scholarly journals Altered fasting and postprandial plasma ghrelin levels in patients with liver failure are normalized after liver transplantation

2010 ◽  
Vol 163 (4) ◽  
pp. 609-616 ◽  
Author(s):  
Maria Teresa Diz-Lois ◽  
Jesús Garcia-Buela ◽  
Francisco Suarez ◽  
Susana Sangiao-Alvarellos ◽  
Ovidio Vidal ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Liver Failure ◽  
Area Under The Curve ◽  
Tolerance Test ◽  
Hepatic Tissue ◽  
Control Group ◽  
Oral Glucose ◽  
Before And After ◽  
Design And Methods ◽  
Overweight Subjects

ContextAnorexia is a problem of paramount importance in patients with advanced liver failure. Ghrelin has important actions on feeding and weight homeostasis. Experimental data exist, which suggest that ghrelin could protect hepatic tissue. Both fasting and post-oral glucose tolerance test (OGTT) ghrelin concentrations are controversial in liver cirrhosis and are unknown after liver transplantation.ObjectiveOur aim was to study fasting ghrelin concentrations and their response to an OGTT in liver failure patients before and after liver transplantation.Design and methodsWe included 21 patients with severe liver failure studied before (pretransplantation, PreT) and 6 months after liver transplantation (posttransplantation, PostT), and 10 age- and body mass index-matched healthy or overweight subjects as the control group (Cont). After an overnight fast, 75 g of oral glucose were administered; glucose, insulin, and ghrelin were obtained at baseline and at times 30, 60, 90, and 120 min.ResultsFasting ghrelin (median and range, pg/ml) levels were lower in PreT: 539 (309–1262) than in Cont: 643 (523–2163),P=0.045. Fasting ghrelin levels increased after liver transplantation, 539 (309–1262) vs 910 (426–3305), for PreT and PostT respectively,P=0.001. The area under the curve (AUC) of ghrelin (pg/ml min) was lower in PreT: 63 900 (37 260–148 410) than in Cont: 76 560 (56 160–206 385),P=0.027. The AUC of ghrelin increased in PostT, 63 900 (37 260–148 410) vs 107 595 (59 535–357 465), for PreT and PostT respectively,P=0.001. Fasting levels and the AUC of ghrelin were similar in PosT and Cont.ConclusionsDecreased fasting and post-OGTT ghrelin levels in liver failure patients were normalized after liver transplantation.

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.

scholarly journals The Influence of First Trimester Maternal Glucose on Fetal Growth and Possible Implications in Pregnancy Evolution

2013 ◽  
Vol 20 (2) ◽  
pp. 141-148
Author(s):  
Monica Vereş ◽  
Szidonia Lacziko ◽  
Aurel Babeş
Keyword(s):  
Birth Weight ◽  
Area Under The Curve ◽  
First Trimester ◽  
Tolerance Test ◽  
Fetal Macrosomia ◽  
Control Group ◽  
Oral Glucose ◽  
Third Trimester ◽  
Maternal Characteristics ◽  
Fetal Birth Weight

AbstractBackground and Aims: Maternal hyperglycemia during the first trimester of pregnancy is frequently associated with the appearance of maternal and fetal complications. The aim of our study was to analyze the influence of the first trimester blood glucose on the glycemic values from the second and third trimester and on fetal birth weight. Material and method: We performed an observational study on a group of 46 pregnant women who finally delivered on due date. We determined glycemia values in the first and third trimester of pregnancy while an Oral Glucose Tolerance Test (OGTT) was performed during the second trimester (24 - 28 weeks of pregnancy). We divided the pregnancies in two groups: with normal glucose or hyperglycemia during the first trimester. Finally we analyzed the influence of first trimester hyperglycemia on different maternal characteristics and on fetal birth weight. Results: Third trimester glycemia was significantly increased in women with first trimester hyperglycemia in comparison with the control group (p= 0.04) but no effect of the last on OGTT values was recorded. The ROC curve for the influence of first trimester glycemia on fetal macrosomia had an Area Under the Curve (AUC) of 0.551. Conclusions: Firsttrimester glycemia has a low diagnostic accuracy in the appreciation of fetal macrosomia risk.

scholarly journals Simple and non-invasive screening method for diabetes based on myoinositol levels in urine samples collected at home

2020 ◽  
Vol 8 (1) ◽  
pp. e000984
Author(s):  
Misaki Takakado ◽  
Yasunori Takata ◽  
Fumio Yamagata ◽  
Michiko Yaguchi ◽  
Go Hiasa ◽  
...  
Keyword(s):  
Test Meal ◽  
Screening Method ◽  
Area Under The Curve ◽  
Tolerance Test ◽  
Urine Samples ◽  
Oral Glucose ◽  
Operating Characteristics ◽  
Non Invasive ◽  
Before And After ◽  
At Home

ObjectiveTo establish a simple screening method for diabetes based on myoinositol (MI) in urine samples collected at home.Research design and methodsInitially, we evaluated the stability of urinary MI (UMI) at room temperature (RT; 25°C) and 37°C in 10 outpatients with type 2 diabetes. We then enrolled 115 volunteers without a current or history of diabetes. In all subjects, glucose intolerance was diagnosed by 75 g oral glucose tolerance test (75gOGTT). To assess the association between UMI or urine glucose (UG) and plasma glucose (PG), urine samples were also collected at 0 and 2 hours during 75gOGTT. All the subjects collected urine samples at home before and 2 hours after consuming the commercially available test meal. UMI levels at wake-up time (UMIwake-up), before (UMIpremeal) and 2 hours after the test meal (UMI2h-postprandial) were measured using an enzymatic method. ΔUMI was defined as UMI2h-postprandial minus UMIpremeal.ResultsDiffering from UG, UMI was stable at RT and 37°C. UMI was increased linearly along with an increase in PG, and no threshold for UMI was observed. UMI was closely associated with blood glucose parameters obtained from a 75gOGTT and hemoglobin A1c (HbA1c) at hospital after adjustment for age, sex, body mass index and serum creatinine. UMIwake-up, UMIpremeal, UMI2h-postprandial and ΔUMI at home were higher in diabetic subjects than non-diabetic subjects even after the above adjustment. Receiver operating characteristics curve (ROC) analyses revealed that for the screening of diabetes, the area under the curve for ROC for UMI2h-postprandial and ΔUMI (0.83 and 0.82, respectively) were not inferior to that for HbA1c ≥48 mmol/mol, which is the American Diabetes Association (ADA) criteria for diabetes.ConclusionsMI measurement in urine samples collected at home before and after the meal would be a simple, non-invasive and valuable screening method for diabetes.

scholarly journals Characterisation of oral and i.v. glucose handling in truncally vagotomised subjects with pyloroplasty

2013 ◽  
Vol 169 (2) ◽  
pp. 187-201 ◽  
Author(s):  
Astrid Plamboeck ◽  
Simon Veedfald ◽  
Carolyn F Deacon ◽  
Bolette Hartmann ◽  
André Wettergren ◽  
...  
Keyword(s):  
Glucagon Secretion ◽  
Tolerance Test ◽  
Glucose Disposal ◽  
Control Group ◽  
Oral Glucose ◽  
Incretin Effect ◽  
Dipeptidyl Peptidase 4 ◽  
Vagal Innervation ◽  
Glucagon Like Peptide 1 ◽  
Design And Methods

ObjectiveGlucagon-like peptide 1 (GLP1) is rapidly inactivated by dipeptidyl peptidase 4 (DPP4), but may interact with vagal neurons at its site of secretion. We investigated the role of vagal innervation for handling of oral and i.v. glucose.Design and methodsTruncally vagotomised subjects (n=16) and matched controls (n=10) underwent 50 g-oral glucose tolerance test (OGTT)±vildagliptin, a DPP4 inhibitor (DPP4i) and isoglycaemic i.v. glucose infusion (IIGI), copying the OGTT without DPP4i.ResultsIsoglycaemia was obtained with 25±2 g glucose in vagotomised subjects and 18±2 g in controls (P<0.03); thus, gastrointestinal-mediated glucose disposal (GIGD) – a measure of glucose handling (100%×(glucoseOGTT−glucoseIIGI/glucoseOGTT)) – was reduced in the vagotomised compared with the control group. Peak intact GLP1 concentrations were higher in the vagotomised group. Gastric emptying was faster in vagotomised subjects after OGTT and was unaffected by DPP4i. The early glucose-dependent insulinotropic polypeptide response was higher in vagotomised subjects. Despite this, the incretin effect was equal in both groups. DPP4i enhanced insulin secretion in controls, but had no effect in the vagotomised subjects. Controls suppressed glucagon concentrations similarly, irrespective of the route of glucose administration, whereas vagotomised subjects showed suppression only during IIGI and exhibited hyperglucagonaemia following OGTT. DPP4i further suppressed glucagon secretion in controls and tended to normalise glucagon responses in vagotomised subjects.ConclusionsGIGD is diminished, but the incretin effect is unaffected in vagotomised subjects despite higher GLP1 levels. This, together with the small effect of DPP4i, is compatible with the notion that part of the physiological effects of GLP1 involves vagal transmission.

scholarly journals Postloading insulinemia is independently associated with arterial stiffness in young Japanese persons

2021 ◽  
Author(s):  
Norimitsu Murai ◽  
Naoko Saito ◽  
Sayuri Nii ◽  
Yuto Nishikawa ◽  
Asami Suzuki ◽  
...  
Keyword(s):  
Arterial Stiffness ◽  
Glucose Tolerance ◽  
Area Under The Curve ◽  
Tolerance Test ◽  
Normal Glucose Tolerance ◽  
Immunoreactive Insulin ◽  
Oral Glucose ◽  
Glucose Loading ◽  
Before And After ◽  
Normal Glucose

AbstractAssociations of arterial stiffness with glucose, insulin, and proinsulin dynamics during the oral glucose tolerance test (OGTT) remain under debate. The aim of this study was to investigate whether plasma glucose (PG), insulin, and proinsulin (Pro) contribute to arterial stiffness, measured by pulse wave velocity (PWV), in young Japanese persons. PG, immunoreactive insulin (IRI), and Pro levels were determined in 1193 young Japanese subjects (<40 years of age) with normal glucose tolerance or nondiabetic hyperglycemia before and at 30, 60, and 120 min during a 75-g OGTT. Participants were divided into two groups according to the median PWV. Background factors, PG, IRI, and Pro levels during the OGTT, and insulin sensitivity (SI) indices in each group were compared. Several multiple regression analysis models were used to evaluate factors contributing to PWV. All IRI and Pro levels before and after glucose loading and the area under the curve (AUC) values for IRI and Pro increased with higher PWV. 1/HOMA-IR and ISI-Matsuda as measures of SI decreased with higher PWV. The IRI AUC and Pro level before glucose loading (Pro0) were independently associated with PWV, in addition to male sex, heart rate, and mean blood pressure. The IRI AUC had a stronger relationship with PWV than Pro0. The IRI AUC had an independent relationship with PWV, whereas both SI indices did not. Postloading insulinemia, but not reduced SI, was independently associated with arterial stiffness in young Japanese persons.

scholarly journals Effect of alterations in blood volume with bed rest on glucose tolerance

2016 ◽  
Vol 121 (5) ◽  
pp. 1098-1105 ◽  
Author(s):  
S. Dandanell ◽  
L. Oberholzer ◽  
S. Keiser ◽  
A. B. Andersen ◽  
T. Haider ◽  
...  
Keyword(s):  
Glucose Tolerance ◽  
Plasma Volume ◽  
Area Under The Curve ◽  
Bed Rest ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Albumin Infusion ◽  
Before And After ◽  
Concomitant Reduction

Bed rest leads to rapid impairments in glucose tolerance. Plasma volume and thus dilution space for glucose are also reduced with bed rest, but the potential influence on glucose tolerance has not been investigated. Accordingly, the aim was to investigate whether bed rest-induced impairments in glucose tolerance are related to a concomitant reduction in plasma volume. This hypothesis was tested mechanistically by restoring plasma volume with albumin infusion after bed rest and parallel determination of glucose tolerance. Fifteen healthy volunteers (age 24 ± 3 yr, body mass index 23 ± 2 kg/m2, maximal oxygen uptake 44 ± 8 ml·min−1·kg−1; means ± SD) completed 4 days of strict bed rest. Glucose tolerance [oral glucose tolerance test (OGTT)] and plasma and blood volumes (carbon monoxide rebreathing) were assessed before and after 3 days of bed rest. On the fourth day of bed rest, plasma volume was restored by means of an albumin infusion prior to an OGTT. Plasma volume was reduced by 9.9 ± 3.0% on bed rest day 3 and area under the curve for OGTT was augmented by 55 ± 67%. However, no association ( R2= 0.09, P = 0.33) between these simultaneously occurring responses was found. While normalization of plasma volume by matched albumin administration (408 ± 104 ml) transiently decreased ( P < 0.05) resting plasma glucose concentration (5.0 ± 0.4 to 4.8 ± 0.3 mmol/l), this did not restore glucose tolerance. Bed rest-induced alterations in dilution space may influence resting glucose values but do not affect area under the curve for OGTT.

Antidiabetic Effects of Ethanolic Extract of Ficus glomerata (L.) Roots

2020 ◽  
Vol 16 (1) ◽  
pp. 33-41
Author(s):  
Mohini C. Upadhye ◽  
Uday Deokate ◽  
Rohini Pujari ◽  
Vishnu Thakare
Keyword(s):  
Body Weight ◽  
Glucose Tolerance ◽  
Density Lipoprotein ◽  
Ethanolic Extract ◽  
Tolerance Test ◽  
Diabetic Rats ◽  
Antidiabetic Activity ◽  
Control Group ◽  
Oral Glucose ◽  
Ficus Glomerata

Background: Ficus glomerata (F. glomerata) Linn. Family Moraceace is a large tree found all over India including outer Himalayan ranges, Punjab, Chota Nagpur, Bihar, Orissa, West Bengal, Rajasthan, Deccan and also as a common plant in South India. It is planted around the home and temples. It is cultivated throughout the year, distributed in evergreen forests and moist localities. Objective: The Ethanolic Extract of roots of F. Glomerata (EEFG) belonging to the family Moraceace, was investigated for its antidiabetic activity using alloxan induced diabetic rats. Methods: Thirty rats were divided into 5 groups having 6 rats in each group. The alloxan was administered to the rats of all groups except normal control group through intraperitoneal route at a concentration of 140mg/kg body weight. A dose of 100mg/kg and 200 mg/kg body weight of EEFG was administered to alloxan induced diabetic rats. The administration of the extract was lasted for 11 days. Effectiveness of the extract on glucose, cholesterol, triglycerides, and high density lipoprotein and protein concentrations was analyzed. Results: Significant (p<0.05) reduction in the levels of glucose, cholesterol, triglyceride of the diabetic rats was observed after treatment with ethanolic extract. After subjecting to oral glucose tolerance test EEFG also showed significant improvement in glucose tolerance. Conclusion: F. glomerata root ethanolic extract showed that it possesses antidiabetic effect and can be found useful for the management of diabetes mellitus.

Comparison of streptozotocin-induced diabetes at different moments of the life of female rats for translational studies

2021 ◽  
pp. 002367722110018
Author(s):  
Yuri K Sinzato ◽  
Eduardo Klöppel ◽  
Carolina A Miranda ◽  
Verônyca G Paula ◽  
Larissa F Alves ◽  
...  
Keyword(s):  
Adult Life ◽  
Tolerance Test ◽  
Full Term ◽  
Female Rats ◽  
Lower Percentage ◽  
Control Group ◽  
Oral Glucose ◽  
Postnatal Life ◽  
Sprague Dawley ◽  
Term Pregnancy

Animal models are widely used for studying diabetes in translational research. However, methods for induction of diabetes are conflicting with regards to their efficacy, reproducibility and cost. A comparison of outcomes between the diabetic models is still unknown, especially full-term pregnancy.To understand the comparison, we analyzed the streptozotocin (STZ)-induced diabetes at three life-different moments during the neonatal period in Sprague–Dawley female rats: at the first (D1), second (D2) and fifth (D5) day of postnatal life. At adulthood (90 days; D90), the animals were submitted to an oral glucose tolerance test (OGTT) for diabetic status confirmation. The diabetic and control rats were mated and sacrificed at full-term pregnancy for different analyses. Group D1 presented a higher mortality percentage after STZ administration than groups D2 and D5. All diabetic groups presented higher blood glucose levels as compared to those of the control group, while group D5 had higher levels of glycemia compared with other groups during OGTT. The diabetic groups showed impaired reproductive outcomes compared with the control group. Group D1 had lower percentages of mated rats and D5 showed a lower percentage of a full-term pregnancy. Besides that, these two groups also showed the highest percentages of inadequate fetal weight. In summary, although all groups fulfill the diagnosis criteria for diabetes in adult life, in our investigation diabetes induced on D5 presents lower costs and higher efficacy and reproducibility for studies involving diabetes-complicated pregnancy.

scholarly journals Tc-99m GSA scintigraphy within the first 3 days after admission as an early predictor of outcome in severe acute liver injury

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yuji Suzuki ◽  
Keisuke Kakisaka ◽  
Takuro Sato ◽  
Ryouichi Mikami ◽  
Hiroaki Abe ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Liver Injury ◽  
Liver Failure ◽  
Acute Liver Failure ◽  
Acute Liver Injury ◽  
Area Under The Curve ◽  
Region Of Interest ◽  
Free Survival ◽  
Risk Of Death ◽  
Poor Outcome

AbstractPatients with severe acute liver injury (SLI) usually recover spontaneously. However, some SLI patients progress to acute liver failure with varying degrees of hepatic encephalopathy. Acute liver failure is associated with high mortality and can be substantially reduced by liver transplantation. Therefore, distinguishing SLI patients who might progress to acute liver failure and are at a risk of death is important when evaluating patients needing liver transplantation. The present study aimed to determine whether technetium-99m-diethylenetriaminepentaacetic acid galactosyl human serum albumin (Tc-99m GSA) scintigraphy can predict the prognosis of patients with SLI. This prospective observational study included 69 SLI patients. The accuracy of Tc-99m GSA for predicting death or liver transplantation for 6 months was assessed. Between the two groups of patients stratified based on the cut-off values from the receiver operating characteristic curves, 6-month transplant-free survival was compared. Sixteen (23.2%) patients died or underwent liver transplantation from admission (poor outcome). The hepatic accumulation index was calculated by dividing the radioactivity of the liver region of interest by that of the liver-plus-heart region of interest at 15 min (i.e., LHL15). The LHL15 in the 16 patients (0.686) was significantly lower than that in survivors (0.836; P < 0.0001). The optimal LHL15 cut-off for distinguishing poor outcome and survival was 0.737 with a sensitivity of 81.3%, specificity of 88.7%, and area under the curve of 0.907 (95% CI, 0.832–0.981). When patients were divided into two groups based on the LHL15 cut-off value, the 6-month transplant-free survival was significantly lower in patients with an LHL15 level ≤ 0.737. Tc-99m GSA scintigraphy may help predict the prognosis of patients with SLI.

First trimester prediction of maternal glycemic status

2015 ◽  
Vol 43 (3) ◽  
Author(s):  
Rinat Gabbay-Benziv ◽  
Lauren E. Doyle ◽  
Miriam Blitzer ◽  
Ahmet A. Baschat
Keyword(s):  
Risk Score ◽  
Predictive Value ◽  
Challenge Test ◽  
Area Under The Curve ◽  
First Trimester ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Operating Characteristics ◽  
Maternal Characteristics ◽  
Predictive Algorithm

AbstractTo predict gestational diabetes mellitus (GDM) or normoglycemic status using first trimester maternal characteristics.We used data from a prospective cohort study. First trimester maternal characteristics were compared between women with and without GDM. Association of these variables with sugar values at glucose challenge test (GCT) and subsequent GDM was tested to identify key parameters. A predictive algorithm for GDM was developed and receiver operating characteristics (ROC) statistics was used to derive the optimal risk score. We defined normoglycemic state, when GCT and all four sugar values at oral glucose tolerance test, whenever obtained, were normal. Using same statistical approach, we developed an algorithm to predict the normoglycemic state.Maternal age, race, prior GDM, first trimester BMI, and systolic blood pressure (SBP) were all significantly associated with GDM. Age, BMI, and SBP were also associated with GCT values. The logistic regression analysis constructed equation and the calculated risk score yielded sensitivity, specificity, positive predictive value, and negative predictive value of 85%, 62%, 13.8%, and 98.3% for a cut-off value of 0.042, respectively (ROC-AUC – area under the curve 0.819, CI – confidence interval 0.769–0.868). The model constructed for normoglycemia prediction demonstrated lower performance (ROC-AUC 0.707, CI 0.668–0.746).GDM prediction can be achieved during the first trimester encounter by integration of maternal characteristics and basic measurements while normoglycemic status prediction is less effective.

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