. [DOI: 10.1055/s-0037-1601731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- C Henke
- University Clinic Carl Gustav Carus at the TU Dresden, Medical Clinic III, DZD, Paul-Langerhans-Institute Dresden, Dresden, Germany
| | - DM Willmes
- University Clinic Carl Gustav Carus at the TU Dresden, Medical Clinic III, DZD, Paul-Langerhans-Institute Dresden, Dresden, Germany
| | - A Kurzbach
- University Clinic Carl Gustav Carus at the TU Dresden, Medical Clinic III, DZD, Paul-Langerhans-Institute Dresden, Dresden, Germany
| | - T Schumann
- University Clinic Carl Gustav Carus at the TU Dresden, Medical Clinic III, DZD, Paul-Langerhans-Institute Dresden, Dresden, Germany
| | - AL Birkenfeld
- University Clinic Carl Gustav Carus at the TU Dresden, Medical Clinic III, DZD, Paul-Langerhans-Institute Dresden, Dresden, Germany
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Loeffelholz C, Mingrone G, Birkenfeld AL. Circulating proneurotensin is related to insulin sensitivity in human subjects after metabolic surgery. DIABETOL STOFFWECHS 2017. [DOI: 10.1055/s-0037-1601622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- C Loeffelholz
- Jena University Hospital, Department of Anesthesiology and Intensive Care, Jena, Germany
| | - G Mingrone
- Catholic University Rome, Department of Internal Medicine, Rome, Italy
| | - AL Birkenfeld
- King's College London, Diabetes and Nutritional Sciences, London, United Kingdom
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Hanefeld M, Appelt D, Engelmann K, Sandner D, Bornstein SR, Ganz X, Henkel E, Haase R, Birkenfeld AL. Serum and Plasma Levels of Vascular Endothelial Growth Factors in Relation to Quality of Glucose Control, Biomarkers of Inflammation, and Diabetic Nephropathy. Horm Metab Res 2016; 48:620. [PMID: 27756080 DOI: 10.1055/s-0036-1585504] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- M Hanefeld
- Study Center Professor Hanefeld, GWT TU-Dresden GmbH, Dresden, Germany
| | - D Appelt
- Study Center Professor Hanefeld, GWT TU-Dresden GmbH, Dresden, Germany
| | - K Engelmann
- Klinik für Augenheilkunde, Klinikum Chemnitz gGmbH, Chemnitz, Germany
| | - D Sandner
- Augenklinik und Poliklinik, Universitätsklinikum "Carl Gustav Carus", Technische Universität Dresden, Dresden, Germany
| | - S R Bornstein
- Medical Clinic III, Universitätsklinikum "Carl Gustav Carus", Paul Langerhans Institute Dresden (PLID), Technische Universität Dresden, Dresden, Germany
| | - X Ganz
- Study Center Professor Hanefeld, GWT TU-Dresden GmbH, Dresden, Germany
| | - E Henkel
- Study Center Professor Hanefeld, GWT TU-Dresden GmbH, Dresden, Germany
| | - R Haase
- Zentrum f. klin. Neurowissenschaften, eHealth Group, Universitätsklinikum "Carl Gustav Carus", Technische Universität Dresden, Dresden, Germany
| | - A L Birkenfeld
- Study Center Professor Hanefeld, GWT TU-Dresden GmbH, Dresden, Germany
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Hanefeld M, Appelt D, Engelmann K, Sandner D, Bornstein SR, Ganz X, Henkel E, Haase R, Birkenfeld AL. Serum and Plasma Levels of Vascular Endothelial Growth Factors in Relation to Quality of Glucose Control, Biomarkers of Inflammation, and Diabetic Nephropathy. Horm Metab Res 2016; 48:529-34. [PMID: 27388431 DOI: 10.1055/s-0042-106295] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Levels of vascular endothelial growth factors (VEGF) are regulated in a complex network of adipokines, glucose control, and low grade inflammation together with activated platelets, leucocytes, and endothelial dysfunction. Increased levels of VEGF are associated with enhanced angiogenesis and impaired repair mechanisms of vascular lesions in endorgans. Little is known about the interaction of systemic VEGF levels with quality of diabetes control, biomarkers of inflammation, and diabetic nephropathy. Moreover, it is unclear, whether serum and plasma VEGF levels are similarly suited to reflect risk associated with VEGF.In this case control study, we analyzed these parameters in serum and plasma of age and sex matched controls without diabetes (n=99) and type 2 diabetes (n=302). Serum VEGF-A was significantly increased in patients with T2DM while plasma levels were in the same range as for controls. Individual levels varied in a wide range. Serum levels were 4.9 times higher in controls and 7.3 times higher in T2DM as compared to plasma levels. T2DM was associated with significantly higher levels of hsCRP, ALAT, and albumin/creatinine ratio. When calculated for tertiles of HbA1c, we observed a highly significant increase from tertile one to the upper tertile for serum VEGF-A but not for plasma VEGF-A. Correlation analysis revealed a significant relationship between VEGF-A, HbA1c, inflammation, and diabetic nephropathy. Our results indicate that increased VEGF-A levels in T2DM significantly depend on quality of HbA1c control. Serum levels of VEGF-A, with a strong contribution of platelet derived VEGF, better reflect the glycemic burden than plasma levels of VEGF-A. Mechanistic studies are needed to explore links to inflammation and diabetic nephropathy.
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Affiliation(s)
- M Hanefeld
- Study Center Professor Hanefeld, GWT TU-Dresden GmbH, Dresden, Germany
| | - D Appelt
- Study Center Professor Hanefeld, GWT TU-Dresden GmbH, Dresden, Germany
| | - K Engelmann
- Klinik für Augenheilkunde, Klinikum Chemnitz gGmbH, Chemnitz, Germany
| | - D Sandner
- Augenklinik und Poliklinik, Universitätsklinikum "Carl Gustav Carus", Technische Universität Dresden, Dresden, Germany
| | - S R Bornstein
- Medical Clinic III, Universitätsklinikum "Carl Gustav Carus", Paul Langerhans Institute Dresden (PLID), Technische Universität Dresden, Dresden, Germany
| | - X Ganz
- Study Center Professor Hanefeld, GWT TU-Dresden GmbH, Dresden, Germany
| | - E Henkel
- Study Center Professor Hanefeld, GWT TU-Dresden GmbH, Dresden, Germany
| | - R Haase
- Zentrum f. klin. Neurowissenschaften, eHealth Group, Universitätsklinikum "Carl Gustav Carus", Technische Universität Dresden, Dresden, Germany
| | - A L Birkenfeld
- Study Center Professor Hanefeld, GWT TU-Dresden GmbH, Dresden, Germany
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Jordan J, Fischer-Posovszky P, Reinke J, Daniels M, Wabitsch M, Engeli S, Birkenfeld AL. A novel heart-adipose tissue axis: Atrial natriuretic peptide and leptin interactions in man. DIABETOL STOFFWECHS 2016. [DOI: 10.1055/s-0036-1584102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Hanefeld M, Appelt D, Engelmann K, Sandner D, Bornstein SR, Ganz X, Henkel E, Haase R, Birkenfeld AL. Einfluss der Qualität der Diabeteskontrolle auf systematische Vascular Endothelial Growth Factors (VEGF) und Biomarker der subklinischen Inflammation bei Typ 2 Diabetes. DIABETOL STOFFWECHS 2016. [DOI: 10.1055/s-0036-1580832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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13
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Brachs S, Winkel AF, Tang H, Birkenfeld AL, Glombik H, Dudda A, Brunner B, Jahn-Hofmann K, Margerie D, Herling AW, Ruetten H, Schmoll D, Spranger J. Slc13a5/mINDY inhibition prevents diet-induced non-alcoholic fatty liver disease in mice and rats. DIABETOL STOFFWECHS 2016. [DOI: 10.1055/s-0036-1580910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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von Loeffelholz C, Horn P, Birkenfeld AL, Claus RA, Metzing BU, Döcke S, Jahreis G, Heller R, Hoppe S, Stockmann M, Lock JF, Rieger A, Weickert MO, Settmacher U, Rauchfuß F, Pfeiffer AFH, Bauer M, Sponholz C. Fetuin A is a Predictor of Liver Fat in Preoperative Patients with Nonalcoholic Fatty Liver Disease. J INVEST SURG 2016; 29:266-74. [PMID: 26980291 DOI: 10.3109/08941939.2016.1149640] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Nonalcoholic fatty liver disease (NAFLD) and steatohepatitis (NASH) are frequent comorbidities in perioperative patients. However, the predictive role of the hepatokine fetuin A was not evaluated in this collective. OBJECTIVE To study fetuin A as predictor of NAFLD/NASH in preoperative patients. METHODS 58 subjects were included. Fetuin A was studied in patients undergoing open abdominal surgery and in a subset with acute liver failure. Blood and liver specimens were sampled. NAFLD was histologically evaluated. Liver fat was additionally analyzed by an enzymatic approach, circulating fetuin A by enzyme linked-immunosorbent assay, fetuin A mRNA by reverse-transcription PCR. RESULTS Univariate correlation studies linked fetuin A to liver steatosis (r = 0.40, p = .029) and hepatocellular ballooning degeneration (r = 0.34, p = .026). Compared to non-NAFLD subjects fetuin A was increased in NAFLD (p = .009) and in NASH (p = .029). However, when corrected for main confounders by linear modeling, fetuin A remained related to hepatic steatosis, but not to ballooning degeneration or other NAFLD features. In support of this, biochemically analyzed liver lipids correlated with fetuin A in plasma (r = 0.34, p = .033) and with hepatic fetuin A mRNA (r = 0.54, p < .001). In addition, plasma fetuin A was related to hepatic mRNA (r = 0.32, p = .036), while circulating levels were reduced by 64% with acute liver failure (p < .001), confirming the liver as main fetuin A source. CONCLUSION Fetuin A is suggested as noninvasive biomarker of hepatic steatosis in preoperative settings.
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Affiliation(s)
- C von Loeffelholz
- a Department of Clinical Nutrition , German Institute of Human Nutrition Potsdam-Rehbruecke , Nuthetal , Germany ;,b Integrated Research and Treatment Center, Center for Sepsis Control and Care (CSCC) , Friedrich Schiller University , Jena , Germany.,c Department of Anaesthesiology and Intensive Care , Jena University Hospital , Jena , Germany
| | - P Horn
- b Integrated Research and Treatment Center, Center for Sepsis Control and Care (CSCC) , Friedrich Schiller University , Jena , Germany.,c Department of Anaesthesiology and Intensive Care , Jena University Hospital , Jena , Germany
| | - A L Birkenfeld
- d Section of Metabolic and Vascular Medicine, Medical Clinic III , University Hospital Carl Gustav Carus , Dresden , Germany
| | - R A Claus
- b Integrated Research and Treatment Center, Center for Sepsis Control and Care (CSCC) , Friedrich Schiller University , Jena , Germany.,c Department of Anaesthesiology and Intensive Care , Jena University Hospital , Jena , Germany
| | - B U Metzing
- b Integrated Research and Treatment Center, Center for Sepsis Control and Care (CSCC) , Friedrich Schiller University , Jena , Germany.,c Department of Anaesthesiology and Intensive Care , Jena University Hospital , Jena , Germany
| | - S Döcke
- a Department of Clinical Nutrition , German Institute of Human Nutrition Potsdam-Rehbruecke , Nuthetal , Germany
| | - G Jahreis
- e Institute of Nutrition , Friedrich Schiller University , Jena , Germany
| | - R Heller
- b Integrated Research and Treatment Center, Center for Sepsis Control and Care (CSCC) , Friedrich Schiller University , Jena , Germany.,f Institute for Molecular Cell Biology , Germany Center for Molecular Biomedicine, Jena University Hospital , Jena , Germany
| | - S Hoppe
- g Department of General, Visceral and Transplantation Surgery , Charité-Universitätsmedizin , Berlin , Germany
| | - M Stockmann
- g Department of General, Visceral and Transplantation Surgery , Charité-Universitätsmedizin , Berlin , Germany
| | - J F Lock
- h Department of General-, Visceral-, Vascular- and Paediatric Surgery , University Hospital of Wuerzburg , Wuerzburg , Germany
| | - A Rieger
- i Institute of Pathology , Charité-Universitätsmedizin , Berlin , Germany
| | - M O Weickert
- j Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism , University Hospitals Coventry and Warwickshire , CV2 2DX , Coventry , UK , Division of Metabolic & Vascular Health , University of Warwick , CV4 7AL , Coventry , UK
| | - U Settmacher
- k Department of General, Visceral and Transplantation Surgery , Friedrich Schiller University of Jena , Jena , Germany
| | - F Rauchfuß
- k Department of General, Visceral and Transplantation Surgery , Friedrich Schiller University of Jena , Jena , Germany
| | - A F H Pfeiffer
- a Department of Clinical Nutrition , German Institute of Human Nutrition Potsdam-Rehbruecke , Nuthetal , Germany ;,l Department of Endocrinology, Diabetes, and Nutrition , Charité-Universitätsmedizin , Berlin , Germany
| | - M Bauer
- b Integrated Research and Treatment Center, Center for Sepsis Control and Care (CSCC) , Friedrich Schiller University , Jena , Germany.,c Department of Anaesthesiology and Intensive Care , Jena University Hospital , Jena , Germany
| | - C Sponholz
- c Department of Anaesthesiology and Intensive Care , Jena University Hospital , Jena , Germany
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Reinke J, Brachs S, Willmes D, Tio J, Spranger J, McBride JD, Ma JX, Birkenfeld AL. Human Kallistatin Promotes Adiposity with Preserved Insulin Sensitivity in mice. Exp Clin Endocrinol Diabetes 2015. [DOI: 10.1055/s-0035-1549069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Bornstein SR, Amiel SA, Rubino F, Mingrone G, Kamvissi V, Solimena M, Bonifacio E, Jones P, Schwarz P, Birkenfeld AL, Behrens A, Barthel A, Lechler R, Peakman M. Creating a "Transcampus" in diabetes research between King's College London and the Technische Universität Dresden: update on islet biology and transplantation. Horm Metab Res 2015; 47:1-3. [PMID: 25478704 DOI: 10.1055/s-0034-1394453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- S R Bornstein
- Department of Medicine III, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden, Dresden, Germany
| | - S A Amiel
- Diabetes and Nutritional Sciences, Hodgkin Building, Guy's Campus, King's College London, London, UK
| | - F Rubino
- Diabetes and Nutritional Sciences, Hodgkin Building, Guy's Campus, King's College London, London, UK
| | - G Mingrone
- Department of Medicine III, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden, Dresden, Germany
| | - V Kamvissi
- Department of Medicine III, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden, Dresden, Germany
| | - M Solimena
- Molecular Diabetology, Paul Langerhans Institute Dresden, TU Dresden
| | - E Bonifacio
- German Center for Diabetes Research (DZD e.V.), Dresden, Germany
| | - P Jones
- Diabetes and Nutritional Sciences, Hodgkin Building, Guy's Campus, King's College London, London, UK
| | - P Schwarz
- Department of Medicine III, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden, Dresden, Germany
| | - A L Birkenfeld
- Department of Medicine III, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden, Dresden, Germany
| | - A Behrens
- Department of Medicine III, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden, Dresden, Germany
| | - A Barthel
- Department of Medicine III, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden, Dresden, Germany
| | - R Lechler
- MRC Centre for Transplantation, King's College London, Guy's Hospital, London, UK
| | - M Peakman
- Department of Immunobiology, King's College London School of Medicine, London, UK
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Döcke S, Lock JF, Birkenfeld AL, Hoppe S, Lieske S, Rieger A, Raschzok N, Sauer IM, Florian S, Osterhoff MA, Heller R, Herrmann K, Lindenmüller S, Horn P, Bauer M, Weickert MO, Neuhaus P, Stockmann M, Möhlig M, Pfeiffer AFH, von Loeffelholz C. Elevated hepatic chemerin mRNA expression in human non-alcoholic fatty liver disease. Eur J Endocrinol 2013; 169:547-57. [PMID: 23935128 DOI: 10.1530/eje-13-0112] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
OBJECTIVE Adipose tissue-derived factors link non-alcoholic fatty liver disease (NAFLD) with obesity, which has also been reported for circulating chemerin. On the other hand, hepatic chemerin and chemokine-like receptor 1 (CMKLR1) mRNA expression has not yet been studied in an extensively characterized patient collective. DESIGN This study was cross-sectional and experimental in design. METHODS Liver tissue samples were harvested from 47 subjects and histologically examined according to the NAFLD activity score (NAS). The concentrations of chemerin and CMKLR1 were measured using semi-quantitative real-time PCR, and the concentration of serum chemerin was measured using ELISA. To evaluate potential effects of chemerin and CMKLR1, cultured primary human hepatocytes (PHHs) were exposed to selected metabolites known to play a role in NAFLD (insulin, glucagon, palmitoic acid, and interleukin-6 (IL6)). RESULTS Chemerin and CMKLR1 mRNA levels were elevated in the human liver. Their expression was correlated with the NAS (R(2)=0.543; P<0.001 and R(2)=0.355; P=0.014 respectively) and was significantly elevated in patients with definite non-alcoholic steatohepatitis (NASH) (P<0.05 respectively). Linear regression analysis confirmed an independent association of liver fibrosis, steatosis, inflammation, and hepatocyte ballooning with hepatic chemerin mRNA expression (P<0.05 respectively). The expression of hepatic chemerin and CMKLR1 was correlated with the measures of obesity (P<0.05). The incubation of PHHs with IL6 significantly increased the expression of CMKLR1 mRNA (P=0.027), while that of chemerin remained unaffected (P>0.05). None of the other metabolites showed an influence (P>0.05). CONCLUSION This is the first study to show that chemerin mRNA expression is significantly elevated in the liver of NASH patients and that CMKLR1 expression is upregulated in liver inflammation, whereby IL6 could play a causal role.
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Affiliation(s)
- S Döcke
- Department of Clinical Nutrition, German Institute of Human Nutrition Potsdam-Rehbruecke, Arthur-Scheunert-Allee 114-116, 14558 Nuthetal, Germany
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Rudovich N, Pivovarova O, Traberth A, Sparwasser A, Weickert MO, Bernigau W, Birkenfeld AL, Arafat AM, Bergmann A, Pfeiffer AFH. Acarbose treatment enhances mid-regional pro-atrial natriuretic peptide concentrations in non-diabetic individuals: further evidence for a common cardiometabolic pathway? Diabetologia 2012; 55:3392-5. [PMID: 22990716 DOI: 10.1007/s00125-012-2724-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2012] [Accepted: 08/10/2012] [Indexed: 10/27/2022]
Affiliation(s)
- N Rudovich
- Department of Clinical Nutrition, German Institute of Human Nutrition Potsdam, Arthur-Scheunert-Allee 114-116, Nuthetal, Germany.
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19
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Loeffelholz CV, Lock JF, Döcke S, Möhlig M, Birkenfeld AL, Hoppe S, Bumke-Vogt C, Florian S, Rieger A, Ringe S, Isken F, Osterhoff MA, Claus RA, Bauer M, Neuhaus P, Weickert MO, Stockmann M, Pfeiffer AFH. Reduzierte AMP-aktivierte Proteinkinase (AMPK) und reduziertes Plasma Adiponektin bei humaner nicht-alkoholischer Fettlebererkrankung (NAFLD). DIABETOL STOFFWECHS 2012. [DOI: 10.1055/s-0032-1314451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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20
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Luedtke A, Boschmann M, Colpe C, Engeli S, Adams F, Birkenfeld AL, Haufe S, Rahn G, Luft FC, Schmidt HHJ, Jordan J. Thiazolidinedione response in familial lipodystrophy patients with LMNA mutations: a case series. Horm Metab Res 2012; 44:306-11. [PMID: 22274718 DOI: 10.1055/s-0031-1301284] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
Type 2 familial partial lipodystrophy (FPLD2) patients show impaired glucose and lipid metabolism resulting from lipodystrophic 'lipid pressure' and an intrinsic defect in skeletal muscle metabolism. Since mutated lamin A may interfere with peroxisome proliferator activator gamma (PPARγ) expression, we hypothesized that PPARγ stimulation improves fat distribution and metabolic abnormalities in these patients. 5 nondiabetic FPLD2 patients were treated with rosiglitazone over 12 months. We assessed body composition, body fat distribution, and skinfold thickness/subcutaneous tissue thickness. We also determined venous glucose, insulin, and free fatty acid (FFA) concentrations, and respiratory quotient (RQ) before and during oral glucose tolerance testing. Adipose tissue and muscle fasting and postprandial metabolism were studied by microdialysis. Within 12 months treatment, hip circumference increased from 93.6±2.78 cm to 96.2±2.3 cm (p<0.05). Rosiglitazone reduced fasting glucose levels and liver transaminases. Baseline and postprandial FFA concentrations were significantly lower after 12 months treatment. RQ and muscle interstitial pyruvate and lactate did not respond to treatment. We conclude that PPARγ stimulation with rosiglitazone modestly improves glucose metabolism in FPLD2 patients presumably through proximal adipose tissue expansion. The intrinsic muscular metabolic defect does not respond to rosiglitazone.
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Affiliation(s)
- A Luedtke
- Departments of Medicine and Anatomy and Cell Biology, College of Physicians and Surgeons, Columbia University, New York, USA
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21
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Weismann D, Erion DM, Ignatova-Todorava I, Nagai Y, Stark R, Hsiao JJ, Flannery C, Birkenfeld AL, May T, Kahn M, Zhang D, Yu XX, Murray SF, Bhanot S, Monia BP, Cline GW, Shulman GI, Samuel VT. Knockdown of the gene encoding Drosophila tribbles homologue 3 (Trib3) improves insulin sensitivity through peroxisome proliferator-activated receptor-γ (PPAR-γ) activation in a rat model of insulin resistance. Diabetologia 2011; 54:935-44. [PMID: 21190014 PMCID: PMC4061906 DOI: 10.1007/s00125-010-1984-5] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2010] [Accepted: 10/20/2010] [Indexed: 11/27/2022]
Abstract
AIMS/HYPOTHESIS Insulin action is purportedly modulated by Drosophila tribbles homologue 3 (TRIB3), which in vitro prevents thymoma viral proto-oncogene (AKT) and peroxisome proliferator-activated receptor-γ (PPAR-γ) activation. However, the physiological impact of TRIB3 action in vivo remains controversial. METHODS We investigated the role of TRIB3 in rats treated with either a control or Trib3 antisense oligonucleotide (ASO). Tissue-specific insulin sensitivity was assessed in vivo using a euglycaemic-hyperinsulinaemic clamp. A separate group was treated with the PPAR-γ antagonist bisphenol-A-diglycidyl ether (BADGE) to assess the role of PPAR-γ in mediating the response to Trib3 ASO. RESULTS Trib3 ASO treatment specifically reduced Trib3 expression by 70% to 80% in liver and white adipose tissue. Fasting plasma glucose, insulin concentrations and basal rate of endogenous glucose production were unchanged. However, Trib3 ASO increased insulin-stimulated whole-body glucose uptake by ~50% during the euglycaemic-hyperinsulinaemic clamp. This was attributable to improved skeletal muscle glucose uptake. Despite the reduction of Trib3 expression, AKT2 activity was not increased. Trib3 ASO increased white adipose tissue mass by 70% and expression of Ppar-γ and its key target genes, raising the possibility that Trib3 ASO improves insulin sensitivity primarily in a PPAR-γ-dependent manner. Co-treatment with BADGE blunted the expansion of white adipose tissue and abrogated the insulin-sensitising effects of Trib3 ASO. Finally, Trib3 ASO also increased plasma HDL-cholesterol, a change that persisted with BADGE co-treatment. CONCLUSIONS/INTERPRETATION These data suggest that TRIB3 inhibition improves insulin sensitivity in vivo primarily in a PPAR-γ-dependent manner and without any change in AKT2 activity.
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Affiliation(s)
- D. Weismann
- Section of Endocrinology, Department of Internal Medicine PO BOX 802010, Yale University School of Medicine, New Haven, CT 06520-8020, USA
- Universitätsklinikum Würzburg, Medizinische Klinik und Poliklinik I, Schwerpunkt Endokrinologie und Diabetologie, Würzburg, Germany
| | - D. M. Erion
- Section of Endocrinology, Department of Internal Medicine PO BOX 802010, Yale University School of Medicine, New Haven, CT 06520-8020, USA
- Department of Cellular and Molecular Physiology, Yale University School of Medicine, New Haven, CT, USA
- Howard Hughes Medical Institute, Yale University School of Medicine, New Haven, CT, USA
| | - I. Ignatova-Todorava
- Section of Endocrinology, Department of Internal Medicine PO BOX 802010, Yale University School of Medicine, New Haven, CT 06520-8020, USA
| | - Y. Nagai
- Section of Endocrinology, Department of Internal Medicine PO BOX 802010, Yale University School of Medicine, New Haven, CT 06520-8020, USA
| | - R. Stark
- Section of Endocrinology, Department of Internal Medicine PO BOX 802010, Yale University School of Medicine, New Haven, CT 06520-8020, USA
| | - J. J. Hsiao
- Section of Endocrinology, Department of Internal Medicine PO BOX 802010, Yale University School of Medicine, New Haven, CT 06520-8020, USA
| | - C. Flannery
- Section of Endocrinology, Department of Internal Medicine PO BOX 802010, Yale University School of Medicine, New Haven, CT 06520-8020, USA
| | - A. L. Birkenfeld
- Section of Endocrinology, Department of Internal Medicine PO BOX 802010, Yale University School of Medicine, New Haven, CT 06520-8020, USA
| | - T. May
- Howard Hughes Medical Institute, Yale University School of Medicine, New Haven, CT, USA
| | - M. Kahn
- Howard Hughes Medical Institute, Yale University School of Medicine, New Haven, CT, USA
| | - D. Zhang
- Howard Hughes Medical Institute, Yale University School of Medicine, New Haven, CT, USA
| | - X. X. Yu
- Isis Pharmaceuticals, Carlsbad, CA, USA
| | | | - S. Bhanot
- Isis Pharmaceuticals, Carlsbad, CA, USA
| | | | - G. W. Cline
- Section of Endocrinology, Department of Internal Medicine PO BOX 802010, Yale University School of Medicine, New Haven, CT 06520-8020, USA
| | - G. I. Shulman
- Section of Endocrinology, Department of Internal Medicine PO BOX 802010, Yale University School of Medicine, New Haven, CT 06520-8020, USA
- Department of Cellular and Molecular Physiology, Yale University School of Medicine, New Haven, CT, USA
- Howard Hughes Medical Institute, Yale University School of Medicine, New Haven, CT, USA
| | - V. T. Samuel
- Section of Endocrinology, Department of Internal Medicine PO BOX 802010, Yale University School of Medicine, New Haven, CT 06520-8020, USA
- Veterans Affairs Medical Center, West Haven, CT, USA
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Wiesner S, Birkenfeld AL, Engeli S, Haufe S, Brechtel L, Wein J, Hermsdorf M, Karnahl B, Berlan M, Lafontan M, Sweep FCGJ, Luft FC, Jordan J. Neurohumoral and metabolic response to exercise in water. Horm Metab Res 2010; 42:334-9. [PMID: 20178064 DOI: 10.1055/s-0030-1248250] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Atrial natriuretic peptide (ANP) stimulates lipid mobilization and lipid oxidation in humans. The mechanism appears to promote lipid mobilization during exercise. We tested the hypothesis that water immersion augments exercise-induced ANP release and that the change in ANP availability is associated with increased lipid mobilization and lipid oxidation. In an open randomized and cross-over fashion we studied 17 men (age 31+/-3.6 years; body mass index 24+/-1.7 kg/m(2); body fat 17+/-6.7%) on no medication. Subjects underwent two incremental exercise tests on a bicycle ergometer. One test was conducted on land and the other test during immersion in water up to the xiphoid process. In a subset (n=7), we obtained electromyography recordings in the left leg. We monitored gas exchange, blood pressure, and heart rate. In addition, we obtained blood samples towards the end of each exercise step to determine ANP, norepinephrine, epinephrine, lactate, free fatty acids, insulin, and glucose concentrations. Heart rate, systolic blood pressure, and oxygen consumption at the anaerobic threshold and during peak exercise were similar on land and with exercise in water. The respiratory quotient was mildly reduced when subjects exercised in water. Glucose and lactate measurements were decreased whereas free fatty acid concentrations were increased with exercise in water. Water immersion attenuated epinephrine and norepinephrine and augmented ANP release during exercise. Even though water immersion blunts exercise-induced sympathoadrenal activation, lipid mobilization and lipid oxidation rate are maintained or even improved. The response may be explained by augmented ANP release.
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Affiliation(s)
- S Wiesner
- Franz-Volhard Clinical Research Center, Medical Faculty of the Charité and HELIOS Klinikum, Berlin, Germany
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Birkenfeld AL, Schroeder C, Tank J, Luft FC, Sharma AM, Jordan J. Controversial Effects of Sibutramine on Autonomic Cardiovascular Regulation. Akt Neurol 2004. [DOI: 10.1055/s-2004-823163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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