Objetivos: El objetivo del presente estudio es comparar la respuesta glucémica e insulinémica de pacientes diabéticos tipo 2 tras la administración oral de 250 ml de dos formulas enterales: una ...formula especifica (Novasource® Diabet Smartflex®) frente a una fórmula isocalórica estándar. Material y métodos: El diseño fue cruzado, recibiendo los pacientes diabéticos (n = 15) de manera aleatoria las dos fórmulas. Se realizó una curva de glucemia e insulinemia en los tiempos 0, 10,20, 30,60, 90, 120,150 y 180 minutos. Las variables analizadas fueron, el área bajo la curva (AUC0-t), la concentración máxima (Cmax), el tiempo en que se alcanza la concentración máxima (Tmax) y las concentraciones de los parámetros bioquímicos en cada período del estudio. Resultados: Se estudiaron 11 varones (73.3%) y 4 mujeres (26.7%), la edad media fue de 56,9 ± 10,9 años. Los pacientes que recibieron Novasource® Diabet presentan una media menor de AUC0-t, diferencia entre medias de glucemia -4.753,26 mg/min/dl (IC 95%: -7.256,7 a -2.249,82), también presentaron una media de insulinemia significativamente menor de AUC0-t, diferencia de medias: -930,27 uU/min/ml (IC 95%: -1.696,34 a -164,2). La Cmax mostró unas medias de glucemia significativamente menores con la fórmula específica, diferencia de medias -26,89 mg/dl (IC 95% 42,11 a -11,67) e insulinemia, diferencia de medias: -5,39 uU/ml (IC 95%: -10,37 a -1,43). El análisis de Tmax muestra que las medias de glucemia con la fórmula específica son significativamente menores, diferencia de medias -19,82 min (IC 95%: -32,11 a -7,33), sin diferencia significativa en la Tmax de insulinemia. Finalmente el análisis de las concentraciones de glucosa en el total del estudio muestra que el grupo con la formula específica tiene una media menor de glucosa 25,77 mg/dl (IC 95%: 18,29 a 33,25), sucediendo lo mismo con la insulinemia 4,39 U/ml (IC 95%: 0,927 a 7,87). Conclusiones: Los pacientes diabéticos tipo 2 que recibieron Novasource® Diabet presentan significativamente menores medias de AUC0-t, Cmax y Tmx en las curvas de glucemia, también presentaron menores medias de AUC0-t y Cmax en las curvas de insulinemia.
Background
Some studies have demonstrated a positive association of the rs7799039 genetic variant of the LEP gene with energy intake and metabolic parameters. The present study aimed to analyse the ...effects of the rs7799039 genetic variant of the LEP gene on metabolic parameters after weight loss secondary to a partial meal‐replacement (pMR) hypocaloric diet.
Methods
We conducted a non‐randomised, single‐treatment study in 122 obese subjects with body mass index (BMI) > 35 kg m–2. The subjects were treated with two intakes of a normocaloric hyperproteic formula during 12 weeks. Anthropometric parameters and biochemical profile were measured at basal time and after 12 weeks. The variant genetic variant (rs7799039) of the LEP gene was assessed by a real‐time polymerase chain reaction.
Results
We recruited 122 subjects 26 GG (21.3%), 59 GA (29.5%) and 37 AA (30.3%). The mean (SD) age of the all group was 59.4 (6.3) years (range 45–63 years) and the mean (SD) BMI was 39.3 (2.8) kg m–2 (range 36.2–45.1 kg m–2). After the pMR hypocaloric diet, body weight, BMI, fat mass, waist circumference, fasting insulin, homeostasis model assessment for insulin resistance and blood pressure decreased in both genotypes. All of these improvements were similar in both genotypes. Moreover, after dietary intervention, only subjects without an A allele showed a significant improvement in triglycerides (GG versus GA + AA) mean (SD) −15.3 (6.4) mg dL−1 versus −3.7 (4.3) mg dL−1: P = 0.02, total cholesterol −25.0 (5.3) mg dL−1 versus −8.1 (3.5) mg dL−1: P = 0.02 and low‐density lipoprotein‐cholesterol −20.7 (4.2) mg dL−1 versus −5.4 (2.3) mg dL−1: P = 0.01.
Conclusions
Subjects with an A allele of the rs7799039 variant in the LEPR gene showed a significant improvement in low‐density lipoprotein‐cholesterol and triglycerides levels after weight loss secondary to a pMR hypocaloric diet.
Subjects with A allele of rs7799039 variant in leptin gene showed a significant improvement in lipid profile with better LDLcholesterol and triglycerides levels after weight loss secondary to a pMR hypocaloric diet.
Some obese subjects with genetic variants of FUT2 gene could be implied in metabolic disorders. The aim of the present investigation was to evaluate the association between SNP rs602662 in FUT2 gene ...with different obesity markers.
166 Caucasian obese subjects were enrolled. Anthropometric parameters, blood pressure, fasting blood glucose, insulin concentration, insulin resistance (HOMA-IR), lipid profile, C reactive protein and prevalence of metabolic syndrome were recorded. The genotype of FUT2 gene polymorphism (rs602662) was evaluated.
The genotype distribution of the rs602662 variant was the following: 29.5% (n=49) (GG), 47.6% (n=79) (GA) and 22.9% (n=38) (AA). We observed statistical differences between both genotypes (GG+GA vs. AA) in BMI (Delta: 0.4±0.01 kg/m2: p=0.04), fat mass (Delta: 3.7±0.3 kg: p=0.02), body weight (Delta: 5.9±0.4 kg: p=0.02), waist circumference (Delta: 7.3+0.9 cm: p=0.03), glucose (Delta: 5.5±0.4 mg/dl: p=0.04), triglycerides (Delta: 25.9±1.4 mg/dl: p=0.01), HDL-cholesterol (Delta: -5.7±1.2 mg/dl: p=0.02), insulin (Delta: 5.0±0.9 mUI/L: p=0.02) and HOMA-IR (Delta: 1.4±0.1 units: p=0.03) levels. Percentages of metabolic syndrome, central obesity, hypertriglyceridemia, low HDL cholesterol and hyperglycemia were lower in AA obese subjects than GG+GA. Logistic regression analysis showed a decreased risk of metabolic syndrome in AA subjects (OR=0.28, 95% CI=0.11-0.71, p=0.01).
AA genotype of FUT2 rs602662 is associated with lower BMI and a better metabolic profile than subjects with GG+GA genotypes.
Single nucleotide variants (SNVs) of ADIPOQ gene on different comorbidities are related to obesity and weight loss. Despite, there are no studies evaluating the effect of rs3774261 on metabolic ...variables after bariatric surgery. We evaluated the effect of SNV rs3774261 of ADIPOQ gene on biochemical changes after biliopancreatic diversion surgery in morbidly obese subjects for 3 years follow-up.
One hundred and forty-nine patients (111 females/38 males) with morbid obesity (body mass index >40 kg/m2) without diabetes mellitus type 2 were enrolled. Biochemical and anthropometric evaluation were registered before and after 1, 2, and 3 years. Genotype of rs3774261 has been studied.
Total cholesterol, LDL-cholesterol and triglyceride levels decreased in all genotype groups during the study. Although the improvement in glucose, insulin and HOMA-IR was significant in two genotypes (AA and AG); these changes were earlier in the AA genotype than in Ag and GG genotypes. Adiponectin levels increased in a significant way in subjects with AA genotype in the 3 follow-up periods (first year delta: 16.4±0.5 ng/ml; p=0.03, second year delta: 21.3±0.5 ng/ mL; p=0.02 and third year delta: 23.6±0.7 ng/mL; p=0.01) and at 3 years in subjects with AG genotype (delta: 18.3±0.4 ng/ mL; p=0.03). The ratio adiponectin/leptin increased in a significant way in subjects with AA genotype in the 3 follow-up times (first year delta: 0.40±0.1 units; p=0.02, second year delta: 0.58±0.1 units; p=0.01 and third year delta: 0.65±0.1 ng/mL; p=0.01) and at 3 years in subjects with AG genotype (delta: 0.61±0.1 ng/ mL; p=0.02). Subjects with GG genotype did not show a significant improvement in these parameters during the follow-up.
G allele carriers of rs3774261 showed a delay in the improvement of glucose metabolism parameters, adiponectin and adiponectin/leptin ratio.
The present pilot trial was carried out to evaluate the effects of an acute treatment with a mixture containing 500 million of Lactobacillus bulgaricus and Streptococcus thermophilus per day in ...patients with non alcoholic fatty liver disease (NAFLD).
A sample of 30 patients with NAFLD (diagnosed by liver biopsy) was enrolled and 28 patients were analyzed in a double blind randomized clinical trial. Patients were randomized to one of the following treatments during 3 months: group I, treated with one tablet per day with 500 million of Lactobacillus bulgaricus and Streptococcus thermophilus and group II, treated with one placebo tablet (120 mg of starch).
In group I, alanine amino transferase (ALT: 67.7 +/- 25.1 vs. 60.4 +/- 30.4 UI/L; p < 0.05), aspartate aminotransferase activity (AST: 41.3 +/- 15.5 vs. 35.6 +/- 10.4 UI/L; p < 0.05) and gammaglutamine transferase levels (gammaGT: 118.2 +/- 63.1 vs. 107.7 +/- 60.8 UI/L; p < 0.05) decreased. In group II, all liver function parameters remained unchanged (ALT: 60.7 +/- 32.1 vs. 64.8 +/- 35.5 UI/L; p < 0.05), aspartate aminotransferase activity (AST: 31.7 +/- 13.1 vs. 36.4 +/- 13.8 UI/L; ns) and gammaglutamine transferase levels (gammaGT: 82.1 +/- 55.1 vs. 83.6 +/- 65.3 UI/L; ns). Anthropometric parameters and cardiovascular risk factors remained unchanged after treatment in both groups.
A tablet of 500 million of Lactobacillus bulgaricus and Streptococcus thermophilus, with a randomized clinical design, improved liver aminotransferases levels in patients with NAFLD.
One common genetic variant rs822393 (-4522C/T) is located in the proximal promoter region of the ADIPOQ gene. The SNP rs822393 regulates adiponectin promoter activity and is associated with ...hypoadiponectinemia. The aim of our study was to analyze the effects after a hypocaloric diet with Mediterranean diet pattern on serum lipid and adipokine levels taking to account rs822393 of ADIPOQ.
A population of 270 obese patients was enrolled. Anthropometric parameter and serum parameters (lipid profile, insulin, homeostasis model assessment (HOMA-IR), glucose, C reactive protein, adiponectin, resistin and leptin levels) were measured, at basal time and after 3 months. All patients were genotyped in the rs822393 polymorphism.
The genotype distribution was: 160 patients (59.3%) CC, 96 patients CT (35.6%) and 14 patients CT (5.1%). After dietary intervention, BMI, weight, fat mass, waist circumference, systolic blood pressure, insulin levels, HOMA-IR, total cholesterol and LDL- cholesterol improved significantly in both genotypes. After dietary intervention (CC vs. CT+TT), HDL-cholesterol (delta: 5.4±1.4 mg/dl vs. -1.8±0.7 mg/dl; p=0.03), serum adiponectin (delta: 21.2±4.1 ng/dl vs. 3.8±3.3 ng/dl; p=0.02) and adiponectin/leptin ratio (delta: 0.53±0.1 vs. 0.16±0.3 ng/dl; p=0.02) improved only in non-T allele carriers. Basal and post-intervention HDL cholesterol, adiponectin levels and adiponectin/leptin ratio were lower in T-allele carriers than non-T Allele carriers.
T allele carriers show lower levels of HDL-cholesterol, adiponectin and adiponectin/leptin ratio than non-T allele carriers. During a hypocaloric diet with Mediterranean partner increases HDL Cholesterol, adiponectin levels and ratio adiponectin/leptin in non-T allele carriers.
Genetic mechanisms have been involved in the pathogenesis of obesity and weight loss due to bariatric surgery. The aim of our work was to evaluate the effects of rs2419621 genetic variant of ACSL5 ...gene on weight and metabolic changes after a robotic sleeve gastrectomy.
48 patients were enrolled. Comorbidities, biochemical and anthropometric parameters evaluation were registered before and after 3, 6 and 12 months follow up. Genotype of rs2419621 ACSL5 gene was evaluated.
We classified the subjects with a dominant model, in two groups: those carriers T allele (TT+CT, 37.5%) and non-carriers T allele (CC, 62.5%). We reported a statistically significant reduction of body weight, waist circumference, percentage of excess of weight loss (EWL%), blood pressure, glucose, insulin, LDL-cholesterol and triglycerides after surgery. After 12 months, delta of (EWL%; 70.1% vs. 64,2%; p=0.04), weight (40.7+4.1 kg vs. 32.5+4.8 kg; p=0.03), waist circumference (29.1+3.1 cm vs. 22.2+2.8 kg; p=0.02) and triglycerides (51.2+9.1 mg/dl vs. 32.1+8.1; p=0.02) were higher in T allele carriers than non-T allele carriers. All comorbidities improved, but the percentage of patients with hypertriglyceridemia diminished early in the 3-month follow-up in the T-allele carriers, and at 12 months, no patient with the T allele had hypertriglyceridemia.
Our data showed that the genetic variant (rs2419621) of ACSL5 gene are associated with better improvement of adiposity and triglyceride levels in subjects with T allele, after a robotic sleeve gastrectomy.
One genetic variant (rs1121980) of FTO gene has been related with body mass index and visceral adiposity. The objective of our study was to investigate the role of rs1121980 genetic variant of FTO ...gene on weight loss and metabolic changes secondary to a partial meal replacement (pMR) hypocaloric diet.
We conducted an interventional study on 219 obese Caucasian subjects with body mass index (BMI) > 30 kg/m2. The subjects received two intakes per day of a normocaloric hyperproteic formula for 12 weeks. Adiposity and biochemical parameters (lipid profile, insulin, homeostasis model assessment (HOMA-IR) and glucose) were determined.
After the pMR diet, body weight, BMI, fat mass, waist circumference, blood pressure, total-cholesterol, LDL-cholesterol, triglyceride, fasting insulin levels and HOMA-IR decreased in both genotype groups. The improvements in adiposity parameters and some biochemical parameters (insulin, HOMA-IR, triglyceride levels) were bigger in non-T allele carriers than in T allele carriers. The percentage of patients who achieved 7.5% weight loss was higher in the non-T carriers (76.7% vs. 48.4%), also with a different average of weight loss (-12.3±0.3 kg vs. -5.9±0.5 kg: p=0.01). The odds ratio to achieve 7.5% of weight loss was (OR= 2.22, 95% CI=1.24-4.01; p=0.02).
Non-T allele carriers of rs1121980 show a higher magnitude of weight loss and improvement in adiposity parameters, insulin, HOMA-IR and triglyceride levels resulting from a pMR diet than T allele carriers.
The role of CB2R gene variants on weight loss after a dietary intervention has been investigated in few studies.
We evaluate the effect of this genetic variant (rs3123554) of CB2R gene on ...cardiovascular risk factors and weight loss secondary to high monounsaturated fat vs a high polyunsaturated fat hypocaloric diets.
A Caucasian population of 362 obese patients was enrolled. Patients were randomly allocated during 3 months to one of two diets (Diet P high polyunsaturated (PUFAs) fat hypocaloric diet vs, Diet M high monounsaturated (MUFAs) fat hypocaloric diet).
In both genotype groups (GG vs GA+AA), body weight, body mass index (BMI), fat mass, waist circumference and systolic blood pressure decreased after diet P and M. Body weight, BMI, fat mass and waist circumference were higher in A allele carriers than non A allele carriers. The improvement of these parameters was higher in non A allele carriers than A allele carriers. In non A allele carriers with both diets, the decrease of total cholesterol, LDL-cholesterol, insulin and HOMA-IR was higher than A allele carriers after both diets. After diet P, triglyceride levels decrease in non A allele carriers.
Our data suggest that carriers of the minor allele of rs3123554 variant of CB2R gene lose less body weight during to different hypocaloric diets with different fatty acid. Moreover, non A-allele carriers showed a better response of LDL-cholesterol, HOMA-IR and insulin levels than A-carriers with both hypocaloric diets.
Non-alcoholic fatty liver disease (NAFLD) is an increasingly recognized health problem. Various treatment strategies such as thiazolidinediones, metformin, lipid-lowering agents and antioxidants have ...been evaluated. So far, no single intervention has convincingly improved liver histology. Experience of using silymarin alone or in combination with other agents in patients with NAFLD is limited in the medical literature. The present study was conducted to evaluate the efficacy of silymarin plus vitamin E in the treatment of NAFLD.
A sample of 36 patients was enrolled. The diagnosis of NAFLD was confirmed by percutaneous liver biopsy. All patients were randomized to one of the following intervention groups: group I: treated with 2 tablets per day of silymarin plus vitamin E (Eurosil 85®, MEDAS SL) and a lifestyle modification program consisting of hypocaloric diet (1520 kcal, 52% of carbohydrates, 25% of lipids and 23% of proteins) and exercise for 3 months and group II (only with the hypocaloric diet). Anthropometric variables as waist circumference, weight, body mass index (BMI) were measured. Biochemical parameters: Glucose, triglycerides, AST, ALT, GGt levels and insulin resistance (HOMA-IR) were determined under fasting conditions. Non-invasive NAFLD-index were applied before and after the treatments: Fatty liver index (FLI), liver accumulation product (LAP) and NAFLD-Fibrosis score (FS).
The mean age was 47.4 ± 11.2 years old (range 18-67); 22 men and 14 women. In group I, 11 patients (61%) have a NAS-score > 5 and 10 (55.5%) in the group II (NS). Anthropometric parameters decreased after treatment in both groups. Patients in both groups showed a decrease in GGt levels after treatment (group I: 68 IU/L vs. 46.2 ± 27 IU/L; p < 0.05 and group II 80.5 ± 46 IU/L vs. 50.3 ± 27 IU/L; p < 0.05). Only in group II we observed a significant decrease in AST and ALT levels. In both groups, we observed a decrease in: FLI index (group I: 86.2 ± 19 vs. 76.9 + 20; p < 0.05 and in group II: 85.2 ± 18 vs. 77.5 ± 23; p < 0.05), and NAFLD-FS index (group I: -1.6 ± 1.8 vs. -2.1 ± 1.5; p < 0.05 and in group II -1 ± 1.9 vs. -1.5 ± 2.1; p < 0.05). Patients in group I who did not get a 5% loss of weight also displayed decreased GGt levels, and in the FLI and NAFLD-FS indexes; whereas patients in group II without decrease of 5% by weight showed no improvement in any of the analyzed parameters.
Treatment with silymarin plus vitamin E and a hypocaloric diet ameliorate function hepatic test, and non-invasive NAFLD index. Silymarin can be an alternative valid therapeutic option particularly when other drugs are not indicated or have failed or as a complementary treatment associated with other therapeutic programs.
