Study on the Effects of Individualized Nutritional Intervention on Pregnancy Outcome and Neonatal Immune Function in Patients with Gestational Diabetes Mellitus

Objective. To study the effects of individualized nutritional intervention on pregnancy outcome and neonatal immune function in patients with gestational diabetes mellitus (GDM). Methods. A retrospective analysis was conducted on 100 GDM patients from the obstetrics and gynecology department of our institute between February 2019 and February 2020. The patients were allocated into the control group given regular intervention and the experimental group given individualized nutritional intervention according to different intervention measures, with 50 cases in each group. The comparison was carried out for patients in the two groups with regard to their modality of delivery, neonatal health, their plasma glucose in fasting state, 2 h after eating, and before bedtime; glycohemoglobin at 8 months of pregnancy, at 9 months of pregnancy, during labor, and 1 month after delivery; their complications; and neonatal CD3+, CD4+, and CD8+ levels. Results. The experimental group outperformed the control group in terms of the spontaneous delivery rate, the number of healthy neonates, and neonatal CD3+, CD4+, and CD8+ levels ( P < 0.05 ). The plasma glucose in fasting state, 2 h after eating, and before bedtime; the glycohemoglobin at 8 months of pregnancy, at 9 months of pregnancy, during labor, and 1 month after delivery; and the incidence of complications of the experimental group were significantly lower than those of the control group ( P < 0.05 ). Conclusion. Individualized nutritional intervention increases the rate of spontaneous delivery in GDM patients, enhances neonatal immune function, stabilizes plasma glucose, and reduces complications.

Non-Fasting Changes of Hs-CRP Level in Chinese Patients With Coronary Heart Disease After A Daily Meal

High-sensitivity C-reactive protein (hs-CRP) is a key inflammatory factor in atherosclerotic cardiovascular diseases. In Chinese patients with coronary heart disease (CHD), the changes in hs-CRP levels after a daily meal and the effect of statins on those were never explored. A total of 300 inpatients with CHD were included. Hs-CRP levels were measured in fasting and non-fasting state at 2 hour (h) and 4h after a daily breakfast. Group with fasting hs-CRP ≤ 3mg/L had significantly higher percentage of patients with statins using ≥ 1 month (m) than that with fasting hs-CRP > 3mg/L (51.4% vs. 23.9%, P < 0.05). Hs-CRP levels were significantly higher in non-fasting state (P < 0.05). Interestingly, the hs-CRP didn’t elevate significantly in inpatients with statins using ≥ 1m in hs-CRP > 3mg/L group, but it elevated significantly after meal in inpatients without and with statins using < 1m (P < 0.05). About 32% of patients with non-fasting hs-CRP > 3mg/L came from those with fasting hs-CRP ≤ 3mg/L. In conclusion, hs-CRP levels increased significantly in CHD patients after a daily meal. When fasting hs-CRP > 3mg/L but not ≤ 3mg/L, statins work partly in reducing hs-CRP elevation in non-fasting state.

The Nutrient Sensor mTORC1 Regulates Insulin Secretion by Modulating ß-cell Autophagy

The dynamic regulation of autophagy in b-cells by cycles of fasting-feeding and its effects on insulin secretion are unknown. In b-cells mTORC1 is inhibited while fasting, and is rapidly stimulated during refeeding by a single amino acid, leucine, and glucose. Stimulation of mTORC1 by nutrients inhibited the autophagy initiator ULK1 and the transcription factor TFEB, thereby preventing autophagy when b-cells are continuously exposed to nutrients. Inhibition of mTORC1 by <i>Raptor</i> knockout mimicked the effects of fasting and stimulated autophagy while inhibiting insulin secretion, whereas moderate inhibition of autophagy under these conditions rescued insulin secretion. These results show that mTORC1 regulates insulin secretion through modulation of autophagy under different nutritional situations. In the fasting state, autophagy is regulated in an mTORC1-dependent manner and its stimulation is required to keep insulin levels low, thereby preventing hypoglycemia. Reciprocally, stimulation of mTORC1 by elevated leucine and glucose, which is common in obesity, may promote hyperinsulinemia by inhibiting autophagy.

The Nutrient Sensor mTORC1 Regulates Insulin Secretion by Modulating ß-cell Autophagy

The dynamic regulation of autophagy in b-cells by cycles of fasting-feeding and its effects on insulin secretion are unknown. In b-cells mTORC1 is inhibited while fasting, and is rapidly stimulated during refeeding by a single amino acid, leucine, and glucose. Stimulation of mTORC1 by nutrients inhibited the autophagy initiator ULK1 and the transcription factor TFEB, thereby preventing autophagy when b-cells are continuously exposed to nutrients. Inhibition of mTORC1 by <i>Raptor</i> knockout mimicked the effects of fasting and stimulated autophagy while inhibiting insulin secretion, whereas moderate inhibition of autophagy under these conditions rescued insulin secretion. These results show that mTORC1 regulates insulin secretion through modulation of autophagy under different nutritional situations. In the fasting state, autophagy is regulated in an mTORC1-dependent manner and its stimulation is required to keep insulin levels low, thereby preventing hypoglycemia. Reciprocally, stimulation of mTORC1 by elevated leucine and glucose, which is common in obesity, may promote hyperinsulinemia by inhibiting autophagy.

Effects of calorie intake and sampling time on thyroid stimulating hormone concentration

BackgroundThis study aimed to investigate the effects of blood collected after calorie intake on the level of thyroid stimulating hormone (TSH), comparing with the blood collected in fasting state.MethodsThis study was a prospective, randomized, controlled study. Subjects from the outpatients in the department of endocrinology without evident of thyroid diseases were included and then randomized into the fasting group, diet intake group, and glucose intake group, respectively. Fasting blood was collected from all the subjects at 7:00 am for the measurement of TSH and free thyroxine (FT4). Afterward, the subjects were maintained at fasting state (fasting group), had an intake of the mixed diet with the calories of 400 Kcal (diet intake group), and had an intake of 75 g glucose (glucose intake group), respectively, and blood was acquired again 2 h later (9:00 am on the same day) for TSH and FT4 measurement. The levels between 7:00 am and 9:00 am were compared.ResultsOf the 150 subjects, 146 met the inclusion criteria, of which 48, 48, and 50 were in the diet intake group, glucose intake group, and fasting group, respectively. The TSH in the diet intake group was significantly lower at 9:00 am (TSH9am) than the level at 2h before (TSH7am) (P<0.001), of which the median variation was -0.71 mU/L, and the median variation rate was -32.4%. In the glucose intake group, the TSH9am was also significantly lower than TSH7am (P<0.001), of which the median variation was -0.73 mU/L, and median variation rate was -31.5%. While in the fasting group, the TSH9am decreased slightly but statistically significantly lower than TSH7am (P<0.001), of which the median variation was -0.1 mU/L, and the median variation rate was -5.2%. According to TSH7am, 9 subjects in total (3 subjects in each group) met the diagnostic criteria of subclinical hypothyroidism. However, according toTSH9am, only 2 patients in the fasting group still met the diagnostic criteria of subclinical hypothyroidism.ConclusionComparing with the fasting state, the TSH level at 2h after the calorie intake was decreased by about 30%, which could influence the diagnosis of subclinical hypothyroidism.Trial registrationChiCTR2100047454.

Comparison between fasting and non-fasting cut-off values of triglyceride in diagnosing high triglyceride in Chinese hypertensive outpatients

Background Hypertension (HBP) often occurs together with hypertriglyceridemia that indicates elevated triglyceride (TG) and remnant cholesterol (RC) levels. Non-fasting (i.e. postprandial) blood lipid test after a daily meal has been recommended by the European Atherosclerosis Society (EAS). However, little is known about the difference between fasting and non-fasting cut-off values in assessing high TG (HTG) and high RC (HRC) in HBP outpatients. Methods Two hundred and twenty-five Chinese outpatients with HBP were enrolled in this study. According to the time of blood lipid test, they were divided into two groups, i.e. the fasting group (n=119) and the non-fasting group (n=139). Non-fasting levels of blood lipids at 2 h after a daily breakfast were also tested in 33 patients among the fasting group. Venous blood samples were collected. Serum levels of blood lipids were measured by the enzymatic and direct methods on a HITACHI 7170A analyzer or estimated via related formulas. Results The non-fasting group had significantly higher levels of TG and RC while lower levels of total cholesterol, low-density lipoprotein cholesterol and non-high-density lipoprotein cholesterol than the fasting group (P༜0.05). According to TG and RC cut-off values of the EAS, the percentages of HTG and HRC in the non-fasting group were 67.6% and 65.6%, respectively, while those in the fasting group were 57.1% and 52.9%, respectively. However, the percentages of HTG in the fasting state and at 2 h after a daily breakfast in 33 outpatients did not reach statistical significance (57.6% v.s. 51.5%). So did the fasting and at 2 h non-fasting percentages of HRC in them. Conclusion Non-fasting blood lipid test could find more HBP outpatients with HTG in Chinese outpatients with HBP. However, the percentage of HTG at 2h after a daily breakfast seemed to be close to that in the fasting state.

Determining the Glycemic Index of Nutritional Product for Diabetes Mellitus- Np through Measuring Glycemic Responses to Reference Food (Glucose) and Test Food (Nutritional product -Np)

The objective was to determine the glycemic index (GI) of Nutritional product for Diabetes Mellitus through measuring glycemic responses to reference food (Glucose) and test among nutritional product 13 participants. The study was a self-controlled clinical trial with 13 qualified participants (8 men and 5 women). They were required to go through the study protocol with reference food and test food. For each individual, seven blood samples were taken in the fasting state and at 15, 30, 45, 60, 90 and 120 minutes after ingestion. Our results show that at all measurement points, the blood glucose levels after consumption of test food were lower than after consumption of reference food. The incremental area under the curve (iAUC) and a GI value of Nutritional product (NP) were calculated for each meal. Mean ± SD of GI value was calculated for test food for the combined group of subjects. Mean iAUC and GI value of Nutritional product were 62,1 ± 12,5 mmol·min/L and 44,9 ± 7,2, significantly lower to those of reference food, which were 132,6 ± 14,8 mmol·min/L and 100, respectively. Finding from the study demonstrated that Nutritional product (GI = 44,9) would be classified as a low – GI food.

Food-Related Brain Activation Measured by fMRI in Adults with Prader–Willi Syndrome

(1) Background: Prader–Willi syndrome (PWS) is characterized by hyperphagia, resulting in morbid obesity if not controlled. The primary aim of this study was to investigate whether PWS patients show altered activation of brain areas involved in hunger. As a secondary objective, we assessed whether there is an association between these brain areas and several endocrine and metabolic factors in the fasting state. (2) Methods: 12 PWS adults and 14 healthy controls (siblings) performed a food-related experimental task after an overnight fast while brain activation in regions of interest was measured by functional MRI. (3) Results: In controls, significantly more activation was found in the left insula (p = 0.004) and the bilateral fusiform gyrus (p = 0.003 and 0.013) when the individuals were watching food as compared to non-food pictures, which was absent in PWS patients. Moreover, in PWS adults watching food versus non-food pictures a significant negative correlation for glucose and right amygdala activation (p_fwe = 0.007) as well as a positive correlation for leptin and right anterior hippocampus/amygdala activation (p_fwe = 0.028) was demonstrated. No significant associations for the other hormonal and metabolic factors were found. (4) Conclusions: PWS individuals show aberrant food-related brain activation in the fasting state. Leptin is associated with activation within the neural motivation/reward circuitry, while the opposite is true for glucose.

Comparison Between Fasting and Non-Fasting Cut-Off Values of Triglyceride in Diagnosing High Triglyceride in Chinese Hypertensive Outpatients

Background: Hypertension (HBP) often occurs together with hypertriglyceridemia that indicates elevated triglyceride (TG) and remnant cholesterol (RC) levels. Non-fasting (i.e. postprandial) blood lipid test after a daily meal has been recommended by the European Atherosclerosis Society (EAS). However, little is known about the difference between fasting and non-fasting cut-off values in assessing high TG (HTG) and high RC (HRC) in HBP outpatients.Methods: Two hundred and twenty-five Chinese outpatients with HBP were enrolled in this study. According to the time of blood lipid test, they were divided into two groups, i.e. the fasting group (n=119) and the non-fasting group (n=139). Non-fasting levels of blood lipids at 2 h after a daily breakfast were also tested in 33 patients among the fasting group. Venous blood samples were collected. Serum levels of blood lipids were measured by the enzymatic and direct methods on a HITACHI 7170A analyzer or estimated via related formulas. Results: The non-fasting group had significantly higher levels of TG and RC while lower levels of total cholesterol, low-density lipoprotein cholesterol and non-high-density lipoprotein cholesterol than the fasting group (P＜0.05). According to TG and RC cut-off values of the EAS, the percentages of HTG and HRC in the non-fasting group were 67.6% and 65.6%, respectively, while those in the fasting group were 57.1% and 52.9%, respectively. However, the percentages of HTG in the fasting state and at 2 h after a daily breakfast in 33 outpatients did not reach statistical significance (57.6% v.s. 51.5%). So did the fasting and at 2 h non-fasting percentages of HRC in them.Conclusion: Non-fasting blood lipid test could find more HBP outpatients with HTG in Chinese outpatients with HBP. However, the percentage of HTG at 2h after a daily breakfast seemed to be close to that in the fasting state.