scholarly journals Metabolic changes following transcatheter bariatric embolotherapy for weight loss in obesity: secondary outcomes from a prospective RCT

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
M Fried ◽  
V.Y Reddy ◽  
P Neuzil ◽  
R Rosen ◽  
P Sramkova ◽  
...  
Keyword(s):  
Weight Loss ◽  
Metabolic Changes ◽  
Exclusion Criterion ◽  
Control Group ◽  
Oral Glucose ◽  
Diabetic Patients ◽  
Funding Source ◽  
Post Intervention ◽  
Private Company ◽  
C Peptide

Abstract Background/Introduction Obesity and its comorbid conditions (i.e. type II diabetes mellitus, atrial fibrillation, coronary artery disease, hypertension, etc...) is a growing burden globally, however, the current treatments (i.e. bariatric surgery, intragasrtic balloons and/or pharmaceutical therapy) pose substantial risks or are contraindicated for various populations. Transcatheter bariatric embolotherapy of left gastric artery by reducing “hunger” hormones from the gastric fundus is a procedure for weight loss that has been growing in prominence over the last several years, however, to date no randomized-controlled trial has been conducted until our study. We studied TBE in a double-blind, sham procedure, first in human RCT of patients (pts) with obesity. Purpose The purpose of this study was to assess the safety and efficacy of TBE for weight loss in obese patients as well as to evaluate metabolic changes. Methods After IV propofol, eligible pts (age 21–60; BMI 35–50 kg/m2) were randomized 1:1 to Sham (skin nick & 1 hr wait) or TBE. All pts received Lifestyle Therapy (behavioral and diet education). Study staff following the pts were also blinded to treatment. Blood samples for gastrointestinal hormones were collected in EDTA tubes containing a protease inhibitor cocktail and frozen per local laboratory standards. All collected samples were assessed together in two batches at the end of the study. The hormones analyzed included ghrelin, GIP, GLP-1, Visfatin, resistin, PAI-1 (total), Leptin, and C-Peptide. An Oral Glucose Tolerance Test (OGTT) and a diabetes assay was performed at baseline and at 6- and 12-months post-intervention. Note, while diabetes was an exclusion criterion for this study, pre-diabetes was not. Results 44 pts were enrolled, of which 40 pts were randomized equally to the groups, with no major complications in either group. TBE demonstrated superior weight loss over the control group at 6- and 12-months post-intervention in both intention-to-treat and per-protocol analyses. At 6 and 12 months, the TBE group demonstrated a clinically meaningful decrease in glucose 1-hour post-fasting by OGTT. GIP levels in the TBE group increased at a mean of 21%, indicative of an improvement in pre-diabetic milieu. Circulating plasma visfatin levels decreased 20% at 6 months and 26% at 12 months in the TBE group indicating a decrease in body fat. C-Peptide levels were noticeably increased in the TBE group at 6 months possibly indicating improvements in insulin sensitivity and beta-cell function. Conclusion(s) TBE is safe and results in clinically significant weight loss and demonstrated a positive effect on glucose homeostasis in pre-diabetic patients. Funding Acknowledgement Type of funding source: Private company. Main funding source(s): Endobar Solutions, LLC

Carbonated beverage consumption is associated with lower C-peptide in adolescents

2019 ◽  
Vol 32 (5) ◽  
pp. 447-454
Author(s):  
Shengkai Ye ◽  
Haiying Chen ◽  
Xia Ren ◽  
Jie Wen ◽  
Ying Du ◽  
...  
Keyword(s):  
Physical Activity ◽  
Multivariate Logistic Regression Analysis ◽  
Blood Lipid ◽  
Control Measures ◽  
Control Group ◽  
Oral Glucose ◽  
C Peptide ◽  
Beverage Consumption ◽  
Carbonated Beverages ◽  
Significant Difference

Abstract Background Too much consumption of carbonated beverages increases the risk of diabetes. Insulin deficiency and the body’s decreased sensitivity to insulin cause diabetes. C-peptide can assess a person’s own insulin secretion. The decrease of C-peptide is closely related to the occurrence of diabetes and its chronic complications. The present study assessed the effect of carbonated beverages on C-peptide in adolescents and analyzed the correlation between C-peptide and the drinking index (DI). Methods The subjects investigated including 463 adolescents were divided into a carbonated beverages group, a non-carbonated beverages group and a control group. The general demographic characteristics, beverage consumption status, physical activity and family history of hypertension and diabetes were interviewed with a questionnaire designed by us. All the subjects maintained their original lifestyle and received the oral glucose tolerance test. Various biochemical indicators and C-peptides were detected in these three groups. The data were analyzed by statistical analysis, and multivariate logistic regression analysis was used to examine the risk factors related to C-peptide. Results Blood glucose, blood lipid, liver function and renal function had no statistically significant difference among the three groups. C-peptide levels were lower in the carbonated beverages group and the non-carbonated beverages group than in the control group. Compared to the non-carbonated beverages group, there was a significant decrease in C-peptide levels in the carbonated beverages group. Logistic analysis demonstrated that DI was negatively correlated with C-peptide levels when the physical activity was adjusted. The odds ratio (OR) (OR = 2.540, 95% confidence interval [CI] 1.121–5.752) value difference was statistically significant at a stratification level of DI ≥ 6. Conclusions The C-peptide of adolescents was affected by the long-term consumption of beverages, and the effect of carbonated beverages was even more obvious. DI ≥ 6 bottle-years was a risk factor for diabetes, and we can constitute prevention and control measures accordingly so as to reduce the incidence of diabetes.

scholarly journals Effect of rosiglitazone on plasma adiponectin levels and arterial stiffness in subjects with prediabetes or non-diabetic metabolic syndrome

2006 ◽  
Vol 154 (3) ◽  
pp. 433-440 ◽  
Author(s):  
Sin Gon Kim ◽  
Ohk Hyun Ryu ◽  
Hee Young Kim ◽  
Kye Won Lee ◽  
Ji A Seo ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Arterial Stiffness ◽  
Linear Regression Analysis ◽  
High Sensitivity ◽  
Multiple Linear Regression Analysis ◽  
Control Group ◽  
Oral Glucose ◽  
Diabetic Patients ◽  
Plasma Adiponectin ◽  
Rosiglitazone Treatment

Objective: Thiazolidinediones have favorable influences on surrogate markers of atherosclerosis such as adiponectin, and arterial stiffness in diabetic patients. However, it is not well known whether these beneficial effects occur in subjects without diabetes, such as prediabetes or the non-diabetic metabolic syndrome (MetS). The present study was therefore designed to evaluate the effectiveness of the insulin-sensitizing agent rosiglitazone on circulating adipocytokine levels and brachial-ankle pulse wave velocity (baPWV) in non-diabetics. Design and methods: Ninety-nine subjects with prediabetes or non-diabetic MetS were randomly assigned to either rosiglitazone or an untreated control group (50 and 49 subjects respectively). The rosiglitazone group was treated daily for 12 weeks with 4 mg rosiglitazone. All subjects received a 75 g oral glucose test (OGTT) before and after treatment. In addition, baPWV, together with the levels of adiponectin, resistin, and high sensitivity C-reactive protein (hsCRP) were determined. Results: Rosiglitazone treatment significantly increased circulating adiponectin levels (P < 0.001) relative to the control group (P = 0.21). Plasma resistin levels were unchanged in both the rosiglitazone-treated and -untreated groups, but baPWV and hsCRP were significantly decreased (P < 0.001 and P = 0.003 respectively) in the rosiglitazone group only. Multiple linear regression analysis showed that changes in plasma adiponectin and baPWV were significantly affected by rosiglitazone treatment. Conclusions: These data suggest that rosiglitazone may have an anti-atherogenic effect in subjects with prediabetes or non-diabetic MetS.

scholarly journals Murine transfer of a human gene variant associated with exceptional longevity displays senolytic effects both in immune compartment and endothelium of aged mice

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
E Ciaglia ◽  
F Montella ◽  
M Malavolta ◽  
A Carrizzo ◽  
V Lopardo ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Human Gene ◽  
Control Group ◽  
Lymphoid Tissues ◽  
Funding Source ◽  
M2 Macrophages ◽  
Private Company ◽  
Hematopoietic Stem ◽  
Exceptional Longevity ◽  
Age Related

Abstract   The persistence and accumulation of senescent cells has been shown to potentially play a role in the pathophysiology of age-related cardiovascular diseases. Indeed with time, a decline in immune efficacy, termed immunesenescence, and a deleterious secretory phenotype of senescent cells (SASP) generate that inflammatory background mainly mediating the elderly cardiovascular phenotype. Long Living Individuals (LLI) which delay aging, represent a model of positive biology and an exceptional resource to study and find a way to improve general public health. Previous studies from our group have shown that a human gene associated with exceptional longevity (LAV-BPIFB4) was able to block the atherosclerotic process in ApoE−/− mice by conferring the animals with a pro-resolving M2 macrophages profile. Furthermore, LAV-BPIFB4 promotes the recruitment of hematopoietic stem cells, reparative vascularization and frailty reduction. Here we sought to underpinn the role of LAV-BPIFB4 in counteracting the age-related remodeling of the immune responses. The effects of systemic adeno-associated viral vector-mediated LAV-BPIFB4 gene transfer on the immune dynamics in old mice have been investigated by an extensive flow cytometric approach in lymphoid tissues (bone marrow, spleen and peripheral blood). C57BL/6J mice were assigned to two age-matched experimental groups: a treatment group (AAV-LAV-BPIFB4; N=6 mice, aged 18–23 months and a control group (AAV-GFP; N=6 mice, aged 18–23 months. 30th and 60th day since the beginning of the infection, SA-beta Gal substrate has been used to identify CD45+ senescent cells in freshly isolated PBMC, splenocytes, bone marrow (BM)-derived cells. As expected, we monitored an increase in SA-betaGal activity in blood. This increase is most significant in CD11b+ myeloid cells, whithout affecting neither CD3+T neither NK1.1+Natural Killer (NK) cell compartment. Notably 30 days AAV-LAV-BPIFB4 infection and to a more the 60 days-treatment, resulted in a significant decrease in senescent pool of peripheral immune cells and a concomitant enrichment of senescent cells in spleen. Concomitantly, aorta from AAV-LAV treated mice showed significant reduction in SA-beta Gal positive area. Furthermore a LAV-BPIFB4 induction of pro-resolving M2 macrophages compared to control group was documented in the main haemocateretic organ. As consequence the senolytic effect of LAV-BPIFB4 gene-therapy well correlated with the rescue of proliferative index of splenocytes upon PHA stimulation, and their functional protective response to lipopolysaccharide (LPS) in term of IL-6 and TNF-alpha secretion. The restoration of a protective and balanced immune response finally reflected the reduction of senescent phenopype acquired by mouse aortic endothelial cells during the aging process in vivo. A better underpinning of the senolytic action of LAV-BPIFB4 may offer a valuable therapeutic tool to reverse aging phenotype causing most of cardiac diseases Funding Acknowledgement Type of funding source: Private company. Main funding source(s): Cariplo Foundation (n.2016-0874) to AAP and CV

scholarly journals Outcomes of a Weight Loss Intervention to Prevent Diabetes Among Low-Income Residents of East Harlem, New York

2019 ◽  
Vol 46 (6) ◽  
pp. 1073-1082 ◽  
Author(s):  
Victoria L. Mayer ◽  
Nita Vangeepuram ◽  
Kezhen Fei ◽  
Emily A. Hanlen-Rosado ◽  
Guedy Arniella ◽  
...  
Keyword(s):  
New York ◽  
Weight Loss ◽  
Low Income ◽  
Diabetes Prevention ◽  
Controlled Trial ◽  
Intervention Group ◽  
Control Group ◽  
Oral Glucose ◽  
East Harlem ◽  
The Impact

There is a need for diabetes prevention efforts targeting vulnerable populations. Our community–academic partnership, the East Harlem Partnership for Diabetes Prevention, conducted a randomized controlled trial to study the impact of peer led diabetes prevention workshops on weight and diabetes risk among an economically and racially diverse population in East Harlem, New York. We recruited overweight/obese adults from more than 50 community sites and conducted oral glucose tolerance testing and completed other clinical assessments and a health and lifestyle survey. We randomized prediabetic participants to intervention or delayed intervention groups. Intervention participants attended eight 90-minute peer-led workshop sessions at community sites. Participants in both groups returned for follow-up assessments 6 months after randomization. The main outcomes were the proportion of participants who achieved 5% weight loss, percentage weight loss, and change in the probability of developing diabetes over the next 7.5 years according to the San Antonio Diabetes Prediction Model. We enrolled 402 participants who were mainly female (85%), Latino (73%) or Black (23%), foreign born (64%), and non-English speaking (58%). At 6 months, the intervention group lost a greater percentage of their baseline weight, had significantly lower rise in HbA1c (glycated hemoglobin), decreased risk of diabetes, larger decreases in fat and fiber intake, improved confidence in nutrition label reading, and decrease in sedentary behavior as compared with the control group. Thus, in partnership with community stakeholders, we created an effective low-resource program that was less intensive than previously studied programs by incorporating strategies to engage and affect our priority population.

Daily mycoprotein consumption for 1 week does not affect insulin sensitivity or glycaemic control but modulates the plasma lipidome in healthy adults: a randomised controlled trial

2020 ◽  
Vol 125 (2) ◽  
pp. 147-160
Author(s):  
Mariana O. C. Coelho ◽  
Alistair J. Monteyne ◽  
Marlou L. Dirks ◽  
Tim J. A. Finnigan ◽  
Francis B. Stephens ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Insulin Sensitivity ◽  
Glycaemic Control ◽  
Healthy Adults ◽  
Blood Glucose Monitoring ◽  
Whole Body ◽  
Control Group ◽  
Oral Glucose ◽  
Post Intervention ◽  
The Impact

AbstractMycoprotein consumption has been shown to improve acute postprandial glycaemic control and decrease circulating cholesterol concentrations. We investigated the impact of incorporating mycoprotein into the diet on insulin sensitivity (IS), glycaemic control and plasma lipoprotein composition. Twenty healthy adults participated in a randomised, parallel-group trial in which they consumed a 7 d fully controlled diet where lunch and dinner contained either meat/fish (control group, CON) or mycoprotein (MYC) as the primary source of dietary protein. Oral glucose tolerance tests were performed pre- and post-intervention, and 24 h continuous blood glucose monitoring was applied throughout. Fasting plasma samples were obtained pre- and post-intervention and were analysed using quantitative, targeted NMR-based metabonomics. There were no changes within or between groups in blood glucose or serum insulin responses, nor in IS or 24 h glycaemic profiles. No differences between groups were found for 171 of the 224 metabonomic targets. Forty-five lipid concentrations of different lipoprotein fractions (VLDL, LDL, intermediate-density lipoprotein and HDL) remained unchanged in CON but showed a coordinated decrease (7–27 %; all P < 0·05) in MYC. Total plasma cholesterol, free cholesterol, LDL-cholesterol, HDL2-cholesterol, DHA and n-3 fatty acids decreased to a larger degree in MYC (14–19 %) compared with CON (3–11 %; P < 0·05). Substituting meat/fish for mycoprotein twice daily for 1 week did not modulate whole-body IS or glycaemic control but resulted in changes to plasma lipid composition, the latter primarily consisting of a coordinated reduction in circulating cholesterol-containing lipoproteins.

scholarly journals Preferential reductions in intermuscular and visceral adipose tissue with exercise-induced weight loss compared with calorie restriction

2012 ◽  
Vol 112 (1) ◽  
pp. 79-85 ◽  
Author(s):  
Joan C. Murphy ◽  
Jennifer L. McDaniel ◽  
Katherine Mora ◽  
Dennis T. Villareal ◽  
Luigi Fontana ◽  
...  
Keyword(s):  
Weight Loss ◽  
Adipose Tissue ◽  
Calorie Restriction ◽  
Visceral Adipose Tissue ◽  
Control Group ◽  
Oral Glucose ◽  
Sensitivity Index ◽  
Fat Depots ◽  
Exercise Induced ◽  
Visceral Adipose

Intermuscular adipose tissue (IMAT) and visceral adipose tissue (VAT) are associated with insulin resistance. We sought to determine whether exercise-induced weight loss (EX) results in greater reductions in IMAT and VAT compared with similar weight loss induced by calorie restriction (CR) and whether these changes are associated with improvements in glucoregulation. Sedentary men and women (50–60 yr; body mass index of 23.5–29.9 kg/m2) were randomized to 1 yr of CR ( n = 17), EX ( n = 16), or a control group (CON; n = 6). Bilateral thigh IMAT and VAT volumes were quantified using multi-slice magnetic resonance imaging. Insulin sensitivity index (ISI) was determined from oral glucose tolerance test glucose and insulin levels. Weight loss was comparable ( P = 0.25) in the CR (−10.8 ± 1.4%) and EX groups (−8.3 ± 1.5%) and greater than in the control group (−2.0 ± 2.4%; P < 0.05). IMAT and VAT reductions were larger in the CR and EX groups than in the CON group ( P ≤ 0.05). After controlling for differences in total fat mass change between the CR and EX groups, IMAT and VAT reductions were nearly twofold greater ( P ≤ 0.05) in the EX group than in the CR group (IMAT: −45 ±5 vs. −25 ± 5 ml; VAT: −490 ± 64 vs. −267 ± 61 ml). In the EX group, the reductions in IMAT were correlated with increases in ISI ( r = −0.71; P = 0.003), whereas in the CR group, VAT reductions were correlated with increases in ISI ( r = −0.64; P = 0.006). In conclusion, calorie restriction and exercise-induced weight loss both decrease IMAT and VAT volumes. However, exercise appears to result in preferential reductions in these fat depots.

scholarly journals Effect of a Chronic Intake of the Natural Sweeteners Xylitol and Erythritol on Glucose Absorption in Humans with Obesity

Nutrients ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 3950
Author(s):  
Valentine Bordier ◽  
Fabienne Teysseire ◽  
Götz Schlotterbeck ◽  
Frank Senner ◽  
Christoph Beglinger ◽  
...  
Keyword(s):  
Glucose Tolerance Test ◽  
Area Under The Curve ◽  
Tolerance Test ◽  
Glucose Absorption ◽  
Control Group ◽  
Oral Glucose ◽  
Post Intervention ◽  
Before And After ◽  
Acute Ingestion ◽  
Intestinal Glucose Absorption

In patients with obesity, accelerated nutrients absorption is observed. Xylitol and erythritol are of interest as alternative sweeteners, and it has been shown in rodent models that their acute ingestion reduces intestinal glucose absorption. This study aims to investigate whether a chronic intake of xylitol and erythritol impacts glucose absorption in humans with obesity. Forty-six participants were randomized to take either 8 g of xylitol or 12 g of erythritol three times a day for five to seven weeks, or to be part of the control group (no substance). Before and after the intervention, intestinal glucose absorption was assessed during an oral glucose tolerance test with 3-Ortho-methyl-glucose (3-OMG). The effect of xylitol or erythritol intake on the area under the curve for 3-OMG concentration was not significant. Neither the time (pre or post intervention), nor the group (control, xylitol, or erythritol), nor the time-by-group interaction effects were significant (p = 0.829, p = 0.821, and p = 0.572, respectively). Therefore, our results show that a chronic intake of the natural sweeteners xylitol and erythritol does not affect intestinal glucose absorption in humans with obesity.

Effect of Chromium Supplementation on Blood Glucose and Lipid Levels in Type 2 Diabetes Mellitus Elderly Patients

2004 ◽  
Vol 74 (3) ◽  
pp. 178-182 ◽  
Author(s):  
Rabinovitz ◽  
Friedensohn ◽  
Leibovitz ◽  
Gabay ◽  
Rocas ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Rehabilitation Program ◽  
Chromium Picolinate ◽  
Dependent Diabetes Mellitus ◽  
Control Group ◽  
Diabetic Patients ◽  
Lipid Levels ◽  
Post Intervention

Intervention trials have shown the beneficial effects of chromium supplementation in type 2 diabetes (non-insulin-dependent diabetes mellitus). This study investigated the effects of chromium picolinate on elderly diabetic patients within a rehabilitation program. Thirty-nine diabetic subjects, average age 73 years (18 males and 21 females), undergoing rehabilitation following stroke or hip fracture, were recruited to participate in this study. An additional 39 diabetic patients constituted the control group. Along with standard treatment for diabetes, the study group received 200 mug of chromium twice a day for a three-week period. Blood samples, dietary intake, and anthropometric data were collected prior to and post-intervention. Throughout the study period, participants received a diet of approximately 1500 kcal/day. Significant differences in the fasting blood level of glucose compared to the baseline (190 mg/dL vs 150 mg/dL, p < 0.001) were found at the end of the study. HbA1c also improved from 8.2% to 7.6% (p < 0.01). Total cholesterol was also reduced from 235 mg/dL to 213 mg/dL (p < 0.02). A trend towards lowered triglyceride levels was also observed (152 mg/dL vs 136 mg/dL). We conclude that, in this population of elderly, diabetic patients undergoing rehabilitation, dietary supplementation with chromium is beneficial in moderating glucose intolerance. In addition, chromium intake appears to lower plasma lipid levels.

scholarly journals Symptomatic endpoint responder rates to BAROSTIM Therapy

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
W.T Abraham ◽  
J Lindenfeld ◽  
F Weaver ◽  
F Zannad ◽  
M Zile ◽  
...  
Keyword(s):  
Nyha Class ◽  
Left Ventricular ◽  
Cardiac Resynchronization ◽  
Control Group ◽  
Funding Source ◽  
Private Company ◽  
Baroreflex Activation Therapy ◽  
Reduced Ejection Fraction ◽  
Control Subjects ◽  
Activation Therapy

Abstract Background Patients with heart failure with reduced ejection fraction (HFrEF) have varying responses to symptomatic endpoints with device-based HF therapies. Purpose Evaluate the symptomatic response to baroreflex activation therapy (BAT) at six months. Methods In a trial of subjects with NYHA Class II (recently III) or III HFrEF, left ventricular EF≤35%, guideline directed medical HF therapy (GDMT), no indication for cardiac resynchronization therapy, and NT-proBNP&lt;1600 pg/ml, 264 subjects were randomized to BAROSTIM therapy plus GDMT (BAT group) or GDMT alone (Control group). Six-minute hall walk (6MHW), Minnesota Living with HF (QOL) and NYHA Class were analyzed. Clinically relevant responders were defined by 6-month improvement in 6MHW&gt;10%, QOL&gt;5 points or improvement in at least one NYHA class; super responders were defined by 6-month improvement in 6MHW&gt;20%, QOL&gt;10 points or improvement to NYHA class I. Results Both clinically relevant and super responders were significantly higher in BAT versus Control subjects for all symptomatic endpoints. In BAT subjects, 72% had clinically relevant improvements in ≥2 endpoints compared to 29% of Control subjects (p&lt;0.001), and 28% of BAT subjects had super responder improvements in ≥2 endpoints versus 10% of Control subjects (p&lt;0.001). Conclusion Among subjects with symptomatic HFrEF, treatment with BAT resulted in clinically relevant and super responder rates. The BAT clinically relevant and super responder rates are similar to those seen with CRT, in CRT-indicated patients. Funding Acknowledgement Type of funding source: Private company. Main funding source(s): CVRx, Inc.

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