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Prosperi-Porta G, Kiamanesh O, Fine N, Ferland A, Harper L, Solverson K, Boiteau P, Helmerson D, Weatherald J. VENTRICULAR-ARTERIAL DECOUPLING IS ASSOCIATED WITH IN-HOSPITAL ADVERSE EVENTS IN NORMOTENSIVE PULMONARY EMNBOLISM. Can J Cardiol 2022. [DOI: 10.1016/j.cjca.2022.08.143] [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: 11/02/2022] Open
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2
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Caron J, duManoir GR, Labrecque L, Chouinard A, Ferland A, Poirier P, Legault S, Brassard P. Impact of type 2 diabetes on cardiorespiratory function and exercise performance. Physiol Rep 2017; 5:5/4/e13145. [PMID: 28242825 PMCID: PMC5328776 DOI: 10.14814/phy2.13145] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Accepted: 12/30/2016] [Indexed: 01/07/2023] Open
Abstract
The aim of this study was to examine the impact of well‐controlled uncomplicated type 2 diabetes (T2D) on exercise performance. Ten obese sedentary men with T2D and nine control participants without diabetes matched for age, sex, and body mass index were recruited. Anthropometric characteristics, blood samples, resting cardiac, and pulmonary functions and maximal oxygen uptake (VO2max) and ventilatory threshold were measured on a first visit. On the four subsequent visits, participants (diabetics: n = 6; controls: n = 7) performed step transitions (6 min) of moderate‐intensity exercise on an upright cycle ergometer from unloaded pedaling to 80% of ventilatory threshold. VO2 (τVO2) and HR (τHR) kinetics were characterized with a mono‐exponential model. VO2max (27.0 ± 3.4 vs. 26.7 ± 5.0 mL kg−1 min−1; P = 0.85), τVO2 (43 ± 6 vs. 43 ± 10 sec; P = 0.73), and τHR (42 ± 17 vs. 43 ± 13 sec; P = 0.94) were similar between diabetics and controls respectively. The remaining variables were also similar between groups, with the exception of lower maximal systolic blood pressure in diabetics (P = 0.047). These results suggest that well‐controlled T2D is not associated with a reduction in VO2max or slower τVO2 and τHR.
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Affiliation(s)
- Joanie Caron
- Department of Kinesiology, Faculty of Medicine, Université Laval, Québec, Québec, Canada.,Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec, Québec, Québec, Canada
| | - Gregory R duManoir
- School of Health & Exercise Sciences, University of British Columbia Okanagan, Kelowna, British Columbia, Canada
| | - Lawrence Labrecque
- Department of Kinesiology, Faculty of Medicine, Université Laval, Québec, Québec, Canada.,Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec, Québec, Québec, Canada
| | - Audrey Chouinard
- Department of Kinesiology, Faculty of Medicine, Université Laval, Québec, Québec, Canada.,Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec, Québec, Québec, Canada
| | - Annie Ferland
- Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec, Québec, Québec, Canada
| | - Paul Poirier
- Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec, Québec, Québec, Canada.,Faculty of Pharmacy, Université Laval, Québec, Québec, Canada
| | - Sylvie Legault
- Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec, Québec, Québec, Canada
| | - Patrice Brassard
- Department of Kinesiology, Faculty of Medicine, Université Laval, Québec, Québec, Canada .,Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec, Québec, Québec, Canada
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3
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Patel SS, Truong U, King M, Ferland A, Moreau KL, Dorosz J, Hokanson JE, Wang H, Kinney GL, Maahs DM, Eckel RH, Nadeau KJ, Cree-Green M. Obese adolescents with polycystic ovarian syndrome have elevated cardiovascular disease risk markers. Vasc Med 2017; 22:85-95. [PMID: 28095749 DOI: 10.1177/1358863x16682107] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Women with polycystic ovarian syndrome (PCOS) have evidence of subclinical cardiovascular disease (CVD). However, insulin resistance, an important factor in the development of CVD in adults, is common in adolescents with PCOS, yet data in adolescents are limited. Therefore, we sought to measure insulin resistance and CVD markers in obese youth with and without PCOS. Thirty-six PCOS and 17 non-PCOS adolescent girls who were obese, sedentary, and non-hypertensive were recruited from clinics located within the Children's Hospital Colorado. Following 3 days of controlled diet and restricted exercise, fasting plasma samples were obtained prior to a hyperinsulinemic euglycemic clamp. PCOS girls were more insulin resistant than controls (glucose infusion rate 5.24±1.86 mg/kg/min vs 9.10±2.69; p<0.001). Girls with PCOS had blood pressure in the normal range, but had greater carotid intima-media thickness (cIMT) (0.49±0.07 mm vs 0.44±0.06; p=0.038), beta stiffness index (5.1±1.3 U vs 4.4±0.9; p=0.037), and reduced arterial compliance (1.95±0.47 mm2/mmHg × 10-1 vs 2.13±0.43; p=0.047). PCOS girls had a normal mean lipid profile, yet had a more atherogenic lipoprotein cholesterol distribution and had persistent elevations of free fatty acids despite hyperinsulinemia (68±28 μmol/mL vs 41±10; p=0.001), both potential contributors to CVD. Free fatty acid concentrations correlated best with all CVD markers. In summary, adolescent girls with PCOS have greater cIMT and stiffer arteries than girls without PCOS, perhaps related to altered lipid metabolism, even when clinical measures of blood pressure and cholesterol profiles are 'normal'. Therefore, management of adolescent PCOS should include assessment of CVD risk factor development.
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Affiliation(s)
- Sonali S Patel
- 1 Department of Pediatrics, Division of Pediatric Cardiology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Uyen Truong
- 1 Department of Pediatrics, Division of Pediatric Cardiology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Martina King
- 2 Department of Medicine, Division of Endocrinology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Annie Ferland
- 2 Department of Medicine, Division of Endocrinology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Kerrie L Moreau
- 3 Department of Medicine, Division of Geriatric Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.,4 Denver Veterans Administration Medical Center, Geriatric Research Education and Clinical Center, Denver, CO, USA
| | - Jennifer Dorosz
- 5 Department of Medicine, Division of Cardiology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - John E Hokanson
- 6 Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Hong Wang
- 6 Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Gregory L Kinney
- 6 Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - David M Maahs
- 7 Barbara Davis Center for Childhood Diabetes, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Robert H Eckel
- 2 Department of Medicine, Division of Endocrinology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Kristen J Nadeau
- 7 Barbara Davis Center for Childhood Diabetes, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.,8 Department of Pediatrics, Division of Pediatric Endocrinology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.,9 Center for Women's Health Research, Aurora, CO, USA
| | - Melanie Cree-Green
- 7 Barbara Davis Center for Childhood Diabetes, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.,8 Department of Pediatrics, Division of Pediatric Endocrinology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.,9 Center for Women's Health Research, Aurora, CO, USA
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Chateau-Degat ML, Dewailly E, Noël M, Valera B, Ferland A, Counil E, Poirier P, Egeland GM. Hypertension among the Inuit from Nunavik: should we expect an increase because of obesity? Int J Circumpolar Health 2016; 69:361-72. [DOI: 10.3402/ijch.v69i4.17630] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Coltman C, Wiens K, Litzenberger K, Silvestri D, Schmidt D, Colwell S, Jones B, Ferland A, Robichaud J. Cardiac Arrest Management in the Post-op Cardiac Surgery Patient: The path LESS traveled. Can J Cardiol 2016. [DOI: 10.1016/j.cjca.2016.07.536] [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: 11/30/2022] Open
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6
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Cree-Green M, Maahs DM, Ferland A, Hokanson JE, Wang H, Pyle L, Kinney GL, King M, Eckel RH, Nadeau KJ. Lipoprotein subfraction cholesterol distribution is more atherogenic in insulin resistant adolescents with type 1 diabetes. Pediatr Diabetes 2016; 17:257-65. [PMID: 26080650 PMCID: PMC4887262 DOI: 10.1111/pedi.12277] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2014] [Revised: 03/15/2015] [Accepted: 03/16/2015] [Indexed: 02/06/2023] Open
Abstract
AIMS/HYPOTHESIS Adolescents with type 1 diabetes (T1D) often have a less atherogenic-appearing fasting lipid profile than controls, despite increased rates of cardiovascular disease (CVD) as adults. We previously reported an atherogenic lipoprotein subfraction cholesterol distribution associated with insulin resistance (IR) in T1D adults. We sought to determine if T1D youth have more atherogenic profile than controls via a cross-sectional study. METHODS Following 3 days of controlled diet and restricted exercise, fasting plasma samples were drawn from 28 T1D youth [50% female, age 15.3 ± 2 yr, body mass index (BMI) 48%ile; diabetes duration 73 ± 52 months, hemoglobin A1c (HbA1c) 8.3 ± 1.4%] and 17 non-diabetic controls (47% female, age: 15.0 ± 2 yr, BMI 49%ile) prior to a hyperinsulinemic euglycemic clamp. Lipoproteins were fractionated by fast protein liquid chromatography (FPLC) and lipoprotein cholesterol distribution determined. Outcome measures were IR assessed by glucose infusion rate (GIR) and FPLC lipoprotein subfraction cholesterol distribution. RESULTS T1D youth were more IR (GIR 9.1 ± 3.6 vs. 14.7 ± 3.9 mg/kg/min, p < 0.0001) and had more cholesterol distributed as small dense low density lipoprotein-cholesterol (LDL-C) and less as large buoyant high density lipoprotein-cholesterol (HDL-C) than controls (p < 0.05), despite no differences in the fasting lipid panel. T1D girls lacked the typical female less-atherogenic profile, whereas control girls tended to have a shift toward less dense LDL-C and HDL-C vs. control boys. Among T1D, IR but not HbA1c was associated with a more atherogenic lipoprotein profile. CONCLUSIONS/INTERPRETATIONS Normal weight T1D youth, especially females, had more atherogenic LDL-C and HDL-C distributions which correlated with lower insulin sensitivity. IR may contribute to the increased CVD burden in T1D.
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Affiliation(s)
- Melanie Cree-Green
- Barbara Davis Center for Childhood Diabetes, University of Colorado Anschutz Medical Campus, Aurora, CO,Department of Pediatrics, Division of Pediatric Endocrinology, University of Colorado Anschutz Medical Campus, Aurora, CO,Center for Women’s Health Research, Aurora, CO
| | - David M. Maahs
- Barbara Davis Center for Childhood Diabetes, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Annie Ferland
- Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - John E. Hokanson
- Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Hong Wang
- Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Laura Pyle
- Department of Pediatrics, Division of Pediatric Endocrinology, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Gregory L. Kinney
- Department of Pediatrics, Division of Pediatric Endocrinology, University of Colorado Anschutz Medical Campus, Aurora, CO,Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Martina King
- Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Robert H. Eckel
- Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Kristen J. Nadeau
- Barbara Davis Center for Childhood Diabetes, University of Colorado Anschutz Medical Campus, Aurora, CO,Department of Pediatrics, Division of Pediatric Endocrinology, University of Colorado Anschutz Medical Campus, Aurora, CO,Center for Women’s Health Research, Aurora, CO
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7
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Thomas EA, Mcnair B, Bechtell JL, Ferland A, Cornier MA, Eckel RH. Greater hunger and less restraint predict weight loss success with phentermine treatment. Obesity (Silver Spring) 2016; 24:37-43. [PMID: 26584649 PMCID: PMC4688167 DOI: 10.1002/oby.21244] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Revised: 07/07/2015] [Accepted: 07/13/2015] [Indexed: 01/12/2023]
Abstract
OBJECTIVE Phentermine is thought to cause weight loss through a reduction in hunger. It was hypothesized that higher hunger ratings would predict greater weight loss with phentermine. METHODS This is an observational pilot study in which all subjects were treated with phentermine for 8 weeks and appetite and eating behaviors were measured at baseline and week 8. Outcomes were compared in subjects with ≥5% vs. <5% weight loss, and linear regression was used to identify predictors of percent weight loss. RESULTS Twenty-seven subjects (37 ± 4.5 years, 93.8 ± 12.1 kg, BMI 33.8 ± 3.1 kg m(-2) ) completed the study, with mean weight loss of -5.4 ± 3.3 kg (-5.7% ± 3.2%). Subjects with ≥5% weight loss had higher baseline pre-breakfast hunger (P = 0.017), desire to eat (P =0.003), and prospective food consumption (0.006) and lower baseline cognitive restraint (P = 0.01). In addition, higher baseline home prospective food consumption (P = 0.002) and lower baseline cognitive restraint (P < 0.001) were found to be predictors of weight loss. CONCLUSIONS These results suggest that individuals reporting greater hunger and less restraint are more likely to achieve significant weight loss with phentermine. This information can be used clinically to determine who might benefit most from phentermine treatment.
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Affiliation(s)
- Elizabeth A Thomas
- Division of Endocrinology, Metabolism and Diabetes, Department of Medicine, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, Colorado, USA
- Anschutz Health and Wellness Center, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Bryan Mcnair
- Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Jamie L Bechtell
- Division of Endocrinology, Metabolism and Diabetes, Department of Medicine, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, Colorado, USA
- Anschutz Health and Wellness Center, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Annie Ferland
- Division of Endocrinology, Metabolism and Diabetes, Department of Medicine, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, Colorado, USA
| | - Marc-Andre Cornier
- Division of Endocrinology, Metabolism and Diabetes, Department of Medicine, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, Colorado, USA
- Anschutz Health and Wellness Center, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Robert H Eckel
- Division of Endocrinology, Metabolism and Diabetes, Department of Medicine, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, Colorado, USA
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8
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Schmidt D, Lazarenko C, Ferland A. TIME TO TALK...THE DEVELOPMENT AND IMPLEMENTATION OF A CARDIAC SURGERY HANDOVER TOOL. Can J Cardiol 2015. [DOI: 10.1016/j.cjca.2015.07.669] [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: 11/30/2022] Open
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9
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Leblanc MÉ, Croteau S, Ferland A, Bussières J, Cloutier L, Hould FS, Biertho L, Moustarah F, Marceau S, Poirier P. Blood pressure assessment in severe obesity: validation of a forearm approach. Obesity (Silver Spring) 2013; 21:E533-41. [PMID: 23512945 DOI: 10.1002/oby.20458] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [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] [Received: 10/06/2012] [Accepted: 03/06/2013] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Obesity is frequently associated with systemic hypertension. Blood pressure measure is inaccurate in severely obese patients because of poor cuff size fitting. The aim of the study is to assess the degree of agreement between the intra-arterial method as the gold standard vs. noninvasive methods, i.e., forearm blood pressure and upper-arm blood pressure measures. DESIGN AND METHODS A total of 1285 measures of intra-arterial and forearm blood pressure were taken in 51 severely obese patients in a supine position in the operating and the recovery room. A subset of 352 upper-arm measures were taken in the recovery room and compared to the intra-arterial and the forearm methods. RESULTS Correlation between the intra-arterial and the forearm measures was 0.90 (P < 0.001) for the 2570 data (systolic and diastolic). Compared to intra-arterial, the forearm method overestimated systolic (6 ± 16 mm Hg, P < 0.001) and underestimated diastolic blood pressure (2 ± 11 mm Hg, P = 0.03). Compared to intra-arterial, upper-arm underestimated systolic (8 ± 16 mm Hg, P < 0.01) and overestimated diastolic blood pressure (9 ± 7 mm Hg, P < 0.001). CONCLUSION The magnitude of differences between the intra-arterial and forearm method was less than differences between the intra-arterial and upper-arm method. Our results suggest that forearm method may be a more accurate alternative to upper-arm measurement to assess blood pressure in severely obese patients.
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Affiliation(s)
- Marie-Éve Leblanc
- Institut Universitaire de Cardiologie et de Pneumologie de Québec, Québec, Canada; Faculté de pharmacie de l'Université Laval, Québec, Canada
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10
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Smith J, Ferland A, Méthot J, Brassard P, Lacroix S, Poirier P, Cianflone K. The beta-1 adrenergic antagonist, atenolol, decreases acylation stimulating protein, exercise capacity and plasma free fatty acids in men with type 2 diabetes. Nutr Metab Cardiovasc Dis 2012; 22:495-502. [PMID: 21247745 DOI: 10.1016/j.numecd.2010.08.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [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] [Received: 12/21/2009] [Revised: 06/22/2010] [Accepted: 08/18/2010] [Indexed: 10/18/2022]
Abstract
BACKGROUND AND AIMS Atenolol is a beta-1 adrenergic antagonist commonly prescribed for the treatment of systemic hypertension or coronary artery disease yet its use in individuals with type 2 diabetes mellitus (T2DM) is controversial due to potentially negative side effects on insulin resistance. Non-esterified fatty acid (NEFA) metabolism is altered in T2DM especially under conditions of metabolic stress such as exercise or the postprandial state. We evaluated atenolol effects on circulating NEFA and related hormones in men with T2DM during acute cardiorespiratory exercise in both the fasting and postprandial state, including the adipokine acylation stimulating protein (ASP) which stimulates adipose tissue NEFA uptake. METHODS AND RESULTS Ten men with T2DM underwent four 1-h exercise sessions at 60% of their maximal oxygen uptake (VO(2max)) under the following conditions: 1) fasting (F), and 2) 2 h postprandial (PP) without medication; and 3) fasting (F-Atenolol), and 4) 2 h postprandial (PP-Atenolol) after a one-week treatment with atenolol. Results were tested for the effects of atenolol via two-way ANOVA for the F vs F-Atenolol and PP vs PP-Atenolol states separately. Atenolol treatment decreased fasting and postprandial glycerol (p < 0.0001) and NEFA (p < 0.0001), postprandial epinephrine (p = 0.048), postprandial cortisol (p = 0.02), postprandial ASP (p = 0.04) and postprandial dopamine (p < 0.004). CONCLUSION Atenolol alters fatty acid metabolism and associated metabolic hormones including ASP during exercise in men with T2DM and its effects are more apparent during conditions of stress such as the postprandial state, acute exercise and obesity.
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Affiliation(s)
- J Smith
- Y2186, 2725 Chemin Ste-Foy, Institut universitaire de cardiologie et de pneumologie de Québec, Université Laval, Québec, Canada G1V 4G5
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Ferland A, Château-Degat ML, Hernandez TL, Eckel RH. Tissue-specific responses of lipoprotein lipase to dietary macronutrient composition as a predictor of weight gain over 4 years. Obesity (Silver Spring) 2012; 20:1006-11. [PMID: 22262159 DOI: 10.1038/oby.2011.372] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [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] [Indexed: 11/08/2022]
Abstract
This study evaluated if the effect of dietary macronutrient composition on adipose tissue lipoprotein lipase (ATLPL) and skeletal muscle lipoprotein lipase (SMLPL) predicted the long-term (over 4 years) changes in body weight and composition in free-living adults. Using a crossover design, 39 healthy subjects (n = 24 normal weight, n = 7 overweight, n = 8 obese) each followed a 2-week isocaloric high-carbohydrate (HC; 55% CHO:25% fat) and high-fat (HF; 30% CHO:50% fat) diet. On day 15 of each diet, biopsies were performed in the fasted state and 6 h after a meal. Body weight and composition were measured annually over 4 years. The outcomes for body weight, fat mass and % body fat were assessed using a linear two-stage mixed model. The mean (±SEM) increase in body weight and fat mass over 4 years was 0.29 ± 0.15 kg/year (P = 0.063) and 0.31 ± 0.15 kg/year (P = 0.051), respectively. The most consistent predictors of future body weight and fat changes were the ΔATLPL and ΔSMLPL responses (0-6 h) to a HC diet/meal. For the HC diet/meal, the subjects who had an increase in ATLPL activity/cell gained more % body fat over 4 years (P = 0.006) whereas subjects who had a decrease in SMLPL activity/g also had an increase in fat mass (P = 0.021). No significant relationships were observed between fasting ATLPL and SMLPL or enzyme responses to meals and any of the outcomes following the HF diet. In free-living adults the variability in tissue-specific lipoprotein lipase (LPL) responsiveness to a HC diet/meal predicts longitudinal changes in body composition.
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Affiliation(s)
- Annie Ferland
- Division of Endocrinology, Metabolism and Diabetes, University of Colorado Anschutz Medical Campus, Anschutz Medical Center, Aurora, Colorado, USA
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12
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Abstract
The prevalence of the metabolic syndrome (MetS) has increased rapidly in North America in recent years. Presently, the MetS is found in 34.3% of the population, and the prevalence is likely to continue to increase in parallel with the obesity epidemic. Losing weight and long-term maintenance of the weight loss are primary targets to beneficially reverse all of the components of the MetS. This paper reviews the clinical and experimental evidence for the reversal of the metabolic complications related to the MetS that follows a sustained weight loss.
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Affiliation(s)
- Annie Ferland
- Division of Endocrinology, Metabolism and Diabetes, University of Colorado Anschutz Medical Campus, Anschutz Medical Center, 12801 E. 17th Avenue, Aurora, CO 80045, USA
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13
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Appoo JJ, Gregory HD, Toeg HD, Prusinkiewicz CA, Kent WDT, Ferland A, Ha DV. Successful reversal of recurrent spinal cord ischemia following endovascular repair of a descending thoracic aortic aneurysm. HSR Proc Intensive Care Cardiovasc Anesth 2012; 4:182-6. [PMID: 23439968 PMCID: PMC3485390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Despite recent advances in technique, spinal cord ischemia remains one of the most dreaded complications of thoracic aortic surgery. Recently, it has been suggested that thoracic endovascular aortic repair may decrease the risk of paraplegia. We present a case of delayed paraplegia following thoracic endovascular aortic repair that was successfully reversed on 3 separate occasions in the same patient. This highlights the importance of vigilant clinical assessments, efficient multidisciplinary teamwork, and maintenance of the determinants of spinal cord perfusion following endovascular thoracic aortic intervention.
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Affiliation(s)
- J J Appoo
- Libin Cardiovascular Institute of Alberta, Division of Cardiac Surgery, University of Calgary, Calgary, Alberta, Canada
| | - H D Gregory
- Department of Anesthesia, University of Calgary, Calgary, Alberta, Canada
| | - H D Toeg
- Ottawa Heart Institute, Division of Cardiac Surgery, University of Ottawa, Ottawa, Ontario, Canada
| | - C A Prusinkiewicz
- Department of Anesthesia, University of Calgary, Calgary, Alberta, Canada
| | - W D T Kent
- Libin Cardiovascular Institute of Alberta, Division of Cardiac Surgery, University of Calgary, Calgary, Alberta, Canada
| | - A Ferland
- Department of Critical Care, University of Calgary, Calgary, Alberta, Canada
| | - D V Ha
- Department of Anesthesia, University of Calgary, Calgary, Alberta, Canada
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14
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Ferland A, Lamarche B, Château-Degat ML, Counil E, Anassour-Laouan-Sidi E, Abdous B, Dewailly É. Dairy product intake and its association with body weight and cardiovascular disease risk factors in a population in dietary transition. J Am Coll Nutr 2011; 30:92-9. [PMID: 21730217 DOI: 10.1080/07315724.2011.10719948] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
OBJECTIVE Higher dairy product intake has shown beneficial effects on body weight, blood pressure, type 2 diabetes, and cardiovascular disease (CVD) risk factors in Caucasian populations. This study evaluated dairy product intake and its association with body weight and CVD risk profile among a population undergoing a dietary transition in Canada, the Nunavik Inuit. METHODS Data were collected from August 27 to October 1, 2004, in the 14 villages of Nunavik on a Canadian research icebreaker (Canadian Coast Guard ship Amundsen). Dairy product intake and calcium intake were evaluated in 543 Inuit using a food frequency questionnaire. Physiological (lipid profile, fasting glucose, and insulin) and anthropometrical measurements were also obtained. RESULTS The range of median dairy product intake extended from 120 g/d in the lowest tertile to 290 g/d in the highest tertile. The median of calcium intake was 524 mg/d. Participants in the highest tertile of dairy product consumption had higher body weight, fat-free mass, waist circumference, waist-to-hip ratio, and fasting glucose concentrations than participants in the lowest tertile (all p < 0.01). After adjustments for potential cofactors, no significant association was observed. A higher prevalence of Inuit participants with metabolic syndrome was observed in the higher tertile compared with the first tertile (10.3% vs 1.6%; p < 0.001). CONCLUSIONS Higher dairy product intake in Nunavik Inuit is not related to protective effects on body weight and CVD. The consumption of dairy products in Nunavik Inuit is probably not sufficient to withdraw beneficial effects on body weight or CVD risk factors, as observed in North American populations.
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Affiliation(s)
- Annie Ferland
- Axe Santé des populations & Environnementale, Centre de recherche du CHUL, Université Laval, Québec, Canada.
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Brassard P, Caron J, duManoir GR, Pelletier C, Salamin G, Ferland A, Poirier P. Is Well-Controlled Type 2 Diabetes Affects Oxygen Uptake Kinetics in Male Subjects? A Pilot Study. Med Sci Sports Exerc 2011. [DOI: 10.1249/01.mss.0000401260.75584.01] [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: 11/21/2022]
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16
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Lucas M, Proust F, Blanchet C, Ferland A, Déry S, Abdous B, Dewailly E. Is marine mammal fat or fish intake most strongly associated with omega-3 blood levels among the Nunavik Inuit? Prostaglandins Leukot Essent Fatty Acids 2010; 83:143-50. [PMID: 20634051 DOI: 10.1016/j.plefa.2010.06.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [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] [Received: 05/10/2010] [Revised: 06/11/2010] [Accepted: 06/24/2010] [Indexed: 01/25/2023]
Abstract
Here we determined the relationship between red blood cell (RBC) omega-3 (n-3) long-chain polyunsaturated fatty acids (LC-PUFAs) and usual dietary marine food product intake among 630 Nunavik Inuit adults. Marine food product intake was determined by a food frequency questionnaire (FFQ) and fatty acids were quantified in RBC membranes. Multiple linear regression was undertaken to determine the relationship between marine food product intake and RBC n-3 LC-PUFAs (dependent variable). Mean RBC n-3 LC-PUFA level was 9.16 ± 0.11% [SEM]. The highest correlations noted with RBC n-3 LC-PUFAs were for marine mammal fat (r(s)=0.41, P<0.0001) and fish (r(s)=0.35, P<0.0001). Age, total marine mammal fat and fish intakes were the variables that contributed the most to predicted RBC n-3 LC-PUFAs and explained 34%, 15% and 5%, respectively, of its variances. Our study indicates that marine mammal fat intake is more important than fish in accounting for RBC n-3 LC-PUFA levels among the Nunavik Inuit.
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Affiliation(s)
- M Lucas
- Axe Santé des Populations et Environnement, Centre Hospitalier de l'Université Laval (CHUL-CHUQ), Delta Building #2 - Office 600, 2875 Laurier Blvd., 6th Floor, Que., Canada G1V 2M2.
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Chateau-Degat ML, Dewailly E, Louchini R, Counil E, Noël M, Ferland A, Lucas M, Valera B, Ekoé JM, Ladouceur R, Déry S, Egeland G. Cardiovascular burden and related risk factors among Nunavik (Quebec) Inuit: insights from baseline findings in the circumpolar Inuit health in transition cohort study. Can J Cardiol 2010; 26:190-6. [PMID: 20548980 PMCID: PMC2903990 DOI: 10.1016/s0828-282x(10)70398-6] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2009] [Accepted: 10/12/2009] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND The Inuit are commonly portrayed to be somehow protected from cardiovascular diseases (CVDs) through their traditional lifestyle and diet. However, actual sociocultural transition and related major, modifiable risk factors have scarcely been quantified in the Inuit population. Such knowledge is extremely valuable in terms of public health intervention. METHODS A total of 887 Inuit residents from Nunavik, Quebec, participated in a cohort study. The estimates presented were derived from anthropometric and biological measurements gathered at the time of recruitment and enhanced by information collected in the medical file of each participant. All estimates were corrected for a complex sampling strategy and bootstrapped to ensure the representativeness of the general Nunavik population. RESULTS Overall, 19% of Inuit had a disease of the circulatory system according to the International Statistical Classification of Diseases and Related Health Problems, 10th revision. Among all disorders, peripheral circulatory system disease was the most prevalent (9%). Prevalences of ischemic heart disease and cerebrovascular disease were of similar magnitude (2.5%). No significant difference in disease prevalence was noted between sexes. The major modifiable CVD risk factors were smoking (84%), obesity (49%) [corrected] (body mass index of greater than 30 kgm2) and elevated blood pressure (13085 mmHg or greater) (18%). Prevalences were globally higher among women. CONCLUSION The current belief that the Inuit are protected from CVD is seriously questioned by the results of the present study. Considering the extremely high prevalence of CVD risk factors, a population-based intervention reinforced for women is urgently needed to reduce their risk.
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Lacroix S, Ferland A, Gilbert P, Lemieux M, Bilodeau L, Poirier P. Cardiac hazard associated with eating habits. A case of infected intrapericardial foreign body due to an ingested toothpick. Can J Cardiol 2009; 25:e263-4. [PMID: 19584985 DOI: 10.1016/s0828-282x(09)70518-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
An unusual case of a toothpick perforating the distal one-third of the duodenum, penetrating the inferior vena cava and thereafter migrating to the right atrium with extensive pericardial fibrosis is reported. A 60-year-old man was admitted to the emergency department because of epigastric pain, which had progressively worsened. After partial recovery, he was discharged. However, after four episodes of different gastrointestinal bacteria septicemias of unknown origin over a period of five months, the patient was transferred to Laval Hospital (Laval, Quebec) for clinical investigation. Cardiac echocardiography demonstrated a right atrial mass, suggestive of the presence of a thrombus. Thus, after exploratory thoracotomy was performed to remove the so-called thrombus, a toothpick was found in the right atrium.
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Affiliation(s)
- Stéphanie Lacroix
- Faculté de Médecine, Institut universitaire de cardiologie et de pneumologie de l'Hôpital Laval, Université Laval, Laval, Québec, Québec G1V 4G5
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19
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Ferland A, Brassard P, Lemieux S, Bergeron J, Bogaty P, Bertrand F, Simard S, Poirier P. Impact of high-fat /low-carbohydrate, high-, low-glycaemic index or low-caloric meals on glucose regulation during aerobic exercise in Type 2 diabetes. Diabet Med 2009; 26:589-95. [PMID: 19538233 DOI: 10.1111/j.1464-5491.2009.02734.x] [Citation(s) in RCA: 19] [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: 11/30/2022]
Abstract
AIMS A decrement in blood glucose (BG) may be observed in patients with Type 2 diabetes (T2DM) when exercise is performed after a meal, in contrast to fasting. We determined the impact of different pre-exercise meal macronutrient compositions with modulation of the glycaemic index (GI) on glucose regulation during exercise in patients with T2DM. METHODS Using a randomized, single-blind crossover design, 10 sedentary men performed five exercise sessions, once after an overnight fast, and also after each of four test meals, consisting of a high-fat/low-carbohydrate meal, a high-GI meal, a low-GI meal, and a low-calorie meal. RESULTS Pre-exercise BG and insulin levels were comparable for all four meals. Exercise decreased BG and insulin levels during all meal conditions (all P < 0.001) compared with the fasting state in which BG levels did not change. The magnitude of BG and insulin decrements was similar after consuming the low-calorie, the high-GI and the high-fat/low-carbohydrate meals, whereas the low-GI meal induced the lowest BG fall. Adrenaline response was higher after consumption of the high-, the low-GI and the low-caloric meals compared with the high-fat/low-carbohydrate meal and with the fasting state (P < 0.05). CONCLUSIONS This study underlines the beneficial effect of low-GI foods and the differential impact of pre-exercise meal macronutrient composition on BG decrease. This may protect against exercise-induced hypoglycaemia, and reiterates the safety of exercising while fasting in T2DM patients.
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Affiliation(s)
- A Ferland
- Laval Hospital Research Centre, Quebec Heart and Lung Institute
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20
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Ferland A, Poirier P, Sériès F. Sibutramine versus continuous positive airway pressure in obese obstructive sleep apnoea patients. Eur Respir J 2009; 34:694-701. [PMID: 19357147 DOI: 10.1183/09031936.00167308] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The aim of the present study was to compare the efficacy of 1 yr of sibutramine-induced weight loss versus continuous positive airway pressure (CPAP) treatment on sleep-disordered breathing, cardiac autonomic function and systemic blood pressure in obese patients with obstructive sleep apnoea. Subjects with a body mass index of > or =30 kg.m(-2) without previous treatment for obstructive sleep apnoea underwent either sibutramine (n = 22) or CPAP (n = 18) treatment for 1 yr. Sibutramine induced a 5.4+/-1.4 kg decrease in body weight compared to the CPAP group, in which no changes in anthropometric variables were observed. The CPAP treatment improved all sleep and respiratory variables, whereas sibutramine-induced weight loss improved only nocturnal arterial oxygen saturation profile. Only CPAP treatment improved night-time systolic and diastolic blood pressure and 24-h and daytime ambulatory diastolic blood pressure. Sibutramine-induced weight loss had no impact on indices of heart rate variability, whereas CPAP treatment increased daytime time domain indices. CPAP treatment for 1 yr had beneficial impacts on nocturnal breathing disturbances, and improved nocturnal oxygenation, night-time systolic and diastolic blood pressure, and daytime cardiac parasympathetic modulation. Sibutramine did not improve sleep-disordered breathing, systemic blood pressure or heart rate variability. There were no adverse effects, such as increment in blood pressure or arrhythmias, associated with this treatment regimen.
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Affiliation(s)
- A Ferland
- Institut universitaire de cardiologie et de pneumologie de Québec, QC, Canada
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21
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Counil E, Chateau-Degat M, Ferland A, Suhas E, Teyssou R, Dewailly E. Populations in transition: how to measure the dietary component ? Can J Diabetes 2009. [DOI: 10.1016/s1499-2671(09)33118-4] [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: 11/29/2022]
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22
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Chateau-Degat M, Counil E, Ferland A, Louan-Sidi E, Suhas E, Teyssou R, Dewailly E. Fasting insulin levels higher among adolescents than adults: an erosion of public health. Can J Diabetes 2009. [DOI: 10.1016/s1499-2671(09)33242-6] [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: 11/29/2022]
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23
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Ludivine M, Chateau-Degat, Ferland A, Egeland G, Lamarche B, Counil É, Dewailly É. Do Higher Serum Selenium Concentrations Increase the Prevalence of Diabetes Among Inuit From Nunavik? Can J Diabetes 2008. [DOI: 10.1016/s1499-2671(08)24128-6] [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: 11/15/2022]
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24
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Counil É, Chateau-degat ML, Ferland A, Julien P, Dewailly É. Sugar-Sweetened Beverages and the Metabolic Syndrome in the Inuit of Nunavik (Northern Québec). Can J Diabetes 2008. [DOI: 10.1016/s1499-2671(08)24035-9] [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: 11/26/2022]
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Ferland A, Brassard P, Croteau S, Lemieux S, Bergeron J, Lacroix S, Fournier L, Poirier P. Impact of β-blocker treatment and nutritional status on glycemic response during exercise in patients with type 2 diabetes. ACTA ACUST UNITED AC 2007; 30:E257-61. [DOI: 10.25011/cim.v30i6.2954] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Purpose: Most individuals with type 2 diabetes are affected by hypertension and thus have higher risk of cardiac complications. In addition to behavioural modifications, such as healthy food choices and regular physical activity, β-blocker treatment may be considered to reduce morbidity and mortality, especially after a cardiovascular event. However, this medication is generally associated with a deleterious impact on glucose metabolism. The objective of the study was to assess the impact of β-blocker treatment on glucose response during exercise in patients with type 2 diabetes, free of cardiovascular complications.
Methods: Ten sedentary men, treated with diet and/or hypoglycemic agents have performed four exercise sessions at 60% of their O2peak, in the fasted state or 2 hours following a standardized breakfast, with and without β-blockers (atenolol 100 mg id for five consecutive days). Blood samples were drawn during the resting period, at 15-min intervals during the exercise session and during the recovery period.
Results: A reduction of blood glucose levels was observed following the exercise session in the postprandial state (48% and 44% reduction with and without β-blockers respectively; P < 0.001). One hour of exercise performed in the fasted state had a minimal impact on glucose and insulin levels, whether with or without β-blockers. β-blocker treatment was not associated with increased baseline blood glucose or insulin levels in the fasted or the postprandial situation.
Conclusion: Dietary status has a more important impact on plasma glucose and insulin modulation than short-term use of β-blockers.
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Brassard P, Ferland A, Marquis K, Maltais F, Jobin J, Poirier P. Impact of diabetes, chronic heart failure, congenital heart disease and chronic obstructive pulmonary disease on acute and chronic exercise responses. Can J Cardiol 2007; 23 Suppl B:89B-96B. [PMID: 17932595 PMCID: PMC2794474 DOI: 10.1016/s0828-282x(07)71018-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2007] [Accepted: 06/09/2007] [Indexed: 01/15/2023] Open
Abstract
Several chronic diseases are known to negatively affect the ability of an individual to perform exercise. However, the altered exercise capacity observed in these patients is not solely associated with the heart and lungs dysfunction. Exercise has also been shown to play an important role in the management of several pathologies encountered in the fields of cardiology and pneumology. Studies conducted in our institution regarding the influence of diabetes, chronic heart failure, congenital heart disease and chronic pulmonary obstructive disease on the acute and chronic exercise responses, along with the beneficial effects of exercise training in these populations, are reviewed.
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Affiliation(s)
- Patrice Brassard
- Centre de recherche de l’Hôpital Laval, Institut universitaire de cardiologie et de pneumologie, Université Laval, Québec
| | - Annie Ferland
- Centre de recherche de l’Hôpital Laval, Institut universitaire de cardiologie et de pneumologie, Université Laval, Québec
| | - Karine Marquis
- Centre de recherche de l’Hôpital Laval, Institut universitaire de cardiologie et de pneumologie, Université Laval, Québec
| | - François Maltais
- Centre de recherche de l’Hôpital Laval, Institut universitaire de cardiologie et de pneumologie, Université Laval, Québec
| | - Jean Jobin
- Centre de recherche de l’Hôpital Laval, Institut universitaire de cardiologie et de pneumologie, Université Laval, Québec
| | - Paul Poirier
- Centre de recherche de l’Hôpital Laval, Institut universitaire de cardiologie et de pneumologie, Université Laval, Québec
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Ferland A, Broderick TL, Nadeau A, Simard S, Martin J, Poirier P. Impact of fasting and postprandial state on plasma carnitine concentrations during aerobic exercise in type 2 diabetes. Acta Diabetol 2007; 44:114-20. [PMID: 17721749 DOI: 10.1007/s00592-007-0251-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [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] [Received: 09/21/2006] [Accepted: 03/09/2007] [Indexed: 11/25/2022]
Abstract
The effects of metabolic states of fasting and post-absorption on plasma concentrations of free carnitine (FC), acylcarnitine (AC) and total carnitine (TC) were compared during submaximal exercise in subjects with type 2 diabetes mellitus. Ten sedentary men (54+/-5 years) treated with oral hypoglycaemic agents were tested on two separate occasions: following an overnight fast and 2 h after a 395-kcal standardised breakfast. Exercise was performed at 60% of [Formula: see text]O(2peak) on a cycle ergometer for 60 min. Blood samples were drawn at rest for baseline values and following 60 min of exercise and 30 min of recovery. Our results show that: (1) baseline levels of TC, FC and AC were similar in fasted and postprandial groups, (2) TC and AC levels were increased during exercise in the fasted group only, (3) FC levels were decreased during exercise in both fasted and postprandial state and (4) the AC/FC ratio increased during exercise in the fasted group. Our results indicate that the metabolic state of the diabetic patient is associated with a different plasma carnitine status. These patterns may reflect differences in energy metabolism associated with fasting and postprandial hyperglycaemia.
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Affiliation(s)
- A Ferland
- University Institute of Cardiology and Pneumology, Laval Hospital, Laval University, 2725 Chemin Sainte-Foy, Sainte-Foy, Québec, Canada, G1V 4G5
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Ferland A, Brassard P, Poirier P. Is aspartame really safer in reducing the risk of hypoglycemia during exercise in patients with type 2 diabetes? Diabetes Care 2007; 30:e59. [PMID: 17596482 DOI: 10.2337/dc06-1888] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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29
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Ferland A, Brassard P, Croteau S, Lemieux S, Bergeron J, Lacroix S, Fournier L, Poirier P. Impact of Beta-Blocker Treatment and the Nutritional Status on Glycemic Response During Exercise in Type 2 Diabetic Patients. CLIN INVEST MED 2007. [DOI: 10.25011/cim.v30i3.1719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background/Objective: More than 60% of type 2 diabetic individuals present with hypertension and have higher risk of cardiac complications. In addition to behavioural modifications, such as healthy food choices and regular physical activity, beta-blocker (BB) treatment may be considered in order to reduce morbidity and mortality especially following a cardiovascular event. However, this medication is generally associated with a deleterious impact on glucose metabolism. To assess the impact of a BB treatment on glucose response in type 2 diabetic patients exempt of cardiovascular complications.
Methods: Six sedentary men, treated with diet and/or a hypoglycemic agent performed four exercise sessions at 60% of their VO2 peak, in the fasted state or 2 hours after a standardized breakfast, with and without BB (Atenolol 100 mg id for five consecutive days). Blood samples were assayed during the resting period, at 15-minutes intervals during the exercise session and the recovery period.
Results: A reduction of blood glucose levels was observed following the exercise session performed in the postabsorptive state (41% and 37% reduction with and without BB treatment respectively; P < 0.01). One hour of exercise performed in the fasted state had minimal impact on glucose and insulin levels, with or without BB. BB treatment was not associated with increased baseline blood glucose or insulin levels in the fasted or the postabsorptive situation.
Conclusion: These results suggest that the nutritional status has a more important impact on plasma glucose and insulin modulation than short-term use of BB per se.
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30
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Brassard P, Ferland A, Croteau S, Fournier L, Jobin J, Poirier P. Impact of Beta-Blockade on Exercise Capacity in Subjects with Type 2 Diabetes. CLIN INVEST MED 2007. [DOI: 10.25011/cim.v30i3.1731] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background: Beta-blockers are prescribed to subjects with type 2 diabetes with coronary disease to reduce all-cause mortality. However, this medication reduces exercise capacity in non diabetic individuals. The purpose of this study was to evaluate the impact of beta-blockade on exercise capacity in diabetic subjects free of coronary disease.
Methods: Ten sedentary men with type 2 diabetes participated in this study. Subjects were treated with oral hypoglycemic agents and/or diet. Exercise capacity was evaluated using an incremental protocol performed on a cycle ergometer. Subjects were evaluated without (WBB group) and following the use of a beta-blocker (Atenolol 100 mg, id) for 5 consecutive days (BB group).
Results: Per study design, subjects were their own control. The BB situation was characterized by a lower resting heart rate (HR) (54±4 vs 74±12 bpm; P < 0.001) and a trend toward a lower resting systolic blood pressure (SBP) (123±11 vs 131±14 mmHg; P=0.1) compared to the WBB evaluation. Even with comparable peak workload achieved (193±27 vs 200±22 watts), there was a 13 % reduction in relative and absolute values of peak oxygen uptake (25.8±3.4 vs 29.7±4.1 ml·kg-1·min-1; P < 0.05 and 2.5±0.5 vs 2.9±0.6 L·min-1 respectively; P < 0.001), a 35 % reduction in peak HR (110±9 vs 169±14 bpm; P < 0.001) and a 21 % reduction in peak SBP (167±24 vs 211±20 mmHg; P < 0.001) in the BB compared to the WBB situation. Also, the BB situation showed a lower peak minute-ventilation (97±15 vs 120±24 L/min; P < 0.05) compared with WBB.
Conclusion: These results suggest that in subjects with type 2 diabetes free of coronary disease, the use of a beta-blockers impedes cardio-respiratory function at peak exercise beyond compensatory mechanisms leading to a decreased exercise capacity.
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Brassard P, Ferland A, Bogaty P, Desmeules M, Jobin J, Poirier P. Influence of glycemic control on pulmonary function and heart rate in response to exercise in subjects with type 2 diabetes mellitus. Metabolism 2006; 55:1532-7. [PMID: 17046557 DOI: 10.1016/j.metabol.2006.06.025] [Citation(s) in RCA: 16] [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] [Received: 01/19/2006] [Accepted: 06/12/2006] [Indexed: 12/11/2022]
Abstract
Conflicting results exist regarding the impact of glycemic control on peak oxygen uptake (VO2peak) in subjects with type 2 diabetes mellitus. The influence of glycemic control on submaximal oxygen uptake (VO2) in these subjects is unknown. The aim of this study was to evaluate the impact of fasting blood glucose (FBG) (short-term glycemic control) and glycated hemoglobin (HbA1c) (long-term glycemic control) on submaximal VO2 and VO2peak during exercise in subjects with type 2 diabetes mellitus without cardiovascular disease. FBG and HbA1c levels and exercise tolerance in 30 sedentary men with type 2 diabetes mellitus treated with oral hypoglycemic agents and/or diet were evaluated. VO2, carbon dioxide production (VCO2), heart rate, pulmonary ventilation (VE), and the respiratory exchange ratio (RER) were measured throughout the exercise protocol. Subjects were separated into 2 groups of the same age, weight, and body mass index according to median FBG and HbA1c levels (6.5 mmol/L and 6.1%, respectively). Per protocol design, there was a significant difference in FBG and HbA1c levels (P < .001), but not for age, weight, or body mass index. There was no significant difference in peak exercise parameters between the 2 groups according to median FBG or median HbA1c levels. However, the subjects with elevated HbA1c level had lower submaximal V e throughout the exercise protocol (P < .03), and the subjects with elevated FBG concentration had a blunted heart rate pattern during submaximal exercise (P < .03). Although relatively small abnormalities in the control of glycemia do not affect VO2peak in subjects with type 2 diabetes mellitus without cardiovascular disease, they may influence pulmonary function and the chronotropic response during submaximal exercise in these subjects.
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Affiliation(s)
- Patrice Brassard
- Centre de Recherche, Hôpital Laval, Institut Universitaire de Cardiologie et de Pneumologie, Université Laval, Ste-Foy, Québec, Canada G1V 4G5
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Croteau S, Ferland A, Poirier P, Page D, Sériès F. P338 Effect of a 1-year treatment with sibutramine on blood pressure in obese at risk patients with obstructive sleep apnea. Sleep Med 2006. [DOI: 10.1016/j.sleep.2006.07.147] [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: 11/26/2022]
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Brassard P, Ferland A, Gaudreault V, Bonneville N, Jobin J, Poirier P. Elevated peak exercise systolic blood pressure is not associated with reduced exercise capacity in subjects with Type 2 diabetes. J Appl Physiol (1985) 2006; 101:893-7. [PMID: 16728521 DOI: 10.1152/japplphysiol.00260.2006] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Subjects with Type 2 diabetes without cardiovascular disease have a reduced exercise capacity compared with nondiabetic subjects. However, the mechanisms responsible for this phenomenon are unknown. The purpose of this study was to evaluate the impact of exercise systolic blood pressure (SBP) response on diverse exercise tolerance parameters in Type 2 diabetic subjects. Twenty-eight sedentary men with Type 2 diabetes were recruited for this study. Subjects were treated with oral hypoglycemic agents and/or diet. Evaluation of glycemic control and peak exercise capacity were performed for each subject. The subjects were divided into two groups according to the median value of peak SBP (210 mmHg) measured in each subject. We observed a 13, 13, and 16% reduction in the relative peak oxygen uptake (V̇o2 peak), absolute V̇o2 peak, and peak work rate in the low- compared with the high-peak SBP group [26.95 (SD 5.35) vs. 30.96 (SD 3.61) ml·kg−1·min−1, 2.5 (SD 0.4) vs. 2.8 (SD 0.6) l/min, and 169 (SD 34) vs. 202 (SD 32) W; all P < 0.05]. After adjusting for age, relative V̇o2 peak was still significantly different ( P < 0.05). There were similar peak respiratory exchange ratio (RER) [1.20 (SD 0.08) vs. 1.16 (SD 0.07); P = 0.24] and peak heart rate [160 (SD 20) vs. 169 (SD 15) beats/min; P = 0.18] between the low- compared with the high-SBP group. No difference in glycemic control was observed between the two groups. The results reported in this study suggest that in subjects with Type 2 diabetes without cardiovascular disease, an elevated exercise SBP is not associated with reduced exercise capacity and its modulation is probably not related to glycemic control.
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Affiliation(s)
- Patrice Brassard
- Institut Universitaire de Cardiologie et de Pneumologie, Centre de Recherche l'Hôpital Laval, Sainte-Foy, Québec, Canada G1V 4G5
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Ferland A, Brassard P, Lemieux S, Bergeron J, Croteau S, Bonneville N, Fournier L, Jobin J, Poirier P. Impact of Aspartame and Sucrose on Adrenergic Response to Aerobic Exercise in Type 2 Diabetic Patients. Med Sci Sports Exerc 2006. [DOI: 10.1249/00005768-200605001-01729] [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: 11/21/2022]
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Brassard P, Ferland A, Gaudreault V, Bonneville N, Fournier L, Jobin J, Poirier P. Impact of an Elevated Maximal Systolic Blood Pressure on Exercise Tolerance in Patients With Type 2 Diabetes. Med Sci Sports Exerc 2006. [DOI: 10.1249/00005768-200605001-00977] [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: 11/21/2022]
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Bonneville N, Brassard P, Ferland A, Fournier L, Croteau S, Jobin J, Poirier P. Impact of a Beta-Blocking Agent on Exercise Tolerance in Type 2 Diabetic Patients. Med Sci Sports Exerc 2006. [DOI: 10.1249/00005768-200605001-02882] [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: 11/21/2022]
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Ferland A, Martin J, Broderick TL, Nadeau A, Jobin J, Poirier P. Impact of Aerobic Exercise on Plasma Carnitine Levels in Type 2 Diabetes. Med Sci Sports Exerc 2004. [DOI: 10.1249/00005768-200405001-01038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Ferland A, Turbide G, Bogaty P, Jobin J, Larivière MM, Poirier P. Type 2 Diabetes and Aerobic Exercise - Is Prior Breakfast Deleterious? Med Sci Sports Exerc 2004. [DOI: 10.1249/00005768-200405001-01581] [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: 11/21/2022]
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Abstract
The amyloid precursor protein (APP) is processed in the secretory and endocytic pathways, where both the neuroprotective alpha-secretase-derived secreted APP (APPs alpha) and the Alzheimer's disease-associated beta-amyloid peptide are generated. All three members of the FE65 protein family bind the cytoplasmic domain of APP, which contains two sorting signals, YTS and YENPTY. We show here that binding of APP to the C-terminal phosphotyrosine interaction domain of hFE65L requires an intact YENPTY clathrin-coated pit internalization sequence. To study the effects of the hFE65L/APP interaction on APP trafficking and processing, we performed pulse/chase experiments and examined APP maturation and secretion in an H4 neuroglioma cell line inducible for expression of the hFE65L protein. Pulse/chase analysis of endogenous APP in these cells showed that the ratio of mature to total cellular APP increased after the induction of hFE65L. We also observed a three-fold increase in the amount of APPs alpha recovered from conditioned media of cells overexpressing hFE65L compared with uninduced controls. The effect of hFE65L on the levels of APPs alpha secreted is due neither to a simple increase in the steady-state levels of APP nor to activation of the protein kinase C-regulated APP secretion pathway. We conclude that the effect of hFE65L on APP processing is due to altered trafficking of APP as it transits through the secretory pathway.
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Affiliation(s)
- S Y Guénette
- Department of Neurology, Massachusetts General Hospital East and Harvard Medical School, Charlestown 02129, USA
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