Management of elevated liver enzymes in geriatric diabetes by yogic practice

Objects: The liver plays a major role in the pathogenesis of type 2 diabetes. Moderately elevated liver enzymes are found in type 2 diabetes.  This study is designed to appraise the role of yoga on liver enzymes in geriatric type 2 diabetes and consequently, the study constantly monitored the improvement related to glycaemic control during the period of observation. Study design: A total number of 143 type 2 diabetes patients in an age group of 60-70 years with a history of diabetes for 5-10 years and having poor glycaemic control (HbA1c > 8 %) residing in Kozhikode district, Kerala, India participated in this study in test and control group together. The subjects were divided into three groups according to their glycaemic control: group I with HbA1c 8.6 – 9.7 %, group II with HbA1c 9.8 – 10.7 % and group III with HbA1c 10.8 – 12.7 %. The yogic practice sessions for the test group lasted for three months for 90 minutes a day, 6 days a week, under the guidance and supervision of experienced trainers.  Each session was systematically divided into structural components with 15 minutes of pranayamas (breath controlling exercises), 10 minutes of warm up exrcises, 50 minutes of asanas (yogic postures) and 15 minutes of supine relaxation in savasana. The control group, mean while, were asked to continue their routine activities like walking and other normal non specific exercises. Glucose, HbA1c, aspartate aminotransferase, alanine aminotransferase and γ- glutamyl transpeptidase were estimated on base line and after 90 days of all the participants. Results: The participants in the test group showed statistically significant (p<0.001) decrease in glucose, HbA1c, and activity of liver enzymes after yogic practice. Conclusions: After 90 days of yogic practices, significant reduction in the liver enzymes was achieved in test group, corresponding to the reduction in blood glucose and HbA1c levels. The findings of this study demonstrate the efficacy of yogic practice, as a therapeutic, preventative and protective agent in geriatric type 2 diabetes mellitus by normalizing the liver function tests along with betterment in their glycaemic condition

A study of serum magnesium, calcium and phosphorus level, and cognition in the elderly population of South India

Introduction: Different studies have shown the role of micro and macronutrients on cognitive function. Macronutrients have been involved in many metabolic activities of the body including oxidation and reduction reactions in the central nervous system. This involvement of macronutrients in the activities of central nervous system indicates its role in cognition. The present study is designed to know the role of macronutrients and its relation with cognition by using biological samples.Materials and methods: A total of 337 subjects with a mean age of 49 participated in the cross sectional study fromdifferent parts ofKerala state in India. Individuals participating in this studywere administered a series of neuropsychological test batteries with major emphasis on 7-min screen test. All test procedures were administered by standard protocol after a written consent was obtained from the participating subjects. Analysis of macronutrients level of magnesium, calcium and phosphorus was done by using serum samples and the data obtained were then statistically analyzed using SPSS software version 17.Results: The macronutrients magnesium, calcium and phosphorus were found to be significantly related to the cognitive score. Increasing magnesiumand calciumlevel was associated with higher cognitive score (P<0.0031 and 0.001 respectively), while lower phosphorus level was significantly associated with lower composite score (P<0.001).Conclusion: The results of our study give us an expression that macronutrients such as calcium, magnesium and phosphorus may be associated with cognitive function in elderly population of our state. But further studies on a larger population are required to come out with a definite conclusion

Quantitative Metabolomics by 1H-NMR and LC-MS/MS Confirms Altered Metabolic Pathways in Diabetes

Insulin is as a major postprandial hormone with profound effects on carbohydrate, fat, and protein metabolism. In the absence of exogenous insulin, patients with type 1 diabetes exhibit a variety of metabolic abnormalities including hyperglycemia, glycosurea, accelerated ketogenesis, and muscle wasting due to increased proteolysis. We analyzed plasma from type 1 diabetic (T1D) humans during insulin treatment (I+) and acute insulin deprivation (I-) and non-diabetic participants (ND) by 1H nuclear magnetic resonance spectroscopy and liquid chromatography-tandem mass spectrometry. The aim was to determine if this combination of analytical methods could provide information on metabolic pathways known to be altered by insulin deficiency. Multivariate statistics differentiated proton spectra from I- and I+ based on several derived plasma metabolites that were elevated during insulin deprivation (lactate, acetate, allantoin, ketones). Mass spectrometry revealed significant perturbations in levels of plasma amino acids and amino acid metabolites during insulin deprivation. Further analysis of metabolite levels measured by the two analytical techniques indicates several known metabolic pathways that are perturbed in T1D (I-) (protein synthesis and breakdown, gluconeogenesis, ketogenesis, amino acid oxidation, mitochondrial bioenergetics, and oxidative stress). This work demonstrates the promise of combining multiple analytical methods with advanced statistical methods in quantitative metabolomics research, which we have applied to the clinical situation of acute insulin deprivation in T1D to reflect the numerous metabolic pathways known to be affected by insulin deficiency

The Effect of High Glucocorticoid Administration and Food Restriction on Rodent Skeletal Muscle Mitochondrial Function and Protein Metabolism

Glucocorticoids levels are high in catabolic conditions but it is unclear how much of the catabolic effects are due to negative energy balance versus glucocorticoids and whether there are distinct effects on metabolism and functions of specific muscle proteins.We determined whether 14 days of high dose methylprednisolone (MPred, 4 mg/kg/d) Vs food restriction (FR, food intake matched to MPred) in rats had different effects on muscle mitochondrial function and protein fractional synthesis rates (FSR). Lower weight loss (15%) occurred in FR than in MPred (30%) rats, while a 15% increase occurred saline-treated Controls. The per cent muscle loss was significantly greater for MPred than FR. Mitochondrial protein FSR in MPred rats was lower in soleus (51 and 43%, respectively) and plantaris (25 and 55%) than in FR, while similar decline in protein FSR of the mixed, sarcoplasmic, and myosin heavy chain occurred. Mitochondrial enzymatic activity and ATP production were unchanged in soleus while in plantaris cytochrome c oxidase activity was lower in FR than Control, and ATP production rate with pyruvate + malate in MPred plantaris was 28% lower in MPred. Branched-chain amino acid catabolic enzyme activities were higher in both FR and MPred rats indicating enhanced amino acid oxidation capacity.MPred and FR had little impact on mitochondrial function but reduction in muscle protein synthesis occurred in MPred that could be explained on the basis of reduced food intake. A greater decline in proteolysis may explain lesser muscle loss in FR than in MPred rats

Mitochondrial function as a determinant of life span

Average human life expectancy has progressively increased over many decades largely due to improvements in nutrition, vaccination, antimicrobial agents, and effective treatment/prevention of cardiovascular disease, cancer, etc. Maximal life span, in contrast, has changed very little. Caloric restriction (CR) increases maximal life span in many species, in concert with improvements in mitochondrial function. These effects have yet to be demonstrated in humans, and the duration and level of CR required to extend life span in animals is not realistic in humans. Physical activity (voluntary exercise) continues to hold much promise for increasing healthy life expectancy in humans, but remains to show any impact to increase maximal life span. However, longevity in Caenorhabditis elegans is related to activity levels, possibly through maintenance of mitochondrial function throughout the life span. In humans, we reported a progressive decline in muscle mitochondrial DNA abundance and protein synthesis with age. Other investigators also noted age-related declines in muscle mitochondrial function, which are related to peak oxygen uptake. Long-term aerobic exercise largely prevented age-related declines in mitochondrial DNA abundance and function in humans and may increase spontaneous activity levels in mice. Notwithstanding, the impact of aerobic exercise and activity levels on maximal life span is uncertain. It is proposed that age-related declines in mitochondrial content and function not only affect physical function, but also play a major role in regulation of life span. Regular aerobic exercise and prevention of adiposity by healthy diet may increase healthy life expectancy and prolong life span through beneficial effects at the level of the mitochondrion

Mitochondrial physiology

As the knowledge base and importance of mitochondrial physiology to evolution, health and disease expands, the necessity for harmonizing the terminology concerning mitochondrial respiratory states and rates has become increasingly apparent. The chemiosmotic theory establishes the mechanism of energy transformation and coupling in oxidative phosphorylation. The unifying concept of the protonmotive force provides the framework for developing a consistent theoretical foundation of mitochondrial physiology and bioenergetics. We follow the latest SI guidelines and those of the International Union of Pure and Applied Chemistry (IUPAC) on terminology in physical chemistry, extended by considerations of open systems and thermodynamics of irreversible processes. The concept-driven constructive terminology incorporates the meaning of each quantity and aligns concepts and symbols with the nomenclature of classical bioenergetics. We endeavour to provide a balanced view of mitochondrial respiratory control and a critical discussion on reporting data of mitochondrial respiration in terms of metabolic flows and fluxes. Uniform standards for evaluation of respiratory states and rates will ultimately contribute to reproducibility between laboratories and thus support the development of data repositories of mitochondrial respiratory function in species, tissues, and cells. Clarity of concept and consistency of nomenclature facilitate effective transdisciplinary communication, education, and ultimately further discovery

Mitochondrial physiology

As the knowledge base and importance of mitochondrial physiology to evolution, health and disease expands, the necessity for harmonizing the terminology concerning mitochondrial respiratory states and rates has become increasingly apparent. The chemiosmotic theory establishes the mechanism of energy transformation and coupling in oxidative phosphorylation. The unifying concept of the protonmotive force provides the framework for developing a consistent theoretical foundation of mitochondrial physiology and bioenergetics. We follow the latest SI guidelines and those of the International Union of Pure and Applied Chemistry (IUPAC) on terminology in physical chemistry, extended by considerations of open systems and thermodynamics of irreversible processes. The concept-driven constructive terminology incorporates the meaning of each quantity and aligns concepts and symbols with the nomenclature of classical bioenergetics. We endeavour to provide a balanced view of mitochondrial respiratory control and a critical discussion on reporting data of mitochondrial respiration in terms of metabolic flows and fluxes. Uniform standards for evaluation of respiratory states and rates will ultimately contribute to reproducibility between laboratories and thus support the development of data repositories of mitochondrial respiratory function in species, tissues, and cells. Clarity of concept and consistency of nomenclature facilitate effective transdisciplinary communication, education, and ultimately further discovery

Effect of calycopteris floribunda leaf extract on streptozotocin induced diabetic rats

The anti-diabetic effect of aqueous extract of the leaves of Calycopteris floribunda (Combretaceae) was investigated in streptozotocin (STZ) induced diabetic rats. Diabetes was induced in rats by a single  intraperitoneal injection of streptozotocin (40 mg / kg body weight). The test group received single dose of the extract (500 mg / kg body weight) daily for 10 days orally. The effect of the extract on the blood glucose and urine glucose was investigated. The present study shows that the Calycopteris floribunda leaves have a significant effect on hyperglycemia and glycosuria in diabetic rats. Further studies are required to elucidate the sites, constituents involved, as well as the cellular and molecular mechanism of actions of Calycopterisfloribunda leaf extract.KEY WORDS:Calycopteris floribunda, Streptozotocin, Diabetes mellitus, Hyperglycemia, Glycosuri

Yogic practice and diabetes mellitus in geriatric patients

Background: Stress has negative effect on health and type 2 diabetes patients may be at an increased risk. Abnormally high levels of free radicals and the simultaneous decline of antioxidant defense mechanisms can increase lipid peroxidation and insulin resistance. The objective of the present study was to demonstrate the efficacy of yogic practice in geriatric patients with type 2 diabetes mellitus and also to compare the efficacy with the state of glycaemic control. Materials and Methods: Seventy three (73) healthy elderly patients of type 2 diabetes mellitus in the age group of 60 to 70 years with a history of diabetes for 5 to 10 years and with poor glycaemic control (HbA 1c >8 %) residing in Kozhikode district were recruited for the study. The subjects were divided into three groups according to their glycaemic control. Group I with HbA 1c 8.6-9.7 %, group II with HbA 1c 9.8-10.7 % and group III with HbA 1c 10.8-12.7 %. Participants did yogic practice under the supervision of experienced trainer, daily 90 minutes and for three months. Biochemical estimation of HbA 1c, glucose, lipid profile, cortisol, ferritin, malondialdehyde (MDA) and catalase activity were carried out on 0 day and 90 th day. Seventy patients participated in a comparable control session. Results: The participants in the test group showed statistically significant (P < 0.001) decrease in glucose, HbA 1c, lipids, cortisol, ferritin, MDA and significant increase in catalase activity after yogic practice. Conclusions: Yoga may improve risk profiles induced by stress in geriatric patients with type 2 diabetes and may have promise for the prevention or delay in diabetes complications. And at all stages of the disease a significant improvement can be achieved by yogic practice in geriatric diabetes