RESUMO
This study aimed to evaluate the effect of early time-restricted eating (eTRE) on metabolic markers and body composition in individuals with overweight or obesity. Seventeen subjects completed a randomized, crossover, and controlled clinical trial. Twelve women and five men participated, with a mean age of 25.8 ± 10.0 years and a BMI of 32.0 ± 6.3 kg/m2. The eTRE intervention included 16 h of fasting (3:00 pm to 7:00 am) and 8 h of ad libitum eating (7:00 am to 03:00 pm) (16:8). The trial included four weeks of interventions followed by a four-week washout period. Body weight, waist and hip circumferences, and body composition measurements were taken. Additionally, a venous blood sample was collected for biochemical determinations. In a before-after analysis, eTRE induced a reduction in BW and BMI in women but this was not significant when compared to the control group. eTRE did not modify any other anthropometric measurements, fasting biochemical parameters, glycemic and insulinemic responses, blood pressure, or subjective appetite. In conclusion, eTRE did not induce beneficial effects on the glycemic and lipid metabolisms, body composition, subjective appetite, or blood pressure. These findings may be attributed to the special characteristics of the population and the short intervention period.
Assuntos
Biomarcadores , Composição Corporal , Estudos Cross-Over , Jejum , Obesidade , Sobrepeso , Humanos , Feminino , Masculino , Adulto , Obesidade/sangue , Sobrepeso/sangue , Biomarcadores/sangue , Adulto Jovem , Índice de Massa Corporal , Glicemia/metabolismo , Adolescente , Pressão Sanguínea , Apetite , Fatores de Tempo , Insulina/sangueRESUMO
We previously observed beneficial effects of native banana starch (NBS) with a high resistant starch (RS) content on glycemic response in lean and obese participants. Here, we aimed to determine the effects of NBS and high-amylose maize starch (HMS) on glycemic control (GC) and glycemic variability (GV) in patients with type 2 diabetes (T2D) when treatments were matched for digestible starch content. In a randomized, crossover study, continuous glucose monitoring (CGM) was performed in 17 participants (aged 28-65 years, BMI ≥ 25 kg/m2, both genders) consuming HMS, NBS, or digestible maize starch (DMS) for 4 days. HMS and NBS induced an increase in 24 h mean blood glucose during days 2 to 4 (p < 0.05). CONGA, GRADE, and J-index values were higher in HMS compared with DMS only at day 4 (p < 0.05). Yet, NBS intake provoked a reduction in fasting glycemia changes from baseline compared with DMS (p = 0.0074). In conclusion, under the experimental conditions, RS from two sources did not improve GC or GV. Future longer studies are needed to determine whether these findings were affected by a different baseline microbiota or other environmental factors.
Assuntos
Glicemia/efeitos dos fármacos , Diabetes Mellitus Tipo 2/complicações , Controle Glicêmico/métodos , Amido Resistente/farmacologia , Adulto , Amilose , Automonitorização da Glicemia , Estudos Cross-Over , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade , Amido/administração & dosagem , Zea mays/químicaRESUMO
BACKGROUND: The use of glutamine and arginine has shown several advantages in postoperative outcomes in patients after gastrointestinal surgery. We determined the effects of its use in patients with enterocutaneous fistula after operative treatment. PATIENTS AND METHODS: Forty patients with enterocutaneous fistula were randomly assigned to one of two groups. The control group received the standard medical care while the patients of the experimental group were supplemented with enteral administration of 4.5 g of arginine and 10 g of glutamine per day for 7 days prior to the surgery. The primary outcome variable was the recurrence of the fistula and the secondary outcomes were preoperative and postoperative serum concentrations of interleukin 6 and C-reactive protein and postoperative infectious complications. RESULTS: Twenty patients were assigned to each group. The fistula recurred in two patients (10%) of the experimental group and in nine patients (45%) of the control group (P < 0.001). We found a total of 13 infectious complications in six patients of the control group (all with fistula recurrence) and none in the experimental group. Mean preoperative serum concentrations of interleukin 6 and C-reactive protein were lower in patients from the experimental group. In addition, these levels were lower in patients who had recurrence if compared to patients that did not recur. CONCLUSION: Preoperative administration of oral arginine and glutamine could be valuable in the postoperative recovery of patients with enterocutaneous fistulas submitted to definitive surgery.
Assuntos
Arginina/administração & dosagem , Fístula Cutânea/cirurgia , Glutamina/administração & dosagem , Fístula Intestinal/cirurgia , Administração Oral , Adulto , Proteína C-Reativa/metabolismo , Fístula Cutânea/sangue , Fístula Cutânea/etiologia , Suplementos Nutricionais , Procedimentos Cirúrgicos do Sistema Digestório/efeitos adversos , Feminino , Humanos , Interleucina-6/sangue , Fístula Intestinal/sangue , Fístula Intestinal/etiologia , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Complicações Pós-Operatórias/cirurgia , Período Pós-Operatório , Cuidados Pré-Operatórios , Estudos Prospectivos , RecidivaRESUMO
An abnormal glycemic profile, including postprandial glycemia and acute glucose spikes, precedes the onset of overt diabetes in obese subjects. Previous studies have shown the beneficial effects of chronic native banana starch (NBS) supplementation. In this study, we examined the effects of acute ingestion of NBS on glycemic profiles by means of continuous glucose monitoring in obese and lean subjects. In a crossover study, obese and lean subjects consumed beverages containing either 38.3 g of NBS or 38.3 g of digestible corn starch (DCS) twice daily during 4 days. On day 5, a 3-h meal tolerance test (MTT) was performed to evaluate glucose and insulin responses. After 1 week of washout period, treatments were inverted. NBS supplementation reduced the 48-h glycemia AUC in lean, obese, and in the combined group of lean and obese subjects in comparison with DCS. Postprandial glucose and insulin responses at MTT were reduced after NBS in comparison with DCS in all groups. However, no changes were observed in glycemic variability (GV) indexes between groups. In conclusion, acute NBS supplementation improved postprandial glucose and insulin responses in obese and lean subjects during 48 h of everyday life and at MTT. Further research to elucidate the mechanism behind these changes is required.
Assuntos
Glicemia/efeitos dos fármacos , Musa , Obesidade , Amido/administração & dosagem , Amido/farmacologia , Adolescente , Adulto , Estudos Cross-Over , Diabetes Mellitus , Feminino , Humanos , Insulina , Masculino , Pessoa de Meia-Idade , Monitorização Fisiológica , Período Pós-Prandial , Adulto JovemRESUMO
The macronutrient component of diets is critical for metabolic control and insulin action. The aim of this study was to compare the effects of high fat diets (HFDs) vs. high carbohydrate diets (HCDs) on metabolic control and insulin resistance in Wistar rats. Thirty animals divided into five groups (n = 6) were fed: (1) Control diet (CD); (2) High-saturated fat diet (HSFD); (3) High-unsaturated fat diet (HUFD); (4) High-digestible starch diet, (HDSD); and (5) High-resistant starch diet (HRSD) during eight weeks. HFDs and HCDs reduced weight gain in comparison with CD, however no statistical significance was reached. Calorie intake was similar in both HFDs and CD, but rats receiving HCDs showed higher calorie consumption than other groups, (p < 0.01). HRSD showed the lowest levels of serum and hepatic lipids. The HUFD induced the lowest fasting glycemia levels and HOMA-IR values. The HDSD group exhibited the highest insulin resistance and hepatic cholesterol content. In conclusion, HUFD exhibited the most beneficial effects on glycemic control meanwhile HRSD induced the highest reduction on lipid content and did not modify insulin sensitivity. In both groups, HFDs and HCDs, the diet constituents were more important factors than caloric intake for metabolic disturbance and insulin resistance.
Assuntos
Dieta Hiperlipídica , Carboidratos da Dieta/farmacologia , Gorduras na Dieta/farmacologia , Resistência à Insulina , Animais , Glicemia/análise , Peso Corporal , Ingestão de Energia , Teste de Tolerância a Glucose , Insulina/sangue , Metabolismo dos Lipídeos , Masculino , Ratos , Ratos WistarRESUMO
Changes in the cellular metabolism assessed by the variability of oxygen consumption (VO(2) ) and carbon dioxide production (VCO(2) ) as well as the association of serum glucose and insulin to energy spectral density (ESD) of VO(2) and VCO(2) were evaluated. Ten nonglucose intolerant and 10 glucose intolerant subjects, aged 21-70 years, were included. Glucose and insulin concentrations and VO(2) and VCO(2) records were collected every 10 min during 3 h. ESD of VO(2) and VCO(2) was estimated and associated with glucose and insulin concentrations. Statistical significance in glucose levels, insulin, and ESD of VO(2) and VCO(2) among nonglucose intolerant subjects and glucose and insulin among glucose intolerance subjects at postload glucose (PLG) state compared with basal state was found. Moreover, glucose was significantly higher in glucose intolerance subjects than nonglucose intolerant subjects for basal and PLG states. These results show an increment in ESD of VO(2) and VCO(2) at PLG state among nonglucose intolerant subjects and suggest that their measurement may be a key indicator of the variability of cellular metabolic activity and contribute to confirm disturbances in glucose metabolism.
Assuntos
Glicemia/metabolismo , Dióxido de Carbono/metabolismo , Intolerância à Glucose/metabolismo , Insulina/sangue , Consumo de Oxigênio , Adulto , Idoso , Calorimetria Indireta/métodos , Dióxido de Carbono/análise , Metabolismo Energético , Jejum , Intolerância à Glucose/sangue , Humanos , Pessoa de Meia-Idade , Estatísticas não ParamétricasRESUMO
Many enterocutaneous fistulas (ECF) require operative treatment. Despite recent advances, rates of recurrence have not changed substantially. This study aims to determine factors associated with recurrence and mortality in patients submitted to surgical repair of ECF. Consecutive patients submitted to surgical repair of ECF during a 5-year period were studied. Several patient, disease, and operative variables were assessed as factors related to recurrence and mortality through univariate and multivariate analysis. There were 35 male and 36 female patients. Median age was 52 years (range, 17-81). ECF recurred in 22 patients (31%), 18 of them (82%) eventually closed with medical and/or surgical treatment. Univariate analyses disclosed noncolonic ECF origin (p = 0.04), high output (p = 0.001), and nonresective surgical options (p = 0.02) as risk factors for recurrence; the latter two remained significant after multivariate analyses. A total of 14 patients died (20%). Univariate analyses revealed risk factors for mortality at diagnosis or referral including malnutrition (p = 0.03), sepsis (p = 0.004), fluid and electrolyte imbalance (p = 0.001), and serum albumin <3 g/dl (p = 0.02). Other significant variables were interval from last abdominal operation to ECF operative treatment ≤20 weeks (p = 0.03), preoperative serum albumin <3 g/dl (p = 0.001), and age ≥55 years (p = 0.03); the latter two remained significant after multivariate analyses. Interestingly, recurrence after surgical treatment was not associated with mortality (p = 0.75). Among several studied variables, recurrence was only independently associated with high output and type of surgical treatment (operations not involving resection of ECF). Interestingly, once ECF recurred its management was as successful as non-recurrent fistulas in our series. Mortality was associated to previously-reported bad prognostic factors at diagnosis or referral.
Assuntos
Fístula Cutânea/mortalidade , Fístula Cutânea/cirurgia , Fístula Intestinal/mortalidade , Fístula Intestinal/cirurgia , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Fístula Cutânea/complicações , Feminino , Humanos , Fístula Intestinal/complicações , Masculino , Desnutrição/complicações , Pessoa de Meia-Idade , Análise Multivariada , Período Pré-Operatório , Recidiva , Reoperação , Fatores de Risco , Sepse/complicações , Albumina Sérica , Desequilíbrio Hidroeletrolítico/complicações , Adulto JovemRESUMO
The modification of free amino groups on proteins, lipids, and nucleic acids by non-enzymatic glycosylation produce a variety of complex structures named advanced glycation end products (AGEs). Glycation of these molecules participate in the development of diabetic complications and related diseases. Diabetes mellitus is characterized by short-term metabolic changes in lipid and protein metabolism, and long-term irreversible changes in vascular and connective tissue. AGEs are directly implicated in the development of chronic complications in diabetes such as nephropathy, rethinopathy, neuropathy, and other related diseases such as atherosclerosis, heart disease, stroke, and peripheral vascular disease. In this review, we aim to explain how glycation occurs in different molecules and what the pathological consequence of AGE formation in diabetes mellitus and other diseases are.
Assuntos
Diabetes Mellitus/metabolismo , Glucose/metabolismo , Complicações do Diabetes/metabolismo , HumanosRESUMO
Few fiber supplements have been studied for physiological effectiveness. The effects of native banana starch (NBS) and soy milk (control) on body weight and insulin sensitivity in obese type 2 diabetics were compared using a blind within-subject crossover design. Subjects undertook two phases of 4-week supplementation either with NBS or soy milk. Patients on NBS lost more body weight than when they were on control treatment. Plasma insulin and HOMA-I were reduced after NBS consumption, compared with baseline levels, but not significantly when compared to the control treatment. Results support the use of NBS as part of dietary fiber supplementation.
Assuntos
Peso Corporal/efeitos dos fármacos , Diabetes Mellitus Tipo 2/fisiopatologia , Resistência à Insulina , Musa/química , Obesidade/fisiopatologia , Amido/administração & dosagem , Adulto , Estudos Cross-Over , Diabetes Mellitus Tipo 2/complicações , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade/complicações , Amido/farmacologiaRESUMO
Advanced glycation end-products (AGEs) are heterogeneous groups of compounds that result from the non-enzymatic reaction of reducing sugars with free amino groups of biological molecules such as proteins, lipids, and nucleic acids. A large number of studies have been focused on AGEs metabolism, analysis, treatments, and their implications in the pathogenesis of diseases, especially in diabetes mellitus. Here, we review recent advances in the understanding of pathological complications caused by the production of AGEs. We provide an overview of the most important issues published within this area in last years; we also present the number of scientific papers related to AGEs available since 1950 until 2008 in the most important fields including metabolism, physiology, and pharmacology, thus as analytical methods for AGE detection and quantification and studies carried out in human body fluids. Data were collected from ovidSP.
Assuntos
Diabetes Mellitus/metabolismo , Produtos Finais de Glicação Avançada , Pesquisa/tendências , Complicações do Diabetes/metabolismo , Produtos Finais de Glicação Avançada/análise , Produtos Finais de Glicação Avançada/biossíntese , Produtos Finais de Glicação Avançada/fisiologia , HumanosRESUMO
Even though the beneficial effects of vitamin E have been experimentally observed, some clinical trials failed to verify a consistent benefit. One reason for this situation has been the difficulty to make comparisons among different studies. There are differences due to subjects, chemical forms of vitamin E, stages of the disease and others. The intake of high doses of vitamin E as a supplement has increased in many countries. Novel studies, have informed that vitamin E not only has antioxidant properties but can acts through precise molecular actions interacting with proteins and enzymes and modulating cellular signaling, transcriptional regulation and apoptosis induction. However, some recent clinical and meta analysis studies have found that daily supplementation with vitamin E 400 IU or higher is associated to increased mortality. In conclusion, a complete understanding of vitamin E actions at the cell does not exist yet and the controversy about its clinical effects is still present. This paper offers current knowledge on the characteristics, metabolism, properties, beneficial effect as well as the potential toxicity of vitamin E.
Assuntos
Suplementos Nutricionais , Vitamina E/uso terapêutico , Antioxidantes/uso terapêutico , Suplementos Nutricionais/efeitos adversos , Humanos , Vitamina E/efeitos adversos , Vitamina E/metabolismoRESUMO
Aunque en estudios de laboratorio se han observado efectos potencialmente benéficos de la vitamina E, los resultados de la evaluación clínica son inconsistentes. Una situación que ha limitado el conocimiento en esta área, es la dificultad para establecer comparaciones entre los diferentes estudios. Existen diferencias entre sujetos, tipos de formulaciones, etapas de la enfermedad, y otros aspectos. El consumo de megadosis de esta vitamina se ha incrementado en muchos países. En estudios recientes se ha informado que además de su capacidad antioxidante, esta vitamina tiene acciones moleculares precisas que influyen sobre la actividad de varias enzimas modulando la expresión de genes y la inducción de apoptosis. Sin embargo, algunos estudios clínicos y metaanálisis han informado que dosis de 400 UI/día o mayores de α-tocoferol, se asocian con aumento del índice de mortalidad. Resulta claro que hasta la fecha no se tiene un conocimiento completo de los efectos de estas sustancias a nivel celular y que existe controversia en los resultados de ensayos clínicos. En el presente trabajo se revisa el conocimiento actual sobre las características de esta vitamina, sus principales efectos benéficos, su toxicidad potencial y se discuten los resultados de algunos metaanálisis recientes en relación al aumento del riesgo de mortalidad.
Even though the beneficial effects of vitamin E have been experimentally observed, some clinical trials failed to verify a consistent benefit. One reason for this situation has been the difficulty to make comparisons among different studies. There are differences due to subjects, chemical forms of vitamin E, stages of the disease and others. The intake of high doses of vitamin E as a supplement has increased in many countries. Novel studies, have informed that vitamin E not only has antioxidant properties but can acts through precise molecular actions interacting with proteins and enzymes and modulating cellular signaling, transcriptional regulation and apoptosis induction. However, some recent clinical and meta analysis studies have found that daily supplementation with vitamin E 400 IU or higher is associated to increased mortality. In conclusion, a complete understanding of vitamin E actions at the cell does not exist yet and the controversy about its clinical effects is still present. This paper offers current knowledge on the characteristics, metabolism, properties, beneficial effect as well as the potential toxicity of vitamin E.
Assuntos
Humanos , Suplementos Nutricionais , Vitamina E/uso terapêutico , Antioxidantes/uso terapêutico , Suplementos Nutricionais/efeitos adversos , Vitamina E/efeitos adversos , Vitamina E/metabolismoRESUMO
Amino groups of amino acids, nucleic acids and lipids can react non-enzymatically with reducing sugars to form unstable Schiff bases that can then undergo the Amadori rearrangement to form irreversible advanced glycation end products (AGEs). Ketoacidosis is a life-threatening complication in patients with untreated diabetes mellitus and it is characterized by increased circulating ketone body concentrations. Recently, the in vitro glycation of hemoglobin by beta-hydroxybutyrate and acetone was described by our laboratory. This study was designed to evaluate the in vitro effect of acetoacetate on brain aminophospholipids at similar concentrations to that observed in ketoacidosis (16.13 mM total ketone bodies). The effect of acetoacetate was compared to that of glucose and the other ketone bodies; beta-hydroxybutyrate and acetone. The antiglycating activity of urea and glycylglycine was also investigated. The incubation of aminophospholipids with acetoacetate results in the formation of a new compound with an absorption peak at 280 nm. When this reaction product was analyzed by thin layer chromatography using an elusion system of methanol:chloroform:acetic acid:water (8:1:1:0.4), the R(f) value obtained (0.24-0.26) was similar to that of the compound formed by aminophospholipids with glucose. In contrast, this reaction product was not detected in those samples containing beta-hydroxybutyrate and acetone. The formation of this new compound was inhibited by urea more effectively than glycylglycine. In conclusion, this study provides the evidence that brain aminophospholipids react with acetoacetate forming AGEs and that this glycating effect of acetoacetate was remarkably decreased by urea, suggesting a protective physiological role for urea in the body as it was previously stated. Finally, this information adds knowledge about the contribution of ketoacidosis in the pathophysiology of diabetic complications, especially in type 1 diabetic patients.
Assuntos
Acetoacetatos/antagonistas & inibidores , Acetoacetatos/farmacologia , Química Encefálica/efeitos dos fármacos , Fosfolipídeos/metabolismo , Ureia/farmacologia , Animais , Bovinos , Cromatografia em Camada Fina , Glucose/farmacologia , Produtos Finais de Glicação Avançada/análise , Produtos Finais de Glicação Avançada/química , Glicilglicina/farmacologia , Corpos Cetônicos/farmacologia , Lipídeos/química , Lipídeos/isolamento & purificação , Espectrofotometria UltravioletaRESUMO
Based on immunohistochemical techniques against connexins and the intercellular flux of staining molecules, it has previously been shown that electrotonic communication occurs among endothelial and vascular smooth muscle cells, this due to the presence of myoendothelial gap junctions. The aim of this study was to evaluate the density of myoendothelial contacts in the left coronary and internal mammary arteries as well as in the left saphenous vein by means of electron microscopy, the distance between both cells participating in an myoendothelial contact with a semi-automatic image analysis system and the presence of homocellular and heterocellular gap junctions between endothelial and smooth muscle cells by using the immunohistochemical technique and confocal microscopy in thoracic aorta were also analyzed. The results are that all blood vessels studied present myoendothelial contacts, while density studies show that they are more abundant in the saphenous vein. The myoendothelial contact distance is constant and in no case the cytoplasmic processes reach the plasma membrane of the partner cell toward which they are advanced. Homocellular gap junctions were found between smooth muscle cells and between endothelial cells. Heterocellular gap junctions were absent, evidencing the possibility that signaling molecules between endothelial and smooth muscle cells may be transferred through plasma membranes as was once thought and not necessarily by electrotonic communication.
Assuntos
Comunicação Celular , Endotélio Vascular/metabolismo , Junções Comunicantes/metabolismo , Músculo Liso Vascular/fisiologia , Transdução de Sinais/fisiologia , Animais , Aorta Torácica/citologia , Aorta Torácica/fisiologia , Vasos Coronários/citologia , Vasos Coronários/fisiologia , Endotélio Vascular/fisiologia , Junções Comunicantes/fisiologia , Imuno-Histoquímica , Masculino , Artéria Torácica Interna/citologia , Artéria Torácica Interna/fisiopatologia , Microscopia Confocal , Microscopia Eletrônica , Músculo Liso Vascular/citologia , Ratos , Ratos Sprague-Dawley , Veia Safena/citologia , Veia Safena/fisiologiaRESUMO
Arginase is the enzyme which synthesizes urea and ornithine, a precursor from which putrescine, spermidine and spermine are formed. These natural polyamines have been implicated in cell growth, replication and wound healing. The present study evaluated the possibility that spermine increases arginase activity and reduces liver damage caused by carbon tetrachloride. Intraperitoneally injected spermine at a dose of 1 mg/kg after a single intragastric administration of carbon tetrachloride (1.6 ml/kg) increased arginase activity (6.30-7.79 microg urea/mg protein per min) (P<0.05) as well as total protein content (0.29-0.37 mg/mg dry weight) in hepatic tissue, compared to the group which only received carbon tetrachloride. When liver cell damage was biochemically assessed, the carbon tetrachloride-treated group showed a 20-fold increase in serum glutamic oxaloacetate transaminase, compared to the control group (P<0.05), and this was significantly diminished by the administration of spermine (P<0.05). Serum triglycerides increased four times compared to the control group as a result of the carbon tetrachloride treatment and were diminished by spermine as well. These results indicate that spermine may play a role in the recovery of liver tissue after carbon tetrachloride-induced liver injury, maybe by increasing the synthesis of putrescine, a polyamine which has been found out to participate in the recovery of the hepatic tissue after an insult with carbon tetrachloride.
Assuntos
Arginase/metabolismo , Tetracloreto de Carbono/toxicidade , Doença Hepática Induzida por Substâncias e Drogas/tratamento farmacológico , Espermina/uso terapêutico , Animais , Aspartato Aminotransferases/sangue , Doença Hepática Induzida por Substâncias e Drogas/enzimologia , Masculino , Ratos , Ratos Long-Evans , Triglicerídeos/sangueRESUMO
In the searching for new substances with the capacity to protect beta-cells from the toxic effects of alloxan, we evaluated the effect of L-arginine and the polyamines putrescine, spermidine and spermine in a murine experimental model of diabetes. Diabetes was induced by the i.p. injection of either 200 mg/kg (24-h experiments) or 120 mg/kg (12 days experiments) body weight. L-Arginine and polyamines were administered 10 min before or 10 min after alloxan administration, once its half-life had elapsed, respectively. In the 24-h study, serum glucose (199.8+/-27.6 mg/dl) and triglyceride (54.6+/-4.9 mg/dl) concentrations showed a protective effect of spermine, as these parameters were not too high (P < or = 0.05), compared to the alloxan-treated group (415.4+/-47.8 and 90.2+/-11.6 mg/dl, respectively), and were closer to glucose (132.3+/-6.0 mg/dl) and similar to triglycerides (63.8+/-7.1 mg/dl) of the control group. A similar pattern was observed on the parameters measured when L-arginine and polyamines were administered daily for 12 days, starting 10 min after a single alloxan administration, which provides evidence that L-arginine and polyamines are effective in impeding the increase in serum glucose, triglyceride and cholesterol concentration showed on day 3 by the alloxan-treated group, as well as a higher acinar cell regenerative capacity as determined by immunohistochemical techniques. Spermine turning out to be more effective than L-arginine, putrescine or spermidine in counteracting the marked hyperglycemia and triglyceridemia showed by the alloxan-treated group and similar in effect when evaluating cholesterolemia. These results show a clear protective role of L-arginine and polyamines over the pancreatic beta-cell, in addition to the induction of neogenesis from both ductal and acinar cells that leads to the recovery of endocrine pancreatic function in rats with experimental diabetes.
Assuntos
Arginina/farmacologia , Diabetes Mellitus Experimental/prevenção & controle , Células Secretoras de Insulina/efeitos dos fármacos , Poliaminas/farmacologia , Aloxano/toxicidade , Animais , Arginina/administração & dosagem , Glicemia/metabolismo , Peso Corporal/efeitos dos fármacos , Bromodesoxiuridina/metabolismo , Proliferação de Células/efeitos dos fármacos , Colesterol/sangue , Diabetes Mellitus Experimental/sangue , Diabetes Mellitus Experimental/induzido quimicamente , Esquema de Medicação , Imunoquímica/métodos , Injeções Intraperitoneais , Células Secretoras de Insulina/citologia , Células Secretoras de Insulina/metabolismo , Masculino , Poliaminas/administração & dosagem , Ratos , Ratos Sprague-Dawley , Fatores de Tempo , Triglicerídeos/sangueRESUMO
This work was designed to study an alternative treatment of diabetes mellitus by using a transplant of hybrid cells obtained by the electrofusion of pancreatic islet cells from a healthy donor with dermic cells obtained from a recipient. The hybrid cells kept the capacity of insulin production, its regulation, and the natural control of glycemia, as well as the factors of histocompatibility to avoid the rejection. Four groups of four rats each were established: Group 1. Healthy animals (healthy control), Group 2. Diabetized non-treated animals (diabetic control), Group 3. Transplant recipient rats with extraction of dermic cells which were mixed with pancreatic insular cells from a healthy donor (transplant without fusion), and Group 4. Transplant recipient rats, with extraction of dermic cells which were electrofused with pancreatic insular cells from a healthy donor (transplant with fusion). For the Group 4, the cells were combined and they were submitted to dielectrophoresis conditions with an alternating current pulse of 15 s of 10 V RMS of 0.5 MHz. The fusion was made with a direct current pulse of 1 ms of 300 V. Clinical signs were registered (weight, diuresis, food and water intake), and several biochemical parameters in blood which included basal glycemia, uric acid, cholesterol, triglycerides, glutamate oxalacetate transaminase, glutamate pyruvate transaminase, urea, creatinine, insulin, glycated hemoglobin were registered. Additionally, ketone bodies and glucose were also measured in urine. All determinations were made at 30, 60, and 90 days. Animals of Group 1 maintained its parameters within the normal ranges. Rats of Group 2 presented alterations corresponding to a diabetic state in almost all the parameters measured, none of the animals showed a tendency to improve spontaneously, two of the rats died at 66 and 72 days. The Group 3 showed a clinical profile similar to the diabetic control group without improvement, only one rat died at day 33, while in the rats transplanted with fusion (Group 4) an improvement was observed on some parameters including body weight, water intake and glycemia. Although insulin concentration was under the normal range, it was higher than in the Group 3. None rat died. These results indicate that it is possible to improve the diabetic profile by the transplant of dermic cells from a diabetic animal fused with insular cells from a healthy donor in the recipient animal.
Assuntos
Derme/citologia , Diabetes Mellitus Experimental/cirurgia , Células Híbridas/transplante , Ilhotas Pancreáticas/citologia , Alanina Transaminase/metabolismo , Animais , Aspartato Aminotransferases/metabolismo , Glicemia/metabolismo , Fusão Celular/métodos , Diabetes Mellitus Experimental/metabolismo , Diabetes Mellitus Experimental/fisiopatologia , Ingestão de Líquidos/fisiologia , Ingestão de Alimentos/fisiologia , Hemoglobinas Glicadas/metabolismo , Células Híbridas/citologia , Insulina/sangue , Corpos Cetônicos/urina , Masculino , Ratos , Ratos Wistar , Aumento de Peso/fisiologiaRESUMO
In this study we evaluate the effects of alpha-tocopherol on the metabolic control and oxidative stress in female patients with type 2 diabetes mellitus. Thirty-four female type 2 diabetics 40-70 years old up to 14 years with diabetes, under medical treatment, were randomly divided in two groups. One group received placebo (Control group, n = 21) and the other received alpha-tocopherol (800 IU/day, n = 13) during 6 weeks. Blood samples were collected at the beginning and at the end of the study to measure malondialdehyde production, glycated hemoglobin, selenium dependent-glutathione peroxidase, Cu,Zn-superoxide dismutase in erythrocytes and total antioxidant status, glucose, lipid and lipoproteins in serum. Erythrocyte malondialdehyde decreased and serum-total antioxidant status increased after alpha-tocopherol treatment (P < 0.0001). However, an unexpected increase on cholesterol levels and a reduced erythrocyte-Cu,Zn-superoxide dismutase activity was observed after alpha-tocopherol treatment. alpha-Tocopherol administration did not affect glucose, glycated hemoglobin, triacylglycerides, lipoprotein levels and serum malondialdehyde. A minor oxidative stress was observed in female type 2 diabetic patients after alpha-tocopherol treatment inferred from the reduced levels of erythrocyte malondialdehyde and the increased values of total antioxidant status. On the other hand, no beneficial changes were observed on glycemic control or lipid metabolism.
Assuntos
Diabetes Mellitus Tipo 2/tratamento farmacológico , Estresse Oxidativo/efeitos dos fármacos , alfa-Tocoferol/análogos & derivados , Adulto , Idoso , Antioxidantes/administração & dosagem , Antioxidantes/uso terapêutico , Cápsulas , LDL-Colesterol/sangue , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/metabolismo , Eritrócitos/efeitos dos fármacos , Eritrócitos/metabolismo , Feminino , Humanos , Peroxidação de Lipídeos/efeitos dos fármacos , Malondialdeído/sangue , Pessoa de Meia-Idade , Superóxido Dismutase/sangue , Fatores de Tempo , Tocoferóis , alfa-Tocoferol/administração & dosagem , alfa-Tocoferol/uso terapêuticoRESUMO
BACKGROUND: The relationship between diabetes mellitus and infection is bidirectional. Diabetes favors infection, while infections make controlling diabetes much more difficult. The most frequent infections encountered in pregnant diabetics are those of the urinary tract (UTI) and cervicovaginal (CVI) area. Periodontal diseases (PD) and active caries (AC) are infectious diseases frequently found in these cases often remaining as hidden entities of low intensity. The aim of this study was to assess whether there is an association between PD and caries with lack of glycemic control often encountered in pregnant type 2 diabetic women. METHODS: A single skilled researcher performed the periodontal evaluation of PD and AC cases. Glycated alpha hemoglobin (HbA(1c)) over 6.5% was used to diagnose metabolic glucose disturbances. The controlled variables were UTI, CVI and adherence to treatment. The statistical tests used were chi-square adjusted for continuity, analysis of variance, odds ratio with 95% confidence intervals and logistic regression with a significance level of p < 0.05. RESULTS: One hundred twenty-seven type 2 diabetic women were seen during the second trimester of their pregnancies. Mean age was 31.3 years; 55% had lack of glycemic control associated with CVI (chi2 21.07, p < 0.000), PD (chi2 5.72, p < 0.005) and UTI (chi2 13.77, p < 0.000) with therapeutic adherence (TA) (chi2 14.80, p < 0.00). No association was found with AC. The logistic regression results showed that UTI, CIV, PD and TA are associated with lack of glycemic control. CONCLUSIONS: Periodontal diseases may act as "hidden" infections in pregnant diabetics and be associated with lack of glycemic control. This situation should be taken into consideration by healthcare teams in charge of prenatal care.
Assuntos
Glicemia/metabolismo , Cárie Dentária/metabolismo , Complicações do Diabetes/metabolismo , Diabetes Mellitus Tipo 2/metabolismo , Doenças da Boca/metabolismo , Gravidez/metabolismo , Adulto , Feminino , Hemoglobinas Glicadas/metabolismo , Humanos , Masculino , Doenças da Boca/diagnóstico , Segundo Trimestre da Gravidez , Análise de Regressão , Infecções Urinárias/metabolismoRESUMO
Experimentally, we demonstrated the beneficial effects of L-arginine on regulation of hyperglycemia and dyslipidemia in experimental diabetes, in addition to a positive anti-aggregating effect in platelets in animals and humans. Here, the effect of L-arginine on foot ulcers from diabetic patients was studied. Three groups of diabetic patients were included: 11 patients without ulcer received neither treatment and served as controls. Eleven patients with diabetic ulcer received the standard treatment, this group served as diabetic control with diabetic ulcer. Eleven remain patients with diabetic ulcer received 10 mM L-arginine subcutaneously on the site of the wound. Biopsy with punch number 5 on wound site comprising both ulcerative and contiguous undamaged skin were performed in all patients with ulcerative lesions before any treatment. Patients with intact skin had biopsy performed with punch number 5 on external malleolar region of right lower limb. Biopsies were examined by light and confocal microscopy utilizing histochemical and immunohistochemical methods. Initial and final blood samples were collected to determine glucose, triglycerides, total cholesterol, glycated hemoglobin (HbA(1c)), low (LDL), and high density lipoproteins (HDL). Significant differences (P < 0.05) were observed between initial and final serum glucose levels for treated patients, and initial serum glucose levels between treated and control patients without diabetic ulcer. Glycated hemoglobin, triglycerides, cholesterol, and lipoprotein levels showed no significant changes. Eight patients treated with L-arginine reached total wound healing and the remaining three who abandoned the study because of change of residence showed relevant improvement. Histochemistry and immunohistochemistry methods have shown vascular impairment in both patients with diabetic ulcer (prior to treatment) and control patients without diabetic ulcer. Our observations strongly support efficacy of L-arginine for successful wound healing of diabetic ulcers.