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Gymnema sylvestre (GS) and berberine (BBR) are natural products that have demonstrated therapeutic potential for the management of obesity and its comorbidities, as effective and safe alternatives to synthetic drugs. Although their anti-obesogenic and antidiabetic properties have been widely studied, comparative research on their impact on the gene expression of adipokines, such as resistin (Res), omentin (Ome), visfatin (Vis) and apelin (Ap), has not been reported. METHODOLOGY: We performed a comparative study in 50 adult Mexican patients with obesity treated with GS or BBR for 3 months. The baseline and final biochemical parameters, body composition, blood pressure, gene expression of Res, Ome, Vis, and Ap, and safety parameters were evaluated. RESULTS: BBR significantly decreased (p < 0.05) body weight, blood pressure and Vis and Ap gene expression and increased Ome, while GS decreased fasting glucose and Res gene expression (p < 0.05). A comparative analysis of the final measurements revealed a lower gene expression of Ap and Vis (p < 0.05) in patients treated with BBR than in those treated with GS. The most frequent adverse effects in both groups were gastrointestinal symptoms, which attenuated during the first month of treatment. CONCLUSION: In patients with obesity, BBR has a better effect on body composition, blood pressure, and the gene expression of adipokines related to metabolic risk, while GS has a better effect on fasting glucose and adipokines related to insulin resistance, with minimal side effects.
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Adipocinas , Berberina , Composição Corporal , Gymnema sylvestre , Obesidade , Resistina , Humanos , Masculino , Feminino , Adulto , Obesidade/tratamento farmacológico , Obesidade/metabolismo , Adipocinas/sangue , Adipocinas/metabolismo , Composição Corporal/efeitos dos fármacos , Pessoa de Meia-Idade , Berberina/farmacologia , Resistina/sangue , Resistina/metabolismo , Apelina , Pressão Sanguínea/efeitos dos fármacos , Nicotinamida Fosforribosiltransferase/metabolismo , Citocinas/metabolismo , Citocinas/sangue , Extratos Vegetais/farmacologia , Glicemia/efeitos dos fármacos , Glicemia/metabolismo , Lectinas , Proteínas Ligadas por GPI/metabolismo , Proteínas Ligadas por GPI/genética , Fármacos Antiobesidade/farmacologia , Fármacos Antiobesidade/uso terapêuticoRESUMO
BACKGROUND: We conducted a systematic review and meta-analysis to examine the effect of dietary intake of cocoa on anthropometric measurements, lipid and glycemic profiles, and blood pressure levels in adults, with and without comorbidities. METHODS: The databases used were MEDLINE (PubMed), EMBASE, Web of Science, Cochrane, LILACS, and SciELO. The eligible studies were randomized clinical trials (RCTs) involving adults undergoing cocoa consumption (cocoa extract or ≥70% cocoa dark chocolate) for ≥4 weeks that evaluated at least one of the following markers: body weight, body mass index (BMI), waist/abdominal circumference, total cholesterol, LDL-c, triglycerides, HDL-c, blood glucose, glycated hemoglobin (HbA1c), and systolic and diastolic blood pressure (SBP/DBP). RESULTS: Thirty-one studies were included, totaling 1986 participants. Cocoa consumption showed no effects on body weight, BMI, waist circumference, triglycerides, HDL-c and HbA1c. Yet, there was a reduction in total cholesterol (-8.35 mg/dL, 95% CI -14.01; -2.69 mg/dL), LDL-c (-9.47 mg/dL, 95% CI -13.75; -5.20 mg/dL), fasting blood glucose (-4.91 mg/dL, 95% CI -8.29; -1.52 mg/dL), SBP (-2.52 mmHg, 95% CI -4.17; -0.88 mmHg), and DBP (-1.58 mmHg, 95% CI -2.54; -0.62 mmHg). CONCLUSIONS: The consumption of cocoa showed protective effects on major cardiometabolic risk markers that have a clinical impact in terms of cardiovascular risk reduction.
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Glicemia , Pressão Sanguínea , Cacau , Fatores de Risco Cardiometabólico , Ensaios Clínicos Controlados Aleatórios como Assunto , Humanos , Glicemia/metabolismo , Biomarcadores/sangue , Hemoglobinas Glicadas/metabolismo , Hemoglobinas Glicadas/análise , Doenças Cardiovasculares/prevenção & controle , Chocolate , Masculino , Feminino , Adulto , Índice de Massa Corporal , Peso Corporal , Circunferência da Cintura , Pessoa de Meia-Idade , Triglicerídeos/sangue , Dieta , Lipídeos/sangueRESUMO
The progression from prediabetes to type-2 diabetes depends on multiple pathophysiological, clinical, and epidemiological factors that generally overlap. Both insulin resistance and decreased insulin secretion are considered to be the main causes. The diagnosis and approach to the prediabetic patient are heterogeneous. There is no agreement on the diagnostic criteria to identify prediabetic subjects or the approach to those with insufficient responses to treatment, with respect to regression to normal glycemic values or the prevention of complications. The stratification of prediabetic patients, considering the indicators of impaired fasting glucose, impaired glucose tolerance, or HbA1c, can help to identify the sub-phenotypes of subjects at risk for T2DM. However, considering other associated risk factors, such as impaired lipid profiles, or risk scores, such as the Finnish Diabetes Risk Score, may improve classification. Nevertheless, we still do not have enough information regarding cardiovascular risk reduction. The sub-phenotyping of subjects with prediabetes may provide an opportunity to improve the screening and management of cardiometabolic risk in subjects with prediabetes.
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The association of diabetes with increased large artery stiffness is not definitively established. We aimed to describe the carotid-femoral pulse wave velocity (cf-PWV) in participants with and without diabetes and whether the cf-PWV could vary among the different laboratory-based criteria used. A cross-sectional analysis using baseline data from 13,912 adults was used. cf-PWV as well as anthropometric, biochemical, and clinical data were measured. Diabetes was defined by previous medical diagnosis, medication use, fasting glucose, an oral glucose tolerance test (GTT), or glycated hemoglobin (HbA1c). The prevalence of diabetes was 18.7%, higher in men than in women. After adjustment, participants with diabetes showed higher cf-PWV (men: 9.7 ± 1.7 vs 9.4 ± 1.7 m/s, P < .05; women: 9.4 ± 1.6 vs 9.1 ± 1.7 m/s, P < .05). We observed a progressive increase in cf-PWV as >1 laboratory-based criterion for diabetes diagnosis was reached. Also, participants with diabetes with alterations in any laboratory-based criteria had higher cf-PWV than participants without diabetes, regardless of sex. In summary, diabetes is associated with higher cf-PWV as is each laboratory-based parameter used for its diagnosis. These results support the strong consequences of glucose dysregulation on the vascular system and provide evidence to screen all parameters involved in glycemic metabolism to improve vascular health.
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Metabolic syndrome (MetS) is a cluster of cardiovascular risk factors, usually with a common pathophysiological origin in insulin resistance and abdominal obesity. Considering the reported effects of ellagic acid (EA) on insulin resistance and abdominal obesity, the aim of this study was to evaluate the effect of EA on the components of MetS, insulin sensitivity and insulin secretion by conducting a randomized, double-blind, placebo-controlled, clinical trial with 32 volunteers diagnosed with MetS. Sixteen patients were randomly allocated, received 500 mg of EA orally twice a day for 12 weeks, and the other 16 received a placebo. Clinical and laboratory determinations were obtained at baseline and at the end of the study. After EA administration, patients reduced their waist circumference (females: 102.2 ± 4.2 to 99.5 ± 3.2 cm (p < 0.05); males: 99.8 ± 6.7 to 96.0 ± 4.7 cm (p < 0.01)), systolic blood pressure (118.1 ± 10.1 to 113.7 ± 7.8 mmHg (p < 0.01)), diastolic blood pressure (118.1 ± 10.1 to 113.7 ± 7.8 mmHg (p < 0.01)), triglycerides (2.8 ± 1.1 to 2.1 ± 0.7 mmol/L (p < 0.01)), fasting plasma glucose (6.5 ± 0.5 to 5.7 ± 0.6 mmol/L (p < 0.01)), fasting plasma insulin (p < 0.01), and insulin secretion (p < 0.05), with an increase of insulin sensitivity (p < 0.01). In male patients, high-density lipoprotein cholesterol increased (p < 0.05). In conclusion, EA improved the components of MetS, reduced hyperinsulinemia, and improved insulin sensitivity.
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Different studies performed in human patients, animal models, and in vitro cell cultures, show a correlation between type 2 diabetes (DBT2) and certain neurodegenerative pathologies. Also, it was proposed that increased inflammation and- or oxidative distress are a possible cause of DBT2-accelerated cognitive decline. The onset of DBT2 is characterized by an increase in blood glucose levels due to (an inability of the body's cells to use insulin properly) called impaired fasting glucose (IFG). Genetic and/or molecular causes of IFG have not yet been established, but metabolic syndrome, obesity, unbalanced diets, and sedentary lifestyle would be responsible, at least in part, for the multiplication in the number of this disease. It has been proposed that hyperglycemia itself causes an imbalance in the redox state and could compromise blood-brain barrier (BBB) causing neurodegeneration. For this reason, we propose, in this review, to evaluate the available data about redox state and neurocognitive studies during the IFG period.
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The search for strategies to develop resilience against metabolic and neuropsychiatric disorders has motivated the clinical and experimental assessment of early life interventions such as lifestyle-based and use of unconventional pharmacological compounds. In this study, we assessed the effects of voluntary physical activity and 7,8-Dihydroxy-4-methylcoumarin (DHMC), independently or in combination, over mice physiological and behavioral parameters, adult hippocampal and hypothalamic neurogenesis, and neurotrophic factors expression in the hypothalamus. C57Bl/6J mice were submitted to a 29-day treatment with DHMC and allowed free access to a running wheel. We found that DHMC treatment alone reduced fasting blood glucose levels. Moreover, physical activity showed an anxiolytic effect in the elevated plus maze task and DHMC produced additional anxiolytic behavior, evidenced by reduced activity during the light cycle in the physical activity group. Although we did not find any differences in hypothalamic or hippocampal adult neurogenesis, DHMC increased gene expression levels of VEGF, which was correlated to the reduced fasting glucose levels. In conclusion, our data emphasize the potential of physical activity in reducing development of neuropsychiatric conditions, such as anxiety, and highlights DHMC as an attractive compound to be investigated in future studies addressing neuropsychiatric disorders associated with metabolic conditions.
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Cumarínicos , Plasticidade Neuronal , Animais , Cumarínicos/farmacologia , Hipocampo/metabolismo , Camundongos , Camundongos Endogâmicos C57BLRESUMO
AIMS: This pilot study aimed to determine if increased serum ferritin (SF) is associated with cardiovascular risk factors in patients with prediabetes. METHODS: Eighteen patients with prediabetes and 36 subjects without prediabetes (control), non-white Hispanic, non-indigenous origin, Mexican mestizo descent were included. Participants had no inflammation, or vascular complications. SF and metabolic markers were evaluated in both groups. RESULTS: SF and oxidized low-density lipoprotein (oxLDL) were increased in prediabetes subjects. Moreover, in prediabetes and control groups as a whole, natural logarithm (ln)-SF correlated with oxLDL and ln-oxLDL/LDL after adjustment for sex, ln-age, ln-fasting plasma glucose (FPG), ln-body mass index, ln-triglyceride (TG), total cholesterol (TC), and high-density lipoproteins. Finally, ln-SF was an independent contributor to ln-oxLDL/LDL ratio in control and prediabetes subjects (ß = 0.2915) after the introduction of potential confounders such as FPG, TC, TG, and hypertension. CONCLUSIONS: The results of this study indicate that hyperferritinemia is associated with oxLDL, considered one of the main cardiovascular risk factors, which allows us to suggest that an increase in SF could contribute to the progression of prediabetes, prior to the appearance of diabetes. Further research is required to establish a causal relationship of iron disruption metabolism in oxLDL generation under prediabetes conditions.
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OBJECTIVES: To investigate the rates of diabetes mellitus (DM) and impaired fasting glucose (IFG) in a population-based sample of individuals aged 75 + years old and their associations with cognitive performance, depression, functionality, and quality of life (QoL). STUDY DESIGN: Overall, 350 people participated in the study. Assessments of cognition, mood, functionality and QoL were performed using the mini-mental state examination (MMSE), clock-drawing, category fluency tests, the Mini-International Neuropsychiatric Interview, Pfeffer's Functional Activities Questionnaire, and the WHO Quality of Life-Old (WHOQOL-OLD). RESULTS: IFG (ADA criteria) was identified in 42.1% of the sample, while the DM rate was 24.1%. Lack of knowledge of the DM diagnosis and lack of treatment occurred in 27% and 39% of the sample, respectively. Rates of dementia and depression, MMSE, category fluency scores, and previous cardiovascular events did not differ between the glycaemic groups. Individuals with DM performed worse on the clock-drawing test, functionality, and WHOQOL-OLD than the other participants. Individuals with IFG presented similar QoL and functionality when compared with the group without DM. CONCLUSIONS: IFG and DM were common in this population-based sample aged 75 + years old, as were inadequate diagnoses and treatments of DM. DM individuals presented poor performance in the executive function test, functionality, and QoL. Further studies are recommended to investigate the value of an IFG diagnosis among the most elderly population.
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Transtorno Depressivo Maior , Diabetes Mellitus , Idoso , Glicemia , Cognição , Diabetes Mellitus/epidemiologia , Jejum , Humanos , Qualidade de VidaRESUMO
Chile is one of the largest consumers of sugar-sweetened beverages (SSB) world-wide. However, it is unknown whether the effects from this highly industrialized food will mimic those reported in industrialized countries or whether they will be modified by local lifestyle or population genetics. Our goal is to evaluate the interaction effect between SSB intake and T2D susceptibility on fasting glucose. We calculated a weighted genetic risk score (GRSw) based on 16 T2D risk SNPs in 2828 non-diabetic participants of the MAUCO cohort. SSB intake was categorized in four levels using a food frequency questionnaire. Log-fasting glucose was regressed on SSB and GRSw tertiles while accounting for socio-demography, lifestyle, obesity, and Amerindian ancestry. Fasting glucose increased systematically per unit of GRSw (ß = 0.02 ± 0.006, p = 0.00002) and by SSB intake (ß[cat4] = 0.04 ± 0.01, p = 0.0001), showing a significant interaction, where the strongest effect was observed in the highest GRSw-tertile and in the highest SSB consumption category (ß = 0.05 ± 0.02, p = 0.02). SNP-wise, SSB interacted with additive effects of rs7903146 (TCF7L2) (ß = 0.05 ± 0.01, p = 0.002) and with the G/G genotype of rs10830963 (MTNRB1B) (ß = 0.19 ± 0.05, p = 0.001). Conclusions: The association between SSB intake and fasting glucose in the Chilean population without diabetes is modified by T2D genetic susceptibility.
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Glicemia/metabolismo , Diabetes Mellitus Tipo 2/etiologia , Jejum/sangue , Bebidas Adoçadas com Açúcar/efeitos adversos , Adulto , Idoso , Chile , Estudos Transversais , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/genética , Feminino , Humanos , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Polimorfismo de Nucleotídeo Único , Estudos Prospectivos , Fatores de RiscoRESUMO
(1) Background: Due to its richness in chlorogenic acids (CGAs), Maté (Ilex paraguariensis A. St.-Hil.) could be of interest in the prevention of cardiometabolic diseases, however clinical evidence are lacking. This trial aimed to evaluate the impact of maté CGAs, consumed in a daily dose achievable through traditional maté beverages, on parameters related to cardiometabolic risk. (2) Design: Thirty-four male volunteers aged 45-65 years and with at most one criteria of metabolic syndrome, were recruited for a randomized, double-blind, placebo-controlled, and crossover study. The volunteers were assigned to consume an encapsulated dry maté extract for four-weeks, providing 580 mg of caffeoyl quinic acid derivatives (CQAs) daily, or a placebo, with a two weeks washout between intervention periods. Anthropometric variables, blood pressure, plasma glucose, lipids, endothelial, and inflammatory biomarkers were measured in overnight-fasted subjects and after a glucose load. (3) Results: We found no significant effects of treatment on these parameters and the response to the glucose load was also similar between the two interventions. However, a significant decrease in fasting glucose was observed between day 0 and day 28 for the maté group only (-0.57 ± 0.11 mmol/L, p < 0.0002). In subjects with an intermediate to high Framingham risk score, consumption of maté extract induced a 10% increase of high-density lipoprotein (HDL)-c from baseline. In a subgroup representative of the study population, significant decreases in the C-reactive protein (CRP) (-50%) and interleukin-6 (IL-6) (-19%) levels were observed. (4) Conclusions: These clinical observations suggest that maté, naturally rich in CGAs, could improve some cardiometabolic markers in subjects with a higher predisposition to metabolic syndrome, even if that remains to be confirmed in new trials specifically targeting this population.
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Doenças Cardiovasculares/prevenção & controle , Ilex paraguariensis , Extratos Vegetais/uso terapêutico , Idoso , Biomarcadores/sangue , Glicemia/efeitos dos fármacos , Pressão Sanguínea/efeitos dos fármacos , Proteína C-Reativa/análise , Estudos Cross-Over , Método Duplo-Cego , Fatores de Risco de Doenças Cardíacas , Humanos , Ilex paraguariensis/química , Interleucina-6/sangue , Lipídeos/sangue , Masculino , Pessoa de Meia-IdadeRESUMO
PURPOSE: To analyze the effects of 2 combined training methods on the cardiometabolic risk factors in adolescents. METHODS: A total of 76 adolescents (16.1 [1.1] y, n = 44 female) were randomized into groups of moderate-intensity continuous training combined with resistance training (MICT + RT), high-intensity interval training combined with resistance training (HIIT + RT), or control. The training sessions were performed twice weekly for 12 weeks. The outcomes evaluated included body fat percentage, waist circumference, fasting blood glucose, fasting insulin, total cholesterol, triglycerides, low-density lipoprotein, high-density lipoprotein, glycated hemoglobin, insulin resistance index, blood pressure, peak oxygen consumption (VO2peak), and cardiometabolic risk Z score. RESULTS: The intervention groups presented a significant reduction in the cardiometabolic risk Z score after 12 weeks of the combined exercise program. In relation to the cardiometabolic risk Z score between groups, the HIIT + RT group presented a significant intervention effect when compared with the control group (Cohen d = 0.23; P < .05). Significant intervention effects were found when comparing the MICT + RT and control groups for body fat percentage, high-density lipoprotein, and VO2peak. Between the HIIT + RT and control groups, significant intervention effects were found for body fat percentage, blood pressure, and VO2peak. There were not significant differences between the HIIT + RT and MICT + RT groups. CONCLUSION: Twelve weeks of HIIT + RT and MICT + RT were effective in significantly reducing the cardiometabolic risk in these adolescents.
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Fatores de Risco Cardiometabólico , Treinamento Intervalado de Alta Intensidade , Treinamento Resistido , Adolescente , Pressão Sanguínea , Composição Corporal , Brasil , Feminino , Humanos , Masculino , Consumo de OxigênioRESUMO
The aim of this study was to evaluate the differences in the metabolic profile and body composition of monozygotic (MZ) twins concordant and discordant for the practice of physical exercise. The sample consisted of 92 MZ twins (72.5% female and 27.5% male, mean age 25.4 ± 5.69 years), registered with the Brazilian Registry of Twins, residing in Natal, Brazil. Data collection was carried out between the years 2016 and 2018. On day 1, subjects underwent a whole-body fitness evaluation, including measures of weight, height, body composition by Dual-Energy X-ray Absorptiometry and the Cardiorespiratory Exercise Test. On day 2, 10 ml blood samples were collected (overnight fasting) to determine the lipid profile and fasting glucose. The sample was separated into three groups: Active Concordant twins (Concordant A, n = 44 subjects), Inactive Concordant twins (Concordant I, n = 22 subjects) and Discordant pairs for Physical Exercise (Discordant PE, n = 26 subjects). The results demonstrated a difference between the discordant twins for exercise and also between the active versus sedentary groups, indicating a causal effect of exercise on the fat percentage, maximum oxygen consumption (VO2max) and second ventilatory threshold variables. Between groups, a difference was also observed between the groups in ventilatory threshold, very low-density lipoprotein and triglycerides. We concluded that, regardless of genetics, the practice of physical exercise was sufficient to generate alterations in body composition and VO2max in MZ twins, but not in the lipid profile or fasting glucose.
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Composição Corporal , Exercício Físico , Metaboloma , Adulto , Glicemia , Brasil , Feminino , Humanos , Lipídeos/sangue , Masculino , Gêmeos Monozigóticos , Adulto JovemRESUMO
BACKGROUND: An Amerindian genetic background could play an important role in susceptibility to metabolic diseases, which have alarmingly increased in recent decades. Mexico has one of the highest prevalences of metabolic disease worldwide. The purpose of this study was to determine the prevalence of metabolic syndrome and its components in a population with high Amerindian ancestry. METHODS: We performed a descriptive, quantitative, and analytical cross-sectional study of 2596 adult indigenous volunteers from 60 different ethnic groups. Metabolic syndrome and its components were evaluated using the American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement criteria. RESULTS: The overall prevalence of metabolic syndrome in the indigenous Mexican population was 50.3%. Although females had a higher prevalence than males (55.6% vs. 38.2%), the males presented with combinations of metabolic syndrome components that confer a higher risk of cardiovascular disease. The most frequent metabolic syndrome component in both genders was low HDL-cholesterol levels (75.8%). Central obesity was the second most frequent component in females (61%), though it had a low prevalence in males (16.5%). The overall prevalence of elevated blood pressure was 42.7% and was higher in males than females (48.8 vs. 40%). We found no gender differences in the overall prevalence of elevated triglycerides (56.7%) or fasting glucose (27.9%). CONCLUSIONS: We documented that individuals with Amerindian ancestry have a high prevalence of metabolic syndrome. Health policies are needed to control the development of metabolic disorders in a population with high genetic risk.
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Indígenas Norte-Americanos/estatística & dados numéricos , Síndrome Metabólica/epidemiologia , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Síndrome Metabólica/etnologia , México/epidemiologia , Pessoa de Meia-Idade , Obesidade Abdominal/epidemiologia , Obesidade Abdominal/etnologia , Prevalência , Fatores de RiscoRESUMO
It has been suggested that the triglyceride and glucose (TyG) index is an early indicator for type 2 diabetes (T2D) in adults. Thus, the aim of this study was to evaluate whether the TyG index is useful in the screening of glucose disorders (GD) in apparently healthy children and adolescents. Eligible participants were apparently healthy children and adolescents. Individuals with new diagnosis of GD were allocated into the study groups with impaired fasting glucose (IFG), impaired glucose tolerance (IGT), and T2D. Participants with normal glucose tolerance (NGT) were the control group. In total, 1872 children and adolescents were enrolled and allocated into the study groups. Diagnosis of NGT, IFG, IGT, and T2D was established in 1541 (82.3%), 256 (13.7%), 66 (3.5%), and 9 (0.4%) children, respectively. In girls, the best cutoff points of the TyG index for identifying IFG, IGT, and T2D were 4.51 (sensitivity 59.8%, specificity 59.8%), 4.55 (sensitivity 63.0%, specificity 64.3%), and 4.63 (sensitivity 75.0%, specificity 74.6%), respectively; and in boys were 4.52 (sensitivity 62.8%, specificity 64.2%), 4.54 (sensitivity 71.8%, specificity 65.1%), and 4.82 (sensitivity 91.0%, specificity 990.6%), respectively.Conclusion: Our results suggest that the TyG index may be a useful tool for screening GD in healthy children and adolescents.What is Known:⢠Prevalence of prediabetes and type 2 diabetes is increasing worldwide among young adults and adolescents.⢠Elevated fasting glucose and triglyceride concentrations have been recognized as independent risk factors for type 2 diabetes.What is New:⢠The TyG index exhibited highest sensitivity and specificity to detect impaired fasting glucose, impaired glucose tolerance, and type 2 diabetes.⢠The TyG index may be a useful tool for the screening of glucose disorders in apparently healthy children and adolescents.
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Glicemia/metabolismo , Regras de Decisão Clínica , Transtornos do Metabolismo de Glucose/diagnóstico , Programas de Rastreamento/métodos , Triglicerídeos/sangue , Adolescente , Doenças Assintomáticas , Biomarcadores/sangue , Estudos de Casos e Controles , Criança , Diagnóstico Precoce , Feminino , Transtornos do Metabolismo de Glucose/sangue , Humanos , Masculino , Sensibilidade e EspecificidadeRESUMO
AIMS/HYPOTHESIS: To understand the complex metabolic changes that occur long before the diagnosis of type 2 diabetes, we investigated differences in metabolomic profiles in plasma between prediabetic and normoglycaemic individuals for subtypes of prediabetes defined by fasting glucose, 2 h glucose and HbA1c measures. METHODS: Untargeted metabolomics data were obtained from 155 plasma samples from 127 Mexican American individuals from Starr County, TX, USA. None had type 2 diabetes at the time of sample collection and 69 had prediabetes by at least one criterion. We tested statistical associations of amino acids and other metabolites with each subtype of prediabetes. RESULTS: We identified distinctive differences in amino acid profiles between prediabetic and normoglycaemic individuals, with further differences in amino acid levels among subtypes of prediabetes. When testing all named metabolites, several fatty acids were also significantly associated with 2 h glucose levels. Multivariate discriminative analyses show that untargeted metabolomic data have considerable potential for identifying metabolic differences among subtypes of prediabetes. CONCLUSIONS/INTERPRETATION: People with each subtype of prediabetes have a distinctive metabolomic signature, beyond the well-known differences in branched-chain amino acids. DATA AVAILABILITY: Metabolomics data are available through the NCBI database of Genotypes and Phenotypes (dbGaP, accession number phs001166; www.ncbi.nlm.nih.gov/projects/gap/cgi-bin/study.cgi?study_id=phs001166.v1.p1).
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Metabolômica/métodos , Adulto , Idoso , Aminoácidos de Cadeia Ramificada/sangue , Aminoácidos de Cadeia Ramificada/metabolismo , Glicemia/metabolismo , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/metabolismo , Jejum/sangue , Hemoglobinas Glicadas/metabolismo , Humanos , Americanos Mexicanos , Pessoa de Meia-Idade , Análise Multivariada , Estado Pré-Diabético/sangue , Estado Pré-Diabético/metabolismo , Texas , Estados Unidos , Adulto JovemRESUMO
In vivo studies show the benefits of the trypsin inhibitor isolated from tamarind (Tamarindusindica L.) (TTI) seeds in satiety and obesity. In the present study, TTI nanoencapsulation (ECW) was performed to potentialize the effect of TTI and allow a controlled release in the stomach. The impact on glycemia, insulin, and lipid profile was evaluated in Wistar rats overfed with a high glycemic index diet (HGLI). Characterization of the nanoparticles and in vitro stability in simulated gastrointestinal conditions, monitored by antitrypsin activity and HPLC, was performed. ECW and empty nanoparticles (CW) were administered by gavage, using 12.5 and 10.0 mg/kg, respectively. Both nanoformulations presented a spherical shape and smooth surface, with an average diameter of 117.4 nm (24.1) for ECW and 123.9 nm (11.3) for CW. ECW maintained the antitrypsin activity (95.5%) in the gastric phase, while TTI was completely hydrolyzed. In Wistar rats, the nanoformulations significantly reduced glycemia and HOMA IR, and ECW increased HDL-c compared to CW (p < 0.05).Pancreas histopathology of animals treated with ECW suggested an onset of tissue repair. Thenanoencapsulation provided TTI protection, gradual release in the desired condition, and improvement of biochemical parameters related to carbohydrate metabolism disorders,without compromising insulinemia.
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Glicemia/metabolismo , HDL-Colesterol/sangue , Hiperglicemia/prevenção & controle , Insulina/sangue , Nanopartículas , Tamarindus/química , Inibidores da Tripsina/administração & dosagem , Animais , Quitosana , Preparações de Ação Retardada , Dieta , Jejum , Índice Glicêmico , Hidrólise , Hiperglicemia/sangue , Hipoglicemiantes/administração & dosagem , Hipoglicemiantes/farmacologia , Hipoglicemiantes/uso terapêutico , Resistência à Insulina , Masculino , Pâncreas/efeitos dos fármacos , Pâncreas/patologia , Extratos Vegetais/administração & dosagem , Extratos Vegetais/farmacologia , Extratos Vegetais/uso terapêutico , Ratos Wistar , Sementes , Tripsina/metabolismo , Inibidores da Tripsina/farmacologia , Inibidores da Tripsina/uso terapêutico , Proteínas do Soro do LeiteRESUMO
OBJECTIVE: The aim was to evaluate whether the Fat-to-Lean Mass (FyM) ratio is associated to glucose metabolic disorders (GMD). DESIGN: Cross-sectional population based study. METHODS: Eligible subjects were healthy men and non-pregnant women with new diagnosis of GMD that were allocated into following groups: 1) Normal Glucose Tolerance (NGT), 2) Diabetes, 3) impaired fasting glucose (IFG)â¯+â¯impaired glucose tolerance (IGT), 4) IGT, and 5) IFG. The FyM index [Total body fat (Kg)/total lean mass (Kg)], and the odds ratio (OR) between FyM index and GMD were estimated. RESULTS: A total of 875 individuals with average age 41.62⯱â¯12.3 were enrolled; of them, 645 (73.1%) women and 230 (22.8%) men; 521 (59.5%), 71 (8.1%), 85 (9.7%), 53 (6.0%), and 145 (16.6%) individuals were allocated into groups with NGT, diabetes, IFGâ¯+â¯IGT, IGT, and IFG, respectively. The FyM was significantly associated with prediabetes and diabetes in women (OR 4.2; 95%CI 3.0-11.1 and ORâ¯=â¯7.2; 95%CI 2.0-15.2) and men (ORâ¯=â¯2.6; 95%CI 1.1-6.7 and ORâ¯=â¯4.6; 95%CI 1.4-15.1). In the overall population, the OR between FyM index with IGT, IFG, and IFGâ¯+â¯IGT was 8.4 (95%CI 2.6-17.4), 5.2 (95%CI 2.6-10.6), and 6.1 (95%CI 1.8-9.5). CONCLUSION: The FyM index was strongly associated with all categories of GMD.
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Tecido Adiposo/fisiopatologia , Adiposidade , Transtornos do Metabolismo de Glucose/diagnóstico , Músculo Esquelético/fisiopatologia , Adulto , Antropometria , Glicemia , Índice de Massa Corporal , Estudos Transversais , Feminino , Intolerância à Glucose , Transtornos do Metabolismo de Glucose/classificação , Transtornos do Metabolismo de Glucose/fisiopatologia , Teste de Tolerância a Glucose , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-IdadeRESUMO
Insulin resistance and defects in other related glycemic traits are common findings in the context of Metabolic Syndrome. Although genetic factors are clearly implied in susceptibility, and some gene variants have been identified mainly in populations of European ancestry, little is known about this aspect in admixed populations. The association of insulin resistance, ß-cell function, fasting insulin and glucose levels with 48 gene variants, previously related to metabolic syndrome components, and with the ancestral genetic composition, estimated on 50 ancestry informative markers, was evaluated in 417 individuals from the Colombian admixed population. The Native American genetic ancestry was associated with a low ß-cell function (odds ratio (OR) of 1.73 and 95% confidence interval (95% CI) of 1.07-2.81, pâ¯=â¯0.026). Significant genotypic associations were obtained (q-valueâ¯<â¯0.05) for gene variants in ACE (rs4340; OR (95% CI): 2.79 (1.58-4.91), insulin resistance; mean difference (95% CI): 0.273 (0.141; 0.406), fasting insulin), ADIPOR2 (rs11061971; OR (95% CI): 0.14 (0.04-0.48), low ß-cell function), MTNR1B (rs10830963; mean difference (95% CI): 0.032 (0.013; 0.051), fasting glucose) and GCK (rs4607517; mean difference (95% CI): 0.038 (0.020;0.056) and rs1799884; mean difference (95% CI): 0.027 (0.013-0.041), fasting glucose). Also the well-known gene variants rs7903146 in TCF7L2, and rs17817449 in FTO, were nominally associated with hyperglycemia (rs7903146), as well as with higher fasting insulin levels (rs17817449). Our findings indicate that gene variants in ACE, ADIPOR2, MTNR1B, GCK, TCF7L2 and FTO, are associated with glycemic traits in the admixed Colombian population, while a higher Native American genetic component is related to lower ß-cell function.
Assuntos
Variação Genética/genética , Índice Glicêmico/genética , Indígenas Norte-Americanos/genética , Proteínas/genética , Dioxigenase FTO Dependente de alfa-Cetoglutarato/genética , Colômbia , Feminino , Genótipo , Quinases do Centro Germinativo , Humanos , Resistência à Insulina/genética , Masculino , Peptidil Dipeptidase A/genética , Proteínas Serina-Treonina Quinases/genética , Receptor MT2 de Melatonina/genética , Receptores de Adiponectina/genética , Proteína 2 Semelhante ao Fator 7 de Transcrição/genética , Adulto JovemRESUMO
RESUMEN Objetivos Analizar: 1) el perfil lipídico en personas con glucemia de ayunas alterada (GAA) y 2) su posible asociación con parámetros clínico-metabólicos. Material y métodos Se reclutaron 101 personas de ambos sexos asistentes a consultorios de la Carrera Universitaria de Medicina Interna UNLP, incluyéndose personas >15 años que firmaron consentimiento informado para participar en el estudio; se excluyeron aquellos tratados con fármacos que afectaran el metabolismo lipídico y con diabetes tipo 2. En ellos se registraron antecedentes personales, heredofamiliares, hábitos de vida y ocurrencia de eventos cardiovasculares previos, índice de masa corporal (IMC), circunferencia de cintura (CC) y tensión arterial. En muestras de sangre se determinó glucemia, HbA1c y perfil lipídico; en la mayoría se agregó insulinemia e índice HOMA-IR. La evaluación estadística incluyó ANOVA y test de Tukey, considerándose significativas diferencias con valor de p ≤0,05. Resultados: 67,32% de los participantes presentaron glucemias ≤100 mg/dl (grupo control) y el 32,67% disglucemias compatibles con el estado de GAA. La edad promedio, el IMC y la CC, los valores de HbA1c, insulina y HOMA-IR al igual que el porcentaje de personas con hipertensión arterial fueron significativamente mayores en este último grupo. Los valores del perfil lipídico registrados fueron mayores en el grupo de GAA excepto el c-HDL en el que fueron menores. Conclusión La dislipemia presente en personas con GAA sería simultáneamente un marcador de ateroesclerosis obliterante y un promotor de la transición a DT2, por lo que requiere su diagnóstico y tratamiento precoz.
ABSTRACT Aims To analyze: 1) the lipid profile in people with impaired fasting glucose (IFG) and 2) its potential association with clinical and metabolic parameters. Materials and methods: 101 people were recruited from those attending the University of Internal Medicine UNLP clinic, including people of both sexes, >15 years who sign informed consent to participate in the study; those treated with drugs that affect lipid metabolism and with type 2 diabetes were excluded. In all of them had we recoded body mass index (BMI), abdominal circumference (AC) and blood pressure. Their personal history, inherited relatives, life habits and occurrence of cardiovascular events were also recorded. In their blood samples, blood glucose, HbA1c and lipid profile were measured as well as insulin and HOMA-IR index in most of them. Statistical evaluation included ANOVA and Tukey's test; significant differences were considered when their p value was ≤0.05. Results 67.32% of the participants presented glycemias ≤100 mg/dl (control group) and 32.67% values compatible with IFG status. Mean age, BMI and WC, HbA1c, insulin and HOMA-IR values, as well as the percentage of people with hypertension, were significantly higher in the latter group. The values of the lipid profile recorded were higher in the GAA group except the HDL-c in which they were lower. Conclusion Since the dyslipidemia present in people with IFG would simultaneously be a marker of atherosclerosis obliterans and a promoter of the transition to DT2, it requires its early diagnosis and treatment.